bluuebunny/crossref_metadata_2025 huggingface dataset:
Minimally invasive video‐assisted total thyroidectomy: An easy to learn technique for skillful surgeons
Authors: Papavramidis Theodossis S. , Michalopoulos Nick , Pliakos John , Triantafillopoulou Konstantina , Sapalidis Konstantinos , Deligiannidis Nikolaos , Kesisoglou Isaak , Ntokmetzioglou Ioannis , Papavramidis Spiros T.
Published: January 2010

Background

Minimally invasive video‐assisted total thyroidectomy (MIVATT) is a treating option for small thyroids that demands skills required for both traditional thyroidectomy and endoscopic surgery. This prospective study aims to define the learning curve for MIVATT for residents, with experience in traditional thyroid and laparoscopic surgery.

Methods

In all, 36 MIVATTs for benign disease were evenly divided among 4 residents. We recorded and analyzed: age, sex, pathology, thyroid weight, duration of the operation, ΔCa (postoperative minus preoperative calcemia), ΔWBC (postoperative minus preoperative white blood cell count), vocal motility, operative difficulty, postoperative vocal alteration, postoperative pain, complications, gram of gland excised per minute of the operation, conversion, and hospitalization.

Results

Statistically significant differences were observed in the different learning points, between duration of surgery (p < .001), operative difficulty (p = .022), grams of gland excised per minute of operation (p < .001), and WBC (p = .011).

Conclusions

Surgeons that are experience in both thyroid and endoscopic surgery are subjects to a short learning curve concerning MIVATT. © 2010 Wiley Periodicals, Inc. Head Neck, 2010
Importance of intraoperative parathyroid hormone measurement in the diagnosis of parathyroid lipoadenoma
Authors: Lee Ann Y. , Wang Beverly Y. , Heller Keith S.
Published: January 2010

Background.

Parathyroid lipoadenoma is an uncommon tumor that may be difficult to diagnose on intraoperative frozen section. Intraoperative parathyroid hormone (PTH) measurement is useful in assessing the adequacy of parathyroidectomy. This case demonstrates the value of intraoperative PTH measurement in recognizing a parathyroid lipoadenoma.

Methods and Results.

A case of a 62‐year‐old woman with primary hyperparathyroidism in which intraoperative PTH measurement helped confirm the diagnosis of parathyroid lipoadenoma is presented.

Conclusions.

In patients with primary hyperparathyroidism, a significant decrease in intraoperative PTH confirms that an enlarged parathyroid with normal to low cellularity containing abundant fat is a lipoadenoma and that further exploration is not necessary. © 2010 Wiley Periodicals, Inc. Head Neck, 2011
New Guaipyridine Sesquiterpene Alkaloids from Artemisia rupestris L.
Authors: Su Zhen , Wu Han‐Kui , He Fei , Slukhan Usmanova , Aisa Haji Akber
Published: January 2010

Three new guaipyridine sesquiterpene alkaloids, rupestine A, B, C (1–3, resp.), and the new nor‐sesquiterpne alkaloid rupestine D (4) were obtained from the flowers of Artemisia rupestris L. Their structures were elucidated on the basis of sepectroscopic data and by comparison with those of the related compounds reported in the literature. In addition, the absolute configurations of 2 and 4 were determined by single‐crystal X‐ray diffraction analyses.
Phytoquinoids and Secoprezizaane‐Type Sesquiterpenes from Illicium arborescens
Authors: Chang Jiun‐Yang , Abd El‐Razek Mohamed H. , Chen Yu‐Hui , Cheng Yuan‐Bin , Chen Shun‐Ying , Chien Ching‐Te , Kuo Yao‐Haur , Shen Ya‐Ching
Published: January 2010

A phytochemical investigation of the MeOH extract of Illicium arborescens yielded the two new phytoquinoid epimers, 2,3‐didehydro‐5‐O‐methyl‐11‐epiillifunone E (1) and 2,3‐didehydro‐5‐O‐methylillifunone E (2), as well as five new sesquiterpene lactones (8,9‐secoprezizaane‐type sesquiterpenes). Two of them, i.e., 3 and 4, were minwanensin‐type sesquiterpenes, the other two, i.e., 5 and 6, had the anisatin‐type (or floridanolide type) skeleton, and the fifth, i.e., 7, was a dunnianin‐type sesquiterpene. Their structures were established by analyses of 1D‐ and 2D‐NMR, HR‐MS, and chemical evidence. The in vitro cytotoxic activity of compounds 1–7 was tested against four human tumor cell lines, including HeLa (cervical epitheloid), WiDr (colon), Daoy (medulloblastoma), and Hep2 (liver carcinoma) human‐tumor cells.
Transcription factor co‐repressors in cancer biology: roles and targeting
Authors: Battaglia Sebastiano , Maguire Orla , Campbell Moray J.
Published: January 2010

Normal transcription displays a high degree of flexibility over the choice, timing and magnitude of mRNA expression levels that tend to oscillate and cycle. These processes allow for combinatorial actions, feedback control and fine‐tuning. A central role has emerged for the transcriptional co‐repressor proteins such as NCOR1, NCOR2/SMRT, CoREST and CTBPs, to control the actions of many transcriptional factors, in large part, by recruitment and activation of a range of chromatin remodeling enzymes. Thus, co‐repressors and chromatin remodeling factors are recruited to transcription factors at specific promoter/enhancer regions and execute changes in the chromatin structure. The specificity of this recruitment is controlled in a spatial‐temporal manner. By playing a central role in transcriptional control, as they move and target transcription factors, co‐repressors act as a key driver in the epigenetic economy of the nucleus. Co‐repressor functions are selectively distorted in malignancy, by both loss and gain of function and contribute to the generation of transcriptional rigidity. Features of transcriptional rigidity apparent in cancer cells include the distorted signaling of nuclear receptors and the WNTs/β‐catenin axis. Understanding and predicting the consequences of altered co‐repressor expression patterns in cancer cells has diagnostic and prognostic significance, and also have the capacity to be targeted through selective epigenetic therapies.
Culture human mesenchymal stem cells with calcium phosphate cement scaffolds for bone repair
Authors: Weir Michael D. , Xu Hockin H. K.
Published: January 2010

