bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of pH and sodium ions on NaHCO3 extractable phosphate in calcareous/sodic soils
Authors: Rimmer David L. , Hamad Muawia E. , Keith Syers J.
Published: October 2006

One calcareous and one sodic soil were treated with solutions of either sodium carbonate (Na2CO3) or sodium perchlorate (NaCIO4) to increase their sodium (Na) saturation before extracting with sodium bicarbonate (NaHCO3) to measure the recovery of native plus added phosphate (P). The Na2CO3 additions also increased pH, and by comparing with the NaCIO4 treatments, it was possible to separate the effects of added Na and pH on extractable P. For the calcareous soil both added Na and increased pH led to increases in the amount of NaHCO3‐extractable P. For the sodic soil the amount of extractable P was mainly affected by pH, with little, if any, effect of the added Na. The suitability of the Olsen test for soil P for Na‐affected soils is discussed.
Effect of cysteine and ribose on the volatile thermal degradation products of a triglyceride and three phospholipids
Authors: Farmer Linda J. , Mottram Donald S.
Published: October 2006

The effect of the Maillard reaction on the volatile products of the degradation of lipids was investigated using an aqueous model system. This paper reports the changes in amounts of selected aliphatic oxidation products formed when beef triglyceride, beef phospholipid, egg phosphatidylcholine and egg phosphatidylethanolamine were heated with cysteine and ribose. The thermal degradation products of these lipids were modified considerably in the presence of cysteine and ribose. The most pronounced alteration was a reduction in the amounts of aldehydes detected, especially unsaturated aldehydes. However, this does not appear to constitute an overall antioxidative effect as ketones. also derived from the oxidation of lipid, showed little change. The 1‐alcohols and 2‐alkylfurans were increased when cysteine and ribose were heated with phosphatidylcholine, but not with the other lipids. While the effect on alcohols and furans is not fully understood, the depletion of aldehydes is thought to be caused by reactions with the amino or thiol groups of the amino acid. Reactions with amino groups are also believed responsible for the lower levels of unsaturated aldehydes formed from phospholipids containing the ethanolamine moiety.
Effects of catecholamines and of tetanic contraction in perfused isolated rabbit muscle on the rate of metabolism after the cessation of perfusion
Authors: Monin G. , Miri A. , Rodet Laurence , Talmant A.
Published: October 2006

The respective influences of tetanic contractions and of high levels of circulating catecholamines on per‐mortem and post‐mortem muscle metabolism were investigated using perfused isolated muscles of rabbits. In this model, death was simulated by cutting off the oxygen supply to the muscle (end of perfusion). The pH and ATP and phosphocreatine contents of muscle tissue were measured at time intervals before and after perfusion. The pH values were affected by catecholamine treatment. Neither ATP nor phosphocreatine level was significantly affected by any treatment.
Nutritive value of pumpkin (Cucurbita Pepo Kakai 35) seed products
Authors: Mansour Esam H , Dworschák Erno , Lugasi Andrea , Barna Éava , Gergely Anna
Published: October 2006

The nutritive value of the pumpkin seed products was evaluated. Isolation of protein eliminated 80% of the phytic acid and 100% of the tannic acid, trypsin inhibitor and flatulence factors. Ethanol treatment during the preparation of the protein concentrate reduced tannic acid by 78% and trypsin inhibitor by 21%, while it had no effect on the phytic acid content. Isoleucine and valine were the first limiting amino acids for meal and protein concentrate, while the sulphur‐containing amino acids and valine were first limiting in pumpkin protein isolate‐I and isolate‐N, respectively. Pumpkin seed products had high levels of crude protein in the range 720–960 g kg−1. In‐vitro protein digestibility and biological value were in the ranges 88–97% and 73–86%, respectively. Both meal and concentrate were rich in minerals (Ca, K, P, Mg, Fe and Zn) while isolates contain remarkable levels of sodium and copper. Pumpkin meal is a good source of the vitamin B group, while a large proportion of these vitamins is lost during the preparation of the protein concentrate and isolates.
Inhibition of oxidative rancidity in frozen cooked fish flakes by tert‐butylhydroquinone and rosemary extract
Authors: Boyd L C , Green D P , Giesbrecht F B , King M F
Published: October 2006

The antioxidant properties of tert‐butylhydroquinone (0·5 g kg−1 + 20 g kg−1 ascorbic acid—TBHQ‐AS) and an extract of rosemary (2·5 g kg−1) alone and in combination were determined by their addition as solutions to cooked fish flakes stored at ‐ 20°C. Oxidation was measured by following changes in free fatty acids, thiobarbituric acid number, fatty acid composition and sensory evaluation. The order of effectiveness in inhibiting oxidation was TBHQ‐AS > combination > rosemary > untreated control −70°C > untreated control ‐20°C. Sensory evaluation indicated that green aroma and flavor notes were associated with the rosemary extract, while fish oil notes were associated with untreated samples.
Tolerance of growing pigs to trypsin and chymotrypsin inhibitors in chickpeas (Cicer arietinum) and pigeonpeas (Cajanus cajan)
Authors: Batterham Edward S , Saini Harpal S , Andersen Lynette M , Baigent Robin D
Published: October 2006

