bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preservation of Tropomyosin-Related Kinase B (TrkB) Signaling by Sodium Orthovanadate Attenuates Early Brain Injury After Subarachnoid Hemorrhage in Rats
Authors: Hasegawa Yu , Suzuki Hidenori , Altay Orhan , Zhang John H. 
Published: December 2010

Background and Purpose—
Recent studies reported that apoptosis was involved in the pathogenesis of early brain injury after subarachnoid hemorrhage (SAH). The aim of this study was to examine whether sodium orthovanadate (SOV) prevents post-SAH apoptosis by modulating growth factors and its downstream receptor tyrosine kinases.

Method—
Rats were operated on with the endovascular perforation model. SAH animals were treated with vehicle, 3 mg/kg and 10 mg/kg SOV, and evaluated regarding neurofunction and brain edema. The expression of growth factors such as mature brain-derived neurotrophic factor, insulin-like growth factor-1, and vascular endothelial growth factor and phosphorylation of tropomyosin-related kinase B, which is a receptor tyrosine kinase for brain-derived neurotrophic factor and the downstream pathway in antiapoptosis, was examined by Western blot analysis. Neuronal cell death was measured with terminal deoxynucleotidyl transferase-mediated uridine 5′-triphosphate-biotin nick end-labeling staining. We also administered K252a, a tropomyosin-related kinase B antagonist, to examine the mechanisms for neuroprotective effects by SOV.

Results—
SOV significantly improved neurofunction and reduced brain edema after SAH. SOV increased mature brain-derived neurotrophic factor and prevented post-SAH tropomyosin-related kinase B inactivation and caspase-3 activation, resulting in attenuation of neuronal cell death in the cortex and hippocampal CA1 region. Preinjection of K252a abolished the beneficial effects of SOV.

Conclusions—
The current study showed that brain-derived neurotrophic factor-induced tropomyosin-related kinase B activation by SOV was necessary for protection against early brain injury after SAH.
Transient Ischemic Attack and Acute Ischemic Stroke
Authors: Wang Jie Jin , Baker Michelle L. , Hand Peter J. , Hankey Graeme J. , Lindley Richard I. , Rochtchina Elena , Wong Tien Y. , Liew Gerald , Mitchell Paul 
Published: December 2010

Background and Purpose—
Small vessel disease plays a role in cerebral events. We aimed to investigate the prevalence and patterns of retinal microvascular signs (surrogates for cerebral small vessel disease) among patients with transient ischemic attack (TIA) or acute stroke and population control subjects.

Methods—
Patients with TIA or acute stroke aged ≥49 years admitted to hospitals in Melbourne and Sydney, Australia, were recruited to the Multi-Centre Retina and Stroke Study (n=693, 2005 to 2007). Control subjects were Blue Mountains Eye Study participants aged ≥49 years without TIAs or stroke (n=3384, 1992 to 1994, west of Sydney). TIA, ischemic stroke, or primary intracerebral hemorrhage was classified using standardized neurological assessments, including neuroimaging. Retinal microvascular signs (retinopathy, focal arteriolar narrowing, arteriovenous nicking, enhanced arteriolar light reflex) were assessed from retinal photographs masked to clinical information.

Results—

Patients with TIA or acute stroke were older than control subjects and more likely to have stroke risk factors. After adjustment for study site and known risk factors, all retinal microvascular signs were more common in patients with TIA or acute stroke than in control subjects (OR, 1.9 to 8.7;
P
<0.001). Patients with TIA and those with ischemic stroke had similar prevalences of nondiabetic retinopathy (26.9% versus 29.5%; OR, 0.8; 95% CI, 0.5 to 1.6), diabetic retinopathy (55.5% versus 50.0%; OR, 1.3; 95% CI, 0.4 to 3.6), focal arteriolar narrowing (15.6% versus 18.4%; OR, 0.8; 95% CI, 0.4 to 1.5), and arteriovenous nicking (23.0% versus 17.8%; OR, 1.4; 95% CI, 0.7 to 2.7).

