bluuebunny/crossref_metadata_2025 huggingface dataset:
Caustic ingestion injuries of the upper aerodigestive tract
Authors: Scott John C. , Jones Bronwyn , Eisele David W. , Ravich William J.
Published: October 2006

Few reports have described in detail the injuries that occur to the oral cavity, pharynx, and larynx following caustic ingestion.1The role of dynamic radiographic studies to delineate the extent of damage has been minimized.2In‐depth radiographic analysis of such cases has not, to our knowledge, been previously reported. In order to examine the injuries and functional abnormalities of these sites following caustic ingestion, the records of The Johns Hopkins Swallowing Center were reviewed. Five patients were identified as having significant upper aerodigestive tract caustic injuries. All patients had dysphagia, epiglottis injuries, and incomplete laryngeal protection with aspiration. Four of five had sustained some degree of esophageal stenosis. Also noted were pharyngeal muscle dysfunction, nasopharyngeal regurgitation, tongue fixation, and hypopharyngeal stenosis. Roentgenographic findings are described and illustrated. The multidisciplinary approach to the management and rehabilitation of these patients is discussed.
Hearing results in retrolabyrinthine vestibular neurectomy
Authors: Teixido Michael , Wiet Richard J.
Published: October 2006

Patients having retrolabyrinthine vestibular neurectomy (RLVN) may have complications that compromise hearing. While most reviews have emphasized sensorineural loss, less attention has been given to conductive hearing loss, which may complicate RLVN. Hearing results of 25 consecutive cases of RLVN performed for Meniere's disease with incapacitating vertigo were tabulated according to 1985 American Academy of Otolaryngology (AAO) guidelines. Nine patients (36%) had improved hearing postoperatively, 5 (20%) had no change in hearing, and 11 (44%) had worse hearing postoperatively. The most commonly observed audiometric change was low‐frequency conductive hearing loss, presumably secondary to partial ossicular fixation by bone dust or fat fibrosis in the attic and antrum. Five patients (20%) had low‐frequency conductive hearing losses that increased by 10 dB or greater over preoperative levels. An additional 7 patients had lesser losses at low frequencies. One patient had a flat conductive hearing loss. Six (24%) of the patients had a decrease in bone levels of greater than 10 dB. Overall hearing results in this study are comparable to those of other series in the literature. Causes and prevention of conductive hearing loss in RLVN are discussed, and a format for presentation of hearing data that will highlight conductive hearing loss after surgery for Meniere's disease is presented.
Comparison of pulsed and continuous wave light in photodynamic therapy of papillomas: An experimental study
Authors: Shikowitz Mark J.
Published: October 2006

Papillomavirus infection of the upper aerodigestive tract is a serious and potentially life‐threatening disease which can result in complete respiratory obstruction. Papillomas are the most common benign neoplasm of the larynx in children but have been shown to have an equal propensity to occur in adults. The hallmark of this disease is one of multiple recurrences despite adequate surgical removal, often resulting in a frustrating and prolonged clinical course. Multiple treatment modalities have been used throughout the years, unfortunately with limited success.

Recent reports on the treatment of virally induced lesions with photodynamic therapy (PDT) using hematoporphyrin derivative (HPD) or its newly purified form dihematoporphyrin ether (DHE) as photosensitizing agents have appeared in the literature. The successful treatment of papillomas in both the animal model and humans holds great promise. The most commonly used activating light source has been the argon pumped‐dye laser (ADL) which produces a continuous wave of coherent light at 630 nm. Although the ADL has proved efficacious in most studies, its cost, size, special cooling water requirements, and large electrical power requirements with limited power output have made it a less than desirable clinical tool.

The gold vapor laser (GVL) has been recently proposed as a possible alternate light source for PDT. This laser appears to be more efficient and offers greater power output while requiring less electrical energy than the ADL. The GVL does not produce the same continuous wave light as the ADL but emits pulsed light with high peak power pulses. Some reports have shown a greater tumor response using the GVL at 628 nm, possibly because of greater tissue penetration from the high‐peak power pulses. At this time, no studies have investigated the effects of pulsed light during PDT on virally induced papillomas.

The present study was conducted to evaluate the efficacy of pulsed light from a GVL as compared to continuous wave light of the ADL in the treatment of papillomas with DHE phototherapy. Statistical analysis of the rate of tumor response, histological changes, and molecular analysis of viral DNA from the involved tissues were performed. Results have shown that the GVL did produce a greater initial rate of tumor response during the first 3 weeks after PDT but did not improve the overall cure rate. Histological and molecular analysis of the treated tissues demonstrated that similar results were obtained when either the ADL or GVL were used as activating light sources.
Immunoglobulin E distribution in atopic nasal mucosa
Authors: Testa Benedetto , Cuccurullo Luigi , Mesolella Carlo , Ferraraccio Franca
Published: October 2006