The threshold level of growing pigs to trypsin and chymotrypsin inhibitors was investigated by adding graded levels of meals rich in these inhibitors to diets and recording responses. Diets were formulated to contain either 250, 500 or 750 g kg−1 of Opal chickpea, dehulled Tyson chickpea or dehulled pigeonpea meals and pig response compared to that of pigs given a wheat and soya‐bean meal control. Trypsin inhibitor levels (mg g−1) of the diets were, respectively, control, 0.2; chickpea meal 1, 1.2.32; chickpea meal 2, 1.7–4.7; pigeonpea meal, 1.4–3.6. Chymotrypsin inhibitor levels (mg g−1) of the diets were, respectively, control, 0.2; chickpea meal 1. 0.9–2.2; chickpea meal 2, 1.6–4.5; pigeonpea meal. 0.8–2.1. The diets were offered ad libitum over the 20–50 kg growth phase. Growth responses of the pigs fed the two chickpea meals were similar to those of the pigs fed the control soya‐bean meal diet (P>0.05). In contrast, the addition of pigeonpea meal linearly depressed growth rate (P<0.001), feed intake (P<0.05) and increased the feed conversion ratio (P<0.05), inclusion levels of the chickpea meals had no effect on organ weights, whereas the inclusion of pigeonpea meal significantly affected the weights of the liver and pancreas (P<0.05), indicating the presence of other anti‐nutritional factors. The results indicate that the growing pig can tolerate dietary levels of at least 4.7 and 4.5 mg g−1 of trypsin and chymotrypsin inhibitors, respectively. These threshold levels are unlikely to be exceeded in conventional diets containing the majority of grain legumes. The results also indicate that dehulled pigeonpea meal contains an anti‐nutritional factor(s) for growing pigs.
Detection of irradiated food: A review
Authors: Glidewell Sheila M , Deighton Nigel , Goodman Bernard A , Hillman John R
Published: October 2006

The sale of irradiated food in the UK has been legal since the start of 1991 with the proviso that it must be labelled as such. At present there are no methods sufficiently accurate and reliable for the routine detection of irradiated food of all varieties. The current state of development of different physical, chemical and biological methods available is reviewed. These comprise electron paramagnetic resonance, luminescence, viscosity changes, detection of radiation‐induced chemical species such as volatile hydrocarbons and o‐tyrosine by chromatographic‐mass spectrometric techniques, changes to DNA and changes in microflora.
Time‐dependent competitive adsorption of milk proteins and surfactants in oil‐in‐water emulsions
Authors: Chen Jianshe , Dickinson Eric
Published: October 2006

Competitive adsorption of pure milk proteins and non‐ionic surfactants has been studied in model oil‐in‐water emulsions (4 g kg−1 β‐lactoglobulin or β‐casein, 200 g kg−1 n‐hexadecane) as a function of the age of the adsorbed protein layer at the oil‐water interface. With β‐lactoglobulin‐stabilised emulsions containing oil‐soluble surfactant C12 E2 (diethylene glycol n‐dodecyl ether), there is found to be a steadily increasing amount of protein associated with the emulsion droplets over a few hours following emulsification. Addition of water‐soluble surfactant Tween 20 (polyoxyethylene (20) sorbitan monolaurate) to a β‐lactoglobulin‐stabilised emulsion (with or without C12E2) leads to less protein displacement if the emulsion is aged prior to addition of Tween 20. Moderate additions of C12E2 or Tween 20 produce no time dependence in the competitive adsorption in β‐casein‐stabilised emulsions, although some time dependence is observed when C12E2 and a high concentration of Tween 20 are present together. Crystallisation of the oil phase in β‐casein‐stabilised emulsions at pH 7 leads to a lowering of the measured protein surface concentration, especially in the presence of C12E2 and a reduction in the surfactant to protein molar ratio required for complete protein displacement by water‐soluble surfactant (Tween 20 or octaethylene glycol n‐dodecyl ether). Under more acidic conditions of pH 5 or pH 3, the surface coverage and ease of displacement of β‐lactoglobulin at the surface of liquid emulsion droplets is substantially different from that under neutral pH conditions.
Determination of 19 rhubarb constituents by high‐performance liquid chromatography–ultraviolet–mass spectrometry
Authors: Lin Ching‐Che , Wu Chuan‐I , Lin Ta‐Chen , Sheu Shuenn‐Jyi
Published: October 2006

Rhubarb (Rhei rhizoma), a commonly used Chinese herb, contains anthraquinones, anthrones, galloylglucoses, stilbenes, and flavan‐3‐ols compounds, etc. as major constituents. Using 19 of these compounds as markers, an HPLC‐UV‐MS method was developed to estimate the quality of rhubarb samples within a period of 70 min. Extracts were analyzed with a Cosmosil 5C18‐MS column and eluted with a gradient comprising an aqueous solution of acetic acid and methanol at a flow rate of 0.9 mL/min. Peaks were detected by absorbance measurements at 254 nm (6 and 8–19) and 280 nm (1–5 and 7), and the peaks of the marker substances were identified from their UV spectra and MS fragmentation patterns. The proposed method yielded a peak–area ratio RSD value with an intraday SD falling within 0.71–1.78% and an interday SD within 0.78–1.98% at a detection limit of 0.2–3.2 μg/mL. The ESI negative ion mode was used to collect data (molecular weight, CID fragments from MS and MS/MS spectra) for 19 compounds from four types of structure categories: anthraquinones, dianthrone glycosides, stilbenes, and galloylglucosides. The information gathered can be used to identify the structures of various peaks appearing in the LC chromatograms of rhubarb samples.
Advantages of ultra performance liquid chromatography over high‐performance liquid chromatography: Comparison of different analytical approaches during analysis of diclofenac gel
Authors: Nováková Lucie , Solichová Dagmar , Solich Petr
Published: October 2006

