bluuebunny/crossref_metadata_2025 huggingface dataset:
Excretion characteristics of urinary 8‐hydroxydeoxyguanosine after dietary exposure to polycyclic aromatic hydrocarbons
Authors: Chien Yeh‐Chung , Yeh Chun‐Ting
Published: October 2009

Urinary 8‐hydroxydeoxyguanosine (8‐OHdG) is considered a noninvasive marker for oxidative stress and also a marker of carcinogenic potential for compounds such as polycyclic aromatic hydrocarbons (PAHs). Although human studies have investigated urinary 8‐OHdG concentrations in PAH‐exposed workers and the general population, the background level and excretion kinetics of urinary 8‐OHdG in humans remain unclear. Two feeding experiments (consumption of barbecued meat of 15 and 30 g/kg for Experiments 1 and 2, respectively) were conducted to examine the excretion characteristics of urinary 8‐OHdG. All urine voided over 7 days was collected, but only first morning (∼8 A.M.) and last afternoon (∼5 P.M.) samples were analyzed for 8‐OHdG. Mean background urinary 8‐OHdG concentration was 4.76 μg/g creatinine. Statistically significant increases (P < 0.05) in urinary 8‐OHdG concentration were observed on the afternoon of the 3rd and 2nd days after barbecued meat consumption for Experiments 1 and 2, respectively. A pattern of diurnal fluctuation (P < 0.05) in 8‐OHdG excretion rate was evident, in that the excretion of 8‐OHdG was faster during the night than during the day. Additionally, significant (P < 0.05) and strong (r > 0.6) correlations were found between urinary 8‐OHdG measured 2–3 days after exposure to barbecued meat, and 1‐hydroxypyrene (1‐OHP) and 3‐hydroxy‐benzo[a]pyrene (3‐OHBaP) concentrations measured within a half day after such exposure. The current results demonstrate a lag in excretion of urinary 8‐OHdG relative to 1‐OHP and 3‐PHBaP after dietary PAH exposure. These relationships highlight the importance of sampling time when assessing PAH‐related DNA lesions through urinary 8‐OHdG. Environ. Mol. Mutagen. 2010. © 2009 Wiley‐Liss, Inc.
Antioxidant activity of essential oils of five spice plants widely used in a Mediterranean diet
Authors: Viuda‐Martos Manuel , Ruiz Navajas Yolanda , Sánchez Zapata Elena , Fernández‐López Juana , Pérez‐Álvarez José A.
Published: October 2009

The oxidative degradation of lipids is one of the main factors limiting the shelf‐life of food products. In recent years, several undesirable disorders have been detected as side‐effects of using commonly used synthetic antioxidants. Apart from their use as aroma additives in food, essential oils from aromatic plants have shown potential for use in small amounts in fat‐containing food systems to prevent or delay some types of chemical deterioration that occur during storage. Using a multiple‐method approach, the antioxidant activity of the essentials oils from several spices widely used in Mediterranean countries was tested: oregano (Origanum vulgare), thyme (Thymus vulgaris), rosemary (Rosmarinus officinalis), sage (Salvia officinalis) and clove (Syzygium aromaticum). Their total phenolic compound content was also determined. The clove essential oil had the highest amount of total phenols (898.89 mg/l GAE) and showed the highest percentage inhibition of DPPH radical (98.74%) and the highest FRAP value (1.47 TEAC). The thyme essential oil produced the highest percentage inhibition of TBARS (89.84%). All the essential oils studied were capable of chelating iron(II), the rosemary essential oil producing the highest effect (76.06%) in this respect. The oregano essential oil had the highest antioxidant activity index in the Rancimat test. Copyright © 2009 John Wiley & Sons, Ltd.
Global and local central non‐upwind finite volume schemes for hyperbolic conservation laws in porous media
Authors: Edwards Michael G.
Published: October 2009

The focus of this paper is on the development of convective flow approximation schemes that offer the benefits of an upwind formalism without actually upwinding. Development of robust schemes that remove or reduce upwind dependence would represent a significant step forward leading to a fundamental simplification of current methods for flow in porous media and reservoir simulation. Copyright © 2009 John Wiley & Sons, Ltd.
Soluble ions more than particulate cobalt‐alloy implant debris induce monocyte costimulatory molecule expression and release of proinflammatory cytokines critical to metal‐induced lymphocyte reactivity
Authors: Caicedo Marco S. , Pennekamp Peter H. , McAllister Kyron , Jacobs Joshua J. , Hallab Nadim J.
Published: October 2009