Conclusions—
Patients with TIA and acute stroke may share similar risk factors or pathogenic mechanisms.
Influence of Effortful Swallow on Pharyngeal Pressure
Authors: Takasaki Kenji , Umeki Hiroshi , Hara Minoru , Kumagami Hidetaka , Takahashi Haruo 
Published: December 2010

ObjectiveTo evaluate the effect of effortful swallow on pharyngeal pressure while swallowing saliva and water using a novel high‐resolution manometry (HRM) system.Study DesignCase series with planned data collection.SettingNagasaki University Hospital.Subjects and MethodsEighteen asymptomatic Japanese adult volunteers were studied. A solid‐state HRM assembly with 36 circumferential sensors spaced 1 cm apart was positioned from the velopharynx to the upper esophagus to record pressures while swallowing. The maximum values of the pressure while swallowing saliva (dry swallowing) and 5 mL of water were measured at the velopharynx, meso‐hypopharynx, and upper esophageal sphincter (UES) with and without effortful swallows.ResultsThe maximum values of dry swallowing pressures (mm Hg) at the velopharynx, meso‐hypopharynx, and UES were significantly higher with effortful swallow (155.7 ± 59.7, 256.7 ± 78.7, and 276.5 ± 87.5, mean ± standard deviation) than without it (115.3 ± 60.8, 172.9 ± 57.0, and 195.8 ± 61.3). Those of water swallowing pressures were also statistically higher with effortful swallow (169.3 ± 69.1, 236.6 ± 77.2, and 267.3 ± 79.1) than without it (119.2 ± 59.7, 189.5 ± 70.7, and 221.3 ± 72.7).ConclusionThe present results provide quantitative evidence of effortful swallow as well as physiological information. It also is hoped to be an aid to future clinical and investigative studies.
Diagnostic Criteria of Nonspecific Hyperreactivity Using Cold Dry Air Provocation With Acoustic Rhinometry
Authors: Kim Young Hyo , Jang Tae Young 
Published: December 2010

ObjectiveThe authors aimed to (1) compare symptom changes in patients with or without nonspecific hyperreactivity, (2) compare changes in total nasal volume (TNV) and minimal cross‐sectional area (MCA) using acoustic rhinometry after cold dry air (CDA) challenge, and (3) set the diagnostic criteria using receiver operating characteristic (ROC) curve analysis.Study DesignProspective pilot.SettingAcademic tertiary rhinologic practice.Subjects and MethodsCDA provocation was performed on 45 patients with self‐reported hypersensitivity to cold dry air (group A) and to 53 patients without such hypersensitivity (group B). Symptoms (as measured by visual analog scale [VAS]), TNV, and MCA were checked before and after provocation.ResultsThe changes in nasal obstruction (1.8 ± 2.1 vs 0.0 ± 2.3) and rhinorrhea (0.8 ± 2.1 vs −0.5 ± 2.3) were significantly greater in group A (P <. 01 in each case). There were no significant differences between groups in VAS scores for sneezing and itching. From the ROC curve, the authors set the diagnostic criterion as “TNSS (total nasal symptom score) change larger than 1.5,” and its sensitivity and specificity were 75.6% and 86.8%, respectively. The criteria “TNV decrease larger than 19.5%” and “MCA change larger than 15.0%” had higher sensitivity and specificity (TNV: 84.4% sensitivity and 77.4% specificity; MCA: 93.3% sensitivity and 77.4% specificity).ConclusionsThe authors were able to propose diagnostic criteria of nonspecific hyperreactivity using a CDA provocation test with acoustic rhinometry. These results are also helpful for understanding the pathophysiologic mechanisms of nonspecific hyperreactivity.
Nasal Base Narrowing
Authors: Ismail Ahmed Soliman 
Published: December 2010

ObjectiveTo evaluate the role of creating an alar‐based advancement flap in narrowing the nasal base and correcting excessive alar flare.Study DesignCase series with chart review.SettingThis is a retrospective record review study.Subjects and MethodsThe study included 35 cases presenting with a wide nasal base and excessive alar flaring. The surgical procedure combined the alar base reduction with alar flare excision by creating a single laterally based alar flap. Any caudal septal deformities and any nasal tip modification procedures were corrected before the nasal base narrowing. The mean follow‐up period was 23 months.ResultsThe mean alar flap narrowing was 6.3 mm, whereas the mean width of sill narrowing was 2.9 mm. This single laterally based advancement alar flap resulted in a more conservative external resection, thus avoiding alar wedge overresection or blunting of the alar‐facial crease. No cases of postoperative bleeding, infection, or keloid were encountered, and the external alar wedge excision healed with no apparent scar that was hidden in the depth of the alar‐facial crease. The risk of notching of the alar rim at the sill incision is reduced by adopting a 2‐layer closure of the vestibular floor.ConclusionThe alar base advancement flap is an effective technique in narrowing both the nasal base and excessive alar flare. It adopts a single skin excision to correct the 2 deformities while commonly feared complications were avoided.
Effects of Surface Dehydration on Mucosal Wave Amplitude and Frequency in Excised Canine Larynges
Authors: Witt Rachel E. , Taylor Lindsay N. , Regner Michael F. , Jiang Jack J. 
Published: December 2010

