bluuebunny/crossref_metadata_2025_split huggingface dataset:
Middle ear ventilation tubes
Authors: Pappas James J. 
Published: September 2006

AbstractTwenty years have now passed since the first tube was placed through the tympanic membrane for middle ear ventilation. In this relatively short period of time, many different ideas for tube design have emerged and are presented. The types of middle ear fluid formation and the relationship of this formation to impaired eustachian tube function are discussed. The main indication for indwelling tubes is chronic secretory otitis media with effusion which fails to respond to conservative treatment; however, indications have been expanded with continued experience. The complications associated with the use of middle ear ventilation tubes are presented. Five years' experience using ventilation tubes in 1,460 ears is reported. Conclusions are based on data compiled from this study.
Transsphenoidal management of pituitary adenomas and other selected lesions of the sella turcica
Authors: Hudson William R. , Kenan Patrick D. 
Published: September 2006

AbstractA presentation is made of 38 lesions of the sella turcica and adjacent structures. All of these patients underwent surgical management by transsphenoidal biopsy and decompression, or resection. A pathological diagnosis was established in each case. The commonest lesion is the pituitary adenoma, with follow‐up presented in 27 cases. The necessity for postoperative radiation and replacement hormone therapy is emphasized. Acceptable control of disease is possible by this treatment regimen. Four cases of cystic craniopharyngioma treated by transsphenoidal fistulization are presented, with effective long term decompression in three. Other benign and malignant lesions of the sella and sphenoid bone are presented. Surgical approaches available for transsphenoidal access to the sella, clinical presentations of the patients in this series, principles of preoperative evaluation, postoperative complications, and results of management, are reviewed.
Neuroma of the chorda tympani nerve
Authors: Pou Jack W. , Chambers Carlton L. 
Published: September 2006

AbstractThis is a case report of an 18‐year‐old Negro female who presented with the chief complaint of a long standing hearing loss. Physical examination revealed a large mass in the right external auditory canal which occupied 80 percent of the cross section area. There was only a tiny rim of the inferior tympanic membrane visable.The patient had a 60 db conductive hearing loss. Mastoid films were normal. At surgery the mass was found to extend into the attic and to almost completely fill the middle ear. When the tumor was removed from the attic, under the malleus and the hypotympanic area, the only attachment was the chorda tympani nerve. The pathology report was neuroma.Photographs were taken and illustrations are presented to confirm these findings.Neuroma has been reported as originating from every branch of the facial nerve with the exception of the chorda tympani nerve. This site of origin has been strikingly absent, especially since the chorda tympani is a component of the facial nerve.Our case is presented to document such an occurrence.
Giant‐cell tumor of the sphenoid and temporal bones
Authors: Glasscock Iii Michael E. , Hunt William E. 
Published: September 2006

AbstractGiant‐cell tumor of bone rarely occurs in the skull. There have been only 14 previously reported benign tumors involving the sphenoid and only 11 found in the temporal bone. While considered benign tumors, they are very aggressive and have a tendency to local recurrence and late malignant change with metastasis. These tumors are predominant in females and occur in the second and third decade of life.Treatment is usually with curettage and/or radiation. It is such a rare tumor that no one individual or group has had extensive clinical experience with the lesion.The purpose of this paper is to present the case of a 29‐year‐old physician's wife who developed frontal headache and diplopia in January of 1966. Skull films revealed a lytic lesion in the left petrous pyramid. After two incomplete removals and a full course of radiation, the tumor progressed to involve the sphenoid, clivus and a portion of the right petrous apex. A middle fossa approach, as described by House, was used to obtain a total removal of the tumor. Four and one half years post surgery, she is free of symptoms clinically and radiographically.In view of the fact that these tumors usually recur within two years this probably represents a cure.
Tumors of the submandibular gland
Authors: Trail Mervin L. , Lubritz Joel 
Published: September 2006

AbstractPrimary neoplasms of the submandibular gland do not hold a statistically impressive position when compared to other tumors in the head and neck. Due in part to their relative rarity, incorrect preoperative diagnosis is not uncommon, but perhaps of more significance is the lack of an adequately prepared management program of these lesions.This presentation reviews tumors of the submandibular gland at the Charity Hospital in New Orleans, La., for the 24‐year period 1948‐1971.
Frontal sinus disease. II. Development of the frontal sinus model: Occlusion of the nasofrontal duct
Authors: Schenck Nicholas L. , Rauchbach Erol , Ogura Joseph H. 
Published: September 2006

