bluuebunny/crossref_metadata_2025_split huggingface dataset:
Expression Profiling of Liposarcoma Yields a Multigene Predictor of Patient Outcome and Identifies Genes That Contribute to Liposarcomagenesis
Authors: Gobble Ryan M. , Qin Li-Xuan , Brill Elliott R. , Angeles Christina V. , Ugras Stacy , O'Connor Rachael B. , Moraco Nicole H. , DeCarolis Penelope L. , Antonescu Cristina , Singer Samuel 
Published: February 2011

Abstract
Liposarcomas are the most common type of soft tissue sarcoma but their genetics are poorly defined. To identify genes that contribute to liposarcomagenesis and serve as prognostic candidates, we undertook expression profiling of 140 primary liposarcoma samples, which were randomly split into training set (n = 95) and test set (n = 45). A multigene predictor for distant recurrence-free survival (DRFS) was developed by the supervised principal component method. Expression levels of the 588 genes in the predictor were used to calculate a risk score for each patient. In validation of the predictor in the test set, patients with low risk score had a 3-year DRFS of 83% versus 45% for high risk score patients (P = 0.001). The HR for high versus low score, adjusted for histologic subtype, was 4.42 (95% CI, 1.26–15.55; P = 0.021). The concordance probability for risk score was 0.732. In contrast, the concordance probability for histologic subtype, which had been considered the best predictor of outcome in liposarcoma, was 0.669. Genes related to adipogenesis, DNA replication, mitosis, and spindle assembly checkpoint control were all highly represented in the multigene predictor. Three genes from the predictor, TOP2A, PTK7, and CHEK1, were found to be overexpressed in liposarcoma samples of all five subtypes and in liposarcoma cell lines. RNAi-mediated knockdown of these genes in liposarcoma cell lines reduced proliferation and invasiveness and increased apoptosis. Taken together, our findings identify genes that seem to be involved in liposarcomagenesis and have promise as therapeutic targets, and support the use of this multigene predictor to improve risk stratification for individual patients with liposarcoma. Cancer Res; 71(7); 2697–705. ©2011 AACR.
Relationship between Radar-Estimated Precipitation and Synoptic Weather Patterns in the European Alps
Authors: Rudolph James V. , Friedrich Katja , Germann Urs 
Published: February 2011

AbstractA 9-yr (2000–08) analysis of precipitation characteristics for the central and western European Alps has been generated from ground-based operational weather radar data provided by the Swiss radar network. The radar-based precipitation analysis focuses on the relationship between synoptic-scale weather patterns and mesoscale precipitation distribution over complex alpine terrain. The analysis divides the Alps into six regions (each approximately 200 × 200 km2in size)—one on the northern side, two each on the western and southern sides of the Alps, and one in the Massif Central—representing various orographic aspects and localized climates within the radar coverage area. For each region, estimated precipitation rate derived from radar data is analyzed on a seasonal basis for total daily precipitation and frequency of high-precipitation-rate events. The summer season has the highest total daily precipitation for all regions in the study, whereas median values of daily precipitation in winter are less than one-half of median daily precipitation for summer. For all regions, high-precipitation-rate events occur most frequently in the summer. Daily synoptic-scale weather patterns are associated with total daily precipitation and frequency of high precipitation rate to show that an advective synoptic-scale pattern with southerly midtropospheric flow results in the highest median and 90th-quantile values for total daily precipitation and that a convective synoptic-scale pattern results in elevated frequency of extreme-precipitation-rate events.
Diagnostic Accuracy of Nasopharyngeal Swabs in Detecting Biofilm‐Producing Bacteria in Chronic Adenoiditis
Authors: Torretta Sara , Drago Lorenzo , Marchisio Paola , Mattina Roberto , Clemente Ignazio Alessandro , Pignataro Lorenzo 
Published: February 2011

