bluuebunny/crossref_metadata_2025_split huggingface dataset:
Regenerated Middle Ear Mucosa after Tympanoplasty. Part II. Scanning Electron Microscopy
Authors: Gamoletti Roberto , Lanzarini Paolo , Sanna Mario , Zini Carlo 
Published: August 2015

The ultrastructural appearance of the regenerated middle ear epithelium, found at the second operation of staged ICWT with mastoidectomy, has been investigated herein with the scanning electron microscope. The regenerated epithelium consists of flat nonciliated cells, “elevated” nonciliated cells with microvilli, and ciliated cells. Secretory material is present on the surface of the “elevated” nonciliated cells surrounding the ciliated ones. Regeneration of the mucosa occurs following precise topographic differences that mimic the distribution of epithelial cells in the normal middle ear. It is confirmed that a morphologically normal middle ear epithelium regenerates to cover all denuded bone surfaces within 12 months—after first stage ICWT with mastoidectomy—when silicone rubber sheeting has been used to maintain an aerated middle ear and mastoid space.
Long‐Term Hearing Results following Middle Fossa Vestibular Nerve Section
Authors: Glasscock Michael E. , Johnson Glenn D. , Poe Dennis S. 
Published: August 2015

Hearing stabilization following middle fossa vestibular nerve section (MFVNS) has been observed to occur in a large percentage of patients (71% to 86%) after short‐term followup. This study looks at the long‐term audiological followup (5 to 15 years) of 46 patients who underwent a MFVNS for intractable Meniere's disease. Although the percentage of patients with stabilized hearing was relatively high within the first 2 years postoperatively (61%), it dropped to 41% after a longer followup of 5 to 15 years. When this patient population is divided into two groups based on their preoperative PTA, those patients in whom hearing had bottomed out to ≥50 dB PTA preoperatively lost only 5 dB PTA over the course of the follow‐up period. The patients with better preoperative hearing (<50 dB PTA) lost 30 dB PTA over the same follow‐up period. As this pattern is similar to what has been observed in nonsurgically treated Meniere's patients, we conclude that the MFVNS has no beneficial effect on the hearing loss associated with Meniere's disease.
High‐Frequency Electrostimulation Hearing after Mastoidectomy
Authors: Hegewald Mark , Heitman Robin , Wiederhold Michael L. , Cooper J.C. , Gates George A. 
Published: August 2015

This study was undertaken to measure the degree of high‐frequency sensorineural hearing loss following mastoid surgery. Twenty‐five patients undergoing mastoidectomy procedures were tested preoperatively, less than 2 days postoperatively, and at 30 days postoperatively using the Tonndorf Audimax 500 high‐frequency audiometer. Electrostimulation thresholds in 1‐kHz intervals, from 1 to 20 kHz, were measured, and the highest detectable frequency was determined to within 0.1 kHz. Surgical drilling time was recorded. Average drilling time was 51 minutes. A significant temporary threshold shift was observed, measurable at multiple frequencies, less than 48 hours after mastoidectomy. There was no clinically significant change in electrostimulation thresholds (measured in 1‐kHz increments, from 1 to 16 kHz) preoperatively to 30 days postoperatively. A statistically significant average loss of 0.89 kHz in the highest frequency producing a measurable response was noted (p< 0.05). Determinations of the highest measurable frequency may be the most sensitive measure of surgically‐induced, high‐frequency sensorineural hearing changes.
Overcoming Laryngospasm by Electrical Stimulation of the Posterior Cricoarytenoid Muscle
Authors: Aviv Jonathan E. , Sanders Ira , Silva David , Kraus Warren M. , Wu Bei‐Lian , Biller Hugh F. 
Published: August 2015

The intent of this study was to demonstrate that the technique of transmucosal electrical stimulation of laryngeal muscles may be of clinical use in airway management. Specifically, its ability to overcome laryngospasm was evaluated. Laryngospasm was induced in eight tracheotomized dogs by hyperventilating each dog, and then applying 0.1 M ammonia to the laryngeal mucosa while administering continuous positive airway pressure (CPAP). Laryngospasm was defined by steady apposition of the vocal cords, massive electromyographic activity in the laryngeal adductor muscles, absence of such activity in the posterior cricoarytenoid muscle (PCA), and intraglottic pressure greater than 80 mm Hg. Upon transmucosal application of 10 mAmp current to the PCA bilaterally, the vocal cords abducted for the duration of the stimulus. We theorize that overcoming laryngospasm by electrostimulation involves a reflexive inhibition of the laryngeal adductors. This study provides an objective model for laryngospasm, and demonstrates that electrical manipulation of the vocal cords may have clinical relevance.
Hearing Aid Use with Minimal High‐Frequency Hearing Loss
Authors: Bennett Carissa D. 
Published: August 2015

