bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hands-Free Cough and Speech in Long-Term Tube-Free Tracheostomy
Authors: Milstein Claudio , Akst Lee M. , Eliachar Isaac 
Published: March 2009

AbstractA surgical technique developed by Dr. Isaac Eliachar in the Section of Laryngotracheal Reconstruction, Cleveland Clinic Department of Otolaryngology, dramatically improves quality of life in patients who require a long-term tracheostoma. This procedure, called “long-term tube-free tracheostomy” (LTTFT), creates a self-sustaining tracheostoma that requires no tracheotomy tubes to maintain patency. The advantages of a tube-free procedure are numerous, and the improvements in quality of life of patients who have successfully undergone this operation are readily noticeable. These benefits include (a) removal of tracheal appliances, such as tracheal tubes, valves, vents, and stents; (b) prevention of tissue damage associated with appliances and a decrease in tissue irritation and formation of granulation tissue; (c) better secretion management, elimination of frequent clogging of tracheal appliances, and need for suction; (d) prevention of aspiration; (e) retention or re-establishment of the functions of sniffing and smelling; and (f) performance of hands-free cough and speech production due to the self-constricting capabilities of the stoma. The purpose of this article is to present the concept of LTTFT as an alternative to standard tracheotomy in select patients. The difference between LTTFT as an alternative to tracheotomy and the impact these differences have upon medical decision-making will be emphasized.
Illoura™: a software tool for analysis, visualization and semantic querying of cellular and other spatial biological data
Authors: McComb Tim , Cairncross Oliver , Noske Andrew B. , Wood David L. A. , Marsh Brad J. , Ragan Mark A. 
Published: March 2009

Abstract
Summary: New high-resolution approaches for mapping ultrastructure of cells in 3D are leading to unprecedented quantities of spatial data. Here we present Illoura, a software tool for the integrated management, analysis and visualization of these data within a semantic context, and illustrate its capability by analysis of spatial relationships in mammalian beta cells.
Availability: http://www.visiblecell.com/illoura
Contact: m.ragan@uq.edu.au
Supplementary information: Supplementary data are available at Bioinformatics online.
Methods and results of in situ target-strength measurements of Atlantic cod (Gadus morhua) during combined trawl-acoustic surveys
Authors: Ermolchev Viacheslav A. 
Published: March 2009

Abstract
Ermolchev, V. A., 2009. Methods and results of in situ target-strength measurements of Atlantic cod (Gadus morhua) during combined trawl-acoustic surveys. – ICES Journal of Marine Science, 66: 1225–1232. This paper presents methods for collecting acoustic and biological data, including in situ target-strength (TS) estimates of fish, with results presented for Atlantic cod (Gadus morhua) obtained from combined trawl-acoustic surveys. These include fish in the small, average, and maximum length classes, within the range 5–136 cm (total fish length, LT). The investigations were done using Simrad EK500/EK60 echosounders with split-beam transducers and special post-processing software. Based on an analysis of data collected in the Barents Sea during 1998–2007, a relationship TS = 25.2 log10(LT) − 74.8 was obtained for Atlantic cod at 38 kHz, with TS in dB and LT in centimetres. Seasonally, and for depths between 50 and 500 m, the variability in cod TS was 3.1 dB, decreasing with depth. The largest day–night difference in mean TS was in August–September, with changes as large as 1.0–1.7 dB. In the other seasons, the day–night difference was <1.0 dB.
Unwarranted Administration of Acetylcholinesterase Inhibitors Can Impair Genioglossus and Diaphragm Muscle Function
Authors: Eikermann Matthias , Fassbender Philipp , Malhotra Atul , Takahashi Masaya , Kubo Shigeto , Jordan Amy S. , Gautam Shiva , White David P. , Chamberlin Nancy L. 
Published: March 2009

Background
It is standard practice to administer a cholinesterase inhibitor (e.g., neostigmine) at the end of a surgical case to reverse suspected effects of neuromuscular blocking agents regardless of whether such residual effects are present. The authors hypothesized that cholinesterase inhibition when given the in absence of neuromuscular blockade (NB) would decrease upper airway dilatory muscle activity and consequently upper airway volume.

