bluuebunny/crossref_metadata_2025 huggingface dataset:
Proteomic identification and early validation of complement 1 inhibitor and pigment epithelium‐derived factor: Two novel biomarkers of Alzheimer's disease in human plasma
Authors: Cutler Paul , Akuffo Emma L. , Bodnar Wanda M. , Briggs Deborah M. , Davis John B. , Debouck Christine M. , Fox Steven M. , Gibson Rachel A. , Gormley Darren A. , Holbrook Joanna D. , Hunter A. Jacqueline , Kinsey Emma E. , Prinjha Rabinder , Richardson Jill C. , Roses Allen D. , Smith Marjorie A. , Tsokanas Nikos , Willé David R. , Wu Wen , Yates John W. , Gloger Israel S.
Published: March 2008

Emerging disease modifying therapeutic strategies for Alzheimer's disease (AD) have generated a critical need for biomarkers of early stage disease. Here, we describe the identification and assessment of a number of candidate biomarkers in patients with mild to moderate probable AD. Plasma from 47 probable Alzheimer's patients and 47 matched controls were analysed by proteomics to define a significant number of proteins whose expression appeared to be associated with AD. These were compared to a similar proteomic comparison of a mouse transgenic model of amyloidosis, which showed encouraging overlap with the human data. From these studies a prioritised list of 31 proteins were then analysed by immunoassay and/or functional assay in the same human cohort to verify the changes observed. Eight proteins continued to show significance by either immunoassay or functional assay in the human plasma and these were tested in a further set of 100 probable AD patients and 100 controls from the original cohort. From our data it appeared that two proteins, serpin F1 (pigment epithelium‐derived factor) and complement C1 inhibitor are down‐regulated in plasma from AD patients.
Abnormal cytoskeletal protein expression in cultured skin fibroblasts from type 1 diabetes mellitus patients with nephropathy: A proteomic approach
Authors: Millioni Renato , Iori Elisabetta , Puricelli Lucia , Arrigoni Giorgio , Vedovato Monica , Trevisan Roberto , James Peter , Tiengo Antonio , Tessari Paolo
Published: March 2008

Diabetic nephropathy (DN) develops in about 40% of insulin‐dependent type 1 diabetes mellitus (T1DM) patients, and is associated not only with diabetes duration and metabolic control, but also with a genetic predisposition. Constitutive alterations of cytoskeletal proteins may play a role in the development of DN. We investigated the expression of these proteins in cultured skin fibroblasts, obtained from long‐term T1DM patients with and without DN but comparable metabolic control, and from matched healthy subjects, by means of 2‐DE electrophoresis and MS‐MALDI analyses. In T1DM with DN, compared to the other two groups, quantitative analyses revealed an altered expression of 17 spots (p<0.05–p<0.01), corresponding to 12 unique proteins. In T1DM with DN, beta‐actin and three isoforms of tubulin beta‐2 chain, tropomodulin‐3, and LASP‐1 were decreased, whereas two tubulin beta‐4 chain isoforms, one alpha actinin‐4 isoform, membrane‐organizing extension spike protein (MOESIN), FLJ00279 (corresponding to a fragment of myosin heavy chain, non‐muscle type A), vinculin, a tropomyosin isoform, and the macrophage capping protein were increased. A shift in caldesmon isoforms was also detected. These results demonstrate an association between DN and the constitutive expression of cytoskeleton proteins in cultured skin fibroblasts from T1DM with DN, which may retain pathophysiologycal implications.
Serum autoantibody to sideroflexin 3 as a novel tumor marker for oral squamous cell carcinoma
Authors: Murase Ryuichi , Abe Yasuhito , Takeuchi Takashi , Nabeta Motowo , Imai Yoshinori , Kamei Yoshiaki , Kagawa‐Miki Lisa , Ueda Norifumi , Sumida Tomoki , Hamakawa Hiroyuki , Kito Katusmi
Published: March 2008

The purpose of this study is to establish a tumor marker that can be applied for the early detection and follow‐up of oral cancer patients. Employing the proteomic approach using MALDI TOF‐MS, 2‐DE, patient's sera and culturing cell lines, the serum autoantibodies (autoAbs) were screened and the serum levels were estimated by ELISA. Targeting the tumor cell invasion into the surrounding stromal tissues, MRC‐5 human fibroblasts were employed as the target cells and a mitochondrial membrane protein, sideroflexin 3 (SFXN3), was identified. The serum anti‐SFXN3‐autoAb levels elevated in patients with the oral squamous cell carcinoma significantly: with 77% sensitivity and 89% specificity against control samples. The serum anti‐SFXN3‐autoAb levels were mildly correlated with the primary tumor sizes, however, the levels were slightly highly elevated in T1 early cancer. An immunohistochemical analysis revealed that the SFXN3 protein is expressed in the stromal fibroblasts between the caner nests and also in the basal layer of the squamous epithelium. Changes in the serum anti‐SFXN3‐autoAb levels after therapy correlated with the clinical tumor burden. These findings demonstrated that the serum anti‐SFXN3‐autoAb is worthy of clinical evaluation as a potentially of the novel tumor maker for the early detection of oral squamous cell carcinoma.
Development and prospects of nitride materials and devices with nonpolar surfaces
Authors: Paskova Tanya
Published: March 2008

