bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Laboratory Values Obtained by Phlebotomy versus Saline Lock Devices
Authors: Corbo Jill , Fu Lequan , Silver Matthew , Atallah Hany , Bijur Polly 
Published: November 2006

Abstract Objectives To assess the utility of a peripheral saline lock device (SLD) as an alternative to a second venipuncture for obtaining selected blood samples. Methods This prospective study used a comparative design and was conducted in an urban emergency department (ED). Adult patients with an existing SLD in place who required serial phlebotomy were eligible for inclusion in the study. Each subject had blood samples obtained by venipuncture (control) with a Vacutainer adapter according to standard protocols. Within 5 minutes of obtaining the control samples, a sample was obtained from the patients' SLDs; a tourniquet was applied proximal to the intravenous line, a 5‐mL waste portion was obtained, and a Vacutainer adapter was placed to draw specimens for testing. Each of the paired samples was analyzed for hematocrit, electrolytes, and cardiac enzymes. The Bland‐Altman method was used to analyze the concordance between each pair of measurements. Paired t‐tests for each of the eight laboratory tests were used to assess whether the values were statistically different from each other. The 95% limits of agreement around the mean differences were calculated. Differences between SLD aspirates and venipuncture aspirates also were compared with the federal regulatory standards that ensure reliable and accurate laboratory testing. Results Eighty‐one patients were eligible for the study; in 73 (90.1%; 95% confidence interval [CI] = 81.5% to 95.6%) of the patients, the SLD could be aspirated for testing. The paired t‐tests indicated that there were no statistically significant differences between the mean values of the two methods of testing. Of the 584 paired values analyzed, 35 (6.0%; 95% CI = 4.3% to 8.2%) exceeded the Bland‐Altman limits of agreement, and 43 (7.4%; 95% CI = 5.4% to 9.8%) fell outside the acceptable range determined by the federal regulation of clinical laboratories. Of those values that exceeded the acceptable Bland‐Altman limits of agreement, none would have resulted in clinical intervention. Conclusions Aspirating blood via an SLD is an acceptable method of obtaining serial laboratory values in a group of stable, consenting adult ED patients.
Confidence Interval Calculation Methods Are Infrequently Reported in Emergency‐medicine Literature
Authors: Marr Amy , Kurz Michael , Stern Jessica , Kulstad Erik 
Published: November 2006

Abstract Background There are many different confidence interval calculation methods, each providing different as well as in some cases inadequate interval estimates. Readers who know which method is used are better able to understand potentially significant limitations in study reports. Objectives To quantify how often confidence interval calculation methods are disclosed by authors in four peer‐reviewed North American emergency‐medicine journals. Methods The authors independently performed searches of four journals for all studies in which comparisons were made between means, medians, proportions, odds ratios, or relative risks. Case reports, editorials, subject reviews, and letters were excluded. Using a standardized abstraction form developed on a spreadsheet, the authors evaluated each article for the reporting of confidence intervals and evaluated the description of methodology used to calculate the confidence intervals. Results A total of 212 articles met the inclusion criteria. Confidence intervals were reported in 123 articles (58%; 95% CI = 51% to 64%); of these, a description of methodology was reported in 12 (9.8%; 95% CI = 5.7% to 16%). Conclusions Confidence interval methods of calculation are disclosed infrequently in emergency medicine literature.
Prognostic Significance of Human Epidermal Growth Factor Receptor Positivity for the Development of Brain Metastasis After Newly Diagnosed Breast Cancer
Authors: Gabos Zsolt , Sinha Richie , Hanson John , Chauhan Nitin , Hugh Judith , Mackey John R. , Abdulkarim Bassam 
Published: November 2006