The distribution of B lymphocytes, and immunoglobulins G, A, M, and E in nasal mucosa was studied in frozen biopsy sections of nasal turbinate from 16 allergic patients and 8 controls. The immunoperoxidase technique was used with monoclonal and polyclonal antibodies. Comparative analyses of serum immunoglobulin levels were also performed. Few B lymphocytes were observed in the nasal mucosa linings in specimens from allergic and non‐allergic patients. In both groups, high positivity for IgG and IgA was observed in the nasal mucosa linings in the specimens. IgM concentration was minimal in both groups. IgE was absent in the nasal turbinate specimens of nonallergic subjects, but was present discontinuously in low concentrations in 7 of the 16 allergic patients. There was no significant difference between allergic and nonallergic patients in the tissue and serum IgG, IgA, and IgM concentrations found. IgE was detected slightly in the nasal mucosa of patients with high IgE serum concentrations (>1000 IU/mL) as well as in patients with very low IgE serum concentration readings. This result raises some doubt on the hypothesis concerning the local production of IgE.
Stimulus Repetition Rate Effect on the Auditory Brainstem Response in Systemic Lupus Erythematosus
Authors: Borton Thomas E. , Eby Thomas L. , Ball Eugene V. , Nolen B. Lynn , Bradley Edwin L.
Published: October 2006

Neuropsychiatric involvement is common in systemic lupus erythematosus (SLE), but, in nearly half of cases, indications are not present on examination. Auditory brainstem response (ABR) measures using differential stimulus repetition rates have been reported as sensitive indicators of subclinical central nervous system (CNS) disorders associated with SLE. In the present study, ABRs were measured in a group of normal‐hearing subjects with SLE, as well as in a group of subject controls. Differences in interpeak latency (IPL) measures obtained using low‐ and high‐stimulus repetition rates did not reach statistical significance (P >.05). Clinical utility of ABRs using high‐ and low‐stimulus repetition rates for the identification of occult CNS disorder in patients with SLE was not demonstrated.
Hemodynamics of the rodent abdominal skin flap following primary ischemia
Authors: Ho Bryan T. , Weinberg Hubert , Zhang Wex X. , Aviv Jonathan E. , Biller Hugh F. , Urken Mark L.
Published: October 2006

The effect of varying periods of ischemia and reperfusion times on subsequent blood flow was studied in the rodent abdominal skin flap. Using perfusion fluorometry, measurements of blood flow were quantified in 60 Sprague‐Dawley rats undergoing clamp‐induced ischemic periods ranging from 0 to 6 hours and reperfusion times ranging from 2 to 8 hours. Flaps subjected to ischemia times of 0, 2, 4, or 6 hours require 8 hours of reperfusion time before reaching baseline levels of blood flow. Blood flow in flaps subjected to 6 hours of ischemia was statistically less than the flow in flaps ischemic for 0, 2, and 4 hours and was directly related to length of reperfusion. These results demonstrate that flap perfusion does not fully take place immediately after clamp release. The factors thought to be responsible for these findings and the implications for the design and interpretation of flap ischemia experiments are discussed.
Sulcus vocalis in laryngeal cancer: A histopathologic study
Authors: Nakayama Meijin , Ford Charles N. , Brandenburg James H. , Bless Diane M.
Published: October 2006

The incidental finding of sulcus vocalis in surgical specimens of patients with laryngeal cancer prompted this review. Sulcus deformities were histologically identified in 28 (48%) of 58 whole‐mount coronal serial‐sectioned laryngeal specimens procured from laryngeal cancer patients. The lesions were analyzed, described, and graded. A control group of 20 larynges, obtained from autopsies of patients without known laryngeal pathology, were similarly processed, and whole‐mount histologic sections were studied. Four of these specimens (20%) also demonstrated sulcus deformities. In the control group, the shape and location of the sulci were similar, but the lesions were smaller than in the cancer group. The sulcus lesions revealed chronic inflammation of the subepithelial tissues with vascular ingrowth and fibrosis of the superficial lamina propria (Reinke's space); in the cancer group the sulcus was usually on the opposite vocal fold, where irritation from the tumor might be anticipated. Although the etiology of the sulci remains controversial, these findings suggest that irritation and inflammation might play a role in the pathogenesis of sulcus vocalis.
Tracheostomal stenosis after total laryngectomy: An analysis of predisposing clinicalfactors
Authors: Kuo Michael , Ho Chiu‐Ming , Wei William I. , Lam Kam‐Hing
Published: October 2006

Stenosis of the terminal tracheostome is a distressing complication of total laryngectomy. A retrospective analysis of 207 patients who underwent total laryngectomy is presented; an overall incidence of tracheostomal stenosis of 13% is reported. The incidence of tracheostomal stenosis is higher in females (26%), patients having immediate tracheoesophageal puncture (19%), pectoralis major myocutaneous flap pharyngeal reconstruction (26%), and tracheostomal infection (50%) which is shown to be significant (P<.05). However, on multivariate analysis, only female sex and tracheostomal infection are independent determinants. Recognition of these clinical factors identifies patients at increased risk of developing this complication and thus allows appropriate perioperative planning to minimize its incidence.
Surgical variables affecting postoperative swallowing efficiency in oral cancer patients: A pilot study
Authors: Mcconnel Fred M. S. , Logemann Jerilyn A. , Rademaker Alfred W. , Pauloski Barbara Roa , Baker Shan R. , Lewin Jan , Shedd Donald , Heiser Mary Anne , Cardinale Salvatore , Collins Sharon , Graner Darlene , Cook Barbara S. , Milianti Frank , Baker Theresa
Published: October 2006

