bluuebunny/crossref_metadata_2025_split huggingface dataset:
Conservative management of vestibular schwannomas: third review of a 10‐year prospective study
Authors: Hajioff D. , Raut V.V. , Walsh R.M. , Bath A.P. , Bance M.L. , Guha A. , Tator C.H. , Rutka J.A. 
Published: June 2008

Keypoints

Seventy‐two patients with a unilateral vestibular schwannoma have been treated conservatively for a median of 121 months. They have been followed prospectively by serial clinical examination, MRI scans and audiometry.
Twenty‐five patients (35%, 95% CI: 24–47) failed conservative management and required active intervention during the study. No factors predictive of tumour growth or failure of conservative management could be identified. Seventy‐five per cent of failures occurred in the first half of the 10‐year study.
The median growth rate for all tumours at 10 years was 1 mm/year (range −0.53–7.84). Cerebellopontine angle tumours grew faster (1.4 mm/year) than intracanalicular tumours (0 mm/year, P < 0.01); 92% had growth rates under 2 mm/year.
Hearing deteriorated substantially even in tumours that did not grow, but did so faster in tumours that grew significantly (mean deterioration in pure tone average at 0.5, 1, 2 and 3 kHz was 36 dB; speech discrimination scores deteriorated by 40%).
Patients who failed conservative management had clinical outcomes that were not different from those who underwent primary treatment without a period of conservative management.
Evaluation of inter‐observer variability in the grading of oral dysplasia using two different grading systems
Authors: Srinivasan R.T. , Snead D. , Matthews P. , Williams H. , Webster K. , Griffin D. , El‐Lalani N. , Mehanna H. 
Published: June 2008

Objectives.  To compare the inter‐observer variability in grading of oral dysplasia between two consultant pathologists specialising in head and neck cancer, and one non‐specialist, using both the WHO classification 2005 and the Binary Grading system (proposed by Kujan et al. 2005).Methods.  Eighty archived oral biopsy slides consisting of cases with different grades of dysplasia treated and followed up in a tertiary regional centre, were reviewed by three pathologists, blinded to the initial diagnosis and the clinical outcome. The H&E slides were graded according to the criteria of both systems. Inter‐observer reliability and variation were computed with kappa coefficient analysis.Results.  The overall inter‐observer kappa agreement for the WHO grading system was κ = 0.21(95% CI: 0.10–0.34) and for the binary system was κ = 0.55(95% CI: 0.42–0.71). There was closer correlation in grading of the lesions between the two experts (WHO κ = 0.40, 95% CI: 0.28–0.53 and Binary κ = 0.59, 95% CI: 0.34–0.80), when compared to that between an expert and the non‐expert (WHO κ = 0.18 95% CI: 0.05–0.30 and Binary κ = 0.32 95% CI: 0.15–0.50) Kappa agreements between the three observers on individual architectural and cytological features of the binary system showed great variability, the highest agreement being in increased mitotic figures (κ = 0.49,95% CI: 0.25–0.72) and the lowest on atypical mitotic figures (κ = 0.15,95% CI: 0.01–0.32).Conclusions.  There was closer agreement between all three pathologists when using the binary system in comparison to the WHO system, but both systems showed at best only moderate agreement. Improved agreement of scoring of individual features of the binary system should improve overall agreement of this system.
Health beliefs and expectations amongst chronic catarrh sufferers
Authors: Cathcart R. , Wilson J. , May C. 
Published: June 2008

Background.  The mere presence of catarrh does not, in itself, compel medical help‐seeking: many experience catarrh and never seek help for it, while others do so after months or even years. We aimed to explore the triggers of help‐seeking in chronic catarrh patients, along with their general health beliefs and the expectations that they hold about the health services that they approach.Method.  A qualitative study using digitally taped semi‐structured interviews of 19 chronic catarrh patients, with full ethical approval. Narrative analysis was performed on the transcribed interviews, using a constant comparative technique approach to the generation of grounded theory, through a process of manual coding and categorisation. Emergent categories were checked for goodness of fit.Results.  Catarrh came to prominence for sufferers through a global shift in body concerns or a relative shift in symptom heirarchy subsequent to a lack of explanation or treatments. Catarrh sufferers had narrow, family‐based lay networks which they found to be frequently dismissive. Temporalisation and worsening of symptoms were the predominant triggers for seeking help. Sufferers attended GPs for a ‘quick‐fix’ and hospitals for ‘investigations’. Short‐term sufferers sought a cure for their symptoms whilst long‐term sufferers accepted reassurance.Conclusions.  Explanantion and closure should be primary aims in managing catarrh patients. Although resolution of symptoms is the pervading hope of chronic catarrh sufferers, a significant majority of interviewees, particularly long‐term sufferers, admitted that they could live with their symptoms so long as they could be given reassurance that pathology was absent and no treatment option overlooked.
Do neonates have a nasal cycle?
Authors: Olarinde O. , Banerjee A. , O’Callaghan C.O. 
Published: June 2008

