bluuebunny/crossref_metadata_2025_split huggingface dataset:
One-carbon metabolism and bipolar disorder
Authors: Baek Ji Hyun , Bernstein Emily E , Nierenberg Andrew A 
Published: August 2013

Objective: Folate is one of the most widely used nutraceuticals for the treatment of mood disorders. In this article, we review folate metabolism, its relationship with bipolar disorder, and its therapeutic potential. Methods: We searched PubMed and the Cochrane Library for relevant articles up to and including the year 2012. Background information, proposed mechanisms of action, and results from clinical trials were reviewed. Results: Folate is an essential cofactor involved in methylation reactions, which are critical for monoamine synthesis and homocysteine regulation. Folate level is thought to be associated with mood disorders and limited response to antidepressants. Functional deficiency, due to a common genetic variant of the methylenetetrahydrofolate reductase (NAD(P)H) ( MTHFR) gene, could also affect the presentation of bipolar disorder. Sodium valproate and lamotrigine, commonly used mood stabilizers for the treatment of bipolar disorder, can potentially interfere with folate and homocysteine metabolism. Previous studies consistently support the efficacy of folate in the treatment of depression; one study showed efficacy in the treatment of mania. Biologically active forms of folate formulations, which do not require biochemical conversion, could be beneficial in the treatment of bipolar disorder. Conclusions: Folate augmentation could be effective for the treatment of bipolar disorder. A common genetic variant of the MTHFR gene might impact the treatment effect of folate augmentation. The biologically active form of folate could potentially correct mood stabilizer-associated functional folate deficiency, help normalize monoamine synthesis, and improve outcomes.
Grant Writing Pearls and Pitfalls: Maximizing Your Funding
Authors: Schmalbach Cecelia E. , Couch Marion E. , Rosenthal Eben L. , Pynnonen Melissa , Liu Jeffrey 
Published: August 2013

Program Description:Seeking an edge in the competitive grant world? This interactive miniseminar will provide a comprehensive review of key elements to a fundable grant. Practical tips on scientific writing, building a productive research team, and maximizing resources will be provided. An overview of basic statistics will help to maximize collaborative efforts with your statistician. Gain insight into the scoring process from an experienced National Institutes of Health reviewer who will highlight common pitfalls. Current 2013 funding mechanisms will also be provided. Residents and faculty new to the grant process, as well as researchers striving to improve their score, will benefit from this course.Educational Objectives:1) Describe key components of a grant to include hypothesis, specific aims, timeline, statistics, budget, and institutional review board. 2) Comprehend the scoring mechanism, review process, and common pitfalls leading to an unfundable grant. 3) Research current grant mechanisms and funding opportunities.
Pediatric Laryngology: Innovations and Updates
Authors: Rickert Scott M. , Statham Melissa M. , de Alarcon Alessandro , Zur Karen B. , Hartnick Christopher J. 
Published: August 2013

Program Description:Pediatric laryngology has experienced tremendous growth with increased focus on voice issues. This miniseminar incorporates viewpoints of several clinicians and will focus on clinically relevant matters for general and specialty otolaryngologists, including diagnosis, common pathologies, and operative and non‐operative approaches and techniques. Pathology includes benign vocal lesions, vocal fold paralysis, recurrent respiratory papillomatosis (RRP), laryngeal webs, and subglottic stenosis. Non‐operative innovations will be discussed, including voice therapy, laryngeal electromyography, botulinum toxin, and fillers. Operative innovations include laser, techniques for vocal fold paralysis, and augmentations to standard open techniques. Differing practical approaches will be discussed in a panel format with presentations of challenging cases.Educational Objectives:1) Illustrate the diagnostic approach of pediatric laryngology and give practical advice towards successful techniques. 2) Describe various diagnostic challenges in pediatric laryngological diseases and illustrate approaches towards proper diagnosis and treatment. 3) Elucidate newer innovative techniques in pediatric laryngology through case discussion and panel discussion.
Build a Better Ear: What's New in Chronic Ear Disease
Authors: D'Eredita Riccardo , Devaiah Anand K. , Lee Kenneth H. , Dornhoffer John L. , O'Reilly Robert C. 
Published: August 2013

