bluuebunny/crossref_metadata_2025_split huggingface dataset:
A model for training and evaluation of myringotomy and tube placement skills
Authors: Malekzadeh Sonya , Hanna Glenn , Wilson Brette , Pehlivanova Marieta , Milmoe Gregory 
Published: June 2011

AbstractObjectives/Hypothesis:Simulation is emerging as a mandatory component of surgical training and a means of demonstrating surgical competency. We designed a cost‐effective, low‐fidelity model to further acquisition of technical skills related to myringotomy and ventilation tube insertion (M&T). The purpose of the study was to examine the skills trainer as a method of assessment to evaluate competency, timeliness, and procedure confidence in junior residents.Study Design:Prospective, randomized.Methods:A simplistic M&T skills box was developed. General surgery interns (n = 20) with no prior procedure training were randomized to receive either didactic instruction or skills training using the model. One hour of lecture or technical skills training was provided to each group. A blinded examiner evaluated the subjects in both groups before and after training. Performance was measured using a global rating scale, task‐specific checklist, and time‐to‐completion. Pre‐ and postsession questionnaires assessed procedure confidence.Results:Analysis revealed a trend toward improvement in global rating scores between groups. There was a statistically significant difference in time improvement between groups (P = .0211). The skills lab group felt they could perform the procedure faster and with improved abilities, as compared to the didactic group (P = .0069 and 0.0007, respectively).Conclusions:Junior surgical residents performed an M&T procedure using a novel, low‐cost model. This study demonstrated the skills lab's positive effect on training as measured by global rating scale, time‐to‐completion, and overall resident confidence. We anticipate its application to be valuable not only in training residents but also in assessing competency.
Staphylococcus aureus biofilms
Authors: Singhal Deepti , Foreman Andrew , Bardy Josh‐Jervis , Wormald Peter‐John 
Published: June 2011

AbstractObjectives/Hypothesis:Chronic rhinosinusitis (CRS) patients with biofilms have persistent postoperative symptoms, ongoing mucosal inflammation, and recurrent infections. Recent evidence suggests that biofilms of differing species confer varying disease profiles in CRS patients. We aimed to prospectively investigate the effects of Staphylococcus aureus, Pseudomonas aeruginosa, Haemophilus influenzae, and fungal biofilms on outcomes following endoscopic sinus surgery (ESS).Study Design:Prospective blinded study.Methods:In this prospective blinded study, 39 patients undergoing ESS for CRS assessed their symptoms preoperatively using internationally accepted standardized symptom scoring systems and quality‐of‐life measures (10‐point visual analog scale, Sino‐Nasal Outcome Test‐20, global severity of CRS). Their sinonasal mucosa was graded (Lund–Kennedy scale) and extent of radiologic disease on computed tomography scans scored (Lund‐McKay scale). Random sinonasal tissue samples were assessed for different bacterial species forming biofilms by using fluorescent in‐situ hybridization and confocal laser microscopy. For 12 months after surgery, CRS symptoms, quality of life, and objective evidence of persisting disease were assessed by using the preoperative tools.Results:Different bacterial species combinations were found in 30 of 39 patients; 60% of these 30 biofilms were polymicrobial biofilms and 70% had S aureus biofilms. Preoperative nasendoscopy and radiologic disease severity were significantly worse in patients with multiple biofilms (P = .02 and P = .01, respectively), and they had worse postsurgery mucosal outcomes on endoscopy (P = .01) requiring significantly more postoperative visits (P = .04). Those with S aureus biofilms progressed poorly with their symptom scores and quality‐of‐life outcomes, with significant differences in nasendoscopy scores (P = .007).Conclusions:S. aureus biofilms play a dominant role in negatively affecting outcomes of ESS with persisting postoperative symptoms, ongoing mucosal inflammation, and infections.
Immunohistochemical detection of pepsin in laryngeal mucosa for diagnosing laryngopharyngeal reflux
Authors: Jiang Aiyun , Liang Maojin , Su Zhenzhong , Chai Liping , Lei Wenbin , Wang Zhangfeng , Wang Anjiang , Wen Weiping , Chen Minhu 
Published: June 2011