AbstractThe history of the surgical treatment of frontal sinusitis and mucocele is a reflection of the uncertainty surrounding its pathogenesis. Since the pioneer work of Coates, Hilding, Proetz, and Walsh over three decades ago, two principal etiologic factors are usually accepted: obstruction of the nasofrontal duct, and mucosal inflammation; however, no one has been able to obstruct reliably the nasofrontal duct in an experimental model (e.g., canine) to see whether such a blockage would actually incite infection or a mucocele. In addition, all previous work was performed from within the sinus cavity.We have been able to obstruct reliably the nasofrontal duct in the dog by manipulating the ethmoturbinates via a lateral rhinotomy, thereby creating a blocked frontal sinus without using a foreign body or voiding the integrity of the sinus cavity itself.Preliminary results show that mucus builds up under pressure within the closed sinus cavity. In this first report, in addition to the surgical method, we present the anatomical, histological, and ultrastructural changes in six experimental dogs at three months, six months and one year. X‐rays show the radiographic changes at various lengths of obstruction.At this point blocking the nasofrontal duct itself does not result in either mucocele formation or infection in our experimental model. A mucocele has been produced in a frontal sinus denuded of its mucoperiosteal lining. We postulate two distinct types of mucocele: one, a “pressure” mucocele in an obstructed sinus, and the second, a “trauma” mucocele which results from regeneration after infection or blunt trauma to the sinus mucosa.This model should allow us to analyze the role of the nasofrontal duct in the pathogenesis of frontal sinus disease. Future application in the investigation of obliterative surgery and frontal sinus trauma is discussed.
Experiences in lateral pharyngotomy
Authors: Ferguson George B. 
Published: September 2006

AbstractLateral pharyngotomy offers good exposure for the removal of many laryngeal and hypopharyngeal tumors. The simplified operation I present avoids damage to voice, deglutition or airway. This approach can be expanded to reach almost any tumor of the pharynx and radical neck dissection can be incorporated. The cosmetic result has been satisfactory, but if individual consideration prompts it, a more horizontal skin‐fold incision can easily be substituted.
Thorium dioxide granuloma of the neck: A report of four cases
Authors: Trible William M. , Small Allen 
Published: September 2006

AbstractFour patients with Thorotrast granuloma are reported. The first patient had a radical neck dissection performed; however, postoperative hemorrhage and fistula occurred with a six‐month delay in healing. The granuloma in this patient had totally occluded his carotid system with a greatly enlarged vertebral artery. A second patient presented with spontaneous bleeding in the neck from a granuloma followed by encephalo‐malacia, hemiparesis and aphasia. The third and fourth patients presented as hoarseness with a hard mass in the neck. All four patients had Thorotrast in the liver and spleen. The latter three had laryngoscopies and in‐cisional neck biopsies as their only surgical treatment. Neck malignancy from Thorotrast is very rare. Despite legal decisions suggesting removal3 and similar suggestions in the literature, the authors feel only small extravasations have had uncomplicated operations. Neck dissection is rarely indicated. Hoarseness can be improved by vocal cord injection. These patients, of course, must be followed periodically as any other tumor, checking the neck mass, liver, and carotid circulation.
An unusual application of a cros hearing aid
Authors: Carver William F. 
Published: September 2006

AbstractThis paper describes the use of the CROS hearing aid principle on cases of congenital atresia. This young girl has had several operations which attempted to create a canal and tympanum, but the canal persisted in closing. A bone vibrator eyeglass hearing aid was fitted but was largely unsuccessful. Having a 50 db air‐conduction loss was handicapping to this youngster, but the usual head hearing aid could not be fitted because of the lack of any canal, causing feedback. She refused a body type aid. The solution is this case was a CROS behind‐the‐ear hearing aid. She enjoys about a 25 db useful gain from this fitting.
Quinsy tonsillectomy
Authors: Yung Lcdr Allan K. , Cantrell Robert W. 
Published: September 2006

