bluuebunny/crossref_metadata_2025 huggingface dataset:
Supramolecular Fibers and Microbelts from a Phthalhydrazide Derivative of Crown Ether with Alkyl Chains
Authors: Otsuki Joe , Okabe Yusuke , Eitaki Satoshi , Sei Yoshihisa , Yamaguchi Kentaro
Published: October 2006

Assemlbing behaviors of some crown ether derivatives with alkyl chains were investigated. It was found that a phthalhydrazide derivative was unique among them in that it assembles into fibers in solution, which transform into microbelts on the surface of highly oriented pyrolytic graphite.
Introduction of F3-Threonine to the Hexapeptide, DSLET: Investigation of the Effect of Fluorine Atoms toward Peptidic Conformations
Authors: Kitamoto Takamasa , Marubayashi Shunsuke , Yamazaki Takashi
Published: October 2006

Introduction of trifluoromethyl-containing threonine to the target hexapeptide, Tyr–d-Ser–Gly–Phe–Leu–Thr (DSLET), led to the apparent conformational alteration due to the electron-withdrawing effect of the CF3 group when compared with the original DSLET on the basis of their NOESY spectra.
Intestinal absorption of fluoride preparations
Authors: Deka Ramesh C. , Kacker Santosh K. , Shambaugh George E.
Published: October 2006

Gastric intestinal absorption of five different preparations of sodium fluoride was measured by means of ten hour urinary excretion. Best absorption was by nonenteric coated sodium fluoride. All three enteric coated preparations showed poorer absorption, with marked individual variations. Florical,r̀ the currently available preparation, showed better absorption than any enteric coated tablets and only slightly less than sodium fluoride alone. For active cochlear otospongiosis two capsules three times a day should be prescribed.
Oncocytoma of the maxillary sinus
Authors: Handler Steven D. , Ward Paul H.
Published: October 2006

A case of oncocytoma of minor salivary gland origin of the left maxillary sinus is presented. No previous reports of oncocytoma confined entirely to the maxillary sinus were found in an extensive computerized search (Medline and Cancerline) of the world literature. The diagnosis and management of these histologically benign but locally aggressive tumors occurring in the head and neck are discussed.
First branchial cleft anomalies
Authors: Belenky Walter M. , Medina Jesus E.
Published: October 2006

A series of nine cases of first branchial cleft anomalies treated at Children's Hospital of Michigan from 1970‐1978 is presented. A review of the literature and analysis of these cases reveals that the accepted criteria for classification of these anomalies are confusing and inadequate as they preclude the proper classification of a number of these cases. The embryogenesis of these anomalies is discussed with attention given to their relationship to the facial nerve. A proper classification is suggested.
A double‐blind comparison of oxatomide (R 35 443) and diphenhydramine in the treatment of hay fever
Authors: Van Der Bijl W. J. F. , Cordier E. , Van Dishoeck E. A. , De Proost W. , Vannieuwenhuyse E.
Published: October 2006

Ninety‐one hay fever patients received either 0.5 mg/kg oxatomide b.i.d. or 0.4 mg/kg diphenhydramine b.i.d. in a two‐month double‐blind study. If necessary this dose could be doubled. The results showed that fewer oxatomide patients needed to double this starting dose and to use a nasal spray. Oxatomide proved to be more effective than diphenhydramine in limiting the severity of the hay fever attacks, as evidenced by the findings that oxatomide patients had fewer complaint‐days, and that more of these patients were rated by the investigators to have excellent or good results. Apart from daytime fatigue, transient in several patients, no oxatomide‐induced side‐effects were found.
Surgical management of early epidermoid carcinoma of the anterior floor of the mouth
Authors: Schramm Victor L. , Myers Eugene N. , Sigler Barbara A.
Published: October 2006

Therapy for early carcinoma of the floor of the mouth is difficult because of the tendency for local invasion of muscle and extension onto the mandible and alveolus. Nearly 100% local control of disease without mandibular complication has been possible with a wide local three‐dimensional resection including marginal mandibulectomy with split thickness skin grafting. The operative technique and special considerations including management of the mandible, submandibular ducts, and airway are detailed. Lymph node metastases have been uncommon. The primary disease and pathology are correlated with regional metastasis, and based on this a treatment plan is recommended.
An evaluation of revision stapes surgery
Authors: Crabtree James A. , Britton B. Hill , Powers W. Hugh
Published: October 2006

The expected success rate in primary stapedectomy is well documented in recent literature, but few reports have commented on the difficulties or the expected results in revision stapes surgery. Reports have dealt with different techniques, but the surgeon and the patient should be aware of the problems and risks involved in revision stapedectomy.

The records of 35 patients who had undergone revision stapedectomy were analyzed to determine the following: 1. cause of failure, 2. how to avoid these difficulties, 3. hearing results, and 4. possible identifying factors which might pinpoint those patients with a high risk for sensorineural hearing loss.

A review of these cases demonstrates that the results of revision stapedectomy are different than those for primary stapedectomy.
Freedom from ototoxicity in aminoglycoside treated neonates: A mistaken notion
Authors: Bernard Philippe A.
Published: October 2006

Pediatricians commonly consider aminoglycoside antibiotics to be less ototoxic in neonates than in adults. This concept is based on the results of pure tone audiometry performed in children treated with aminoglycosides during the neonatal period. However, conflicting results were obtained when using brain stem response audiometry (BSRA) in a group of 26 aminoglycoside treated neonates and a control group of 20 treated neonates during their stays in intensive care units (mean gestational age: 34.6 weeks). Latencies of wave V significantly differed between the two groups indicating hearing alterations in the treated group. A statistical correlation was demonstrated between initial and final values of wave V and the total doses of antibiotic administered per kilogram of body weight (p < 0.01). Most neonates were premature with an immature hearing apparatus.