Purpose As survival in breast cancer patients is improving, brain metastases are becoming increasingly prevalent. The risk of brain metastases in newly diagnosed human epidermal growth factor receptor 2 (HER-2) –overexpressing breast cancer patients is not yet fully defined. We aimed to analyze the risk of brain metastasis in newly diagnosed HER-2–positive breast cancer patients in comparison with HER-2–negative patients. Patients and Methods To determine the incidence of brain metastases in HER-2–overexpressing patients, we analyzed a cohort of newly diagnosed 301 HER-2–positive and 363 HER-2–negative patients identified between January 1998 and December 2003. The association between histologic features and the occurrence of brain metastases was evaluated with univariate and multivariate Cox regression analysis. Results Median follow-up was 3.9 years. Brain metastases were identified in 9% (27 patients) with HER-2–overexpressing breast cancer compared with only 1.9% (7 patients) in the HER-2 negative patients (hazard ratio 4.23 [1.84-9.74], P = .0007). HER-2 overexpression, tumor size larger than 2 cm, at least one positive node, and grade 2/3 disease were predictors of brain metastases in univariate analysis. In multivariate analysis, HER-2 overexpression, tumor size larger than 2 cm, and hormone-receptor negativity were independent prognostic factors for the development of brain metastases, whereas hormone-receptor expression was protective. Conclusion Our study shows that newly diagnosed HER-2–overexpressing breast cancer patients are at increased risk for brain metastases. Because most brain metastases occur after the development of systemic disease, these findings prompt consideration of brain prophylaxis strategies with HER-2–inhibiting small molecules able to cross the blood-brain barrier and/or radiologic screening to detect asymptomatic brain metastases.
Phonotactics and Articulatory Coordination Interact in Phonology: Evidence from Nonnative Production
Authors: Davidson Lisa 
Published: November 2006

AbstractA core area of phonology is the study of phonotactics, or how sounds are linearly combined. Recent cross‐linguistic analyses have shown that the phonology determines not only phonotactics but also the articulatory coordination or timing of adjacent sounds. In this article, I explore how the relation between coordination and phonotactics affects speakers producing nonnative sequences. Recent experimental results (Davidson 2005, 2006) have shown that English speakers often repair unattested word‐initial sequences (e.g., /zg/, /vz/) by producing the consonants with a less overlapping coordination. A theoretical account of the experimental results employs Gafos's (2002) constraint‐based grammar of coordination. In addition to Gafos's Alignment constraints establishing temporal relations between consonants, a family of Release constraints is proposed to encode phonotactic restrictions. The interaction of Alignment and Release constraints accounts for why speakers produce nonnative sequences by failing to adequately overlap the articulation of the consonants. The optimality theoretic analysis also incorporates floating constraints to explain why speakers are not equally accurate on all unattested clusters.
Dynamics of Phonological Cognition
Authors: Gafos Adamantios I. , Benus Stefan 
Published: November 2006

AbstractA fundamental problem in spoken language is the duality between the continuous aspects of phonetic performance and the discrete aspects of phonological competence. We study 2 instances of this problem from the phenomenon of voicing neutralization and vowel harmony. In each case, we present a model where the experimentally observed continuous distinctions are linked to the discreteness of phonological form using the mathematics of nonlinear dynamics.
Faithful Contrastive Features in Learning
Authors: Tesar Bruce 
Published: November 2006

AbstractThis article pursues the idea of inferring aspects of phonological underlying forms directly from surface contrasts by looking at optimality theoretic linguistic systems (Prince & Smolensky, 1993/2004). The main result proves that linguistic systems satisfying certain conditions have the faithful contrastive feature property: Whenever 2 distinct morphemes contrast on the surface in a particular environment, at least 1 of the underlying features on which the 2 differ must be realized faithfully on the surface. A learning procedure exploiting the faithful contrastive feature property, contrast analysis, can set the underlying values of some features, even where featural minimal pairs do not exist, but is nevertheless fundamentally limited in what it can set. This work suggests that observation of surface contrasts between pairs of words can contribute to the learning of underlying forms, while still supporting the view that interaction with the phonological mapping will be necessary to fully determine underlying forms.
Improvement of the agitation granulation method to prepare granules containing a high content of a very hygroscopic drug
Authors: Hirai Nobuaki , Ishikawa Kazuyuki , Takahashi Koichi 
Published: November 2006

