bluuebunny/crossref_metadata_2025_split huggingface dataset:
Phase II Trial of the Sigma-1 Receptor Agonist Cutamesine (SA4503) for Recovery Enhancement After Acute Ischemic Stroke
Authors: Urfer Roman , Moebius Hans J. , Skoloudik David , Santamarina Estevo , Sato Wakao , Mita Shiro , Muir Keith W. 
Published: October 2014

Background and Purpose—
The σ-1 receptor (Sig-1R) agonist cutamesine (SA4503) enhanced functional recovery after experimental stroke with a treatment initiation window of 48 hours and chronic treatment for 28 days. We conducted a phase 2 clinical trial exploring the safety, tolerability, dose range, and functional effects of cutamesine in patients with ischemic stroke.

Methods—
Subjects were randomized between 48 and 72 hours after stroke to receive cutamesine 1 mg/d, 3 mg/d, or placebo for 28 days. Effects on safety and function were assessed at baseline, at end of treatment (day 28), and at end of follow-up (day 56).

Results—

In 60 patients, treatment with both cutamesine dosages was safe and well tolerated without significant differences in numbers of treatment emergent or serious adverse events. No significant effect was observed on the primary efficacy measure (change in National Institutes of Health Stroke Scale from baseline to day 56) or modified Rankin Scale and Barthel Index scores. Post hoc analysis of moderately and severely affected patients (baseline National Institutes of Health Stroke Scale, ≥7 and ≥10) showed greater National Institutes of Health Stroke Scale improvements in the 3 mg/d cutamesine group when compared with placebo (
P
=0.034 and
P
=0.038, respectively). A trend toward a higher proportion being able to complete a 10m timed walk was observed for cutamesine-treated subjects.

Conclusions—
Cutamesine was safe and well tolerated at both dosage levels. Although no significant effects on functional end points were seen in the population as a whole, greater improvement in National Institutes of Health Stroke Scale scores among patients with greater pretreatment deficits seen in post hoc analysis warrants further investigation. Additional studies should focus on the patient population with moderate-to-severe stroke.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov/show/NCT00639249
. Unique identifier: NCT00639249. The EudraCT number is 2007-004840-60 (
https://www.clinicaltrialsregister.eu/ctr-search/trial/2007-004840-60/GB
).
Hemorrhagic Stroke and Cerebral Paragonimiasis
Authors: Xia Yong , Ju Yan , Chen Jing , You Chao 
Published: October 2014

Background and Purpose—

We retrospectively analyzed the clinical and imaging characteristics, diagnosis, and treatment outcomes of 10 patients with hemorrhagic cerebral paragonimiasis (CP), and we evaluated the influence of
Paragonimus
infection on cerebrovascular damage.

Methods—
Ten patients (7 male and 3 female; median age 15.7 years, range 4–46 years) with hemorrhagic CP were diagnosed between April 2009 and January 2013. All patients underwent the head computed tomography scans and 9 patients underwent MRI examinations. Four patients underwent computed tomographic angiography, magnetic resonance angiography, and digital subtraction angiography. Liquid-based cytological examination of cerebrospinal fluid was performed in 7 patients. Follow-up examinations were performed for 9 cases for a period of 12 to 62 months.

Results—
Hemorrhagic CP accounted for 37% of CP cases (10/27). No patients were initially diagnosed with CP. The major symptoms of hemorrhagic CP included acute headache, vomiting, hemiparalysis, epilepsy, blurred vision, sensory impairment, and tinnitus. Four cases were surgically treated. Most symptoms markedly improved, but fine motor dysfunction and mental dysfunction remained in 3 surgical patients.

Conclusions—

Hemorrhagic stroke typically occurred during the acute stage and in the early stages of further
Paragonimus
migration. Delay of treatment increased the risk of initial and recurrent stroke.
Use of the Pediatric Quality of Life Inventory to Assess the Health-Related Quality of Life in Children with Recurrent Respiratory Papillomatosis
Authors: Lindman Jonathan P. , Lewis Linda S. , Accortt Neil , Wiatrak Brian J. 
Published: October 2014