The quest to use nonpolar surfaces of nitride materials and devices started a few years ago with the aim to avoid the strong internal electric fields in active regions of optoelec‐tronic devices and to improve their efficiency. Starting with the growth optimizations, the progression via thorough understanding of new physical properties of the materials has led to significant improvement of device performance and to novel device concepts. In this review a historical survey of nonpolar nitride growth achievements is made. Along the way new challenges in material growth and characterization have been encountered and more sophisticated methods have been developed, which are briefly summarized. The main properties of the nitride materials grown in nonpolar directions are discussed with emphasis on the deviations from those of nitrides grown along the polar direction. Physical phenomena such as inherently present anisotropic in‐plane strain and optical polarization anisotropy have been proposed for the realization of novel polarized light‐emitting diodes, polarization‐sensitive detectors and modulators. The present status of the nitride devices with nonpolar and semipolar surfaces is discussed, and an outlook of the future trends is presented. (© 2008 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)
UV irradiation effects on TiO2 thin films
Authors: Fernández‐Rodríguez M. , Rico V. J. , González‐Elipe A. R. , Álvarez‐Herrero A.
Published: March 2008

This paper presents the behaviour of a standard optical coating to be used in aerospace applications when exposed to ultraviolet (UV) irradiation. Ellipsometric measurements are carried out in order to monitor the effects produced on the optical properties of the TiO2 film when it is exposed to a 500 W Xenon lamp during the time intervals of 1 hour, 22 hours and 42 hours. The ellipsometric measurements show that main changes occur in the real part of the refractive index after the first hour of exposure to UV irradiation. To assess a possible relation between the hydrophilicity that the UV irradiation typically induces on the TiO2 thin film, and the variation of the optical properties of the film, the water contact angle on the TiO2 optical coating was also measured after irradiation under similar conditions. (© 2008 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)
Spheroidal coordinate systems for modelling global atmospheres
Authors: White A. A. , Staniforth A. , Wood N.
Published: March 2008

In meteorological dynamics it is common practice to represent the potential surfaces of apparent gravity (the geopotentials) as spheres, and consequently the use of spherical polar coordinates in models of the global atmosphere is widespread. Several writers have considered how oblate spheroidal coordinates might be used instead, thus enabling the Figure of the Earth to be better represented. It is observed here that oblate spheroidal coordinate systems are conventionally defined using confocal oblate spheroids, and that such spheroids are inappropriate representations of the geopotentials because they imply the wrong sign for the latitudinal variation of apparent gravity. Re‐examination of a classical problem of Newtonian gravitation shows that, near the Earth, the geopotentials are to a very good approximation spheroids, but not spheroids of an analytically simple type. However, similar oblate spheroids are a qualitatively correct model of the near‐Earth geopotentials, and are a quantitatively good approximation in so far as Newton's uniform‐density model adequately describes the real Earth. An orthogonal curvilinear coordinate system based on similar oblate spheroids is proposed and examined. © Crown Copyright 2008. Reproduced with the permission of Her Majesty's Stationery Office. Published by John Wiley & Sons, Ltd
On the energetics of maximum‐entropy temperature profiles
Authors: Akmaev R. A.
Published: March 2008

The problem of determining a maximum‐entropy state in an atmospheric column has different solutions depending on the constraints imposed. As was first shown by J. W. Gibbs, maximization of entropy in a thermally‐isolated, i.e. energy‐conserving, atmosphere yields an isothermal temperature distribution. It has since been argued that conservation of the mass‐weighted integral of potential temperature, or of the column potential enthalpy, is more appropriate for certain dynamical processes. The solution of the maximization problem satisfying this second constraint is quite different: an adiabatic temperature profile.

Here, the comparative energetics of entropy maximization is examined in more detail. The main new result is that some exact statements may be formulated as inequalities. It can be rigorously shown, for example, that maximization of entropy under the conservation of potential enthalpy in an initially stable stratification always requires additional energy, and so cannot be accomplished in an isolated layer. Conversely, a temperature profile satisfying the second condition always possesses less entropy than an isothermal state with the same total energy, and so cannot be in thermodynamic equilibrium. Starting with these fundamental results, this paper discusses basic properties, and specific examples, of dynamical processes transporting heat vertically and generating entropy under various constraints, and demonstrates the importance of their physically‐consistent parametrization in atmospheric models. Copyright © 2008 Royal Meteorological Society
Comparison between XPS‐ and FTIR‐analysis of plasma‐treated polypropylene film surfaces
Authors: Morent R. , De Geyter N. , Leys C. , Gengembre L. , Payen E.
Published: March 2008

Plasma treatment is often used to modify the surface properties of polymer films, since it offers numerous advantages over the conventional surface modification techniques. In this paper, a polypropylene (PP) film is plasma‐treated using a dielectric barrier discharge (DBD) operating in air at medium pressure (5.0 kPa). The modified polymer films are characterized using contact angle measurements, XPS‐analysis and attenuated total reflectance‐Fourier transform infrared (ATR‐FTIR) spectroscopy. Results show that plasma treatment leads to a remarkable decrease in contact angle owing to the implantation of oxygen‐containing functional groups. Using XPS and ATR‐FTIR, these oxygen‐containing groups can be identified as CO, CO and OCO. In this paper, it is also shown that XPS is well‐suited to provide quantitative chemical analysis of the PP films, while ATR‐FTIR can only give qualitative information. To perform quantitative ATR‐FTIR measurements, chemical derivatization will be explored in the near future. Copyright © 2008 John Wiley & Sons, Ltd.
Height of the cerebellar vermis and gestational age at birth
Authors: Pogliani L. , Radaelli G. , Manfredini V. , Lista G. , Zuccotti G. V.
Published: March 2008

Objectives

The objective of this study was to construct reference ranges of the neonatal cerebellar vermis height with respect to the gestational age at birth.