Abstract
This study describes a new approach to the preparation of a granulate with a high content of a very hygroscopic powder or drug, using the agitation granulation method, and the development of a tablet formulation using these granulates. A Chinese medicine extract, Hatimi-zio-gan, was used as the model of a very hygroscopic drug. Among the several excipients tested, only porous calcium silicate could be used to prepare granules, with a mixing ratio (extract to porous calcium silicate) from 2:1 to 20:1. With other excipients, very large lumps were formed during the granulation process. The best mixing ratio of extract to porous calcium silicate was 6:1. For preparation of the granules, water could be added to the mixed powder within a range of 1- to 4-times the amount of porous calcium silicate. From these results, it was concluded that the ability of porous calcium silicate to hold large amounts of water in its numerous pores may allow for the preparation of granulates with a high content of very hygroscopic drugs. Starch with partial α-links, carboxymethyl starch sodium salt and crospovidone were used for selection of the disintegration agent. When crospovidone was used as a disintegration agent, tablets containing about 70% of the Chinese medicine extract disintegrated in less than 7 min, with good dissolution rates. The same process was applied to extracts of Hotyu-ekki-to, Syo-seiryu-to, Boi-ogi-to and Bohu-tusyo-san. The absorption of paeoniflorin, a characteristic monoterpene glucoside contained in Hatimi-zio-gan extract, was evaluated in beagle dogs after oral administration of the Hatimi-zio-gan tablets prepared in this study. The values of Cmax and AUC obtained after administration of the tablets prepared in this study were significantly greater than those obtained for commercial tablets.
Inhibitory effects of angiotensin II receptor antagonists and leukotriene receptor antagonists on the transport of human organic anion transporter 4
Authors: Yamashita Fumiaki , Ohtani Hisakazu , Koyabu Noriko , Ushigome Fumihiko , Satoh Hiroki , Murakami Hideyasu , Uchiumi Takeshi , Nakamura Takanori , Kuwano Michihiko , Tsujimoto Masayuki , Sawada Yasufumi 
Published: November 2006

Abstract
Human organic anion transporter 4 (OAT4) is the only member of the OAT family that is expressed in the placenta and also expressed in kidney. Although OAT4 has been shown to transport certain organic anions as well as other members of the OAT family, fewer numbers of substrates have been identified for OAT4 compared with OAT1 and OAT3, suggesting that the substrate specificity of OAT4 is greater than other OAT members. However, the substrate specificity of OAT4 remains to be investigated in detail. The aim of this study was to examine the effects of various drugs on the OAT4-mediated transport of estrone-3-sulfate, a typical substrate of OAT4, by using human embryonic kidney cells stably transfected with OAT4 (HEK-OAT4). HEK-OAT4 cells exhibited concentration-dependent uptake of estrone-3-sulfate, with a Km value of 20.9 ± 3.53 μM. Dehydroepiandrosterone sulfate and probenecid potently inhibited estrone-3-sulfate uptake. We also searched for the potential inhibitors of OAT4 and identified candesartan, candesartan cilexetil, losartan, losartan carboxyl (EXP3174) and valsartan as inhibitors of OAT4, with Ki values of 88.9, 135.2, 24.8, 13.8 and 19.6 μM, respectively. The above angiotensin II receptor antagonists and leukotriene receptor antagonists share a common structural feature, that is the tetrazole group. Although pranlukast is devoid of anionic motifs other than the tetrazole group, it potently inhibited the OAT4-mediated uptake of estrone-3-sulfate, indicating that a tetrazole group may be one important structural feature in substrate recognition by OAT4.
In-vitro mutagenic potential and effect on permeability of co-administered drugs across Caco-2 cell monolayers of Rubus idaeus and its fortified fractions
Authors: Kreander Kari , Galkin Anna , Vuorela Satu , Tammela Päivi , Laitinen Leena , Heinonen Marina , Vuorela Pia 
Published: November 2006

Abstract
This study investigated the mutagenic, anti-mutagenic and cytotoxic effects of acetone extract of raspberry, Rubus idaeus L. (v. Ottawa) Rosaceae, and the isolated and characterized ellagitannin and anthocyanin fractions thereof, suitable for food applications. The studied raspberry extract and fractions did not show any mutagenic effects determined in the miniaturized Ames test and were not cytotoxic to Caco-2 cells at the used concentrations. However, the anti-mutagenic properties were changed (i.e. decreased mutagenicity of 2-nitrofluorene in strain TA98, and slightly increased mutagenicity of 2-aminoanthracene in strain TA100) with metabolic activation. Further, their influence on the permeability of co-administered common drugs (ketoprofen, paracetamol, metoprolol and verapamil) across Caco-2 monolayers was evaluated. The apical-to-basolateral permeability of highly permeable verapamil was mostly affected (decreased) during co-administration of the raspberry extract or the ellagitannin fraction. Ketoprofen permeability was decreased by the ellagitannin fraction. Consumption of food rich in phytochemicals, as demonstrated here with chemically characterized raspberry extract and fractions, with well-absorbing drugs would seem to affect the permeability of some of these drugs depending on the components. Thus their effects on the absorption of drugs in-vivo cannot be excluded.
Enhanced delivery of nebulised salbutamol during non-invasive ventilation
Authors: Calvert Lori D , Jackson Judith M , White Judy A , Barry Peter W , Kinnear William J , O'Callaghan Christopher 
Published: November 2006