Objectives: The objective of this study was to use the Pediatric Quality of Life Inventory (PedsQL), a 23-question modular instrument designed to measure the health-related quality of life (HRQOL) in children and adolescents, to compare the HRQOL in children with recurrent respiratory papillomatosis (RRP) with the HRQOLs reported for healthy children and children with other chronic medical conditions. Methods: The PedsQL version 4.0 Generic Core Scales consist of 23 questions in 4 subscales (Physical, Emotional, Social, and School Functioning) for parent-proxy reporting on the HRQOL in children ages 2 to 4 years, parent reporting for children 5 to 18 years, and child self-reporting for ages 5 to 7 years (age-adjusted questions and rating scales) and 8 to 18 years. The questionnaires were administered in person or by telephone to 22 children with RRP and (or, for children 2 to 4 years of age) one parent recruited from a tertiary pediatric otolaryngology practice. The results were compared with validated norms for healthy children and scores for children whose parents reported a chronic medical condition. Results: Compared with healthy controls, the children 5 to 18 years of age with RRP self-reported a significantly (p < .05) worse HRQOL as measured by the PedsQL Total Score, Psychosocial Health score (a combination of Emotional, Social, and School Functioning Scores), and Social Functioning and School Functioning scores. Self-reported scores for the children 5 to 18 years of age with RRP compared with children with other chronic illnesses followed the same trend, and the difference approached statistical significance (p = .05) for the School Functioning Subscale scores. The parent-proxy report (for children 2 to 18 years of age) scores for children with RRP were significantly lower (p < .0001) on every scale and in total compared with scores for healthy children. Compared with scores of children with other chronic medical conditions, the parent-proxy report scores were significantly lower for psychosocial health (p = .005) and school functioning (p<.0001). Conclusions: Children with RRP report a lower quality of life than do those who are healthy, and a quality of life similar to that of those who have other chronic medical problems. The parent reports also reflect a lower quality of life for children affected by this disease, as compared with healthy children. The PedsQL demonstrated a statistically significant low HRQOL in children with RRP; however, the clinical implications of this finding appear trivial. A distinct, disease-specific survey for RRP, if developed, would have enhanced responsiveness and sensitivity to change (due to the natural course of the disease and/or surgical treatments).
Myonuclear Addition to Uninjured Laryngeal Myofibers in Adult Rabbits
Authors: Goding George S. , Al-Sharif Kais I. , McLoon Linda K. 
Published: October 2014

Objectives: In normal mature limb skeletal muscle, satellite cells are quiescent and myonuclei do not divide after formation of their associated myofibers in the absence of injury. The possibility of myonuclear addition in uninjured laryngeal myofibers of adult rabbits was investigated in an immunohistochemical pilot study. Methods: Bromodeoxyuridine (brdU), a marker for cell division, was administered by intraperitoneal injection over a 12-hour period in rabbits. The number of brdU-positive myonuclei per myofiber was determined on cross sections through the thyroarytenoid (TA) and posterior cricoarytenoid (PCA) muscles. Results: In the TA muscle, 0.13% ± 0.03% (mean ± SEM) of the myofibers counted had a brdU-positive nucleus. In the PCA muscle, 0.13% ± 0.01% of the myofibers counted had a brdU-positive nucleus. Approximately 0.2% and 0.3% of the myofibers of the TA and PCA muscles, respectively, had brdU-positive satellite cells associated with them. Tibialis anterior and pectoralis major muscle controls were negative for brdU-positive myonuclei. Conclusions: These data support the possibility of continuous remodeling in uninjured adult laryngeal myofibers and accentuate the distinct nature of laryngeal muscle relative to limb skeletal muscle in the rabbit model.
Oral Melanoacanthoma: A Case Report, a Review of the Literature, and a New Treatment Option
Authors: Andrews Brian T. , Trask Douglas K. 
Published: October 2014

Objectives: Oral melanoacanthoma is a rare condition that presents as a pigmented, painful lesion, most commonly on the buccal mucosa. Argon plasma coagulation is a new treatment option for benign oral lesions and is hypothesized to be efficacious for this rare mucosal disorder. Methods: Treatment of a case and a review of the English-language literature were performed. Results: One patient received a diagnosis of oral melanoacanthoma, and argon plasma coagulation treatment resulted in ablation of the lesion with excellent mucosal healing. A review of the literature demonstrated that this lesion is most commonly associated with black (90.9%), adult female (69.7%) patients and is most commonly located on the buccal mucosa (64.7%). Conclusions: Oral melanoacanthoma is a rare, benign mucosal lesion that may require surgical intervention for symptomatic relief. Argon plasma coagulation is a relatively safe and effective means of treating this lesion. Argon plasma coagulation treatment may be expanded to include other benign, superficial lesions of the oral mucosa.
Platelet Gel for Endoscopic Sinus Surgery
Authors: Pomerantz Jonathan , Dutton Jay M. 
Published: October 2014