ObjectiveEvaluate the effect of vocal fold surface dehydration on mucosal wave amplitude and frequency.Study DesignControlled test‐retest.SettingLarynges were mounted on an excised larynx phonation system and attached to a pseudolung in a triple‐walled sound‐attenuated room that eliminated background noise and maintained a stabilized room temperature and humidity level.Subjects and MethodsHigh‐speed video was recorded for 8 excised canine larynges during exposure to dehumidified air at 20 cm H2O. Control trials consisted of high‐speed videos recorded for 2 excised canine larynges during exposure to humidified air at the same pressure.ResultsIn the majority of larynges, increased levels of dehydration were correlated with decreased amplitude and frequency. The slope of the linear regression fitted to the change in amplitude (P =. 003) and the percent change (P <. 001) between the initial and final trials were significantly decreased in dehydrated larynges. These measurements with respect to the change in frequency were also significantly decreased in dehydrated larynges (P <. 001; P =. 027).ConclusionVocal fold surface dehydration caused a decrease in mucosal wave amplitude and frequency. This study provides objective, quantitative support for the mechanism of voice deterioration observed after extreme surface dehydration.
Impact of a Laryngectomy and Surgical Closure Technique on Swallow Biomechanics and Dysphagia Severity
Authors: Maclean Julia , Szczesniak Michal , Cotton Susan , Cook Ian , Perry Alison 
Published: December 2010

ObjectiveThe incidence of self‐reported dysphagia following a laryngectomy is high (72%). The impact, if any, of a surgical closure technique on swallowing biomechanics and dysphagia severity is not known. To date, there is no recommended standard procedure for pharyngeal reconstruction during laryngectomy surgery. The aim of this study was to determine how laryngectomy surgery alters swallowing biomechanics, pharyngeal peak deglutitive pressure, and hypopharyngeal intrabolus pressures and whether these changes in pressure correlate with specific surgical closure after total laryngectomy or with dysphagia severity.Study DesignCombined videoradiography and manometry was used to measure peak mid‐pharyngeal, tongue, and intrabolus pressures; anatomical derangements; postswallow residue; and pharyngeal dimensions.SettingRadiology Department, St George Hospital, Sydney, Australia.SubjectsTwenty‐four patients following total laryngectomy surgery and age‐matched control data.ResultsWhen compared to controls, peak mid‐pharyngeal pressures were significantly reduced in laryngectomy patients (P <. 001). Hypopharyngeal intrabolus pressures were significantly higher in patients when compared to controls (P <. 001). Patients who had undergone mucosa‐and‐muscle pharyngeal reconstruction had higher peak mid‐pharyngeal pressures compared to those who had mucosa‐alone closure (P ≤. 04). Combined mucosa‐and‐muscle closure was also associated with reduced postswallow residue, indicative of a more efficient swallow.ConclusionFollowing laryngectomy surgery, pharyngeal pro‐pulsive contractile forces are impaired, and there is increased resistance to bolus flow across the pharyngoesophageal segment. These adverse biomechanical effects can be influenced by surgical techniques, providing surgeons with evidence for optimum pharyngeal closure following a laryngectomy to improve swallowing outcomes.
Video Pneumatic Otoscopy for the Diagnosis of Conductive Hearing Loss With Normal Tympanic Membranes
Authors: Lee Jae Kwon , Cho Yang‐Sun , Ko Moon Hee , Lee Won Yong , Kim Hyung‐Jin , Kim Eunhee , Chung Won‐Ho , Hong Sung Hwa 
Published: December 2010

