bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mandibular Fracture Reduction with Eccentric Dynamic Compression Plate: New Treatment for an Old Problem
Authors: Levine Paul A. , Goode Richard L. 
Published: January 2017

We describe a technique and theory of application of the Eccentric Dynamic Compression Plate (EDCP) and the Dynamic Compression Plate (DCP) for mandibular fracture fixation, developed by Speissl in Switzerland, and our experience with the application of 15 plates in ten edentulous or nearly edentulous patients over the past 18 months. While we have had soft tissue infections in 4 of 15 fracture sites, our results reveal satisfactory bony healing in 14 of 15 fracture sites. We, therefore, believe that while this technique is still in the infant stages of clinical application in the United States, it has the potential to revolutionize the thinking and practice of mandibular fracture therapy.
Benign Adenoma of the Middle Ear Cavity Causing Facial Paralysis
Authors: Zahtz Gerald D. , Zielinski Benjamin , Abramson Allan L. 
Published: January 2017

The otologic surgeon infrequently encounters tumors confined to the middle ear cavity. A 30‐year‐old man had a right facial nerve palsy that was believed to be secondary to chronic otitis media. At surgical exploration, an adenoma of the middle ear involving the ossicles and overlying the facial nerve was found, a radical mastoidectomy performed, and subsequent complete recovery of the facial nerve noted.To our knowledge, this is the first case of a middle ear benign adenoma causing a facial paralysis and the pathology, cause, and differential diagnosis will be discussed.
The Relationship of Hematocrit Levels to Skin Flap Survival Length in the Pig
Authors: Alperstein Jeffrey B. , Levine Howard L. , Tucker Harvey M. 
Published: January 2017

The work of several investigators suggests that anemia may increase the survival length of skin flaps in the dog and the rabbit. The following experiment was designed to study the survival of standardized skin flaps of varying lengths in normocythemic, polycythemic, and anemic pigs. The pig was chosen because of the similarity of its skin to that of human skin.Twenty‐nine standardized random‐pattern flaps and six standardized arterial flaps were studied in pigs with varying hematocrits. A statistically significant increase was found in the survival lengths of skin flaps in the polycythemic animal as compared with the anemic one. No significant difference was found when the flap survival lengths of the normocythemic control animal were compared with those of the polycythemic animal or with those of the anemic animal. These findings suggest that relative polycythemia may allow improved flap length‐survival and, in contradistinction to the findings of previous investigators, that anemia does not result in improved survival length.
The Role of Ige‐Mediated Hypersensitivity in Otitis Media with Effusion
Authors: Bernstein Joel M. , Ellis Elliot , Li Philip 
Published: January 2017

Forty‐one children with recurrent otitis media with effusion (OME) were evaluated for IgE mediated allergy by critical analysis of history, physical findings, skin testing for selected antigens, and laboratory determination of total IgE and radioallergosorbent testing (RAST) for six inhalant and two food allergens. The children were divided into an allergic and nonallergic group. The allergic group clearly had higher total IgE in their serum. There was an elevation of middle ear effusion (MEE) IgE in 5 of 20 allergic cases. In three of these five patients or 15% of the allergic group, the IgE/mg protein was higher in the MEE than in the corresponding serum, suggesting the possibility of local production of IgE.Specific IgE antibody as measured by RAST was noted in 9 of 20 MEE and 5 of 20 nasal washings in the allergic group and in only 2 of 21 MEE and in 10 nasal washings of the nonallergic group.Nasal IgE was substantially increased in three patients of the allergic group; however, the corresponding MEE IgE was not increased in proportion to the nasal IgE. The MEE RAST was positive in 22% of the allergic group and in less than 1% of the nonallergic group. Nasal RAST was positive in 20% of the allergic group and in none of the nonallergic group.We conclude that IgE‐mediated allergic reactions may play a role in the pathogenesis of OME in only about 15% of children defined as allergic on the basis of clinical and laboratory evidence. Allergy investigation as a diagnostic procedure in children with recurrent OME, but without a history of allergy on the basis of history, family history, or laboratory testing is likely to be nonproductive.
Tympanic Membrane Debridement with the CO2 Laser
Authors: Epley John M. 
Published: January 2017