To demonstrate the effect of aminoglycosides on the developing organ of Corti, neonate kittens were chosen as animal models — the onset of hearing occurs 10 days after birth. BSRA was performed every 3 days from birth for 20 days and thereafter every 6 days for the following 30 days. Five kittens treated with a low dose of gentamicin for 20 days were compared with a control group of 5 untreated kittens from the same litters and a group of S adult cats receiving the same antibiotic therapy. On the 50th day, all animals were sacrificed and their cochleas were prepared for electron microscopic evaluation. No ultrastructural modifications or BSRA alterations were noted in the adult group. The untreated kittens exhibited a normal pattern of BSRA maturation and their organs of Corti appeared normal. On the contrary, evidence of abnormal hearing maturation and of anatomical damage in the outer hair cells of the first coil of the cochlea was found in the treated kittens. Laboratory findings corroborate our clinical findings that aminoglycoside antibiotics are more ototoxic in neonates than in adult cats.
Surgery for snoring
Authors: Pelausa Edilberto O. , Tarshis Lome M.
Published: October 2006

Snoring is a common obnoxious disturbance in human society. Although considered a mere nuisance by most, it can have significant social and medical effects. Snoring has caused marriage breakdown and murder. It can lead to hypertension, heart failure, and the obstructive sleep apnea syndrome.

Since Ikematsu developed palatopharyngoplasty (PPP) in 1952 and Fujlta introduced it to North America in 1981, numerous reports have alluded to its efficacy in the management of snoring.

From June 1986 to February 1988, 110 PPP operations were performed at The Wellesley Hospital, University of Toronto. Of these, 58 patients responded to review and questionnaire. Elimination or improvement of their snoring was reported by 75.9% of patients. Complications encountered are discussed.

We conclude that palatopharyngoplasty (PPP) is a safe and effective technique in the treatment of problematic snoring.
Rhodamine‐123 as a new laser dye: In vivo study of dye effects on murine metabolism, histology and ultrastructure
Authors: Castro Dan J. , Saxton Romaine E. , Rodgerson Denis O. , Fu Yao Shi , Bhuta Sunita M. , Fetterman Harold R. , Castro Donna J. , Tartell Paul B. , Ward Paul H.
Published: October 2006

Rhodamine‐123 (Rh‐123) is a mitochondrial‐specific dye that has recently proven to be an effective fluorochrome for photo‐dynamic therapy of squamous carcinoma cells and melanomas with the Argon laser. Complete eradication of heterotrans‐planted human tumors in nude mice was possible if tumors were first “sensitized” to Rh‐123 and then treated with the Argon laser. Prior to initiation of human testing of this technique, the toxicity and pathological changes in BALB/c mice were tested by an escalating dose schedule after systemic injection of Rh‐123. Animals' body weight, blood chemistry, enzymes and organ evaluation for histology, and ultrastructural changes were analyzed for 3 weeks after injection with Rh‐123. The results of this study demonstrate that Rh‐123 has significant systemic toxicity in BALB/c mice injected at doses of 10 μg/g of body weight and above, manifested by chronic weight loss and elevation of muscle enzymes with death of the animals injected at doses higher than 50 μg/g of body weight. At doses of 1 μg/g of Rh‐123, no local or systemic toxicity was observed even after a 3‐week follow‐up, suggesting that safe and effective tumor sensi‐tization might be possible in humans at this concentration. The high effectiveness of this new technique of photodynamic therapy and the low toxicity of this dye in this preclinical model system suggests that Rh‐123 and the Argon laser may represent a powerful new method for treatment of superficial malignancies.
Vocal cord paralysis and recovery with thyroid lymphoma
Authors: Sobol Steven M. , Jiu John B. , Grozea Petre N.
Published: October 2006

Vocal cord paralysis has been reported in 33 patients with thyroid lymphoma for an estimated overall incidence of 17%. There is little expectation of vocal cord function recovery, both because neoplastic invasion is believed irreversible and since surgery often necessitates sacrifice of the recurrent laryngeal nerve. Unlike in most well differentiated thyroid malignancies, external radiation therapy plays a vital role in the treatment of thyroid lymphoma. The patient presented here had complete recovery of vocal cord function following radiation therapy for a large thyroid lymphoma associated with vocal cord paralysis. This is the first reported case of such recovery following treatment for a thyroid neoplasm. The rather rapid and complete recovery of neural function suggests that, at least in some, paralysis is caused by reversible compression rather than by neural invasion or tumor‐induced neurolysis.
Tracheal reconstruction with pedicled thyroid cartilage
Authors: Fischer Newton D. , Fry Terry L. , Pillsbury Harold C.
Published: October 2006

Limited areas of tracheal stenosis have been repaired with a variety of techniques. More extensive upper tracheal defects present a greater challenge with less predictable success. The following is the description of yet another technique for reconstruction of extensive upper tracheal defects. We report on the use of a muscle‐pedicled thyroid alar graft which carries its own blood supply and perichondrial covering, supplies a large, conveniently shaped graft, requires one operative site and one operative sitting, and has proven advantageous even in the compromised patient.
Clinical experience with a short‐acting caloric test
Authors: Proctor Leonard R.
Published: October 2006

The prolonged labyrinthine slimulation produced by the conventional caloric irrigation is uncomfortable and fatiguing to patients and necessitates an undesirable waiting period between applications of the test. The present report describes the use of a short‐acting caloric test, and an analysis of all available data on 100 consecutive patients evaluated with this procedure.