Objectives: New techniques are being utilized to improve outcomes for endoscopic sinus surgery, including newer forms of packing. Platelet gel is an innovative technique that holds many advantages, including comfort, hemostasis, and growth factors that may improve wound healing. This report discusses the theoretical advantages of this packing material and describes the initial results in a cohort of patients who underwent endoscopic sinus surgery. Methods: A cohort of patients who underwent endoscopic sinus surgery were interviewed and evaluated after the placement of platelet gel. A quality of life study was also administered for further understanding. Results: None of the patients in the study had postoperative epistaxis that required additional packing, and there were no instances of synechia formation or exuberant granulation tissue. Although not statistically significant because of a small population, the quality of life scores did show improvement over the control group. Conclusions: Platelet gel used as a packing material after endoscopic sinus surgery offers efficient hemostatic properties, as well as growth factors that can advance the healing process. The quality of life of the patient may be improved by the use of platelet gel packing.
Hemorrhage following Coblation Tonsillectomy
Authors: Windfuhr Jochen P. , Deck Jens C. , Remmert Stephan 
Published: October 2014

Objectives: We performed a prospective study to evaluate the incidence of post-tonsillectomy hemorrhage (PTH) in adults and children who underwent Coblation tonsillectomy (CTE) under general anesthesia. Methods: The data of 63 adults and children (mean age, 21.8 years) were analyzed. Results: There were 7 episodes of considerable bleeding (11.1%) that required surgical treatment under general anesthesia in 6 patients, of whom 5 experienced secondary bleeding (>24 hours). Moreover, bleeding and massive swelling of the pharynx required surgical treatment and prolonged intubation (35 hours) in 1 patient. None of the patients received blood transfusions. There was no case with a lethal outcome. Less intense bleeding (clots; blood-tinged sputum) was observed in 17 patients (27%) who required readmission or prolonged inpatient observation, 1 of whom had previously undergone surgical treatment of PTH. However, these 17 patients had an uneventful clinical course. In total, 22 patients experienced minor or major forms of PTH (34.9%). Conclusions: At least in our hands, CTE dramatically increased the frequency of PTH. The high rate of secondary bleeding contrasts with our documented experience using conventional methods, ie, cold dissection and suture ligation, to achieve hemostasis (7.9% with CTE versus <0.8% with conventional methods). Therefore, at our institution, tonsillectomy with conventional instruments remains the method of choice.
Inside-Out Complete Tonsillectomy: Extended Intracapsular Tonsillectomy for Severe Sore Throat
Authors: Isaacson Glenn 
Published: October 2014

Objectives: This consecutive case series is presented to describe inside-out complete tonsillectomy and to assess its effects on postoperative pain and bleeding and its initial effectiveness in controlling recurrent sore throat and peritonsillar abscess formation. Methods: Bipolar electrosurgical scissors are used for bloodless resection of 90% of the tonsillar mass. During controlled resection, tonsil tissue is intentionally left at the superior and inferior poles and at the deepest part of the tonsillar fossa to provide coverage for nutrient arteries and the tonsillar plexus of veins. This tissue is then electrodesiccated and removed under direct vision and indirect mirror guidance to achieve complete tonsillectomy. Results: One hundred eighty-three consecutive tonsillectomies were performed by a single surgeon in a 16-month period, 47 of which were for the indication of recurrent sore throat (44) or recurrent peritonsillar abscess (3). Among these 47 children, there were 2 readmissions for dehydration. There were no immediate or delayed bleeding episodes. The average child required 4 days of narcotic pain medication. The mean annualized number of severe sore throats decreased from 5.24 before operation to 0.36 after operation (p <.0001, Student's paired t-test). There were no recurrent peritonsillar abscesses. Conclusions: Inside-out complete tonsillectomy achieves the surgical goal of complete tonsillectomy with the smallest possible wound and minimal injury to the surrounding tissue. The perioperative morbidity is markedly decreased compared to that of historical controls. The initial results suggest effectiveness similar to that of extracapsular tonsillectomy.
Study of Cyfra 21–1, a Tumor Marker, in Head and Neck Squamous Cell Carcinoma
Authors: Céruse Philippe , Rabilloud Muriel , Charrié Anne , Dubreuil Christian , Disant François 
Published: October 2014