Methods
The authors measured genioglossus and diaphragm electromyograms during spontaneous ventilation in anesthetized, tracheostomized rats before and after administration of neostigmine (0.03, 0.06, or 0.12 mg/kg), after recovery of the train-of-four ratio (quadriceps femoris muscle) to unity after NB (n = 18). For comparison, the authors made the same measurements in rats that had no previous NB (n = 27). In intact anesthetized rats, the authors measured upper airway volume and end-expiratory lung volume by magnetic resonance imaging before and after 0.12 mg/kg neostigmine (n = 9).

Results
Neostigmine treatment in rats that had fully recovered from NB based on the train-of-four ratio caused dose-dependent decreases in genioglossus electromyogram (to 70.3 +/- 7.6, 49.2 +/- 3.2, and 39.7 +/- 2.3% of control, respectively), decreases in diaphragm electromyogram (to 103.1 +/- 6.5, 83.1 +/- 4.7, and 68.7 +/- 7.3% of control), and decreases in minute ventilation to a nadir value of 79.6 +/- 6% of preneostigmine baseline. Genioglossus electromyogram effects were the same when neostigmine was given with no previous NB. Neostigmine caused a decrease in upper airway volume to 83 +/- 3% of control, whereas end-expiratory lung volume remained constant.

Conclusions
The cholinesterase inhibitor neostigmine markedly impairs upper airway dilator volume, genioglossus muscle function, diaphragmatic function, and breathing when given after recovery from vecuronium-induced neuromuscular block.
A New and Safe Device for Minimally Invasive Saphenous Vein Harvesting: Results after 100 Cases
Authors: D'Arrigo Giuseppe , Mauceri Gaetano , Mudanò Marco , Scolaro Antonio , Fraggetta Filippo , Grasso Giuseppe , Lomeo Alberto 
Published: March 2009

Purpose The saphenous vein is the most commonly used bypass conduit for coronary surgery. Endoscopic harvesting techniques are associated with significant reduction of wound complications but are time-consuming and expensive. The authors developed a device to perform minimally invasive harvesting of the saphenous vein—rapidly, inexpensively, and safely. Description Patients hospitalized for isolated CABG (n = 134) participated in the study. Each vein had been harvested through the use of our minimally invasive system. Evaluation The veins were harvested in 130 cases; 378 vein samples were collected for pathology study, with complete integrity of the vein as the result of the “no touch” technique with the device. This integrity could be very important for the long-term patency of the vein graft. After surgery, there were no wound dehiscences, infections, or major hematomas. There was 1 case (0.76%) of superficial hematoma and 3 cases (2.30%) of lymphoceles. Conclusions Although commercial disposable systems are now available to allow minimally invasive harvesting of the saphenous vein, the authors think that harvesting the greater saphenous vein with the cylinder steel device is easy to learn can be used safely and at much-reduced costs.
Significance of Bowel Wall Abnormalities at Ultrasound in Henoch‐Schönlein Purpura
Authors: Nchimi Alain , Khamis Jamil , Paquot Isabelle , Bury Françoise , Magotteaux Paul 
Published: March 2009

ABSTRACTObjectives:To describe the polymorphism of intestinal ultrasound findings in children with gastrointestinal symptoms of Henoch Schönlein purpura (HSP) and to investigate the clinical relevance of these findings in terms of symptoms and length of hospitalization.Patients and Methods:Clinical and ultrasound data from 43 consecutive children with HSP (36 with and 7 without abdominal symptoms) were reviewed. Patients with abdominal symptoms of HSP were divided into 4 groups (0–III) representing at ultrasound normal appearance and differentiated, pseudodifferentiated, and dedifferentiated bowel wall thickening, respectively. The diagnostic value of ultrasound in diagnosing gastrointestinal involvement of HSP (grades I–III) was calculated using as the standard of reference the absence or presence of clinical symptoms. Average duration of symptoms and hospitalization in the 4 groups was compared.Results:The respective sensitivity, specificity, positive predictive value, and negative predictive value of ultrasound for the diagnosis of gastrointestinal involvement of HSP was 83.3%, 100%, 100%, and 53.8%. Groups 0 to III contained, respectively, 5/36 (13.9%), 6/36 (16.7%), 22/36 (61.1%), and 3/36 (8.3%) patients. The groups' average duration of symptoms, respectively, was 2.20 ± 2.06, 5.67 ± 1.88, 6.29 ± .94, and 17.67 ± 2.66 days, whereas the length of hospitalization, respectively, was 4.80 ± 2.96, 9.17 ± 2.70, 11.46 ± 1.35, and 24.67 ± 3.82 days. The duration of both symptoms and hospitalization was significantly higher in group III than in the other groups (P < 0.05).Conclusions:In children with gastrointestinal involvement of HSP, dedifferentiated wall thickening as shown by ultrasound is associated with a poor clinical prognosis.
Brachial Plexopathies: Etiology, Frequency, and Electrodiagnostic Localization
Authors: Moghekar Ajit R , Moghekar Abhay R , Karli Necdet , Chaudhry Vinay 
Published: March 2009