Methods

This observational study assessed 434 neonates born at 25–42 weeks' gestation. The neonates were singleton and appropriate in size for gestational age, and did not exhibit any abnormalities or neonatal disease. Gestational age was based on the date of the last menstrual period and confirmed by ultrasound examination performed within the 12th week of pregnancy. Sonographic measurements of the height of the cerebellar vermis in the mid‐sagittal plane were performed within 24 h of birth by the same neonatal sonographer. Reference ranges (5th, 50th and 95th centiles) were estimated by a mean and SD model based on least‐squares polynomial regression.

Results

Neonatal sonographic measurements were obtained in all cases. Mean (SD) maternal age was 30.2 (4.3) years. Mean cerebellar vermis height adjusted for gestational age did not differ between males and females, the mean adjusted difference being 0.012 (95% CI, − 0.009 to 0.033) cm. Mean cerebellar vermis height (cm) against gestational age (weeks) was suitably modeled by a linear‐cubic polynomial as − 1.784 + 0.137 × GA − 0.000019 × GA3 (SD = − 0.147 + 0.008 × GA), where GA = gestational age.

Conclusions

Reference ranges for the height of the cerebellar vermis at birth with respect to gestational age at birth have been constructed in appropriate‐for‐gestational‐age neonates. Copyright © 2008 ISUOG. Published by John Wiley & Sons, Ltd.
Frontomaxillary facial angle in trisomy 21 fetuses at 16–24 weeks of gestation
Authors: Molina F. , Persico N. , Borenstein M. , Sonek J. , Nicolaides K. H.
Published: March 2008

Objectives

To establish a normal range for the frontomaxillary facial (FMF) angle by three‐dimensional (3D) ultrasound imaging and to examine the FMF angle in trisomy 21 fetuses at 16–24 weeks of gestation.

Methods

We measured the FMF angle using 3D volumes of the fetal profile obtained with the transducer parallel to the long axis of the nose and at 45° to the palate, which had been acquired from 150 normal fetuses and 23 fetuses with trisomy 21.

Results

In the normal group there was no significant association between the FMF angle and gestational age; the mean FMF angle was 83.9° (range, 76.9–90.2°) and the 95th centile was 88.5°. In 15 (65.2%) of the fetuses with trisomy 21 the FMF angle was greater than 88.5°. Repeatability studies demonstrated that in 95% of cases the difference between two measurements of FMF angle by the same operator and different operators was less than 5°.

Conclusions

In the majority of second‐trimester fetuses with trisomy 21 the FMF angle is increased. Copyright © 2008 ISUOG. Published by John Wiley & Sons, Ltd.
Antioxidant and Antithrombotic Activities of Rapeseed Peptides
Authors: Zhang Shao Bing , Wang Zhang , Xu Shi Ying
Published: March 2008

The antioxidant and antithrombotic activities of crude rapeseed peptides (CRPs) and peptide fractions (RP25 and RP55) prepared from aqueous enzymatic extraction (AEE) of rapeseed were determined. The reducing power of RP55 and CRPs was higher than that of RP25 at the same concentrations. Rapeseed peptides exhibited marked antioxidant activities. The median effective dose (ED50) values of CRPs, RP25 and RP55 for α,α‐diphenyl‐β‐picrylhydrazyl (DPPH) radical scavenging were 72, 499 and 41 μg/mL, respectively. The ED50 values for RP25 and RP55 for hydroxyl radicals scavenging were 2.53 and 6.79 mg/mL, respectively while the ED50 values of RP55 and CRPs for inhibition of lipid peroxidation in a liposome model system were 4.06 and 4.69 mg/mL, respectively. The inhibitory effect on lipid oxidation of RP55 was similar to that of ascorbic acid at a concentration of 5.0 mg/mL. A good positive correlation existed between the peptide concentration and antioxidant activity. RP55 generally showed more potent antioxidant activities except for hydroxyl radicals scavenging ability than RP25 and CRPs at the same concentrations, which was thought to relate to the significantly higher contents of hydrophobic amino acid, tannin, and the brown color substances in RP55. Rapeseed peptides possessed marked inhibitory activities on the thrombin‐catalyzed coagulation of fibrinogen, however, their inhibitory effects were not comparable to that of heparin.
Preterm births: Can neonatal pain alter the development of endogenous gating systems?
Authors: Goffaux Philippe , Lafrenaye Sylvie , Morin Mélanie , Patural Hugues , Demers Geneviève , Marchand Serge
Published: March 2008

Prematurity is known to affect the development of various neurophysiological systems, including the maturation of pain and cardiac circuits. The purpose of this study was to see if numerous painful interventions, experienced soon after birth, affect counterirritation‐induced analgesia (triggered using the cold pressor test) later in life. A total of 26 children, between the ages of 7 and 11 participated in the study. Children were divided into three groups, according to their birth status (i.e., term‐born, born preterm and exposed to numerous painful interventions, or born preterm and exposed to few painful interventions). Primary outcome measures were heat pain thresholds, heat sensitivity scores, and cardiac reactivity. Results showed that preterm children and term‐born children had comparable pain thresholds. Exposure to conditioning cold stimulation significantly increased heart rate and significantly decreased the thermal pain sensitivity of term‐born children. These physiological reactions were also observed among preterm children who were only exposed to a few painful interventions at birth. Changes in heart rate and pain sensitivity in response to conditioning cold stimulation were not observed in preterm children that had been exposed to numerous painful procedures during the neonatal period. These results suggest that early pain does not lead to enhanced pain sensitivity when premature babies become children, but that their endogenous pain modulatory mechanisms are not as well developed as those of children not exposed to noxious insult at birth. Greater frequency of painful procedures also dampened the rise in heart rate normally observed when experimental pain is experienced.
Massage or music for pain relief in labour: A pilot randomised placebo controlled trial
Authors: Kimber L. , McNabb M. , Mc Court C. , Haines A. , Brocklehurst P.
Published: March 2008