Aseptic osteolysis has been associated with excessive immune reactivity to particulate implant debris; however, innate and adaptive immune mechanisms that underlie implant debris reactivity remain incompletely understood. Although particulate debris has been implicated as the major type of implant debris mediating macrophage‐induced osteolysis, the degree to which metal ions affect a proinflammatory response (if at all) remains unknown. We hypothesized that both soluble and particulate metal implant debris will induce proinflammatory responses in human monocytes resulting in cytokine production and elevated expression of T cell costimulatory molecules, facilitating adaptive immune responses. We tested this hypothesis by characterizing the response of a human monocyte cell line (THP‐1), isolated primary human monocytes and PBMCs challenged with Co‐Cr‐Mo alloy particles and soluble cobalt, chromium, molybdenum, and nickel ions. Our results indicate that soluble cobalt, nickel, and molybdenum can induce monocyte up‐regulation of T cell costimulatory molecules (CD80, CD86, ICAM‐1) in human monocytes/macrophages. Furthermore, cobalt, molybdenum ions, and Co‐Cr‐Mo alloy particles similarly induce elevated secretion of IL‐1β, TNFα, and IL‐6. Antibody blockade of CD80 and CD86, crucial secondary molecules for adaptive responses, abrogated lymphocyte reactivity to metal challenge in metal reactive subjects. Also the addition of IL‐1 receptor antagonist (IL‐1ra), (which indirectly blocks pro‐IL‐1β and thus IL‐1β release), significantly reduced lymphocyte reactivity in metal‐reactive subjects. Thus, both soluble and particulate metal implant debris induce monocyte/macrophage proinflammatory responses that are metal and individual specific. This suggests metal‐induced up‐regulation of costimulatory molecules and proinflammatory cytokine production is necessary to induce lymphocyte activation/proliferation to metal implant debris. © 2009 Wiley Periodicals, Inc. J Biomed Mater Res 2010
Community involvement and victimization at school: an analysis through family, personal and social adjustment
Authors: Jiménez Teresa Isabel , Musitu, Gonzalo , Ramos Manuel Jesús , Murgui Sergio
Published: October 2009

The present study analyzes the impact of adolescents' community involvement on victimization by peers at school through various indicators of family, personal and social adjustment (openness of communication with mother and father, life satisfaction, social self‐esteem, and loneliness). Participating in the project were 565 adolescents aged 11 to 18 (51% male) drawn from secondary schools in Spain. Statistical analyses were conducted using bivariate correlations, the t test and structural equation modeling. Results indicated an indirect and protective influence of community involvement, openness of communication with parents and life satisfaction on victimization by peers. There was also a direct protective effect of social self‐esteem and a direct risk effect of loneliness on victimization at school. Findings are discussed in light of the consideration that community involvement is a key factor in the promotion of other protective factors related to adolescent victimization at school. © 2009 Wiley Periodicals, Inc.
Building strong communities: an evaluation of a neighborhood leadership program in a diverse urban area
Authors: Ayón Cecilia , Lee Cheryl D.
Published: October 2009

The purpose of this study was to describe and evaluate an intervention used to train neighborhood leaders about community organizing and to enhance leadership skills. A mixed‐method design was used which included (a) a pre‐ and posttest assessment of 83 participants, and (b) qualitative descriptive interviews of 33 participants. Over half of the participants in the study were from ethnic minority groups (Latino or Cambodian). At posttest assessment, the participants improved in leadership skills (p=.001) and experience (p=.001) subscales. The qualitative interviews revealed that participants continued to be active in their communities by implementing neighborhood programs or starting community organizations. It is recommended that community practitioners and activists support neighborhood leadership programs to foster growth and enrichment in communities, and researchers/practitioners evaluate these projects with multiple methods to broaden scholarship in this important arena. © 2009 Wiley Periodicals, Inc.
HUI Mālama O Ke Kai: a positive prevention‐based youth development program based on native hawaiian values and activities
Authors: Hishinuma Earl S. , Chang, Janice Y. , Sy Angela , Greaney Malia F. , Morris Katherine A. , Scronce Ami C. , Rehuher, Davis , Nishimura Stephanie T.
Published: October 2009

Evaluation of after‐school programs that are culturally and place‐based and promote positive youth development among minority and indigenous youths has not been widely published. The present evaluation is the first of its kind of an after‐school, youth‐risk prevention program called Hui Malāma O Ke Kai (HMK), that emphasizes Native Hawaiian values and activities to promote positive youth development for fifth and sixth graders (N=110) in a rural Native Hawaiian community. Results indicated positive gains on youth self‐reports in Native Hawaiian values, self‐esteem, antidrug use, violence prevention strategies, and healthy lifestyle in Year 1, and in family cohesion, school success, and violence prevention strategies in Year 2. Parent reports of their children indicated positive gains in selected domains. Implications include the support for a promising culturally appropriate program, expansion to middle‐school‐aged youths, and parent involvement. © 2009 Wiley Periodicals, Inc.
Bite force and performance in the durophagous bonnethead shark, Sphyrna tiburo
Authors: Mara Kyle R. , Motta Philip J. , Huber Daniel R.
Published: October 2009

Bite force, a measure of performance, can be used to link anatomical form and function. Earlier studies have shown bite force to have a significant influence on dietary constraints and ontogenetic shifts in resource utilization. The bonnethead shark, Sphyrna tiburo, is a durophagous member of the family Sphyrnidae. Its diet in South Florida waters consists almost entirely of blue crabs, which are crushed or ingested whole. This abundant coastal predator's feeding mechanism is specialized for the consumption of hard prey, including a modified biting pattern and molariform teeth. The goals of this research were to (1) characterize the mechanical function of the feeding mechanism of S. tiburo through biomechanical modeling of biting and in vivo bite force measurements; (2) compare the bite force of S. tiburo with those of other fishes; and (3) identify functional constraints on prey capture by comparing the bite force of S. tiburo with the fracture properties of its primary prey item, blue crabs. Maximum theoretical bite force ranged from 25.7 N anteriorly to 107.9 N posteriorly. S. tiburo has the second lowest mass specific bite force for any fish studied to date, and its posterior mechanical advantage of 0.88 is lower than other durophagous chondrichthyans, indicating that this independent evolutionary acquisition of durophagy was not accompanied by the associated morphological changes found in other durophagous cartilaginous fishes. Blue crab fracture forces (30.0–490.0 N) range well above the maximum bite force of S. tiburo, suggesting that prey material properties functionally constrain dietary ecology to some degree. J. Exp. Zool. 313A:95–105, 2010. © 2009 Wiley‐Liss, Inc.
Cycles and paths in edge‐colored graphs with given degrees
Authors: Abouelaoualim, A. , Das K. Ch. , de la Vega W. Fernandez , Karpinski M. , Manoussakis Y. , Martinhon C. A. , Saad R.
Published: October 2009

