bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of Sleep-Disordered Breathing on Physical Traits, School Performance, and Behavior of Korean Elementary School Students in the Upper Grade Levels
Authors: Kim Jin Kook , Lee Ji Hye , Lee Seung-Hoon , Hong Seok-Chan , Cho Jae Hoon 
Published: October 2014

Objectives: We investigated the physical traits, school performance, and behavior of Korean children with sleep-disordered breathing (SDB). Methods: We recruited 679 students from an elementary school in Seoul, Korea. We used a survey to collect information on the absence or presence of SDB at both the child's preschool age and his or her current age and on the degree of behavioral disturbance. Physical traits and examination scores were also analyzed. We divided the children into 4 groups: Non-SDB group, past SDB group, recent SDB group, and continuous SDB group. Comparisons between these four groups were conducted. Results: Sixty-one students were excluded because of incomplete information. The current body mass index was significantly higher in the past (19.7 ± 3.6), recent (21.2 ± 3.6), and continuous SDB groups (20.7 ± 3.9) than in the non-SDB group (18.8 ± 3.2), but only for male students (p < 0.001). The examination scores were not different among the four groups, but the behavioral disturbance scores were much higher in the past, recent, and continuous SDB groups than in the non-SDB group for both genders. Conclusions: Among these Korean elementary school students in the upper grade levels, the presence of current or past SDB appeared to influence the current body mass index in boys and the presence of behavioral disturbances in both genders. However, SDB was not associated with school performance.
Adhesion of a Monolayer of Fibroblast Cells to Fibronectin under Sonic Vibrations in a Bioreactor
Authors: Titze Ingo R. , Klemuk Sarah A. , Lu Xiaoying 
Published: October 2014

Objectives: We examined cell adhesion to a surface under vibrational forces approximating those of phonation. Methods: A monolayer of human fibroblast cells was seeded on a fibronectin-coated glass coverslip, which was attached to either the rotating part or the stationary part of a rheometer-bioreactor. The temperature, humidity, carbon dioxide level, nutrients, and cell seeding density were controlled. The cell density was on the order of 1,000 to 5,000 cells per square millimeter. Target stresses above 1 kPa at an oscillatory frequency of 100 Hz were chosen to reflect conditions of vocal fold tissue vibration. Results: Fibronectin coating provided enough adhesion to support at least 2 kPa of oscillating stress, but only about 0.1 kPa of steady rotational shear. For stresses exceeding those limits, the cells were not able to adhere to the thin film of fibronectin. Conclusions: Cells will adhere to a planar surface under stresses typical of phonation, which provide a more stringent test than adherence in a 3-dimensional matrix. The density of cell seeding on the coverslip played a role in cell–extracellular matrix adhesion, in that the cells adhered to each other more than to the fibronectin coating when the cells were nearly confluent.
Novel Device for Tissue Cooling during Endoscopic Laryngeal Laser Surgery: Thermal Damage Study in an Ex Vivo Calf Model
Authors: Koo Hae Jin , Burns James A. , Kobler James B. , Heaton James T. , Zeitels Steven M. 
Published: October 2014

Objectives: Minimizing collateral thermal damage during endoscopic laryngeal laser surgery remains a priority, and tissue cooling is one way to achieve this goal. Cooling systems utilizing compressed air have been shown to reduce the extent of thermal trauma on the vocal folds, but these units are not ideal for endoscopic applications because cooling is inefficient at the low airflows needed. We examined whether a novel vortex cooling device that generates cooled air at low flow rates would provide a cooling benefit beyond that which could be obtained by using room-temperature air for cooling tissue or by using no cooling during simulated laryngeal laser surgery. Methods: A continuous-wave thulium laser was used to incise glottic tissue in 12 calf vocal folds. Cooling was achieved with a prototype vortex cooler (9°C air output; flow rate, 3 L/min), and tissue temperature measurements were compared to those with room-air cooling and no cooling. Thermal damage was analyzed histologically by measuring the depth of lactate dehydrogenase inactivation surrounding the mucosal incision. The cooling conditions were tested during time-constant cuts (8 seconds) and depth-constant cuts (into the thyroarytenoid muscle). Results: During time-constant cuts, comparison between vortex cooling and room-air cooling revealed that vortex cooling resulted in a thermal damage zone that was 14% smaller (519 versus 603 μm; p < 0.05). During depth-constant cuts, vortex cooling created a thermal damage zone that was 32% smaller than that created with no cooling (p < 0.01) and 9% smaller than that created with room-air cooling (p < 0.01). Conclusions: Vortex cooling reduces thermal damage more effectively than room-air cooling or no cooling during both time-constant and depth-constant thulium laser cuts.
Bioactive Glass S53P4 in Mastoid Obliteration Surgery for Chronic Otitis Media and Cerebrospinal Fluid Leakage
Authors: Sarin Jussi , Grénman Reidar , Aitasalo Kalle , Pulkkinen Jaakko 
Published: October 2014