Program Description:There is a growing interest in implementing surgical techniques and using novel materials for tympanic membrane perforation repair. Bioactive materials, cartilage and fascia grafts derived from the recipient patient, novel partial ossicular replacement prostheses and total ossicular replacement prostheses, and novel technologies (ie, otoendoscopy) are in continuous evolution, striving for higher quality and longer duration and stability in otologic surgery grafting. The presenters will provide descriptions and show videos demonstrating the function of these different materials and techniques. In addition, a non‐committee panel will present an evidence‐based medicine (EBM) algorithm for treatment:”What Literature says—an EBM decision Algorithm as Key to Success.”Educational Objectives:1) Describe the variety of grafting materials, protheses, and different techniques available for surgical repair of tympanic membrane perforations. 2) Discuss the advantages and limitations of using these technologies and materials. 3) Assess the validity of the studies presented to evaluate the efficacy of these surgical tools.
Practical Otologic Considerations in Head Injury
Authors: Holtel Michael R. , Littlefield Philip D. , Hoffer Michael , Balough Ben J. 
Published: August 2013

Program Description:After our nation's longest period of conflict, it is important to look for experience and medical advances that might improve our care of the injured patient. Targeting general otolaryngologists, we will present an overview for otologic care of the trauma patient presenting to your office. Emphasis will include an update on surgical management of facial nerve injury, manifestations and treatment of balance disorders after concussion and head trauma, repair of traumatic tympanic membrane perforations, and hearing loss.Educational Objectives:1) Articulate timing and indications for surgical treatment of facial nerve injury. 2) Describe treatment principles and best practice for post–head trauma balance disorders. 3) Recognize treatment of traumatic perforations and hearing injury.
AAO‐HNS Clinical Practice Guideline on Tympanostomy Tubes
Authors: Rosenfeld Richard M. , Pynnonen Melissa , Tunkel David E. , Schwartz Seth R. 
Published: August 2013

Program Description:Insertion of tympanostomy tubes is the most common ambulatory surgery performed on children in the United States. This miniseminar will highlight key recommendations from the new AAO‐HNS guideline on tympanostomy tubes, developed by a multidisciplinary panel using methodology consistent with current Institute of Medicine standards. Emphasis is placed on surgical indications (otitis media with effusion and recurrent acute otitis media), caregiver education, management of tube otorrhea, use of water precautions, and special considerations for children who are at risk for developmental delays. The lively panel discussion will include case presentations and time for questions and answers.Educational Objectives:1) Recognize evidence‐based indications for tympanostomy tubes in children with otitis media with effusion and/or recurrent acute otitis media. 2) Identify children with otitis media with effusion who are at risk for developmental delays and might benefit from insertion of tympanostomy tubes. 3) Educate caregivers of children with tympanostomy tubes on the need for water precautions, management of tube otorrhea, and expectations for follow‐up and monitoring while the tubes remain in place.
Endoscopic Orbital Surgery: Current and Future Applications
Authors: Kingdom Todd T. , Ramakrishnan Vijay R. , Durairaj Vikram D. , Strong E. Bradley 
Published: August 2013

Program Description:As otolaryngologists gain experience with endoscopic surgery of the sinuses and skull base, the next natural extension is toward the orbit. The purpose of this miniseminar is to review current and future applications of endoscopic orbital surgery for management of epiphora, thyroid eye disease, orbital trauma, and orbital tumors. We will use a case‐based format to discuss rationale, pearls and pitfalls for dacryocystorhinostomy, orbital and optic nerve decompression, orbital fracture repair, and tumor surgery. Both endoscopic and open approaches to these cases will be compared, and surgical decision‐making will be addressed.Educational Objectives:1) Conduct sound decision‐making in the endoscopic and open approaches to DCR and orbital decompression. 2) Examine how endoscopic techniques can be applied to surgery within the orbit. 3) Recognize when endoscopic approaches may be useful adjuncts to traditional open orbital surgery.
Septoplasty: Traditional, Open, Endoscopic, and Advanced
Authors: Setzen Michael , Rhee John S. , Han Joseph 
Published: August 2013

