bluuebunny/crossref_metadata_2025_split huggingface dataset:
Excessive Toxicity When Treating Central Tumors in a Phase II Study of Stereotactic Body Radiation Therapy for Medically Inoperable Early-Stage Lung Cancer
Authors: Timmerman Robert , McGarry Ronald , Yiannoutsos Constantin , Papiez Lech , Tudor Kathy , DeLuca Jill , Ewing Marvene , Abdulrahman Ramzi , DesRosiers Colleen , Williams Mark , Fletcher James 
Published: October 2006

Purpose Surgical resection is standard therapy in stage I non–small-cell lung cancer (NSCLC); however, many patients are inoperable due to comorbid diseases. Building on a previously reported phase I trial, we carried out a prospective phase II trial using stereotactic body radiation therapy (SBRT) in this population. Patients and Methods Eligible patients included clinically staged T1 or T2 (≤ 7 cm), N0, M0, biopsy-confirmed NSCLC. All patients had comorbid medical problems that precluded lobectomy. SBRT treatment dose was 60 to 66 Gy total in three fractions during 1 to 2 weeks. Results All 70 patients enrolled completed therapy as planned and median follow-up was 17.5 months. The 3-month major response rate was 60%. Kaplan-Meier local control at 2 years was 95%. Altogether, 28 patients have died as a result of cancer (n = 5), treatment (n = 6), or comorbid illnesses (n = 17). Median overall survival was 32.6 months and 2-year overall survival was 54.7%. Grade 3 to 5 toxicity occurred in a total of 14 patients. Among patients experiencing toxicity, the median time to observation was 10.5 months. Patients treated for tumors in the peripheral lung had 2-year freedom from severe toxicity of 83% compared with only 54% for patients with central tumors. Conclusion High rates of local control are achieved with this SBRT regimen in medically inoperable patients with stage I NSCLC. Both local recurrence and toxicity occur late after this treatment. This regimen should not be used for patients with tumors near the central airways due to excessive toxicity.
Extradural Anterior Clinoidectomy as an Alternative Approach for Optic Nerve Decompression: Anatomic Study and Clinical Experience
Authors: Yang Yang , Wang Hongjie , Shao Yi , Wei Zenghua , Zhu Shugan , Wang Jiangang 
Published: October 2006

Abstract

OBJECTIVE:
We introduce pterional craniotomy extradural anterior clinoidectomy as a new alternative approach for optic nerve decompression in patients with traumatic optic neuropathy.

METHODS:
Intracranial structures pertinent to pterional craniotomy extradural anterior clinoidectomy were carefully studied in 10 dry craniums and 10 cranial bases with dura mater. Important parameters of these structures were measured. Stepwise dissections simulating pterional craniotomy extradural anterior clinoidectomy were performed in 20 cadaver heads bilaterally. Pterional craniotomy extradural anterior clinoidectomy was then applied to 12 patients (13 eyes) with traumatic optic neuropathy and severe visual dysfunction.

RESULTS:
The anatomic features and their variations of optic canal, ophthalmic artery, falciform ligament, and Zinn's ring (annular tendon) were studied and measured in detail. Extensive opening of the optic canal and optic nerve sheath was successfully achieved in all 12 patients without major surgical complications. Significant visual acuity improvement occurred in eight (nine eyes) out of our 12 patients after surgery. The surgical techniques and advantages of pterional craniotomy extradural anterior clinoidectomy for optic nerve decompression are presented and discussed in detail. @@CONCLUSION:@@ Pterional craniotomy extradural anterior clinoidectomy is a promising new alternative approach for optic nerve decompression in patients with traumatic optic neuropathy.
Giant Cerebral Aneurysms: Endovascular Challenges
Authors: Wehman J Christopher , Hanel Ricardo A. , Levy Elad I. , Hopkins L Nelson 
Published: October 2006

Abstract

OBJECTIVE:
Giant (≥25 mm in diameter) cerebral aneurysms have a poor natural history, with high risks of subarachnoid hemorrhage or progressive disability or death caused by mass effect or stroke. Surgical treatment may be effective but carries a high burden of morbidity and mortality. Thus, attempts at endovascular solutions to these complex lesions have been developed to offer therapy at reduced risk.