Because the labyrinthine stimulus produced by the new method is short‐acting and because the stimulus was applied at reduced intensity in patients who were more sensitive, the new procedure was well tolerated even when five or more irrigations were used. It was found convenient to repeat irrigations when results were uncertain, thereby ensuring a more reliable assessment of vestibular function.
Rotational testing in patients with bilateral peripheral vestibular disease
Authors: Baloh R. W. , Hess K. , Honrubia V. , Yee R. D.
Published: October 2006

We performed quantitative low and high frequency rotational testing in 17 patients with bilateral peripheral vestibular deficits. A characteristic pattern of decreased gain and increased phase lead at low frequencies of sinusoidal stimulation and decreased time constant to impulsive stimulation was observed in most patients. The results of caloric testing correlated with the results of low frequency rotational testing but not with the results of high frequency testing. Only 2 patients complained of oscillopsia at the time of testing and both of these had decreased vestibulo‐ocular reflex gain at low and high frequencies of sinusoidal rotation.
Cervical thymic cysts: Case report and review of literature
Authors: Barat Michel , Sciubba James J. , Abramson Allan L.
Published: October 2006

An unusual case of cervical thymic cysts in a 4‐year‐old boy is presented. The embryology, histopathology, and clinical presentation is discussed. This entity should be included in the differential diagnosis of cystic neck masses in the pediatric age group.
Granulomas of the vocal cords caused by sporothrix schenckii
Authors: Agger William A. , Seager Glenn M.
Published: October 2006

A 42‐year‐old female acquired an acute respiratory infection one week after working in a sphagnum moss packing plant. Three and one half months later direct laryngoscopic examination, done because of persistent hoarseness, revealed granulomas of the left true cord. Initial biopsy showed noncaseating granulomas, and a repeat biopsy with fungal cultures grew Sporothrix schenekii. The patient was treated with an oral solution of saturated potassium iodide and gradually improved although mild hoarseness has persisted.
Management of perforations of the hypopharynx and cervical esophagus
Authors: Tate John L. , Shockley William W. , Stucker Fred J.
Published: October 2006

Complications related to perforations of the upper aerodigestive system carry a 15% mortality. Nine cases of intraluminnl injuries to the hypopharynx and cervical esophagus are reviewed. Seven were related to iatrogenic causes and two associated with foreign bodies. This study details the cause and location of the injuries, associated signs and symptoms, and the resultant morbidity. A protocol for the management of suspected perforations is outlined.
Jet insufflation anesthesia for endolaryngeal laser surgery: A review of 318 consecutive cases
Authors: Rontal Eugene , Rontal Michael , Wenokur Milford E.
Published: October 2006

A series of 318 patients utilizing the jet insufflation technique for laser laryngeal anesthesia was studied. The technique utilizes a foil wrapped catheter placed below the vocal cords and attached to the Sanders ventilating adapter. Two pneumothoraces in children, one dental injury and one tube ignition were noted — all without permanent sequelae. Subsequent modification in technique prevented recurrence of these complications. The results indicate that this is a safe technique for laryngeal laser surgery, providing excellent visualization of the larynx while maintaining good oxygenation and airway control.
Unilateral sensorineural hearing loss: Analysis of 200 consecutive cases
Authors: Kumar Arvind , Maudelonde Claire , Mafee Mahmood
Published: October 2006

The spectrum of diseases diagnosed and the protocol used in the investigation of 200 consecutive patients with unilateral sensorineural hearing loss (SNHL) is presented. The diagnostic tests found most useful in defining the site of the lesion were a combination of a well‐masked pure tone audiogram, speech discrimination score (SDS), acoustic reflex test (ART), and a vestibular evaluation using photoelectric nystagmography (PENG) and the Torok Monothermal Differential Caloric Test. With this protocol, the site of the lesion was correctly defined in 94% of patients with unilateral progressive SNHL. Laboratory and radiological studies confirmed a variety of lesions other than acoustic tumors. It is, therefore, felt that the primary objective of investigations should be to define the site of the lesion rather than aim to diagnose a specific disease entity.
Avoiding problems in tracheotomy
Authors: Kirchner John A.
Published: October 2006

The surgeon can minimize postoperative problems that may develop after tracheotomy by 1. ligating the veins that cross the midline (over‐dependence on cautery often results in postoperative bleeding); 2. dividing and suture‐ligating the thyroid isthmus; 3. avoiding sharp dissection or blind clamping at the sternal notch; 4. leaving the deep layers of the wound open, to avoid subcutaneous or mediastinal emphysema; 5. avoiding a low horizontal skin incision; and 6. using guide sutures at tracheal opening in the infant.
Laser lingual tonsillectomy
Authors: Krespi Yosef P. , Har‐El Gady , Levine Toni M. , Ossoff Robert H. , Wurster Carl F. , Paulsen Jorgen W.
Published: October 2006

Diseases of the lingual tonsils are generally overlooked in both clinical practice and medical literature. Infections of the lingual tonsils are usually treated medically, although in patients with symptomatic chronic inflammation or hyperplasia of the lingual tonsils, surgical intervention may be indicated.