ObjectiveTo evaluate the usefulness of video pneumatic otoscopy (VPO) for the diagnosis of conductive hearing loss (CHL) with normal tympanic membranes (TM).Study DesignProspective study.SettingTertiary care hospital.Subjects and MethodsThirty‐seven ears with CHL and 9 control ears with normal TMs were included. The VPO was performed preoperatively in all patients. The authors captured TM images in 3 stages of the VPO (static, positive, and negative pressure stage) in all subjects and measured the amount of relative position differences of the umbo. Pure‐tone audiometry and temporal bone computed tomography (TBCT) were performed preoperatively. The possible causes of hearing loss were evaluated during exploratory tympanotomy in the patients with CHL.ResultsFifteen patients had stapedial fixation, 10 had fixation of the malleus or incus (MIF), and 12 had ossicular discontinuity. The positional differences between the negative and positive pressure stage of the MIF group were significantly smaller between the CHL and control groups (P =. 001). The air‐bone gap showed no significant difference among the CHL groups. The sensitivity, specificity, and diagnostic accuracy of the VPO for the diagnosis of MIF, with a cutoff value of 1.5% or less in terms of the movement of umbo, were 80.0%, 92.6%, and 89.2%, respectively. These findings were comparable to those of the TBCT, which were 90.0%, 85.2%, and 86.5%, respectively.ConclusionThe VPO is a simple, noninvasive, and accurate tool for the differential diagnosis of CHL with a normal TM.
Disparities in Children With Otitis Media
Authors: Patel Sundip , Schroeder James W. 
Published: December 2010

ObjectivesTo determine the difference between children with private and public insurance at the time of referral to a pediatric otolaryngologist.Study DesignProspective study.SettingTertiary care hospital.Subjects and MethodsData relating to the severity of a patient’s otitis media (number of infections, doctor visits, antibiotic courses) were collected by phone interview. All patients referred to a pediatric otolaryngologist at an urban tertiary care hospital over a 5‐month period were included.ResultsOne hundred eighty‐three children were studied: 87 consecutive patients in the private third‐party insurance group (PIN) and 96 patients in the state‐based Medicaid insurance group (PA). During the 6 months prior to referral, children in the PIN group had a median 4 acute otitis media infections with 5 courses of oral antibiotics and 6 primary care visits compared to 3 infections with 3 courses of antibiotics and 4 primary care visits for the PA group (P =. 0009, P ≤. 0001, P =. 0003, respectively). For recurrent acute otitis media, the PA group had a significantly longer time with disease prior to referral than the PIN group (P =. 0478).ConclusionChildren in this metropolitan area referred for tympanostomy tube placement with PIN are younger, have more episodes of acute otitis media, receive more antibiotic courses, and have more primary care visits in the 6 months prior to referral than their PA counterparts. Additional research is required to determine why these differences exist, especially in light of ongoing changes to the health care system.
Remodeling of Articular Cartilage and Subchondral Bone After Bone Grafting and Matrix-Associated Autologous Chondrocyte Implantation for Osteochondritis Dissecans of the Knee
Authors: Ochs Björn Gunnar , Müller-Horvat Christian , Albrecht Dirk , Schewe Bernhard , Weise Kuno , Aicher Wilhelm Karl , Rolauffs Bernd 
Published: December 2010

Background: Osteochondritis dissecans (OCD) of the knee is a challenging problem. Previously, the authors implemented a novel 1-step surgical procedure for OCD treatment consisting of matrix-associated autologous chondrocyte implantation (ACI) and simultaneous bone reconstruction including the subchondral lamina. Purpose: This study presents the 2-to 5-year results after this technique, assessing correlations of clinical function and cartilage and bone remodeling processes. Study Design: Case series; Level of evidence, 4. Methods: Twenty-six patients with symptomatic condylar knee OCD (International Cartilage Repair Society OCD III/IV) were treated with matrix-associated ACI and monocortical cancellous cylinders for defect filling and subchondral bone plate reconstruction using cortical graft layers as novel subchondral lamina. Evaluations were performed with clinical rating scales and 1.5-T magnetic resonance imaging using the magnetic resonance observation of cartilage repair tissue (MOCART) score and a newly implemented subchondral lamina remodeling grade. Results: The defect size was 5.3 ± 2.3 cm2. The defect depth was 8.7 ± 2.4 mm. After a follow-up of 39.8 ± 12.0 months, all scores improved significantly. Nineteen patients (73%) reached good/excellent results in the Lysholm-Gillquist score (preoperatively: 53.2 ± 18.0 points; latest follow-up: 88.5 ± 9.5 points) and the Cincinnati knee rating score (preoperatively: 51.7 ± 13.0 points; latest follow-up: 84.6 ± 11.7 points) and significant improvements in the subjective International Knee Documentation Committee (IKDC) score by 27.9% (preoperatively: 50.5% ± 16.1%; latest follow-up: 78.4% ± 13.4%). The MOCART score reached 62.4 ± 18.9 points. The clinical improvement and tissue remodeling occurred simultaneously and timed; thus, the cartilage defect filling and the lamina remodeling grades correlated significantly with each other, the follow-up time, and almost all clinical scores. Conclusion: The simultaneous reconstruction of deep osteochondral defects of the knee OCD with monocortical cancellous cylinders and matrix-associated ACI is a biological, 1-step alternative to osteochondral cylinder transfer or conventional ACI that leads to good clinical and magnetic resonance imaging results after an intermediate follow-up period. The present study demonstrated simultaneous remodeling processes of articular cartilage repair tissue and subchondral lamina; this synchronization is not yet understood and deserves further investigation.
Knockdown Epithelial Membrane Protein 1 Suppresses Human Degenerative Intervertebral Disc–Derived Nucleus Pulposus Cell Proliferation
Authors: Li Zhi-Yong , Xiong Shao-Hu , Hu Ming , Zhang Chuan-Sen 
Published: December 2010

