bluuebunny/crossref_metadata_2025_split huggingface dataset:
An alternative management approach to paranasal sinus fibro‐osseous lesions
Authors: Ooi Eng H. , Glicksman Jordan T. , Vescan Allan D. , Witterick Ian J. 
Published: February 2011

AbstractBackgroundFibro‐osseous lesions of the paranasal sinuses are an uncommon heterogeneous group of lesions with variable clinical presentation. It is unclear whether these lesions directly cause symptoms or secondarily obstruct the sinuses with resultant rhinosinusitis. We have used an expectant management approach in selected patients that includes observation with serial scans or endoscopic sinus surgery (ESS) to improve the outflow tract of the affected sinus without resection of the lesion. The purpose of this work is to review our experience with management of paranasal sinus fibro‐osseous lesions.MethodsRetrospective chart review from 1997 to 2009.ResultsA total of 44 patients were identified in this study. There were 19 (43%) osteoma and 25 (57%) fibrous dysplasia cases. The presenting symptoms were mainly sinonasal with headaches (36%), pain/pressure (19%), and nasal obstruction (17%). Two patients (4.5%) presented with proptosis and diplopia. Five (11%) patients had associated nasal polyps. The diagnosis was an incidental finding in seventeen (38%) cases. Twenty‐two (50%) patients were managed conservatively with serial computed tomography (CT) scans to monitor for interval growth over a mean interval of 41.8 months (range, 13–130 months). There were 2 patients in the observation group with CT scan evidence of interval growth with an increase in size of 1 mm and 9 mm over 130 and 36 months, respectively. Twelve symptomatic patients (27%) underwent ESS without resection of the lesion, with symptomatic improvement in 11 patients (92%). Four patients (9%) underwent endoscopic biopsy to attain histological diagnosis. Six (13%) patients in this study had resection of their lesion with 5 of the patients having symptomatic improvement following resection.ConclusionIn patients with fibro‐osseous lesions, we support an expectant management approach of asymptomatic patients with observation and serial imaging, treating selected symptomatic patients with ESS and resection of the lesion in patients with orbital complications, progressive growth of the lesion, or persistent symptoms. © 2011 ARS‐AAOA, LLC.
Sphenoid “drill‐out” for chronic sphenoid rhinosinusitis
Authors: Leight W. Derek , Leopold Donald A. 
Published: February 2011

AbstractBackgroundChronic sphenoid rhinosinusitis (CSR) refractory to both medical management and 1 or more sphenoidotomies is a difficult entity to treat. In contrast to the surgical hierarchy that exists for the frontal sinus, there is no systematic approach for addressing persistent disease in the sphenoid. Sphenoid marsupialization has been advocated as a method of addressing recurrent sphenoid sinusitis.ObjectiveWe present a new technique called the sphenoid drill‐out, which we place between traditional sphenoidotomy and sphenoid marsupialization in the surgical hierarchy for management of CSR.MethodsWe performed a retrospective review on all patients undergoing sphenoidotomy between 2005 and 2009. We studied demographics, procedure type, diagnoses, comorbidities, efficacy, revision rate, and endoscopic outcomes using Lund‐Kennedy scores.ResultsA total of 10 patients underwent sphenoid drill‐out for CSR. Average follow up was 17 months. Patients had an average of 5 prior sinus surgeries with 2.6 prior sphenoidotomies. One patient required a revision drill‐out procedure. The mean preoperative and postoperative Lund‐Kennedy scores were 6.67 and 1.78, which was a statistically significant difference.ConclusionThe sphenoid drill‐out procedure is safe and effective for the management of recalcitrant CSR. It should be considered as an intermediate procedure between sphenoidotomy and sphenoid marsupialization. © 2011 ARS‐AAOA, LLC.
Real‐time tracking and virtual endoscopy in cone‐beam CT‐guided surgery of the sinuses and skull base in a cadaver model
Authors: Prisman Eitan , Daly Michael J. , Chan Harley , Siewerdsen Jeffrey H. , Vescan Allan , Irish Jonathan C. 
Published: February 2011