Abstract
Non-invasive ventilation (NIV) is used to treat acute respiratory failure. Nebulised drugs can be delivered concurrently with NIV or during breaks from ventilatory support. We hypothesised that the amount of nebulised salbutamol inhaled when delivered via bi-level ventilation would be no different to the amount available directly from the same nebuliser. A standard bi-level ventilation circuit was attached to a lung model simulating adult respiration. Drug delivery was compared when salbutamol (5 mg) was nebulised at different positions in the circuit and separately, with no ventilator. The amount of salbutamol contained in various particle size fractions was also determined. Nebuliser position within the NIV circuit was critically important for drug delivery. Optimal delivery of salbutamol occurred with the expiration port between the facemask and nebuliser (647 ± 67 μg). This was significantly better than nebulisation without the ventilator (424 ± 61 μg; P &lt; 0.01). Delivery when the nebuliser was positioned between the facemask and expiration port was 544 ± 85 μg. The amount of salbutamol contained in particles &lt; 5 μm was significantly increased when the nebuliser was used in conjunction with bi-level ventilation (576 ± 60 μg vs 300 ± 43 μg, P &lt; 0.001). We conclude that nebulised bronchodilator therapy, using a Cirrus jet nebuliser, during bi-level ventilation increases respirable particles likely to be inhaled when the nebuliser is optimally positioned within the circuit.
Wegener's granulomatosis
Authors: Kornblut Alan D. , Wolff Sheldon M. , Eefries Hugh O. , Fauci Anthony S. 
Published: November 2006

AbstractWegener's granulomatosis is characterized by a necrotizing granulomatous vasculitis which can be found in both the upper and lower respiratory tracts and with either focal or proliferative glomerulonephritis. However, any organ system can be affected by the disease.Over the past 17 years, 47 patients with histologically proven Wegener's granulomatosis have been treated at the National Institute of Allergy and Infectious Disease. Since 1972, patients with head and neck manifestations have been managed in collaboration with the Department of Otolaryngology, National Naval Medical Center. Experiences with these patients have shown that all have had some degree of respiratory tract involvement, with 42/47 having disease in the nose or paranasal sinuses. An effective therapeutic regimen is possible with immunosuppressants (particularly cyclophosphamide) and locally supportive measures. As a result of such therapy, more than 80% of the patients treated have experienced long‐term remissions. The clinical implications of this therapy are discussed, and a protocol for patient management presented.
Nasal polyps in children
Authors: Schramm Victor L. , Effron Morris Z. 
Published: November 2006

AbstractThe inflammatory nasal polyp is the most common benign or malignant nasal mass seen in children. Nasal polyps in the pediatric population appear to occur as inflammatory responses to bacterial infections. In 33% of the patients with polyps whom we studied, antral choanal polyps were noted, and in 20% of the patients the polyps were unilateral but not antral choanal. In 18% of the patients the polyps were bilateral and in an additional 29% they occurred bilaterally in association with cystic fibrosis. History of an allergy is infrequently associated with nasal polyps; allergies are potentially major contributing factors to nasal polyps only in patients without cystic fibrosis whose nasal polyps are bilateral. Patients with antral choanal polyps are most successfully managed by simultaneous Caldwell‐Luc antrostomy and polypectomy. Sixty percent of patients with nasal polyps and cystic fibrosis are adequately managed with a single intranasal polypectomy. Simultaneous sinus surgery and polypectomy should be considered for all patients with recurrent polyps and for all patients with clinical or radiographic evidence of significant sinusitis. Complications, including epistaxis and intranasal synechia, occurred in 3% of the 170 surgical procedures performed.
The otolaryngologist's role in the diagnosis and treatment of amyotrophic lateral sclerosis
Authors: McGuirt W. Frederick , Blalock David 
Published: November 2006