Precise control of tissue penetration can be provided by the CO2 laser at low power. At 1 W, superficial lesions of the tympanic membrane were successfully extirpated in ten patients. The beam produced immediate delamination and carbonization of the external layer, which usually included the lesion, with no apparent effect on the underlying tissue. This charred layer was easily removed mechanically in a bloodless field. No permanent perforations resulted. Extirpation of canal lesions was less effective.
Severe Upper Airway Obstruction Caused by Bullous Pemphigoid: Diagnostic Usefulness of the Flow‐Volume Curve
Authors: Hallenborg Carl , Rowe Lee D. , Gamsu Cordon , Boushey Homer A. , Golden Jeffrey A. 
Published: January 2017

The site and severity of upper airway obstruction were accurately determined by analysis of the flow‐volume curve obtained from a dyspneic patient with bullous pemphigoid. The limitation of maximum inspiratory flow to 0.5 L/s and of maximum expiratory flow to 0.7 L/s over most of the vital capacity suggested that the lumen of the extrathoracic trachea was narrowed to a diameter of 3 mm. The marked improvement in flow with the patient breathing a helium‐oxygen mixture further confirmed that flow was limited in a large central airway. The predictions made from analysis of the flow‐volume curve were confirmed by fiberoptic bronchoscopic examination and by computerized axial tomography, which revealed severe supraglottic obstruction. After a tracheostomy was performed, maximal inspiratory and expiratory flows were normal.
Argon Laser and Soft Tissue Interaction
Authors: Gillis T. M. , Strong M. Stuart , Shapshay Stanley M. , Incze J. , Simpson George 
Published: January 2017

The interaction of the argon laser with the mucous membrane of the upper aerodigestive tract was studied. The advantages of the argon laser are a small spot that can be varied in size and intensity, selective vascular absorption, the capability of being incorporated into a flexible delivery system, and a coincident aiming beam. The acute soft tissue effects are characterized by subepithelial extension, with a variable delayed reaction between the application of the laser and a detectable break in the epithelium. Postoperative edema persisted, with an increase in the lateral spread of the lesion over 3 days and an acute inflammatory reaction extending over 7 days. By 21 days the lesions were reepithelialized and healed, but their width was 30% greater than the original defect. The unpredictable interaction with soft tissue, the postoperative edema, and the quality of wound healing are disadvantages. The argon laser appears to have limited clinical potential as a surgical tool for the air and food passages.
Cochleosacculotomy
Authors: Silverstein Herbert , Hyman Susan , Silverstein David 
Published: January 2017

Schuknecht introduced the cochleosacculotomy procedure in 1982. This procedure has an advantage in that it can be done with a local anesthesic. The idea is to create a permanent fistula between the endolymph and perilymph. The fistula is created by introducing a 3 mm right‐angle pick through the round‐window membrane, thus rupturing the cochlear duct and osseous spiral lamina. The procedure is safe and rapid, with minimal postoperative morbidity. Its success rate in curing vertigo was 70% during a 6‐month follow‐up period. The main drawback is that the surgeon cannot visualize the area of the fistula. One week after the procedure, 8 of 14 patients had a sensorineural hearing loss of greater than 15 dB (pure‐tone average [PTA]), and 11 of 14 had a loss of speech discrimination greater than 15%. In the next 1 to 3 months postoperatively, hearing generally improved, so that 3 of 10 had a 15 dB (PTA) loss and 8 of 10 had a loss of speech discrimination greater than 15%. At this time follow‐up has been too short to determine long‐term effects and results. Early results, however, indicate that this procedure may have value in selected patients with Meniere's disease when hearing preservation is not of great concern.
Simultaneous Use of CO2 Laser with Continuous Monitoring of Eighth Cranial Nerve Action Potential during Acoustic Neuroma Surgery
Authors: Silverstein Herbert , Norrell Horace , Hyman Susan M. 
Published: January 2017