AbstractBackgroundCustom software was developed to integrate intraoperative cone‐beam computed tomography (CBCT) images with endoscopic video for surgical navigation and guidance. A cadaveric head was used to assess the accuracy and potential clinical utility of the following functionality: (1) real‐time tracking of the endoscope in intraoperative 3‐dimensional (3D) CBCT; (2) projecting an orthogonal reconstructed CBCT image, at or beyond the endoscope, which is parallel to the tip of the endoscope corresponding to the surgical plane; (3) virtual reality fusion of endoscopic video and 3D CBCT surface rendering; and (4) overlay of preoperatively defined contours of anatomical structures of interest.MethodsAnatomical landmarks were contoured in CBCT of a cadaveric head. An experienced endoscopic surgeon was oriented to the software and asked to rate the utility of the navigation software in carrying out predefined surgical tasks. Utility was evaluated using a rating scale for: (1) safely completing the task; and (2) potential for surgical training. Surgical tasks included: (1) uncinectomy; (2) ethmoidectomy; (3) sphenoidectomy/pituitary resection; and (4) clival resection. CBCT images were updated following each ablative task.ResultsAs a teaching tool, the software was evaluated as “very useful” for all surgical tasks. Regarding safety and task completion, the software was evaluated as “no advantage” for task (1), “minimal” for task (2), and “very useful” for tasks (3) and (4). Landmark identification for structures behind bone was “very useful” for both categories.ConclusionThe software increased surgical confidence in safely completing challenging ablative tasks by presenting real‐time image guidance for highly complex ablative procedures. In addition, such technology offers a valuable teaching aid to surgeons in training. © 2011 ARS‐AAOA, LLC.
Factors associated with computed tomography status in patients presenting with a history of chronic rhinosinusitis
Authors: Abrass Leah J. , Chandra Rakesh K. , Conley David B. , Tan Bruce K. , Kern Robert C. 
Published: February 2011

AbstractBackgroundThe diagnosis of chronic rhinosinusitis (CRS) is based upon symptomatic criteria and objective measures. However, patients suspected to have CRS based on a positive history but negative endoscopies remain a diagnostic challenge. We investigated the utility of point of care computed tomography (POC‐CT) in resolving this issue.MethodsThe study group consisted of a simple random sample of 100 patients presenting with active CRS symptoms and negative endoscopies who underwent POC‐CT at initial presentation. Presenting symptoms and comorbidities were correlated with CT scan results (positive/negative) using univariate and multivariate logistic regression models.ResultsPOC‐CT was considered positive in 49% of patients. Univariate analysis revealed that patients complaining nasal obstruction were significantly more likely to have a positive scan (odds ratio [OR], 2.74; p = 0.047), while those with postnasal drip (OR, 0.44; p = 0.047) or cough (OR, 0.17; p = 0.03) were less likely to have positive scan results. In the multivariate model, these trends persisted without reaching statistical significance. Under univariate analysis, patients who were prescribed antibiotics, oral steroids, or nasal steroids at this initial visit were more likely to have had a positive CT. These trends also persisted in the multivariate model, with significance observed for the association between antibiotic prescription and a positive scan (p = 0.001).ConclusionLess than 50% of patients with active CRS symptoms had radiographic manifestations of sinus disease. Other etiologies must be considered higher in the differential for those presenting primarily with complaints referable to the throat. POC‐CT averted unnecessary antibiotics in these patients. © 2011 ARS‐AAOA, LLC.
Safety and efficacy of a novel bioabsorbable, steroid‐eluting sinus stent
Authors: Murr Andrew H. , Smith Timothy L. , Hwang Peter H. , Bhattacharyya Neil , Lanier Brent J. , Stambaugh James W. , Mugglin Andrew S. 
Published: February 2011

AbstractBackgroundInflammation/polyp recurrence, adhesions, and middle turbinate lateralization are causes of suboptimal outcomes following sinus surgery and lead to increased rates of revision. A bioabsorbable, drug‐eluting stent was evaluated for its ability to preserve sinus patency by providing controlled steroid delivery to the sinus mucosa. The study objective was to assess safety and efficacy of a steroid‐eluting sinus stent when used following functional endoscopic sinus surgery (FESS) in patients with chronic rhinosinusitis (CRS).MethodsProspective, multicenter, randomized, double‐blind clinical trial, enrolling 43 patients in 2 groups. One group (n = 38) used an intrapatient control design comparing drug‐eluting to non‐drug‐eluting stents. The other group (n = 5) received bilateral drug‐eluting stents to assess systemic safety. Endoscopic follow‐up was performed for 60 days. Efficacy endpoints included assessment of inflammation, polyp formation, adhesions, and middle turbinate position.ResultsStents were successfully deployed in all 86 sinuses. Compared to the control stent, the drug‐eluting stent provided statistically significant reduction in inflammation at days 21 to 45 (p < 0.003), frequency of polyp formation (p = 0.0391), and frequency of significant adhesion (p = 0.0313). Reduced frequency of middle turbinate lateralization was also apparent though not statistically significant. No device‐related adverse events occurred. Eluted steroid was unquantifiable systemically and there was no evidence of adrenal cortical suppression.ConclusionThis study demonstrates the safety and efficacy of a novel bioabsorbable, steroid‐eluting stent for use in CRS patients. The steroid‐eluting stent is effective in improving wound healing by preserving sinus patency, reducing inflammation, and minimizing adhesions via controlled local steroid delivery without measurable systemic exposure. © 2011 ARS‐AAOA, LLC.
The analyst as father: remembering and repeating – in the hope of working through
Authors: Hill Christine A. S. 
Published: February 2011