METHODS:
The authors reviewed their clinical experience and the current body of literature concerning giant cerebral aneurysms and present their perspective on the current state of the art in endovascular therapy for these aneurysms. A variety of techniques are described that can be used in an attempt to provide a solution to the wide variety of clinical dilemmas associated with the management of these difficult lesions. Preprocedural planning and periprocedural considerations are discussed briefly. The use of intracranial balloons and stents are described in conjunction with the use of detachable platinum coils. The developing concept of using stents alone to treat aneurysms is discussed. Alternative methods of treating giant aneurysms are discussed.

RESULTS:
Current endovascular approaches, when properly selected and applied, can provide lower-risk therapies than conventional microsurgical approaches for patients harboring giant cerebral aneurysms. However, endovascular approaches do not, at present, provide results that are as durable as current surgical techniques for giant cerebral aneurysms.

CONCLUSION:
Treatment of giant cerebral aneurysms via endovascular therapeutics requires the interventionist to possess an extensive armamentarium. Meticulous preprocedure evaluation, patient selection, and execution of the treatment plan enable safe and effective management. Current therapies do not provide an ideal solution for every patient, so one must consider creative and evolving solutions to these difficult clinical challenges. The procedural morbidity of open surgery versus the decreased durability of current endovascular techniques must be assessed carefully.
Interactions between the human gastrocnemius muscle and the Achilles tendon during incline, level and decline locomotion
Authors: Lichtwark G. A. , Wilson A. M. 
Published: October 2006

SUMMARY
Muscles are required to perform or absorb mechanical work under different conditions. However the ability of a muscle to do this depends on the interaction between its contractile components and its elastic components. In the present study we have used ultrasound to examine the length changes of the gastrocnemius medialis muscle fascicle along with those of the elastic Achilles tendon during locomotion under different incline conditions. Six male participants walked (at 5 km h-1) on a treadmill at grades of -10%,0% and 10% and ran (at 10 km h-1) at grades of 0% and 10%, whilst simultaneous ultrasound, electromyography and kinematics were recorded. In both walking and running, force was developed isometrically; however,increases in incline increased the muscle fascicle length at which force was developed. Force was developed at shorter muscle lengths for running when compared to walking. Substantial levels of Achilles tendon strain were recorded in both walking and running conditions, which allowed the muscle fascicles to act at speeds more favourable for power production. In all conditions, positive work was performed by the muscle. The measurements suggest that there is very little change in the function of the muscle fascicles at different slopes or speeds, despite changes in the required external work. This may be a consequence of the role of this biarticular muscle or of the load sharing between the other muscles of the triceps surae.
Electrophysiological evidence for linear polarization sensitivity in the compound eyes of the stomatopod crustacean Gonodactylus chiragra
Authors: Kleinlogel Sonja , Marshall N. Justin 
Published: October 2006

SUMMARY
Gonodactyloid stomatopod crustaceans possess polarization vision, which enables them to discriminate light of different e-vector angle. Their unusual apposition compound eyes are divided by an equatorial band of six rows of enlarged, structurally modified ommatidia, the mid-band (MB). The rhabdoms of the two most ventral MB rows 5 and 6 are structurally designed for polarization vision. Here we show, with electrophysiological recordings, that the photoreceptors R1-R7 within these two MB rows in Gonodactylus chiragra are highly sensitive to linear polarized light of two orthogonal directions (PS=6.1). They possess a narrow spectral sensitivity peaking at 565 nm. Unexpectedly, photoreceptors within the distal rhabdomal tier of MB row 2 also possess highly sensitive linear polarization receptors, which are in their spectral and polarization characteristics similar to the receptors of MB rows 5 and 6. Photoreceptors R1-R7 within the remainder of the MB exhibit low polarization sensitivity (PS=2.3). Outside the MB, in the two hemispheres,R1-R7 possess medium linear polarization sensitivity (PS=3.8) and a broad spectral sensitivity peaking at around 500 nm, typical for most crustaceans. Throughout the retina the most distally situated UV-sensitive R8 cells are not sensitive to linear polarized light.
Study of aero-engine oil-air separators
Authors: Eastwick C. N. , Simmons K , Wang Y , Hibberd S 
Published: October 2006