Program Description:Deviated septum is a key factor in altered nasal physiology resulting in nasal obstruction negatively impacting a patient's quality of life. Reported failure rates of septoplasty surgery are as high as 25‐50%. Inadequate assessment and correction of challenging cases contribute to this failure rate. Challenging scenarios include deviation at caudal or high dorsal areas, complex deformations, revision cases, associated perforation, acute traumatic injuries, and association with severe sinonasal inflammation. This interactive case‐based session with audience response will engage attendees. The speakers will share their thought process, surgical strategies, techniques, and pearls promoting better surgical outcomes.Educational Objectives:1) Discuss the specific mechanism of nasal obstruction by the deviated septum and minimize complication when performing initial or revision septoplasty. 2) Debate the cause of persistent nasal obstruction after initial septoplasty. 3) Explain effective surgical techniques to optimize outcomes and minimize complication when performing initial or revision septoplasty.
Incidental Thyroid Nodules: Clinical Presentation and Outcomes
Authors: Chaikhoutdinov Irina , Mitzner Ron , Yoo Frederick , Fornadley Jeffrey , Goldenberg David 
Published: August 2013

Objectives:Examine patients with incidentally discovered thyroid nodules (IDTNs) with focus on identification, evaluation, surgical intervention, and rates of malignancy.Methods:Retrospective chart review performed at a tertiary care medical center. Patients were identified by cross‐referencing thyroid diagnosis codes with ultrasound (US) codes, identifying a total of 1408 thyroid patients evaluated between July 2008 and June 2009. Information regarding demographics, follow‐up, and outcomes was extracted from the medical record.Results:A total of 249 patients with IDTNs were identified. Most were identified on chest CT (44.6%). Most commonly, imaging was obtained for evaluation of an unrelated malignancy (26.9%). Initial evaluation of IDTNs was performed by US in 62.2% and US with fine needle aspiration (FNA) in 36.1% of patients. Patients with US as the initial study appeared to undergo more studies than patients who underwent US/FNA. 170 (68.3%) underwent ultrasound (US)/FNA. The most common pathology was benign follicular nodule (64.1%) and papillary thyroid cancer (PTC) (13.5%). Fifty‐five (22.1%) patients underwent thyroidectomy. Forty‐seven patients underwent surgery for suspicion of malignancy. Preoperative FNA pathology was PTC in 22 patients, followed by follicular neoplasm in 17 patients. On final pathology, 33 malignancies were present. Of these, 28 were PTC. The overall malignancy rate for incidental thyroid nodules was 13.3%.Conclusions:This study identified a surprisingly high rate of malignancy of at least 13.3% in IDTNs, reaffirming that incidental thyroid nodules should undergo thorough workup. Obtaining US/FNA early in the workup appears to decrease the number of studies ordered.
Increased Aquaporin‐1 Expression Is Associated with Improved Prognosis in Salivary Gland Adenoid Cystic Carcinoma
Authors: Tan Marietta , Shao Chunbo , Bishop Justin , Westra William H. , Ha Patrick K. 
Published: August 2013

Objectives:Aquaporin‐1 (AQP1) is a candidate oncogene that is epigenetically modified in adenoid cystic carcinoma (ACC). We sought to 1) assess AQP1 promoter methylation and gene expression in an ACC cohort, 2) identify correlations between AQP1 and clinical outcomes, and 3) explore the role of AQP1 in tumor progression in vitro.Methods:DNA and RNA were isolated from ACC tumors and control salivary gland tissues. Quantitative methylation‐specific polymerase chain reaction (PCR) was performed on bisulfite‐treated DNA. Quantitative reverse transcription PCR was performed after cDNA synthesis. Retrospective chart review was performed for collection of demographic information and clinical outcomes. Cell lines stably over‐expressing an AQP1 plasmid or empty vector were generated. Cell scratch and Matrigel invasion assays were then performed.Results:Methylation results from 77 ACC tumors and 30 controls demonstrated that AQP1 was hypomethylated in tumors (P < 0.0001). Fifty‐eight tumors (75.3%) displayed AQP1 hypomethylation compared to controls. AQP1 expression was assessed in 58 tumors and 23 controls, and a trend towards increased expression in tumors was found (P = 0.08). Statistical analysis revealed no associations between AQP1 methylation status and clinical outcomes. However, increased AQP1 expression was associated with improved overall survival and longer time to metastasis (P < 0.05). AQP1 over‐expression in vitro did not affect cell migratory or invasive capacities in cell scratch and invasion assays.Conclusions:AQP1 hypomethylation is common in ACC, and AQP1 tends to be over‐expressed in these tumors. Increased AQP1 expression is associated with improved prognosis. Further in vitro studies are necessary to clarify the role of AQP1 in ACC progression.
Management of the Unknown Primary in the Era of HPV and Robotics
Authors: Newman Jason G. , O'Malley Bert W. , Rassekh Christopher H. , Lin Alexander , Chalian Ara A. , Lajud Shayanne A. , Weinstein Gregory S. 
Published: August 2013