Sufficient degree conditions for the existence of properly edge‐colored cycles and paths in edge‐colored graphs, multigraphs and random graphs are investigated. In particular, we prove that an edge‐colored multigraph of order n on at least three colors and with minimum colored degree greater than or equal to ⌈(n+1)/2⌉ has properly edge‐colored cycles of all possible lengths, including hamiltonian cycles. Longest properly edge‐colored paths and hamiltonian paths between given vertices are considered as well. © 2009 Wiley Periodicals, Inc. J Graph Theory 64: 63–86, 2010
A note on regular Ramsey graphs
Authors: Alon Noga , Ben‐Shimon Sonny , Krivelevich Michael
Published: October 2009

We prove that there is an absolute constant C>0 so that for every natural n there exists a triangle‐free regular graph with no independent set of size at least \documentclass{article}\usepackage{amssymb}\usepackage{amsbsy}\usepackage[mathscr]{euscript}\footskip=0pc\pagestyle{empty}\begin{document}\({{C}}\sqrt{{{n}}\log{{n}}}\).\end{document} © 2009 Wiley Periodicals, Inc. J Graph Theory 64: 244–249, 2010
Hypersensitivity to foods: The adaptation phenomenon
Authors: Wilson William H.
Published: October 2009

The ability of certain patients with an allergic diathesis to adapt to the ingestion of specific foods to which they are allergic accounts for the present confusion relative to the role food hypersensitivity plays in clinical medicine. An understanding of the concept of adaptation in ingestant allergy, with its stimulatory and withdrawal periods, aids both patient and physician in appreciating the problems involved in the recognition of food hypersensitivity.

Specific adaptation undergoes a chronological development from the non‐adapted stage through full adaptation to eventual maladaptation. Recognition of the stage of development present offers further diagnostic help in evaluation of the allergic patient.

Reintroduction of a specific food into the diet after establishment of an induced nonadapted phase provides an accurate means of determining hypersensitivity to individual ingestants.
Noxious effects upon cochlear metabolism
Authors: Thalmann R. , Thalmann I. , Ise I. , Paloheimo S.
Published: October 2009

The influence of various toxic substances and of drugs with ototoxic side effects upon energy generation, energy utilization, and membrane processes of the cochlea were studied. None of the drugs tested interfered with energy generation to as great an extent as did anoxia or cyanide and 2,4‐dinitrophenol. Ouabain produced a pronounced interference with energy utilization of the stria vascularis. The “loop” diuretics ethacrynic acid and furosemide produced a reduction of energy utilization of a lesser degree than did ouabain. The “loop” diuretics do not seem to exert their toxic action upon strial Na+K+‐ATPase, but may act by interfering with strial adenylate cyclase. Aminoglycoside antibiotics and diuretic and nondiuretic mercurials seem to exert their primary noxious action upon cochlear function by interfering with membrane processes of the structures bounding the cochlear duct.
Malignant neoplasms of the nasal cavities and paranasal sinuses: (A retrospective study)
Authors: Jackson R. T. , Fitz‐Hugh G. S. , Constable William C.
Published: October 2009

This study presents a retrospective look at 115 patients evaluated here from 1957 to 1974. In this series, 57 percent were males and 43 percent females, 84 percent were Caucasian and 16 percent Negro. Lesions confined to or originating in the antrum made up 67 percent while non‐antral lesions were 33 percent. Mean age at diagnosis was 59.1 years. Smoking and drinking history did not appear to be contributory.

Antral lesions were retrospectively staged according to Sisson's TNM classification. Sixteen tumor types were involved, with the most common being epidermoid. Diagnosis was most often made by intranasal or Cald‐well‐Luc biopsy. Most frequent symptoms, as well as earliest symptoms, were nasal obstruction, localized pain, and epistaxis. Average duration of symptoms was 6.4 months.

