bluuebunny/crossref_metadata_2025 huggingface dataset:
Study of Lubricant‐Induced Changes in Chronic Snorers (SLICCS)
Authors: Wijewickrama Rohan C. , Blalock David , Mims James W.
Published: October 2004

OBJECTIVE

The efficacy of many of the noninvasive treatments for snoring has not been evaluated in controlled trials. This paper seeks to evaluate the efficacy of an oil‐based spray in the treatment of snoring, in a double‐blinded, placebo‐controlled, crossover trial using objective acoustic analysis and subjective questionnaires.

STUDY DESIGN AND SETTING

Participants were randomized to use both oil‐based oral spray (treatment) and water‐based oral spray (placebo) during a two‐night in‐home study period. Questionnaires were completed by participant and bed‐partner in addition to audio‐tape recordings which were analyzed for frequency, duration, and mean energy of snoring.

RESULTS

Greatest snoring rate demonstrated 30% = benefit; 40% = no change; 30% = adverse effect (n = 20). Percent time snoring yielded: 30% benefit; 15% no change; 55% adverse effect (n = 20). Study data results for mean energy were (n = 12): benefit = 17%, no change = 33%, adverse effect = 50%. Bed‐partner observations (n = 17) demonstrated 37% = benefit; 38% = no change; 25% = adverse effect.

CONCLUSION/SIGNIFICANCE

Objective and subjective evaluation of the performance of the oil‐based Snoreless spray in comparison to placebo demonstrated a lack of efficacy in snoring reduction.
Oral Dextromethorphan Reduces Perioperative Analgesic Administration in Children Undergoing Tympanomastoid Surgery
Authors: Hasan Rashed A. , Kartush Jack M. , Thomas John D. , Sigler Diana L.
Published: October 2004

OBJECTIVE

To determine whether oral dextromethorphan (1 mg/kg) given one hour prior to surgery decreases opioid administration in the perioperative period in children undergoing tympanomastoid surgery.

METHODS

This was a prospective randomized double‐blinded and placebo‐controlled study in which 20 male and 18 female children (age 11.5 ± 3.5 years) were enrolled. Nineteen children received dextromethorphan (DM), while the other 19 received placebos. Postoperative pain was assessed using a visual analogue scale and a pain score of ≥5 was treated with intravenous morphine sulfate. Patients were discharged home on oral oxycodone.

RESULTS

The total doses of fentanyl administered during surgery were higher in the placebo group compared to the DM group (4.1 ± 2 vs 2.6 ± 1.4 μg/kg, P = 0.02) and the total doses of intravenous morphine administered in the postoperative period were also higher in the placebo group compared to the DM group (150 ± 80 vs 73 ± 56 μg/kg, P = 0.004). The placebo group had a higher pain score at the time of admission to the Day Surgery Unit (DSU) and a higher maximum pain score, compared to the DM group, during their combined stay in the Post‐Anesthesia Care Unit and DSU (7.3 ± 1.5 vs 3.1 ± 2.6, P = 0.001).

CONCLUSIONS

Premedication with DM reduces the need for opioid administration in the perioperative period in children undergoing tympanomastoid surgery. EBM rating: A.
The Development of Alcohol Use Disorders
Authors: Sher Kenneth J. , Grekin Emily R. , Williams Natalie A.
Published: October 2004

Pathological alcohol use is a complex and costly problem. This chapter focuses on recent developments in the etiology of alcohol use disorders. Literature is reviewed from the fields of epidemiology, genetics, personality, neuropsychology, parenting, and social influences. In addition, theoretical models that describe pathways to the development of alcohol use disorders are presented. Particular emphasis is given to ways in which genetic, environmental, psychopharmacological, and personological literatures can inform one another.
Surface Electromyographic Studies of Swallowing in Normal Subjects: A Review of 440 Adults. Report 2. Quantitative Data: Amplitude Measures
Authors: Vaiman Michael , Eviatar Ephraim , Segal Samuel
Published: October 2004

OBJECTIVES

Surface electromyographic (EMG) studies were performed on 420 normal adults to establish normative database for muscle activity's amplitude during swallowing and drinking clinically useful for ENT department.

STUDY DESIGN

Prospective observational study of healthy volunteers.

METHODS

Parameters evaluated during swallowing include the EMG activity of the orbicularis oris, masseter, submental, and infrahyoid muscle groups covered by platysma (range, mean, SD). Four tests were examined including voluntary swallow of saliva (“dry” swallow), voluntary single water swallows as normal (variable volume of a bolus), voluntary single swallows of fixed amount of water (20 mL), and continuous drinking of 100 mL of water. Activity of the above‐mentioned muscles during swallowing was measured for groups of adults of different age groups. Groups included volunteers and were separated into age groups as follows: ages 18‐30, 31‐40, 41‐50, 51‐60, 61‐70, and 70+ years of age.

RESULTS

Normative data for electric muscle activity (mean ± SD; range, in μV) during single swallowing and continuous drinking are established for healthy adults. The range of submental group activity during swallows showed a significant decrease with the age, whereas the range of masseter activity changed insignificantly (1‐dimensional analysis of variance, SPSS, Chi‐square criterion, 95% confidence interval). There were no significant changes in mean muscle activity between different age groups. These parameters represent activities required for normal deglutition, and can be used to identify abnormalities in ENT patients, and provide a basis for comparison of swallowing performance both within and between patients. These measurements can be performed in a simple way, cause no discomfort, do not use radiation, and are noninvasive. The relevance and clinical utility of new and alternative measures, in particular, are discussed.