In a 38‐year‐old patient with bilateral acoustic neuromas a CO2 laser mounted on an operating microscope was used to remove the tumor on the right side. The technique of tumor evaporation reduced surgical manipulation. The eighth cranial nerve action potential was continuously monitored with the recording electrode fixed to the proximal trunk of the eighth nerve. Clicks were delivered through an ear mold insert at a sound pressure level of 115 dB at 10 clicks/sec. The preoperative auditory brain stem response (ABR) showed no wave I and a delayed wave V and no response to electrocochleography with a promontory electrode. Tumor removal resulted In an improvement In the abnormal action potential latency from 5.1 msec to 4.32 msec. Overuse of the laser above the cochlear nerve caused a transient reduction in wave amplitude. At the end of the procedure the latency was 4.6 msec, and the amplitude was reduced to 2.3 μV. Audiometry at 1 week showed the pure‐tone speech reception threshold reduced from 50 dB preoperatively to 60 dB postoperatively and discrimination reduced from 72% to 52%. There are two advantages to direct monitoring of the eighth nerve action potential: surgical trauma to the auditory nerve can be identified rapidly without averaging as many responses as are necessary when using ABR to monitor surgery; and when there is no preoperative response to electrocochleography or ABR, surgical manipulation can still be guided by direct recording from the eighth nerve. To our knowledge this is the first case in which an acoustic neuroma was removed with a CO2 laser while the eighth nerve action potential was continuously monitored. The combination of these two new techniques may allow the surgeon to preserve auditory function in a greater percentage of cases.
Results of surgical repair of inapparent perilymph fistulas
Authors: Parell G. Joseph , Becker Gary D. 
Published: January 2017

In patients who are thought to have a perilymph (PL) fistula, careful inspection of the round and oval windows during exploratory tympanotomy may be normal. The decision must then be made either to terminate the procedure—knowing that the patient's symptoms will probably continue or deteriorate—or to repair both windows as if PL fistulas were present, risking further damage to the inner ear. From a series of 14 patients explored for possible PL fistulas, we report on 6 patients with preoperative diagnoses of PL fistula, based on history, physical examination, and audiometry. Symptoms resulting from trauma were present from 10 days to 23 years before surgery. During exploratory tympanotomy, no fistulas were evident; however, both the oval and round windows were repaired with tissue grafts. Follow up—for 1 to 5 years—revealed that vertigo was relieved in all patients. Postoperatively, one patient had a mild conductive hearing loss; yet no patient sustained a sensory neural hearing loss. We conclude that patch grafting of both the oval and round windows is a safe and effective method of treating suspected, but inapparent fistulas. Patient selection, surgical technique, and results shall be detailed.
Effect of Epidermal Growth Factor (EGF) on a Newly Established Head and Neck Squamous Carcinoma Cell Line
Authors: Weber Randal S. , Pathak Sen , Frankenthaler Robert , Gallick Gary E. , Sacks Peter G. 
Published: January 2017

A new cell line designated 584A2 has been recently established from a patient with squamous cell carcinoma of the larynx. Cytogenetic analysis of the cell line revealed multiple copies of chromosome 7, as well as a homogeneous staining region (HSR) on one chromosome 7. Since overexpression of epidermal growth factor (EGF) cell surface receptors (EGFr) often occurs in other squamous carcinoma cell lines, it was predicted that 584A2 might overexpress EFGr. This was confirmed by: (1) metabolic labeling, with subsequent immunoprecipitation of EGFr and comparing autoradiographs to a cell line without an HSR and fewer copies of chromosome 7, and (2) performing EGF binding assays with Scatchard analysis. Since overexpression of EGFr correlates with an inhibitory effect of EGF on cell culture, the biological effects of EGF on 584A2 were examined in this study. At 5 ng/ml (serum‐free medium), EFG stimulated incorporation of [3H] thymidine into trichloroacetic acid‐precipitable material compared with controls. Incorporation increased between days 0 to 1 and 1 to 2 days with a 6‐ to 7‐fold maximum. Dose‐response studies (0 to 100 ng/ml) indicated maximum incorporation (6‐ to 7‐fold) occurred between 0.1 ng/ml and 1.0 ng/ml. Cell growth was monitored over 7 days and, during this time, 5 ng/ml EGF produced a 10‐ to 12‐fold increase in absolute cell numbers when compared with controls. We concluded that, unlike other squamous carcinoma lines with elevated EGFr, EGF stimulates rather than inhibits 584A2 cell proliferation.
Validation of a Revised Visual Analog Scale for Premenstrual Mood Symptoms: Results from Prospective and Retrospective Trials
Authors: Steiner Meir , Streiner David L , Pham Ba‘ 
Published: January 2017