Objectives: We performed a prospective study to determine the cutoff value and the prognostic value of Cyfra 21–1, a serum tumor marker, in head and neck squamous cell carcinoma (HNSCC). Methods: The serum concentration of Cyfra 21–1 was measured in a group of 300 patients (group 1) with HNSCC, in a control group of 71 healthy subjects (group 2), and in a group of 73 patients with a nonmalignant tumor or inflammatory disease (group 3). The concentrations were compared between the various groups and subgroups; the cutoff value was calculated with a receiver operating characteristic curve. Furthermore, the serum concentrations of Cyfra 21–1 before treatment in the group of 300 patients were compared with the stage of the disease and with the evolution of the overall survival rate and the disease-free survival rate. Finally, to determine whether Cyfra 21–1 is an independent prognostic factor, we compared the concentrations, by a Cox model, with the classic prognostic factors of HNSCC. Results: At the cutoff value of 1 ng/mL, the specificity was 94% and the sensitivity was 72%. The serum concentrations of Cyfra 21–1 were statistically correlated with the stage of the disease. The overall survival rate and the disease-free survival rate were lower in patients with high serum concentrations, and these differences were statistically significant (p <.001). The Cox model allows us to conclude that Cyfra 21–1 is a prognostic marker that is independent of other classic prognostic factors. Conclusions: Cyfra 21–1 is an interesting tumor marker that could be proposed for the early detection of HNSCC with a cutoff value of 1 ng/mL. Furthermore, Cyfra 21–1 can be considered an independent prognostic marker.
Nitrotyrosine in Otitis Media with Effusion
Authors: Hisamatsu Ken-Ichi , Inoue Hajime , Makiyama Kiyoshi , Homma Masami 
Published: October 2014

Objectives: Our purpose was to investigate mucosal cell injury due to the nitric oxide (NO)-superoxide system in otitis media with effusion. Methods: We determined the levels of nitrotyrosine (NT) and NO and the activities of superoxide dismutase (SOD) and lactic dehydrogenase (LDH) in 90 middle ear fluid samples. Results: The NT concentration was significantly higher in group A (<16 years old) than in group C (>50 years old; p <.05), and significantly higher in the acute group than in the chronic group (p <.05). The NO concentration did not show a significant difference among the groups. The activity of SOD showed significant correlations with the concentrations of NT and NO and with LDH activity (p <.05). The LDH activity was significantly greater in group A than in group C (p <.05). Conclusions: Our results indicate involvement of the NO-superoxide system in the pathogenesis of otitis media with effusion, showing evidence of protein and/or cell injury in the middle ear.
Western Blot Immunoassay for HSP-70 Antibodies in Idiopathic Tinnitus: A Preliminary Report
Authors: Savastano Marina , Celadin Marilena , Pittoni Marina , Plebani Mario , Marioni Gino 
Published: October 2014

Objectives: Our preliminary study investigated the role of nonspecific immunologic tests and immunoassay for heat shock protein 70 (HSP-70) in supporting the possibility of an autoimmune inner ear process determining idiopathic tinnitus. Methods: Thirty-six consecutive patients with idiopathic tinnitus without other otologic or autoimmune diseases and 20 healthy blood donor subjects underwent determinations of circulating immune complexes (CICs) and other nonspecific immunologic factors and immunoassay for HSP-70. Results: The mean CIC values were 4.2 μg/mL in the tinnitus patients and 0.9 μg/mL in the control group (p = .012). Thirteen of the 36 tinnitus patients and none of the control group were HSP-70-positive. Ten of the 13 HSP-70-positive patients had CIC values higher than normal. In the tinnitus group, the mean CIC values were 6.9 μg/mL and 2.6 μg/mL in the HSP-70-positive and –negative subgroups, respectively (p = .024). Conclusions: It may be hypothesized that in a significant number of cases, idiopathic tinnitus could be induced by immune response to inner ear–specific HSP-70.
Human Adult Deglutition during Sleep
Authors: Sato Kiminori , Nakashima Tadashi 
Published: October 2014

