bluuebunny/crossref_metadata_2025_split huggingface dataset:
The use of the weber tuning fork test and ‘scratch test’ in postoperative tympanomastoid surgery
Authors: Buckland J.R. , Geyer M. , Maleki N. , Mitchell T.E. 
Published: December 2006

Objective.  To compare the use of the Weber tuning fork test and ‘Scratch test’ in postoperative patients following tympanomastoid surgery.Method.  Prospective cohort study with control group. Southampton University Hospitals NHS Trust. Secondary care. 19 patients undergoing routine tympanomastoid surgery for middle ear disease and 18 patients undergoing translabyrinthine surgery for lateral skull base lesions.Main Outcome Measures.  Localisation of Weber tuning fork. Positive or negative Scratch test: clinician applies a gentle scratch using index finger to the bandage over the operated ear. Postoperative pure tone audiometry.Results.  In the context of diagnosing a hearing or non‐hearing ear, the Weber test had a specificity of 78% and sensitivity of 100%. The scratch test had a specificity of 100% and sensitivity of 100%. The Weber was 93% specific and 93% sensitive for diagnosing a unilateral conductive hearing loss.Conclusions.  As a means of diagnosing an acute postoperative dead ear the Scratch test is an accurate alternative to the Weber test.References 1 Miltenburg D.M. (1994) The validity of tuning fork tests in diagnosing hearing loss. J Otolaryngol. 23, 254–2592 Behn A., Laszlo C.A., Black D., et al. (2005) Which is mightier, the tuning fork or the bone oscillator? J Otolarygol. 34, 135–139
Systematic reviews – triumph of form over substance?
Authors: Thomas L. , Wilson J.A. 
Published: December 2006

Keypoints• Cochrane systematic reviews are conducted to identify level 1a evidence. So far the ENT group have published 24 reviews, while around 70 titles are in various stages of the review process. Only one review has been able to produce Ia evidence and the rest recommended further trials.• The majority of otorhinolaryngology reviews are unable to identify level 1a evidence due to the paucity of high quality randomised control trials.• This presents a challenge, therefore – to identify and discuss alternate methods of evidence gathering for future research?
Heparanase expression: a potential ancillary diagnostic tool for distinguishing between malignant cells and reactive mesothelium in body cavity effusions
Authors: Doviner V. , Maly B. , Reinhartz T. , Vlodavsky I. , Sherman Y. 
Published: December 2006

Objective: Heparanase, an endoglycosidase that cleaves heparan sulphate, is frequently expressed in carcinomas and was suggested to play a role in cell invasion and metastasis. We investigated whether heparanase expression may serve as a reliable marker to discriminate benign mesothelial cells from malignant cells shed into body cavities.Methods and results: Cytological smears of effusions from 51 hospitalized patients were immunostained for heparanase. Strong immunoreactivity was noted in 35 of 40 (88%) carcinoma samples and in all three malignant mesothelioma cases. Only rare (<3%) reactive mesothelial cells were noted showing a faint negligible staining. Specificity was 100%, sensitivity 88%, and positive and negative predictive values were 100% and 89% respectively.Conclusions: Our results suggest that heparanase may be of value as a complementary component in a diagnostic panel of markers, contributing to its reliability and accuracy.
Transbronchial fine needle aspiration cytology in the diagnosis of mediastinal/hilar sarcoidosis
Authors: Smojver‐Ježek S. , Peroš‐Golubičić T. , Tekavec‐Trkanjec J. , Mažuranić I. , Alilović M. 
Published: December 2006

Objective:  The diagnostic value of transbronchial/transtracheal fine needle aspiration (TBFNA) cytology in the patients with mediastinal and/or hilar lymphadenopathy has been investigated.Method:  Out of 116 patients with mediastinal/hilar lymphadenopathy, the diagnosis of sarcoidosis was established in 88 (75.9%). One hundred and seventy‐one TBFNAs from different lymph node stations were performed using a cytological 26‐gauge needle. Adequate lymph node samples were obtained in 157 of 171 (91.8%) TBFNA and 14 of 171 (8.2%) TBFNA samples were inadequate.Results:  Cytological findings consistent with sarcoidosis were found in 79 of 88 (89.77%) patients and 133 of 157 (84.71%) samples. The sensitivity of TBFNA cytology in sarcoidosis presenting as mediastinal/hilar lymphadenopathy was 78.7%, specificity 92.3%.Conclusions:  Overall diagnostic accuracy of TBFNA cytology in the diagnosis of sarcoidosis was 86.2%, and cytological findings consistent with sarcoidosis were the only morphological diagnosis of sarcoidosis in 63.6% of patients.
Fine‐needle aspiration of renal angiomyolipoma: a report of four cases
Authors: Handa U. , Nanda A. , Mohan H. 
Published: December 2006