For aero-engines, oil-air separation is a key function, and one approach to assessing separator effectiveness is computational fluid dynamics (CFD). The two-phase flow is complex and oil can be present in different forms (for example, droplets, mist, film). However, necessary modelling simplifications may affect solution accuracy and range of validity. This article presents a modelling methodology for oil-air separators; the effect of simplifications is discussed and their relative magnitude assessed. Comparison with available experimental data is presented. It is concluded that although simplification has an impact, the significant features of the oil-air separator are predicted with sufficient accuracy to allow design comparisons. Two separator configurations, one internal to a bearing chamber and one external, are modelled and the data presented. Flow fields are compared and the effectiveness of the separators in removing oil droplets prior to impact on the breather (primary separation) presented. The separation performance of the external design is largely independent of shaft speed, with all droplets >3 μm removed before impact on the breather. The critical droplet diameter of the internal design is larger, varying with breather configuration and shaft speed but the power loss is an order of magnitude lower than for the external design.
Energy and carbon audit of a rooftop wind turbine
Authors: Rankine R. K. , Chick J. P. , Harrison G. P. 
Published: October 2006

Microgeneration is being promoted as a means of lowering carbon dioxide (CO2) emissions by replacing electricity from the grid with production from small domestic generators. One concern over this drive is that the use of smaller plant could lead to the loss of economies of scale. Partly, this relates to cost but also in terms of energy consumed and CO2 emitted over the life cycle of the microgenerator. Here, an analysis is presented of a life-cycle audit of the energy use and CO2 emissions for the ‘SWIFT’, a 1.5 kW rooftop-mounted, grid-connected wind turbine. The analysis shows that per kilowatt-hour of electricity generated by the turbine, the energy intensity and CO2 emissions are comparable with larger wind turbines and significantly lower than fossil-fuelled generation. With energy and carbon intensities sensitive to assumed levels of production, assessments were carried out for an annual production range of 1000–4000 kWh, representing capacity factors of 8–31 per cent. For the manufacturer's estimated production of 2000 to 3000 kWh and, giving credit for component recycling, the energy payback period was found to be between 17 and 25 months, whereas the CO2 payback was between 13 and 20 months. Across the full production range, the energy and carbon payback periods were 13–50 months and 10–39 months, respectively. A key outcome of the study is to inform the manufacturer of the opportunities for improving the energy and carbon intensities of the turbine. A simple example is presented showing the impact of replacing one of the larger aluminium components with alternative materials.
Studies in tympanometry: Validation of the present technique for determining intra‐tympanic pressures through the intact eardrum
Authors: Eliachar Isaac , Northern Jerry L. 
Published: October 2006

AbstractA simple technique designed to relate controlled changes in middle ear pressures brought about in the pressure chamber with simultaneously measured tympanometric recordings was used to validate the electroacoustic impedance assessment of intratympanic air pressures in human beings.The data obtained showed the absolute and tympanometric results to be in close approximation. Tympanometry in its capacity of evaluating Eustachian tube functions, was classified into two versions: the static type, which records the consequent results of Eustachian tube functions or malfunction, together with a graphic estimation of the overall tympanic membrane compliance; and the dynamic type, that actually records and assesses Eustachian functions quantitatively. The contribution of this work toward further understanding and usage of tympanometry in clinical practice is briefly discussed in view of the proven validity and reliability of the test.
Actinomycosis of the tympanomastoid
Authors: Leek Joseph H. 
Published: October 2006

AbstractAn informational survey about actinomycosis is presented. Following this review, the case reports of two patients with actinomycosis of the tympanomastoid are discussed in detail.The bizarre clinical course and the unusual gross pathological findings during surgery should alert the otologist to consider actinomycosis as the etiologic entity. Effective treatment combines surgery and long‐term chemotherapy.
The significance of positive margins in hemilaryngectomy specimens.
Authors: Bauer W. C. , Lesinski S. G. , Ogura J. H. 
Published: October 2006