ABSTRACT

Objectives:
Brachial plexopathy is clinically, and electrodiagnostically, a well-recognized entity. However, the involvement pattern of different parts of the plexus with different etiologies has not been well-characterized.

Methods:
A retrospective analysis of clinical and electrophysiologic findings in 203 patients with brachial plexopathies was performed.

Results:
Of 203 patients with brachial plexopathy, 182 (90%) were supraclavicular and 21 (10%) were infraclavicular. The following localizations were noted: upper trunk (UT) 27%; lower trunk (LT) 11%; UT + MT (middle trunk) 11%; LT + MT 7%; UT + MT + LT 25%; and UT + LT 1. Among the patients with brachial neuritis, 47% patients did not have pain before the onset and only 28% had a definable antecedent illness.

Conclusion:
We report the largest to date reported case series of well-characterized brachial plexopathy patients. Upper trunk was the most frequently affected site of injury. In brachial neuritis, absence of pain and antecedent viral illness is more common than described in the literature.
Myotonic Dystrophy Type 1 Presenting With Ventilatory Failure
Authors: Souayah Nizar , Tick Chong Peter Siao , Dreyer Michael , Cros Didier , Schmahmann Jeremy D 
Published: March 2009

Abstract

Objective:
To report a series of patients with adult onset myotonic dystrophy type 1 (DM1) in whom the presenting symptom was ventilatory failure.

Background:
Ventilatory failure is a common complication of DM1 and may be a presenting symptom in the setting of anesthesia or surgery, but it is not known to be a heralding manifestation.

Method:
Case series.

Results and Discussion:
Three adults developed dyspnea leading to ventilatory failure, with no cardiac or pulmonary causes identified. Case 1 required intubation for ventilator support and was sedated with propofol. There was no clinical myotonia, and electromyography (EMG) demonstrated brief runs of myotonic discharges. Examination 3 weeks later off propofol revealed percussion myotonia, and EMG evidence of long runs of myotonic discharges. Genetic testing confirmed the diagnosis of DM1. Case 2 had cataracts and ptosis but no known diagnosis of DM and no previous neurological impairments. Case 3 was previously neurologically asymptomatic but her son had congenital DM1. The diagnosis was confirmed by EMG in cases 2 and 3, and both patients were managed with bilevel ventilation (BIPAP).

Conclusion:
Myotonic dystrophy type 1 should be considered in the differential diagnosis of acute ventilatory failure in adults.
Acute Axonal Poly-Radiculoneuropathy Associated With Partially Treated Brucellosis: A Case Report
Authors: Haghighi Afshin Borhani , Sabayan Behnam 
Published: March 2009

Abstract

We report a case of partially treated brucellosis that developed quadriparesis, sixth and seventh cranial nerve palsy, and apnea. Electrodiagnostic studies were in favor of acute axonal poly-radiculoneuropathy. Crossreactive immunological responses due to molecular mimicry between Brucella lipooligosaccharide and GM1 ganglioside may justify the development of acute axonal polyradiculoneuropathy after brucellosis.
Renal Outcome in Off-Pump Coronary Artery Bypass Grafting: Predictors for Renal Impairment with Multivariate Analysis
Authors: Ogawa Mitsugu , Doi Kiyoshi , Yamada Yoshiaki , Okawa Kazunari , Kan'bara Tamotsu , Koushi Keitarou , Yaku Hitoshi 
Published: March 2009