Miniaturization embracing instrumentation, column particle size, and column dimensions is one of the major current trends in separation techniques. This leads to shortening of analysis time and great savings in solvent consumption. Ultra performance liquid chromatography (UPLC) is one of the new developments in liquid chromatography. An ultra‐high pressure system allows using of small particle‐packed columns with small diameter, which has a positive effect on both system efficiency and analysis time. An analytical method for determination of the active substance diclofenac, the degradation product 1‐(2,6‐dichlorphenyl)‐2‐indolinone, and the preservatives methylparaben and propylparaben was used for testing and comparing LC systems. Various octadecylsilica‐based analytical columns were examined. Acquity UPLC BEH C18 (2.1×50 mm, 1.7 μm) and (2.1×100 mm, 1.7 μm) were tested for UPLC. The following analytical columns were used in a test for HPLC: Purospher RP 18e (125×4.0 mm, 5 μm), Zorbax Eclipse XDB C18 (75×4.6 mm, 3.5 μm), Zorbax Eclipse SB C18 (50×4.6 mm, 1.8 μm), as was a monolithic column (Chromolith Performance RP‐18e (100×4.6 mm). Results of a System Suitability Test (SST) were calculated and compared for each chromatographic peak. System efficiency and analysis duration were compared with regard to solvent consumption and system maintenance
Successful antiparkinsonian medication withdrawal in patients with Parkinsonism and normal FP‐CIT SPECT
Authors: Marshall Vicky L. , Patterson Jim , Hadley Donald M. , Grosset Katherine A. , Grosset Donald G.
Published: October 2006

Between 4% and 14% of patients diagnosed with Parkinson's disease and entering clinical trials have normal presynaptic dopaminergic imaging. The effects of antiparkinsonian therapy have varied in these studies, and the consequences of stopping treatment are not reported. We present 11 patients who initially fulfilled diagnostic criteria and were treated for Parkinson's disease but in whom emerging diagnostic doubts led to antiparkinsonian therapy withdrawal, which was achieved without deterioration. Such cases represent a nondegenerative form of Parkinsonism, which does not benefit from dopaminergic therapy. Prospective vigilance regarding this category is of importance in clinical practice and clinical trials. © 2006 Movement Disorder Society
Abnormalities in motor cortical plasticity differentiate manifesting and nonmanifesting DYT1 carriers
Authors: Edwards Mark J. , Huang Ying‐Zu , Mir Pablo , Rothwell John C. , Bhatia Kailash P.
Published: October 2006

A mutation in the DYT1 gene causes dominantly inherited childhood‐onset primary dystonia, but intriguingly, only 30 to 40% of those who carry the mutation ever develop symptoms. We have used the unique model provided by this group of patients to investigate the hypothesis that abnormalities in brain plasticity underlie the pathophysiology of primary dystonia. We recruited 8 DYT1 gene carriers with dystonia, 6 DYT1 gene carriers without dystonia, 6 patients with sporadic primary dystonia (torticollis), and 10 healthy control subjects. Groups were age‐matched. We compared the effect in these groups of subjects of repetitive transcranial magnetic stimulation (rTMS) delivered to the motor cortex, by assessing changes in corticospinal excitability following rTMS. rTMS was given in the form of theta burst stimulation (TBS) using the inhibitory protocol “cTBS” (total of 300 pulses in 50‐Hz bursts given every 5Hz). DYT1 gene carriers with dystonia and subjects with torticollis had a significantly prolonged response to rTMS in comparison with healthy subjects. In contrast, DYT1 gene carriers without dystonia had no significant response to rTMS. These data demonstrate an excessive response to an experimental “plasticity probing protocol” in subjects with dystonia, but a lack of response in genetically susceptible individuals who have not developed dystonia. These preliminary data suggest that the propensity to undergo plastic change may affect the development of symptoms in genetically susceptible individuals and that this may be an important mechanism in the pathogenesis of primary dystonia in general. © 2006 Movement Disorder Society
Neurological manifestations in Wilson's disease: Report of 119 cases
Authors: Machado Alexandre , Fen Chien Hsin , Mitiko Deguti Marta , Cançado Eduardo , Soares Azevedo Raymundo , Scaff Milberto , Reis Barbosa Egberto
Published: October 2006

We describe the neurological manifestations of 119 patients with WD (93 index cases and 26 affected family members) seen between 1963 and 2004. The mean age at symptoms onset was 19.6 years (range, 7–37 years). Medical records were reviewed for the patient's first neurological examination. The most frequent neurological manifestations observed were dysarthria (91%), gait disturbance (75%), risus sardonicus (72%), dystonia (69%), rigidity (66%), tremor (60%), and dysphagia (50%). Less frequent manifestations were chorea (16%) and athetosis (14%). Rare neurological presentations were seizures (4.2%), and pyramidal signs (3%). © 2006 Movement Disorder Society
Muscle blood flow and oxygenation measured by NMR imaging and spectroscopy
Authors: Carlier P. G. , Bertoldi D. , Baligand C. , Wary C. , Fromes Y.
Published: October 2006