Research on massage therapy for maternal pain and anxiety in labour is currently limited to four small trials. Each used different massage techniques, at different frequencies and durations, and relaxation techniques were included in three trials. Given the need to investigate massage interventions that complement maternal neurophysiological adaptations to labour and birth pain(s), we designed a pilot randomised controlled trial (RCT) to test the effects of a massage programme practised during physiological changes in pain threshold, from late pregnancy to birth, on women's reported pain, measured by a visual analogue scale (VAS) at 90min following birth. To control for the potential bias of the possible effects of support offered within preparation for the intervention group, the study included 3 arms – intervention (massage programme with relaxation techniques), placebo (music with relaxation techniques) and control (usual care). The placebo offered a non‐pharmacological coping strategy, to ensure that use of massage was the only difference between intervention and placebo groups. There was a trend towards slightly lower mean pain scores in the intervention group but these differences were not statistically significant. No differences were found in use of pharmacological analgesia, need for augmentation or mode of delivery. There was a trend towards more positive views of labour preparedness and sense of control in the intervention and placebo groups, compared with the control group. These findings suggest that regular massage with relaxation techniques from late pregnancy to birth is an acceptable coping strategy that merits a large trial with sufficient power to detect differences in reported pain as a primary outcome measure.
Calmodulin‐binding transcription activator (CAMTA) 3 mediates biotic defense responses in Arabidopsis
Authors: Galon Yael , Nave Roy , Boyce Joy M. , Nachmias Dikla , Knight Marc R. , Fromm Hillel
Published: March 2008

Calmodulin‐binding transcription activator (CAMTA) 3 (also called SR1) is a calmodulin‐binding transcription factor in Arabidopsis. Two homozygous T‐DNA insertion mutants (camta3‐1, camta3‐2) showed enhanced spontaneous lesions. Transcriptome analysis of both mutants revealed 6 genes with attenuated expression and 99 genes with elevated expression. Of the latter, 32 genes are related to defense against pathogens (e.g. WRKY33, PR1 and chitinase). Propagation of a virulent strain of the bacterial pathogen Pseudomonas syringae and the fungal pathogen Botrytis cinerea were attenuated in both mutants. Moreover, both mutants accumulated high levels of H2O2. We suggest that CAMTA3 regulates the expression of a set of genes involved in biotic defense responses.
Compensatory activation of the multidrug transporters Pdr5p, Snq2p, and Yor1p by Pdr1p in Saccharomyces cerevisiae
Authors: Kolaczkowska Anna , Kolaczkowski Marcin , Goffeau André , Moye-Rowley W. Scott
Published: March 2008

In Saccharomyces cerevisiae, the transcription factors Pdr1p and Pdr3p activate the expression of several genes, including PDR5, SNQ2, and YOR1, which encode ATP‐binding cassette transporters that extrude dozens of antifungals with overlapping but distinct specificity. In this study, it was observed that growth resistance to specific Pdr5p substrates rose upon disruption of the YOR1 or SNQ2 coding region and was accompanied by increased efflux. Similarly, resistance to Yor1p‐ and Snq2p‐specific substrates increased upon deletion of PDR5. The mRNA and protein levels of the respective transporters increased in parallel to drug resistance. β‐Galactosidase activity fused to the PDR5 or YOR1 promoter required the presence of Pdr1p and its specific binding sites for the compensatory induction, whereas Pdr3p had an inhibitory effect.
Protein flexibility in psychrophilic and mesophilic trypsins. Evidence of evolutionary conservation of protein dynamics in trypsin‐like serine‐proteases
Authors: Papaleo Elena , Pasi Marco , Riccardi Laura , Sambi Ilaria , Fantucci Piercarlo , Gioia Luca De
Published: March 2008

Psychrophilic trypsins present fewer interdomain interactions and enhanced localized flexibility in regions close to the catalytic site. Notably, these regions fit well with the pattern of protein flexibility previously reported for psychrophilic elastases. Our results indicate that specific sites within the serine‐protease fold can be considered hot spots of cold‐adaptation and that psychrophilic trypsins and elastases have independently discovered similar molecular strategies to optimize flexibility at low temperatures.
Differences in Pregnancy Desire Among Pregnant Female Adolescents at a State‐Funded Family Planning Clinic
Authors: Heavey Elizabeth J. , Moysich Kirsten B. , Hyland Andrew , Druschel Charlotte M. , Sill Michael W.
Published: March 2008

We wished to examine variables associated with pregnancy desire among pregnant adolescents from low socioeconomic backgrounds. This study analyzed 335 charts at a state‐funded family planning clinic. Participants were adolescents who had a positive pregnancy test at the clinic on the day of the survey. Logistic regression was utilized to determine differences in pregnancy desire. We found that Hispanic teens were more than twice as likely to desire pregnancy as African American teens (adjusted odds ratio [AOR], 2.22; 95% confidence interval [CI], 1.22−3.65), and adolescents who were not in school were almost twice as likely as those who were in school full‐time to desire pregnancy (AOR, 1.83; 95% CI, 1.08 −3.09). Hispanic teens who were not in school were 12 times more likely to desire pregnancy than African American teens who were in school full‐time (odds ratio [OR], 11.47; 95% CI, 3.68 −35.75). Adolescent pregnancy desire is significantly associated with educational status and racial background. Developing culturally appropriate interventions to encourage continued education and asking about community and familial norms are essential steps in addressing this issue.
The correlation between pharyngeal narrowing and the severity of sleep‐disordered breathing
Authors: Kim Hyo Yeol , Bok Kwon Hyo , Dhong Hun‐Jong , Chung Seung‐Kyu
Published: March 2008

OBJECTIVE

The aim of this study was to examine the correlation between the degree or shape of pharyngeal narrowing as observed during the Muller maneuver and the severity of sleep‐disordered breathing (SDB).