Objectives: We evaluated the results of cases of chronic otitis media treated with mastoid obliteration surgery using bioactive glass S53P4. Methods: Twenty-five patients with chronic otitis media and 1 patient with cerebrospinal fluid leakage without chronic infection were treated with bioactive glass S53P4. Twenty patients had had previous surgery because of chronic otitis media with or without cholesteatoma. A mastoid obliteration was performed with bioactive glass S53P4 granules and a musculoperiosteal flap with or without bone paté. In 2 patients with a bony dehiscence at the middle cranial fossa, a bioactive glass plate was used to support the protruding dura. In addition, in 3 patients, occlusion of a dural fistula was needed. The median follow-up period was 34.5 months (range, 1 to 182 months). Results: Excluding the 2 patients with only 1 month of follow-up at our department, 96% of the patients had a dry, safe ear or only intermittent otorrhea. In 92% of the patients, the objective of achieving a smaller or nonexistent cavity was achieved. Conclusions: Bioactive glass S53P4 is a noteworthy material in mastoid obliteration surgery.
Streptococcal Tonsillitis and Acute Streptococcal Myocarditis: An Unusual Combination Assessed by Cardiac Magnetic Resonance Imaging and Endomyocardial Biopsy
Authors: Mavrogeni Sophie , Bratis Konstantinos , Kitsiou Anastasia , Kolovou Genovefa 
Published: October 2014

Objectives: Acute streptococcal tonsillitis is occasionally combined with myocarditis. Our aim was to examine patients with tonsillitis in whom myocarditis was suspected by using cardiac magnetic resonance imaging (MRI) and endomyocardial biopsy. Methods: After prospective evaluation of 200 patients with tonsillitis, 17 men (median age, 23 years; age range, 18 to 29 years) were recruited for cardiac MRI because of a suspicion of myocarditis. Chest pain 3 to 5 days after tonsillitis was the main complaint in 15 patients, and atypical chest discomfort in 2 patients. We performed cardiac MRI including short TI inversion recovery T2-weighted scanning and T1-weighted scanning with early gadolinium enhancement (EGE) and late gadolinium enhancement (LGE). The left ventricular ejection fraction and the presence of myocarditis were evaluated by the standard protocol. A T2 ratio of greater than 2 and an EGE value of greater than 4 were considered abnormal. Heart biopsy was suggested for patients with a reduced left ventricular ejection fraction. Results: Cardiac enzyme levels were increased in 8 of the 17 patients. Increased T2 ratio values (median, 2.8; range, 2.5 to 4.0) were documented in 16 patients. The EGE values were increased (median, 12; range, 8 to 19) in 16 patients. Positive LGE was identified in 13 patients. Endomyocardial biopsy in 4 patients revealed acute myocarditis, and polymerase chain reaction analysis identified streptococcal genomes. Re-evaluation by cardiac MRI 3 months later showed normal results in 14 patients. Conclusions: Acute streptococcal tonsillitis can be occasionally complicated by myocarditis with either a typical or an atypical presentation. Cardiac MRI can facilitate the diagnosis in both forms and allow a noninvasive follow-up.
Analysis of the Roles of Smoking and Allergy in Nasal Polyposis
Authors: Görgülü Orhan , Özdemir Süleyman , Canbolat Emre Polat , Sayar Çağdaş , Olgun Mustafa Kemal , Akbaş Yücel 
Published: October 2014