Therapy was generally in the form of radiotherapy alone, preoperative radiotherapy and surgery, surgery and postoperative radiotherapy, or surgery alone. Local recurrences occurred in 44 percent of antral lesions and 50 percent of non‐antral lesions. Regional (cervical) nodal metastases developed in 25 percent of antral lesions and 11 percent of non‐antral lesions. Distant metastases developed in 30 percent of antral cases and 35 percent of non‐antral cases. Five‐year survival was 32 percent (35 percent determinate) for the total group. The more advanced the staging of the antral lesions, the worse the prognosis. Best survival figures were in the areas of preoperative radiotherapy and surgery at 38 percent (43 percent) and surgery alone at 56 percent (59 percent).
The medical and surgical approach in management of the unilateral opacified antrum
Authors: Eichel Berkley S.
Published: October 2009

The approach to the diagnosis and treatment of the patient with the unilateral opacified maxillary antrum presents a challenging problem. A total of 55 patients have been completely followed over a six‐year period. Medical management, immediate, and delayed surgical intervention are discussed over a broad array of cases. Approximately one‐half of those cases not requiring immediate surgical intervention recovered on medical management alone. The requirements for eventual surgical intervention and the results are discussed in the remaining cases.
“Practical suggestions on facial plastic surgery — How i do it”: Revision of depressed scars of the head and neck
Authors: Toomey James M.
Published: October 2009

Depressed scars of the head and neck can be predictably and satisfactorily revised by the combination of local subcutaneous flaps with the accepted techniques of superficial scar revision.
Endolymphatic sac valve implant surgery
Authors: Arenberg I. Kaufman , Stahle Jan , Glasscock Michael E. , Shambaugh George E.
Published: October 2009

A resurgence of interest in surgery on the endolymphatic sac (ELS), not only for relief of vertigo but also for stabilization or improvement of hearing, has emerged. With the concept of operating early in the course of the disease after the diagnosis is well established, various modifications of existing procedures on the ELS have been utilized in an attempt to improve the overall results. One such major modification is the unidirectional inner ear valve implant modified from the eye valve for glaucoma. This valve implant has produced impressive one‐year results for both hearing improvements and relief of vertigo in patients who were scheduled for labyrinthectomy. Subsequent preliminary reports by several investigators show good to excellent results for the hearing (AAOO — Class B or A) as well as the vertigo without consideration for the stage of the disease. This study presents primarily the step by step technique with drawings and a color atlas to facilitate the correct performance of this surgery.
Endolymphatic sac valve implant surgery: II: The unidirectional inner ear valve implant
Authors: Arenberg I. Kaufman , Newkirk John B. , Stahle Jan
Published: October 2009

A unidirectional inner ear valve implant was developed to direct excess endolymph out of the inner ear in the hydropic state (Ménière's disease) into the mastoid cavity. A detailed technical description of the valve implant is presented as well as some technical aspects of the valve implant based on the surgical anatomy of the endolymphatic sac.
Sudden hearing loss in divers and fliers
Authors: Pullen Fredric W. , Rosenberg Gary J. , Cabeza Constance H.
Published: October 2009

Many papers have been written about sudden sensory hearing loss and the effect of barotrauma on the inner ear. Fistulae of the round and oval window membranes have been implicated in the great majority of these cases.

It has usually been recommended that the patient be treated with conservative therapy, such as bed rest, for a period of as long as 30 days and that the final hearing results are as good or better than those that have been surgically explored and corrected.

In our experience immediate surgical exploration and correction of sudden severe or profound sensorineural deafness in the diver or flier is absolutely essential and the excellent results of hearing improvement in this select group certainly corroborates this theory. Other cases with the hearing loss limited to the high frequencies most notably have tinnitus and surgical exploration does not improve the hearing but may improve vertigo if present. Numerous cases are presented to support these supositions.
Pediatric vocal cord paralysis
Authors: Dedo Douglas D.
Published: October 2009

Pediatric vocal cord paralysis accounts for approximately 10% of all congenital laryngeal lesions. Early detection of these neurogenic disorders is based upon a high index of suspicion and is important to prevent catastrophes during periods of acute respiratory embarrassment. This paper reviews the symptoms, etiology and management of unilateral and bilateral vocal cord paralysis as it pertains to this age group. A case is presented of a neonate with vocal cord paralysis and associated hydrocephalous and meningomyelocele to illustrate many of the problems associated with pediatric laryngeal paralysis.
Schwannomas of the parapharyngeal space and jugular foramen
Authors: Maniglia Anthony J. , Chandler J. Ryan , Goodwin William J. , Parker Joseph C.
Published: October 2009

Schwannomas or neurilemmomas are among the most common neoplasms occupying the parapharyngeal space, yet only 107 cases have been previously reported. Neurilemmomas involving the jugular foramen are extremely rare. Only 55 cases have been reported in the world literature.

The neoplasm occurred in the parapharyngeal space in three of our patients and in the jugular foramen in another patient. Of the tumors located in the parapharyngeal space, the nerve of origin in one of them was the glossopharyngeal, which is extremely rare. Adequate exposure for complete excision of parapharyngeal space tumors is best obtained through an external incision and should not be attempted transorally.

In the jugular foramen case, the neoplasm arose from the vagus nerve high in the neck and extended intracranially in a “dumbbell” shape into the posterior cranial fossa. Total removal was successfully accomplished in one stage, by using a subtotal temporal bone resection — upper neck — posterior cranial fossa approach.

Surgical removal is the treatment of choice. Schwannomas rarely recur following complete excision.
The grand biopsy for the “cold” thyroid nodule
Authors: Stucker Frederick J. , Lacher Arthur B. , Hirokawa Ronald H.
Published: October 2009

A lobe and isthmusectomy is our standard surgical management for the cold nodule of the thyroid. Experience indicates that the great majority of cold nodules prove benign. It is manifest that the attendant morbidity for this surgery be extremely low.