CONCLUSIONS

In single swallow tests range of electric activity of involved muscles is more informative than its mean. In the continuous drinking test, the mean electric activity is the only electric variance that can be evaluated. Orbicularis oris muscle activity is not important when reflex phase of a swallow is evaluated. Surface EMG of swallowing is a simple and reliable method for evaluation of swallowing with a low level of discomfort during the examination. The method can be easily used in outpatient ENT departments for quick evaluation of patients. The normative amplitude data can be used for comparison purposes in preoperaive and postoperative stages and in EMG monitoring during ENT treatment.
The Impact of Fiducial Distribution on Headset‐Based Registration in Image‐Guided Sinus Surgery
Authors: Knott P. Daniel , Maurer Calvin R. , Gallivan Ryan , Roh Hwan‐Jung , Citardi Martin J.
Published: October 2004

OBJECTIVE

The objective of this study was to assess registration error due to fiducial configuration for the ENT headsets for the CBYON Suite (CBYON, Mountain View, CA) and InstaTrak (GEMS Navigation and Visualization, Waukesha, WI).

STUDY DESIGN

Axial CT scans (1‐mm slice thickness) were obtained of for 24 cadaveric heads using the CBYON headset and for 23 cadaveric heads using the GEMS headset. The CBYON and GEMS NAV software were used to calculate the fiducial registration error (FRE). Fiducial localization error (FLE) was estimated from FRE. Theoretical target registration error (TRE) was calculated at 11 targets.

RESULTS

The FRE for CBYON and GEMS NAV was 0.69 mm and 0.27 mm, respectively. The theoretical TRE for CBYON and GEMS NAV was 0.41 mm and 0.30 mm, respectively. The theoretical TRE was greater at targets posterior in the sinus cavities.

CONCLUSION

Theoretical TRE values for both ENT headsets are less than clinically observed TRE. Clinically observed TRE is likely due to repositioning accuracy. EBM rating: B‐2.
Otorhinolaryngology or Otolaryngology? An Etymological Approach
Authors: Ramoutsaki Ioanna A. , Bizakis John G. , Ramoutsakis John A. , Bizakis Argyro J. , Helidonis Emmanuel S.
Published: October 2004

The variety and the confusion over the name of many medical terms, including otorhinolaryngological ones prompted us to search their etymology. The term “otorhinolaryngology” (combined form from the ancient Greek words: ous, rhina, larynx, and logos) and the term indicating the specialized doctor who practices “Otorhinolaryngology,” widely known as ENT in a brief version, are being examined. The investigation leads us to see which of these terms is the appropriate and etymologically correct one, and to support clearly the term “otorhinolaryngology” instead of “otolaryngology” and “otorhinolaryngologist” instead of “ENT.”
The Dilemma of the Normal Baseline Parathyroid Hormone Level using the Intraoperative PTH Assay
Authors: Vasan Nilesh R. , Blick Kenneth E. , Krempl Greg A. , Medina Jesus E.
Published: October 2004

OBJECTIVE

To analyze patients with “normal” baseline quick intraoperative parathyroid hormone (QPTH) levels during parathyroidectomy and to determine the prevalence of this finding, the usefulness of the assay in this situation, and to explain the possible causes for this phenomenon.

STUDY DESIGN AND SETTING

Patients who underwent parathyroidectomy using QPTH in a tertiary hospital.

METHODS

Retrospective analysis of 39 patients treated surgically for primary hyperparathyroidism using QPTH.

RESULTS

Of the patients, 14 (36%) had normal baseline QPTH. 8 patients with localizing sestamibi scans had a single adenoma, and excision resulted in a mean decrease of 85.4% in QPTH. Six patients had nonlocalizing sestamibi scans, 1 patient had an 84% drop in QPTH level after removal of a single adenoma, and 5 patients had hyperplasia requiring ≥3 glands excision. At 11.36 months' mean follow‐up, 13 patients (93%) were normocalcemic.

CONCLUSIONS

A “normal” baseline QPTH level was found in 36% of patients. A 50% decrease in QPTH remains predictive of biochemical cures in patients with localizing sestamibi scans. The likely explanation for this variability in “normal” levels between different assays is the variability in detection of the 7‐84 PTH fragment, which results in an overestimation of the PTH level. Assays such as the QPTH, which are more sensitive for the biologically active PTH molecule [(1‐84) PTH] than other laboratory PTH assays will tend to have lower PTH levels that can be within the normal range. EBM rating: B‐3.
Use of the 2.0‐mm Locking Reconstruction Plate in Primary Oromandibular Reconstruction after Composite Resection
Authors: Militsakh Oleg N. , Wallace Derrick I. , Kriet J. David , Girod Douglas A. , Olvera Melissa S. , Tsue Terance T.
Published: October 2004

OBJECTIVE

To review our experience with 2.0‐mm locking reconstruction plate (LRP) system for patients requiring oromandibular reconstruction.

STUDY DESIGN

Retrospective case review of 43 consecutive patients who underwent mandibular composite resection with immediate reconstruction.

SETTING

Tertiary care center.

RESULTS

Forty‐three patients underwent oromandibular reconstruction with the 2.0‐mm mandibular LRP system and free flaps containing vascularized bone. Mean follow‐up was 11 months. There were no intraoperative difficulties utilizing this system. Two (5%) patients had partial fasciocutaneous flap loss resulting in plate exposure. There were no instances of plate fracture or complications requiring plate removal to date.

CONCLUSION

2.0‐mm LRP mandibular system is reliable even in the setting of previous or adjuvant radiation therapy. Its technical ease of application, contouring malleability, and very low profile have proven to be advantageous in oromandibular reconstruction.