Because of its moldability and excellent osteoconductivity, calcium phosphate cement (CPC) is highly promising for craniofacial and orthopedic applications. The objectives of this study were to investigate the response of human mesenchymal stem cells (hMSCs) to a high‐strength CPC‐chitosan scaffold and to examine cell proliferation and osteogenic differentiation. hMSCs were seeded onto CPC‐chitosan composite, CPC control, and tissue culture polystyrene (TCPS). Alkaline phosphatase activity (ALP) and mineralization of hMSCs were measured. CPC‐chitosan had a flexural strength (mean ± SD; n = 5) of (19.5 ± 1.4) MPa, higher than (8.0 ± 1.4) MPa of CPC control (p < 0.05). The percentage of live hMSCs on CPC‐chitosan was (90.5 ± 1.3)% at 8 days, matching (90.7 ± 3.8)% of CPC control (p > 0.1). The CPC‐chitosan surface area covered by the attached hMSCs increased from (51 ± 11)% at 1 day to (90 ± 4)% at 8 days (p < 0.05), matching those of CPC control (p > 0.1). Hence, the CPC strength was significantly increased via chitosan without compromising the hMSC response. At 8 days, there was a significant increase in ALP of cells in osteogenic media (10.99 ± 0.93) [(mM pNpp/min)/(μg DNA)] versus control media (3.62 ± 0.40) (p < 0.05). hMSCs in osteogenic media exhibited greater mineralization area of (47.5 ± 19.7)% compared with (6.1 ± 2.3)% in control medium on TCPS (p < 0.05). In conclusion, hMSCs showed excellent attachment and viability on the strong and tough CPC‐chitosan scaffold, matching the hMSC response on CPC control. hMSCs were successfully differentiated down the osteogenic lineage. Hence, the strong, in situ hardening CPC‐chitosan scaffold may be useful as a moderate load‐bearing vehicle to deliver hMSCs for maxillofacial and orthopedic bone tissue engineering. © 2010 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2010
Transcriptional regulation of human FE65, a ligand of Alzheimer's disease amyloid precursor protein, by Sp1
Authors: Yu Hoi‐Tin , Chan William Wai‐Lun , Chai Ka‐Ho , Lee Chris Wing‐Cheung , Chang Raymond Chuen‐Chung , Yu Man‐Shan , McLoughlin Declan M. , Miller Christopher C.J. , Lau Kwok‐Fai
Published: January 2010

FE65 is a neuronal‐enriched adaptor protein that binds to the Alzheimer's disease amyloid precursor protein (APP). FE65 forms a transcriptionally active complex with the APP intracellular domain (AICD). The precise gene targets for this complex are unclear but several Alzheimer's disease‐linked genes have been proposed. Additionally, evidence suggests that FE65 influences APP metabolism. The mechanism by which FE65 expression is regulated is as yet unknown. To gain insight into the regulatory mechanism, we cloned a 1.6 kb fragment upstream of the human FE65 gene and found that it possesses particularly strong promoter activity in neurones. To delineate essential regions in the human FE65 promoter, a series of deletion mutants were generated. The minimal FE65 promoter was located between −100 and +5, which contains a functional Sp1 site. Overexpression of the transcription factor Sp1 potentiates the FE65 promoter activity. Conversely, suppression of the FE65 promoter was observed in cells either treated with an Sp1 inhibitor or in which Sp1 was knocked down. Furthermore, reduced levels of Sp1 resulted in downregulation of endogenous FE65 mRNA and protein. These findings reveal that Sp1 plays a crucial role in transcriptional control of the human FE65 gene. J. Cell. Biochem. 109: 782–793, 2010. © 2010 Wiley‐Liss, Inc.
Effect of polyethylene oxide–polyethylene glycol content and humidity on performance of electro‐active paper actuators based on cellulose/polyethylene oxide–polyethylene glycol microcomposite
Authors: Mahadeva Suresha K. , Kim Jaehwan
Published: January 2010

The effect of humidity and polyethylene oxide (PEO)–polyethylene glycol (PEG) content on the actuator performance of cellulose/PEO–PEG microcomposites was studied. Upon blending 5% PEO–PEG, the maximum bending displacement of the actuator increased nearly twice compared to that of cellulose EAPap actuator. However, further increase of PEO–PEG content resulted in decreased actuator performance. This might be due to the increased intermolecular interaction by hydrogen bonding that reduces the mobility of the molecules. The actuator performance test showed that the increase in humidity level rather reduced the maximum displacement of the actuators. X‐ray diffractogram and Fourier transform infrared spectrum analysis suggested a structural change of the microcomposites as well as disruption of cellulose/PEO–PEG association attributed to the actuator performance degradation at high humidity level. POLYM. ENG. SCI., 2010. © 2010 Society of Plastics Engineers
Helix‐sheet packing in proteins
Authors: Hu Chengcheng , Koehl Patrice
Published: January 2010