AbstractThe usual treatment for peritonsillar abscess in the United States is incision, drainage and antibiotic therapy followed by tonsillectomy several weeks later. Why this treatment began is not clear but it probably originated from fear of complications which might arise from operating during the acute stage.This therapy requires two hospitalizations and tonsillectomy after previous abscess can be difficult. Tonsillitis or peritonsillar abscess can recur any time after the initial abscess is treated. A series of 50 cases of peritonsillar abscesses treated by immediate tonsillectomy is presented and evaluated. The results show this operation has a low morbidity and no significantly greater complication rate than elective tonsillectomy.
Frontal sinus disease. IV. Cellular response to experimentally‐induced infection
Authors: Schenck Nicholas L. , Rauchbach Erol 
Published: September 2006

AbstractThe pathogenesis of chronic frontal sinusitis is poorly understood. The canine frontal sinus model was developed to isolate experimentally the variables involved. We have recently determined that blockage of the naso‐frontal duct does not, by itself, produce sinusitis or mucocele experimentally. The purpose of the present investigation is to examine the histo‐logical and ultrastructural responses of the sinus mucosa to artificially‐induced infection.Bone wax was implanted in the canine frontal sinus via an osteoplastic flap, and subsequently removed three months later. Radiological, histo‐logical and ultrastructural analysis of the resultant infected mucosa was performed at periods up to one year.The sinus mucosa did not return to normal up to nine months following removal of the infection‐inciting foreign body. Persistent changes included epithelial and submucosal thickening, polypoid degeneration, matting of the ciliary carpet, and “bursting” of the ciliary cell bodies.In the light of this and previous experiments, an insidious cycle of events leading to irreversible frontal sinus disease is postulated, requiring the interplay of at least three variables: the infectious insults, the response of the sinus mucosa, and the variable patency of the nasofrontal duct.
Renal Outcome of Neonatal Renal Venous Thrombosis: Review of 28 Patients and Effectiveness of Fibrinolytics and Heparin in 10 Patients
Authors: Messinger Yoav , Sheaffer Jan Watterson , Mrozek Jeanne , Smith Clark M. , Sinaiko Alan R. 
Published: September 2006

OBJECTIVES. Neonatal renal venous thrombosis is a rare disorder that can result in severe renal damage. To evaluate the experience over 10 years and review the effectiveness of fibrinolytic and/or heparin therapy, chart reviews were performed for newborns with renal venous thrombosis.
PATIENTS, INTERVENTIONS, AND OUTCOME MEASURES. Twenty-eight newborns with renal venous thrombosis were treated at Children's Hospitals and Clinics of Minnesota and Fairview University Medical Center from 1991 to 2001.
RESULTS. Unilateral involvement was noted in 25 neonates (89%) and bilateral involvement in 3 (11%). Unilateral renal venous thrombosis affected mostly term infants, whereas 2 of 3 infants with bilateral renal venous thrombosis were &lt;32 weeks' gestational age (birth weight: 745–1505 g). One mother had antiphospholipid syndrome. Of 11 neonates evaluated for congenital thrombophilia, 1 had the factor V Leiden mutation. Ten neonates received either unfractionated or low molecular weight heparin for 3 days to 7 months. Three infants with unilateral renal venous thrombosis treated with heparin alone did not seem to benefit from such therapy. Seven neonates were treated with fibrinolytics and unfractionated heparin (4 neonates with unilateral renal venous thrombosis and 3 with bilateral renal venous thrombosis). Treatment with fibrinolytics did not result in restoration of renal function in the 4 neonates with unilateral renal venous thrombosis but was associated with return of almost normal function in the 2 neonates with bilateral renal venous thrombosis who received fibrinolytics immediately after renal venous thrombosis diagnosis. Two neonates treated with fibrinolytics suffered bleeding complications at the area of adrenal hemorrhage. Two neonates (not treated for renal venous thrombosis) died as a result of underlying disease.
CONCLUSIONS. Most neonatal renal venous thrombosis is unilateral and does not respond to fibrinolytic therapy and heparin. The use of fibrinolytics may prevent chronic renal failure in neonates with bilateral renal venous thrombosis if begun within 24 hours of diagnosis. Fibrinolytic therapy, however, is associated with a risk of bleeding, specifically if there is an associated adrenal hemorrhage.
Management and Outcomes of Double Aortic Arch in 81 Patients
Authors: Alsenaidi Khalfan , Gurofsky Rebecca , Karamlou Tara , Williams William G. , McCrindle Brian W. 
Published: September 2006