SIGNIFICANCE

No previous descriptions of use of the 2.0‐mm LRP in combination with osteocutaneous free flaps for mandibular reconstruction are found in the literature. EBM rating: C.
Endoscopic Approach to Orbital Blowout Fracture Repair
Authors: Strong E. Bradley , Kim Kenneth K. , Diaz Rodney C.
Published: October 2004

OBJECTIVES

Transconjunctival and subciliary approaches to orbital floor blowout fractures (OBF) have known risks of postoperative eyelid malposition. This study evaluates the endoscopic transmaxillary repair of OBFs in a cadaveric model and clinical setting.

METHODS

Sixteen cadaveric and 10 clinical OBFs were repaired endoscopically. A Caldwell‐Luc approach and modified sinus surgery instrumentation were used to repair each fracture. Variations in fracture pattern, instrumentation, and surgical technique were evaluated.

RESULTS

Endoscopic repair was achieved in all 16 cadaveric orbits and in 9 of 10 patients. Fracture patterns were classified as either medial or lateral to the infraorbital nerve. Average clinical operating time was 1:38. Of 9 postoperative CT scans, 5 were rated as excellent, 3 as good, and 1 as poor.

CONCLUSIONS

The endoscopic transmaxillary approach is a safe, viable technique for OBF repair. It offers improved visualization, anatomic fracture repair, no risk of postoperative eyelid complications, and good clinical results. EBM rating: C.
Contemporary Staging and Prognosis for Primary Tracheal Malignancies: A Population‐Based Analysis
Authors: Bhattacharyya Neil
Published: October 2004

OBJECTIVE

Determine staging characteristics and survival outcomes for primary malignancies of the trachea.

DESIGN

Cross‐sectional analysis of national cancer database.

METHODS

Cases of primary tracheal malignancy were extracted from the Surveillance, Epidemiology, and End Results database for the time period 1988‐2000. T‐stage, N‐stage, and overall stage of presentation were determined. Mean, median, and 5‐year survival statistics were computed using Kaplan‐Meier survival analysis for each tumor histology and for the overall cohort according to stage.

RESULTS

Ninety‐two cases with adequate histologic information were identified. Mean age at presentation was 59.3 years with an equal sex distribution. Squamous cell carcinoma was the most common tumor type (41 cases) followed by adenoid cystic carcinoma (19 cases). Forty‐nine cases (53%) presented with stage 3 or stage 4 disease. Squamous cell carcinoma exhibited poorer survival (mean survival, 44.0 month, 5‐year survival, 34%) than adenoid cystic carcinoma (mean survival, 115 month, 5‐year survival, 78%). Five‐year unadjusted survival rates according to overall stage were 52.8%, 70.0%, 75.0%, 15.1%, respectively.

CONCLUSIONS

Primary tracheal malignancies often present with advanced stage. Patients with squamous cell carcinoma of the trachea have poorer prognoses when compared with adenoid cystic carcinoma and other tumor types. Staging tracheal cancer with a TNM‐based system helps predict survival. EBM rating: C.
A New Immune‐Competent Animal Model of Mucosally Derived Squamous Cell Carcinoma
Authors: Djalilian Hamid R. , Lessan Khashayar , Grami Vahid , Pambuccian E. , Spellman Stephen R. , Low Walter C. , Hall Walter A. , Ondrey Frank G.
Published: October 2004

OBJECTIVES

To develop an immune‐competent animal model for mucosally derived squamous cell carcinoma (SCCA).

STUDY DESIGN

Fifteen Fischer 344 rats were inoculated with 1, 2, 5, 10, or 20 × 106 FAT7 cells in their flanks. The animals were observed for tumor growth and metastasis.

RESULTS

All animals developed tumors that grew exponentially. Pulmonary metastases developed in all animals and 13% developed lymph node metastases.

CONCLUSION

The FAT7 flank tumor in Fischer 344 rats is a new animal model that closely resembles the behavior of human mucosal head and neck cancer.

SIGNIFICANCE

The existence of an immune‐competent, mucosally derived, and reliable animal model of SCCA that somewhat resembles human head and neck SCCA gives the opportunity to perform immune‐modulating experiments on head and neck cancer in these animals. EBM rating: B‐3.
Intracranial Blood Flow Velocities and Co2 Reactivity in Diagnosing Migraine‐Related Dizziness
Authors: Le Thong T. , Burch Christina M. , Sargent Eric W.
Published: October 2004

OBJECTIVE

Migraine‐related dizziness can present with or without headache, often making diagnosis difficult. Flow velocity and CO2 reactivity testing using transcranial Doppler (TCD) measurement of intracranial blood flow has been described as abnormal in patients with classic or common migraine. This study sought to determine the utility, if any, of this noninvasive technique in the diagnosis of migraine‐related dizziness.

STUDY DESIGN AND SETTING

A prospective, controlled study in academic neurotology and neurology practices was conducted. Nine patients with migraine‐related dizziness and 10 patients with no history of migraine or dizziness were tested with transcranial Doppler ultrasound in a blinded fashion.

RESULTS

No statistically significant differences in intracranial blood flow velocities or in cerebrovascular reactivity to hypocapnia were found between patients and controls.

CONCLUSIONS

Assessment of intracranial blood flow velocity and CO2 reactivity using TCD does not help in the diagnosis of migraine‐related dizziness.