The three‐dimensional structure of a protein is organized around the packing of its secondary structure elements. Although much is known about the packing geometry observed between α‐helices and between β‐sheets, there has been little progress on characterizing helix–sheet interactions. We present an analysis of the conformation of αβ2 motifs in proteins, corresponding to all occurrences of helices in contact with two strands that are hydrogen bonded. The geometry of the αβ2 motif is characterized by the azimuthal angle θ between the helix axis and an average vector representing the two strands, the elevation angle ψ between the helix axis and the plane containing the two strands, and the distance D between the helix and the strands. We observe that the helix tends to align to the two strands, with a preference for an antiparallel orientation if the two strands are parallel; this preference is diminished for other topologies of the β‐sheet. Side‐chain packing at the interface between the helix and the strands is mostly hydrophobic, with a preference for aliphatic amino acids in the strand and aromatic amino acids in the helix. From the knowledge of the geometry and amino acid propensities of αβ2 motifs in proteins, we have derived different statistical potentials that are shown to be efficient in picking native‐like conformations among a set of non‐native conformations in well‐known decoy datasets. The information on the geometry of αβ2 motifs as well as the related statistical potentials have applications in the field of protein structure prediction. Proteins 2010. © 2010 Wiley‐Liss, Inc.
Effect of acid‐based chemical polish etching on the performance of silicon heterojunction solar cells
Authors: Zhang Yu , Zhou Yuqin , Jiang Zhenyu , Liu Fengzhen , Zhu Meifang
Published: January 2010

An acid‐based chemical polish (CP) was introduced to deal with the c‐Si wafer textured by an alkaline solution. With prolonging the CP etching time (tCP), the average angle of pyramid peak (ϕ) is monotonously increased. It can be well explained by mass‐transfer etching theory. The reduction of the surface roughness and the increasing of ϕ by CP etching improve the coverage and contact between the thin film and the substrate. The effect of CP on the cell's performance was investigated. The CP etching reduces the series resistance (Rs) and enhances the fill factor (FF). The average reflectivity of substrate increases with tCP and reaches to the maximal value of about 13.0% at tCP = 120 s. A long CP etching time shows a negative effect on the short‐circuit current density (Jsc). The micro‐region chemical analysis shows that, with increasing tCP, the Na+ content of substrate decreases effectively. The minority carrier lifetime of the textured substrate and the cell's open‐circuit voltage (Voc) increase with increasing tCP. The above results indicate that adding the acid‐based CP etching to the textured Si wafer is benefited to the performance of salor cells (© 2010 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)
Polycrystalline silicon thin films on glass obtained by nickel‐induced crystallization of amorphous silicon
Authors: Schmidt J. A. , Budini N. , Arce R. D. , Buitrago R. H.
Published: January 2010

In this work, we use the nickel‐induced crystallization process to crystallize a‐Si:H thin films at temperatures compatible with the utilization of glass substrates. Hydrogenated amorphous silicon films are deposited on planar float glass (Schott AF37) by plasma‐enhanced chemical vapour deposition. The films, between 400 and 1400 nm thick, are grown intrinsic, slightly p‐doped (p‐) or with a combined structure of heavily p‐doped / slightly p‐doped (p+/p‐) layers. On these films we sputter nickel with concentrations between 2.5×1014 and 3×1015 at./cm2, and then we anneal the samples in a standard nitrogen‐purged tube furnace. The process evolves through the formation of the nickel silicide NiSi2, which has a lattice constant very similar to that of c‐Si and acts as a nucleation centre. As a result of this thermal treatment we obtain thin polycrystalline films with a grain size over 100 μm. The high crystallinity of the samples is confirmed through optical and electron microscopy observations, X‐rays diffraction and Raman spectroscopy. (© 2010 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)
Psychological and symptomatic stress‐related disorders with radio‐electric treatment: psychometric evaluation
Authors: Rinaldi Salvatore , Fontani Vania , Aravagli Lucia , Margotti Matteo Lotti
Published: January 2010

The purpose of this study was the evaluation of the effectiveness in the improvement of the psychic and symptomatic stress‐related disorders by means of radio‐electric stimulation on some auricular reflex points with a device named the radio‐electric asymmetric conveyer (REAC). This study was conducted on 124 subjects with psychological distress symptoms that were assessed by the Symptomatic Check List‐90 (SCL‐90) pre‐ and post‐intervention. After randomization, two groups were created: a group treated with effective REAC and a group that underwent the same treatment with disarmed REAC (the placebo group). There was a significant reduction in SCL‐90 scores in the treated group compared with the placebo group. The results of the psychometric tests showed that the subjects who underwent effective therapy showed a statistically significant (p < 0.05) reduction in their level of stress and psychological disorders compared with the control group. The reduction of the levels of perceived stress and the reduction of the psychic and symptomatic stress‐related disorders assessed by SCL‐90 tests, obtained after one cycle of reflex auricular protocol REAC treatment, showed that this treatment can be useful in the cure of psychological stress‐related symptoms. Copyright © 2009 John Wiley & Sons, Ltd.
Physical self‐concept and social physique anxiety: invariance across culture, gender and age
Authors: Hagger Martin S. , Stevenson Andy , Chatzisarantis Nikos L. D. , Gaspar Pedro Miguel Pereira , Ferreira José Pedro Leitão , Ravé José María González
Published: January 2010