AbstractObjectives/Hypothesis:To investigate whether the pepsin immunohistochemical (IHC) staining of the laryngeal mucosa epithelia is an available test for diagnosing laryngopharyngeal reflux (LPR) in clinic.Study Design:Prospective case series.Methods:Biopsy specimens from interarytenoid mucosa of LPR patients (seven acid LPR and eight nonacid LPR) and 21 sex‐ and age‐matched normal controls were obtained for pepsin IHC staining. The diagnosis of LPR was based on 24‐hour combined multichannel intraluminal esophageal impedance pH monitoring. The results of IHC staining were semiquantitatively analyzed and scored as negative (−), weakly positive (+), moderately positive (++), and strongly positive (+++).Results:Six of seven acid LPR (85.7%) and six of eight nonacid LPR (75%) mucosa samples were moderate to strongly positive for intracellular pepsin. By contrast, only three of 21 normal controls (14.3%) were moderately positive. The difference in intracellular pepsin between LPR and the normal laryngeal mucosa was statistically significant (P < .01). No significant difference in intracellular pepsin was observed between the acid and nonacid LPR mucosal samples (P = .453). Using weak positivity (+) as a cutpoint, the presence of intracellular pepsin in the laryngeal mucosa had a sensitivity of 100% and a specificity of 47.6% in detecting LPR (P < .05). However, using the moderate positivity (++) as the cutpoint, the pepsin had a slightly decreased sensitivity of 80% but a sharply increased specificity of 85.7% (P < .05) in the detection of LPR.Conclusions:Pepsin IHC staining of the laryngeal mucosa appears to be a sensitive and specific test for diagnosing LPR in a clinical application.
Telemedicine—An efficient and cost‐effective approach in parathyroid surgery
Authors: Urquhart Andrew C. , Antoniotti Nina M. , Berg Richard L. 
Published: June 2011

AbstractObjectives/Hypothesis:To demonstrate the effectiveness and cost benefit of using telemedicine for the postoperative visit in patients undergoing parathyroidectomy for primary hyperparathyroidism.Study Design:Prospective noncontrolled study at a tertiary medical center of a cohort of 39 patients undergoing postoperative care after parathyroidectomy through TeleHealth at a number of sites at various distances from the primary surgical facility.Methods:From October 2006 through January 2010, 149 patients underwent parathyroidectomy for primary hyperparathyroidism at one tertiary medical center by a single surgeon. Age, sex, distance from the patient's home to the surgical center and to the TeleHealth site, effective completion of the TeleHealth visit, and postoperative complications were recorded.Results:Of the 149 patients who underwent parathyroidectomy, 39 had their postoperative visit using TeleHealth (26%). There were 26 females (67%) and 13 (33%) males. Mean age was 64 years. All visits were effectively carried out and completed with a nurse and the patient at a remote TeleHealth site and the surgeon at the surgical center site. There were no postoperative surgical complications noted with the visits. Average round‐distance travel saved was 119 miles. The travel distance saved translated into an average savings of $357.00 per patient (which included estimations of transportation costs and lost work time), with further immeasurable benefits to the patient and healthcare system.Conclusions:TeleHealth is a cost‐effective and efficient way to follow‐up with patients who have undergone parathyroidectomy, with significant convenience and financial benefits for the patient and healthcare system.
CO2 laser ablation and balloon dilation for acquired nasopharyngeal stenosis: A novel technique
Authors: Sidell Douglas , Chhetri Dinesh K. 
Published: June 2011

AbstractObjectives/Hypothesis:Although acquired nasopharyngeal stenosis (NPS) is frequently attributed to infectious and granulomatous processes, it can also occur secondary to external beam radiation therapy for head and neck cancer. NPS can be treated with local flaps, laser excision, nasal stenting, and combinations thereof. Unfortunately, the postoperative course is frequently complicated by scarring and restenosis that often necessitates multiple revision surgeries. The objective of this study is to report a novel endoscopic approach, employing the use of a flexible CO2 laser in combination with balloon dilation and mitomycin‐C application, allowing for the successful treatment of acquired NPS with lasting results.Study Design:Retrospective review of case series.Methods:An endoscope with a working channel is passed transnasally to the location of nasopharyngeal stenosis. A flexible CO2 laser fiber is then inserted via the working channel of the scope. Precise radial incisions are made on the stenosis using the laser under direct visualization. The laser is removed, and a controlled radial expansion balloon dilation device is inserted, advanced to span the segment of stenosis, and inflated to achieve adequate dilation. Mitomycin‐C is then applied topically to the area of dilation.Results:Three patients with severe NPS were treated using this novel technique. All patients had successful long‐lasting dilation of NPS without complications over a follow‐up period ranging from 12 to 18 months.Conclusions:Acquired NPS can be successfully treated with durable results with radial laser incisions and controlled radial expansion balloon dilation.
The effects of unilateral cochlear implantation on the tinnitus handicap inventory and the influence on quality of life
Authors: Amoodi Hosam A. , Mick Paul T. , Shipp David B. , Friesen Lendra M. , Nedzelski Julian M. , Chen Joseph M. , Lin Vincent Y. W. 
Published: June 2011