This study examined the correlation between swallow function at 3 months postoperatively and surgical variables including volume resected, flap volume, ratio of flap volume to volume resected, percentage of oral tongue, tongue base, and anterior and lateral floor of mouth resected, and whether or not the mandible was preserved in 30 surgically treated oral cancer patients. Swallows of measured amounts of liquid and paste (pudding) materials were examined videofluoroscopically. Nine measures of swallow function were completed for each swallow. A factor analysis of all swallow variables was done for liquid and for paste consistencies to determine whether one measure was statistically representative of all swallow measures. This analysis indicated that oral pharyngeal swallow efficiency (OPSE) represented all measures for both liquid and paste consistencies. Then the correlation between OPSE and surgical variables was defined. Only percentage of oral tongue and percentage of tongue base resected were significantly negatively correlated with OPSE. That is, OPSE decreased for both liquid and paste as percentage of oral tongue or percentage of tongue base resected increased. Results are discussed in terms of diet choices and surgical management.
The maximal stimulation and facial nerve conduction latency tests: Predicting the outcome of bell's palsy
Authors: Ruboyianes John M. , Adour Kedar K. , Santos David Q. , Von Doersten Peter G.
Published: October 2006

To test the hypothesis that the facial nerve conduction latency test is a better and earlier indicator of prognosis than other electrodiagnostic tests, 86 patients with Bell's palsy were followed for a minimum of 4 months. To select control subjects for our own research clinic and for comparison with the patient population, latency values in 25 normal volunteers (50 sides) were determined. Serial maximal stimulation tests (MST) and latency tests were conducted to determine disease severity and prognosis in Bell's palsy patients. Outcome was graded using the Facial Paralysis Recovery Profile (FPRP) and Facial Paralysis Recovery Index (FPRI) as well as the House grading system. The capability of the two tests to accurately predict outcome was evaluated. The MST accurately predicted outcome in 94% of patients studied. In the control group, normal latency values were a mean 3.8 msec with a standard deviation of 0.49. In the patient population, latency values were either within normal limits or absent. When done within 4 days of onset of Bell's palsy, neither test was capable of predicting axonal degeneration. Statistical analyses included Fisher's Exact Test, the paired Student's t test, and correlation coefficient calculations.
Congenital cholesteatoma
Authors: Friedberg Jacob
Published: October 2006

Since the late 1970s, the author has had the opportunity to prospectively study, document, and surgically manage 40 cases of congenital cholesteatoma. All cases met strict criteria for inclusion in the study, all were surgically and pathologically confirmed, and were definitively followed. During that same period, 38 cases were managed by other members of the otolaryngology department.

It is the purpose of this thesis to critically study this personal and institutional experience, and to validate the rationale for early diagnosis and prompt and effective surgical intervention.
Human papillomavirus (HPV) in sinonasal papillomas: A study of 78 cases using in situ hybridization and polymerase chain reaction
Authors: Buchwald Christian , Franzmann Maria‐Benedicte , Jacobsen Grete Krag , Lindeberg Henning
Published: October 2006

To determine the role of human papillomavirus (HPV) in the etiology of sinonasal papillomas, 57 inverted papillomas including 5 cases associated with carcinomas, 16 exophytic papillomas, and 5 cases of columnar cell papillomas were examined for the presence of HPV DNA by in situ hybridization and polymerase chain reaction (PCR). The genetic studies were performed on the formalin‐fixed, paraffin‐embedded material.

In only 6% of the 52 benign inverted papillomas was HPV DNA identified, whereas 69% of the exophytic papillomas were infected by HPV DNA. In none of the 5 cases with columnar cell papillomas could HPV be demonstrated. HPV 6/11 was identified in all of these HPV‐positive cases. In the carcinoma area, HPV was detected in 2 (1 HPV 6/11 and 1 HPV 18) of the 5 inverted papillomas associated with carcinomas. The findings confirm the presence of HPV DNA in sinonasal papillomas. The results also indicate that HPV 6/11 may be involved in the pathogenesis of, solely, exophytic papillomas. We found that in situ hybridization and PCR seem equally sensitive in detecting HPV in sinonasal papillomas.
Effect of local epinephrine on cutaneous bloodflow in the human neck
Authors: O'Malley Timothy P. , Postma Gregory N. , Holtel Michael , Girod Douglas A.
Published: October 2006

The effectiveness of local anesthetics is improved by the addition of a vasoconstrictor which increases duration of action and decreases both systemic toxic reactions and local bleeding. Epinephrine, the standard drug for vasoconstriction, has some limitations due to potential dose‐related cardiac and local toxic effects. The authors examined the minimal effective epinephrine concentration required for maximal cutaneous vasoconstriction in the human subject so as to limit potential dose‐related side effects. In a randomized, double‐blinded prospective study, 23 patients undergoing head and neck surgical procedures under general anesthesia were enrolled to quantify the effect of subdermal infiltration of 1% lidocaine with epinephrine at varying concentrations on local cutaneous bloodflow utilizing laser Doppler flowmetry. A comparison of the onset of vasoconstriction and magnitude of diminished bloodflow was made for several commonly used concentrations of epinephrine, with 1% lidocaine and normal saline serving as controls. There were no significant differences (P>.05) between epinephrine concentrations of 1:400,000, 1:200,000, 1:100,000, and 1:50,000 when examining onset and magnitude of vasoconstriction.
Three‐dimensional reconstruction of the feline larynx with serial histologic sections
Authors: Moses Ron L. , Flint Paul W. , Paik C. H. , Zinreich S. James , Cummings Charles W.
Published: October 2006