Eighty‐two patients with benign inflammatory problems of the lingual tonsils, who were not improved by medical management, underwent laser lingual tonsillectomy at four different medical centers, between 1984 and 1987. The procedure was tolerated well by all of the patients, with no significant operative complications. Short‐ and long‐term results were satisfactory. Laser surgery is an effective method for the treatment of benign hyperplastic and inflammatory diseases of the lingual tonsils.
A prospective randomized study of four commonly used tympanostomy tubes
Authors: Weigel Mark T. , Parker Michael Y. , Goldsmith Manning M. , Postma Duncan S. , Pillsbury Harold C.
Published: October 2006

Tympanostomy tube placement has clearly been shown to be an efficacious treatment for recurrent bouts of acute otitis media or chronic otitis media with effusion. However, there are few objective, prospective, randomized studies present in the literature to aid the clinical otolaryngologist with the proper tube choice for middle ear aeration.

A prospective, randomized study was undertaken of four commonly used tympanostomy tubes. Shepard Teflon® grommet, Armstrong beveled tube, Reuter‐Bobbin tube, and Goode T‐tube. This study was undertaken to determine which of these tubes had the fewest number of postplacement complications, including otorrhea, plugging, residual perforation, or chronic persistence in the tympanic membrane. Average follow‐up was 17 months.

The Shepard and Armstrong tubes showed a comparatively low rate of plugging and otorrhea. Both tubes had extrusion times that averaged less than 1 year. The Reuter‐Bobbin tube had a much greater rate of plugging, compared to the other tubes. The T‐tube had an increased incidence of otorrhea and persistence in the tympanic membrane well beyond 1 year. The T‐tube was also the only tube in this study associated with residual perforations.
Intentionally induced abnormalities in optokinetic pattern tests
Authors: Gyo Kiyofumi
Published: October 2006

Abnormalities of optokinetic nystagmus are easily detected by administering an optokinetic pattern test, in which optokinetic nystagmus responses to acceleration and deceleration of a series of optokinetic stimuli are recorded at slow paper speed, and the results are visually assessed based on the response pattern. Although optokinetic pattern tests ore regarded as valuable in diagnosing lesions of the nervous system that directly or indirectly relate to the reflex route of optokinetic nystagmus, these tests can be significantly influenced by the intention of the person being tested. The present study revealed that the majority of abnormal optokinetic patterns can be induced intentionally. This indicates that optokinetic pattern tests are of limited diagnostic value, and a definite diagnosis should not be made based solely on the optokinetic pattern test result.
Early alterations of cochlear function in experimental perilymph fistulas
Authors: Böhmer Andreas
Published: October 2006

Alterations of cochlear function secondary to perforation of the round window membrane in guinea pigs were expected to reveal sensitive and/or specific audiometric parameters in perilymph fistulas. A perforation of the round window membrane either did not affect acoustic compound action potential thresholds, or induced a delayed, possibly conductive, inner ear hearing loss. Also, evoked supra‐threshold responses deteriorated progressively and independently of the increase of compound action potential thresholds. A sudden (conductive) hearing loss and a poor response to suprathreshold stimulation might indicate inner ear damage secondary to a perilymphatic fistula.
Endolaryngeal jet ventilation: A 10‐year review
Authors: Shikowitz Mark J. , Abramson Allan L. , Liberatore Lisa
Published: October 2006

Jet ventilation for microsurgery of the larynx has been in common use at our institution since 1978. There were 942 cases performed, with ages ranging from 7 days to 90 years. A specially modified laryngoscope with multiple ports into which a 14‐ or 16‐gauge ventilation needle can be advanced just distal to the vocal cords simplifies this form of anesthesia and ventilation.

Jet ventilation has been advocated in place of conventional ventilation methods during carbon dioxide laser surgery because it eliminates the potential fire hazard of the endotracheal tube and allows superior visibility of the vocal cords. Despite these advantages, it is still not in common use. We will review the airway mechanics and special anesthesia considerations that make jet ventilation a safe and time‐proven technique.
Observation of the external aperture of the vestibular aqueduct using three‐dimensional surface reconstruction imaging
Authors: Yamamoto Etsuo , Mizukami Chikashi , Isono Michio , Ohmura Masaki , Hirono Yoshinobu
Published: October 2006

Observation of the external aperture of the vestibular aqueduct was hitherto possible only in cadavers or dry temporal bones; however, by applying three‐dimensional surface reconstruction imaging, it is now possible to observe solid‐looking images of this structure in living humans. When the width of the external aperture of the vestibular aqueduct was measured in 58 people, it was found to be significantly narrower in the affected ears of patients with Meniere's disease than in normal ears.
Lipomas of the internal auditory canal
Authors: Saunders James E. , Kwartler Jed A. , Wolf Helmut K. , Brackmann Derald E. , Mcelveen John T.
Published: October 2006

Intracranial lipomas are rare tumors which may occur in the cerebellopontine angle (CPA) or internal auditory canal (IAC). Although seemingly innocuous in other parts of the body, lipomas within the CPA and IAC often involve the surrounding cranial nerves, making attempts at hearing conservation largely unsuccessful.