Objectives: Recent studies on the etiopathogenesis of nasal polyps have shown that smoking and nonallergenic inhalants such as occupational dust exposure cause chronic inflammation of the nasal mucosa. These factors may be associated with nasal polyps. The aim of this study was to use laboratory tests to investigate the effects of smoking and allergens on the development of nasal polyps. Methods: The study included 60 consecutive patients with a diagnosis of nasal polyposis who were treated with functional endoscopic sinus surgery at our clinic and 25 smoker and 25 nonsmoker participants who constituted a control group. Results: In the patient and control groups, the mean absorbance value for cotinine in smokers was found to be statistically significantly lower than that in nonsmokers. There was a significant difference between the groups with respect to blood cotinine positivity. No significant difference was found between the groups in terms of allergy parameters. In the regression model, smoking was found to be the only significant risk factor for the development of nasal polyps, independent of smoking duration, absorbance value, or cotinine positivity. Conclusions: Smoking restriction and avoiding exposure to cigarette smoke by patients with nasal polyps may be an important strategy in the prevention and recurrence of nasal polyposis. No direct relationship was determined between allergy and nasal polyposis.
Transcervical Approach to Benign Parapharyngeal Space Tumors
Authors: Chang Steven S. , Goldenberg David , Koch Wayne M. 
Published: October 2014

Objectives: We describe our experience with the postoperative sequelae, complications, and recurrences associated with resection of a series of parapharyngeal space (PPS) tumors via a transcervical approach without submandibular gland excision, parotidectomy, or mandibulotomy. Methods: We performed a retrospective review of 51 cases, 40 of which were pleomorphic adenomas and 11 of which were lipomas or schwannomas. Results: Of 30 fine-needle aspirations performed, 24 indicated pleomorphic adenoma before operation. Twenty-eight of the 30 fine-needle aspirations yielded diagnoses that were consistent with the final pathologic diagnoses. The average hospital stay was 1.05 days. After operation, there were 9 cases of trismus, 4 cases of “first bite” pain, and 7 cases of transient marginal nerve weakness. There were no recurrences over an average follow-up of 115 months. Conclusions: The majority of PPS tumors are benign. It is important to use an approach that allows complete tumor excision but does not impart undue postoperative morbidity. We demonstrate that the transcervical approach without submandibular gland excision, parotidectomy, or mandibulotomy is ideal for benign PPS tumors.
Experimental Exploration of the Soft Tissue Conduction Pathway from Skin Stimulation Site to Inner Ear
Authors: de Jong Marrigje A. , Perez Ronen , Adelman Cahtia , Sohmer Haim 
Published: October 2014

Objectives: Auditory sensation can be elicited by air conduction (AC) and by bone conduction (BC). It is also possible to elicit such responses by applying the standard clinical bone vibrator to the skin over soft tissue sites on the head, neck, or thorax of humans and animals. This mode of auditory stimulation has been called soft tissue conduction (STC). This study was designed to investigate the pathway between soft tissue sites and the ear. Methods: The air in the middle ear was replaced with saline solution in an animal with unique anatomy — The fat sand rat, in which about 70% of a thin-walled inner ear bulges into the middle ear bulla cavity — While we recorded the auditory brain stem responses (ABRs) to AC, BC, and STC stimulation. Results: This replacement of air with saline solution led to a significant improvement in STC threshold. With AC stimulation, the ABR threshold was elevated and the latency of the first ABR wave was prolonged. Consistent changes were not seen with BC stimulation. Conclusions: When the air (which has a very low acoustic impedance) that normally surrounds most of the inner ear is replaced with saline solution (which has an acoustic impedance similar to that of soft tissues), the STC threshold is improved. This improvement may be due to improved transmission of acoustic energy from the soft tissues to the inner ear.
Diagnosis and Management of New-Onset Hoarseness: A Survey of the American Broncho-Esophagological Association
Authors: Paul Benjamin C. , Branski Ryan C. , Amin Milan R. 
Published: October 2014