Tissue perfusion and oxygenation in many organs can be evaluated by various NMR techniques. This review focuses on the specificities, limitations and adaptations of the NMR tools available to investigate perfusion and oxygenation in the skeletal muscle of humans and animal models. A description of how they may be used simultaneously is provided as well. 1H NMR spectroscopy of myoglobin (Mb) monitors intramyocytic oxygenation. It measures the level of deoxy‐Mb, from which Mb concentration, Mb desaturation/resaturation rates, muscle oxygenation changes and intracellular partial oxygen pressure (pO2) can be calculated. Positive and negative blood oxygen level‐dependent (BOLD) contrasts exist in skeletal muscle. BOLD contrasts primarily reflect changes in capillary–venous oxygenation, but are also directly or indirectly dependent on muscle blood volume, perfusion, vascular network architecture and angulation, relative to the main magnetic field. Arterial spin labelling (ASL) techniques, having high spatial and temporal resolution, are the methods of choice to quantify and map skeletal muscle perfusion non‐invasively. Limitations of ASL are poor contrast‐to‐noise ratio and sensitivity to movement; however, with the introduction of specific adaptations, it has been proven possible to measure skeletal muscle perfusion at both rest and during exercise. The possibility of combining these NMR measurements with others into a single dynamic protocol is most interesting. The ‘multiparametric functional (mpf) NMR’ concept can be extended to include the evaluation of muscle energy metabolism simultaneously with 31P NMR or with lactate double quantum filtered 1H NMR spectroscopy, an approach which would make NMR an exceptional tool for non‐invasive investigations of integrative physiology and biochemistry in skeletal muscle in vivo. Copyright © 2006 John Wiley & Sons, Ltd.
Cloning and characterization of Rab Escort Protein (REP) from Arabidopsis thaliana
Authors: Wojtas M. , Swiezewski S. , Sarnowski T.J. , Plochocka D. , Chelstowska A. , Tolmachova T. , Swiezewska E.
Published: October 2006

Intracellular vesicular trafficking is regulated by Rab proteins, small GTPases that require posttranslational geranylgeranylation for biological activity. This covalent modification is catalyzed by Rab geranylgeranyl transferase (RabGGTase) and proceeds only in the presence of accessory Rab Escort Protein (REP). In this communication, we report the cloning and characterization of REP gene of Arabidopsis thaliana. Highest expression of REP mRNA was detected in leaves and flowers in contrast to stems and roots. AtREP is recognized by anti‐rat REP1 serum. Interaction of AtREP with the protein substrate is presented, as well as a structural model obtained through homology modeling, based on the known structure of rat REP1.
Addiction to opioids in chronic pain patients: A literature review
Authors: Højsted Jette , Sjøgren Per
Published: October 2006

Opioids have proven very useful for treatment of acute pain and cancer pain, and in the developed countries opioids are increasingly used for treatment of chronic non‐malignant pain patients as well. This literature review aims at giving an overview of definitions, mechanisms, diagnostic criteria, incidence and prevalence of addiction in opioid treated pain patients, screening tools for assessing opioid addiction in chronic pain patients and recommendations regarding addiction problems in national and international guidelines for opioid treatment in cancer patients and chronic non‐malignant pain patients.

The review indicates that the prevalence of addiction varied from 0% up to 50% in chronic non‐malignant pain patients, and from 0% to 7.7% in cancer patients depending of the subpopulation studied and the criteria used. The risk of addiction has to be considered when initiating long‐term opioid treatment as addiction may result in poor pain control. Several screening tools were identified, but only a few were thoroughly validated with respect to validity and reliability.

Most of the identified guidelines mention addiction as a potential problem. The guidelines in cancer pain management are concerned with the fact that pain may be under treated because of fear of addiction, and the guidelines in management of non‐malignant pain patients include warnings of addiction. According to the literature, it seems appropriate and necessary to be aware of the problems associated with addiction during long‐term opioid treatment, and specialised treatment facilities for pain management or addiction medicine should be consulted in these cases.
Botulinum toxin A for myofascial trigger point injection: A qualitative systematic review
Authors: Ho Kok‐Yuen , Tan Kian‐Hian
Published: October 2006

Botulinum toxin injection is used to treat various pain conditions including muscle spasticity, dystonia, headache and myofascial pain. Results are conflicting regarding the use of Botulinum toxin for trigger point injection in terms of improvement in pain. The aim of this study was to carry out a systematic review to assess the evidence for efficacy of Botulinum toxin A (BTA) compared with placebo for myofascial trigger point injection.

Electronic databases on Medline, Cochrane Library, Scopus, CINAHL were queried using key words such as “botulinum toxin”, “myofascial pain”, “trigger point”, “chronic pain” and “musculoskeletal pain”. Relevant published randomized controlled trials that described the use of BTA as injection therapy for trigger points were considered for inclusion. The five‐item 0–16 point Oxford Pain Validity Scale (OPVS) was used as a selection criteria for suitable clinical trials. Trials were also assessed based on quality using the Oxford Rating Scale. Data extracted from qualified trials included outcome measures such as pain intensity and pain pressure threshold. All studies were ranked according to the OPVS and the authors’ conclusions were compared.

Five clinical trials met the inclusion criteria. One trial concluded that BTA was effective, and four concluded that it was not effective for reducing pain arising from trigger points. OPVS scores ranged from 8 to 14 with the negative studies corresponding with higher validity scores. The current evidence does not support the use of BTA injection in trigger points for myofascial pain. The data is limited and clinically heterogeneous.
(2α,3β)‐2,3‐Dihydroxyolean‐12‐en‐28‐oic acid, a new natural triterpene from Olea europea, induces caspase dependent apoptosis selectively in colon adenocarcinoma cells
Authors: Reyes Fernando J. , Centelles Josep J. , Lupiáñez José A. , Cascante Marta
Published: October 2006

Triterpenoids are known to induce apoptosis and to be anti‐tumoural. Maslinic acid, a pentacyclic triterpene, is present in high concentrations in olive pomace. This study examines the response of HT29 and Caco‐2 colon‐cancer cell lines to maslinic‐acid treatment. At concentrations inhibiting cell growth by 50–80% (IC50HT29 = 61 ± 1 μM, IC80HT29 = 76 ± 1 μM and IC50Caco‐2 = 85 ± 5 μM, IC80Caco‐2 = 116 ± 5 μM), maslinic acid induced strong G0/G1 cell‐cycle arrest and DNA fragmentation, and increased caspase‐3 activity. However, maslinic acid did not alter the cell cycle or induce apoptosis in the non‐tumoural intestine cell lines IEC‐6 and IEC‐18. Moreover, maslinic acid induced cell differentiation in colon adenocarcinoma cells. These findings support a role for maslinic acid as a tumour suppressant and as a possible new therapeutic tool for aberrant cell proliferation in the colon. In this report, we demonstrate for the first time that, in tumoural cancer cells, maslinic acid exerts a significant anti‐proliferation effect by inducing an apoptotic process characterized by caspase‐3 activation by a p53‐independent mechanism, which occurs via mitochondrial disturbances and cytochrome c release.
Bowel injury following induced abortion
Authors: Jhobta R.S. , Attri A.K. , Jhobta A.
Published: October 2006