This study examined the effects of culture, gender and age on the structure and mean levels of physical self‐concept (PSC) and social physique anxiety (SPA) in adolescents from Portugal and Spain. An additional aim was to examine the effects of these variables on the PSC‐SPA correlation. Adolescents (N = 3528, age range 12–18 years) completed the social physique anxiety scale and physical self‐worth scale from the physical self‐perception profile. Single‐ and multi‐sample confirmatory factor analyses supported a two‐factor model of PSC and SPA in the overall sample and within and across the culture, gender and age subsamples. Latent means analyses indicated that females tended to have significantly higher average SPA levels and lower PSC levels relative to males. There was a general downward trend in PSC in males and females in each cultural group. SPA was relatively consistent in females and higher than males in most groups. SPA was relatively similar in males and females in younger age groups (born 1994–1996), but declined in older males. SPA was similar in Portuguese males and females in the youngest age group (born 1996), but males tended to have lower scores in older age groups. Results generally support hypotheses and are discussed relative to self‐presentation models and coping with appearance‐related stress. Copyright © 2010 John Wiley & Sons, Ltd.
Culture‐general and ‐specific associations of attachment avoidance and anxiety with perceived parental warmth and psychological control among Turk and Belgian adolescents☆
Authors: Güngör Derya , Bornstein Marc H.
Published: January 2010

Both the adolescent peer attachment and perceived parenting style literatures emphasize the role of the quality of the parent–child relationship in children's healthy adjustment beyond the family, but few studies have investigated links between adolescents' peer attachment and perceptions of parenting. We investigate relations of adolescents' perceptions of warmth and psychological control from parents with avoidance and anxiety in attachment to close friends in two contrasting cultures. Altogether, 262 Turk and 263 Belgian youth between 14 and 18 years of age participated. Cross‐culturally, attachment avoidance was negatively related to maternal warmth, and attachment anxiety positively related to maternal and paternal control and negatively to paternal warmth. Beyond these general relations, attachment avoidance was associated with paternal psychological control in Belgians but not in Turks. The study provides cross‐cultural evidence for specific relations between peer attachment and perceived parenting and suggests a culture‐specific pathway for the development of attachment avoidance.
Engagement in adolescent career preparation: Social support, personality and the development of choice decidedness and congruence
Authors: Hirschi Andreas , Niles Spencer G. , Akos Patrick
Published: January 2010

This longitudinal panel study investigated predictors and outcomes of active engagement in career preparation among 349 Swiss adolescents from the beginning to the end of eighth grade. Latent variable structural equation modeling was applied. The results showed that engagement in terms of self‐ and environmental‐exploration and active career planning related positively to interindividual increases in career decidedness and choice congruence. More perceived social support, early goal decidedness, and particular personality traits predicted more engagement. Support and personality impacted outcomes only mediated through engagement. Early decidedness and congruence were significant predictors of their respective later levels. Implications for practice are presented.
The cartography of pain: The evolving contribution of pain maps
Authors: Schott Geoffrey D.
Published: January 2010

Pain maps are nowadays widely used in clinical practice. This article aims to critically review the fundamental principles that underlie the mapping of pain, to analyse the evolving iconography of pain maps and their sometimes straightforward and sometimes contentious nature when used in the clinic, and to draw attention to some more recent developments in mapping pain. It is concluded that these maps are intriguing and evolving cartographic tools which can be used for depicting not only the spatial features but also the interpretative or perceptual components and accompaniments of pain.
Use of a redox‐sensing GFP (c‐roGFP1) for real‐time monitoring of cytosol redox status in Arabidopsis thaliana water‐stressed plants
Authors: Jubany-Mari T. , Alegre-Batlle L. , Jiang K. , Feldman L.J.
Published: January 2010

Using Arabidopsis plants transformed with a redox‐sensing green fluorescent protein targeted to the cytosol (c‐roGFP1), we have demonstrated, in real time, measurements of reversible changes of redox status in the cytosol of plants subjected to a gradual water‐stress, followed by re‐watering. Plants sensed water stress, and changed the redox potential of their cytosol to a more oxidized value after a gradually‐imposed water stress. Small variations in the cytosol redox potential and ascorbate (AA) values suggest that this parameter was tightly regulated. The re‐watering was paralleled by a return of water stress, redox potential and ascorbate to initial values, showing the reversibility of water stress and its consequences.
Influence of the hepatitis C virus 3′‐untranslated region on IRES‐dependent and cap‐dependent translation initiation
Authors: Bung C. , Bochkaeva Z. , Terenin I. , Zinovkin R. , Shatsky I.N. , Niepmann M.
Published: January 2010

Translation of hepatitis C virus (HCV) genomic RNA is directed by an internal ribosome entry site (IRES) in the 5′‐untranslated region (5′‐UTR), and the HCV 3′‐UTR enhances IRES activity. Since the HCV 3′‐UTR has a unique structure among 3′‐UTRs, we checked possible communication between the 5′‐ and the 3′‐UTR of HCV during translation using chimeric reporter RNAs. We show that translation directed by the HCV IRES and by the HCV‐like IRES of porcine teschovirus (PTV) which belongs to a quite distinct family of viruses (picornaviruses) or by the EMCV IRES is also enhanced by the HCV 3′‐UTR or by a poly(A)‐tail in different cell types.
Magnetic resonance imaging of guinea pig cochlea after vasopressin‐induced or surgically induced endolymphatic hydrops
Authors: Marshall Allen F. , Jewells Valerie L. , Kranz Peter , Lee Yeuh Z. , Lin Weili , Zdanski Carlton J.
Published: January 2010

Objective

To investigate the ability to detect the in vivo cochlear changes associated with vasopressin‐induced and surgically induced endolymphatic hydrops using MRI at 3 tesla (T).

Study Design

Prospective, animal model.

Setting

Animal laboratory.