SUBJECTS AND METHODS

We enrolled 33 patients with SDB, and they underwent polysomnography (PSG). The degree of pharyngeal narrowing (grade I‐IV) according to fiberoptic nasopharyngoscopy with the Muller maneuver (FNMM) and the shape of pharyngeal narrowing were evaluated at different anatomical levels. These variables were compared with the total apnea hypopnea index (AHI), the supine AHI, and the lateral AHI obtained by PSG.

RESULTS

The retroglossal FNMM grades revealed significant correlation with total AHI (P = 0.030) and supine AHI (P = 0.012). The retropalatal FNMM grades were significantly correlated with lateral AHI (P = 0.020). The lateral‐narrowing type at the retropalatal level is more significantly associated with higher total AHI compared with the anteroposterior‐narrowing type (P = 0.010).

CONCLUSION

The anatomic level and the degree of pharyngeal narrowing observed during FNMM revealed a correlation with the AHIs of different sleeping positions.
The impact of cochlear implantation on quality of life: The role of audiologic performance and variables
Authors: Hirschfelder Anke , Gräbel Stefan , Olze Heidi
Published: March 2008

OBJECTIVE

The purpose of this study was to assess the impact of cochlear implantation (CI) on health‐related quality of life (HRQOL), to correlate the results with audiologic performance, and to analyze the influence of variables that possibly affect the CI outcome.

STUDY DESIGN

A retrospective study.

SUBJECTS AND METHODS

Fifty‐six adult CI users were evaluated by two HRQOL‐questionnaires (the Nijmegen Cochlear Implant Questionnaire [NCIQ] and the Medical Outcome Study Short‐Form 36 [SF‐36]) and speech‐perception tests (Freiburger monosyllable and Hochmair, Schulz, Moser (HSM) sentence test).

RESULTS

The NCIQ showed significant improvements in the total score and in all subdomains after CI. The NCIQ total score and the advanced sound‐perception and speech‐production score correlated significantly with speech test results. Significant inverse relationships were noted between speech test results and duration of deafness. Significant associations were found between time since CI, NCIQ total score, and speech test results.

CONCLUSION

The NCIQ was able to detect significant effects of CI on HRQOL and correlated with audiologic measures, supporting its use as a measurement tool in CI.
Childhood epistaxis and nasal colonization with Staphylococcus aureus
Authors: Whymark Andrew D. , Crampsey David P. , Fraser Lyndsay , Moore Philip , Williams Craig , Kubba Haytham
Published: March 2008

OBJECTIVE

Epistaxis is very common in children but its cause remains unknown. We postulate that nasal colonization with Staphylococcus aureus leads to inflammation, crusting, and ultimately new vessel formation.

STUDY DESIGN

A prospective case‐control study.

SUBJECTS AND METHODS

Sixty‐seven children were recruited, 42 with epistaxis (22 had crusting in the nasal vestibule; 20 did not) and 25 control subjects. A microbiology swab was taken from the anterior nasal cavity of each child.

RESULTS

All groups were equally likely to have a positive culture. S aureus was more common in the epistaxis group (P = 0.008) compared with the control group. There was no difference in the prevalence of S aureus between crust and noncrust groups. Epistaxis patients were much less likely to have isolates of respiratory pathogens or a skin commensal.

CONCLUSION

Children with epistaxis are more likely to have nasal colonization with S aureus than controls. Our data would support the hypothesis that S aureus replaces existing nasal flora and causes inflammation and new vessel formation.
Chemical meningitis following cerebellopontine angle tumor surgery
Authors: Sanchez Gabriela B. , Kaylie David M. , O'Malley Matthew R. , Labadie Robert F. , Jackson C. Gary , Haynes David S.
Published: March 2008

OBJECTIVE

Postoperative chemical meningitis mimics bacterial meningitis, complicating the diagnosis until results of cerebrospinal fluid (CSF) cultures can be obtained. We analyzed clinical and laboratory data from a series of 1146 patients to identify findings that could exclude bacterial meningitis.

SUBJECTS AND METHODS

We reviewed the charts of patients who developed meningitis after cerebellopontine angle surgery. Lumbar puncture data from asymptomatic postoperative patients were our control.

STUDY DESIGN

Clinical symptoms, CSF profiles, and serum white blood cell (WBC) counts were compared between patients with chemical meningitis, bacterial meningitis, and asymptomatic patients.

RESULTS

The incidence of meningitis in our series of 1146 patients was 4.54 percent; 0.87 percent was culture‐proven bacterial meningitis. The patients with bacterial meningitis had significantly higher CSF and serum WBC counts, and lower CSF glucose. The major difference between asymptomatic patients and those with chemical meningitis was the significantly lower ratio of CSF WBCs to red blood cells (RBCs) in asymptomatic patients.

CONCLUSION

Patients with mild CSF leukocytosis and normal CSF glucose without high serum WBC counts or focal neurological deficits may be treated for chemical meningitis.
Pediatric obstructive sleep apnea and quality of life: A meta‐analysis
Authors: Baldassari Cristina M. , Mitchell Ronald B. , Schubert Christine , Rudnick Emily F.
Published: March 2008

OBJECTIVE

1) To assess the quality of life (QOL) in children with obstructive sleep apnea (OSA) compared with QOL of children with chronic medical conditions, and 2) To determine QOL in children with OSA after adenotonsillectomy in short‐ and long‐term follow‐up.

DATA SOURCES/REVIEW METHODS

A literature review on QOL in pediatric OSA using the PubMed database.