Objectives.  To study the dynamic behaviour of the nasal mucosa in neonates.Method.  Although the nasal cycle has been described in adults,1 studies regarding the nasal cycle physiology in neonates are scarce. Acoustic rhinometry (RHIN 2000 miniprobe) was carried out in ten neonates over periods ranging from 165 to 255 min at 15‐min intervals. Inclusion criteria were babies with no upper airway symptoms and no abnormality on anterior rhinoscopy. All examinations were carried out by the same examiner under similar conditions. The minimum cross sectional area (MCA10–40) and volume of nasal cavity (Vol10–40) were analysed for correlation using the Pearson's correlation coefficient.Results.  Correlation (alternating pattern) between the right and left sides was found to be significant in one baby.Conclusions.  Ninety percent of the neonates we examined did not demonstrate a nasal cycle. We demonstrated an alternating pattern in one baby. Neonates probably do not have a nasal cycle as demonstrated in adults.Reference.  1 Fisher E.W., Scadding G.K. & Lund V.J. (1993) The role of acoustic rhinometry in studying the nasal cycle. Rhinology 2, 57–61
Immunological responses of laryngeal mucosa to short‐term endotracheal intubation
Authors: Hughes O.R. , Ayling S.M. , Birchall M.A. 
Published: June 2008

Objectives.  Short‐term intubation (<4 h) is common in elective surgery and has been associated with post‐operative changes to the voice. Furthermore, short‐term endotracheal intubation is often used in microlaryngoscopy. Therefore research into laryngeal physiology requires an understanding of the changes to mucosal biology that result from intubation. Very little is known of the early cellular processes involved in laryngeal injury. We aim to establish how the cells of the innate immune system in the larynx are influenced by short‐term intubation.Methods.  Biopsies were taken from the supraglottis and subglottis of five pairs of NIH minipigs fully matched at the major histocompatibility complex (MHC) locus. One of each pair was intubated 48 h prior to laryngeal biopsy; the other had not received previous intubation. Multiple‐colour immunofluorescence histology was used to quantify the numbers of immunologically active mucosal cells at each site.Results.  At 48 h following endotracheal intubation, there was no significant difference (P > 0.05) in total number of myeloid cells immunologically active in the supraglottic or subglottic mucosa. In the subglottis there was a small increase in the number of CD14+ and CD16+ cells in three out of four pairs following intubation; largest percentage increase in CD14+ and CD16+ expression between pairs was 74% (P = 0.011) and 72% (P = 0.007) respectively.Conclusions.  At 48 h post‐intubation our results points to a continued innate immune response in the subglottis; this is consistent with previous histological and clinical studies that have identified the subglottis as the focus for post‐intubation injury.References.  1 Gould S.J. & Howard S. (1985) The histopathology of the larynx in the neonate following endotracheal intubation. J. Pathol. 146, 301–3112 Beckford N.S., Mayo R., Wilkinson A. & Tierney M. (1990) Effects of short‐term endotracheal intubation on vocal function. Laryngoscope 100, 331–336
Biopolymer nanoparticles as antigen delivery vehicles for immunotherapy of head and neck squamous cell carcinoma (HNSCC)
Authors: Prasad S. , Cody V. , Hanlon D. , Edelson R.L. , Saltzman M. , Sasaki C.T. , Birchall M.A. 
Published: June 2008