Subjects and Methods

In group 1, five guinea pigs underwent post–gadolinium temporal bone MRI before and after seven and 14 days of chronic systemic administration of vasopressin by osmotic pump. In group 2, five guinea pigs underwent temporal bone MRI eight weeks after unilateral surgical ablation of the endolymphatic sac. Three‐tesla high‐resolution T1‐weighted sequences were acquired pre‐ and postcontrast administration. Region of interest signal intensities of the perilymph and endolymph were analyzed manually. Quantitative evaluation of hydrops was measured histologically.

Results

Gadolinium preferentially concentrated in the perilymph, allowing for distinction of cochlear compartments on 3.0‐T MRI. The T1‐weighted contrast MRI of vasopressin‐induced hydropic cochlea showed significant increases in signal intensity of the endolymph and perilymph. Surgically induced unilateral hydropic cochlea also showed increased signal intensity, compared with the control cochlea of the same animal, but less of an increase than the vasopressin group. The histological degree of hydrops induced in the vasopressin group was comparable to previous studies.

Conclusions

In vivo postcontrast MRI of the inner ear demonstrated cochlear changes associated with chronic systemic administration of vasopressin and surgical ablation of the endolymphatic sac. Understanding the MRI appearance of endolymphatic hydrops induced by various methods contributes to the future use of MRI as a possible tool in the diagnosis and treatment of Ménière's disease.
Keratocystic odontogenic tumor associated with nevoid basal cell carcinoma syndrome: Similar behavior to sporadic type?
Authors: Figueroa Adriana , Correnti Maria , Avila Maira , Andea Aleodor , DeVilliers Patricia , Rivera Helen
Published: January 2010

Objective

The objective of this study was to analyze the expression of proliferative markers and p53 in keratocystic odontogenic tumor (KCOT) sporadic type and KCOT associated with nevoid basal cell carcinoma syndrome (NBCCS).

Study Design and Setting

We performed a cross‐sectional study. A total of 19 patients with KCOT were selected from the Oral Pathology Laboratory archives, Central University of Venezuela, from 1995 to 2005.

Subjects and Methods

Twelve cases corresponded to sporadic KCOT, and seven cases were associated with NBCCS. Immunohistochemical analysis for p53, proliferating cell nuclear antigen (PCNA), and Ki‐67 was performed in all 19 cases.

Results

Of the seven cases associated with NBCCS, six (86%) were positive for PCNA. From the 12 sporadic cases, nine (75%) were positive for PCNA. Only one case of sporadic KCOT showed Ki‐67 positivity. Five of 12 (42%) cases of sporadic KCOT were positive for p53, and only one (14%) case associated with NBCCS was positive for p53.

Conclusion

On the basis of the analysis of the expression of PCNA, Ki‐67, and p53, there appears to be no evidence to indicate higher aggressiveness in growth and infiltrative behavior in syndromic KCOT compared with the sporadic type. Therefore, surgical treatment may be approached in the same manner in KCOT sporadic and syndromic with the goal of minimizing recurrence.
Article Commentary: Practitioners need corporate compliance education: AAO–HNS survey results
Authors: Devaiah Anand , Jacobowitz Ofer , Siegel Gordy , Shah Udayan K.
Published: January 2010

The environment in which otolaryngologists coexist with device and drug development has become increasingly complex. There are broad implications for both the academic and the private practitioner, with neither group being more or less insulated than the other. From the medical, ethical, and resource‐oriented standpoints, otolaryngologists must consider this evolving area very carefully. A survey of the American Association of Otolaryngology–Head and Neck Surgery membership identified areas of education to improve the awareness and knowledge base of these complex considerations. In particular, knowledge of legal proceedings, Food and Drug Administration processes, relevant hospital resources, and conflict of interest considerations were areas in which the membership would benefit from further instruction.
Clinical course of arteriovenous malformations of the head and neck: A case series
Authors: Richter Gresham T. , Suen James Y.
Published: January 2010

Objective

To demonstrate, in a case series, the relentless growth of arteriovenous malformations (AVMs) of the head and neck and the importance of their vigilant management within the context of a modified staging system.

Study Design

Retrospective review.

Setting

Tertiary care institution, Vascular Anomalies Center.

Subjects and Methods

Subjects were patients with advanced AVMs presenting to our Vascular Anomalies Center. Medical records were examined for age at first diagnosis, disease course, prior treatments, age at presentation, management, therapeutic outcomes, stage of disease, and impact on quality of life. Early patient photographs were evaluated.

Results

Ten patients (ages 13‐46 yrs) with extensive cervicofacial AVMs were examined. Progressive growth, worsening symptoms, and graduated disease stage were universally experienced by each patient, as evident by serial photographs, over a course of many years. Each patient presented to our institution with massive lesions, bleeding, pain, and facial destruction. Prior embolization and/or surgery had been performed in all but one patient. Every patient had been previously told that their AVMs were incurable or that treatment options were exhausted. The patients were subsequently treated at our institution with surgical resection with or without preoperative embolization. Disease control, symptom improvement, and enhanced daily functioning were attained in each patient.

Conclusion

The natural course of AVMs is progressive, invasive, and destructive. Vigilant observation, early treatment, and radical therapy are necessary for AVMs of the head and neck.
Time of cochlear implant surgery in academic settings
Authors: Majdani Omid , Schuman Theodore A. , Haynes David S. , Dietrich Mary S. , Leinung Martin , Lenarz Thomas , Labadie Robert F.
Published: January 2010

Objective

Establish the time required to perform cochlear implantation (CI) in academic settings.

Study Design

Historical cohort study.

Setting

German and American academic centers.

Patients

A total of 2639 patients underwent CI (1997‐2007). We excluded patients receiving an experimental device or technique and those with abnormal cochlear anatomy or incomplete charts, leaving 2253 for analysis.