AbstractThis clinicopathologic study was undertaken to determine the meaning of surgical margins “involved” with carcinoma. The fate of hemilaryngectomy patients whose specimens had this finding was compared with that of patients who had “uninvolved” margins.A consecutive series of 111 hemilaryngectomies performed for previously untreated invasive epidermoid carcinoma was analyzed. Serial step sections in a longitudinal plane were available for re‐examination and re‐evaluation of the surgical margins in each case. Clinical follow‐up on every patient was current through 1972.Thirty‐nine patients had cancer involvement of a margin in the hemilaryngectomy specimen. None of these patients received any immediate therapy but were followed only. Seven of these patients (18 percent) subsequently developed a biopsy proven local recurrence. Four of the 72 patients (6 percent) with uninvolved margins developed a local recurrence. The site of the positive margin in the specimen was compared with the clinical site of recurrence.The seven local recurrences in patients with positive margins were treated with full course irradiation or total laryngectomy. All of these patients are alive and free of cancer or have died of other causes without evidence of cancer. Of the four local recurrences in patients with negative margins one died of cancer; two are living and well, and one died of other causes.This study provides evidence to support the conservative management of those hemilaryngectomy patients who have involved margins in the resection specimen. No immediate treatment is required. Careful follow‐up is indicated with 18 percent chance of clinical recurrence. These biopsy proven recurrences can then be successfully treated with total laryngectomy or full course irradiation.Utilizing this approach none of the 39 patients with involved margins died of cancer in the 5 to 12‐year follow‐up period.
Optimal treatment for the technically resectable squamous cell carcinoma of the supraglottic larynx.
Authors: Goepfert Helmuth , Jesse Richard H. , Fletcher Gilbert H. , Hamberger Arthur 
Published: October 2006

AbstractThe charts of 431 patients with squamous cell carcinoma of the supraglottic larynx observed at the M. D. Anderson Hospital between January, 1954, and June, 1971, were analyzed. This study is concerned with those patients who had a technically resectable lesion. Emphasis is directed to the analysis of the effectiveness of primary irradiation instead of partial laryngectomy for those lesions which are technically suitable for a partial resection and to define the groups of patients which are best treated by combining surgery and planned postoperative irradiation.One hundred forty‐seven patients with T1 and T2 lesions, selected exophytic T3 lesions of the suprahyoid epiglottis and aryepiglottic folds and some selected exophytic T4 lesions of the suprahyoid epiglottis received irradiation for their laryngeal lesion. A satisfactory control of the laryngeal disease has been obtained with preservation of a normal voice ranging from 88.5 percent for T1 lesions to 60 percent for T4 lesions.Comparing the groups of patients who had surgery alone or postoperative irradiation an NED rate of 63 percent was found in the latter group which is clearly superior to the 37 percent found in the surgery only group. There is no difference for the five‐year NED rates, because the patients who had surgery and postoperative irradiation had more advanced neck disease which is a cause for distant metastases. The incidence of recurrences above the clavicles is clearly less in the patients having had surgery and postoperative irradiation than in those who had surgery alone. Correlating in the two groups, surgery only and surgery followed by planned irradiation, the surgical staging of the neck metastases with recurrences above the clavicles within 24 months after treatment, it was found that the planned combined treatment has reduced the recurrence rate from 45 percent to 15 percent in the N2 and N3 patients.Postoperative irradiation should be given routinely after resection for all T4 lesions and for any T3 lesion which extends to the pharyngeal wall(s), vallecula, base of tongue, and pyriform sinus. Postoperative irradiation should also be given for any patient whose nodal classification is greater than N1. Irradiation should be given within six weeks (preferably three to four weeks) after the surgical procedure. To achieve this goal, the operation need only remove grossly detectable disease.
The safety of intubation in croup and epiglottitis: An eight‐year follow‐up.
Authors: Schuller David E. , Birck Herbert G. 
Published: October 2006