This paper reviews a new technique to develop high‐resolution three‐dimensional (3‐D) images of the larynx using histological sections. Three‐dimensional computer‐reconstructed histological sections of the cat are used in this study to evaluate the recurrent laryngeal nerve (RLN) in its true anatomic course, with emphasis on its relationship to surrounding structures (laryngeal framework). A cat model was used because of specimen availability and technical ease of tissue preparation. Computer‐reconstructed serial histologic sections add a new dimension to the study of laryngeal anatomy, laryngeal trauma, and growth patterns of laryngeal cancer. The technical aspects of three‐dimensional reconstruction and future applications are discussed.
Biochemical evidence of platelet‐activating factor (paf) in human middle ear effusions
Authors: Furukawa Masayuki , Kubo Nobuo , Yamashita Toshio
Published: October 2006

Platelet‐activating factor (PAF) is one of the most potent biological lipid mediators. This is especially true in relation to inflammation. In order to characterize the biochemical features of otitis media with effusion, the authors characterized and determined the concentration of the PAF present in human middle ear effusions obtained from 23 patients with otitis media with effusion. Each sample of middle ear effusion was divided into two groups: serous (n = 12) and mucoid effusions (n = 11). The platelet‐activating factor activity was found mainly in mucoid middle ear effusions, and the amounts of PAF were higher in mucoid type (3.55 ± 1.19 ng/g, mean ± standard deviation [SD]) than in the serous type (0.44 ± 0.19 ng/g). Phospholipids obtained from the middle ear effusions contained a large amount of lyso‐platelet‐activating factor, the biologically inactive precursor or breakdown product of platelet‐activating factor. Based on these findings, it is suggested that platelet‐activating factor may play an important role as a mediator of the inflammatory responses in the pathogenesis of otitis media with effusion.
Comparison of laser doppler flowmeter and radioactive microspheres in measuring blood flow in pig skin flaps
Authors: Rival Richard , Bance Manohar , Antonyshyn Oleh , Phillips John , Pang Cho Y.
Published: October 2006

Laser Doppler flowmetry is a noninvasive technique commonly used to monitor skin perfusion after free‐tissue transfer or replantation in reconstructive surgery. Several investigators have expressed concern about the reliability of the quantitative value provided by laser Doppler flowmeters (LDF) and the extent to which they reflect nutrient blood flow. This experiment was designed to compare quantitatively the skin blood flow in the pig measured by LDF and by 15‐μm radioactive microspheres (RMs). It was observed that the skin blood flow rates measured by LDF and RMs in the normal skin and in acute random‐pattern and arterialized skin flaps were highly correlated (r = 0.93, P<.01). However, the skin blood flow rates measured by LDF were consistently higher (P≤.05) than the corresponding flow rates measured by RMs, and this discrepancy increased considerably at low skin blood flow rates (< 2 mL/min/100 g). We speculated that the LDF most likely measured both nutrient and arteriovenous shunt flow in the skin and that this arteriovenous shunt flow at least in part caused the discrepancy in skin blood flow rates measured by the LDF and RMs because the 15‐um RMs are known to measure nutrient blood flow only. The inherent variations and errors in LDF technique were also discussed.
Eosinophilic infiltration in advanced laryngeal squamous cell carcinoma
Authors: Sassier Alfred M. , Mcclatchey Kenneth D. , Wolf Gregory T. , Fisher Susan G.
Published: October 2006

Tumor‐associated tissue eosinophilia (TATE) has been related to prognosis in epithelial cancers, including cancers at several head and neck sites. This study prospectively examined 248 patients with stage in and IV laryngeal squamous cell carcinoma to determine prevalence and potential prognostic significance of TATE. Pretreatment tumor specimens were histopathologically evaluated. Presence and degree of TATE were analyzed with regard to other tumor characteristics, patient characteristics, and outcome criteria. Median follow‐up was 48 months. Eosinophilia was found in 22.5% of specimens and was not related to tumor site, stage, patient age or sex, or treatment modality. Overall and disease‐free survival rates and response to induction chemotherapy did not differ significantly with respect to TATE. This study represents the first long‐term, prospective evaluation of TATE and its prognostic significance in a single head and neck site. Contrary to the findings of earlier preliminary reports, our results suggest that TATE is not a clinical useful prognostic parameter in advanced laryngeal squamous cell carcinoma.
Perceptual and respiratory responses to added nasal airway resistance loads in older adults
Authors: Laine Maija T. , Warren Donald W.
Published: October 2006