AbstractObjectives/Hypothesis:Cochlear implantation is now the standard of care in patients with significant sensorineural hearing loss. It is well known that patients with severe hearing loss also experience disabling tinnitus. The purpose of this study was to assess the effects of cochlear implants on the perception of tinnitus using the Tinnitus Handicap Inventory (THI).Study Design:Prospective, longitudinal study of 142 cochlear implant patients.Methods:The THI was administered to 142 patients pre‐ and postimplantation. Outcome measures were obtained 12 months after the implantation. Secondary analyses to examine the correlation between changes in THI scores and outcome measures such as Hearing Handicap Inventory, Hearing in Noise Test (HINT), and short‐form 36 (SF‐36) quality‐of‐life scores were performed.Results:Patients demonstrated statistically significant reduction of the THI scores including its subscales (P < .001). Prior to implantation, 37% of patients described their tinnitus as moderate to severe. Postoperatively, this percentage decreased to 10%. Cochlear implantation resulted in complete tinnitus suppression in 37% and tinnitus reduction in another 29% of patients. THI scores significantly correlated with three domains of the SF‐36 quality‐of‐life questionnaire, namely social, emotional, and general health domains.Conclusions:Cochlear implants have a significant suppressive effect on tinnitus in 66% of implant users. Although the reduction in the subjectively perceived tinnitus was statistically significant, it did not correlate with HINT; however, it did correlate with three quality‐of‐life domains, more significantly for those whose pretreatment conditions were moderate or worse.
Intraoperative photodynamic detection of normal parathyroid glands using 5‐aminolevulinic acid
Authors: Suzuki Takeshi , Numata Tsutomu , Shibuya Mariko 
Published: June 2011

AbstractObjectiveIt is important to identify and save the normal parathyroid glands during head and neck surgery because of their role in regulating the blood calcium level, yet it is often difficult to localize normal parathyroid glands during surgery. Fluorescence‐guided parathyroidectomy in patients with hyperparathyroidism has already proved useful. However, there are few reports of fluorescence‐guided localization of normal parathyroid glands in humans. We investigated the utility of fluorescence‐guided localization of normal parathyroid glands during thyroidectomy and completed a spectral fluorescence analysis of the accumulation of 5‐aminolevulinic acid metabolites in the parathyroid glands.MethodsEight patients with benign thyroid disease and five with malignant thyroid tumors were given 20 mg/kg body weight of 5‐aminolevulinic acid orally 5 hours before surgery. After the posterior surface of the thyroid gland was exposed and the recurrent laryngeal nerve was identified, we illuminated the area with a violet‐blue light of 405 nm. Tissues showing red fluorescence were biopsied to analyze the spectral fluorescence.ResultsUnder the violet‐blue light, normal parathyroid glands showed red fluorescence, while the surrounding structures such as the thyroid gland, muscles, and fat remained nonfluorescent. The spectral peak was observed at 635 nm indicating 5‐aminolevulinic acid metabolites. Histopathologically, the biopsied tissue corresponded to normal parathyroid glands.Conclusions5‐Aminolevulinic acid is useful to localize the normal parathyroid glands during thyroid surgery in humans.
Disruption of ephrin B/Eph B interaction results in abnormal cochlear innervation patterns
Authors: Zhou Constance Q. , Lee James , Henkemeyer Mark J. , Lee Kenneth H. 
Published: June 2011