SIGNIFICANCE

A reliable objective test for the diagnosis of migraine‐related dizziness remains elusive, and the diagnosis of this patient group continues to be suboptimal.
Modulation of Th1 and Th2 Cytokine Profiles and Their Association with Advanced Head and Neck Squamous Cell Carcinoma
Authors: Sparano Anthony , Lathers Deanne M. R. , Achille Nicholas , Petruzzelli Guy J. , Young M. Rita I.
Published: October 2004

OBJECTIVE

Plasma cytokine concentrations from patients with head and neck squamous cell carcinoma (HNSCC) were measured to determine whether the potential modulation of host Th1 vs Th2 immune responses are associated with advanced clinical disease.

STUDY DESIGN AND SETTING

The concentrations of IL‐4, IL‐6, IL‐10, and IL‐12 were measured in the plasma of 58 patients with histologically proven HNSCC. These data were examined with respect to the histologic size (T‐stage) of the primary tumor, and presence of nodal metastasis.

RESULTS

The concentrations of IL‐12 were greater from patients without nodal metastasis, and with T1/T2‐stage tumors. IL‐10 levels were greater from patients with nodal metastasis, and with T3/T4‐stage tumors. The concentrations of IL‐6 were greater from patients with T3/T4‐stage tumors.

CONCLUSIONS

Using parameters of primary tumor size and presence of nodal metastasis, patients with advanced HNSCC have significantly less plasma IL‐12 levels, and greater plasma IL‐10 and IL‐6 levels.

SIGNIFICANCE

Patients with advanced HNSCC have a potentially diminished Th1 immune response, and a stronger potential Th2 immune response when compared to that of patients with less advanced disease. EBM rating: D‐5.
The Effects of Superoxide Dismutase in Gerbils with Bacterial Meningitis
Authors: Ge Norman N. , Brodie Shauna A. , Tinling Steven P. , Brodie Hilary A.
Published: October 2004

BACKGROUND

Inflammatory products, such as oxygen radicals generated during the course of bacterial meningitis, can damage nerve endings, hair cells, and/or supporting cells in the cochlea. Superoxide dismutase (SOD), an O2‐scavenger, has been shown to play an important role in the protection against radical toxicity in various animal experiments.

OBJECTIVE

To study the antioxidant effects of SOD on the inflammatory response of gerbils with bacterial meningitis.

STUDY DESIGN

Meningitis was induced in three groups of 10 gerbils by intrathecal (IT) injection of Streptococcus pneumoniae into the cisterna magna. Group 1 received IT SOD, group 2 received intramuscular (IM) SOD, and group 3, the control group, received IM normal saline. Histologic data and auditory brainstem responses (ABR) were obtained from each gerbil.

RESULTS

Fibrosis and/or neo‐ossification were near absent in the IT SOD group and significantly less fibrosis occurred in the IM group (IT vs. IM: P = 0.010; IT vs. control group: P = 0.001). The amount of surviving spiral ganglion cells correlated inversely with the extent of fibrosis (r = −0.753, P < 0.00001).

CONCLUSIONS

IT injection of SOD significantly reduced cochlear fibrosis and neo‐ossification, reduced the spiral ganglion cell loss, and decreased damage of the cochlear components following bacterial meningitis.
Allergic Fungal Sinusitis: Can We Predict the Recurrence?
Authors: Sohail Masroor Alam , Al Khabori Mazin Jawad , Hyder Jamil , Verma Ashok
Published: October 2004

OBJECTIVE

The goal of the present study was to find out if recurrence can be predicted in cases of allergic fungal sinusitis. We also studied the influence of postoperative corticosteroid therapy on recurrence following surgery.

STUDY DESIGN AND SETTING

This study was conducted at the ENT Department of Al Nahdha Hospital, which is a tertiary referral and teaching hospital in Muscat, Sultanate of Oman. The study is a retrospective analysis of 32 cases of allergic fungal sinusitis. Age, sex, extent of disease, and preoperative serum IgE levels were compared in patients who had recurrence with those who did not. We also studied the incidence, onset, and severity of recurrence in patients who received systemic corticosteroid as postoperative therapy and compared these values to those who received nasal corticosteroid spray only.

RESULTS

No statistically significant difference was noted in the parameters of age, sex, extent of disease, and preoperative serum IgE levels when these values were compared in the group of patients who had recurrence (8 patients) with the group of patients who did not (32 patients). No statistically significant difference was found in the incidence of recurrence in patients in whom systemic corticosteroids were used postoperatively (17 patients) compared with patients who used nasal corticosteroid spray only (15 patients). However, when the patient had a recurrence, when it occurred it was earlier and more severe in patients who used nasal corticosteroid spray only (4 patients).

CONCLUSIONS

At the present time, it is not possible to predict recurrence using parameters of age, sex, extent of disease, and serum IgE levels. Larger number of patients preferably in a prospective multicenter meta study are required to address this issue. Though use of systemic corticosteroid does not decrease the incidence of recurrence, it may delay the onset of recurrence and decrease the severity of recurrence.
Electrocautery versus Cold Knife Technique Adenotonsillectomy: A Cost Analysis
Authors: O‐lee T. J. , Rowe Mark
Published: October 2004

OBJECTIVE

Much has been written about the merits of various techniques of adenotonsillectomy. Proponents of each technique tout many virtues over one another. However, cost remains one variable that has not been thoroughly addressed. In this study, we compared the surgery time, anesthesia time, bleeding, and cost between 2 well‐established techniques. Electrocautery tonsillectomy/adenoid ablation was compared against traditional cold knife dissection with adenoid curette.

STUDY DESIGN AND SETTING

A retrospective chart review of 275 patients in a large tertiary teaching hospital.

RESULTS

The electrocautery group had overall savings of 8, 8, and 9 minutes in surgery, anesthesia, and operating room times, respectively. In terms of cost, the variable cost of the electrocautery group was 19% less than the cold knife dissection group.