Intervention

Unilateral, bilateral, and revision CI with devices approved in the U.S. and Europe.

Main Outcome Measures

Mean surgical time (ST) and total operating room time (TORT).

Results

Mixed model analysis was used; estimated marginal means were calculated in minutes after adjusting for random effect of individual surgeon. There were no differences between unilateral (ST = 171, TORT = 245) and revision CI (ST = 160, TORT = 232), but bilateral procedures were longer (ST = 295, TORT = 377, P < 0.001). In unilateral surgeries, Cochlear Limited (CL) devices were implanted faster (ST = 165, TORT = 225) than Advanced Bionics (ABC) (ST = 183, P = 0.001; TORT = 240, P = 0.023) or MedEl (ST = 193, P < 0.001; TORT = 253, P = 0.002) devices. There were no differences for unilateral CI between ABC and MedEl devices. For revision CI, ABC devices (ST = 141, TORT = 219) were implanted faster than CL devices (ST = 181, P = 0.001; TORT = 266, P < 0.001). There were no differences by age group or between Germany and the U.S. ST and TORT were shorter for 575 CIs performed in the final two years of the study (unilateral CI: ST = 145, TORT = 209; bilateral CI: ST = 259, TORT = 330; revision CI: ST = 138, TORT = 205). For unilateral CI, ST and TORT decreased yearly (linear regression, P < 0.001) and inversely correlated with surgeon experience (linear regression, P < 0.01).

Conclusions

We report the time required to perform CI in academic settings—data that are vital for cost‐benefit analyses and assessing new CI techniques.
Clinical assessment of adenoidal obstruction based on the nasal obstruction index is no longer useful in children
Authors: Marchisio Paola , Torretta Sara , Capaccio Pasquale , Esposito Susanna , Dusi Elisa , Nazzari Erica , Bossi Anna , Pignataro Lorenzo , Principi Nicola
Published: January 2010

Objective

To evaluate the accuracy of clinical assessment of adenoidal obstruction based on a standardized score of the degree of mouth breathing and speech hyponasality (nasal obstruction index [NOI]) in comparison to nasal fiberoptic endoscopy.

Study Design

Cross‐sectional study with planned data collection.

Setting

Outpatient clinics of the Departments of Maternal and Pediatric Sciences and Specialized Surgical Sciences, University of Milan, Italy.

Subjects and Methods

Children aged three to 12 years with adenoidal obstruction suspected on the grounds of persistent/recurrent otitis media or perceived obstructive nasal breathing were eligible. Ear, nose, and throat examination, allergy testing, NOI measurement, and nasal fiberoptic endoscopy to assess the degree of adenoidal hypertrophy were performed. Agreement between the NOI and adenoidal hypertrophy grade was assessed in the patients as a whole and by clinical subgroups.

Results

A total of 202 children were enrolled: 54.9 percent had otological diseases and 45.1 percent had perceived obstructive nasal breathing. Most of the children (79.2%) showed mild or moderate clinical nasal obstruction. Adenoidal hypertrophy ranged from no obstruction (18%) to severe obstruction (38%). There was no substantial agreement between the NOI and the degree of adenoidal obstruction in the population as a whole and in all the clinical subgroups. False positive findings were significantly more frequent among allergic children (50%) than non‐allergic children (22.4%, P = 0.009).

Conclusion

Clinical assessment based on the NOI is incapable of accurately predicting the degree of adenoidal obstruction. In children with clinical nasal obstruction not explainable by adenoidal size, the clinician should consider, among causes of more anterior obstruction, nasal allergy.
Influence of head rotation on upper esophageal sphincter pressure evaluated by high‐resolution manometry system
Authors: Takasaki Kenji , Umeki Hiroshi , Kumagami Hidetaka , Takahashi Haruo
Published: January 2010

Objectives

This study aimed to quantify the effects of head rotation on upper esophageal sphincter (UES) pressure in healthy subjects using a novel high‐resolution manometry (HRM) system.

Study Design

Prospective study.

Setting

Nagasaki University Hospital.

Subjects and Methods

Eighteen asymptomatic Japanese male adult volunteers were studied. A solid‐state HRM was positioned to record resting UES pressure. After endoscopically confirming on which side of the pyriform sinus the manometric sensor was positioned within the hypopharynx, we measured the maximum and mean values of the resting UES pressure and the length of the zone of the UES along the esophagus with the patients in the following positions: 1) neutral and straightforward head position (NSF), 2) turning the head in the direction of the side in which the sensor was positioned (HSS), and 3) turning the head in the opposite direction of the side with sensor (HOS).

Results

The maximum and mean values of the resting UES pressure were statistically higher in HSS than in NSF (P = 0.0001 and P < 0.0001, respectively), and were statistically lower in HOS than in NSF (P < 0.0001 and P < 0.0001, respectively). The length of the zone of the UES was statistically shorter in HOS than in NSF (P < 0.0001), but there was no significant difference in resting UES pressure along the esophagus between HSS and NSF (P = 0.3024).

Conclusion

The present study provided us with physiological information regarding normal UES pressure in relation to head rotation. This data will be of aid to future clinical and investigative swallowing studies. Additionally, the current study provides evidence of the safety and usefulness of the head rotation maneuver for dysphagic patients.
Conservative management of advanced external auditory canal cholesteatoma
Authors: Darr E. Ashlie , Linstrom Christopher J.
Published: January 2010

Objective

To investigate the spectrum of disease presentation and clinical management of primary external auditory canal cholesteatoma (EACC).

Study Design

Case series with chart review.

Setting

Specialty teaching hospital.