Our experience reviewing thyroid surgery for only benign disease indicates that complications are indeed uncommon. Our surgical management of the cold nodule includes resection of a lobe and isthmus with exploration and palpation of the opposite side. The nerve is routinely identified and preserved. In the past 18 months, we have experienced two minor postoperative complications in 36 consecutive cases of the lobe and isthmus resection for benign disease.
Sinus complications of frontal craniotomy
Authors: Schramm Victor L. , Maroon Joseph C.
Published: October 2009

Frontal sinusitis, or inflamatory complications of sinusitis, may occur as a consequence of frontal craniotomy when the sinus has been entered during the craniotomy. This may happen particularly during surgery to treat an aneurysm or to excise a tumor in the sellar area. These complications may also occur if the sinus is entered during routine craniotomy when the sinus is high or asymmetrical, or during reduction of frontal bone fractures. This presentation describes the etiology of such inflammatory complications and describes the approach to treatment of such complications, as well as outlining their prevention.
Longitudinal assessment of eustachian tube function in children
Authors: Beery Quinter C. , Doyle William J. , Cantekin Erdem I. , Bluestone Charles D.
Published: October 2009

Eustachian tube function was evaluated in 27 children (32 ears) with tympanostomy tubes at 6‐week intervals for 12 to 30 months. Using a modified inflation‐deflation test of passive and active ventilatory function, it was found that the ears had persistent functional obstruction. Most ears exhibited no significant change in tubal function throughout the observation period. There was no difference in the ventilatory function when the nasal airway was congested (other than due to purulent upper respiratory tract infection) and not congested. However, significant seasonal effects on Eustachian tube ventilatory function were recorded: function was poorer in the winter than in the summer. No relationship was found between Eustachian tube ventilatory function and the age of the child.
Maintenance of cochlear function with artificial oxygen carriers
Authors: Wada J. , Paloheimo S. , Thalmann I. , Bohne B. A. , Thalmann R.
Published: October 2009

By means of vascular perfusion via the anterior inferior cerebellar artery with a blood substitute containing the perfluorochemical FC 47 as oxygen carrier, it is possible to maintain normal or near normal levels of the cochlear microphonics and the endolymphatic potential of the guinea pig for periods of 90 min. or longer. Following 60 min. of perfusion with artificial blood, the levels of ATP and 5′AMP in the stria vascularis and the organ of Corti are comparable to those of nonperfused control animals maintained at optimal metabolic conditions. Following the same period of perfusion, the appearance of the organ of Corti is normal, but small vacuoles, presumably deposits of FC 47, are visible in the marginal cells of the stria vascularis. Preliminary experiments concerning the survival time and the revival time of the cochlear potentials, as well as the response to furosemide, ouabain, and mersalyl are presented to illustrate the value of this method in elucidating various biochemical and pharmacological problems of the cochlea.
Otolaryngologic presentation of Tic‐like disorders
Authors: Vogel Daniel H.
Published: October 2009

Common otolaryngologic symptoms such as coughing and sneezing may not be manifestations of disease of the upper respiratory tract. Two cases are reported in which these symptoms were the first evidence of tic‐like disorders. A short discussion of one such disorder, Gilles de la Tourette's syndrome, is presented. The entity of paroxysmal smeezing is also mentioned. It is pointed out that, in the absence of otolaryngologic disease, these disorders may first present to an otolaryngologist for diagnosis.
A new parameter in brain stem evoked response: Component wave areas
Authors: Anthony Philip F. , Durrett Richard , Pulec Jack L. , Hartstone Julie L.
Published: October 2009

Using a newly developed brain stem evoked response (BSER) parameter in preliminary testing, the authors can individually identify the auditory thresholds of 500 Hz, 1000 Hz and 2000 Hz to within 15‐25 db.

The authors have developed an accurate method of breaking down the complex BSER curve, using a successive approximation technique, into its individual component curves. Each component curve is thought to represent the isolated electrical activity of one generator site. The component curves are the shape of normal distribution curves. The area under each individual component curve is the new parameter which the authors feel represents the isolated electrical activity of one generator site.

Using this parameter a clinical trial was performed. Constant ipsilateral pure tone masking was superimposed upon the stimulus clicks in the test ears of two subjects. The constant ipsilateral masking was superimposed at 500 Hz, 1000 Hz and 2000 Hz. A statistically significant decrease in the area of component wave II (one masking sound caused an increased area) was seen when the pure tone masking sound became at least 15‐25 db louder than the patient's threshold at that individual frequency. These preliminary results give reason to think that a method of quantification of BSER responses has been found. More importantly, a method of identifying individual audiometric thresholds from 500 Hz throughout 2000 Hz to within 15‐25 db has been found. These findings need extensive further testing.
Plastic surgical education for the otolaryngologist
Authors: Webster Richard C. , Smith Richard C.
Published: October 2009

Otolaryngology shares responsibility for provision of plastic surgical services involving facial and cervical structures, but many training programs have been weak in this part of the specialty. Some still are.

Beginning in 1963 when a national organization was formed, leading facial plastic surgeons and the senior author analyzed the weaknesses and embarked on a program to correct these educational deficits. There was widespread lack of surgical background, woefully inadequate knowledge of soft tissue techniques, and poor understanding of dynamics involved in cosmetic procedures.