AbstractThis paper arose from a PhD thesis entitled “What do patients want? Psychoanalytic perspectives from the couch”. As outcome studies in psychoanalysis have usually only acknowledged the analyst's voice, this empirical research provided an opportunity for patients to be heard. The aim was to discover what they themselves perceived as helpful, or unhelpful, in the analytic process. One of the central themes that emerged was a powerful connection between the analytic and real life experiences of father, at many levels, which needed to be explored within the transference relationship with the analyst. From this material two broad areas surfaced: the “emotionally present” and “emotionally absent” analyst. Specific case material from patients' narratives is used to demonstrate the very powerful nature of the transference/counter‐transference relationship, the significance of early relating patterns which need to be understood and skillfully addressed, and the difficulties encountered when repetition occurs and the analytic task of working through does not take place. “Father hunger” is prominent. An exploration of central issues which have contributed to such a variation in these experiences draws attention to the significance of the analysts' personal characteristics as a major impact on analytic outcomes. Copyright © 2011 John Wiley & Sons, Ltd.
Emodin Prolongs Recipient Survival Time After Orthotopic Liver Transplantation in Rats by Polarizing the Th1/Th2 Paradigm to Th2
Authors: Tong Hongfei , Chen Kangjie , Chen Hui , Wu Huayong , Lin Haiduo , Ni Zhonglin , Lin Shengzhang 
Published: February 2011

AbstractAdvances in immunosuppressive drugs have improved the short‐term survival of liver transplantation. However, drug toxicities have been a serious problem in patients after long‐term administration. Therefore, it is necessary to develop a novel immunosuppressant with low‐toxicity. We investigated the immunosuppressive effects of Emodin on acute graft rejection following liver transplantation in rats. The recipient rats of orthotopic liver transplantation were divided into groups as follows: isograft+NS group, allograft+NS group, and allograft+emodin group. The survival time of the recipients in each group was recorded. Histopathological changes in the liver, as well as serum concentrations of IL‐2, TNF‐α, and IL‐10 and their expressions in liver tissue were determined. Our results showed that Emodin treatment prolonged liver allograft survival time and inhibited histopathologic changes of acute graft rejection. The rejection activity index in groups isograft+NS, allograft+NS, and allograft+emodin were 1.52 ± 0.37, 6.95 ± 0.75, and 4.23 ± 0.51, respectively (P < 0.01, isograft+NS group vs. allograft+emodin group and allograft+NS group vs. allograft+emodin group). The serum levels of IL‐2 and TNF‐α were down‐regulated but that of IL‐10 was up‐regulated by Emodin. Serum levels of IL‐2 and TNF‐α were higher in allograft+NS group than the allograft+emodin group, but that of IL‐10 showed opposite effects (P < 0.05 or 0.01). Changes in the expression of these cytokines in transplanted liver tissue were consistent with changes in serum concentrations. These results demonstrate that Emodin has therapeutic potentials for alleviating acute rejection following liver transplantation in rats and prolonging liver allograft survival. The mechanisms underlying this effect may be associated with polarizing the Th1/Th2 paradigm to Th2. Anat Rec, 2011. © 2011 Wiley‐Liss, Inc.
Expression of trypsin‐like serine peptidases in pre‐imaginal stages of Aedes aegypti (Diptera: Culicidae)
Authors: Mesquita‐Rodrigues Camila , Saboia‐Vahia Leonardo , Cuervo Patrícia , Masini d'Avila Levy Claudia , Alves Honorio Nildimar , Domont Gilberto Barbosa , Batista de Jesus Jose 
Published: February 2011