Objectives:A subset of patients with squamous cell carcinoma of the head and neck present with a cervical metastasis from an unknown primary site. Currently, many of these patients have human papillomavirus (HPV) positive tumors, making the oropharynx the most likely primary site. Objectives: 1) Develop a minimally invasive approach to identify and definitively treat patients initially diagnosed with carcinoma of unknown primary (CUP) using transoral robotic surgery (TORS). Additionally, we anticipate that this aggressive approach will yield the primary lesion in a higher subset of patients.Methods:A retrospective chart review study was conducted to evaluate a novel minimally‐invasive management approach using TORS to assess the primary site.Results:We identified 12 patients with CUP of the head and neck that had undergone this approach from December 2011 to April 2012. Ten patients were classified as HPV positive using p16 staining as surrogate marker. The primary site was identified in 10 of 12 patients (83%), the majority of which was found to be the base of tongue.Conclusions:We have developed a minimally invasive surgical approach using TORS for the diagnosis and subsequent management of the patient with CUP. Using this algorithm, we are able to move from frozen section directly to an en bloc definitive resection in many patients. Our results show a significant rate of primary tumor identification using a robotic‐assisted approach and support the rationale for further investigation of this technique.
Computer‐Aided Designed and 3‐Dimensionally Printed Porous Tissue Bioscaffolds for Craniofacial Soft‐Tissue Reconstruction
Authors: Zopf David A. , Mitsak Annie , Flanagan Colleen L. , Maki Aaron , Wheeler Matthew , Green Glenn E. , Hollister Scott J. 
Published: August 2013

Objectives:Introduce our groups’ innovative processes using image‐based design and several 3‐dimensionally printed scaffolds for head and neck cartilaginous reconstruction. Applications for auricular reconstruction and nasal reconstruction are discussed. Study Design: Proof of concept revealing novel methods for bioscaffold production with in vitro and in vivo data demonstrating preliminary scaffold behavior.Methods:DICOM computed tomography (CT) images undergo segmentation and image‐based Boolean design. Three‐dimensional (3D) designed, bioresorbable, poly‐L‐caprolactone scaffolds are printed. Subcutaneous in vivo implantation of auricular and nasal scaffolds was performed in a porcine model. Auricular scaffolds were seeded with primary porcine auricular chondrocytes in a hyaluronic acid/collagen hydrogel, and cultured in a prochondrogenic bioreactor environment.Results:Auricular and nasal constructs with several micropore architectures are rapidly manufactured with high fidelity anatomic appearance. Subcutaneous in vivo implantation of auricular and nasal scaffolds resulted in excellent appearance. Histologic analysis demonstrated cartilaginous growth within and respecting the boundaries of the scaffold. Cartilage growth was not seen outside of the scaffold, potentially suggesting a prochondrogenic effect of the scaffold or prevention of chondrocyte dedifferentiation.Conclusions:Image‐based design processes and 3D printing in the production of cartilaginous structures for several challenging reconstructive applications is introduced. Bioscaffolds may allow regeneration of soft tissue structures that are replaced with native extracellular matrix.
Submandibular Gland Preservation during Concurrent Neck Dissection and Transoral Surgery for Oropharyngeal Squamous Cell Carcinoma
Authors: Howard Brittany E. , Nagel Thomas H. , Cheng Meng‐Ru , Hinni Michael L. 
Published: August 2013