Annual meetings, international symposia, numerous courses, and extensive videotape and microfiche production, as well as political and academic recognition, have all helped plastic surgical teaching endeavors at both residency and postgraduate levels. However, much remains to be done. Program directors are the “key” people here. Suggestions for future action are presented.
Surgical treatment of hypopharyngeal stenosis in children
Authors: Hamaker Ronald C. , Conley John
Published: October 2009

Five cases are presented of severe scarring, in the hypopharynx in children, which did not respond to conservative measures. These patients were treated by excision of the scar tissue and reconstitution of the area by Z‐plasty, local mucosal flaps, regional chest flaps and colon transfer depending upon the severity of the problem. All had rehabilitation undertaken of the structural integrity of deglutive, respiratory, and vocal mechanisms. It is recommended that in this type of problem early rehabilitation is warranted rather than subjecting the child to prolonged gastrostomy and tracheotomy into puberty. When extended, the morbidity has a physical and psychological affect on these children.
Modified asai procedure
Authors: Saunders William H.
Published: October 2009

To develop a method of establishing speech in the patient who could not develop esophageal speech after laryngectomy, a modification of the Asai procedure with a specially designed Silastic prosthesis was used in three female patients.

All three patients had immediate return of voice and were pleased initially. Eventually, however, because of complicating factors, all three operations were revised back to the original state and the new method considered as a failure.

The reason for this presentation is to stimulate other surgeons to consider the problem further and perhaps to glean from this technique some useful considerations.
Panel discussion: Glomus jugulare tumors of the temporal bone. Malcolm D. Graham, Ann Arbor, mich., moderator. Radiological appearance of glomus tumors
Authors: Wright J. William , Wright J. William , Hicks George W.
Published: October 2009

Depending upon the stage of pathogenesis, some glomus tumors demonstrate characteristic radiographic findings which permit a presumptive diagnosis of this type of tumor. Three factors are helpful in interpreting multidirectional tomography of the temporal bone when a glomus tumor is suspected. The tumor shows a predilection for bony erosion of the carotid crest and hypotympanum. It tends to destroy bone in its path by small lobulated invasions producing a fairly well demarcated border of crescentic shaped translucencies. In contradistinction to other tumors and infections, glomus tumors tend to spare the lateral wall of the attic and the ossicular chain even when the tumor is fairly well advanced in size.
Nasal surgery and airway resistance
Authors: Kosoy Jerome
Published: October 2009

This study investigates the effects of surgery and bronchodilatation on nasal and pulmonary resistance. The plethysmograph is evaluated as a clinical tool for nasal flow studies. The method of adapting the plethysmograph to measure nasal resistance is presented.

Discriminant Function Analysis considers the effects of surgery and bronchodilatation on 15 variables. The statistical analysis of 38 cases demonstrates the benefits of improved nasal airway for pulmonary airway resistance.

A review of the literature points out many of the difficulties in measuring nasal airflow. The plethysmograph emerges as an available easily adapted clinical tool that overcomes many of the short‐comings in earlier techniques and in rhinomanometry.

The rhinologist is offered further insight into the nasopulmonary relationship and the use of the plethysmograph to document the effects of nasal surgery.
Autogenous vaccine treatment of juvenile laryngeal papillomatosis
Authors: Stephens Charlene B. , Arnold Godfrey E. , Hardy Cheryl L. , Butchko Gregory M.
Published: October 2009

Seventeen cases of juvenile laryngeal papillomatosis have been seen and treated with microlaryngoscopy, removal of papillomas, and administering of autogenous vaccine. Holinger's original findings could be confirmed. The operation frequency of 9 patients was significantly reduced, 5 were improved, and 3 unchanged. In no case was an undesirable reaction to the vaccine observed. Electron microscopy showed no virus‐like particles in the papilloma but a section of a vulvar wart did show the virus.
Adverse effects of lidocaine and methylparaben on tracheal ciliary activity
Authors: Mostow Steven R. , Dreisin Robert B. , Manawadu Bingumal R. , Laforce F. Marc
Published: October 2009

The effect of standard concentrations of lidocaine HC1 and methylparaben (preservative) on the ciliary activity of ferret tracheal rings in organ culture was assessed. Pure lidocaine concentrations as low as 0.5% caused complete ciliostasis which was reversible after removal of the drug. One percent and two percent effects were not completely reversible. Pure methylparaben concentrations as low as 0.06 mg/ml paralyzed cilia; and, at concentrations of 0.5 mg/ml or higher, adverse effects were not completely reversible. When lidoacine and methylparaben were combined at the same ratio used in commercial preparations, their ciliotoxic effects were additive. These data suggest that topical respiratory anesthesia may result in prolonged ciliary paralysis.
Benign eccrine cylindroma of the external auditory canal.
Authors: Wilson Ralph S. , Johnson Jonas T.
Published: October 2009

The benign eccrine cylindroma is one of a number of histologically different tumors of the external auditory canal that have been grouped by some as “ceruminomas.” The eccrine cylindroma, malignant apocrine gland tumors, and the adenoid cystic carcinomas of salivary gland origin are distinctly different histologically and in natural history and prognosis. Therapy should, therefore, be tailored to the specific tumor.

A patient is presented who developed an asymptomatic external auditory canal mass that was initially incompletely excised. A recurrence five years later again proved to be a benign eccrine cylindroma of sweat gland origin. Successful and adequate treatment was local excision with a cuff of normal tissue.