Objective:  Renal angiomyolipoma is an uncommon benign tumour composed of smooth muscle cells, blood vessels and adipose tissue. The cytological findings of this tumour are described.Methods:  A retrospective analysis of four cases of angiomyolipoma diagnosed on fine‐needle aspiration cytology (FNAC) during the period 1998–2004 was carried out. All the aspirations were carried out under ultrasonographic image guidance.Results:  Smears from three cases showed oval‐ to spindle‐shaped tumour cells, cohesive stromal fragments embedded in adipose tissue and branching blood vessels in a haemorrhagic background. No mitotic figures were seen. Smears from one case showed adipose tissue and blood. In this case, sections from the cell block showed mature adipose tissue and small blood vessels.Conclusion:  The diagnosis of angiomyolipoma can be made by FNAC under image guidance and a cell block may be quite helpful in making a correct diagnosis. It is important to establish a correct preoperative diagnosis as treatment of these tumours is conservative and this obviates the need for total nephrectomy.
Pitfalls in the diagnosis of Wegener's granulomatosis on fine needle aspiration cytology
Authors: Awasthi A. , Malhotra P. , Gupta N. , Gupta D. , Rajwanshi A. 
Published: December 2006

Objective:  To review the clinical and pathological findings in six suspected cases of Wegener's granulomatosis (WG) and highlight the diagnostic difficulties faced by the cytopathologist.Methods:  Retrospective review of records of the Cytopathology Department to identify patients who underwent image‐guided transthoracic pulmonary fine needle aspiration cytology (FNAC) for pulmonary lesions of suspected WG and those who were subsequently confirmed to have WG. Detailed evaluation of cytomorphological features was carried out.Results:  A total of six cases were identified in whom the initial procedure to obtain a pathological diagnosis was transthoracic FNAC. In one case, atypical squamous cells on cytology initially suggested a diagnosis of squamous cell carcinoma while in another a diagnosis of WG was made on cytology; however, a subsequent lung biopsy revealed silicosis.Conclusion:  Acute inflammation and necrosis are the most consistent cytopathological findings in WG. In selected cases FNAC can provide supportive pathological evidence to establish a diagnosis of WG.
Reduced endothelial progenitor cells in European and South Asian men with atherosclerosis
Authors: Hughes A. D. , Coady E. , Raynor S. , Mayet J. , Wright A. R. , Shore A. C. , Kooner J. S. , Thom S. A. McG. , Chaturvedi N. 
Published: December 2006

AbstractBackground  Circulating endothelial progenitor cells (EPCs) play a role in the repair and regeneration of the endothelium and may represent a novel cardiovascular risk factor. South Asian subjects have an increased risk of cardiovascular disease which is not fully explained by known risk factors. This study examined associations of EPCs with atherosclerosis and possible ethnic differences in EPCs.Materials and methods  A population sample of 58 European and South Asian adult men was enriched with the recruitment of an additional 59 European and South Asian men with known coronary disease. The coronary artery calcification score was measured by multi‐slice computerized tomography (CT), carotid and femoral intima‐media thickness (IMT), and femoral plaques were measured by ultrasound. The subjects were further subdivided into three categories of coronary artery disease on the basis of coronary artery calcification score and clinical history. Total EPCs and non‐senescent EPCs (ns‐EPCs) were quantified after 5 days cell culture and the number of late outgrowth colonies was measured over a 6‐week test period. Circulating CD34+ haematopoietic precursor cells were measured by flow cytometry.Results  Individuals with femoral plaques had reduced total and ns‐EPCs. The number of ns‐EPCs were reduced in individuals with the most coronary atheroma and were inversely related to the coronary calcification score and femoral IMT. These relationships persisted after multivariate adjustment for other risk factors. The numbers of late outgrowth colonies or circulating CD34+ cells were unrelated to the presence of atherosclerosis. There were no differences in the number of EPCs between European and South Asian subjects.Conclusion  The number of EPCs are reduced in subjects with atherosclerosis independent of other risk factors. Reduction in EPC numbers may be an independent risk factor for atherosclerosis but does not explain ethnic differences in cardiovascular risk.
Expression of the target receptor CD33 in CD34+/CD38−/CD123+ AML stem cells
Authors: Hauswirth A.W. , Florian S. , Printz D. , Sotlar K. , Krauth M.‐T. , Fritsch G. , Schernthaner G.‐H. , Wacheck V. , Selzer E. , Sperr W.R. , Valent P. 
Published: December 2006