RESULTS

The literature search yielded 10 articles that satisfied inclusion and exclusion criteria. In three studies, the Child Health Questionnaire (CHQ) survey was used to compare 193 patients who had OSA with 93 children who had juvenile rheumatoid arthritis (JRA) and with 815 healthy children. Of 12 CHQ subscale scores for children with OSA, 8 scores were significantly lower (indicating a poorer QOL) than controls. Children with OSA scored 19.23 points lower than healthy children in the subscale of parental impact‐emotional. Children with OSA had QOL scores that were similar to those of children with JRA. In seven publications, 369 children with OSA undergoing adenotonsillectomy were studied by using the OSA‐18 QOL instrument. The total OSA‐18 score and each of the domain scores showed significant improvement (P < 0.0001) after adenotonsillectomy. At long‐term follow‐up, QOL scores remained significantly improved.

CONCLUSIONS

Pediatric OSA has a significant impact on QOL. QOL in pediatric OSA is similar to that of children with JRA. Large improvements in QOL occur after adenotonsillectomy, and these findings are maintained in the long‐term. The literature lacks control studies on QOL in pediatric OSA.
A randomized crossover trial of conservative snoring treatments: Mandibular repositioning splint and nasal CPAP
Authors: Robertson Stuart , Murray Maria , Young David , Pilley Richard , Dempster John
Published: March 2008

OBJECTIVE

To compare the effectiveness of a mandibular repositioning splint (MRS) and nasal continuous positive airway pressure (CPAP) device as first‐line treatments for disruptive snoring.

STUDY DESIGN

Prospective randomized crossover trial.

SUBJECTS AND METHODS

Twenty snorers received 3 months of treatment with both an MRS and nasal CPAP. Snoring Outcomes Survey (SOS), Snoring Bed Partner Survey, and Epworth questionnaires were completed serially. Changes in questionnaire scores were analyzed with a general linear statistical model and by analysis of variance.

RESULTS

There was a significant difference between the three preference outcomes for the mean SOS changes (P = 0.003). The mean SOS change was significantly greater for those who preferred MRS to CPAP (mean score difference, 27.15). Eight snorers chose final long‐term MRS treatment, five chose nasal CPAP, and seven chose neither.

CONCLUSION

The majority of disruptive snorers can be managed effectively with conservative treatments and therefore avoid surgery.
Comparative study of four radiofrequency generators for the treatment of snoring
Authors: Blumen Marc B. , Chalumeau Frédéric , Gauthier Anne , Bobin Serge , Coste André , Chabolle Frédéric
Published: March 2008

OBJECTIVE

To compare the efficacy and safety of four radio‐frequency generators (Ellman, Select Sutter, Coblator, Somnus) for the treatment of simple snoring.

MATERIALS AND METHODS

Multicenter, randomized, prospective single‐blind study on 120 selected patients with simple snoring (apnea/hypopnea index <10/h of sleep). Snoring sound intensity was measured on a visual analog scale and the partner's short‐term satisfaction rate was evaluated after two treatment sessions maximum. Discomfort, pain, and medication intake were compared.

RESULTS

Radiofrequency decreased the snoring sound intensity from 7.9 ± 1.7 to 4.4 ± 2.7 (P < 0.0001). The four radio‐frequency generators had a statistically comparable efficacy. The Ellman generator caused less discomfort and required less antiinflammatory drugs.

CONCLUSION

Despite different technical characteristics, the four generators had a comparable efficacy with good safety. The Ellman generator induced the least discomfort.
Acute bacterial rhinosinusitis and otitis media: Changes in pathogenicity following widespread use of pneumococcal conjugate vaccine
Authors: Benninger Michael S.
Published: March 2008

OBJECTIVE

Acute bacterial rhinosinusitis and acute otitis media are two of the most common respiratory tract infections. The common pathogenic bacteria associated with these infections are Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, and Staphylococcus aureus. With the recent widespread use of pneumococcal conjugate vaccine, there is evidence that there is a shift of both the pneumococcal serotypes and the distribution of pathogenic bacteria. The purpose of this article was to investigate whether the literature supports changes in pathogenicity of acute bacterial rhinosinusitis and otitis media after widespread use of conjugate pneumococcal vaccine.

DATA SOURCES

MEDLINE search of the literature was performed between 1995 and 2007.

REVIEW METHODS

Literature review of changes in distribution of pathogens, resistance rates, and pneumococcal serotype changes before and after widespread use of conjugate pneumococcal vaccine.

RESULTS

There is evidence that the distribution of pneumococcal serotypes has changed after the widespread use of conjugate pneumococcal vaccine. There appears to be both less invasive and noninvasive pneumococcal disease and with childhood immunization there also appears to be a protective effect on adults (herd immunity). Increases in nonvaccine serotypes, some with high levels of resistance are being identified in some communities. There is also growing evidence that there may be an increasing prevalence of Haemophilus influenzae in these infections.

CONCLUSIONS

Widespread use of conjugate pneumococcal vaccine has led to decreasing incidence of pneumococcal otitis media and likely also acute bacterial rhinosinusitis, which may have implications for treatment recommendations for these infections.
Prospective analysis of epicutaneous testing for inhalant allergy: Comparison of arm and back subsites with mRAST
Authors: Batra Pete S. , Yappel‐Sinkko Kathy , Bena James , Leong Jern‐Lin , Citardi Martin J. , Lanza Donald C.
Published: March 2008

OBJECTIVES

1) To compare epicutaneous testing (ET) from four skin subsites (forearm, upper arm, upper back, lower back) and 2) to compare ET to modified RAST (mRAST) for inhalant allergens.

STUDY DESIGN

Prospective clinical trial.