AbstractA series of 815 infectious croup (i.e., laryngotracheobronchitis) cases and 55 epiglottitis cases, encompassing an eight‐year interval, is reviewed to determine the incidence of adverse effects of nasotracheal intubation used to manage upper airway obstruction. The racial, sex, and age distributions, in addition to modalities of treatment, are presented. The intubated cases (86 patients), representing 6.5 percent of all croup cases and 60 percent of all epiglottitis cases, are described in more detail with respect to presenting symptoms and physical findings. The average duration of intubation is 55 hours for epiglottitis and 88 hours for croup. The incidence of immediate, reversible complications for the entire intubated series is 7 percent. The incidence of delayed, irreversible complications, as determined by: 1. noting any persistent post‐extubation symptoms; 2. measuring peak expiratory flow rates; and 3. laryngeal polytomography, is 1.6 percent. The mortality secondary to intubation is 0 percent. The complication rate (1.6 percent) in this series of nasotracheal intubations is lower than the mortality (3.6 percent) in a large collective series of pediatric tracheotomies performed for airway obstruction in croup or epiglottitis. Other advantages of intubation vs. tracheotomy are described (i.e., shorter hospital stay, dilatatory effect of endotracheal tube). The authors conclude that nasotracheal intubation is safer than pediatric tracheotomy and should be considered the procedure of choice in the management of upper airway obstruction secondary to croup or epiglottitis.
The use of spectrograms in the evaluation of vocal cord injection.
Authors: Rontal Eugene , Rontal Michael , Rolnick Michael I. 
Published: October 2006

AbstractThe utilization of voice spectrography can be an important adjunct to the assessment of vocal cord function by both laryngologists and speech pathologists. It is especially useful in determining the effectiveness of vocal cord Teflon paste injection procedures. Dysphonic characteristics are made visible, and their improvement can be monitored. As such, spectrographic analysis should be considered as a useful tool for the laryngologist.
Frontal sinus disease: III. Experimental and clinical factors in failure of the frontal osteoplastic operation.
Authors: Schenck Nicholas L. 
Published: October 2006

AbstractThe surgical approach to frontal sinus disease has been subject to much variation. Experimental evidence for new treatment modalities is quite limited. Frontal osteoplasty, while probably the best procedure to date, has up to a 25 percent failure rate. Possible complications include recurrent disease, incomplete bony obliteration (Macbeth technique), infection of the adipose implant, frontal bossing or depression, and laceration of the dura.Four experimental groups were designed using the canine frontal sinus model. Results indicated that stripping the mucosa in a normal sinus with intact periosteum and a patent nasofrontal duct will not consistently lead to normal mucosal regeneration. Second, the additional factor of removing the periosteum (as in osteoplasty by osteoneogenesis), leads to partial fibrous obliteration complicated by mucocele formation. Third, sinus obliteration by osteoneogenesis was much more consistent with concurrent closure of the nasofrontal duct. Fourth, intentionally leaving a strip of mucosa leads to failure of obliteration by osteoneogenesis 100 percent of the time. Finally, bony‐fibrous obliteration increases with time but is still incomplete after one year.In light of these results, fat obliteration with closure of the nasofrontal duct is probably more reliable than obliteration by osteoneogenesis.
Mucosal melanomas of the head and neck.
Authors: Barton Richard Thomas 
Published: October 2006

AbstractMalignant melanomas arising from the mucosal areas of the head and neck are rare. When such neoplasms are encountered, the problem of their management is often poorly resolved. Cases of primary malignant melanoma of the maxillary sinus, the nasopharynx, oral cavity and laryngo‐pharynx are presented and the results of treatment analyzed.Much of the difficulty in therapy is due to an incomplete understanding of the mechanisms which determine survival. A brief discussion of melanoma immunology is presented. Surgery (including cryosurgery) remains the primary therapy when possible. The role of chemotherapy, immunotherapy and radiation therapy in such lesions cannot be clearly delineated at this time.