Objective: Bowel injury is an uncommonly reported yet serious complication of induced abortion, which is often performed illegally by persons without any medical training in developing countries. A sudden increase in cases prompted the authors to analyze this problem. Method: A retrospective review was done of 11 cases of bowel injury following induced abortion seen over 2 years at Government Medical College and Hospital, Chandigarh, India. Results: Young, married women of low socioeconomic status with a strong preference for male children were the predominant recipients of induced abortion in India. The terminal ileum and pelvic colon were the most commonly injured portions of the bowel owing to their anatomic locations. Conclusion: Preoperative resuscitation, then resection with exteriorization of bowel and thorough peritoneal lavage, is the treatment for bowel injury incurred during induced abortion when the patient presents late.
Gestational weight gain differentials in the presence of intimate partner violence
Authors: Moraes C.L. , Amorim A.R. , Reichenheim M.E.
Published: October 2006

Objective: To assess whether gestational weight gain (GWG) during pregnancy is linked to intimate partner violence (IPV). Methods: A total of 394 women being delivered at term at Rio de Janeiro public maternities from March to October 2000 were randomly selected. The Revised Conflict Tactics Scales were used to assess IPV and GWG was expressed through the Net Weight Gain (NWG) indicator. Multiple linear regression was used to control for socioeconomic, demographic, reproductive, and nutritional confounding factors, as well as lifestyle factors such as alcohol, drug, and tobacco consumption. Results: Even after adjustment, increased physical abuse from male partners was statistically associated with lesser weight gain during pregnancy. Compared with women unexposed to IPV, those with the highest physical abuse score showed deficits of 3245 g and 3959 g, respectively, according to 2 models that did and did not control for lifestyles factors. Conclusion: Physical violence between intimate partners constitutes an independent risk factor for GWG deficit during pregnancy.
Endoscopic sinus surgery for antrochoanal polyps in children
Authors: Lee Ta‐Jen , Huang Shiang‐Fu
Published: October 2006

Objective

The antrochoanal polyp (ACP) occurs predominantly in children and young adults. Endoscopic surgery is effective for the treatment of ACPs in adults; however, articles discussing the treatment in pediatric patients are rare. The purpose of this study was to evaluate the outcome of endoscopic treatment of ACPs in children.

Study Design and Setting

Between January 1998 and February 2004, 26 children were prospectively enrolled in this study. Completely removing the base of the ACPs was achieved through transnasal endoscopic (TE) or combined endoscopic and transcanine (CET) approach. The CET approach was used in ACPs originated from the lateral wall of antrum. All patients received CT scan 1 year after surgery to evaluate the outcome of surgery.

Results

Most of the ACPs were multitudinous and the distributions of the ACPs' origin in the maxillary sinus were as follows: posterior wall (92.3%), lateral wall (61.5%), and inferior wall (38.5). The success rate was 76.9% in the TE approach and 100% in the CET approach. Three in the TE approach recurred and all of them had concomitant rhinosinusitis. All three patients were cured in the revision CET operations. No major complications occurred.

Conclusion

Endoscopic treatment of ACPs in children is safe and effective. Early diagnosis and treatment of ACPs is important because secondary rhinosinusitis can make the disease complicated and the surgeries difficult.
A rare but serious entity: Nasogastric tube syndrome
Authors: Brousseau Valérie Julie , Kost Karen M.
Published: October 2006

Since its first description by Hunter in 17901, the nasogastric tube has become a frequently used method of alleviating gastrointestinal symptoms. Because the morbidity associated with its use is low the risks of complications are often underestimated. We present a case of bilateral vocal cord paralysis and supraglottic edema following nasogastric tube insertion—also known as Nasogastric Tube Syndrome (NGTS). Although this complication is rare, it can be life threatening. We discuss this phenomenon in the context of a meta‐analysis of reported cases, notably: presenting symptoms, time at development and resolution of symptoms in relation to nasogastric intubation and propose treatment options.
Coblation vs electrocautery tonsillectomy: Postoperative recovery in adults
Authors: Leong Tan Alvin Kah , Hsu Pon Poh , Eng Soh Ping , Ng Yuk Hui , Sun Lu Peter Kuo , Tan Su Meng , Say Jia Huey , Chan Yiong Huak
Published: October 2006

Objective

Comparison of coblation and monopolar electrocautery tonsillectomy in terms of postoperative pain and recovery.

Study Design

Prospective double‐blind randomized controlled trial.

Methods

Patients with recurrent tonsillitis requiring tonsillectomy were randomized to 2 groups: coblation or monopolar electrocautery tonsillectomy. Postoperative pain, complications, and days taken to return to work and normal diet were compared and analyzed with the aid of a pain diary, given to the patient.

Results

67 patients were recruited. Patients undergoing coblation tonsillectomy were able to return to normal diet in a shorter space of time following surgery. Patients undergoing coblation tonsillectomy were more likely to recommend the surgery than patients undergoing electrocautery tonsillectomy. No significant differences in the daily visual analog score for pain were seen for both groups of patients.