SUBJECTS AND METHODS

Fifty one patients underwent ET at four skin subsites and mRAST to six antigens and positive and negative controls.

RESULTS

The forearm and upper back showed best sensitivity to positive controls and all subsites demonstrated similar specificity to negative controls. The forearm and upper back demonstrated best sensitivity and specificity for most antigens. No statistically significant differences were noted for antigen sensitivity and specificity for the four subsites. ET and mRAST agreed best on D. farinae and timothy grass and least on short ragweed and dog epithelium.

CONCLUSION

This study confirms that forearm and upper back demonstrate very good sensitivity and specificity for positive and negative controls and most tested antigens. This has important diagnostic implications for clinical practice of inhalant allergy.
Effect of topical ciprofloxacin/dexamethasone or dexamethasone alone on acute Streptococcus pneumoniae rhinosinusitis in mice
Authors: Sahin‐Yilmaz Asli , Baroody Fuad , Markaryan Adam , Thompson Kenneth , Wall G. Michael , Naclerio Robert
Published: March 2008

OBJECTIVE

To test whether intranasal ciprofloxacin/dexamethasone or dexamethasone alone affects the course of acute bacterial rhinosinusitis in mice.

STUDY DESIGN

We performed a randomized, double‐blind, parallel, placebo‐controlled study in mice.

SUBJECTS AND METHODS

Three groups of 10 C57B1/6 mice were infected with Streptococcus pneumoniae, and then 1 day later randomized to treatment with placebo, ciprofloxacin plus dexamethasone, or dexamethasone. The mice were killed 3 or 10 days after treatment was begun.

RESULTS

The placebo‐treated mice became infected and developed an inflammatory cell infiltration in their sinuses. None of the treatments significantly affected the course of the illness.

CONCLUSION

The lack of topical, intranasal efficacy of ciprofloxacin and dexamethasone could be attributed to subpotent dosage, rapid nasal clearance, or inability of the drops to reach the site of infection. Treatment with dexamethasone neither improved nor worsened the bacterial infection.
Characteristics and outcomes of malpractice claims after tonsillectomy
Authors: Morris Luc G.T. , Lieberman Seth M. , Reitzen Shari D. , Edelstein David R. , Ziff David J.S. , Katz Alvin , Komisar Arnold
Published: March 2008

OBJECTIVE

To characterize the background and outcomes of tonsillectomy malpractice claims.

METHODS

Review of 69 New York State insurance claims (Part I) and 87 national court trials (Part II) alleging injury after tonsillectomy.

RESULTS

Part I. New York State insurance cases were most commonly discontinued (44%) or settled (42%) before trial. Compensations with a settlement or verdict were made in 48 percent of cases. Part II. Death or major injury occurred in 52 percent of insurance cases, with a mean award of $403,656 being made to plaintiffs. Of cases reaching trial, 60 percent of plaintiffs were compensated. Awards against anesthesiologists were more frequent and higher than against surgeons ($5 million vs $839,650). Death or major injury occurred in 52 percent of court cases, resulting in mean indemnity of $3.8 million. Most cases of death or major injury were attributable to airway complications.

CONCLUSIONS

Approximately half of both New York state claims and court cases involved death or devastating morbidity, mostly related to airway complications, resulting in large awards. Tonsillectomy is a source of uncommon but potentially high‐dollar—value litigation exposure to the surgeon, often attributable to non‐surgical complications.
Survival outcomes for head and neck squamous cell carcinoma arising after lymphoma
Authors: Moore Michael G. , Bhattacharyya Neil
Published: March 2008

OBJECTIVE

Determine onset and survival of head and neck squamous cell carcinoma (HNSCC) after lymphoma.

STUDY DESIGN

Case‐control.

METHODS

Cases of HNSCC occurring as a second primary malignancy after prior diagnosis of lymphoma were extracted from the Surveillance, Epidemiology and End Results database. Survivals were compared with age‐ and stage‐matched control cases of HNSCC.

RESULTS

A total of 333 cases of HNSCC after lymphoma (53 Hodgkin's and 280 non‐Hodgkin's lymphomas) were identified as occurring on average 70.7 months after lymphoma. Post‐lymphoma HNSCC cases exhibited poorer mean (median) Kaplan‐Meier overall survival of 57.0 months (29.0 months) vs 84.2 months (42.0 months) for controls (P = 0.008). However, after exclusion of lymphoma‐related deaths, post‐lymphoma HNSCC survival improved to 63.9 (86.3) months (P = 0.191). HNSCC occurring after Hodgkin's disease exhibited better mean survival (92.5 months) than extranodal non‐Hodgkin's (43.5 months) and nodal non‐Hodgkin's (50.7 months) disease (P = 0.049).

CONCLUSIONS

Patients with HNSCC with prior lymphoma, especially non‐Hodgkin's lymphoma, exhibit poorer survival than first primary HNSCC cases.
Changes in listening habits and quality of musical sound after cochlear implantation
Authors: Lassaletta Luis , Castro Alejandro , Bastarrica Marta , Pérez‐Mora Rosa , Herrán Belén , Sanz Lorena , de Sarriá M. Josefa , Gavilán Javier
Published: March 2008

OBJECTIVE

To evaluate listening habits and quality of musical sound after cochlear implantation.

STUDY DESIGN

A total of 89 consecutive, adult, postlingually deafened, cochlear implant recipients entered the study. Music questionnaire included questions about musical background, listening habits, and quality of musical sound through cochlear implants. Music perception was evaluated with the Primary Measures of Music Audiation (PMMA). The questionnaire and the PMMA were administered to 67 and 65 patients, respectively.