Objective.  To determine whether nanoparticles (NP) made from FDA‐approved biopolymers could be incorporated into a novel clinically translatable dendritic cell (DC)‐based therapy for HNSCC.Methods.  Head and neck squamous cell carcinoma lines were used to make lysates employing multiple techniques, and with varying amounts of protein so as to improve encapsulation within differing molecular weights of Poly (lactic‐co‐glycolic acid) (PLGA) polymers. NP were fabricated by a double emulsion solvent‐evaporation technique with flash freeze‐lyophilization. Encapsulation and release profile were studied to determine the ideal formulation. These findings were adopted for encapsulating tumour material from five patients with advanced HNSCC. Pattern of protein release was detected using Silver stained SDS‐PAGE gels and immunoblotting for p53. GM‐CSF/IL‐4 DC made from blood monocyte precursors were loaded with either the soluble or encapsulated versions of tumour lysate, and used for stimulation of magnetic bead‐isolated autologous CD8+ T‐cells. Differences in Th1/Th2 responses were estimated by Cytometric bead array (CBA). NP morphology and DC loading were evaluated by scanning electron microscopy.Results.  Optimal release was recorded from 80 K PLGA NP containing a lysate made using four cycles of freeze‐thaw plus 15‐s sonication followed by brief lyophilization. NP were small enough to be phagocytosed by DC. Encapsulation and release was directly proportional to the lysate concentration with no major antigen degradation. In four patients, CBA showed significantly increased IFN‐γ or decreased IL‐10 (P = 0.012) production associated with NP encapsulation.Conclusions.  Biopolymer NP can efficiently deliver the panoply of unknown tumour antigens. This strategy has been optimized for use in a clinical trial.References.  1 Sandor M., Enscore D., Weston P et al. (2001) Effect of protein molecular weight on release from micron‐sized PLGA microspheres. J. Control. Release 76, 297–3112 Elamanchili P., Lutsiak C., Hamdy S et al. (2007) ‘Pathogen‐mimicking’ nanoparticles for vaccine delivery to dendritic cells. J. Immunother.30, 378–395
The perceptual assessment of voice in post‐laryngectomy tracheoesophageal speakers
Authors: Hurren A. , Hildreth A. , Carding P.N. 
Published: June 2008

Objectives.  To investigate the inter and intra rater reliability of expert raters concerning two alaryngeal voice parameters: ‘overall grade’ and ‘neoglottal tonicity’. Reliable perceptual assessment is essential for surgical and therapeutic outcome measurement but has been minimally researched to date.Method.  Nine speech and language therapists and four ENT surgeons judged audio recordings of 55 tracheoesophageal speakers. ‘Overall grade’ was rated with a 0–3 equally appearing interval scale and ‘neoglottal tonicity’ with an 11 point bipolar semantic scale. Ratings were repeated one‐month later. Weighted kappa reliability co‐efficients were calculated with StatXact.Results.  The effect of ‘neoglottal’ tonicity on ‘overall grade’ was examined via linear regression using the combined grades of the 4 senior SLT's. R2 coefficient = 0.62, implying that 62% of the variance in ‘overall grade’ is attributable to tonicity.Conclusions.  Strength of agreement1 was good for inter and intra rater reliability for ‘overall grade’. Intra‐rater agreement for ‘neoglottal tonicity’ was also good but inter‐rater judgements were only moderate. However experienced therapists demonstrated good inter rater reliability for ‘neoglottal tonicity’ suggesting this group may be the optimal judges for alaryngeal voice assessment. The R2 coefficient indicates ‘tonicity’ is a good predictor of ‘overall grade’ for experienced SLT raters.Reference. 1 Landis J.R. & Koch G.G. (1977) The measurement of observer agreement for categorical data. Biometrics 33, 159–174
Localisation training of unilateral cochlear implanted children
Authors: Murphy J. , Summerfield A.Q. , O’Donoghue G.M. , Moore D.R. 
Published: June 2008

Objectives.  Spatial hearing is a particularly important ability for normal development. It aids appropriate orientation of a child towards a target sound and segregation of targets from noise, thus facilitating listening, especially in complex, acoustic environments (e.g. classrooms). Our aim was to investigate the potential of behavioural training to improve the localisation ability of children using unilateral cochlear implant (CI).Methods.  Five unilateral CI users (10–16 years old) participated in a single 2‐h training session. Localisation training was presented via a 24 loudspeaker ring. Pre‐ and post‐training assessments employed, five video monitors, paired with five loudspeakers (30° angular separation), each displayed a talker saying ‘Hello, what toy is this?’ The task of the listener was to identify the only talker whose image was co‐located with the sound. In Phase 1 training two loudspeakers separated by 120° were used and participants were coached to use head movements facilitating greater access to dynamic loudness cues. An above chance performance provided entry into Phase 2. Here the stimulus separation varied adaptively between 120–30° to facilitate training around threshold levels.Results.  Our data indicate that unilateral CI users’ pre‐training performance (P (correct) 0.45) improved in the final assessment (P (correct) 0.55) following a period of training. A likelihood ratio test showed P < 0.01.Conclusions.  In just a single session it was possible to train implant users on a skill that may help them in their everyday life. Further research is needed to show whether the training is long lasting enough to be truly useful.
Accuracy of CT in the measurement of stapes prostheses using a temporal bone model
Authors: Rowlands R.G. , Beale T. , Wright A. 
Published: June 2008