AbstractObjective:To determine the expression patterns of B ephrins and Ephs in the cochlea and identify functional consequences of disruption of ephrin B/Eph B interactions in both cultured spiral ganglion neurons and in the cochlea of live animals.Study Design:The expression patterns of various B ephrins and Ephs were determined in mice with Lac‐Z mutation. Mice with null function of individual B ephrin and Eph proteins and those with multiple knockouts were studied for cochlear innervation patterns.Methods:Mice with B ephrins and Ephs disrupted with the β‐galactosidase gene were sacrificed at P6, and their cochleae isolated and processed for Lac‐Z staining to determine expression of these proteins in cochlear tissue. Spiral ganglion cells from wild‐type as well as ephrin B1 knockout mice were isolated and cocultured with Eph B2 expressing Cos1 cells and neurite lengths were determined. Fluorescent lipophillic dyes were used to label spiral ganglion cell nerve fibers to determine cochlear innervation patterns in wild‐type and knockout mice.Results:Eph B1, B2, and ephrin B2 but not B3 was expressed in the cochlea. Eph B2 inhibited outgrowth of spiral ganglion cell axons from wild‐type mice, but not from ephrin B1 knockout mice in culture. Knockout mice with null function of ephrin B1 alone or Eph B1, Eph B2, Eph B3 in combination demonstrated abnormal innervation patterns in the organ of Corti.Conclusions:Disruption of B ephrins and Ephs results in functional consequences in spiral ganglion cells, suggesting that these proteins play a role in establishing normal innervation patterns in the cochlea.
Improved growth curve measurements after supraglottoplasty
Authors: Meier Jeremy D. , Nguyen Shaun A. , White David R. 
Published: June 2011

AbstractObjectives/Hypothesis:To evaluate changes in growth curve measurements after supraglottoplasty and compare these patterns to patients with laryngomalacia treated conservatively.Study Design:Retrospective case–control study.Methods:Children treated surgically for laryngomalacia were compared to control groups of patients who underwent observation or medical treatment only. Body weight the day of surgery and on follow‐up visits was plotted on a standardized growth curve and the z‐score calculated.Results:A total of 15 patients were included that were observed (group 1), 71 patients that were treated with medical therapy only (group 2), and 29 patients that underwent surgery (group 3). The average z‐score at the time of surgery was significantly worse in group 3 (−0.854 ± 1.080), compared to the z‐score at the time of diagnosis in group 1 (−0.086 ± 0.834), and the time when antireflux therapy was initiated in group 2 (−0.120 ± 0.979). Within 3 months from surgery, significant improvement on the growth curve was seen in group 3 (P = .009). After 12 months, all three groups approached the mean on the growth curve.Conclusions:In this series, patients with severe laryngomalacia who warranted surgery presented with significantly lower percentile weight on a standardized growth curve than patients who required only medical or conservative treatment. Substantial improvement in growth curve percentile was seen in the immediate months following supraglottoplasty. Long‐term follow‐up after supraglottoplasty shows that infants return to a mean weight on the growth curve.
Transmastoid extradural–intracranial approach for repair of transtemporal meningoencephalocele: A review of 31 consecutive cases
Authors: Semaan Maroun T. , Gilpin David A. , Hsu Daniel P. , Wasman Jay K. , Megerian Cliff A. 
Published: June 2011

AbstractObjective:To review the clinical presentation, surgical techniques, and outcomes of the transmastoid extradural–intracranial (TMEDIC) approach for the treatment of transtemporal meningoencephalocele.Hypothesis:The TMEDIC is a safe and effective approach to repair meningoencephalocele originating from the middle or posterior cranial fossa.Study Design:Retrospective chart review.Setting:Academic neurotologic tertiary referral center.Patients:Thirty‐one consecutive patients diagnosed with transpetrous meningo(encephalo)cele, with or without cerebrospinal fluid leak, between January of 2003 and October of 2010.Intervention:TMEDIC approach for repairing herniated neural tissue through the tegmen or posterior fossa plate using the combination of autologous cartilage, fascia, and tissue sealant.Main Outcome Measures:Anatomic location, size, and number of defects, presence of herniated brain tissue, pre‐ and postoperative hearing thresholds, and failure rate.Results:Mean age was 62 ± 26 years. The etiology was spontaneous in 25/31 (80%), congenital in 3/31 (10%), chronic otitis media in 2/31 (6%), and posttraumatic in 1/31 (4%). Posttympanostomy tube clear otorrhea was the presenting sign in 21/31 (68%) of patients. The mean duration of symptoms was 26 months (range: 1–240). The defect involved the middle fossa (MF) floor in 25/31 (90%). Both the tegmen tympani and mastoideum were involved in 12/31 (39%) of patients and multiple dehiscences were seen in 7/31 (22%). In 17/31 (55%) of cases the size exceeded 1 cm. No recurrences were seen.Conclusion:The TMEDIC is a safe and effective method to repair transtemporal meningoencephalocele obviating the need for a middle fossa craniotomy in certain cases.
FIELD OBSERVATIONS OF WINDBLOWN SAND AND DUST IN THE TAKIMAKAN DESERT, NW CHINA, AND INSIGHTS INTO MODERN DUST SOURCES
Authors: Wang H. , Jia X. 
Published: June 2011