A variety of tumors originating from the adnexal skin structures may appear in the external auditory meatus and canal. Treatment must include biopsy and close consultation with the pathologist. The term cylindroma has been loosely applied to both benign and malignant glandular neoplasms but its usage should be restricted to the specific benign eccrine cylindroma herein described. A rationale of therapy is presented.
Keratosis obturans and external auditory canal cholesteatoma
Authors: Piepergerdes James C. , Kramer Bernard M. , Behnke Ernest E.
Published: October 2009

Keratosis obturans and external auditory canal cholesteatoma (EACC) have previously been considered to represent the same disease process. However, review of the literature and our cases reveal these to be two different clinical and pathological processes. Keratosis obturans presents as hearing loss and usually acute, severe pain secondary to the accumulation of large plugs of desquamated keratin in the ear canal. External auditory canal cholesteatoma presents as otorrhea with a chronic, dull pain secondary to an invasion of squamous tissue into a localized area of periosteitis in the canal wall.

The treatment previously recommended for both of these conditions has been conservative debridement of the external canal and application of topical medication. While this remains the treatment of choice for keratosis obturans, surgery may be required to eradicate EACC.
The use of an abdominal pedicle flap in reconstructing nasal tip avulsion
Authors: Abbenhaus James I.
Published: October 2009

Numerous flaps are available for reconstruction of the nose. However, most all of these utilize local or adjacent tissue which can result in moderate facial mutilation and scarring. The abdominal pedicle‐radial artery‐nose transfer flap has been previously described by Kilner and Chitrov. Both procedures somewhat compromise the final outcome and thus only portions of each were used in the design of this flap. The size of the flap was determined by doubling the width of the base of the nose and doubling the estimated length of the nose and tubing it. After staged transfer from abdomen to wrist to remaining nose, the distal end is defatted and cut into a three lobed flap for sculpturing the nasal tip and columella.
The effect of prolonged exposure to industrial noise on otosclerosis
Authors: Alberti P. W. , Hyde M. L. , Symons F. M. , Miller R. B.
Published: October 2009

More than 3000 workers referred by the Workmen's Compensation Board of Ontario have been evaluated for pension for industrial hearing loss. They include the normal proportion of otosclerotics, many of whom have had surgical therapy. The operations have been done by a wide variety of surgeons in the province of Ontario, and the results are representative of those which will be obtained in a large section of the Canadian community. The results are significantly worse than generally quoted, and some of the deficiencies are attributable to occupation. These include perilymph fistula from excessive straining and sensorineural hearing loss due to noise exposure. Detailed results will be presented.
First branchial cleft anomalies
Authors: Olsen Kerry D. , Maragos Nicolas E. , Weiland Louis H.
Published: October 2009

Our experience with anomalies of the first branchial cleft is reviewed. This includes 38 cases, the largest series collected to date. A new classification is proposed based on the anatomic findings – whether cyst, sinus, or fistula is present. The embryology and pathology of first cleft anomalies are discussed and an approach to the diagnosis and management of these lesions is given. In addition, a patient with a branchial cleft defect involving the middle ear space is reported.
Cerebellar infarction – a presentation of vertigo
Authors: Rubenstein Ronald L. , Norman David M. , Schindler Robert A. , Kaseff Leon
Published: October 2009

The differential diagnosis of acute vertigo includes cerebellar infarction. In the past, a mortality rate of 50% – 80% was reported with cerebellar infarction. This is no doubt related to an inability to accurately diagnose small lesions which carry a better prognosis. The advent of computerized tomography (CT) now permits accurate diagnosis of small cerebellar infarctions.

Seven patients admitted with acute onset of vertigo which mimicked a peripheral labyrinthine disorder are presented. In all patients a cerebellar etiology was demonstrated by CT. One patient had been subjected to therapeutic labyrinthectomy; three of seven patients had associated unilateral hearing loss suggesting partial brain stem involvement.

The CT findings in cerebellar infarction are often subtle and require careful interpretation. Computerized tomography should be included in the routine work‐up of acute vertigo with any associated neurologic finding to aid in proper diagnosis and effect appropriate treatment.
Clinical application of saccade‐reflex testing in man
Authors: Konrad Horst R.
Published: October 2009

Computer‐aided measurements of saccade‐reflex reaction times, velocities, and accuracies have become important tools in the detection of central nervous system pathology. Because of improved knowledge of the reflex pathways in man, saccade testing can assist in differentiating between brain stem, cerebellar, or cerebral disorders and point toward unilateral lesions. Saccade‐reflex testing is also useful in determining disability and measuring over time the course of central nervous system disorders. Further work, correlating lesions observed by high‐resolution imaging techniques with abnormalities in reflexes, continues to improve the understanding of saccade mechanisms in man. Specific cases are used to show the effects of anatomic lesions on changes in saccade reflexes. The results from 100 consecutive patients evaluated for dizziness are provided in order to illustrate the prevalence of saccade abnormalities and the relationship between abnormalities in vestibular and slow and fast eye‐movement reflexes. Patients complaining of disequilibrium and visual disturbances frequently have abnormalities in the saccade system, abnormalities which are often overlooked in present clinical testing of the dizzy patient.
Histopathologic changes in snoring and obstructive sleep apnea syndrome
Authors: Woodson B. Tucker , Toohill Robert J. , Garancis John C.
Published: October 2009