AbstractThis study reports the biochemical characterization and comparative analyses of highly active serine proteases in the larval and pupal developmental stages of Aedes aegypti (Linnaeus) using substrate‐SDS‐PAGE. Zymographic analysis of larval stadia detected proteolytic activity in 6–8 bands with apparent molecular masses ranging from 20 to 250 kDa, with activity observed from pH 5.5 to 10.0. The pupal stage showed a complex proteolytic activity in at least 11 bands with apparent Mr ranging from 25 to 250 kDa, and pH optimum at 10.0. The proteolytic activities of both larval and pupal stages were strongly inhibited by phenyl‐methyl sulfonyl‐fluoride and N‐α‐Tosyl‐L‐lysine chloromethyl ketone hydrochloride, indicating that the main proteases expressed by these developmental stages are trypsin‐like serine proteases. The enzymes were active at temperatures ranging from 4 to 85°C, with optimal activity between 37 and 60°C, and low activity at 85°C. Comparative analysis between the proteolytic enzymes expressed by larvae and pupae showed that substantial changes in the expression of active trypsin‐like serine proteases occur during the developmental cycle of A. aegypti. © 2011 Wiley Periodicals, Inc.
Lipid accumulation and utilization by oocytes and eggs of Rhodnius prolixus
Authors: Santos Rachel , Rosas‐Oliveira Rafael , Saraiva Felipe B. , Majerowicz David , Gondim Katia C. 
Published: February 2011

AbstractInsect eggs must contain the necessary nutrients for embryonic growth. In this article, we investigated the accumulation of triacylglycerol (TAG) in growing oocytes and its utilization during embryonic development. TAG makes up about 60% of the neutral lipids in oocytes and accumulates as oocytes grow, from 2.2 ± 0.1 µg in follicles containing 1.0 mm length oocytes to 10.2 ± 0.8 µg in 2.0 mm length oocytes. Lipophorin (Lp), the hemolymphatic lipoprotein, radioactively labeled in free fatty acid (FFA) or diacylglycerol (DAG), was used to follow the transport of these lipids to the ovary. Radioactivity from both lipid classes accumulated in the oocytes, which was abolished at 4°C. The capacity of the ovary to receive FFA or DAG from Lp varied according to time after a blood meal and reached a maximum around the second day. 3H‐DAG supplied by Lp to the ovaries was used in the synthesis of TAG as, 48 hr after injection, most of the radioactivity was found in TAG (85.7% of labeling in neutral lipids). During embryogenesis, lipid stores were mobilized, and the TAG content decreased from 16.4 ± 2.1 µg/egg on the first day to 10.0 ± 1.3 µg on day 15, just before hatching. Of these, 7.4 ± 0.9 µg were found in the newly emerged nymphs. In unfertilized eggs, the TAG content did not change. Although the TAG content decreased during embryogenesis, the relative lipid composition of the egg did not change. The amount of TAG in the nymph slowly decreased during the days after hatching. © 2011 Wiley Periodicals, Inc.
High‐level expression of the Geranylgeranyl diphosphate synthase gene in the frontal gland of soldiers in Reticulitermes speratus (Isoptera: Rhinotermitidae)
Authors: Hojo Masaru , Toga Kouhei , Watanabe Dai , Yamamoto Tomoyo , Maekawa Kiyoto 
Published: February 2011

AbstractDefensive strategies of termite soldiers are roughly classified as either mechanical, using mandibles and/or the whole head, or chemical, using frontal gland secretion. Soldiers of the genus Nasutitermes (Termitidae, Nasutitermitinae), which is one of the most derived termite genera, use only chemical defenses, and diterpene defensive secretions were suggested to be synthesized through geranylgeranyl diphosphate (GGPP). On the other hand, soldiers of the genus Reticulitermes (Rhinotermitidae, Heterotermitinae) mainly use mechanical defenses, but also use supplementary chemical defenses involving frontal gland secretions, including diterpene alcohol. In this study, to confirm whether the GGPP is used for diterpene synthesis in a representative of an earlier‐branching termite lineage, the GGPP synthase gene (RsGGPPS) was identified in the rhinotermitid Reticulitermes speratus (Kolbe). The relative expression level of RsGGPPS in soldiers was three‐fold higher than in workers. Furthermore, RsGGPPS gene expression was detected in epithelial class 1 gland cells around the frontal‐gland reservoir. Although GGPP is used for various essential cellular roles in animals, RsGGPPS is suggested to be used not only for these essential roles but also for diterpene synthesis in order to produce defensive secretions. Chemical structures of the diterpene identified from Reticulitermes and Nasutitermes are extremely different from each other, and the two genera are phylogenetically distant from each other. Thus, these two lineages may have independently acquired the abilities of diterpene synthesis from GGPP. © 2011 Wiley Periodicals, Inc.
A Strategy for Neuraminidase Inhibitors Using Mechanism‐Based Labeling Information
Authors: Hinou Hiroshi , Miyoshi Risho , Takasu Yasuaki , Kai Hirokazu , Kurogochi Masaki , Arioka Shingo , Gao Xiao‐Dong , Miura Nobuaki , Fujitani Naoki , Omoto Shinya , Yoshinaga Tomokazu , Fujiwara Tamio , Noshi Takeshi , Togame Hiroko , Takemoto Hiroshi , Nishimura Shin‐Ichiro 
Published: February 2011