In an attempt to differentiate the IAC lipoma from the more commonly found acoustic schwannoma, the preoperative imaging studies (magnetic resonance and computerized tomography) on five previously unreported cases of IAC lipomas were evaluated. Based on these studies, features were determined that may allow the surgeon to diagnose IAC lipomas preoperatively. These features will be discussed, as well as the surgical and pathological findings.
Response of the stria vascularis to corticosteroids
Authors: Rarey Kyle E. , Lohuis Peter J. F. M. , Ten Cate Wouter‐J. F.
Published: October 2006

Structural changes in the cellular architecture of the stria vascularis in adrenalectomized rats were quantitated by stereological methods after the administration of either aldosterone or dexamethasone. The volume densities of the differing strial components from steroid‐administered animals were determined to approximate those of sham‐adrenalectomized animals in general. The increased volume density of intercellular space as was observed following adrenalectomy, however, was only restored after the administration of aldosterone. These data correlate a recovery of the cellular architecture of the stria vascularis in adrenalectomized animals with the restoration of endogenous levels of adrenal steroids. These findings provide further information with regard to the effects of varying serum levels of corticosteroids on inner ear morphology.
Experimental reconstruction of anterior and circumferential defects of the cervical trachea
Authors: Petroianu Andy , Barbosa Alfredo José Afonso
Published: October 2006

Despite the variety of materials employable in the rehabilitation of the cervical trachea, long‐term success is rarely achieved. Both gross and microscopic postoperative developments were studied on 45 dogs submitted to nine different types of reconstruction of anterior and circumferential defects. In the majority of cases, the grafts and prostheses used for repairs, enveloped by connective and inflammatory tissue, were either absorbed or expelled. Only pedicled autologous grafts survived rejection. Failure of tracheal replacements appears to be confined to tracheal and local phenomena. Such events impaired the incorporation of any type of graft or prosthesis.
Laryngeal verrucous carcinoma: A clinicopathologic study and detection of human papillomavirus using polymerase chain reaction
Authors: Fliss Dan M. , Noble‐Topham Sandra E. , Mclachlin C. Margaret , Freeman Jeremy L. , Noyek Arnold M. , Van Nostrand A. W. Peter , Hartwick R. Warren J.
Published: October 2006

Laryngeal verrucous carcinoma (LVC) is a rare, well‐differentiated variant of squamous carcinoma with a low malignant potential. Human papillomavirus (HPV)–16 DNA has been identified in a small number of LVC and an etiologic relationship has been suggested. A correlative clinical and molecular pathological study was performed in order to determine the prevalence and typing of HPV DNA in LVC. Possible associations between patient and tumor subsets, and the presence of HPV DNA were also investigated. Formalin‐fixed, paraffin‐embedded tissue samples from 29 patients with LVC were examined by polymerase chain reaction (PCR) using DNA primers specific for HPV types 6b/11, 16, and 18. Overall, HPVDNA was detected in 13 (45%) of the cases. Of these, HPV‐16 DNA, HPV‐18 DNA, and both HPV‐16 DNA and HPV‐18 DNA were detected in 4 (14% overall; 31% of positive cases), 4, and 5 (17% overall; 38% of positive cases), respectively. HPV‐6b/11 DNA was not detected in any LVCs. In 16 cases, no HPV DNA was detected. There was a trend toward HPV DNA detection in higher stage tumors. HPV DNA detection was unrelated to patient age, tumor site, or radiotherapeutic responsiveness. The detection of HPV DNA in 45% of LVCs suggests an association between the presence of HPV‐16 DNA and HPV‐18 DNA, and some LVCs.
Testing biomechanical strength of repairs for the mandibular angle fracture
Authors: Dichard Arthur , Klotch Douglas W.
Published: October 2006

A biomechanical model using polystyrene mandibles with simple angle fractures was developed to evaluate the structural strength of a variety of commonly used plate repairs. The model standardized the fracture location, load site, plate location, and site of deformation measurement. The only variables in the study were the nine different reconstruction types tested.

Precise measurements of the deformation under load demonstrated statistically significant intra‐group reproducibility for each repair. Data support previous clinical and experimental studies demonstrating the superiority of a two‐plate system applied to the tension and compression regions of the mandible when compared to single‐plate repairs using either noncompression (bridging) or eccentric dynamic compression plates.
Tongue reinnervation by hypoglossal‐lingual nerve transfer
Authors: Weinberger J. M. , Houlden D. , Mackinnon S. E. , Evans P. J.
Published: October 2006

The morbidity associated with total glossectomy for treatment of base of tongue carcinomas provides the impetus to investigate techniques to salvage the uninvolved normal anterior tongue. This report describes a method of reinnervation of the anterior tongue using a hypoglossal‐lingual transfer. In Cynomologous monkeys, unilateral transfers with and without a subsequent muscle fillet resulted in reinnervation from the base to the tip of the tongue. It is proposed that hypoglossal‐lingual nerve transfers be considered to allow sparing and return of function to the anterior tongue in conjunction with a resection of the tongue base. Additional experiments confirmed that the base of the tongue, like other midline muscles, has bilateral and separate innervation. The presence of a physiological lingual‐hypoglossal reflex in the normal animal was documented.
Laser laryngoplasty for laryngomalacia
Authors: McClurg F. L. Don , Evans David A.
Published: October 2006

Laryngomalacia is the most common cause of stridor in infants. In severe cases, it results in obstructive sleep apnea, cor pulmonale, gastroesophageal reflux, failure to thrive, and pectus excavatum.