This Study evaluated the use of hearing aids by patients with hearing threshold levels of 20 dB or less at 500 and 1000 Hz and 35 dB or less at 2000 Hz. Ninety‐eight patients completed a 30‐day trial with amplification. Six months later, patients were interviewed by telephone and questioned on hearing aid use and perceived unaided and aided difficulty in various listening environments. Results of the study demonstrated that patients with minimal high‐frequency hearing loss can benefit from the use of hearing aids. Ninety‐two percent of the patients elected to purchase the hearing aids and 85% considered the aids a worthwhile investment after 6 months of use. Patients showed a mean improvement from moderate unaided to slight aided difficulty at work and in general social situations. The only variable that predicted success with hearing aids was degree of unaided difficulty at work. Patients who perceived less unaided difficulty at work were less likely to obtain benefit from the use of the hearing aids.
Lack of Efficacy of Middle‐Ear Inflation: Treatment of Otitis Media with Effusion in Children
Authors: Chan Kenny H. , Bluestone Charles D. 
Published: August 2015

A randomized controlled trial was conducted to evaluate the efficacy of autoinflation of the middle ear in the treatment of otitis media with effusion. Forty‐one children with middle ear effusion not responsive to antimicrobial therapy enrolled in the study. Of these subjects, 75 percent had effusion duration over 3 months. A system consisting of a disposable anesthesia mask attached to a flowmeter was used to teach children to perform autoinflation based on a modified Valsalva technique. Subjects were stratified according to their ability to achieve tubal opening as assessed by tympanometry and tubosonometry. Subjects were randomly assigned to either treatment or observation group and were followed weekly for 2 weeks; subjects in the treatment group attempted inflation three times each day for 2 weeks. Of the 19 subjects who were in the autoinflation group, only one (5.3 percent) was effusion‐free at the two‐week endpoint and of the 21 subjects in the control, only two (9.5 percent) were without middle‐ear effusion. Autoinflation was ineffective for treatment of children with otitis media with effusion in our study.
Evaluating the effects of mindfulness-based interventions for informal palliative caregivers: A systematic literature review
Authors: Jaffray Linda , Bridgman Heather , Stephens Miranda , Skinner Timothy 
Published: August 2015

Background: There is a need to identify proactive, evidence-based interventions to support informal palliative caregivers. Mindfulness-based interventions, evidenced in the literature as providing physical and mental health benefits for diverse populations, may have application in the setting of palliative caregiving. Aim: To describe, evaluate and synthesise the peer-reviewed literature on the effects of mindfulness-based interventions for informal palliative caregivers. Design: A Systematic Literature Review according to the Preferred Reporting Items for Systematic Review and Meta Analyses guidelines and a Narrative synthesis. Data sources: The Cochrane Library, CINAHL, MEDLINE, PsycINFO and EMBASE databases, searched from inception to February 2014 and references of included studies. Results: A total of 13 articles, reporting 10 studies ( n = 432 participants) were included. All studies were conducted in the last 5 years. Dementia caregivers were the most frequently researched population ( n = 7). Results suggest that mindfulness-based interventions are feasible and acceptable to offer to informal palliative caregivers and may provide benefit, particularly in terms of reducing depression and caregiver burden and increasing quality of life. However, effects were not as robust as findings in the wider mindfulness intervention literature. Conclusion: This is the first systematic literature review on this topic. Results suggest both feasibility and potential benefit. Further qualitative research is required to explore the outcomes identified by informal caregivers themselves as the reduced magnitude of effect may suggest that we are not measuring the right outcomes in this context. This would inform more sensitive outcome measures for future intervention studies and guide the development and application of mindfulness-based models in this area.
Patellofemoral Pressure Changes After Static and Dynamic Medial Patellofemoral Ligament Reconstructions
Authors: Rood Akkie , Hannink Gerjon , Lenting Anke , Groenen Karlijn , Koëter Sander , Verdonschot Nico , van Kampen Albert 
Published: August 2015