AbstractBackground  CD33 (Siglec‐3) is becoming increasingly important as a target of antibody‐mediated therapy in acute myeloid leukaemia (AML). In normal myelopoiesis, expression of CD33 is restricted to advanced stages of differentiation, whereas primitive stem cells do not express CD33. In the present study, we asked whether leukaemic stem cells in patients with AML express CD33.Materials and methods  A multicolour‐staining technique was applied in 11 patients with AML, and leukaemic progenitors defined as CD34+/CD38−/CD123+ cells. AML stem cells were purified by cell sorting and were examined for expression of CD33 mRNA by reverse transcriptase–polymerase chain reaction (RT–PCR).Results  In all patients in whom the majority of myeloblasts expressed CD33 (n = 8), AML progenitors reacted with the CD33 antibody P67·6. Repopulation experiments utilizing irradiated NOD/SCID mice confirmed that AML stem cells in these patients reside within the CD33+ subpopulation of the leukaemic clone. Moreover, highly purified AML stem cells (> 98% purity) from patients with CD33+ AML were found to express CD33 mRNA in RT–PCR analyses. CD33 was neither detectable on CD34+/CD38− cells in normal bone marrow nor on leukaemic stem cells in patients with CD33‐negative AML.Conclusions  Leukaemic stem cells in patients with CD33+ AML express CD33. This observation is in favour of novel treatment concepts employing CD33‐targeting antibodies in AML.
Relaxation of human placental arteries and veins by ATP‐sensitive potassium channel openers
Authors: Jewsbury S. , Baker P. N. , Wareing M. 
Published: December 2006

AbstractBackground  Adenosine triphosphate (ATP)‐sensitive potassium channels (KATP) are important modulators of vascular tone. Preliminary data from our laboratory suggests that KATP channels are expressed in the fetoplacental vasculature where addition of pinacidil, a specific KATP opener, promotes relaxation. We aimed to assess the effects of KRN2391 and KRN4884 on the fetoplacental vasculature, which are putative KATP channel openers.Materials and methods  Functional activity of KATP channels was assessed in chorionic plate arteries and veins using wire myography. Cromakalim‐, KRN2391‐ and KRN4884‐induced relaxations were assessed in the presence and absence of agonist‐induced pretone. Cromakalim, an established KATP channel opener, acted as control.Results  KRN2391 evoked significantly greater relaxation of chorionic plate arteries and veins than either KRN4884 or cromakalim. KRN2391‐induced relaxation of precontracted arteries and veins was reduced in the presence of inhibitiors of the nitric oxide pathway (L‐NNA or LY83583). With KRN4884, there was no contribution of nitric oxide to the induced relaxation.Conclusions  We conclude that KATP channels play an important role in controlling placental vascular tone. KRN2391 induces relaxation of human placental blood vessels by activation of KATP channels and via activation of nitric oxide‐dependent pathways.
Impaired cardiac autonomic function in women with prior gestational diabetes mellitus
Authors: Gasic S. , Winzer Ch. , Bayerle‐Eder M. , Roden A. , Pacini G. , Kautzky‐Willer A. 
Published: December 2006