Conclusions

Our results showed that coblation tonsillectomy has a faster recovery period and may offer advantages when compared to monopolar electrocautery tonsillectomy.
Frontal sinus fractures: A 28‐year retrospective review
Authors: Strong E. Bradley , Pahlavan Nima , Saito David
Published: October 2006

OBJECTIVES

To analyze 202 consecutive frontal sinus fracture (FSF) patients treated between 1974 and 2002 at the University of California, Davis.

METHODS

A retrospective chart review was performed, including all patients with frontal sinus fractures from 1987 to 2002. This and 72 previously reported patients (1974‐1986) were analyzed, comparing age, gender, fracture type, associated fractures, procedure type, and complications.

RESULTS

Frontal sinus fractures resulting from motor vehicle accidents (MVAs) decreased from 71% to 52% (P < 0.05). Fractures from assaults increased from 9% to 21% (P < 0.05). The incidence of “through and through” fractures decreased from 40% to 11% (P < 0.05). Whereas combined anterior/posterior table fractures increased from 36% to 57% (P < 0.05).

CONCLUSION

The etiology and severity of FSF has changed from 1974 to 2002. This is reflected in a reduced number of fractures resulting from MVAs as well as a reduced severity of injury. The most likely explanation is the use of safety belts and airbags.
Transcutaneous electrical stimulation versus traditional dysphagia therapy: A nonconcurrent cohort study
Authors: Blumenfeld Liza , Hahn Yoav , LePage Amanda , Leonard Rebecca , Belafsky Peter C.
Published: October 2006

OBJECTIVE

The purpose of this investigation was to critically evaluate the efficacy of electrical stimulation (ES) in treating persons with dysphagia and aspiration.

STUDY DESIGN

Nonconcurrent cohort study.

METHODOLOGY

The charts of 40 consecutive individuals undergoing ES and 40 consecutive persons undergoing traditional dysphagia therapy (TDT) were reviewed. Pre‐ and post‐therapy treatment success was compared utilizing a previously described swallow severity scale. A linear regression analysis was employed to adjust for potential confounding variables.

RESULTS

The swallow severity scale improved from 0.50 to 1.48 in the TDT group (P < 0.05) and from 0.28 to 3.23 in the ES group (P < 0.001). After adjusting for potential confounding factors, persons receiving ES did significantly better in regard to improvement in their swallowing function than persons receiving TDT (P = 0.003).

CONCLUSIONS

The results of this nonconcurrent cohort study suggest that dysphagia therapy with transcutaneous electrical stimulation is superior to traditional dysphagia therapy alone in individuals in a long‐term acute care facility.
Reconstruction of upper digestive tract: Reducing morbidity by laparoscopic pull‐up
Authors: DePaula Aureo L. , Macedo Antonio L.V. , Cernea Claudio R. , Schraibman Vladimir , Pinus Jacques , Milanez José R. , Succi José E. , Hojaij Flávio C. , de Carlucci Dorival , Nishio Sunao
Published: October 2006

BACKGROUND

Gastric pull‐up is a useful method for reconstruction of the upper digestive tract, with considerable morbidity/mortality, especially in esophageal cancers (EC)

OBJECTIVE

To analyze the experience of a multidisciplinary team with a laparoscopic gastric pull‐up (LGPU) method, with or without thoracoscopy, in a series of 120 patients with EC.

STUDY DESIGN

Retrospective.

PATIENTS AND METHODS

From 1992 to 2004, 120 EC [cervical/cervicothoracic (3.0%), middle third (15.0%), and inferior third (82.0%)]. Most were squamous cell carcinomas (47.0%) and adenocarcinomas (34.0%). Stomach was dissected and mobilized exclusively by laparoscopy. Occasionally, laparoscopic approach was extended cranially, until connecting with cervical dissection. In other cases, dissection of thoracic esophagus was accomplished through a thoracoscopic approach.

RESULTS

Eighty‐one patients (68.0%) had LGPU; 39 (32.0%) needed thoracoscopy. Mortality was 5.9%. Complications were fistula (10.0%) and pneumonia (10.0%). All fistulae closed spontaneously; 89.2% of patients could swallow a normal oral diet.

CONCLUSION

Low morbidity/mortality of LGPU for EC compared favorably with conventional techniques.
Validation of a new grading system for endoscopic examination of adenoid hypertrophy
Authors: Parikh Sanjay R. , Coronel Mark , Lee James J. , Brown Seth M.
Published: October 2006

Objective

To propose and validate a new subjective grading system of adenoid size with flexible fiberoptic evaluation.

Study Design and Setting

Digital video clips of 24 flexible fiberoptic nasopharyngeal exams were presented to 24 examiners (otolaryngology resident and consultant physicians) at a tertiary care institution. Examiners were asked to use the proposed grading system to rate adenoid hypertrophy. Kappa statistical analysis was used to evaluate the degree of intergrader agreement or disagreement.

Results

Statistical analysis of intergrader agreement demonstrated an overall Kappa score of 0.71 suggesting a “substantial” strength of agreement. The Kappa strength of agreement was found to be 0.83 (almost perfect) among consultant physicians and 0.62 (substantial) among resident physicians.

Conclusions

The proposed adenoid staging system is a reliable and consistent method of staging adenoid tissue size.

Significance

This new validated grading system may be a useful standard for reporting adenoid size in future clinical outcome studies.
Implantable Doppler flow system: Experience with 24 microvascular free‐flap operations
Authors: Pryor Shepherd G. , Moore Eric J. , Kasperbauer Jan L.
Published: October 2006

Objective

Microvascular reconstruction requires postoperative monitoring to prevent vascular occlusion and flap failure. These methods require skilled personnel and can delay diagnosis and treatment of threatened flap failures. The Cook‐Swartz implantable Doppler flow system provides continual feedback on vascular pedicle status, which in turn provides rapid assessment of minute‐to‐minute changes in flap vasculature that may allow intervention before total vascular occlusion and expeditious reexploration for threatened flap failure, possibly improving flap salvage.