AbstractIn the early insidious phase of Amyotrophic Lateral Sclerosis (ALS), the patient will often present initially to the otolaryngologist for a presumed speech problem or dysphagia. Adult onset hypernasality, breathiness, articulation defects and voice harshness should all be seen as possible early signs of ALS and may allow the otolaryngologist to be the primary diagnostician for that disease; three such cases are reported here.Once the diagnosis of ALS is made, the otolaryngologist may be involved at different stages in the disease, offering treatment such as Teflon® injections, pharyngeal flap, obturator fitting, cricopharyngeal myotomy, tracheostomy, and cervical esophagostomy for speech, swallowing and aspiration problems. Although they do not halt the progression of this fatal disease, these procedures provide an improved quality of life for the patient whose intellectual function is preserved while his motor functions progressively deteriorate. This is most important for the minority of patients having prolonged survival.
Laryngeal radiation after hemilaryngectomy
Authors: Lee Fransiska , Perlmutter Steven , Ogura Joseph H. 
Published: November 2006

AbstractLaryngeal radiation was administered to 30 patients after hemilaryngectomy for true vocal cord carcinoma at Washington University Medical Center during the years 1957‐1976. Twelve patients were irradiated at the time of gross recurrence and 5/12 (42%) of these patients had recurrence of their disease after radiation. Eighteen patients were irradiated immediately after hemilaryngectomy because positive margins were seen in the hemilaryngectomy specimen and 5/18 (28%) of these had recurrence. All but 1 recurrence occurred within 13 months following radiation. Total laryngectomy salvaged an additional 3 patients for ultimate cancer control in 23/30 (77%). This high dose laryngeal irradiation was well tolerated. A major complication occurred in 1 patient (3%) and consisted of permanent laryngeal edema necessitating tracheostomy but permitting useful speech. Mild complications occurred in 5 patients.
Maximal nerve excitability testing versus neuromyography: Prognostic value in patients with facial paralysis
Authors: Adour Kedar K. , Sheldon Murray I. , Kahn Zev M. 
Published: November 2006

AbstractNeuromyography (NMG) is compared with maximal nerve excitability testing (NET) as a prognostic tool in facial paralysis. Normal latencies, summation muscle action potentials, and test/retest reliability were determined in three groups of subjects. NMG was performed in 33 control subjects of Group 1 to determine test/retest reliability. To determine the range of normal facial nerve conduction latency and amplitude and configuration of the summation muscle action potentials, NMG was performed in 172 otolaryngologic control patients without facial paralysis. NMG arid NET were then compared in Group 3, which consisted of 43 patients with Bell's palsy. Fluctuations in NMG were then analyzed in a fourth test series of three subjects from Group 1, in whom summation muscle action potentials at various positions of the electrodes were compared. The high rate of fluctuations observed indicates the need for further assessment of test/retest reliability and standardization of normal values in NMG. Our results indicate that maximal NET is more reliable than NMG for prognosis of facial paralysis.
The evaluation of dizziness in children
Authors: Fried Marvin P. 
Published: November 2006

AbstractA child with symptoms that relate to the balance mechanism can be a complex diagnostic problem. Often an adequate history is difficult to obtain because of the child's age and limitation of expression. Psychosomatic illness can frequently present as dizziness in children; however, this should not preclude a thorough evaluation. It is the purpose of this paper to outline these possibilities and the characteristics unique to each. The differential diagnosis can be grouped into central (central nervous system) and peripheral (otologic) categories, with a few miscellaneous conditions.A basic evaluation should include a complete neurotologic examination, audiogram and electronystagmogram. An electroencephalogram is frequently a valuable diagnostic adjunct. Further testing should be decided on the basis of the patient's history, examination and prior results.The records of children admitted to Boston City Hospital over a one‐year period were reviewed. Of 2,088 pediatric patients, 238 had discharge diagnoses pertinent to the balance mechanism. Of these, 14 had a presenting symptom of dizziness. These cases are analyzed.