Our experience with 24 children who underwent laser excision of redundant supraglottic tissue from May 1987 to July 1991 is reviewed. The technique emphasizes preoperative planning with flexible fiberoptic laryngoscopy, apneic anesthetic for the procedure, conservative resection of tissue, and the need for complete airway evaluation. In our series, 71% of patients experienced complete resolution of symptoms. Nine of 10 postoperative sleep studies indicated improvement. In 4 patients, collapse developed later in other areas of the supraglottis, resulting in recurrence of stridor several months after the initial procedure, and requiring revision laryngoplasty. In several patients with other significant sites of upper airway obstruction (e.g., tonsils and adenoids, and a tongue base cyst), laryngomalacia became more significant following alleviation of the primary source of airway obstruction. Twelve patients (50%) required additional airway procedures either before or following initial laryngoplasty. Patient selection, sleep study data, and complications are reviewed.
Salvage split course brachytherapy for tonsil and soft palate carcinoma: Treatment techniques and results
Authors: Maulard C. , Housset M. , Delanian S. , Ucla L. , Rozec C. , Chauveinc L. , Baillet F.
Published: October 2006

From December 1981 to October 1990, 28 patients with prior irradiation of the oropharynx underwent salvage brachytherapy for a squamous cell carcinoma of the tonsil and/or the soft palate. The patients were free of cervical nodes and without metastatic disease. There were 4 immediate failures of radiotherapy, 14 local recurrences, and 10 new malignancies. The mean size of the lesion was 2.7 ± 1.7 cm (range, 0.5 to 7 cm). The initial irradiation had delivered 40 to 80 Gy (mean, 69 Gy) to the oropharynx with a mean interval between external therapy and salvage treatment of 22 ± 28 months. Salvage brachytherapy consisted of two split course implants done 1 month apart, delivering 35 and 30 Gy, respectively. Fifteen patients (46.5%) were clinically disease‐free before the second implant and 23 (82%) were clinically disease‐free at the end of treatment. Five local failures have been observed without any influence of the tumor size, the topographic site of the tumor, or the histological differentiation. Of the 4 patients who previously had failed with external beam therapy, 3 were disease‐free after salvage brachytherapy. Among the 23 patients in complete remission, 4 (17%) presented a local recurrence within a mean time of 5 months. The overall local control rate was 68% with a mean follow‐up of 41 ± 29 months. The overall actuarial survival was 25% and 19% at 2 and 5 years, respectively; it was 30% at 5 years for the patients presenting with lesions less than or equal to 3 cm. Tolerance was acceptable. Among the 23 patients who achieved complete remission, subsequent soft‐tissue necrosis was observed in 4 cases. For these 4 patients, the interval between previous radiation therapy and salvage treatment was short (mean, 7 months). Interstitial split course brachytherapy offers an effective and reasonable option for salvage therapy in patients with recurrent and second cancers occurring in the tonsillar region and in the soft palate, even when the tumor arises in a zone that has previously received high‐dose irradiation.
The uncinate process: A histological and morphological study
Authors: Wakey Mark , Takeno Sachio , Hawke Michael
Published: October 2006

The uncinate process (UP) has become a familiar anatomical landmark to otolaryngologists due to the increasing popularity of functional endoscopic sinus surgery (FESS) in recent years. This study examines the histological and morphological features of UPs removed from a group of patients undergoing FESS operations for chronic sinusitis. The structure of the UP by light microscopy (LM) is reported. A relatively high proportion of goblet cells and seromucous glands was noted. Scanning electron microscopy (SEM) identified four surface cell types on the UP. Furthermore, four categories of surface morphology were noted. The most common appearance was of predominantly ciliated cells. A nonciliated surface ultrastructure is associated with a longer history of sinonasal symptoms and a higher incidence of surgical intervention.
The early development of sino‐nasal mucosa
Authors: Wake Mark , Takeno Sachio , Hawke Michael
Published: October 2006

The development of human nasal mucosa was studied in 20 fetal heads between 8 and 24 weeks of gestation. Initially the nasal cavity is lined by a single layer of flattened cells, which produces two to three layers of undifferentiated spherical cells. Olfactory epithelium lines the cranial portion of the human fetal nasal cavity at 8 weeks of gestation. Pseudostratified ciliated cuboidal or columnar epithelium appears at 9 weeks of gestation in the nasal cavity and between 14 and 16 weeks of gestation in the primitive ethmoid sinuses and maxillary sinus infundibulum. Goblet cells and glandular acini appear between 12 and 14 weeks of gestation. Initially these goblet cells/glands are found predominantly in the anterior nasal cavity but are more evenly distributed at 24 weeks of gestation. The epithelial development of the nasal septum generally precedes that of the lateral nasal wall. This study documents nasal mucosal maturation and associated anatomic development in the human fetus.
The effect of prostaglandins E2 and F2a on brain and tracheal ciliary activity
Authors: Roth Yehudah , Kronenberg Jona
Published: October 2006

Prostaglandins E2 and F2a have a mild stimulatory effect (+ 11% to 18% from baseline) on the in vitro ciliary beat frequency in tracheal rings, which contain mucus‐producing cells, and in brain slices, which are devoid of mucus. Results are compared with previous studies and the merits of the used experimental models are discussed.
Age‐related basement membrane thickening of the vocal cords in sudden infant death syndrome (SIDS)
Authors: Shatz Anat , Arensburg Baruch , Hiss Yehuda , Hammel Ilan , Variend Sadik
Published: October 2006