Study Design and Setting

Charts of 24 patients with microvascular free‐flap reconstruction and implantation of Doppler flow system at Mayo Clinic Rochester were retrospectively reviewed. Surgical technique and flap outcomes were evaluated.

Results

Microvascular reconstruction and implantation of Doppler flow system were successful in all patients. Complications were minimal, and postoperative monitoring system facilitated rapid reexploration when necessary. Flap viability was 96%.

Conclusion

Doppler flow system is reliable for monitoring minute‐to‐minute changes in microvascular flap vascular status postoperatively, and allows rapid recognition of complications and facilitating reexploration. This is a valuable, easily mastered tool for microvascular reconstructive surgery.

Significance

May alter postoperative monitoring techniques of microvascular surgeons.
Innervation of the trapezius muscle: Is cervical contribution important to its function?
Authors: Zhao Wen , Sun Jian , Zheng Jia‐Wei , Li Jun , He Yue , Zhang Zhi‐Yuan
Published: October 2006

Objective

To study the effect of the cervical plexus and the accessory nerve to the function of the trapezius muscle.

Study Design and Setting

Eighteen adult male Sprague‐Dawley rats were randomly divided into three groups. The neurotomies were performed in the left sides and the right sides served as within‐subject controls. In group A, the accessory nerve was transected. The C2‐5 were transected in group B, and both of the accessory nerve and C2‐5 were cut in group C. The electrophysiologic, myophysiologic, and histologic changes of the muscles were measured.

Results

There were significant differences (P < 0.05) between the three groups in the recovery rates of the transverse area of the muscles. The CMAP recorded from the experimental sides in group B were similar to the control sides. The values of the maximum tension of the tetanus contraction between the two sides showed no differences either (P > 0.05).

Conclusion

The accessory nerve supplies the most important motor input to the trapezius. Motor innervations of the cervical plexus are not very significant.
Endoscopic transeptal surgery for choanal atresia with a stentless folded‐over‐flap technique
Authors: Cedin Antonio C. , Fujita Reginaldo , Oswaldo Laércio M. Cruz
Published: October 2006

OBJECTIVE

To analyze long‐term results of a new stentless surgical technique for choanal atresia that also used no packing.

STUDY DESIGN

Prospective study.

METHODS

Ten patients (3 bilateral and 7 unilateral), with ages ranging from 4 days to 30 years, were operated on. The follow‐up was 6 months to 36 months. This approach allowed resection of the posterior portion of the vomer, atretic plate, and part of the medial pterygoid process. Flaps were fashioned from septal, nasal, and pharyngeal mucosa from the atretic plates and fixed with fibrin glue. Postoperative control included nasal endoscopy and computerized tomography (CT).

RESULTS

Adequate functional nasal breathing was maintained during follow‐up.

CONCLUSIONS

This technique was satisfactory and safe, allowing fast recovery in a one‐step surgery, using neither stents nor nasal packing. Long‐term patency with no reduction in functional quality was also observed.
Determinants of success in endoscopic cerebrospinal fluid leak repair
Authors: Basu Devraj , Haughey Bruce H. , Hartman James M.
Published: October 2006

OBJECTIVES

To identify factors influencing success in endoscopic repair of CSF leaks of the anterior skull base.

METHODS

Through retrospective chart review, 24 endoscopic closures of anterior skull base CSF leaks were analyzed for factors correlating with initial repair outcome.

RESULTS

Thirteen patients with either spontaneous leaks or iatrogenic leaks arising from FESS were repaired with significantly lower recurrence rate (8%) than 11 patients with leaks induced by skull base procedures (45%). However, in the latter group, only 14% recurred when the dural defect was directly visualized, whereas leaks always recurred when bony dehiscences were patched in the absence of visible dural defects. Such defects were least frequently localized in patients with craniotomy‐induced leaks. A trend toward morbid obesity was also noted among repair failures.

CONCLUSIONS

Direct visualization of the dural defect is essential for endoscopic repair of anterior skull base CSF leaks, with craniotomy‐induced leaks being the most challenging to localize. Obesity is another likely factor contributing to repair failure.
Toxic metabolic encephalopathy after parathyroidectomy with methylene blue localization
Authors: Kartha Swapna S. , Chris Chacko E. , Bumpous Jeffrey M. , Fleming Muffin , Lentsch Eric J. , Flynn Michael B.
Published: October 2006

OBJECTIVE

To determine the correlation between methylene blue use and toxic metabolic encephalopathy in patients undergoing surgery for primary hyperparathyroidism.

STUDY DESIGN AND SETTING

A retrospective study of 193 patients was performed to collect demographic, perioperative, and postoperative data. Patients were divided into two groups: Group A (postoperative neurological sequelae) and Group B (no neurological sequelae). All data points were compared between the groups.

RESULTS

Twelve of 193 patients were placed in Group A; 181 patients were placed in Group B. Ten patients in Group A were female, and 10 patients were older than 60 years. Of the patients in Group A, 100% were taking a serotonin reuptake inhibitor (SRI). In Group B, 8.8% of patients were taking an SRI.

CONCLUSION

All the patients who experienced transient neurological events were taking an SRI. A correlation can be made between methylene blue infusion and SRI usage.