ObjectivesBiofilms are organized bacterial communities that are playing an increasing role in otolaryngological diseases such as chronic or recurrent middle ear otitis and adenotonsillitis. Various cultural techniques are available to detect biofilm‐producing bacteria (BPB), but microbiological analysis of bioptic staining is the reference diagnostic procedure. To our knowledge, the accuracy of nasopharyngeal swabs in diagnosing BPB has never been assessed.Study DesignA prospective study of diagnostic accuracy.SettingOutpatient clinics of the Departments of Specialist Surgical Sciences and Maternal and Pediatric Sciences, University of Milan, Italy.Subjects and MethodsForty‐two pediatric subjects with chronic adenoiditis (aged 4‐18 years) underwent adenoidectomy, during which multiple transoral nasopharyngeal swabs and adenoidal biopsies were performed. BPB were detected by spectrophotometry, and the accuracy of detecting BPB in nasopharyngeal swabs was compared with that of biopsy.ResultsBPB were detected in 73.8% of the nasopharyngeal swabs and in 69.1% of the biopsies. The sensitivity and specificity of the nasopharyngeal swabs were, respectively, 75.9% (95% confidence interval [CI], 60.3%‐91.4%) and 30.8% (95% CI, 5.7%‐55.9%); positive and negative predictive values were, respectively, 71.0% (95% CI, 55.0%‐86.9%) and 36.4% (95% CI, 7.9%‐64.8%); and the area under the receiver‐operating characteristic curve was 0.5 (95% CI, 0.4‐0.7).ConclusionsIn comparison with biopsy, nasopharyngeal swabs seem to be inaccurate in detecting BPB and should be cautiously used in clinical practice. As these preliminary findings may have been due to the well‐known resistance of biofilm to mechanical injuries (such as swab rubbing) or the small study population, they need to be confirmed in larger patient series.
Preoperative Parathyroid Hormone Levels as a Predictor of Postthyroidectomy Hypocalcemia
Authors: Sands Noah , Young Jonathan , MacNamara Elizabeth , Black Martin J. , Tamilia Michael , Hier Michael P. , Payne Richard J. 
Published: February 2011

ObjectivesThe goal of the present study is to determine whether a decline in the 1‐hour postoperative parathyroid hormone (PTH) level relative to the preoperative level is predictive of hypocalcemia.MethodsThis is a retrospective study involving 142 consecutive patients who underwent total thyroidectomy. Changes in preoperative PTH levels were then compared with the 1‐hour levels.ResultsThirty‐four of 142 patients (23.9%) who underwent total thyroidectomy developed hypocalcemia. Thirty‐one of the 34 patients who became hypocalcemic had a 1‐hour postoperative PTH drop of 70% or more when compared with the preoperative value (sensitivity = 91%, specificity = 98%, positive predictive value = 94%, and negative predictive value = 97%).ConclusionA decline in the preoperative PTH level of 70% or greater at 1 hour following total thyroidectomy appears to be a reliable predictor of patients at risk of developing hypocalcemia. By allowing thyroid surgeons to identify these patients in the early postoperative period, calcium supplementation can be initiated sooner.
Malignant External Otitis
Authors: Soudry Ethan , Hamzany Yaniv , Preis Michal , Joshua Benzion , Hadar Tuvia , Nageris Ben I. 
Published: February 2011

ObjectiveTo study the effect of specific clinical, laboratory, and imaging parameters on the course of severe (type 1) malignant external otitis (MEO).Study DesignCase series with chart review.SettingTertiary, university‐affiliated medical center.Subjects and MethodsFifty‐seven patients hospitalized with severe MEO were followed for disease course and survival in a tertiary center between 1990 and 2008.ResultsIn 20% of patients, disease was persistent and/or aggressive despite prolonged and extensive treatment. Of this subgroup, 45% died of the disease. Prognostic factors of persistent/aggressive disease were facial nerve paralysis, bilateral disease, and significant major computed tomography findings (temporomandibular joint destruction, infratemporal fossa or nasopharyngeal soft tissue involvement). Cultures grew fungi in 5 patients, and follow‐up imaging revealed disease progression. The overall 5‐year survival was 55% for patients with short‐term disease and 40% for patients with persistent/ aggressive disease (P =. 086). By age, 5‐year survival was 75% in patients younger than 70 years old and 44% in older patients (P =. 029).ConclusionsA significant subset of patients with MEO has a prolonged, aggressive, and highly fatal disease that needs to be identified early. These patients more frequently have bilateral disease, cranial nerve paralysis, and positive computed tomography findings. Their follow‐up should routinely include imaging studies to evaluate disease progression, and every effort should be made to identify and treat underlying fungal infection.
Otolaryngology Resident Workflow
Authors: Victores Andrew , Roberts Jess , Sturm‐O’Brien Angela , Victores Nina , Uecker Wil , Alford Bobby , Takashima Mas 
Published: February 2011