Background: Reconstructing the medial patellofemoral ligament (MPFL) has become a key procedure for stabilizing the patella. Different techniques to reconstruct the MPFL have been described: static techniques in which the graft is fixed rigidly to the bone or dynamic techniques with soft tissue fixation. Static MPFL reconstruction is most commonly used. However, dynamic reconstruction deforms more easily and presumably functions more like the native MPFL. Purpose/Hypothesis: The aim of the study was to evaluate the effect of the different MPFL fixation techniques on patellofemoral pressures compared with the native situation. The hypothesis was that dynamic reconstruction would result in patellofemoral pressures closer to those generated in an intact knee. Study Design: Controlled laboratory study. Methods: Seven fresh-frozen knee specimens were tested in an in vitro knee joint loading apparatus. Tekscan pressure-sensitive films fixed to the retropatellar cartilage measured mean patellofemoral and peak pressures, contact area, and location of the center of force (COF) at fixed flexion angles from 0° to 110°. Four different conditions were tested: intact, dynamic, partial dynamic, and static MPFL reconstruction. Data were analyzed using linear mixed models. Results: Static MPFL reconstruction resulted in higher peak and mean pressures from 60° to 110° of flexion ( P < .001). There were no differences in pressure between the 2 different dynamic reconstructions and the intact situation ( P > .05). The COF in the static reconstruction group moved more medially on the patella from 50° to 110° of flexion compared with the other conditions. The contact area showed no significant differences between the test conditions. Conclusion: After static MPFL reconstruction, the patellofemoral pressures in flexion angles from 60° to 110° were 3 to 5 times higher than those in the intact situation. The pressures after dynamic MPFL reconstruction were similar as compared with those in the intact situation, and therefore, dynamic MPFL reconstruction could be a safer option than static reconstruction for stabilizing the patella. Clinical Relevance: This study showed that static MPFL reconstruction results in higher patellofemoral pressures and thus enhances the chance of osteoarthritis in the long term, while dynamic reconstruction results in more normal pressures.
Coronary Microembolization Induces Cardiomyocyte Apoptosis in Swine by Activating the LOX-1-Dependent Mitochondrial Pathway and Caspase-8-Dependent Pathway
Authors: Liu Tao , Zhou You , Wang Jiang-You , Su Qiang , Tang Zhong-Li , Liu Yang-Chun , Li Lang 
Published: August 2015

Background: Cardiomyocyte apoptosis by coronary microembolization (CME) contributes to myocardial dysfunction, in which mitochondrial pathway and death receptor pathway are activated. Lectin-like oxidized low-density lipoprotein receptor 1 (LOX-1) is a membrane protein involved in apoptosis. The study aimed to explore the role of LOX-1 in the activation of these 2 major apoptotic pathways. Methods: Twenty Bama miniature swine were randomized into 4 groups (n = 5 per group). The groups were Sham, CME, LOX-1 small-interfering RNA (siRNA), and control siRNA. Microspheres were injected into the left anterior descending artery of swine to establish CME model. Twelve hours after operation, cardiac function, serum c-troponin I level, microinfarct, and apoptotic index were examined. The levels of LOX-1, Bcl-2, Bax, cytochrome c as well as cleaved caspase 9, -8, and -3 were detected. Results: Myocardial dysfunction, enhanced serum c-troponin I, microinfarct, and apoptosis were induced following CME. Moreover, CME induced increased expression of LOX-1, Bax, cytochrome c, cleaved caspase 9, -8, and -3 as well as decreased Bcl-2 expression levels. The LOX-1 siRNA reversed these effects by CME except cleaved caspase 8 expression, while the control siRNA had no effect. Conclusion: Coronary microembolization induces cardiomyocyte apoptosis via the LOX-1-dependent mitochondrial pathway and caspase 8-dependent pathway.
Association Between Daily Time Spent in Sedentary Behavior and Duration of Hyperglycemia in Type 2 Diabetes
Authors: Fritschi Cynthia , Park Hanjong , Richardson Andrew , Park Chang , Collins Eileen G. , Mermelstein Robin , Riesche Lauren , Quinn Laurie 
Published: August 2015