Objective Recent studies on the efficacy of off-pump coronary artery bypass grafting (OPCABG) have reported encouraging results on postoperative renal function, but improvements can still be made. Methods A total of 368 patients, none needing chronic dialysis, underwent isolated OPCABG at our institution between January 1999 and March 2005. They were divided into 3 groups according to renal function as indicated by the serum creatinine levels: group N (n = 332) with normal function, group M (n = 30) with mild to moderate renal dysfunction, and group S (n = 6), with severe renal dysfunction. Creatinine ratio and early outcomes were compared among the groups. Predictors for renal impairment were determined by multiple regression analysis. Results In-hospital mortality rate was similar (group N, 0.6%; group M, 0%; group S, 0%). The percentage of patients with a creatinine ratio greater than 1.6 was significantly larger in group S (group N, 13%; group M, 13%; group S, 50%; P < 0.05). Postoperative hemodialysis, which was temporary, was required more frequently in group S (group N, 0.3%; group M, 3%; group S, 67%; P < 0.05). In group N, 38 patients (11%) had new renal impairment after OPCABG. Preoperative serum creatinine levels ≥2.5 mg/dL, ejection fraction <0.4, amount of blood transfusion, and more than 4 bypasses were potent predictors for postoperative renal impairment. Conclusions Clinical results of OPCABG on renal function were satisfactory regardless of preoperative renal function. However, perioperative renal function should be closely monitored in patients with known risk factors, even when OPCABG is performed.
Thoracic Aortic Stent Grafting in Patients with Connective Tissue Disorders: A Word of Caution
Authors: Mohammadi Siamak , Normand Jean-Pierre , Voisine Pierre , Dagenais François 
Published: March 2009

Objective Use of thoracic Stent-graft in patients with connective tissue disorders (CTD) remains limited. We herein report 3 patients with CTD who underwent stent grafting. Methods and Results Case 1; A male Marfan patient was operated for thoraco-abdominal aneurysm. On computed tomography (CT), large false aneurysm at the proximal anastomosis was documented which was excluded with a 30 mm Talent stent-graft with 10–15% oversize. Case 2; A female with Ehlers-Danlos syndrome had undergone resection of descending aortic thoracic aneurysm presented with an enlarging aneurysm distal to the graft. Three Talent stent-grafts (15% oversize) were deployed with balloon dilatation to exclude the aneurysm. The immediate postoperative period was complicated by an extensive intramural hematoma of the descending aorta with hemothorax, managed conservatively. Case 3; A female Marfan patient had undergone Bentall procedure and mitral repair followed with resection of the proximal descending aorta. Three months later a false aneurysm at the distal anastomosis was treated with a 24 mm Valiant stent-graft (30% oversize). Aortic dissection distal to stent was documented on the early postoperative CT. The dissected aneurysm enlarged significantly with a type I distal endoleak during follow-up. Concomitantly, the patient presented a class III dyspnea owing to a severe mitral regurgitation. The patient underwent a successful MVR and stent-graft explantation with replacement of the descending aorta. Conclusion Significant complications supervened when stent-grafts were deployed in native aorta. We thus recommend that deploying a stent-graft in a CTD diseased aorta should be considered a relative contraindication. In cases with prohibitive or high risk surgery, use of a stent-graft with minimal radial force and minimal oversizing without balloon dilatation should be considered.
Value of Sestamibi Scans in Tertiary Hyperparathyroidism
Authors: Loftus Kelly A. , Anderson Susan , Mulloy Anthony L. , Terris David J. 
Published: March 2009

AbstractObjectives: To determine the value of preoperative 99mTc‐sestamibi scans and the incidence of ectopic glands in tertiary hyperparathyroidism.Design: Prospective, non‐randomized analysis of a consecutive cohort of surgical patients from the Medical College of Georgia Thyroid/Parathyroid Center.Materials and Methods: A consecutive series of patients with tertiary hyperparathyroidism undergoing parathyroidectomy was analyzed. Demographic data, preoperative 99mTc‐sestamibi scintigraphy results, location of diseased glands, pre‐ and postoperative calcium, and parathyroid hormone levels were collected.Results: Twenty‐one patients underwent parathyroidectomy for tertiary hyperparathyroidism between March 2004 and September 2006. Of these 21 patients, 3 were re‐operative cases for persistent hypercalcemia and each was found to have a single diseased gland. Of the 18 patients undergoing first time surgery, 15 had four‐gland hyperplasia, 2 patients had single adenomas, and 1 patient had a double adenoma. Nine of the 21 patients (43%) had ectopic glands (2 of these patients had 2 ectopic glands each). The overall sensitivity of the preoperative 99mTc‐sestamibi scintigraphy was 76% and was not significantly different when comparing patients with ectopic glands (78%) and those without (75%).Conclusions: 99mTc sestamibi scintigraphy has high positive predictive value and sensitivity in patients with tertiary hyperparathyroidism. Sestamibi scanning is particularly valuable in this patient population since the incidence of ectopic glands may be higher than previously recognized.
Resting Energy Expenditure in Children With Inflammatory Bowel Disease
Authors: Hill RJ , Cleghorn GJ , Withers GD , Lewindon PJ , Ee LC , Connor F , Davies PSW 
Published: March 2009