Objective: Our previous work showed that epithelial membrane protein 1 (EMP1) is highly expressed in nucleus pulposus of the human degenerative intervertebral disc. The present study was designed to investigate the role of EMP1 in nucleus pulposus cells in intervertebral disc degeneration (IDD). Design: Human nucleus pulposus cells derived from degenerative intervertebral discs were cultured. EMP1 expression was knocked down by lentivirus-mediated specific interfering RNA. Cell morphology was observed, and cell proliferation, apoptosis, and cycle were evaluated. Results: Knockdown of EMP1 inhibited cell proliferation, caused cells to shrink, and accelerated the apoptosis induced by serum deprivation or addition of cycloheximide but did not evoke apoptosis in normal culture conditions. Conclusions: These findings suggest that EMP1 promoted chondrocyte proliferation, survival, and morphological change of cells during IDD, implying that EMP1 may be a target for biological therapy for IDD.
Immune reconstitution is preserved in hematopoietic stem cell transplantation coadministered with regulatory T cells for GVHD prevention
Authors: Gaidot Aline , Landau Dan Avi , Martin Gaëlle Hélène , Bonduelle Olivia , Grinberg-Bleyer Yenkel , Matheoud Diana , Grégoire Sylvie , Baillou Claude , Combadière Béhazine , Piaggio Eliane , Cohen José Laurent 
Published: December 2010

AbstractRecipient-specific regulatory T cells (rsTreg) can prevent graft-versus-host disease (GVHD) by inhibiting donor T-cell expansion after hematopoietic stem cell transplantation (HSCT) in mice. Importantly, in adult humans, because of thymus involution, immune reconstitution during the first months after HSCT relies on the peripheral expansion of donor T cells initially present in the graft. Therefore, we developed a mouse model of HSCT that excludes thymic output to study the effect of rsTreg on immune reconstitution derived from postthymic mature T cells present within the graft. We showed that GVHD prevention with rsTreg was associated with improvement of the limited immune reconstitution compared with GVHD mice in terms of cell numbers, activation phenotype, and cytokine production. We further demonstrated a preserved in vivo immune function using vaccinia infection and third-party skin-graft rejection models, suggesting that rsTreg immunosuppression was relatively specific of GVHD. Finally, we showed that rsTreg extensively proliferated during the first 2 weeks and then declined. In turn, donor Treg proliferated from day 15 on. Taken together, these results suggest that rsTreg GVHD prevention is associated with improved early immune reconstitution in a model that more closely approximates the biology of allogeneic HSCT in human adults.
How I treat late effects in adults after allogeneic stem cell transplantation
Authors: Savani Bipin N. , Griffith Michelle L. , Jagasia Shubhada , Lee Stephanie J. 
Published: December 2010

Abstract
More than 25 000 allogeneic hematopoietic stem cell transplantations (allo-HCTs) are expected to be performed worldwide in 2010, a number that has been increasing yearly. With broadening indications, more options for allo-HCT, and improvement in survival, by 2020 there may be up to half a million long-term survivors after allo-HCT worldwide. These patients have increased risks for various late complications, which can cause morbidity and mortality. Most long-term survivors return to the care of their local hematologists/oncologists or primary care physicians, who may not be familiar with specialized monitoring recommendations for this patient population. The purpose of this article is to describe practical approaches to screening for and managing these late effects, with the goal of reducing preventable morbidity and mortality associated with allo-HCT.