Exercise and sedentary behavior have different physiologic effects, which have yet to be fully explained. Time spent in sedentary behavior has been associated with glucose intolerance in adults at risk for type 2 diabetes, but these data have come largely from cross-sectional studies that have not explored this relationship in adults with diabetes. The specific aim of this study was to examine the relationship between time spent in sedentary behavior and glucose levels in adults diagnosed with type 2 diabetes over 3–5 days. Methods: Using continuous and concurrent data gathered from wrist accelerometry and a Continuous Glucose-Monitoring Sensor (CGMS), we conducted a longitudinal, descriptive study involving 86 patients with type 2 diabetes. Results: More time spent in sedentary behavior was predictive of significant increases in time spent in hyperglycemia ( B = 0.12, p < .05). Conclusions: These findings highlight the relationship between time spent sedentary and time spent in hyperglycemia, as identified through our use of objective, continuous data collection methods for both sedentary behavior and glucose levels across multiple days (Actiwatch, CGMS). For patients with type 2 diabetes, these findings emphasize the need for the development of individualized interventions aimed at decreasing the amount of time spent in hyperglycemia by reducing sedentary time.
Mechanisms of Neointima Formation—Lessons from Experimental Models
Authors: De Meyer Guido RY , Bult Hidde 
Published: August 2015

The lamina intima of an artery is the region between the endothelial cell surface and the internal elastic lamina, which forms the luminal margin of the media. In humans the intima of atherosclerosis-prone arteries becomes thicker due to accumulation of smooth muscle cells, which originate from the media. The introduction of percutaneous transluminal coronary angioplasty (PTCA) boosted scientific interest in intimal thickening, because restenosis remains an unresolved problem of this intervention. In order to unravel the mechanisms of intimal thickening there is a need for appropriate animal models. A brief overview of these models is given together with factors that control proliferation and/or migration. Despite intensive research on neointima formation, an effective therapy for restenosis has not emerged to date. This may be due to the fact that other processes, such as acute elastic recoil and chronic constrictive remodeling may contribute to lumen narrowing as well. Other limitations of neointima models are related to species and anatomical differences. Most studies are performed in arteries that are either lesion-free, or contain relatively mild plaques, in contrast to the complicated, stenotic lesions that are the substrate for human PTCA. Other differences are the severity of the injury and incorporation of a mural fibrin-rich thrombus. Nevertheless, studies based on superficial injury, like the frequently used balloon denudation model, are useful. There are similarities with angioplasty, such as endothelial cell damage and proliferation of medial and intimal smooth muscle cells. The use of techniques such as differential display, gene transfer and application of antisense oligonucleotides may provide new therapeutic approaches to reduce neointima formation.
The Microcirculation in Venous Hypertension
Authors: Smith Philip D Coleridge 
Published: August 2015

Venous ulceration is a common problem in western countries and results in large costs to healthcare systems. A number of hypotheses of the mechanisms of development of venous ulceration have been advanced, but this question has not been fully resolved. In recent years research effort has focused on the microcirculation of the skin and many methods of investigation have been employed to study this. Some of the principal findings described in published work are reviewed in this article. It seems unlikely from the available evidence that venous ulceration is attributable solely to failure of diffusion of oxygen and other small nutritional molecules to the tissues of the skin. The microvascular changes in the skin are characterised by activated endothelium and perivascular inflammatory cells. It is much more likely that leucocytes attach themselves to the cutaneous microcirculation, become activated and produce endothelial injury. Repeated over many months or years, this chronic inflammatory process leads to be tissues changes of lipodermatosclerosis. Although there is evidence of leucocyte involvement in the pathogenesis of venous ulceration, the exact mechanisms remain to be resolved. Improved treatment for patients may be devised once a better understanding of the basic causes of this condition has been reached.
Aldosterone effects on glomerular structure and function
Authors: Bernardi Stella , Toffoli Barbara , Zennaro Cristina , Bossi Fleur , Losurdo Pasquale , Michelli Andrea , Carretta Renzo , Mulatero Paolo , Fallo Francesco , Veglio Franco , Fabris Bruno 
Published: August 2015