OBJECTIVES. Double aortic arch is a common form of complete vascular ring, encircling both the trachea and esophagus, resulting in noncardiac morbidity. We sought to describe management and outcomes in a large single institution clinical series.PATIENTS AND METHODS. We reviewed the medical charts of all of the patients diagnosed with double aortic arch at age &lt;18 years. Data regarding clinical presentation, anatomy, management, and outcomes were abstracted.RESULTS. We identified 81 patients (67% males) born between 1964 and 2005 and presenting at a median age of 5 months (range: birth to 10.3 years). Respiratory symptoms were present in 91%, including stridor in 77%. Gastrointestinal symptoms were present in 40%, with choking with feeds being most common. The dominant branch of the double aortic arch was right in 72%. Associated cardiac anomalies were present in 18%, with noncardiac anomalies in 7%. Repair was performed in 79 patients at a median age of 6 months. There were 2 deaths after surgical repair with no late deaths, with Kaplan-Meier survival estimates of 96% at 5 years. Postoperative complications included chylothorax in 9%. Only 1 patient required reoperation. The most common symptoms at most recent follow-up were respiratory (54%) followed by gastrointestinal symptoms (6%). Postoperative tracheal stenosis was documented in 14%, with tracheomalacia in 7%. There were no late reoperations and no evidence of aortic arch obstruction.CONCLUSIONS. Outcomes are excellent after repair of double aortic arch, although persistent respiratory symptoms are frequent and probably associated with previous compression-related maldevelopment of the trachea and major airways.
The Effect of Pioglitazone on the Liver
Authors: Gastaldelli Amalia , Miyazaki Yoshinori , Mahankali Archana , Berria Rachele , Pettiti Maura , Buzzigoli Emma , Ferrannini Eleuterio , DeFronzo Ralph A. 
Published: September 2006

OBJECTIVE—Diabetic hyperglycemia results from insulin resistance of peripheral tissues and glucose overproduction due to increased gluconeogenesis (GNG). Thiazolidinediones (TZDs) improve peripheral insulin sensitivity, but the effect on the liver is less clear. The goal of this study was to examine the effect of TZDs on GNG.RESEARCH DESIGN AND METHODS—Twenty sulfonylurea-treated type 2 diabetic subjects were randomly assigned (double-blind study) to receive pioglitazone (PIO group; 45 mg/day) or placebo (Plc group) for 4 months to assess endogenous glucose production (EGP) (3-3H-glucose infusion), GNG (D2O technique), and insulin sensitivity by two-step hyperinsulinemic-euglycemic clamp (240 and 960 pmol/min per m2).RESULTS—Fasting plasma glucose (FPG) (10.0 ± 0.8 to 7.7 ± 0.7 mmol/l) and HbA1c (9.0 ± 0.4 to 7.3 ± 0.6%) decreased in the PIO and increased in Plc group (P &lt; 0.05 PIO vs. Plc). Insulin sensitivity increased ∼40% during high insulin clamp after pioglitazone (P &lt; 0.01) and remained unchanged in the Plc group (P &lt; 0.05 PIO vs. Plc). EGP did not change, while GNG decreased in the PIO group (9.6 ± 0.7 to 8.7 ± 0.6 μmol · min−1 · kgffm−1) and increased in the Plc group (8.0 ± 0.5 to 9.6 ± 0.8) (P &lt; 0.05 PIO vs. Plc). Change in FPG correlated with change in GNG flux (r = 0.63, P &lt; 0.003) and in insulin sensitivity (r = 0.59, P &lt; 0.01). Plasma adiponectin increased after pioglitazone (P &lt; 0.001) and correlated with ΔFPG (r = −0.54, P &lt; 0.03), ΔGNG flux (r = −0.47, P &lt; 0.05), and Δinsulin sensitivity (r = 0.65, P &lt; 0.005). Plasma free fatty acids decreased after pioglitazone and correlated with ΔGNG flux (r = 0.54, P &lt; 0.02). From stepwise regression analysis, the strongest determinant of change in FPG was change in GNG flux.CONCLUSIONS—Pioglitazone improves FPG, primarily by reducing GNG flux in type 2 diabetic subjects.
The Sensitivity and Specificity of Nonmydriatic Digital Stereoscopic Retinal Imaging in Detecting Diabetic Retinopathy
Authors: Ahmed Jehanara , Ward Thomas P. , Bursell Sven-Eric , Aiello Lloyd M. , Cavallerano Jerry D. , Vigersky Robert A. 
Published: September 2006