AbstractBackground  Cardiac autonomic neuropathy is a common dysfunction in manifest diabetes mellitus and is associated with duration of diabetes and/or an inadequate glycaemic control. Heart rate variability (HRV) reflects autonomic heart function. The aim of the present study was to investigate whether in women with prior gestational diabetes (GD; pre‐type 2 diabetes) alterations of cardiac autonomic function can be observed after delivery in relation to insulin sensitivity and glycaemic control.Materials and methods  Forty‐eight healthy women with prior GD were consecutively admitted to the study. HRV was analysed by both time, as well as frequency, domain methods using 24‐h Holter monitoring. In addition, 20 women with normal glucose tolerance during and after pregnancy were investigated as control subjects. All women underwent a frequently sampled intravenous glucose tolerance test (FSIGT) for measurement of insulin sensitivity.Results  Time domain analysis (standard deviation of normal RR intervals; SDNN) showed a reduced HRV in 25 out of the 48 (52%) women with prior GD. Frequency domain analysis revealed that in these 25 subjects both low and high frequency components of power spectral density (reflecting mainly sympathetic respectively parasympathetic activity) were reduced, indicating that sympathetic as well as parasympathetic functional impairment may be assumed. However, a relative predominance of the sympathetic over parasympathetic cardiac function was observed. The impairment of cardiac autonomic function (reduced SDNN) was correlated with HbA1c values and the 2‐h blood glucose concentration (oral glucose tolerance test) but not with insulin sensitivity.Conclusion  The present results demonstrate that in 52% of the women examined who had prior GD, an impairment of cardiac sympathetic as well as parasympathetic function was present, which related to glycaemic control, but not to insulin sensitivity. This infers that functional autonomic changes could be an early prognostic indicator in pre‐type 2 diabetes.
Induction of hepatitis C virus (HCV)‐specific T cells by needle stick injury in the absence of HCV‐viraemia
Authors: Kubitschke A. , Bahr M. J. , Aslan N. , Bader C. , Tillmann H. L. , Sarrazin C. , Greten T. , Wiegand J. , Manns M. P. , Wedemeyer H. 
Published: December 2006

AbstractBackground  The risk of hepatitis C virus (HCV) infection after occupational exposure is low with seroconversion rates between 0 and 5%. However, factors associated with natural resistance against HCV after needle stick injury are poorly defined. HCV‐specific T‐cell responses have been described in cross‐sectional studies of exposed HCV‐seronegative individuals.Materials and methods  In this study, we prospectively followed 10 healthcare professionals who experienced an injury with an HCV‐contaminated needle. Blood samples were taken on the day or the day after the event and at different time points during follow‐up for up to 32 months. HCV‐specific T‐cell responses were investigated directly ex vivo and in T‐cell lines.Results  None of the individuals became positive for HCV‐RNA in serum tested with the highly sensitive transcription‐mediated amplification (TMA)‐assay or in peripheral blood mononuclear cells (PBMC). All of them remained anti‐HCV negative throughout follow‐up. At the time of injury, HCV‐specific CD4+ T‐cell responses were already detectable in two individuals and became detectable thereafter in three additional persons. Transient HCV‐specific CD8+ T‐cell responses developed in two HLA‐A2 positive patients, which became negative until the most recent follow‐up after 5 and 17 months, respectively.Conclusion  We demonstrate the development of HCV‐specific T cells in HCV‐exposed individuals after needle stick injury indicating subinfectious exposure to HCV. T‐cell immunity against HCV may contribute to the low prevalence of HCV in medical healthcare professionals in Western countries.
The metabolic syndrome: metabolic changes with vascular consequences
Authors: Wassink A. M. J. , Olijhoek J. K. , Visseren F. L. J. 
Published: December 2006

AbstractDespite criticism regarding its clinical relevance, the concept of the metabolic syndrome improves our understanding of both the pathophysiology of insulin resistance and its associated metabolic changes and vascular consequences. Free fatty acids (FFA) and tumour necrosis factor‐alpha (TNF‐α) play prominent roles in the development of insulin resistance by impairing the intracellular insulin signalling transduction pathway. Obesity is an independent risk factor for cardiovascular disease and strongly related to insulin resistance. In case of obesity, FFAs and TNF‐α are produced in abundance by adipocytes, whereas the production of adiponectin, an anti‐inflammatory adipokine, is reduced. This imbalanced production of pro‐ and anti‐inflammatory adipokines, as observed in adipocyte dysfunction, is thought to be the driving force behind insulin resistance. The role of several recently discovered adipokines such as resistin, visfatin and retinol‐binding protein (RBP)‐4 in the pathogenesis of insulin resistance is increasingly understood. Insulin resistance induces several metabolic changes, including hyperglycaemia, dyslipidaemia and hypertension, all leading to increased cardiovascular risk. In addition, the dysfunctional adipocyte, reflected largely by low adiponectin levels and a high TNF‐α concentration, directly influences the vascular endothelium, causing endothelial dysfunction and atherosclerosis. Adipocyte dysfunction could therefore be regarded as the common antecedent of both insulin resistance and atherosclerosis and functions as the link between obesity and cardiovascular disease. Targeting the dysfunctional adipocyte may reduce the risk for both cardiovascular disease and the development of type 2 diabetes. Although lifestyle intervention remains the cornerstone of therapy in improving insulin sensitivity and its associated metabolic changes, medical treatment might prove to be important as well.
Contemporary carbon balance and late Holocene carbon accumulation in a northern peatland
Authors: ROULET NIGEL T. , LAFLEUR PETER M. , RICHARD PIERRE J. H. , MOORE TIM R. , HUMPHREYS ELYN R. , BUBIER JILL 
Published: December 2006