Sudden infant death syndrome (SIDS) remains the leading cause of death in the Western world among infants between the ages of 1 month to 1 year. The diagnosis can only be established at autopsy, at which time no obvious or recognizable pathology is evident. A correlation between thickening of the basement membrane of the true vocal cords and the victim's age was observed in all 51 larynges examined, whereas no such finding was detected in 82 larynges of infants who died of other causes. Thus, the data support the authors' previous morphological results suggesting the use of basement membrane thickening as a marker of positive diagnosis of SIDS at autopsy. The possibility that an immune process may be associated with this syndrome merits further investigation and could prove to be of great importance.
Safety of ototopical antibiotics
Authors: Bradley Welling D. , Arick Forrest L. , Goll Frederick
Published: October 2006

A prospective randomized study analyzing the safety and efficacy of a single dose of ototopical antibiotics following human middle ear tympanostomy tube insertion was performed. Fifty children undergoing bilateral tympanostomy tube insertion were studied by the placement of 0.5 mL of Cortisporin Otic Suspension (COS; Burroughs Wellcome Co., Research Triangle Park, N.C.) to one middle ear space by random assignment. Preoperative and postoperative audiograms were obtained, and the presence of otorrhea was noted. In one patient sensorineural hearing loss of 6 dB developed bilaterally, which was symmetric in both the treated and the untreated ear. This preliminary study showed no statistical difference in hearing loss or postoperative otorrhea associated with a single application of Cortisporin to the middle ear space.
Magnetic resonance imaging (MRI) assessment of vocal fold medialization surgery
Authors: Ford Charles N. , Unger June M. , Zundel Roger S. , Bless Diane M.
Published: October 2006

Historically, clinicians have used subjective assessment and perceptual judgments, supplemented with acoustic measures, aerodynamic studies, and videostroboscopy, to determine the effects of phonosurgery. When phonosurgical results are poor, magnetic resonance imaging (MRI) can be useful in determining how the surgical modifications contributed to the anatomical and functional status of the vocal folds.

The authors present examples of MRI following vocal fold medialization by injection, thyroplasty, and arytenoid adduction. Findings reveal that the superior contrast resolution of MRI can precisely identify placement and persistence of injected implants and is particularly helpful in showing effects of the size and shape of alloplastic prostheses on vocal fold displacement. Such information is useful in troubleshooting suboptimal results and in planning revision thyroplasty by defining modification in the design of prostheses and the placement of cartilaginous windows in medialization thyroplasty. MRI can also aid in confirming indications for and limitations of certain procedures.
Rhinoscleroma treated with ciprofloxacin: A case report
Authors: Avery Robin K. , Salman Salah D. , Baker Ann Sullivan
Published: October 2006

Rhinoscleroma, a chronic progressive infection of the nose and associated structures caused by Klebsiella rhinoscleromatis, has posed a therapeutic dilemma since its identification in the late 1800s. Although a number of antibiotics have been found to be effective in this relapsing disorder, 1‐6 the lengthy duration of treatment can lead to problems with adverse effects and compliance, especially with the traditional therapies of streptomycin and tetracycline. We report on a patient with extensive nasal rhinoscleroma who achieved pathologic and bacteriologic resolution during treatment with oral ciprofloxacin after previous courses of tetracycline and trimethoprim‐sulfamethoxazole. Ciprofloxacin may prove to be useful in the therapy of rhinoscleroma because it is convenient for oral administration, achieves good tissue levels, is concentrated in macrophages, 7 and is generally well tolerated as long‐term therapy. As mentioned in a recent review of patients with rhinoscleroma at the Mayo Clinic, the fluoroquinolones deserve further study as potentially highly effective agents for this uncommon but significant infectious condition.8
A Point Mutation in theAspergillus nidulans sonBNup98 Nuclear Pore Complex Gene Causes Conditional DNA Damage Sensitivity
Authors: De Souza Colin P C , Hashmi Shahr B , Horn Kevin P , Osmani Stephen A
Published: October 2006

The nuclear pore complex (NPC) is embedded in the nuclear envelope where it mediates transport between the cytoplasm and nucleus and helps to organize nuclear architecture. We previously isolated sonB1, a mutation encoding a single amino acid substitution within the Aspergillus nidulans SONBnNup98 NPC protein (nucleoporin). Here we demonstrate that this mutation causes marked DNA damage sensitivity at 42°. Although SONBnNup98 has roles in the G2 transition, we demonstrate that the G2 DNA damage checkpoint is functional in the sonB1 mutant at 42°. The MRN complex is composed of MRE11, RAD50, and NBS1 and functions in checkpoint signaling, DNA repair, and telomere maintenance. At 42° we find that the DNA damage response defect of sonB1 mutants causes synthetic lethality when combined with mutations in scaANBS1, the A. nidulans homolog of NBS1. We provide evidence that this synthetic lethality is independent of MRN cell cycle checkpoint functions or MREAMRE11-mediated DNA repair functions. We also demonstrate that the single A. nidulans histone H2A gene contains the C-terminal SQE motif of histone H2AX isoforms and that this motif is required for the DNA damage response. We propose that the sonB1 nucleoporin mutation causes a defect in a novel part of the DNA damage response.
Diverse Roles for Histone H2A Modifications in DNA Damage Response Pathways in Yeast
Authors: Moore John D , Yazgan Oya , Ataian Yeganeh , Krebs Jocelyn E
Published: October 2006