ObjectiveTo investigate workflow in an otolaryngology–head and neck surgery residency program over 1 year and identify areas for improvement in the efficiency of resident education and training.Study DesignTime‐motion study.SettingAn urban, county hospital and a Veterans Affairs medical center hospital.Subjects and MethodsEight otolaryngology residents (4 residents at postgraduate year [PGY] 2 and 4 at PGY 4) were studied using direct observations early and late in the 2008‐2009 academic year. Resident activities were categorized, and a database program was generated for a handheld computer to facilitate time entry. Resident activities were classified into a taxonomy of tasks and their educational value was assessed. For each PGY level studied, observations were made for clinic and operative days.ResultsResidents spent their day on direct patient care (43.5%), indirect patient care (33.7%), didactic education (9.6%), personal activities (7.5%), and transit (5.8%), with activities of marginal educational value consuming 16% of their time. Major inefficiencies included managing administrative tasks, scheduling, and technical difficulties. On average, residents devoted significantly more time to marginal tasks on clinic days (19%) than on operative days (12%; P <. 001). These data were compared with previously published data obtained during the pre–Accreditation Council for Graduate Medical Education (ACGME) duty hour mandates era.ConclusionThis study evaluates resident workflow and efficiency over the course of a PGY in an ACGME‐accredited otolaryngology residency program. By understanding the time motion of residents, interruptions and inefficiencies in workflow can be identified to direct future changes to enhance resident education and training in the era of the ACGME duty hours mandate.
Cellular Adaptive Inflammation Mediates Airway Granulation in a Murine Model of Subglottic Stenosis
Authors: Ghosh Ankona , Malaisrie Nora , Leahy Kevin P. , Singhal Sunil , Einhorn Eugene , Howlett Paul , Cohen Noam A. , Mirza Natasha 
Published: February 2011

ObjectiveTo determine the contribution of B‐ and T‐cell–mediated inflammation in a murine airway granulation model.Study DesignPilot study in a modified murine model.SettingPhiladelphia VA Medical Center Research Building.Subjects and MethodsLaryngotracheal complexes (LTCs) from 54 donor C57BL/6 mice were harvested and divided into 3 groups: (1) uninjured, (2) mechanically injured using a wire brush, and (3) chemically injured using hydrochloric acid. One donor LTC from each group was placed in deep dorsal subcutaneous pockets of either severe combined immunodeficiency (SCID)– or C57BL‐recipient mice, for a total of 3 transplanted tracheas per recipient mouse. After 3 weeks, the transplanted LTCs were harvested from both C57BL‐ and SCID‐recipient mice. Tissues were fixed, sectioned, and stained with hematoxylin and eosin. Representative slides were reviewed by a blinded pathologist to determine the formation of granulation tissue and graded as to the degree of formation of granulation tissue.ResultsDespite significant granulation formation in C57BL‐recipient mice, direct airway injury did not induce the formation of granulation tissue under the disrupted epithelium of airway mucosa in SCID mice 3 weeks after injury.ConclusionThe data indicate that the immune response that results in the formation of granulation tissue is mediated by circulating B‐ and/or T‐cell processes rather than resident airway immune cells. Further studies focusing on cellular adaptive immune processes in response to airway injury may provide a novel treatment modality for subglottic stenosis.
Interdisciplinary Treatment for Vestibular Dysfunction
Authors: Naber Christine M. , Water‐Schmeder Omay , Bohrer Pamela S. , Matonak Kathy , Bernstein Allan L. , Merchant Maqdooda A. 
Published: February 2011