CONCLUSION/SIGNIFICANCE

This study demonstrated that cautery ablation of adenoids, when employed as part of adenotonsillectomy, enables the surgical team to save significant amount of time, and substantial cost for patients. EBM rating: B‐3.
CO2 Laser Stapedotomy with the “One‐Shot” Technique— Clinical Results
Authors: Jovanovic S. , Schönfeld U. , Scherer H.
Published: October 2004

OBJECTIVE

To further optimize the surgical technique with the CO2 laser in stapes surgery a scanner system was used to obtain a footplate perforation of 0.5 to 0.6 mm with only 1 laser application (“one‐shot” stapedotomy).

STUDY DESIGN

188 patients with otosclerosis were submitted to a primary CO2 laser stapedotomy with the SurgiTouch® scanner. This study surveys the surgical technique and clinical results.

RESULTS

An adequately large perforation diameter could be achieved with a single shot in 68% of the patients treated with the SurgiTouch® scanner. In 11% of the patients, a second laser application at the same site was necessary. In 21% of the patients, the perforation had to be enlarged by several slightly overlapping laser applications without scanner. The clinical data of this study clearly documents that there is no evidence of laser depending inner ear affections.

CONCLUSION

The CO2 laser combined with modern scanner systems is well suited for application in stapes surgery.
Radiation‐Induced Malignancy of the Head and Neck
Authors: Sale Keith A. , Wallace Derrick I. , Girod Douglas A. , Tsue Terance T.
Published: October 2004

OBJECTIVE

Our goal was to evaluate our experience with radiation‐induced malignancy (RIM), compare that experience to the literature, and review treatment modalities.

STUDY DESIGN AND SETTING

The setting is the University of Kansas Medical Center. A retrospective review was performed to identify patients with RIM. Patients were included if they met the criteria for RIM as delineated in the literature.

RESULTS

Thirteen patients met the criteria for RIM. The mean latency period was 22 years. Sarcomas were the most common type of RIM and the paranasal sinuses were the most common location. Surgical resection was our treatment of choice.

CONCLUSIONS

Our patient series differs from previous reports in that sarcomas were the predominating RIM and the paranasal sinuses were the most common location. We noted a shorter latency period than has been previously published. Surgical excision is the treatment of choice. EBM rating: C.
The Fluorescence of Thyroid Tissue
Authors: Pitman Michael Jay , Rosenthal Joshua Michael , Savage Howard E. , Yu Goupei , McCormick Steven A. , Katz Alvin , Alfano Robert R. , Schantz Stimson Pryor
Published: October 2004

OBJECTIVE

To investigate the fluorescent characteristics of different thyroid tissues.

STUDY DESIGN

Fresh ex vivo thyroid tissue was surfaced scanned with a fluorescence spectrophotometer. Resultant spectra were evaluated via interpeak ratios.

RESULTS

Interpeak ratios of all histologies were found to be significantly different from each other (P < 0.001). The diagnostic sensitivity and specificity of fluorescent spectroscopy was 86% and 91% for thyroid nodule capsule, 78% and 59% for papillary thyroid carcinoma, and 82% and 63% for normal thyroid, respectively.

CONCLUSION

Fluorescent spectroscopy can been used to identify significant differences in the fluorescent characteristics of various thyroid histologies.

SIGNIFICANCE

This study is the first investigation of the fluorescence of thyroid tissue. The diagnostic ability of fluorescent spectrometry may allow it to be used as a localization aid for fine needle aspiration, using optical fiber probes. Further investigations may enhance the sensitivity and specificity of fluorescent spectrometry allowing it to replace or compliment fine needle aspiration. EBM rating: B‐3.
Alterations in Eotaxin, Monocyte Chemoattractant Protein‐4, Interleukin‐5, and Interleukin‐13 After Systemic Steroid Treatment for Nasal Polyps
Authors: Woodworth Bradford A. , Joseph Kusumam , Kaplan Allen P. , Schlosser Rodney J.
Published: October 2004

OBJECTIVE

To determine alterations in Th2 chemokines eotaxin and monocyte chemoattractant protein‐4 (MCP‐4), and cytokines interleukin‐5 (IL‐5) and interleukin‐13 (IL‐13), in nasal polyps (NP) after steroid treatment.

STUDY DESIGN

Cytokine/chemokine levels were measured in NP before and after steroid therapy and compared to control sinus mucosa.

RESULTS

Twenty‐one patients (control = 7, NP = 14) were enrolled. Eotaxin and MCP‐4 were significantly higher than control tissue (P = 0.004 and 0.003). All four mediators decreased after steroid treatment (P < 0.03). IL‐5 and IL‐13 in untreated polyps were not significantly different from controls. Patients showed clinical improvement according to SNOT‐20 scores (average presteroid score 19, post‐steroid score 13) and endoscopic grading (1.75 each side presteroid, 1.13 poststeroid).

CONCLUSIONS

Steroids significantly decreased all cytokine/chemokine levels, but the impact on Th2 chemokines was of a much greater magnitude.

SIGNIFICANCE

Novel approaches to block inflammatory mediators, particularly Th2 chemokines, may lead to better control of nasal polyposis in the future.
Continuous Laryngeal Nerve Integrity Monitoring During Thyroidectomy: Does it Reduce Risk of Injury?
Authors: Robertson Matt L. , Steward David L. , Gluckman Jack L. , Welge Jeff
Published: October 2004

OBJECTIVE

To determine if continuous laryngeal nerve integrity monitoring (NIM) during thyroidectomy is associated with a decreased risk of postoperative recurrent laryngeal nerve (RLN) injury.