OBJECTIVE—The objective of this study was to determine the sensitivity and specificity of Joslin Vision Network nonmydriatic digital stereoscopic retinal imaging (NMDSRI) as a screening tool in detecting diabetic retinopathy.
RESEARCH DESIGN AND METHODS—We reviewed the records of 244 patients with diabetes who had a dilated funduscopic examination (DFE) and NMDSRI done within 1 year of each other at four locations in the metropolitan Washington, DC, area. The images were transmitted through a local area network to a central reading location where they were graded by a single retinal specialist.
RESULTS—Images of 482 eyes from 243 patients were included in the study. Four images did not transmit, and 35% of the images were not gradable. Of the remaining 311 eyes, there was 86% agreement in the grading between NMDSRI and DFE: 227 eyes with no diabetic retinopathy and 40 eyes with diabetic retinopathy. In 46 eyes (15%) there was a disagreement between gradings made by the two techniques. NMDSRI detected diabetic retinopathy in 35 eyes reported as normal by DFE, and in the remaining 11 eyes, the DFE grade was one grade higher than the NMDSRI grade. Adjudicated nonconcordant examinations were within one grade. In the 76 eyes with diabetic retinopathy, retinal thickness could not be assessed in 17 (21%) eyes. When the NMDSRI result was gradable, the overall sensitivity of NMDSRI was 98% and the specificity was 100% for retinopathy within one grade of the DFE. In the limited number of eyes that had diabetic retinopathy with macular edema (six), agreement with the clinical examination was 100%.
CONCLUSIONS—NMDSRI is a sensitive and specific method for the screening and diagnosis of diabetic retinopathy, which may help improve compliance with the standards of eye care for patients with diabetes.
Effect of Weight Loss and Nutritional Intervention on Arterial Stiffness in Type 2 Diabetes
Authors: Barinas-Mitchell Emma , Kuller Lewis H. , Sutton-Tyrrell Kim , Hegazi Refaat , Harper Patricia , Mancino Juliet , Kelley David E. 
Published: September 2006

OBJECTIVE—There is increased stiffness of the large central arteries in type 2 diabetic patients, and obesity is a risk factor. However, the effect of intentional weight loss on arterial stiffness is uncertain, and the purpose of the current study was to assess this effect.
RESEARCH DESIGN AND METHODS— Arterial stiffness was assessed by measuring aortic pulse wave velocity (aPWV) at baseline and at completion of a 1-year weight loss intervention. Metabolic control of type 2 diabetes was also appraised.
RESULTS— Mean weight loss at 1 year in 38 volunteers with type 2 diabetes was 7.8%. There were improvements in HbA1c, LDL cholesterol, homeostasis model assessment of insulin resistance, and inflammatory markers (plasminogen activator inhibitor-1, tumor necrosis factor-α, interleukin-6, and C-reactive protein). There was also a significant improvement in aPWV at completion of weight loss intervention, from 740 to 690 cm/s (P &lt; 0.05).
CONCLUSIONS— Moderate weight loss improves arterial stiffness in type 2 diabetes.
Comparison of betaine and l-stachydrine as phase-transfer catalysts in Michael addition and Darzens reaction
Authors: Veverková E. , Droppová R. , Toma Š. 
Published: September 2006

AbstractBetaine and l-stachydrine have been tested as phase-transfer catalysts in Michael and Darzens reactions. The catalytic effect of l-stachydrine was found comparable to that of betaine in Michael addition and even higher when considering Darzens reaction. The desired products have been obtained in higher yields in solid-liquid system than under liquid-liquid bi-phase conditions. The influence of microwave irradiation and ultrasound on the reaction rate has been studied.
Synthesis and cyclization reactions with pyrazolopyrimidinyl keto esters part I. Reactivity of pyrazolopyrimidinyl β-keto ester and pyrazolopyrimidinyl α,β-unsaturated ketones
Authors: Awas M. 
Published: September 2006

Abstract5-Acetyl-4,5-dihydro-1-phenylpyrazolo[3,4-d]pyrimidin-4-one was prepared and subjected to various chemical transformations to give novel 5-heterocyclic pyrazolopyrimidinone derivatives of expected important biological activity. Then, the latter compounds were used to obtain β-keto ester and α,β-unsaturated carbonylpyrazolopyrimidinones which were used as alternate precursors to produce new pyrazolopyrimidinones substituted with five-membered heterocycles such as pyrazole and isoxazole. The structure of these compounds was identified on the basis of their chemical behaviour as well as elemental and spectral analysis.