Objectives:Analyze the effect of ipsilateral submandibular gland preservation on patients undergoing concurrent neck dissection and transoral surgery for oropharyngeal squamous cell carcinoma. Evaluate for 1) intraoperative communications between the oropharynx and neck, 2) postoperative salivary leaks, and 3) oncologic outcomes.Methods:Retrospective chart review of oropharyngeal squamous cell carcinoma patients undergoing transoral surgery with simultaneous neck dissection(s) at a tertiary referral center between 1999 and 2013 with analysis of operative technique, pathologic diagnosis, postoperative course, complications, and oncologic outcomes.Results:Overall 253 patients were identified. Of these, 96 patients underwent ipsilateral submandibular gland preservation and 157 underwent ipsilateral submandibular gland removal at the time of neck dissection. The prevalence of intraoperative communication between the neck and oropharynx was significantly lower (P = 0.0017) in cases with submandibular gland preservation (2.08%, n = 2) compared to those with submandibular gland removal (14.13%, n = 22). Similarly, there were fewer postoperative salivary leaks with gland preservation. No postoperative leaks occurred in the gland preservation group (0%, n = 0) compared to a leak prevalence of 8.92% (n = 14) when the gland was removed (P = 0.0041). There was no difference in local (P = 0.2208), regional (P =0.9624), or distant disease (P = 0.7523) recurrence between the groups.Conclusions:Submandibular gland preservation during neck dissection in patients undergoing transoral surgery for oropharyngeal squamous cell carcinoma reduces the risk of intraoperative and postoperative salivary leaks without compromising oncologic outcomes.
Transoral Resection Technique and Resected Tissue Volume in Patients with Oropharyngeal Squamous Cell Carcinoma
Authors: Cho Min‐Jeong , Sumer Baran D. 
Published: August 2013

Objectives:Elucidate the relationship between transoral resection technique and resected tissue volume in patients with early stage oropharyngeal squamous cell cancer (OPSCC) and determine if resection volume affects functional outcome.Methods:Forty‐six patients with previously untreated early T‐stage OPSCC underwent transoral laser microsurgery (TLMS) and transoral robotic surgery (TORS) between 2008 and 2013 at academic referral center were studied retrospectively. The resected tissue volume, the location of resection, and MD Anderson Dysphagia Inventory (MDADI) were described.Results:Mean resected tissue volume for T1 tumors with TORS was 11.44 cm3 and was 7.90 cm3 with TLMS, (P = 0.44). Mean resected tissue volume for T2 tumors with TORS was 19.45 cm3 and 10.73 cm3 for TLMS (P = 0.194). With a median follow‐up of 11 months, the average of MDADI score was 77.9 for TORS and 74.2 for TLMS for T1 tumors, (P = 1) and 67.9 for TORS and 50.1 for TLMS, (P = 0.052) for T2 tumors. MDADI score for T1 with TLMS and TORS combined was 76.7 and for T2 was 63.45 (P = 0.0048).Conclusions:TLMS and TORS are minimally invasive surgical approaches used to treat OPSCC. Both techniques employ different resection techniques; TLMS removes smaller, tumor specific volumes while TORS has anatomy‐based predefined resection limits. Our study shows that despite these differences in surgical technique, there is no statistical difference in resected tissue volumes and swallowing function for T1 and T2 tumors removed by both techniques. However, functional outcome of both techniques combined for T1 tumors were superior to T2 tumors.
The Development and Application of a Rhinoplasty Operation Record System Using a Mobile Device
Authors: Seok Jungirl , Rhee Chae‐Seo , Jin Hong‐Ryul 
Published: August 2013

Objectives:Drawing on a piece of paper and saving the scanned documents has mainly been the way to record in rhinoplasty, so far. However, it is difficult to store and retrieve the drawings using this method. The authors suggest a recording system using a mobile device and have found it useful in storing and transmitting the drawings.Methods:Based on iPad 4.0, the rhinoplasty record application program (Rhinograph) was developed. The SQLite was used as an internal database, and the program was developed using XCode 4. The authors kept the operation records of 10 patients who had undergone rhinoplasty and confirmed the usefulness and convenience of this system.Results:The program was divided into 6 parts: 1) the operation sheet (operation registration, surgical details, and notations), 2) looking up, modifying, and converting the system to PDF/JPG files with email transmissions, 3) the template developing system with frequently used techniques, 4) the database backup and conversion to Excel files, 5) registering user emails and signatures, and 6) the description of the applications. The program resulted in equal convenience and accuracy as hand‐drawing among the 10 patients. In addition, the mobile device was easily carried in the operating room and outpatient clinics.Conclusions:The rhinoplasty recording system using a mobile device was found to be as effective as the traditional way of recording and helped remove the constraints of place. In addition, it was shown to be convenient to store and analyze the data.