STUDY DESIGN AND SETTING

Retrospective cohort study of 165 patients who underwent thyroidectomy at a resident teaching institution between 1999 and 2002. The control group had 120 nerves at risk (NAR) whereas the NIM group consisted of 116 NAR. Primary outcome measures included postoperative RLN paralysis, paresis, and total injury rates.

RESULTS

RLN paralysis occurred in 2.54% NAR in the control group and 0.86% in the NIM group (relative risk (RR) = 0.34, 95% confidence interval (CI95) = 0.04‐3.27, P = 0.62). Temporary RLN paresis occurred in 4.24% NAR in the control group and 3.45% in the NIM group (RR = 0.9, CI95 = 0.23‐3.55, P = 0.89). Total RLN injury occurred in 6.78% NAR in the control group and 4.31% in the NIM group (RR = 0.66, CI95 = 0.21‐2.09, P = 0.48). When compared to all other NAR, advanced T‐stage malignancy was associated with a significantly increased risk of RLN paresis (T4 RR = 9.0, CI95 = 2.56‐31.67, P = 0.0006; T3+T4 RR = 7.5, CI95 = 2.17‐25.86, P = 0.0001) but not paralysis. NIM did not significantly reduce the risk of RLN paresis in the advanced T‐stage subset (T3+T4 RR = 0.36, CI95 = 0.04‐3.0, P = 0.59).

CONCLUSION

There were no statistically significant differences in RLN paralysis, paresis, or total injury rates between control and NIM groups, even in subsets with advanced T‐stage and increased baseline risk. Advanced T‐stage is a significant predictor of RLN paresis in this cohort.
Primary Hyperparathyroidism in Young Adults
Authors: Joshua Benzion , Feinmesser Raphael , Ulanovski David , Gilat Hanna , Sulkes Jaqueline , Eshed Varda , Shpitzer Thomas
Published: October 2004

OBJECTIVE

The purpose of this study was to compare the incidence of multiglandular disease and rate of treatment failure between younger and older patients with primary hyperparathyroidism.

STUDY DESIGN AND SETTING

The medical charts of patients who underwent surgery for primary hyperparathyroidism at our tertiary‐care institution between 1995 and 2001 were reviewed.

RESULTS

Three hundred nineteen patients were identified, of whom 33 were aged 40 years or less. There were no statistically significant differences between the younger and older groups in the incidence of multiglandular disease (9.1% for both, P = 1.00) or in the treatment failure rate (12.1% and 8%, respectively, P = 0.43). Sonography was significantly more sensitive than technetium Tc‐sestamibi in the younger group (96% vs 57%, P < 0.05). Parathyroid hormone level and gland weight were significantly higher in the older group (P = 0.004).

CONCLUSION

Our results suggest that the same treatment strategy should be applied to all patients with primary hyperparathyroidism. Ultrasound appears to be the localization procedure of choice in younger patients.
IMMIGRATION AND POLITICS
Authors: Cornelius Wayne A. , Rosenblum Marc R.
Published: October 2004

▪ Abstract  With nearly one in ten residents of advanced industrialized states now an immigrant, international migration has become a fundamental driver of social, economic, and political change. We review alternative models of migratory behavior (which emphasize structural factors largely beyond states' control) as well as models of immigration policy making that seek to explain the gaps between stated policy and actual outcomes. Some scholars attempt to explain the limited efficacy of control policies by focusing on domestic interest groups, political institutions, and the interaction among them; others approach the issue from an international or “intermestic” perspective. Despite the modest effects of control measures on unauthorized flows of economic migrants and asylum seekers, governments continue to determine the proportion of migrants who enjoy legal status, the specific membership rights associated with different legal (and undocumented) migrant classes, and how policies are implemented. These choices have important implications for how the costs and benefits of migration are distributed among different groups of migrants, native-born workers, employers, consumers, and taxpayers.
Semiparametric method for estimating paleodemographic profiles from age indicator data
Authors: Müller Hans‐Georg , Love Brad , Hoppa Robert D.
Published: October 2004

This paper addresses the problem of estimating an age‐at‐death distribution or paleodemographic profile from osteological data. It is demonstrated that the classical two‐stage procedure whereby one first constructs estimates of age‐at‐death of individual skeletons and then uses these age estimates to obtain a paleodemographic profile is not a correct approach. This is a consequence of Bayes' theorem. Instead, we demonstrate a valid approach that proceeds from the opposite starting point: given skeletal age‐at‐death, one first estimates the probability of assigning the skeleton into a specific osteological age‐indicator stage. We show that this leads to a statistically valid method for obtaining a paleodemographic profile, and moreover, that valid individual age estimation itself requires a demographic profile and therefore is done subsequent to its construction. Individual age estimation thus becomes the last rather than the first step in the estimation procedure.

A central concept of our statistical approach is that of a weight function. A weight function is associated with each osteological age‐indicator stage or category, and provides the probability that a specific age indicator stage is observed, given age‐at‐death of the individual. We recommend that weight functions be estimated nonparametrically from a reference data set. In their entirety, the weight functions characterize the relevant stochastic properties of a chosen age indicator. For actual estimation of the paleodemographic profile, a parametric age distribution in the target sample is assumed. The maximum likelihood method is used to identify the unknown parameters of this distribution. As some components are estimated nonparametrically, one then has a semiparametric model. We show how to obtain valid estimates of individual age‐at‐death, confidence regions, and goodness‐of‐fit tests. The methods are illustrated with both real and simulated data. Am J Phys Anthropol 117:1–14, 2002. © 2002 Wiley‐Liss, Inc.
Finger length and distal finger extent patterns in humans
Authors: Peters Michael , Mackenzie Kevin , Bryden Pam
Published: October 2004