Objective: Previous studies have demonstrated that visual analog scales (VASs) are valid and reliable instruments for measuring the severity of premenstrual symptoms. Most of these studies, though, predate the introduction of DSM-IV diagnostic criteria for premenstrual dysphoric disorder (PMDD). Our objective was to assess the reliability and validity of VASs that were revised to better reflect the DSM-IV definition of PMDD. Methods: Concurrent information from the well-validated Premenstrual Tension Syndrome-Observer (PMTS-O) rating scale was used to evaluate the revised VASs. Data from 4 randomized controlled trials ( n = 1208) evaluating the efficacy of paroxetine for the treatment of PMDD were used. Cronbach's alpha coefficient was used to evaluate the internal consistency of the core VAS mood items. Pearson's correlation between scores from the 2 scales was used to assess reliability. Results: The internal consistency among the core VAS mood items (Cronbach's α > 0.90 across trials) was high. Luteal VAS scores and corresponding PMTS-O scores were moderately correlated at baseline ( P < 0.01). Luteal VAS change scores and corresponding PMTS-O change scores were strongly correlated ( P < 0.01). These results did not differ regardless of whether the PMTS-O data were collected prospectively or retrospectively. Conclusion: The revised VASs, which approximate the current DSM-IV definition of PMDD, provide a valid and reliable measure of the severity of premenstrual symptoms when evaluated against the validated PMTS-O scale. Our results also suggest that, whether observers assessed severity of PMDD symptoms retrospectively or prospectively using the PMTS-O scale, the correlations with the patient-reported VAS scores were comparable.
Prevalence of Depression and Prescriptions for Antidepressants, Bella Coola Valley, 2001
Authors: Thommasen Harvey V , Baggaley Earle , Thommasen Carol , Zhang William 
Published: January 2017

Objective: To determine the prevalence of depression–anxiety disorders and the degree to which physicians prescribed antidepressants for Aboriginal and non-Aboriginal populations living in a remote rural community in British Columbia in 2001. Methods: To obtain data for our main outcome measures, we retrospectively reviewed the charts of 2375 patients living in the Bella Coola Valley as of September 2001 and attending the Bella Coola Medical Clinic. Results: The 2001 prevalence rate of depression–anxiety disorders in the Bella Coola Valley was 7.5% (177/2375). Depression was the most common problem (86%) in these patients. Women had a higher rate of depression–anxiety disorders (10.3%) than did men (4.7%) ( P < 0.001). Non-Aboriginal people had a slightly higher rate (8.5%) than did Aboriginal people (6.3%); however, the difference was not statistically significant. Antidepressant medications were commonly prescribed for chronic pain and insomnia. The general pattern of antidepressant medication use in 2001 among both Aboriginal and non-Aboriginal people living in the Bella Coola Valley was as follows: peak use of antidepressants was in the middle to late years; the rate for women was roughly double the rate for men; and proportionately more Aboriginal people, especially the women, were taking antidepressants. Conclusions: Depression–anxiety disorder prevalence rates for Aboriginal and non-Aboriginal populations are similar. When using antidepressant medication prescriptions as a community health indicator, health care administrators should be aware that antidepressant medications are commonly prescribed for conditions other than depression–anxiety disorder.
The Prevalence and Incidence of Treated Major Depressive Disorder among National Health Insurance Enrollees in Taiwan, 1996 to 2003
Authors: Chien I-Chia , Kuo Chien-Cheng , Bih Shin-Huey , Chou Yiing-Jenq , Lin Ching-Heng , Lee Cheng-Hua , Chou Pesus 
Published: January 2017