ABSTRACTObjectives:There is controversy in the literature regarding the effect of inflammatory bowel disease (IBD) on resting energy expenditure (REE). In many cases this may have resulted from inappropriate adjustment of REE measurements to account for differences in body composition. This article considers how to appropriately adjust measurements of REE for differences in body composition between individuals with IBD.Patients and Methods:Body composition, assessed via total body potassium to yield a measure of body cell mass (BCM), and REE measurements were performed in 41 children with Crohn disease and ulcerative colitis in the Royal Children's Hospital, Brisbane, Australia. Log‐log regression was used to determine the power function to which BCM should be raised to appropriately adjust REE to account for differences in body composition between children.Results:The appropriate value to “adjust” BCM was found to be 0.49, with a standard error of 0.10.Conclusions:Clearly, there is a need to adjust for differences in body composition, or at the very least body weight, in metabolic studies in children with IBD. We suggest that raising BCM to the power of 0.5 is both a numerically convenient and a statistically valid way of achieving this aim. Under circumstances in which the measurement of BCM is not available, raising body weight to the power of 0.5 remains appropriate. The important issue of whether REE is changed in cases of IBD can then be appropriately addressed.
Eosinophilic Oesophagitis: Epidemiology, Clinical Aspects, and Association to Allergy
Authors: Nielsen Rasmus G , Husby Steffen 
Published: March 2009

ABSTRACTEosinophilic oesophagitis is characterised by age‐dependent symptoms mimicking gastrooesophageal reflux disease, a distinct endoscopic appearance and a histological picture with extensive infiltration of eosinophils in the oesophageal mucosa. Eosinophilic oesophagitis is more frequently seen in males, and patients often belong to the paediatric or adolescence age groups. The exact prevalence of eosinophilic oesophagitis is unknown, but it has been suggested that the United States has a higher prevalence than Europe. Several treatment algorithms have been suggested, including elemental diets, oral steroids, inhaled (swallowed) steroids, and leucotriene receptor antagonists. Detailed information on the eosinophilic inflammatory processes in the oesophageal mucosa was initially obtained from animal models, in particular with regard to the role of interleukin‐5 and the chemokine eotaxin‐1 in eosinophilic recruitment. Studies have suggested a cytotoxic effect of eosinophilic degranulation products on nerve fibers in the gastric/intestinal mucosa, implicating a direct effect of allergic inflammation on gastrointestinal motility. Human studies recently have emphasized the role of eotaxin‐3 and identified a single nucleotide polymorphism probably related to disease susceptibility.
Subclinical Neurological Abnormalities in Children With Celiac Disease Receiving a Gluten‐free Diet
Authors: Cakir D , Tosun A , Polat M , Celebisoy N , Gokben S , Aydogdu S , Yagci RV , Tekgul H 
Published: March 2009

ABSTRACTObjectives:Because clinically evident manifestations are frequent in adults with celiac disease (CD), we aimed to investigate whether early neurological abnormalities may be detected in children with CD.Methods:Electroencephalography, electromyography, and somatosensory evoked potentials were performed in children with CD receiving a gluten‐free diet.Results:The neurophysiological tests revealed subclinical neurological abnormalities associated with CD in 3 (11%) of 27 children: 2 had peripheral polyneuropathy documented with electromyography, and 1 had prolonged latencies in somatosensory evoked potential. Magnetic resonance imaging showed abnormalities in 2 (7.4%) of children: pontine demyelinization in 1 and cortical atrophy in the other.Conclusions:Because the rate of neurological problems is increased in children with CD, neurological abnormalities should be carefully investigated early after the diagnosis of CD is made.