The fingers in the adult human hand differ in length and in distal extent. The literature agrees that in the clear majority of males, the distal extent of the ring finger tends to be relatively greater (using the middle finger as standard) than the index finger. However, the results for females vary considerably, with some studies reporting that females show a similar pattern to that of males, while others suggest that the prevalence of a longer index finger is relatively or absolutely more common in females. We provide a review of the literature, and a set of data for both finger length and distal fingertip extent of the finger for a contemporary cohort of young adult females and males (n = 502). Finger length measures favor the ring finger of both sexes, with smaller between‐finger differences for females than for males. However, while the distal fingertip extent favors the ring finger of both hands in males, in females the left hand shows no significant differences, and the right hand shows a small index finger advantage. Thus, the sexual dimorphism in finger measures is more strongly expressed in the distal extent of fingertips than in the length of fingers. The sex differences in distal fingertip extent derive from the index finger only, with a lesser distal extent of the index finger, relative to the middle finger, in males than in females. Am J Phys Anthropol 117:209–217, 2002. © 2002 Wiley‐Liss, Inc.
Mechanical and thermal properties of poly(ethylene terephthalate) fibers crosslinked with disulfonyl azides
Authors: Baker D. A. , East G. C. , Mukhopadhyay S. K.
Published: October 2004

A novel method for the crosslinking of poly(ethylene terephthalate) fibers is described using 1,6‐hexanedisulfonyl azide, 1,3‐benzenedisulfonyl azide, and 2,6‐naphthalenedisulfonyl azide. The azides are diffused into poly(ethylene terephthalate) fibers (Dacron) from perchloroethylene solution, and the fibers are heat treated to bring about decomposition of the sulfonyl azide and give rise to crosslinking. A study is made of the mechanical and thermal properties of the resultant fibers, which are changed considerably in comparison to the untreated fiber. © 2002 Wiley Periodicals, Inc. J Appl Polym Sci 83: 1517–1527, 2002
Modification of cellulase with polyalkylene oxide allyl ester–maleic acid anhydride copolymer and its application to the pulp and paper industry
Authors: Park Kwinam , Park Jinwon , Lee Ju‐Han
Published: October 2004

Functional copolymer‐modified cellulase was applied to newspaper reprocessing. The new copolymers, composed of polyalkylene oxide (PAO) and maleic acid anhydride (MA), were synthesized to modify the cellulase. MA was attached to PAO allyl ester, formed by the reaction between PAO allyl alcohol and lauric acid. The modification is produced by the ability of MA to react with the amino acid group of the cellulase for modification. At the maximum degree of modification of 52%, modified cellulase showed more than 65% activity over the unmodified native cellulase. When modified cellulase was applied to the waste paper reprocessing, it was found that the cellulase enhanced the detachment of ink particles from paper. PAO was found to also cause the removal of the detached ink particles by floatation. This process creates a more moderate environment than conventional methods, improves the physical properties of the paper such as freeness and whiteness in comparison to conventional NaOH methods, while maintaining the same ink particle removal ability. © 2002 Wiley Periodicals, Inc. J Appl Polym Sci 84: 894–899, 2002; DOI 10.1002/app.10088
Synthesis and characteristics of chelating fibers containing imidazoline group or thioamide group
Authors: Liu Ruixia , Li Yi , Tang Hongxiao
Published: October 2004

Two types of chelating fibers containing an imidazoline or thioamide group were prepared through the functionalization of hydrazine‐modified polyacrylonitrile fiber by ethylenediamine and through the amination and sulfurization reaction of the hydrazine‐modified polyacrylonitrile fiber under appropriate conditions, respectively. It is shown that the reaction temperature, time, and agent concentration are the dominant factors in the synthesis of fibrous sorbents. The increase of the ethylenediamine concentration from 33 to 45% (v/v) at 95–98°C results in a twofold higher increase of the fibrous sorbent with the imidazoline group, and a doubling of the reaction time from 2 to 4 h leads to a weight increase of the fibrous sorbent from 10 to 25% (w/w). Raising the temperature by about 5°C significantly accelerates the amination reaction of the hydrazine‐modified fiber, but the temperature is an insensitive factor in the thioamide‐functionalized reaction of the aminated fiber. The introduction of a thioamide or imidazoline group is further verified by IR spectroscopy analysis. X‐ray diffraction spectroscopy indicates the absolute disappearance of crystalline peaks for the fibers containing an imidazoline or thioamide group. However, the crosslinking reaction of the polyacrylonitrile fiber by hydrazine may make up for the effect of the crystallinity on the mechanical strength of the fibers, and the surface crackles of fibrous sorbents are not found by SEM photographs. The adsorption experiment results show that the newly prepared sorbents have high sorption capacities for noble metals in a high acidity, and it is also proved that Au(III) loaded on the chelating fibers may be reduced to Au(0). © 2002 Wiley Periodicals, Inc. J Appl Polym Sci 83: 1608–1616, 2002
Effect of reactive polyurethane on toughness of unsaturated polyester resin
Authors: Min Kyung‐Eun , Hwang Yeong‐Geun , Choi Gwan‐Young , Kim Ho‐Gyum , Kim Woo‐Sik , Lee Dong‐Ho , Park Lee‐Soon , Seo Kwan‐Ho , Kang Inn‐Kyu , Jun Il‐Ryun , Lim Jeong‐Cheol , Song Han‐Chul
Published: October 2004