Objectives: Clearance of the pharynx by deglutition is important in protecting the airway. The pattern of deglutition during sleep was investigated. Methods: Deglutition during sleep was examined in 8 normal human adults via time-matched recordings of polysomnography and surface electromyography (EMG) of the thyrohyoid and suprahyoid muscles. Results: During sleep, deglutition was episodic, and was absent for long periods. The mean number of swallows per hour (±SD) during the total sleep time was 2.9 ±1.3. The mean period of the longest absence of deglutition was 50.6 ± 10.2 minutes. Most deglutition occurred in association with spontaneous electroencephalographic arousal in rapid eye movement (REM) sleep and non-REM sleep. Deglutition was related to sleep stage. The mean number of swallows per hour was 7.2 ± 3.5 during stage 1 sleep and 2.0 ± 0.7 during stage 2 sleep. There was little deglutition during stages 3 and 4. The deeper the sleep stage became, the lower the mean deglutition frequency became. The mean number of swallows per hour was 2.7 ± 2.2 during REM sleep. The EMG amplitude dropped to the lowest level of recording and hypotonic EMG activity increased during REM sleep. Conclusions: Deglutition, a vital function, is infrequent during sleep.
Cysteinyl Leukotriene 1 Receptor Expression in Nasal Polyps
Authors: Chao Siew-Shuen , Graham Scott M. , Brown Christopher L. , Kline Joel N. , Hussain Iftikhar 
Published: October 2014

Objectives: The pathogenesis of nasal polyps, thought to involve complex interactions between different factors, is currently not fully understood. Recent studies have suggested the involvement of cysteinyl leukotrienes (CysLTs) in nasal polyp development. To further understand the role of CysLTs in polyp pathogenesis, we studied the expression of CysLT1 receptors in nasal polyps. Methods: The study group comprised polyps removed endoscopically from 20 consecutive patients. Samples of ethmoid mucosa from 4 patients who underwent orbital decompression for Graves' ophthalmopathy were used as controls. The presence of CysLT1 receptors was determined with a rabbit anti-human anti–CysLT1 receptor polyclonal antibody. Cells with and without CysLT1 receptor expression were counted within the epithelial layer and stroma by means of light microscopy (40× magnification). Results: There were significantly more cells expressing CysLT1 receptors in the stroma than in the epithelium in both nasal polyps and control specimens. The stroma of polyps also contained more CysLT1 receptor–expressing cells than did controls (29 × 103 ± 7 × 103 versus 3 × 103 ± 3 × 103 cells per square millimeter; p > .01). In the epithelium of polyps, there was significantly higher expression of CysLT1 receptors than in controls (7 × 103 ± 3 × 103 versus 0 cells per square millimeter; p = .02). No significant differences in polyps were found between patients with and patients without Samter's triad and asthma. Conclusions: The significant up-regulation of CysLT1 receptors we found in both the stroma and the epithelium of nasal polyps suggests the presence of an inflammatory component in the pathogenesis of polyps, and possibly explains the efficacy of leukotriene modifiers in their treatment.
Short-Duration Enzymatic Treatment Promotes Integration of a Cartilage Graft in a Defect
Authors: Janssen Luuk M. , der Maur Caroline D. In , Bos P. Koen , Hardillo Jose A. , van Osch Gerjo J. V. M. 
Published: October 2014

Objectives: Surgical manipulation of cartilage tissue is associated with chondrocyte death in the wound edges that hinders integration. The objective of this study was to evaluate the effect of a short course of treatment of a cartilage graft with a combination of hyaluronidase and collagenase on chondrocyte density and integrative capacity. Methods: Cartilage explants were treated with enzymes for various time periods and at various concentrations. A central core was punched out of a larger explant, treated with enzymes, reimplanted, and placed subcutaneously in athymic mice. The number of chondrocytes in the wound edges was counted, and the integrative capacity of the grafts was evaluated by histology. Results: Treatment with collagenase for 48 hours led to a significant increase in the number of vital chondrocytes and restored it to normal after 14 days of culture. Treatment with hyaluronidase and collagenase for 48 hours further increased chondrocyte densities to supranormal values. Shortening the treatment to 1 hour restored the chondrocyte density to normal after 14 days of culture. In vivo integration experiments showed increased chondrocyte densities in treated wound edges and extracellular matrix fibers crossing over from enzyme-treated parts to untreated parts. Conclusions: Short-duration treatment of a cartilage graft with a combination of hyaluronidase and collagenase increases cell density at wound edges and promotes integrative repair.