ObjectiveTo investigate whether an interdisciplinary program for vestibular patients improved health outcomes and health care utilization.Study DesignCase series with chart review.SettingOutpatient neurotology clinic.Subjects and MethodsPatients (N = 167) with dizziness attended an interdisciplinary neurotology clinic; 129 were offered group treatment. After an introductory session, group treatment included 5 sessions incorporating mindfulness, cognitive‐behavioral techniques, and vestibular rehabilitation. Physical and emotional functioning, depression, anxiety, dizziness, impairment, coping, skill use, and patient satisfaction were measured with rating scales pre‐ and postgroup treatment. Data from 51 patients (male/female = 14/37; age range, 25‐82 years) were analyzed with paired t tests or nonparametric tests. Logistic regression analyzed predictors of outcome and utilization for 116 patients (male/female = 81/35; age range, 11‐86 years) attending the interdisciplinary clinic, introductory session, and/or group.ResultsAfter group treatment, patients reported better mood (P =. 0482); better physical (P =. 0006) and mental (P =. 0183) health; better functionality, coping, and skill use (Ps <. 0001); less impairment (P <. 0001); and fewer limitations from dizziness (P <. 0001). Higher pretreatment levels of depression (P =. 0216), poorer initial mental (P =. 0164) or physical (P =. 0059) health, and peripheral diagnosis (P =. 0220) predicted better outcome. Group treatment decreased utilization more than the interdisciplinary clinic with (P =. 0183) or without (P =. 0196) the introductory session; 78% of patients with any level of participation showed less utilization. Clinic patients had fewer radiology procedures than group patients (P =. 0365). Patients were highly satisfied with the program and found it more effective than previous treatment.ConclusionInterdisciplinary treatment improves patient coping, functionality, and satisfaction and decreases overall health care utilization in vestibular patients.
Ossicular Chain Reconstruction Using Titanium versus Hydroxyapatite Implants
Authors: Gelfand Yuri M. , Chang C. Y. Joseph 
Published: February 2011

ObjectivesCompare the efficacy of total and partial ossicular chain reconstruction using hydroxyapatite (HA) implants versus titanium (Ti) implants.DesignCase series with chart review.SettingAcademic tertiary referral center and private practice.Subjects and Methods404 patients underwent ossiculoplasty using either Ti or HA implants from June 1996 to September 2008. Patient data were collected retrospectively from the senior author’s electronic database of surgical cases.ResultsThe change in air–bone gap (ΔABG) (defined as the difference between the means of preoperative and postoperative ABG) was 9.9 dB for the HA group that received partial ossicular reconstruction prosthesis (PORP), 9.5 dB for the Ti PORP group, 12.3 dB for the Ti group that received total ossicular reconstruction prosthesis (TORP), and 10.0 dB for the HA TORP group. There was no statistically significant difference between the HA and Ti groups. There was no significant difference in hearing results between canal wall up (CWU) and canal wall down (CWD) cases in which mastoidectomy was performed. Four confounding factors (preoperative otorrhea, preoperative perforation, cholesteatoma, mastoidectomy performed) were analyzed using regression analysis. In the Ti PORP group, the presence of cholesteatoma was found to have a significant negative bias for hearing results.ConclusionNo statistically significant differences in hearing results were found between the HA and the Ti partial and total ossiculoplasty prostheses. No outcome difference was found between CWU versus CWD mastoidectomy groups for any type of implant used. A randomized, prospective study is necessary for a more definitive comparison of efficacy between HA and Ti OCR implants.
Preliminary Findings on the Effects of Topical Photoactivated Antimicrobial Methyl‐δ‐Aminolevulinic Acid on Murine Hearing Thresholds
Authors: Roehm Corrie E. , Valdez Tulio A. , Parham Kourosh 
Published: February 2011

This study evaluates the ototoxicity of a potential novel ototopical antimicrobial, photoactivated methyl‐δ‐aminolevulinic acid (M‐ALA). Ten CBA/J mice received intratympanic injections of 10 mM M‐ALA and 640 nm light source illumination for 7 days, with contralateral ears receiving saline. Auditory‐evoked brainstem response (ABR) thresholds (8, 16, 24, and 32 kHz) were determined preinjection and at 1, 30, and 90 days postinjection. Mean ABR thresholds were similar after intratympanic administration of M‐ALA and saline (F ratio, 0.001; P =. 971). ABR thresholds temporarily increased in both groups (F ratio, 28.52; P =. 00) at day 1 postinjection of intratympanic treatments but returned to baseline at day 30 and 90. This temporary elevation was associated with tympanic membrane perforations and granulation tissue at the injection sites, which resolved by day 30 posttreatment. The preliminary findings indicate that intratympanic application of M‐ALA with light activation over a 7‐day course in a murine model does not produce measurable ototoxicity and is well tolerated.
Lesions of the Biceps Pulley
Authors: Braun Sepp , Horan Marilee P. , Elser Florian , Millett Peter J. 
Published: February 2011