There are many types of DNA damage that are repaired by a multiplicity of different repair pathways. All damage and repair occur in the context of chromatin, and histone modifications are involved in many repair processes. We have analyzed the roles of H2A and its modifications in repair by mutagenizing modifiable residues in the N- and C-terminal tails of yeast H2A and by testing strains containing these mutations in multiple DNA repair assays. We show that residues in both tails are important for homologous recombination and nonhomologous end-joining pathways of double-strand break repair, as well as for survival of UV irradiation and oxidative damage. We show that H2A serine 122 is important for repair and/or survival in each of these assays. We also observe a complex pattern of H2A phosphorylation at residues S122, T126, and S129 in response to different damage conditions. We find that overlapping but nonidentical groups of H2A residues in both tails are involved in different pathways of repair. These data suggest the presence of a set of H2A “damage codes” in which distinct patterns of modifications on both tails of H2A may be used to identify specific types of damage or to promote specific repair pathways.
Nonsurgical Approaches to Colorectal Cancer
Authors: Ryan David P.
Published: October 2006

Learning Objectives

After completing this course, the reader will be able to: Describe the potential for nonsurgical approaches to colon cancer.Discuss radiofrequency ablation data for metastatic colon cancer.Discuss the utility of radiation in metastatic colon cancer patients.

Access and take the CME test online and receive 1 AMA PRA Category 1 Credit™ at CME.TheOncologist.com
Effluent suspended solid control of activated sludge process by fuzzy control approach
Authors: Tsai Yung‐Pin , Ouyang Chaio‐Fuei , Wu Ming‐Yang , Chiang Wei‐Ling
Published: October 2006

The influent flow rate and substrate concentration normally vary with time in a municipal wastewater treatment plant (MWWTP). The treatment units must be operated dynamically to prevent the process from failing, reducing treatment efficiency, and creating a lack of stability. Using real time operation data to control the dynamic activated sludge process (DASP) systematically is an alternative approach to the expert system, which is based on experts' knowledge and/or operators' experiences and whose control rules are typically difficult to be derived by a systematic approach. The fuzzy control theory based on modified Newton's method can make real‐time control feasible and is adopted in this study. The theory is definitely a systematic approach toward deriving optimum control strategies on‐line. The optimum control strategies derived from the proposed approach are verified by experimental results that indicate that the forecast and control abilities of fuzzy model are sufficient. The proposed systematic approach only requires on‐line monitored data, not experts' knowledge and operators' experiences, to adequately control the complex system. This feature is possible despite the fact that the system information is not clearly described, the kinetic model and related parameters are unknown, or the dynamic behaviors of the process are not thoroughly understood. Moreover, a comparison is also made in this study of the results between F:M ratio and fuzzy control strategies. That comparison reveals that the F:M control might not be appropriate for DASP when municipal wastewater is treated. The fuzzy control strategies confirm that the operating concepts for DASP are similar to those for a steady‐state condition and can make the effluent quality better and more stable. The only difference between both systems is that time delay problems arise in DASP, but not in steady‐state ASP.
Field assessment of trace element uptake by six vegetables from N‐Viro Soil
Authors: Logan T. J. , Goins L. E. , Lindsay B. J.
Published: October 2006

A field experiment was conducted to measure the uptake of selected trace elements (Cd, Cu, Ni, Pb, and Zn) by six vegetable crops (cabbage, carrot, dry bean, lettuce, potato, and tomato) from a single large (500 mt/ha) application of N‐Viro Soil, an advanced alkaline stabilized biosolids product. Crops were grown for 3 yr (1993, 1994, 1995) after application of the biosolids in 1992. Differences among the metals for uptake by the different crops were consistent and were overall in the order: Zn > Cu > Ni > Cd > Pb. This reflects both the total soil content (Zn > Pb > Ni = Cu > Cd) and intrinsic solubilities of the metals in soil (Cd > Zn > Cu > Ni > Pb). Trace element plant uptake declined from 1993 to 1995. In general, lettuce, bean, and tomato had the highest relative trace element concentrations and cabbage the lowest, and the carrot and potato peels were elevated only in Pb compared with the flesh. Plant uptake response slopes were low compared with literature values and often negative, and the results suggest that large applications of the test material pose no threat to the food chain from trace element uptake by crops.
The Use of Tetracaine 0.25% Solution in Nasal Packing Removal
Authors: Lachanas Vassilios A. , Karatzias George T. , Pinakas Vassilios G. , Hatziioannou John K. , Sandris Vassilios G.
Published: October 2006

Background

The aim of this study was to evaluate efficacy of Merocel nasal package rehydration with tetracaine 0.25% solution, in reducing discomfort of nasal packing removal after septoplasty.

Methods

A prospective study was conducted on patients undergoing pure septoplasty. Merocel packing was applied in each side and kept for 2 days postoperatively. Merocel was rehydrated before removal, with 4 mL of saline on one side and 4 mL of tetracaine 0.25% solution on the other side. Patients were asked to evaluate severity of pain during nasal packing removal on each side by a visual analog scale. Patients’ data, pain score, and potential complications were placed in a database and statistically assessed.

Results

Our series consisted of 141 persons. Statistical analysis showed significant lower pain score in favor of the tetracaine group. No tetracaine complications or side effects occurred.

Conclusion

Merocel packing rehydration with tetracaine 0.25% solution is an easy, safe, inexpensive, and effective analgesia method for nasal packing removal in septoplasty.