AbstractA potent inhibitor for Vibrio cholerae neuraminidase (VCNA) was developed by using a novel two‐step strategy, a target amino acid validation using mechanism‐based labeling information, and a potent inhibitor search using a focused library. The labeling information suggested the hidden dynamics of a loop structure of VCNA, which can be a potential target of the novel inhibitor. A focused library composed of 187 compounds was prepared from a 9‐azide derivative of 2,3‐dehydro‐N‐acetylneuraminic acid (DANA) to interrupt the function of the loop of the labeled residues. Inhibitor 3c showed potent inhibition properties and was the strongest inhibitor with FANA, a N‐trifluoroacetyl derivative of DANA. Validation studies of the inhibitor with a detergent and a Lineweaver–Burk plot suggested that the 9‐substitution group would interact hydrophobically with the target loop moiety, adding a noncompetitive inhibition property to the DANA skeleton. This information enabled us to design compound 4 having the combined structure of 3c and FANA. Compound 4 showed the most potent inhibition (Ki=73 nM, mixed inhibition) of VCNA with high selectivity among the tested viral, bacterial, and mammal neuraminidases.
Analogy of fixed route shared taxi (taxi khattee) and bus services under various demand density and economical conditions
Authors: Gholami Ali , Mohaymany Afshin Shariat 
Published: February 2011

AbstractTaxi khattee is a fixed route unregulated shared taxi. It is a very common mode of transportation in Iran. Fixed route, unscheduled operation, open, unlimited pick‐up and drop‐off locations, and share ride are common features of taxi khattees. Low passenger capacity and working in high demand corridors provides for the possibility of high service frequencies any time of the day. Taxi khattees are similar to jitneys, which are obsolete or illegal in many countries. The aim of this research is to design transit network of an area using taxi khattees in addition to buses. The methodology employed in this paper simultaneously considers the costs to the users and operators on the one hand, and those of the public non‐users on the other hand. Taxi khattees are used in the design of a multimodal network along with buses to characterize the appropriate economic domain for their use. Moreover, their operation indices are compared against those of buses. A sensitivity analysis is carried out on various performance measures. Results show taxi khattees should be used in areas where population density is low, work force is inexpensive, social costs are not considered in fare calculation, and users' value of time is high. The study contradicts the common belief that since taxi khattees provide a high frequency compared to buses, they are economically plausible to use in a transit fleet. Copyright © 2011 John Wiley & Sons, Ltd.
Integrated fuzzy signal and ramp‐metering at a diamond interchange
Authors: Pham V.C. , Alam F. , Potgieter J. , Fang F.C. , Xu W.L. 
Published: February 2011

SUMMARYWe propose a fuzzy logic control for the integrated signal operation of a diamond interchange and its ramp meter, to improve traffic flows on surface streets and motorway. This fuzzy logic diamond interchange (FLDI) comprises of three modules: fuzzy phase timing (FPT) module that controls the green time extension of the current phase, phase logic selection (PLS) module that decides the next phase based on the pre‐defined phase sequence or phase logic and, fuzzy ramp‐metering (FRM) module that determines the cycle time of the ramp meter based on current traffic volumes and conditions of the surface streets and the motorways. The FLDI is implemented in Advanced Interactive Microscopic Simulator for Urban and Non‐Urban Network Version 6 (AIMSUN 6), and compared with the traffic actuated signal control. Simulation results show that the FLDI outperforms the traffic‐actuated models with lower system total travel time, average delay, and improvements in downstream average speed and average delay. Copyright © 2011 John Wiley & Sons, Ltd.