The purpose of the present study was to assess breathing behavior under various nasal resistance load conditions and, in particular, to determine whether respiratory responses to added nasal resistance loads occur before the threshold perception of an added load. The participants were 40 older adults who ranged in age from 59 to 82 years. Nasal airflow and resistance were measured with the pressure‐flow technique, which was modified to create calibrated resistance loads. Statistical analyses revealed a significant decrease in airflow rate and volume during load conditions both before perceptual detection and at detection of increased resistance in comparison to a “no load” condition. No differences in respiratory behaviors were found between the load condition just before perceptual detection of an increased resistance load and the load condition at detection. The present findings suggest that physiologic responses to changes in the airway environment apparently occur even before there is perceptual recognition that the environment has changed.
The effect of very early cleft palate closure on the need for ventilation tubes in the first years of life
Authors: Nunn Donald R. , Derkay Craig S. , Darrow David H. , Magee William , Strasnick Barry
Published: October 2006

The otologic consequences associated with cleft palates are well known. Closure of palatal clefts within the first weeks of life has many potential benefits, including improved feeding and cosmesis. The potential otologic benefits of very early closure are not known. Eighteen newborns have undergone closure of their palatal clefts within the first month of life with subsequent otolaryngology follow‐up through our craniofacial center. Thirteen (72%) of the 18 still required placement of ventilation tubes during their first 3 years of life because of persistent effusion (for more than 120 days) or recurrent infection (more than four episodes in 6 months or more than six episodes in 12 months). Very early cleft palate closure may not significantly alter the need for ventilation tubes in children with palatal clefts.
Modified transnasal endoscopic lothrop procedure: Further considerations
Authors: Becker Daniel G. , Moore David , Lindsey William H. , Gross William E. , Gross Charles W.
Published: October 2006

The Lothrop procedure resects the medial frontal sinus floor, superior nasal septum, and intersinus septum to create a large frontonasal communication. However, the external approach often allowed medial collapse of soft tissue and stenosis of the nasofrontal communication. We describe a modified transnasal endoscopic Lothrop procedure in which drills are used for cases in which frontal recess exploration fails to relieve obstruction of the frontal sinus. The lateral bony walls are preserved, and medial collapse does not occur. The mucosa of the posterior table and posterior nasofrontal duct is preserved, and a single common frontal opening is created. We have found this approach to be safe and reliable. Fourteen patients have undergone this procedure without complication, achieving resolution or improvement of their symptoms and maintaining wide patency of the frontonasal opening. We recognize that long‐term follow‐up will be required but remain encouraged with our favorable results to date.

Laryngoscope, 105:1161‐1166, 1995
Cochlear implantation in the congenital malformed cochlea
Authors: Slattery William H. , Luxford William M.
Published: October 2006

Cochlear implantation has proven beneficial for numerous children with profound congenital hearing impairments. Some congenitally deaf ears, however, may have anatomical malformations. This study reports the authors' recent experience with cochlear implants in patients with congenital inner ear malformations.

Since 1987, 10 patients with congenital abnormal inner ear structures have been implanted at the House Ear Clinic; 8 with abnormal cochleas and 2 with enlarged vestibular aqueducts. Nine patients received the Nucleus 22 device and 1 patient was implanted with the 3M/House device. Some modifications of the routine surgical approach were required in 5 patients. A cerebrospinal fluid (CSF) leak occurred in 4 of the 10 cases. There was a relationship between the degree of abnormality and the number of electrodes that could be inserted. All 10 patients can perceive sound and are active users of their implants.

Laryngoscope, 105:1184‐1187, 1995
Otitis Media Following Tympanostomy Tube Placement in Children With IgG2 Deficiency
Authors: Masin Jeffrey S. , Hostoffer Robert W. , Arnold James E.
Published: October 2006

Children with IgG2 deficiency commonly develop recurrent acute otitis media. It is believed that these infections are secondary to impaired antibody response rather than eustachian tube dysfunction and are therefore less responsive to treatment with tympanostomy tubes.

The authors compared the incidence of acute otitis media in IgG2‐deficient patients following tympanostomy tube placement with controls in a retrospective cohort study. The charts of 20 patients (10 with IgG2 deficiency and 10 controls) were reviewed. Episodes of otitis media were recorded for 12 months. IgG2‐deficient patients experienced three times as many occurrences of otitis media as did controls. This suggests that otitis media is much more common in these patients following tympanostomy tube placement. We believe that an immunodeficiency workup should be considered in patients with multiple episodes of otitis media following placement of tympanostomy tubes.
Mucociliary clearance abnormalities in the hiv‐infected patient: A precursor to acute sinusitis
Authors: Milgrim Laurence M. , Rubin John S. , Small Catherine B.
Published: October 2006