Objectives.  To evaluate whether it would be possible to measure accurately a range of stapes prostheses of different lengths and makes using spiral CT imaging and a radiologist who would report the images in a blinded fashion. To establish the distance from the tip of each prosthesis to the metallic component in metal – plastic prostheses.Method.  Eight stapes prostheses (2 fluoroplastic‐stainless steel; 2 fluoroplastic‐platinum; 2 fluoroplastic‐nitinol; 2 fluoroplastic only) were selected and placed onto the long process of the incus and over the oval window of a dried temporal bone preparation. CT scans were then performed and multiplanar reformatting techniques used to allow measurement of the length of the prostheses. The prostheses were then photographed and measured using high definition digital prints after slicing them in half to expose the central metallic component.Results.  The median difference between the actual and observed length of the 6 metallic/fluoroplastic stapes prostheses was 0.25 mm (0.05–0.55 mm). In contrast the 2 fluoroplastic prostheses were accurately measured as 4 and 5 mm respectively. The median distance of the metallic component from the end of the prosthesis was found to be 1.75 mm (1.5–1.9 mm).Conclusion.  Modern spiral CT scanners can visualise the fluoroplastic component of stapes prostheses to assess its position. However, our series shows that the length of mixed metallic/fluoroplastic prostheses may be still be inaccurately measured by up to 0.55 mm. Reliance on measuring the metallic component of the prosthesis may also overestimate the proportion of prostheses that are short of the footplate.References.  1 Kosling S. & Bootz F. (2001) CT and MR imaging after middle ear surgery. Eur. J. Radiol. 40, 113–1182 Pickuth D., Brandt S., Berghaus A., Spielmann R.P. & Heywang‐Kobrunner S.H. (2000) Vertigo after stapes surgery: the role of high resolution CT. Br. J. Radiol. 73, 1021–1023
Invasive Infections with Community-Associated Methicillin-Resistant
Staphylococcus aureus
after Kidney Transplantation
Authors: Adeyemi Oluwadamilola A. , Qi Chao , Zembower Teresa R. , Ison Michael G. , Grant Thomas H. , Hartigan Brian J. , Malczynski Michael , Stosor Valentina 
Published: June 2008

ABSTRACT

We report two cases of invasive infections caused by Panton-Valentine leukocidin-positive, community-associated, methicillin-resistant
Staphylococcus aureus
(CA-MRSA) after kidney transplantation. This report emphasizes the clinical importance of considering CA-MRSA as a causative agent in the differential diagnosis of infections of the skin and soft tissues in organ transplant recipients.
Herpes Simplex Virus Type 2 Displays Atypical Melting-Temperature Profiles at Low Viral Titers
Authors: LeBlanc Jason J. , Campbell Sarah , Pettipas Janice , Hatchette Todd F. , Davidson Ross J. 
Published: June 2008

ABSTRACT

Real-time PCR is a powerful tool for the detection and typing of herpes simplex virus (HSV). HSV types 1 and 2 can be distinguished by using the differences in the melting temperatures (
T

m

s) of the hybridization probes. The efficacy of
T

m

profiling with low DNA concentrations was evaluated in this study.
DNA gag/Adenovirus Type 5 (Ad5) gag and Ad5 gag/Ad5 gag Vaccines Induce Distinct T-Cell Response Profiles
Authors: Cox Kara S. , Clair James H. , Prokop Michael T. , Sykes Kara J. , Dubey Sheri A. , Shiver John W. , Robertson Michael N. , Casimiro Danilo R. 
Published: June 2008