Subjects and Methods

Ten cases of primary EACC were identified in nine patients treated over 14 years (1995‐2009). Cases were reviewed with regard to demographics, presentation, physical examination, CT findings, and clinical management.

Results

The most common symptoms were otalgia and hearing loss, followed by otorrhea and tinnitus. Erosion was present in the mastoid air cells in seven patients, middle ear in six, temporomandibular joint in two, otic capsule in two, and fallopian canal in one patient. Eight of nine patients were managed with serial debridement.

Conclusions

EACC is associated with adjacent bony erosion, most often involving the inferior EAC. Despite the potentially destructive nature of these lesions, most cases can be successfully managed with serial debridement.
Lumen formation in three‐dimensional cultures of salivary acinar cells
Authors: Pradhan Swati , Liu Chao , Zhang Chu , Jia Xinqiao , Farach‐Carson Mary C. , Witt Robert L.
Published: January 2010

Objective

Development of an artificial salivary gland will benefit patients with xerostomia after radiation therapy for upper respiratory cancer. The goal is to devise a three‐dimensional (3D) culture system in which salivary cells differentiate into polarized acini that express essential biomarkers and directionally secrete α‐amylase. Differentiated acini‐like structures in a 3D biomaterial‐based scaffold will mimic salivary gland functions.

Study Design

Cells were seeded onto HA‐based hydrogels containing PlnDIV peptide and allowed to differentiate into acini‐like structures. Cell viability and phenotype were examined.

Setting

Laboratory‐based tissue procurement study.

Subjects and Methods

Salivary gland tissue was obtained from patients undergoing surgery. Marker expression established the phenotype of salivary gland cells. Perlecan/HSPG2, an important component of the basement membrane, was highly expressed in salivary gland tissue. A culture system consisting of hyaluronic acid (HA) hydrogel and a coupled bioactive peptide derived from domain IV of perlecan (PlnDIV) was used. Prior studies demonstrated differentiation of acinar cells into lobular structures that mimicked intact glands when cultured on PlnDIV peptide–coated surfaces.

Results

Lobular acini‐like structures formed on hydrogels and expressed tight junction components such as zona occludens 1. Acini‐like structures were stained for the presence of α‐amylase. Live/dead staining revealed the presence of apoptotic cells in the center of the acini‐like structures, indicative of lumen formation.

Conclusion

A novel system supporting acini‐like assembly in a 3D culture system was established. Presence of biomarkers and secretion of salivary enzymes confirms functionality in vitro. Future experiments will test the 3D system in an animal model.
Hearing impairment and poverty: The epidemiology of ear disease in Peruvian schoolchildren
Authors: Czechowicz Josephine A. , Messner Anna H. , Alarcon‐Matutti Edith , Alarcon Jorge , Quinones‐Calderon Gina , Montano Silvia , Zunt Joseph R.
Published: January 2010

Objectives

1) To measure prevalence of hearing impairment (HI) in schoolchildren living in poverty in Peru. 2) To identify risk factors for HI and assess its impact on academic performance.

Study Design

Cross‐sectional.

Setting

Elementary schools in an asentimiento humano (shantytown) near Lima, Peru, October 2008 to March 2009.

Subjects

Schoolchildren (n = 335), ages six to 19 years.

Methods

Audiological health was assessed with pure‐tone audiometry, tympanometry, and otoscopy. The primary outcome was HI, defined as average threshold >25 dB HL for 0.5, 1, 2, and 4 kHz, in one or both ears (per World Health Organization/International Organization for Standardization). A questionnaire on health history was administered to parents. Statistical analysis included univariate analysis for χ2 values and odds ratios (ORs), and multivariate logistic regression.

Results

HI prevalence: 6.9 percent (95% confidence interval [CI] 4.2%‐9.6%). Risk factors for HI (OR, 95% CI, P value): neonatal jaundice (5.59, 1.63‐19.2, 0.015), seizure (7.31, 2.50‐21.4, 0.0013), hospitalization (4.01, 1.66‐9.68, 0.003), recurrent otitis media (5.06, 1.98‐12.9, 0.002), past otorrhea (4.70, 1.84‐12.0, 0.003), family history of HI at <35 years (2.91, 1.19‐7.14, 0.026), tympanic membrane abnormality (13.8, 4.48‐42.7, <0.001), cerumen impaction (15.8, 4.71‐53.1, <0.001), and eustachian tube dysfunction (4.87, 1.74‐13.7, <0.001). HI was an independent predictor of academic failure (3.36, 1.15‐9.82, 0.03).

Conclusions

Impoverished Peruvian schoolchildren were four to seven times more likely to experience HI than children living in higher‐income countries. Untreated middle ear disease in the context of limited access to pediatric care was a major risk factor for HI. Furthermore, HI was associated with worse scholastic achievement. These results support prioritization of pediatric ear health as an essential component of the global health agenda, especially in resource‐poor countries.
Assessment of the chin in patients undergoing rhinoplasty: What proportion may benefit from chin augmentation?
Authors: Ahmed Jahangir , Patil Sachin , Jayaraj Samuel
Published: January 2010

Objective

The chin is an important determinant of the lower third of the face, carrying much significance in an esthetically balanced facial appearance. It is, however, often neglected in patients undergoing rhinoplasty procedures in the UK National Health Service (NHS). The aim of this study was to establish the percentage of a cohort of rhinoplasty patients who may also have benefited from chin augmentation.

Study Design

A cross‐sectional study.