RESULTS

Listening habits significantly decreased postimplantation. The mean score (0–100) for the adjective pairs “like—dislike,” “sounds like music—doesn't sound like music,” “natural—mechanical,” and “easy to follow—difficult to follow” was 60, 59, 50, and 40, respectively. The adjective pairs were associated with music enjoyment. Mean PMMA scores were 71 and 78 percent for tone and rhythm, respectively, with no association with music enjoyment.

CONCLUSION

Music perception through a cochlear implant is a complex phenomenon that depends on audiological and non‐audiological factors.
Intranasal Aspergillus fumigatus exposure induces eosinophilic inflammation and olfactory sensory neuron cell death in mice
Authors: Epstein Victoria A. , Bryce Paul J. , Conley David B. , Kern Robert C. , Robinson Alan M.
Published: March 2008

OBJECTIVE

To determine the effects of eosinophilic inflammation on olfactory sensory neuron cell death.

STUDY DESIGN

Mice were sensitized to intranasal Aspergillus fumigatus extract and subsequently challenged acutely or chronically with the same allergen. The olfactory neuroepithelium was assessed for immunohistochemical evidence of apoptosis and inflammation.

RESULTS

Sensitized mice challenged with allergen demonstrated elevated eosinophil infiltration of the respiratory and olfactory mucosae, with olfactory sensory neuron apoptosis. Remarkably, massive neuronal apoptosis without eosinophil infiltration occurred in nonsensitized mice after a single dose of extract.

CONCLUSION

Intranasal sensitization with A fumigatus results in a model with multifactorial effects. Protocols using A fumigatus to induce allergic rhinitis may need modification to allow confident interpretation.

SIGNIFICANCE

Fungal allergens may contribute to anosmia through the induction of olfactory sensory neuron apoptosis, with and without prior sensitization.
Atypical mycobacterial infection of the head and neck in children: A 5‐year retrospective review
Authors: Fraser Lyndsay , Moore Phillip , Kubba Haytham
Published: March 2008

OBJECTIVE

We review the management of 31 cases of atypical mycobacterial lymphadenitis presenting to a tertiary referral pediatric otolaryngology department between February 2002 and February 2007.

STUDY DESIGN

Retrospective case review.

SUBJECTS AND METHODS

Cases were identified by using the hospital's correspondence and pathology databases. Demographic and clinical information was collected. Descriptive and nonparametric inferential statistics (SPSS; SPSS Inc, Chicago, IL) were calculated.

RESULTS

Four patients were treated conservatively with triple‐therapy antibiotics. Twenty‐seven underwent surgical excision plus 3 months of clarithromycin postoperatively. Thirteen percent developed nodal recurrence; this appeared to be unrelated to the operation performed (χ8 2 = 5.8, P = 0.69) or the management modality used (P = 0.35). Patients with previous surgery were more likely to have recurrent infection (χ2 2 = 9.3, P = 0.01).

CONCLUSIONS

In our experience, nodal excision plus postoperative clarithromycin remains the best treatment option for most children, although those with limited disease may benefit from combination antibiotic therapy. Previous incision and drainage leads to high recurrence rates after later excision and therefore, heightened awareness of these infections is essential to ensure appropriate early management.
Clinical features and treatment of retropharyngeal abscess in children
Authors: Page Nathan C. , Bauer Erik M. , Lieu Judith E.C.
Published: March 2008

OBJECTIVE

To characterize presentation, treatment, and outcomes of pediatric retropharyngeal abscess (RPA) and determine optimal treatment.

STUDY DESIGN

Retrospective cohort.

SUBJECTS AND METHODS

Chart review of 162 pediatric patients with RPA.

RESULTS

Initial treatment was surgery in 126 and intravenous antibiotics in 36, of which 17 required surgery. Findings were negative in 30, murky fluid in 34, and pus in 79. Factors predicting positive surgical drainage were duration of symptoms for more than 2 days, prior antibiotic treatment, and CT lesion cross‐sectional area >2.0 cm2. A history of rash was a negative predictor. The mean length of stay (LOS) was 4.8 vs 3.6 days (P = 0.14), and duration of fever (DOF) was 2.5 vs 1.4 days (P = 0.01) for patients with no fluid and fluid at surgery, respectively. For antibiotic vs surgery groups, LOS was 4.4 vs 3.6 days (P = 0.14) and DOF was 2.4 versus 1.5 days (P = 0.0061).

CONCLUSIONS

These predictive factors may be useful in selecting patients with retropharyngeal abscesses who might be treated with intravenous antibiotics alone.
Minimally invasive parathyroidectomy using local anesthesia with intravenous sedation and targeted approaches
Authors: Shindo Maisie L. , Rosenthal Joshua M. , Lee Thomas
Published: March 2008

OBJECTIVES

Minimally invasive parathyroidectomy (MIP) is generally performed under general anesthesia. This study evaluates the efficacy and safety of MIP performed under intravenous sedation with local anesthesia.

STUDY DESIGN

Historical cohort study.

SUBJECTS

One hundred eighty‐six consecutive patients undergoing MIP using sedation with local anesthesia.

METHODS

Two different targeted approaches were used to achieve good exposure with minimal retraction, which allows the procedure to be performed with little discomfort. In all patients, an adenoma was localized preoperatively and its depth mapped by sestamibi scan with single‐photon emission computed tomography and/or ultrasound. A midline anterior approach was used for inferior glands that were superficially located. A lateral approach was used for glands that were located posteriorly or superiorly.

RESULTS

MIP was successfully completed under local/sedation in 177 patients; 167 were discharged the same day. Complications include two pneumothorax, one small hematoma, and one transient vocal cord paralysis.

CONCLUSIONS

By using a targeted approach, MIP can be safely performed under local anesthesia in appropriately selected patients.