ABSTRACT

Results from Merck's phase II adenovirus type 5 (Ad5) gag/pol/nef test-of-concept trial showed that the vaccine lacked efficacy against human immunodeficiency virus (HIV) infection in a high-risk population. Among the many questions to be explored following this outcome are whether (i) the Ad5 vaccine induced the quality of T-cell responses necessary for efficacy and (ii) the lack of efficacy in the Ad5 vaccine can be generalized to other vector approaches intended to induce HIV type 1 (HIV-1)-specific T-cell responses. Here we present a comprehensive evaluation of the T-cell response profiles from cohorts of clinical trial subjects who received the HIV CAM-1 gag insert delivered by either a regimen with DNA priming followed by Ad5 boosting (
n
= 50) or a homologous Ad5/Ad5 prime-boost regimen (
n
= 70). The samples were tested using a statistically qualified nine-color intracellular cytokine staining assay measuring interleukin-2 (IL-2), tumor necrosis factor alpha, macrophage inflammatory protein 1β, and gamma interferon production and expression of CD107a. Both vaccine regimens induced CD4
+
and CD8
+
HIV gag-specific T-cell responses which variably expressed several intracellular markers. Several trends were observed in which the frequencies of HIV-1-specific CD4
+
T cells and IL-2 production from antigen-specific CD8
+
T cells in the DNA/Ad5 cohort were more pronounced than in the Ad5/Ad5 cohort. Implications of these results for future vaccine development will be discussed.
Role of Interferon in the Replication of Human Parainfluenza Virus Type 1 Wild Type and Mutant Viruses in Human Ciliated Airway Epithelium
Authors: Bartlett Emmalene J. , Hennessey Margaret , Skiadopoulos Mario H. , Schmidt Alexander C. , Collins Peter L. , Murphy Brian R. , Pickles Raymond J. 
Published: June 2008

ABSTRACT

Human parainfluenza virus type 1 (HPIV1) is a significant cause of pediatric respiratory disease in the upper and lower airways. An in vitro model of human ciliated airway epithelium (HAE), a useful tool for studying respiratory virus-host interactions, was used in this study to show that HPIV1 selectively infects ciliated cells within the HAE and that progeny virus is released from the apical surface with little apparent gross cytopathology. In HAE, type I interferon (IFN) is induced following infection with an HPIV1 mutant expressing defective C proteins with an F170S amino acid substitution, rHPIV1-C
F170S
, but not following infection with wild-type HPIV1. IFN induction coincided with a 100- to 1,000-fold reduction in virus titer, supporting the hypothesis that the HPIV1 C proteins are critical for the inhibition of the innate immune response. Two recently characterized live attenuated HPIV1 vaccine candidates expressing mutant C proteins were also evaluated in HAE. The vaccine candidates, rHPIV1-C
R84G/Δ170
HN
T553A
L
Y942A
and rHPIV1-C
R84G/Δ170
HN
T553A
L
Δ1710-11
, which contain temperature-sensitive (
ts
) attenuating (
att
) and non-
ts att
mutations, were highly restricted in growth in HAE at permissive (32°C) and restrictive (37°C) temperatures. The viruses grew slightly better at 37°C than at 32°C, and rHPIV1-C
R84G/Δ170
HN
T553A
L
Y942A
was less attenuated than rHPIV1-C
R84G/Δ170
HN
T553A
L
Δ1710-11
. The level of replication in HAE correlated with that previously observed for African green monkeys, suggesting that the HAE model has potential as a tool for the preclinical evaluation of HPIV1 vaccines, although how these in vitro data will correlate with vaccine virus replication in seronegative human subjects remains to be seen.
Competition Model for Upregulation of the Major Histocompatibility Complex Class II-Associated Invariant Chain by Human Immunodeficiency Virus Type 1 Nef
Authors: Mitchell Richard S. , Chaudhuri Rittik , Lindwasser O. Wolf , Tanaka Kristie A. , Lau David , Murillo Rudy , Bonifacino Juan S. , Guatelli John C. 
Published: June 2008

ABSTRACT

The human immunodeficiency virus type 1 (HIV-1) Nef protein upregulates the expression of the invariant chain (Ii)/major histocompatibility complex class II (MHC-II) complex at the cell surface. This complex appears to reach the antigen-loading endosomal compartment at least in part via an indirect pathway in which it is internalized from the cell surface via the adaptor protein 2 (AP-2) complex. Here we provide evidence for a competition model to explain how Nef upregulates the expression of Ii at the cell surface. In this model, Nef and Ii compete for binding to AP-2. In support of this model, Nef decreased the rate of internalization of Ii from the cell surface. The AP-binding dileucine motif in Nef, ENTSLL
165
, was necessary and sufficient for the upregulation of Ii. In addition, two leucine-based AP-binding motifs in the Ii cytoplasmic tail, DDQRDLI
8
and EQLPML
17
, were critical for the efficient upregulation of Ii by Nef. Experiments using Nef variants in which the native dileucine-based sorting motif was replaced with similar motifs from cellular transmembrane proteins allowed modulation of AP-binding specificity. Analysis of these variants suggested that the binding of Nef to AP-2 is sufficient to upregulate Ii at the plasma membrane. Finally, interference with the expression of AP-2 caused an upregulation of Ii at the plasma membrane, and this decreased the effect of Nef. These data indicate that Nef usurps AP-2 complexes to dysregulate Ii trafficking and potentially interfere with antigen presentation in the context of MHC-II.