Objectives: The recently published Clinical Practice Guideline raised issues related to the value and timing of laryngoscopy in patients with hoarseness. We sought to determine the extent to which these guidelines concur with clinical practice among members of the American Broncho-Esophagological Association (ABEA). Methods: A web-based survey was distributed to ABEA members, composed of four sections: 1) background and demographics; 2) information regarding the appropriate length of time that new-onset dysphonia may be managed before laryngeal visualization, given particular comorbidities; 3) the frequency and risks of office-based flexible transnasal laryngoscopy; and 4) the overall value of laryngoscopy and stroboscopy. Results: Seventy-one ABEA members completed the survey; they had a combined 1,468 years of post-residency experience. Approximately 75% of respondents were involved in a fully academic practice. Across all respondents, an average of 11 patients with new voice complaints were seen per week. Overall, 98.6% of respondents believe that laryngoscopy is very valuable. Stridor in a neonate and potential foreign bodies were both conditions necessitating laryngoscopy on the day of presentation. In patients with no serious underlying condition(s), the mean duration until laryngoscopy was 12.96 days (range, 0 to 30 days). Conclusions: These data suggest that the current practice patterns among experts in the field are divergent from the recently published Guideline.
Functional and Oncological Outcomes of Primary versus Salvage Transoral Laser Microsurgery for Supraglottic Carcinoma
Authors: Hutcheson Katherine A. , Jantharapattana Kitti , Barringer Denise A. , Lewin Jan S. , Holsinger F. Christopher 
Published: October 2014

Objectives: We evaluated the functional and oncological outcomes of transoral laser microsurgery (TLM) in patients with previously untreated supraglottic carcinoma compared with the outcomes in salvage cases after radiation-based treatment. Methods: We conducted a retrospective case-control study at a single academic tertiary care institution. The functional outcomes were stratified by prior irradiation and were assessed at baseline, less than 1 week after operation, and at last follow-up. Results: Five patients underwent TLM for previously untreated disease, and 5 previously irradiated patients underwent salvage TLM for local failure. No patient required tracheostomy. There was no local recurrence after TLM as primary therapy, and none of those patients required radiotherapy. One salvage patient developed local recurrence. The duration of feeding tube dependence (p = 0.049) and the rates of chronic aspiration (more than 1 month after operation; p = 0.048) were significantly higher in the salvage TLM cases than in the previously untreated cases. The median scores on the PSS-HN Understandability of Speech were 75 (“usually understandable”) in the salvage group and 100 (“always understandable”) in the previously untreated group. Conclusions: Both local control and function were better in the previously untreated patients than in the salvage patients. Our findings provide support for the use of TLM as a primary treatment modality for selected supraglottic carcinomas, but also suggest a potential for functional recovery in both previously untreated and salvage cases.
Benign Paroxysmal Positional Vertigo Associated with Meniere's Disease: Epidemiological, Pathophysiologic, Clinical, and Therapeutic Aspects
Authors: Balatsouras Dimitrios G. , Ganelis Panayotis , Aspris Andreas , Economou Nicolas C. , Moukos Antonis , Koukoutsis George 
Published: October 2014

Objectives: We studied the demographic, pathogenetic, and clinical features of benign paroxysmal positional vertigo (BPPV) associated with Meniere's disease. Methods: The medical records of patients with BPPV associated with Meniere's disease were reviewed. In all patients, results of a complete otolaryngological, audiological, and neurotologic evaluation, including nystagmography, were available. Patients with idiopathic BPPV were used as a control group. Results: Twenty-nine patients with both disorders were found and were compared with 233 patients with idiopathic BPPV. The patients with BPPV associated with Meniere's disease presented the following features, in which they differed from the patients with idiopathic BPPV: 1) a higher percentage of female patients; 2) a longer duration of symptoms; 3) common involvement of the horizontal semicircular canal; 4) a greater incidence of canal paresis; and 5) more therapeutic sessions needed for cure and a higher rate of recurrence. Conclusions: The BPPV associated with Meniere's disease differs from idiopathic BPPV in regard to several epidemiological and clinical features, may follow a different course, and responds less effectively to treatment.
Hemodynamic Changes during Otolaryngological Office-Based Flexible Endoscopic Procedures
Authors: Morrison Michele P. , O'Rourke Ashli , Dion Gregory R. , Eller Robert L. , Weinberger Paul , Postma Gregory N. 
Published: October 2014