Objective: Experimental evidence suggests that aldosterone directly contributes to organ damage by promoting cell growth, fibrosis, and inflammation. Based on these premises, this work aimed to assess the glomerular effects of aldosterone, alone and in combination with salt. Methods: After undergoing uninephrectomy, 75 rats were allocated to five groups: control, salt diet, aldosterone, aldosterone + salt diet, aldosterone + salt diet and eplerenone, and they were all studied for four weeks. We focused on glomerular structural, functional, and molecular changes, including slit diaphragm components, local renin–angiotensin system activation, as well as pro-oxidative and profibrotic changes. Results: Aldosterone significantly increased systolic blood pressure, led to glomerular hypertrophy, mesangial expansion, and it significantly increased the glomerular permeability to albumin and the albumin excretion rate, indicating the presence of glomerular damage. These effects were worsened by adding salt to aldosterone, while they were reduced by eplerenone. Aldosterone-induced glomerular damage was associated with glomerular angiotensin-converting enzyme (ACE) 2 downregulation, with ACE/ACE2 ratio increase, ANP decrease, as well as with glomerular pro-oxidative and profibrotic changes. Conclusions: Aldosterone damages not only the structure but also the function of the glomerulus. ACE/ACE2 upregulation, ACE2 and ANP downregulation, and pro-oxidative and profibrotic changes are possible mechanisms accounting for aldosterone-induced glomerular injury.
Correlation between renin-angiotensin system gene polymorphisms and essential hypertension in the Chinese Yi ethnic group
Authors: Yang Yu-Ling , Mo Yan-Ping , He Yong-Shu , Yang Fang , Xu Yan , Li Cheng-Cheng , Wang Jiao , Reng Hao-Ming , Long Li 
Published: August 2015

Introduction: The renin-angiotensin system (RAS) has been considered to play an important role in the regulation of blood pressure. This study aimed to investigate the correlation between RAS gene polymorphisms and essential hypertension (EH) in the Chinese Yi ethnic group. Materials and methods: A total of 244 EH subjects and 185 normotensive individuals from the Chinese Yi ethnic group were genotyped for AGT M235T (rs699), AT1R A1166C (rs5186), ACE I/D (rs4340) and ACE G2350A (rs4343) polymorphisms by the polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP) method. Results: Significant differences in the allele and genotype frequency of ACE G2350A were observed between the EH cases and controls ( p=0.001, 0.002). After being grouped by gender, significant differences in the allele and genotype frequency of ACE G2350A and AT1R A1166C were observed between females of the EH cases and controls ( ACE G2350A: p=0.000, 0.002; AT1R A1166C: p=0.008, 0.011). After excluding the influence of multifactorial interactions, the ACE G2350A polymorphism is significantly associated with the pathogenesis of EH in the Chinese Yi ethnic group (odds ratio ( OR)=1.656, 95% confidence interval (CI) 1.807–2.524, p=0.019). Conclusions: The RAS-related ACE G2350A polymorphism is associated with the pathogenesis of EH in the Chinese Yi ethnic group.
Ten-year experience in subclavian revascularisation. A parallel comparative observational study
Authors: Byrne C , Tawfick W , Hynes N , Sultan S 
Published: August 2015

Introduction Subclavian stenosis has a prevalence of approximately 2% in the community, and 7% within a clinical population. It is closely linked with hypertension and smoking. There is a relative paucity of published data to inform clinicians on the optimal mode of treatment for subclavian artery stenosis. Objectives To compare clinical outcomes of subclavian bypass surgery with that of subclavian endovascular re-vascularisation. Endpoints were survival time, re-intervention-free survival, and symptom-free survival. Method In all, 21 subclavian interventions were performed from 2000 to 2010. We compared angioplasty vs angioplasty with stenting vs bypass. Results Technical success was 100% in all groups. Symptom-free survival, at 70 months, was 60% in the angioplasty group, 100% in the angioplasty and stenting group and 75% in the bypass group. Re-intervention rate was 40% in the angioplasty group, 0% in the angioplasty and stenting group and 25% in the bypass group. Median time for re-intervention was 9.5 months in angioplasty patients and 36 months in bypass patients ( p = 0.102). Target lesion revascularisation was 20.0% for angioplasty procedures, 16.67% for angioplasty and stenting and 25% for bypass procedures. Conclusion Angioplasty with stenting provides improved symptom-free survival and freedom from re-intervention in patients with symptomatic subclavian artery stenosis.