ABSTRACTDespite the importance of desert dust at global and regional scales, its exact provenance is often unclear. The Taklimakan Desert in northwest China is a common source of high‐frequency regional dust storms and is also a large source of global dust production. On the basis of field observations and the determination of the fraction of aeolian dust in surface samples, we characterized the relative intensity of windblown sand/dust processes in the Taklimakan and the volume of dust emitted (PM10) during these processes. Major dust sources were degraded lands on the eastern desert margin, the Gobi and alluvial, fluvial and aeolian sediments occurring on the desert margin. These areas have high PM10 emission capacity due to high‐surface PM10 concentrations and intensive windblown sand/dust activity. Despite having intensive windblown sand activity, the central desert had lower PM10 dust emission capacity (<1·6 kg day−1 m−2 in spring, <0·08 kg day−1 m−2 in other seasons) due to lower surface PM10 fraction. The dry Taitema Lake bed was a source of potentially high dust emissions (at least 4·4–17 kg day−1 m−2 for the monitoring period) due to the intensity windblown sand/dust activities, despite low PM10 concentrations. The dry river beds on the southeastern desert margin had lower dust emission potential due to low PM10 concentrations and windblown sand/dust activity. Most dust emission sources lie in the paths of prevailing winds, leading to aeolian dust transported to and deposited in the desert hinterland or Hotan, Yutian and Minfeng areas, where wind stream convergence leads to high‐frequency dust storms. Copyright © 2011 John Wiley & Sons, Ltd.
The Role of Dimension in Multivalent Binding Events: Structure–Activity Relationship of Dendritic Polyglycerol Sulfate Binding to L‐Selectin in Correlation with Size and Surface Charge Density
Authors: Weinhart Marie , Gröger Dominic , Enders Sven , Riese Sebastian B. , Dernedde Jens , Kainthan Rajesh K. , Brooks Donald E. , Haag Rainer 
Published: June 2011

AbstractL‐, P‐, and E‐Selectin are cell adhesion molecules that play a crucial role in leukocyte recruitment from the blood stream to the afflicted tissue in an acute and chronic inflammatory setting. Since selectins mediate the initial contact of leukocytes to the vascular endothelium, they have evolved as a valuable therapeutic target in diseases related to inflammation by inhibition of the physiological selectin–ligand interactions. In a previous study, it was demonstrated that dPGS, a fully synthetic heparin analogue, works as an efficient inhibitor towards L‐ and P‐selectin in vitro as well as in vivo. Herein, the focus is directed towards the effect of size and charge density of the polyanion. The efficiency of L‐selectin inhibition via an SPR‐based in vitro assay and a cell‐based flow chamber assay is investigated with dPGS ranging from approximately 4 to 2000 kDa. SPR measurements show that the inhibitory potential of highly sulfated dPGS increases with size and charge density. Thereby, IC50 values from the micromolar to the low picomolar range are determined. The same tendency could be observed in a cell‐based flow chamber assay with three representative dPGS samples. This structure–affinity relationship of dPGS suggests that the strong inhibitory potential of dPGS is not only based on the strong electrostatic interaction with areas of cationic surface potential on L‐selectin but is also due to a steric shielding of the carbohydrate binding site by large, flexible dPGS particles. magnified image
Characterization of Water‐Dispersible n‐Type Poly(benzimidazobenzophenanthroline) Derivatives
Authors: Wagner Michal , Österholm Anna , Hirvonen Sami‐Pekka , Tenhu Heikki , Ivaska Ari , Kvarnström Carita 
Published: June 2011

AbstractNovel water dispersible poly(benzimidazobenzophenanthroline) polymers functionalized with poly(ethylene oxide) (BBL:PEO) have been investigated by cyclic voltammetry, in situ UV‐vis spectroscopy and atomic force microscopy. The cyclic voltammograms recorded during n‐doping indicate that the drop coated BBL:PEO films retain their properties despite functionalization. A small influence of the PEO side chains on redox properties of the investigated polymers was found, diminishing however after annealing. During spectroscopic experiments structural changes connected with polymer charging were observed (in accordance with a two electron transfer process). The functionalization of BBL with PEO side chains provided an easy processing method to obtain smooth and reproducible polymer films. magnified image