The pathophysiologic events that lead to the loss of airway compensation in obstructive sleep apnea (OSA) are poorly understood. The development of airway instability may be secondary to changes in neurologic control, airway morphology, or both. To identify potential histopathologic features of pharyngeal tissues that may contribute to OSA, transverse sections of the distal soft palate and uvula were qualitatively compared using light and electron microscopy from 4 severe apneics (>50 apnea/hour), 4 severe snorers (<20 apnea/hour), and 4 nonsnorers. Light microscopy of both apneics and snorers revealed mucous gland hypertrophy with ductal dilation and focal squamous metaplasia, disruption of muscle bundles by infiltrating mucous glands, focal atrophy of muscle fibers, and extensive edema of the lamina propria with vascular dilation. Severe snorers did not differ qualitatively from apneics in the characteristic changes found; however, some snorers had less extensive changes. No distinctive histopathologic findings could be associated with the development of apnea. Electron microscopy of severe apneics identified frequent focal degeneration of myelinated nerve fibers and axons. The finding of similar histopathologic changes in apneics and severe snorers supports previous speculation of a common etiology not directly related to apnea, such as vibratory trauma to pharyngeal tissues. Degenerative changes in peripheral nerves, identified on electron microscopy, however, may contribute to airway instability and the development of obstructive apnea by impairing pharyngeal reflexes.
Human respiratory mucosa in a nonadhesive stationary organ culture system
Authors: Steinsvåg S. K. , Strand M. , Berg ø. , Olofsson J. , Miaguchi M.
Published: October 2009

Fragments of human adenoid tissue were transferred to a nonadhesive, stationary organ culture system. The culture period was 40 days. In culture, beating cilia could be observed at the surface of the fragments. Light microscopy, scanning electron microscopy, and transmission electron microscopy showed that the tissue fragments were covered by a multilayered, pseudostratified, ciliated epithelium. Beneath the epithelium was a basement membrane. At the start of the culture period, the central parts of the fragments were dominated by lymphocytes. These lymphocytes gradually disappeared and were replaced by a collagen‐containing stroma with scattered fibroblasts. The tissue fragments can be used as an organ culture model for normal respiratory mucosa.
Effect of cricopharyngeus myotomy on postlaryngectomy pharyngeal contraction pressures
Authors: Horowitz Jay B. , Sasaki Clarence T.
Published: October 2009

After total laryngectomy, the cricopharyngeus muscle, when intact, appears to inhibit the free flow of saliva and secretions past the pharyngeal repair into the upper esophagus. The authors hypothesize that cricopharyngeus myotomy reduces sphincteric pressure, thereby diminishing forces against the pharyngeal suture line. Peak pharyngeal pressures were recorded in patients who underwent total laryngectomy with and without cricopharyngeus myotomy. In patients without concurrent myotomy, peak pharyngeal pressures were all greater than 60 mm Hg. With concurrent myotomy, peak pharyngeal pressures averaged less than 40 mm Hg. Concurrent myotomy carries with it the potential for minimizing postoperative fistulization, eliminating dysphagia of cricopharyngeus spasm, and improving the acquisition of alaryngeal speech.
Congenital perilymphatic fistula and associated middle ear abnormalities
Authors: Weber Peter C. , Perez Blas A. , Bluestone Charles D.
Published: October 2009

To specifically determine the frequency and type of middle ear abnormalities associated with perilymphatic fistula (PLF), a retrospective chart review was performed of 94 patients (117 ears) who underwent exploratory tympanotomy for PLF from 1980 to 1989. Of these 94 patients, 60 (63.8%) had a PLF identified. Of the 117 ears explored, 80 (68.4%) had a PLF, and in 65 (81.3%) of these ears, a middle ear malformation was associated with the PLF. Of these 65 ears in which a congenital middle ear abnormality was observed, a malformed stapes was the most common abnormality seen (39 ears, 60%), followed by a deformed round window (20 ears, 30.8%), a deformed incus (11 ears, 16.9%), and a deformed promontory (2 ears, 3%). Often these malformations coexisted amongst themselves or with inner ear abnormalities. Sixteen children (25 ears) had an inner ear malformation identified on computed tomography (CT); all of these children had a PLF found at the time of surgery. This study demonstrated that 86.3% of the ears found to have a PLF had a deformity of the middle ear, inner ear, or both. A malformation of the stapes, most frequently identified as a deformity of its superstructure (and presumably also the anterior footplate), was the most common congenital middle ear abnormality found to be associated with PLF in children.
Endothelial cell growth factor (ECGF) application to irradiated soft tissue
Authors: Hom David B. , Assefa Girma , Song Chang W.
Published: October 2009

After total laryngectomy, the cricopharyngeus muscle, when intact, appears to inhibit the free flow of saliva and secretions past the pharyngeal repair into the upper esophagus. The authors hypothesize that cricopharyngeus myotomy reduces sphincteric pressure, thereby diminishing forces against the pharyngeal suture line. Peak pharyngeal pressures were recorded in patients who underwent total laryngectomy with and without cricopharyngeus myotomy. In patients without concurrent myotomy, peak pharyngeal pressures were all greater than 60 mm Hg. With concurrent myotomy, peak pharyngeal pressures averaged less than 40 mm Hg. Concurrent myotomy carries with it the potential for minimizing postoperative fistulization, eliminating dysphagia of cricopharyngeus spasm, and improving the acquisition of alaryngeal speech.