Objectives: A preponderance of literature supports the safety of office-based flexible endoscopic procedures of the upper aerodigestive tract; however, until recently there were no data regarding hemodynamic stability during these procedures. A recent study showed intraprocedure changes in patients' hemodynamic parameters, raising the concern that perhaps patients should be monitored during these procedures. The aim of our study was to determine whether physiologically significant alterations in vital signs occur during office-based flexible endoscopic procedures. Methods: We performed a retrospective review of 100 consecutive patients who underwent office-based flexible endoscopic procedures of the upper aerodigestive tract from July 2010 to October 2011. Baseline values and the maximal changes in systolic blood pressure, diastolic blood pressure, heart rate, and oxygen saturation were recorded and compared. Results: One hundred consecutive patients were included in the study. Twenty-one patients (21%) had severe hypertension and 40 patients (40%) had tachycardia during the procedure. The mean change overall in systolic blood pressure was 26.2 mm Hg (p < 0.001), the mean change in diastolic blood pressure was 13.9 mm Hg (p < 0.001), the mean change in heart rate was 16.6 beats per minute (p < 0.001), and the mean change in oxygen saturation was 1.6% (p < 0.001). These changes were significant. On further breakdown into groups, patients over 50 years of age and patients who were undergoing esophageal or laser procedures had significant elevations in heart rate (p = 0.01 and p = 0.04, respectively). An elevation in diastolic blood pressure was also significant in patients who were undergoing esophageal or laser procedures (p = 0.04 for both). Conclusions: These data concur with those of the previous report that found potentially significant hemodynamic changes during office-based procedures. Although preliminary, our findings suggest that it may be wise to monitor vital signs in patients over 50 years of age and patients who are undergoing an esophageal or laser procedure who are at risk for complications that could arise from tachycardia and hypertension.
Is Obesity Truly a Risk Factor for Mortality after Tracheotomy?
Authors: Meacham Ryan , Vieira Francisco 
Published: October 2014

Objectives: We sought to determine the short-term and long-term overall mortality rates in obese and non-obese patients after tracheotomy and to evaluate which factors, including the Charlson Comorbidity Index (CCI), predict mortality rates among obese patients. Methods: We performed a retrospective chart review of patients who underwent open tracheotomy in the operating room at a single hospital from 2005 to 2010. Results: Of 200 patients reviewed, 146 were non-obese and 54 were obese. The rate of mortality was higher at 30 days (p = 0.02) and at 1 year (p = 0.04) in obese patients (35.1% and 59.2%, respectively) than in non-obese patients (19.2% and 42.5%, respectively). The need for tracheotomy due to ventilator-dependent respiratory failure (VDRF) was much higher (p < 0.001) in obese patients (83.3%) than in non-obese patients (56.8%), and the rate of mortality was significantly higher (p < 0.001) in those who required tracheotomy for VDRF (32.8% at 30 days and 57% at 1 year) than in those who required tracheotomy for all other indications (4.2% at 30 days and 25% at 1 year). The mortality risk increased with higher CCI scores at both 30 days (p = 0.08) and 1 year (p = 0.009). Conclusions: The overall mortality rate is higher in obese patients after tracheotomy than in non-obese control subjects in the short and long terms. This increased rate of mortality is due to the heightened incidence of tracheotomy for VDRF among obese patients. The mortality rates after tracheotomy correlate well with the CCI.
Is Preoperative Computed Tomographic Density Measurement of Soft Tissues Helpful in the Diagnosis of Cholesteatoma?
Authors: Lee Dong-Hee , Kim Choung-Soo , Park Chang-Woo , Chung Dae-Young 
Published: October 2014

Objectives: We undertook to verify the usefulness of computed tomography Hounsfield units (HU) in differentiating cholesteatoma from inflammatory tissue. Methods: In 91 enrolled cases, the lesions were classified according to the gross pathology, and the specific locations of each lesion were documented by 1 surgeon within 1 day after the operation. The densities in HU of cholesteatoma and non-cholesteatoma lesions were retrospectively measured 3 times by the same examiner, and the difference between the two groups was analyzed. The interobserver reliability among the 3 examiners was assessed to verify the confidence level of the HU measurements in preoperative detection of cholesteatoma. Results: The mean HU values of cholesteatoma were 35.7 to 66.6 HU, and those of non-cholesteatoma lesions were 32.9 to 51.3 HU. A general linear model–repeated-measures analysis of variance did not show any significant difference between the cholesteatoma and non-cholesteatoma lesions (p = 0.305). The general linear model–repeated-measures analysis of variance showed a significant difference of the measured HU levels among the 3 examiners (p = 0.021). Conclusions: This study showed that the HU values on preoperative computed tomography did not suffice for the detection of cholesteatoma lesions. A clinician's physical examination together with an interpretation of computed tomography is still the “gold standard” method.