Objective: We used the National Health Insurance (NHI) database to examine the prevalence and incidence of treated major depressive disorder (MDD) and their associated factors. Method: The National Health Research Institute provided a database of 200 432 randomly selected subjects for study. We obtained a population-based random sample aged 15 years or older ( n = 136 045) as a fixed cohort dated 1996 to 2003. We identified study subjects with a principal diagnosis of MDD who had at least one service claim during these years for either ambulatory or inpatient care. Results: From 1996 to 2003, the cumulative treated prevalence increased from 1.67 per 1000 to 17.24 per 1000. From 1997 to 2003, the annual treated incidence increased from 1.89 per 1000 to 2.58 per 1000. A higher incidence of treated MDD was detected in the groups aged 25 to 44 years (hazard ratio [HR] 1.28; 95% confidence interval [CI], 1.13 to 1.45), 45 to 64 years (HR 1.90; 95%CI, 1.66 to 2.16), and 65 years or older (HR 1.87; 95%CI, 1.59 to 2.20); in female subjects (HR 1.97; 95%CI, 1.80 to 2.15); in those with with an insurance amount of US$1281 or more (HR 1.15; 95%CI, 1.01 to 1.31); in those with a fixed premium (HR 1.44; 95%CI, 1.27 to 1.62); and among those who lived in urban areas (HR 1.22; 95%CI, 1.10 to 1.35). Conclusions: For treated MDD, the prevalence and incidence in Taiwan were lower than in community studies in Western countries. Individuals with MDD are underdiagnosed and undertreated in Taiwan.
An Outcome Measure in Schizophrenia: Mortality
Authors: Seeman Mary V 
Published: January 2017

Objective: To determine the current outcome of schizophrenia, with mortality rate as the outcome measure. Method: Recent health, suicide, victim of violence, and mortality statistics were reviewed. Results: The general health of individuals with schizophrenia suffers from neglect, poor life style choices, and current treatments that increase death rates. Conclusion: Mortality in schizophrenia is rising, and it is the responsibility of physicians and health care planners to intervene.
Depressed Mood in the Suicidal Population
Authors: Bethell Jennifer , Rhodes Anne E 
Published: January 2017

Objective: To determine whether, and to what extent, those who reported suicidal ideation and (or) attempts in the previous year, without meeting the criteria for major depressive episode (MDE), might still have experienced subthreshold depression. Method: Data from the Canadian Community Health Survey: Mental Health and Well-Being (CCHS 1.2) were examined to estimate and compare the prevalence of depressed mood, a core symptom of MDE and subthreshold depression, within the previous month for the following 4 population groups: MDE within the previous month [D(1 month)], MDE within the previous year but not the previous month [D(1 year)], suicidality without MDE within the previous year (D-S+), and no MDE or suicidality within the previous year (D-S-). Results: As expected, the D(1 month) group showed the highest prevalence of depressed mood in the previous month. However, the D-S+ group had a significantly higher prevalence of depressed mood than the D-S-group and only a slightly lower level than that of the D(1 year) group. Conclusions: A fraction of those who reported suicidality in the previous year met the criteria for MDE during that time; however, subthreshold depression might be common in the suicidal population. Future epidemiologic research in the areas of suicidality and depression will benefit from a comprehensive assessment of subthreshold depression.
Clinical and Demographic Variables Related to “Fitness to Stand Trial” Assessments in Manitoba
Authors: Robertson R Gail , Gupton Ted , McCabe Scott B , Bankier Robert G 
Published: January 2017

Objective: To assess the extent to which clinical and nonclinical variables have been used by mental health professionals in Manitoba to determine fitness to stand trial. Researchers at a forensic setting in another province have suggested that demographic variables account for as much of the variance in predicting the outcome of these assessments as clinical variables. Method: These variables were assessed by the examination of 100 fitness assessments conducted at Winnipeg's Forensic Services unit during a 2-year period. Results: Contrary to findings reported in Ontario, the variance in fitness evaluations in Manitoba was primarily accounted for by clinical rather than demographic variables. Conclusion: Since Manitoba's forensic clinicians were using standardized criteria that were very similar to 1992 Criminal Code revisions of fitness, the findings attest to the usefulness of these criteria.