AbstractNorthern peatlands contain up to 25% of the world's soil carbon (C) and have an estimated annual exchange of CO2‐C with the atmosphere of 0.1–0.5 Pg yr−1 and of CH4‐C of 10–25 Tg yr−1. Despite this overall importance to the global C cycle, there have been few, if any, complete multiyear annual C balances for these ecosystems. We report a 6‐year balance computed from continuous net ecosystem CO2 exchange (NEE), regular instantaneous measurements of methane (CH4) emissions, and export of dissolved organic C (DOC) from a northern ombrotrophic bog. From these observations, we have constructed complete seasonal and annual C balances, examined their seasonal and interannual variability, and compared the mean 6‐year contemporary C exchange with the apparent C accumulation for the last 3000 years obtained from C density and age‐depth profiles from two peat cores. The 6‐year mean NEE‐C and CH4‐C exchange, and net DOC loss are −40.2±40.5 (±1 SD), 3.7±0.5, and 14.9±3.1 g m−2 yr−1, giving a 6‐year mean balance of −21.5±39.0 g m−2 yr−1 (where positive exchange is a loss of C from the ecosystem). NEE had the largest magnitude and variability of the components of the C balance, but DOC and CH4 had similar proportional variabilities and their inclusion is essential to resolve the C balance. There are large interseasonal and interannual ranges to the exchanges due to variations in climatic conditions. We estimate from the largest and smallest seasonal exchanges, quasi‐maximum limits of the annual C balance between 50 and −105 g m−2 yr−1. The net C accumulation rate obtained from the two peatland cores for the interval 400–3000 bp (samples from the anoxic layer only) were 21.9±2.8 and 14.0±37.6 g m−2 yr−1, which are not significantly different from the 6‐year mean contemporary exchange.
Seedling survival in a northern temperate forest understory is increased by elevated atmospheric carbon dioxide and atmospheric nitrogen deposition
Authors: SEFCIK LESLEY T. , ZAK DONALD R. , ELLSWORTH DAVID S. 
Published: December 2006

AbstractWe tested the main and interactive effects of elevated carbon dioxide concentration ([CO2]), nitrogen (N), and light availability on leaf photosynthesis, and plant growth and survival in understory seedlings grown in an N‐limited northern hardwood forest. For two growing seasons, we exposed six species of tree seedlings (Betula papyrifera, Populus tremuloides, Acer saccharum,Fagus grandifolia,Pinus strobus, andPrunus serotina) to a factorial combination of atmospheric CO2(ambient, and elevated CO2at 658 μmol CO2 mol−1) and N deposition (ambient and ambient +30 kg N ha−1 yr−1) in open‐top chambers placed in an understory light gradient. Elevated CO2exposure significantly increased apparent quantum efficiency of electron transport by 41% (P<0.0001), light‐limited photosynthesis by 47% (P<0.0001), and light‐saturated photosynthesis by 60% (P<0.003) compared with seedlings grown in ambient [CO2]. Experimental N deposition significantly increased light‐limited photosynthesis as light availability increased (P<0.037). Species differed in the magnitude of light‐saturated photosynthetic response to elevated N and light treatments (P<0.016). Elevated CO2exposure and high N availability did not affect seedling growth; however, growth increased slightly with light availability (R2=0.26,P<0.0001). Experimental N deposition significantly increased average survival of all species by 48% (P<0.012). However, seedling survival was greatest (85%) under conditions of both high [CO2] and N deposition (P<0.009). Path analysis determined that the greatest predictor for seedling survival in the understory was total biomass (R2=0.39,P<0.001), and that carboxylation capacity (Vcmax) was a better predictor for seedling growth and survival than maximum photosynthetic rate (Amax). Our results suggest that increasing [CO2] and N deposition from fossil fuel combustion could alter understory tree species recruitment dynamics through changes in seedling survival, and this has the potential to alter future forest species composition.