Subjects and Methods

The digital preoperative pictures of the last 100 patients who underwent rhinoplasty at our institution were retrieved. Four popular methods of assessment were used to assess the chin, that is, those advocated by Silver, Legan, Merrifield, and Gonzales‐Ulloa. All analyses were performed on Adobe Photoshop CS4 by two ENT registrars. Values were regarded as positive when there was interobserver agreement. Relevant angles were averaged.

Results

A total of 94 photographs were suitable for analysis. There were 58 males. Depending on the method of assessment, the percentage of males who fulfilled criteria for augmentation ranged from 17 to 62 percent and for females the range was 42 to 81 percent. Additionally, 21 percent of males were positive on three or more of the methods utilized. The respective figure was 58 percent for females.

Conclusion

Surgeons who practice rhinoplasty should consider making an objective assessment of the need for possible chin augmentation. Our study shows that as many as 81 percent of patients may benefit, although this figure varies with the method of assessment. In this study, the necessity for further analysis with a view to chin augmentation was more likely in women.
The children speak: An examination of the quality of life of pediatric cochlear implant users
Authors: Loy Betty , Warner‐Czyz Andrea D. , Tong Liyue , Tobey Emily A. , Roland Peter S.
Published: January 2010

Objective

To examine the results of health‐related quality‐of‐life questionnaire scores from profoundly deaf children fitted with at least one cochlear implant (CI) and to compare their responses with those of normal‐hearing mates of similar age and their parents.

Study Design

Cross‐sectional study utilizing a generic quality‐of‐life questionnaire designed to be completed by both parents and children independently of each other.

Setting

Questionnaires completed at various summer camps designed for children with CIs in Texas and Colorado.

Subjects and Methods

Eighty‐eight families from 16 states were divided into two subgroups by age of cochlear implantation: an eight‐ to 11‐year‐old group and a 12‐ to 16‐year‐old group. The KINDL‐R Questionnaire for Measuring Health‐Related Quality of Life in Children and Adolescents was distributed, and CI participants completed the questionnaire independently of their participating family member.

Results

CI users in both age groups scored similarly to their normal‐hearing peers and their parents. Younger CI users scored their family domain lower compared with their normal‐hearing peers. Teen CI users scored the school domain lower compared with their parents. Among CI participants, earlier implantation and longer CI use resulted in higher quality‐of‐life scores.

Conclusion

Children with CIs experience quality of life similar to that of normal‐hearing peers. Parents are reliable reporters on the status of their child's overall quality of life.
Hearing evaluation of intratympanic methylprednisolone perfusion for refractory sudden sensorineural hearing loss
Authors: She Wandong , Dai Yanhong , Du Xiaoping , Yu Chenjie , Chen Feng , Wang Junguo , Qin Xiaoming
Published: January 2010

Objective

To investigate the effectiveness and safety of intratympanic methylprednisolone perfusion (IMP) through a microcatheter in patients with sudden sensorineural hearing loss (SSNHL) who failed a conventional treatment.

Study Design

Prospective clinical study.

Setting

This study was conducted in Nanjing Drum Tower Hospital, Nanjing University Medical School.

Subjects and Methods

Patients who had failed a minimum 10‐day conventional treatment were included. Twenty‐six patients in the study group (SG) received methylprednisolone perfusion through a microcatheter placed into the tympanum once a day for 10 days and the conventional treatment. Twenty‐three patients who received a second conventional treatment (no steroid) served as the comparison group (CG). All patients were followed up for three months after the end of treatment.

Results

The effective rates for SG and CG were 50 percent (61.9% when only patients with an interval from onset to IMP ≤ 60 days were included) and 21.7 percent, respectively (χ2 = 4.194, P = 0.041). The pure‐tone average improvement was 20.2 ± 15.6 dB in SG, and 9.2 ± 13.7 dB in CG (z = 2.51, P = 0.011). In SG, hearing improvement at low frequencies was better than that at high frequencies. The interval from onset to IMP affected the efficacy of IMP.

Conclusion

IMP through a microcatheter is a promising treatment for refractory SSNHL. The data suggest that the treatment may be more effective when administered at the earlier stages of SSNHL when the conventional treatment has failed.
A prospective study of vitamin intake and the risk of hearing loss in men
Authors: Shargorodsky Josef , Curhan Sharon G. , Eavey Roland , Curhan Gary C.
Published: January 2010

Objective

Hearing loss is the most common sensory disorder in the United States, afflicting more than 36 million people. Higher intakes of vitamins C, E, beta carotene, B12, and folate have been proposed to reduce the risk of hearing loss.

Study Design

We prospectively evaluated the association between intake from foods and supplements of vitamins C, E, beta carotene, B12, and folate, and the incidence of hearing loss.

Setting

Health Professionals Follow‐up Study.

Subjects and Methods

A total of 26,273 men aged 40 to 74 years at baseline in 1986. Participants completed questionnaires about lifestyle and medical history every two years and diet every four years. Information on self‐reported professionally diagnosed hearing loss and year of diagnosis was obtained from the 2004 questionnaire, and cases were defined as hearing loss diagnosed between 1986 and 2004. Cox proportional hazards multivariate regression was used to adjust for potential confounders.

Results

There were 3559 cases of hearing loss identified. Overall, there was no significant association between vitamin intake and risk of hearing loss. Among men aged ≥60 years, total folate intake was associated with a reduced risk of hearing loss; the relative risk for men aged ≥60 years old in the highest quintile compared with the lowest quintile of folate intake was 0.79 (95% confidence interval 0.65‐0.96).

Conclusions

Higher intake of vitamin C, E, beta carotene, or B12 does not reduce the risk of hearing loss in adult males. Men aged ≥60 years may benefit from higher folate intake to reduce the risk of developing hearing loss.