An increasing number of patients with human immunodeficiency virus (HIV) suffer from acute infectious sinusitis, and many suffer recurrent episodes at a higher rate than their non‐HIV counterparts. This study investigates a mechanism underlying the increased incidence of sinusitis, that of prolonged mucociliary transport time (MTT). Nasal mucociliary clearance was examined in 30 HIV‐infected patients and 30 matched, non‐HIV controls using a nasal saccharin transport test. MTTs for the study group and the controls were 11.9 ± 5.9 minutes and 7.4 ± 3.7 minutes, respectively. This difference attained statistical significance (P < .05). Study group patients with a history of sinusitis had a mean MTT of 13.7 ± 6.8 minutes. Those with complaints of “new onset” nasal obstruction since HIV conversion had a mean MTT of 13.5±6.8 minutes. Statistical significance (P < .05) was found comparing these times to controls, as well as to study patients without these symptoms. These data support an inherent delay of mucociliary clearance in HIV‐infected patients which is chronic, possibly irreversible, and, in association with nasal obstruction, represents a major mechanism of both the high acute and recurrent sinusitis rate in this population. The cause of the mucociliary delay is still unclear and needs to be further investigated.
Congenital tracheal cartilaginous sleeve
Authors: Lin Sandra Y. , Chen Jiann‐Chyuan , Hotaling Andrew J. , Holinger Lauren D.
Published: October 2006

The congenital tracheal cartilaginous sleeve (TCS) results from a vertical fusion of the tracheal cartilages. This rare malformation is usually associated with one of the craniosynostosis syndromes, such as Crouzon's disease, Pfeiffer's syndrome, or Goldenhar's syndrome. Three new cases of TCS are reported, two with autopsy findings including the histopathology of horizontal tracheal sections. Salient features of the clinical presentation, diagnostic evaluation, endoscopic findings, histopathology, treatment, and prognosis for TCS are summarized from the perspective of the otolaryngologist. In addition, the literature is reviewed, and previously reported cases are discussed.

Although infants with TCS often have multiple abnormalities, this tracheal malformation is not incompatible with life. Since multiple lesions of the larynx and trachea may be present, endoscopic evaluation is recommended for infants with TCS who experience airway distress.

A smooth trachea lacking the normal ridges of tracheal arches suggests the diagnosis of TCS. With early recognition and appropriate management (including tracheotomy, if necessary, and aggressive management of pulmonary hygiene), patients may survive into childhood.
Measuring gender equality: reflecting on experiences and challenges in the UK and Ireland
Authors: Breitenbach Esther , Galligan Yvonne
Published: October 2006

English

This article focuses on the experience of developing gender equality indicators in the UK and Republic of Ireland and on the challenges confronting policy makers in mainstreaming gender equality into public policies. It identifies the internationalisation of gender equality as a critical pressure on governments to address gender mainstreaming, and summarises the literature on gender equality indicators as a policy response to this demand. It reflects on experiences in the UK and Ireland in developing gender equality indicators and concludes with a discussion of methodological and political challenges confronting policy makers in incorporating gender mainstreaming into general policy concerns.
Disabled citizens and social exclusion: the role of direct payments
Authors: Rummery Kirstein
Published: October 2006

English

This article develops a framework of citizenship, in the light of current developments in social theory, policy and practice, to analyse the social rights and duties of disabled citizens in the UK. It looks at the complex interplay between disabled people's roles as carers, cared-for, workers and employers, by moving the debate on from seeing disabled people as the passive recipients of care to seeing them as active citizens. It asks whether developments in policy, such as the growing use of direct payments, can support disabled people in their struggle to avoid social exclusion and be treated as full citizens.
The emergence of contrasting domestic violence regimes in post-communist Europe
Authors: Johnson Janet Elise , Brunell Laura
Published: October 2006

English

Between the end of socialism and the 2004 European Union enlargement, options for women in Central and Eastern Europe seeking to overcome domestic violence grew noticeably. Because these options include both social movement organisations and the state, we adopt what we call a ‘domestic violence regime’ approach, comparing 11 countries and exploring four – Poland, Russia, Slovakia and Armenia – in more depth. Considering the impact of foreign intervention in encouraging and complicating these reforms, the conclusion draws implications for European policy makers concerned with gender equality.
Polymyxin B and Doxycycline Use in Patients with Multidrug-Resistant Acinetobacter baumannii Infections in the Intensive Care Unit
Authors: Holloway Katherine P , Rouphael Nadine G , Wells Jane B , King Mark D , Blumberg Henry M
Published: October 2006

Background:

Multidrug-resistant Acinetobacter baumannii (MDR-Ab) has emerged as an increasingly problematic cause of hospital-acquired infections in the intensive care unit (ICU). MDR-Ab is resistant to most standard antimicrobials but often retains susceptibility to polymyxin B and doxycycline.

Objective:

To evaluate the efficacy and toxicity of polymyxin B and doxycycline in the treatment of MDR-Ab infections.

Methods:

A retrospective chart review was conducted between March 2002 and May 2005 in patients who received doxycycline or polymyxin B for treatment of MDR-Ab infections in ICUs within Grady Memorial Hospital, Atlanta, GA.

Results:

Thirty-seven patients with MDR-Ab infections were treated with polymyxin B or doxycycline. Median age was 41 years and median ICU length of stay was 18 days prior to acquisition of MDR-Ab. Clinical cure was observed in 22 of 29 (76%) evaluable patients treated with polymyxin B and 2 of 4 (50%) patients treated with doxycycline. In patients with follow-up cultures, microbiological cure was observed in 17 of 21 (81%) patients treated with polymyxin B and 2 of 3 (67%) patients treated with doxycycline. Nephrotoxicity developed in 21% (7 of 33) of patients who received polymyxin B. Neurotoxicity was observed in 2 (6%) patients who received polymyxin B. No adverse reactions were observed with doxycycline. Overall, crude mortality was 27% (9 of 33) and 75% (3 of 4) among those who received polymyxin B and doxycycline, respectively. Three (9%) deaths were attributed to polymyxin B treatment failure, and no deaths were attributed to doxycycline treatment failure.