SIGNIFICANCE

Patients taking SRIs may represent a high‐risk group for postoperative neurological events when methylene blue is utilized.
Comparison of frontal pneumatization patterns between Koreans and Caucasians
Authors: Cho Jae Hoon , Citardi Martin J. , Lee Walter T. , Sautter Nathan B. , Lee Heung‐Man , Yoon Joo‐Heon , Hong Seok‐Chan , Kim Jin Kook
Published: October 2006

OBJECTIVE

To evaluate the prevalence of specific frontal recess cells in Korean and Caucasian populations; to evaluate and compare the relationship between anterior skull base length and frontal recess pneumatization in these two populations.

MATERIALS AND METHODS

Frontal recess anatomy was studied with high resolution sinus CT scans obtained in 60 Korean adults and 41 Caucasian adults. None of the subjects had a history of frontal sinus disease or trauma. The anterior cranial base length (ACBL, distance between the nasion and center of the pituitary fossa) and anterior ethmoid length (AEL, distance between the nasion and upper attachment of basal lamella) was also measured on each side.

RESULTS

Supraorbital ethmoid cells were more common in Caucasians whereas suprabullar cells and recessus terminalis were more common in Koreans. The prevalence of some frontal recess pneumatization patterns (specifically supraorbital ethmoid cell, suprabullar cell, and recessus terminalis) were more commonly associated with race rather than with ACBL or AEL.

CONCLUSION

Frontal recess pneumatization patterns differ in the Korean and Caucasian adult populations. Because corresponding differences in skull base length were not identified, these differences seem likely to reflect other factors. Such information has clinical significance for frontal recess surgery in these patient populations.
Minimally invasive nonendoscopic thyroidectomy
Authors: Cavicchi Ottavio , Piccin Ottavio , Rinaldi Ceroni Alberto , Caliceti Umberto
Published: October 2006

OBJECTIVES

Minimal‐access thyroid surgery, using various techniques, is increasingly being reported. The present study reviews our experience with thyroid surgery using a minimally invasive approach (MIT).

STUDY DESIGN

Between October 2002 and December 2004, a prospective nonrandomized study of patients undergoing thyroid surgery was performed to evaluate the variables that might condition the indications to minimally invasive nonendoscopic approach.

RESULTS

296 patients underwent thyroid surgery; 46 of these were eligible for MIT through a 2.5‐ to 3‐cm incision. There was one case of transient inferior laryngeal nerve palsy and no postoperative definitive hypoparathyroidism. MIT was converted to conventional thyroidectomy only in two cases. Cosmetic results were considered excellent by all patients.

CONCLUSIONS

Minimal‐access thyroid surgery is a safe and feasible alternative to conventional thyroid surgery in selected cases. The advantage that this technique offers, in addition to low morbidity, is an improved cosmetic result.
Perceptual voice analysis of patients with subglottic stenosis
Authors: Ettema Sandra L. , Tolejano Carol Jorgensen , Thielkes Robert J. , Toohill Robert J. , Merati Albert L.
Published: October 2006

OBJECTIVES

To characterize the perceptual assessment of vocal quality in subglottic stenosis (SGS) patients and to identify risk factors for dysphonia.

STUDY DESIGN AND SETTING

Retrospective review, academic center.

METHODS

Perceptual voice assessment using GRBAS scale (Grade, Roughness, Breathiness, Asthenia, Strain); patient characteristics determined for 31 SGS cases.

RESULTS

The mean GRBAS (0 to 3 scale, 0 = normal quality) for SGS patients at their initial visit was G(1.4)R(1.2)B(0.5) A(0.5)S(1.1). For males vs females: G(2.1 vs 1.1)R(2.0 vs 0.8)B(1.0 vs 0.4)A(1.0 vs 0.3)S(1.7 vs 0.9). The Grade (P < 0.03), Breathiness (P < 0.04), and Asthenia (P < 0.02) assessments were significantly more dysphonic in patients with multilevel stenosis; vocal fold motion impairment (VFMI) also impacted overall Grade (P < 0.01). Overall Grade (P < 0.002), Roughness (P < 0.007), and Breathiness (P < 0.006) were significantly worse in patients with prior airway surgery.

CONCLUSION

SGS patients demonstrate a mild to moderate change in perceptual voice characteristics with males in this series being more affected than females. Negative risk factors include multiple stenoses, VFMI, and previous airway surgery.

SIGNIFICANCE

This is the first systematic report of perceptual voice assessment in subglottic stenosis. SGS patients have notable degrees of dysphonia with identifiable risk factors.
Nasal polyposis: Prevalence of positive food and inhalant skin tests
Authors: Collins Melanie M. , Loughran Sean , Davidson Pauline , Wilson Janet A.
Published: October 2006

OBJECTIVES

To investigate the etiology of nasal polyps and its relationship to allergy. The prevalence of positive food and inhalant skin tests in patients with nasal polyps and nonatopic controls was compared.

STUDY DESIGN AND SETTING

Prospective controlled study in tertiary referral rhinology clinic.

RESULTS

Seventy percent (70%) of the patients with nasal polyps had positive skin tests to an average of four foodstuffs, compared to 34 percent of controls (P = 0.006). Only 35 percent of the nasal polyp patients also had positive inhalant skin tests. Overall, the prevalence of positive inhalant skin tests was similar in the nasal polyp patients and controls.

CONCLUSIONS

These findings suggest that the positive skin tests to foods are not merely a reflection of the general atopic status of patients with nasal polyps. It may be that non‐IgE‐mediated hypersensitivities, such as to ingested foods, play a role on the basis of a significant number of patients with positive intradermal skin tests to foods.

SIGNIFICANCE

Evaluation of the allergic status of patients with polyposis is important. Dietary manipulation may be indicated, though its role needs further investigation.