Unsaturated polyester (UP) resin is one of the major thermosetting resins and is very useful as a matrix resin of composite material for its processibility. UP resin, however, has several shortcomings: it is weak in alkalis, volume shrinkage occurs during the crosslinking reaction of the oligomeric UP resin with a styrene monomer, and it is also brittle. The mechanical properties of UP resin can be enhanced by blending it with various materials. In this study, polyurethane (PU) was used as a modifier to improve the toughness of the UP resin. The effect of the polyol molecular weight as a PU soft segment and the PU contents on the toughness of PU‐modified UP resins were studied. A UP/PU polymer network may occur through a reaction between an isocyanate group in the methyl diisocyanate (MDI) and a hydroxyl one in the UP molecules. The maximum toughness was observed at approximately 2 wt % of the PU content. These results can be rationalized by the incorporation of a rubbery PU segment into a brittle UP resin. © 2002 John Wiley & Sons, Inc. J Appl Polym Sci 84: 735–740, 2002; DOI 10.1002/app.10169
Iodination of plasticized poly(vinyl chloride) in aqueous media via phase transfer catalysis
Authors: Lakshmi S. , Jayakrishnan A.
Published: October 2004

Nucleophilic substitution of chlorine on plasticized poly(vinyl chloride) (PVC) was carried out using potassium iodide (KI) in the presence of a phase transfer catalyst (PTC) in aqueous media. Iodination was confirmed using energy dispersive X‐ray analysis (EDAX). The extent of iodination was studied with respect to time, temperature, concentration of the reactants, as well as different PTCs. Among the different PTCs examined, tetrabutylammonium bromide (TBAB) and tetrabutylammonium hydrogen sulfate (TBAH) were found to be highly efficient for the reaction. About 25% increase in weight was observed for PVC sheets iodinated under optimal reaction conditions. The thermal stability of the modified PVC was found to be impaired upon iodination. The iodinated PVC released iodide ions when kept in distilled water, as evidenced by UV spectroscopy. Sustained release of iodide ion in distilled water was followed up for about 30 days. © 2002 Wiley Periodicals, Inc. J Appl Polym Sci 84: 493–499, 2002; DOI 10.1002/app.10176
Preparation and characterization of interpenetrating network beads of poly(vinyl alcohol)‐grafted‐poly(acrylamide) with sodium alginate and their controlled release characteristics for cypermethrin pesticide
Authors: Kumbar Sangamesh G. , Aminabhavi Tejraj M.
Published: October 2004

Interpenetrating network polymeric beads of poly(vinyl alcohol)‐grafted‐acrylamide with sodium alginate have been prepared by crosslinking with glutaraldehyde. Cypermethrin, a widely used pesticide, was loaded with 80% efficiency in these hydrogel beads. The beads were characterized by Fourier transform infrared spectroscopy to confirm the grafting. Scanning electron microscopy was used to know the morphology of the beads. Equilibrium swelling experiments indicated that swelling of the beads decreased with an increase in crosslinking. The in vitro release studies were performed under static conditions and the release data have been fitted to an empirical relation to estimate the transport parameters. The diffusion coefficients have been calculated for the transport of pesticide through the polymeric beads using the initial time approximation method. These values showed decrease with increasing crosslinking as well as increasing pesticide loading. © 2002 Wiley Periodicals, Inc. J Appl Polym Sci 84: 552–560, 2002; DOI 10.1002/app.10306
Synthesis and characterization of block copolymers containing PC segments and PHTH‐6 mesogenic units
Authors: Zhao Xiongyan , Hu Xiao , Yue Chee Yoon , Zhang Huijing , Zhou Qixiang
Published: October 2004

Liquid crystalline block copolymers that incorporate both PHTH‐6 mesogenic units and polycarbonate (PC) segments in the main chain were synthesized by polycondensation in solution of hydroxyl‐terminated PC and acid‐chloride‐terminated PHTH‐6. The copolymer compositions were determined from 1H‐NMR data. The structure, thermal properties, as well as liquid crystalline behavior of the block copolymers were characterized by 1H‐NMR, Fourier transform infrared (FTIR), differential scanning calorimetry (DSC), polarizing optical microscopy (POM), transmission electron microscopy (TEM), and X‐ray scattering, etc. A novel kind of morphology of a liquid crystalline block copolymer, a feathery structure, was observed for the first time, in which the PHTH‐6 mesogenic microphase dispersed in the PC microdomain in the form of feathery structure. These block copolymers showed a microphase‐separation system, for which the geometry on a length scale changes from tens of nanometers to 600 nm and the degree of phase separation was strongly dependent on the segment lengths incorporated. © 2002 Wiley Periodicals, Inc. J Appl Polym Sci 84: 283–294, 2002; DOI 10.1002/app.10318
Synthesis and properties of agglomerating agent for high‐solids NBR latices
Authors: Cho Kyo Dong , Jang Killsoo , Yang Gun‐Ho , Chang Jin Gyu , Ha Ki Ryong , Park Jong Woo , Park Lee Soon , Song Sang Moo
Published: October 2004

Agglomerating agents were synthesized in a latex form utilizing a seeded emulsion polymerization method to get high solid content NBR latex without exhibiting excessively high viscosity and unstability in the concentration process. An agglomerating agent synthesized with ethylacrylate in the core part and methacrylamide as the hydrophilic monomer in the shell effectively increased the average size of the NBR base latex when it was mixed with the NBR latex and settled for about 2 h. The NBR latex, treated with the proper amount of an agglomerating agent, could be concentrated up to 60.5 wt % solid, while an untreated NBR latex could only be concentrated to 45.0 wt % solid due to the viscosity buildup. © 2002 Wiley Periodicals, Inc. J Appl Polym Sci 84: 276–282, 2002; DOI 10.1002/app.10325