Conclusions:

Polymyxin B was effectively used to treat a substantial proportion of critically ill patients with MDR-Ab infection and was associated with a similar rate of nephrotoxicity as previously reported. Doxycycline monotherapy was used in a limited number of patients for the treatment of MDR-Ab; further evaluation of its efficacy in larger numbers of patients is warranted.
Defining the common feature: Task‐related differences as the basis for dyadic identity
Authors: Rink Floor , Ellemers Naomi
Published: September 2006

In this paper, we present an experimental study that examines the influence of work‐goal differences and informational differences on the formation of a common identity in dyads. We show that when both kinds of differences are present within a dyad, these differences – just like similarities – come to be seen as defining dyadic features. Furthermore, mediational analysis shows that as the accumulation of differences results in a clearer conception of the dyad, it fosters dyadic identification. This is not the case when dyad members only differ from each other in one respect (i.e. either in work goals or information), while remaining similar in the other. The results are explained in the light of recent insights and developments in the social identity tradition.
Trait conscientiousness, leader‐member exchange, job satisfaction and organizational citizenship behaviour: A test of an integrative model
Authors: Lapierre Laurent M. , Hackett Rick D.
Published: September 2006

Competing theoretical models were tested, linking organizational citizenship behaviour (OCB) to trait conscientiousness, job satisfaction and leader‐member‐exchange (LMX) quality. Meta‐analytic structural equation modelling results provide strongest support for a model wherein more conscientious employees display more OCB, which enhances LMX quality, leading to greater job satisfaction. In‐turn, employees reciprocate their higher job satisfaction by demonstrating more OCB. Beyond supporting the view that OCB represents employee reciprocation for the satisfying job experiences typically stemming from higher‐quality LMX, our findings help to legitimize the notion that OCB may be used, particularly by more conscientious employees, as a means of nurturing higher‐quality LMX and to gain access to more satisfying job experiences.
A normative study of the Coolidge axis‐II inventory, short form
Authors: Watson David C. , Sinha Birendra K.
Published: September 2006

Coolidge (2001) has developed a short‐form, the short Coolidge axis‐two inventory (SCATI), a 70‐item version of the original 225‐item Coolidge axis‐II inventory (CATI). In a normative study of this instrument, the test was found to have many of the psychometric properties of the original. Multivariate analysis revealed that the internal structure of the SCATI is similar to the original.
Extracellular Matrix-mediated Tissue Remodeling Following Axial Movement of Teeth
Authors: Luan Xianghong , Ito Yoshihiro , Holliday Sean , Walker Cameron , Daniel Jon , Galang Therese M. , Fukui Tadayoshi , Yamane Akira , Begole Ellen , Evans Carla , Diekwisch Thomas G.H.
Published: October 2006

Tooth eruption is a multifactorial process involving movement of existing tissues and formation of new tissues coordinated by a complex set of genetic events. We have used the model of the unopposed rodent molar to study morphological and genetic mechanisms involved in axial movement of teeth. Following extraction of opposing upper molars, lower molars supererupted by 0.13 mm. Labeled tissue sections revealed significant amounts of new bone and cementum apposition at the root apex of the unopposed side following supereruption for 12 days. Newly apposited cementum and alveolar bone layers were approximately 3-fold thicker in the experimental vs the control group, whereas periodontal ligament width was maintained. Tartrate-resistant acid phosphatase staining indicated bone resorption at the mesial alveolar walls of unopposed molars and provided in tandem with new bone formation at the distal alveolar walls an explanation for the distal drift of molars in this model. Microarray analysis and semiquantitative RT-PCR demonstrated a significant increase in collagen I, integrin β5, and SPARC gene expression as revealed by comparison between the unopposed molar group and the control group. Immunohistochemical verification revealed increased levels of integrin β5 and SPARC labeling in the periodontal ligament of the unopposed molar. Together our findings suggest that posteruptive axial movement of teeth was accomplished by significant formation of new root cementum and alveolar bone at the root apex in tandem with upregulation of collagen I, integrin β5, and SPARC gene expression.
Effects of Age, System Experience, and Navigation Technique on Driving with an Advanced Traveler Information System
Authors: Dingus Thomas A. , Hulse Melissa C. , Mollenhauer Michael A. , Fleischman Rebecca N. , Mcgehee Daniel V. , Manakkal Natarajan
Published: October 2006

This paper explores the effects of age, system experience, and navigation technique on driving, navigation performance, and safety for drivers who used TravTek, an Advanced Traveler Information System. The first two studies investigated various route guidance configurations on the road in a specially equipped instrumented vehicle with an experimenter present. The third was a naturalistic quasi-experimental field study that collected data unobtrusively from more than 1200 TravTek rental car drivers with no in-vehicle experimenter. The results suggest that with increased experience, drivers become familiar with the system and develop strategies for substantially more efficient and safer use. The results also showed that drivers over age 65 had difficulty driving and navigating concurrently. They compensated by driving slowly and more cautiously. Despite this increased caution, older drivers made more safety-related errors than did younger drivers. The results also showed that older drivers benefited substantially from a well-designed ATIS driver interface.
Influence of Lift Moment in Determining MAWL
Authors: Davis Kermit G. , Kirking Bryan C. , Gaudes Laura L. , Yang Jaehwan , Marras William S.
Published: October 2006