Background: Lesions of the biceps pulley and instability of the long head of the biceps tendon are common diagnoses in patients with anterior shoulder pain. Purpose: To analyze the pathoanatomy of the biceps reflection pulley (“pulley”) in consecutive patients undergoing shoulder arthroscopy. Study Design: Cohort study (prevalence); Level of evidence, 2. Methods: Prospective data were collected on 229 shoulders in consecutive patients (155 male,74 female) who underwent shoulder arthroscopy (121 rotator cuff pathology, 50 instability, 43 osteoarthritis, 15 miscellaneous). The average age was 48.5 years (range, 18-76 years). Sixty-eight shoulders had underwent a previous surgery. Results: The long head of the biceps tendon was absent in 21 shoulders (9.2%); 1 was excluded for incomplete data. In 207 shoulders, the mean width of the long head of the biceps tendon was 6.0 mm (range, 3-10 mm), and the pulley complex, 7.2 mm (range, 4-15 mm). Sixty-seven patients (32.4%) had a pulley tear: 48 shoulders had anteromedial pulley tears, 32 posterolateral, with 13 combined anteromedial-posterolateral lesions. Patients with pulley tears were significantly older than those without (57 vs 44 years, P < .001). For anteromedial pulley tears, the mean width of the long head of the biceps tendon was significantly larger in the torn group (6.4 vs 5.8 mm, P = .012). The anteromedial or posterolateral pulley tears were significantly associated with subluxation or dislocation of the long head of the biceps tendon ( P = .001), with a pulley torn in all 27 cases of biceps dislocation. In 173 shoulders with a centered long head of the biceps tendon, the pulley was torn in 36 (23 anteromedial, 18 posterolateral [with 5 being combined]). Pulley tears and rotator cuff injury showed a significant association ( P < .001). Superior labral anterior posterior lesions were significantly associated with anteromedial ( P < .008) and posterolateral pulley tears ( P < .021). Conclusion: Pulley lesions are fairly common in patients undergoing arthroscopic surgery and were found in 32.4% of this prospective cohort (67 of 207). Current consensus indicates that pulley lesions are often associated with rotator cuff tears. This series also showed correlations with superior labral anterior posterior tears, biceps instability, and long head of the biceps tendon tears.
Comparison of Postural Stability Between Injured and Uninjured Ballet Dancers
Authors: Lin Cheng-Feng , Lee I-Jung , Liao Jung-Hsien , Wu Hong-Wen , Su Fong-Chin 
Published: February 2011

Background: Ballet movements require a limited base of support; thus, ballet dancers require a high level of postural control. However, postural stability in ballet dancers is still unclear and needs to be understood. Purpose: To evaluate ballet dancers’ postural stability in performing single-leg standing, the en pointe task, and the first and fifth positions and to determine differences in task performance among healthy nondancers, healthy dancers, and dancers with ankle sprains. Study Design: Controlled laboratory study. Methods: Injured dancers, uninjured dancers, and nondancers were recruited for this study (N = 33 age-matched participants; n= 11 per group). The tasks tested were single-leg standing with eyes open and closed, first position, fifth position, and en pointe. Center of pressure parameters were calculated from the ground-reaction force collected with 1 force plate. Analysis of variance was used to assess the differences of center of pressure parameters among 3 groups in single-leg standing; independent t test was used to examine the differences of center of pressure parameters between injured and uninjured dancers. Results: During single-leg standing, injured dancers had significantly greater maximum displacement in the medial-lateral direction and total trajectory of center of pressure, compared with the uninjured dancers and nondancers. During the first and fifth positions, the injured dancers demonstrated significantly greater standard deviation of center of pressure position in the medial-lateral and anterior-posterior directions, compared with the uninjured dancers. During en pointe, the injured dancers had significantly greater maximum displacement in the medial-lateral direction and the anterior-posterior direction, compared with the uninjured dancers. Conclusion: The injured and uninjured dancers demonstrated differences in postural stability in the medial-lateral direction during single-leg standing and the ballet postures. Although the injured dancers received ballet training, their postural stability may still be inferior to that of the nondancers. Clinical Relevance: This study is a first step in understanding that injured ballet dancers do not have the same postural stability as uninjured dancers and that it is even inferior to that of nondancers, which is important to understand for further study on rehabilitation. The future development of effective balance training programs for ballet dancers with ankle injuries should emphasize improvements in medial-lateral directional balance.