An experiment was performed to determine whether maximum acceptable weight of lift (MAWL) estimates were consistent with previously reported values when the MAWL was determined without visual feedback during the weight adjustment period. Twelve healthy male students performed four lifting tasks similar to those often performed in previous psychophysical studies: floor to knuckle at 1 lift per min, floor to knuckle at 4.3 lifts per min, knuckle to shoulder at 1 lift per min, and knuckle to shoulder at 4.3 lifts per min. When compared with the previous studies with similar box dimensions, similar trends between the conditions were present, but a slight reduction in weight was usually chosen by the participant in this study. However, the results of this study agreed with previous psychophysical studies when the distance of the load from the spine (moment arm) was taken into consideration by either comparing the MAWLs with those of a large box or by comparing load moments. Hence this study shows that eliminating visual feedback during the adjustment periods did not significantly alter the MAWLs from previous studies. It also indicates that one must use caution when applying the MAWL in the workplace because the MAWL is very sensitive to moment arm.
COMMENTARY Heeding the Legacy of Meister, Brunswik, & Gibson: Toward a Broader View of Human Factors Research
Authors: Vicente Kim J.
Published: October 2006

THE PROBLEM The fact that one has to justify a study of human behaviour in a natural setting, where humans ordinarily behave, as opposed to in a laboratory setting, is certainly extraordinary.
Driver Acceptance of Unreliable Traffic Information in Familiar and Unfamiliar Settings
Authors: Kantowitz Barry H. , Hanowski Richard J. , Kantowitz Susan C.
Published: October 2006

How reliable must traffic information be for motorists to trust and accept such advice? This study provides data to aid the designer of advanced traveler information systems (ATIS) in selecting an appropriate level of system accuracy. The Battelle Route Guidance Simulator was used to study the effects of information accuracy and familiarity of the driving environment on objective and subjective indices of driver performance and opinion. The simulator provided real-time information and traffic video. Information was 100%, 71%, or 43% accurate. Drivers experienced either Seattle and its environs or an artificial setting that was topologically matched to Seattle. Results showed that 100% accurate information yielded the best driver performance and subjective opinion, information that was 71% accurate was still accepted and used, but information that was 43% accurate produced powerful decrements in performance and opinion. Simulated ATIS information was not used as effectively in the familiar Seattle setting. Driver trust decreased with inaccurate information but recovered---though not always fully---with subsequent accurate information.
Automotive HUDs: The Overlooked Safety Issues
Authors: Tufano Daniel R.
Published: October 2006

The transfer of tactical aviation technology into automobiles is creating information display requirements that are likely to be met by use of the head-up display (HUD). These developments are based largely on conclusions that the HUD-related safety issues raised in the aviation HUD literature can be dismissed and that the benefits of using HUDs are certain. Such conclusions either neglect relevant research or are supported by a very small amount of evidence, much of which is either irrelevant or generated within a flawed methodological paradigm. This critical review covers the issues of (a) HUD focal distance and its effect on the perception of outside objects and (b) the effects of HUD imagery on visual attention. The issues of focal distance, cognitive capture, and the inherent connection between the two may have a greater impact on safety in the automotive context than they do in aviation.
Crash Reduction with an Advance Brake Warning System: A Digital Simulation
Authors: Shinar David , Rotenberg Eli , Cohen Tal
Published: October 2006

A digital Monte Carlo-type simulation was used to evaluate the effectiveness of an advance brake warning system (ABWS) in reducing rear-end collisions. The ABWS we evaluated activates the brake lights in response to rapid release of the gas pedal, which is characteristic of emergency braking. This reduces the lag in the onset of the brake light by the movement time from the gas pedal to the brake pedal. Using empirical distributions of driver perception reaction time and movement times, it was shown that the ABWS is most effective in preventing collisions on dry roads whenever the headway between vehicles decreases to 1.0 s or less. Vehicle speed was not a significant factor in crash prevention or severity reduction.
Effect of Selected In-Vehicle Route Guidance Systems on Driver Reaction Times
Authors: Srinivasan Raghavan , Jovanis Paul P.
Published: October 2006

Experiments were conducted in a fixed-base, high-fidelity simulator to evaluate selected in-vehicle route guidance systems. Drivers navigated a simulated network using five route guidance systems: paper map, head-down turn-by-turn display, head-down electronic route map, head-up turn-by-turn display, and an audio guidance system. The primary measure of driving performance was the reaction time to a scanning task. Other measures included navigation errors, workload, and perception ratings. Censored regression models were developed to study the effect of route guidance type on reaction times. Results indicated that the drivers responded the fastest while using the audio system and the slowest while using the paper map. The head-up turn-by-turn display was associated with lower reaction times compared with an identically designed head-down turn-by-turn display. The head-down electronic map, despite its complexity, performed better than the head-down turn-by-turn display.