bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing and Documenting General Competencies in Otolaryngology Resident Training Programs
Authors: Roark Rick M. , Schaefer Steven D. , Yu Guo‐Pei , Branovan Daniel I. , Peterson Stephen J. , Lee Wei‐Nchih 
Published: April 2006

AbstractObjectives: The objectives of this study were to: 1) implement web‐based instruments for assessing and documenting the general competencies of otolaryngology resident education, as outlined by the Accreditation Council of Graduate Medical Education (ACGME); and 2) examine the benefit and validity of this online system for measuring educational outcomes and for identifying insufficiencies in the training program as they occur.Methods: We developed an online assessment system for a surgical postgraduate education program and examined its feasibility, usability, and validity. Evaluations of behaviors, skills, and attitudes of 26 residents were completed online by faculty, peers, and nonphysician professionals during a 3‐year period. Analyses included calculation and evaluation of total average performance scores of each resident by different evaluators. Evaluations were also compared with American Board of Otolaryngology‐administered in‐service examination (ISE) scores for each resident. Convergent validity was examined statistically by comparing ratings among the different evaluator types.Results: Questionnaires and software were found to be simple to use and efficient in collecting essential information. From July 2002 to June 2005, 1,336 evaluation forms were available for analysis. The average score assigned by faculty was 4.31, significantly lower than that by nonphysician professionals (4.66) and residents evaluating peers (4.63) (P < .001), whereas scores were similar between nonphysician professionals and resident peers. Average scores between faculty and nonphysician groups showed correlation in constructs of communication and relationship with patients, but not in those of professionalism and documentation. Correlation was observed in respect for patients but not in medical knowledge between faculty and resident peer groups. Resident ISE scores improved in the third year of the study and demonstrated high correlation with faculty perceptions of medical knowledge (r = 0.65, P = .007).Conclusions: Compliance for completion of forms was 97%. The system facilitated the educational management of our training program along multiple dimensions. The small perceptual differences among a highly selected group of residents have made the unambiguous validation of the system challenging. The instruments and approach warrant further study. Improvements are likely best achieved in broad consultation among other otolaryngology programs.
Endoscopic Sentinel Lymph Node Biopsy in a Porcine Model
Authors: Pitman Karen T. , Sisk Jamie D. 
Published: April 2006

AbstractObjective: The objective of this study was to investigate the feasibility of endoscopic sentinel lymph node biopsy in a porcine model.Methods: One hundred microcuries of technetium‐labeled sulfa colloid (Tc‐SC) was injected into the right and left ventrolateral surfaces of the oral tongue of six adult Yorkshire pigs. A handheld gamma probe was used to locate the region of focal radioactivity on the neck that corresponded to the sentinel lymph node (SLN). Next, 0.25 mL of isosulfan blue dye was injected into the Tc‐SC injection sites on the tongue. Endoscopic SLN dissection was then performed using a combination of balloon dissection and CO2 insufflation. The operative time, blood loss, and radioactivity of the SLN were measured for each animal.Results: The SLN was detected transcutaneously with the gamma probe, and endoscopic SLN excision was successful. Endoscopic visualization and an endoscopic gamma probe confirmed the presence of both isosulfan blue dye and radiopositivity in the SLN in each pig. The procedure lasted 22 to 61 minutes (median duration, 35 minutes). There was no measurable blood loss in any of the animals. Mean radioactivity measured 14,466 counts/second per lymph node.Conclusions: Endoscopic SLN biopsy for oral tongue lesions is feasible and warrants further study.
FDG‐PET in the Clinically Negative Neck in Oral Squamous Cell Carcinoma
Authors: Wensing Bart M. , Vogel Wouter V. , Marres Henri A. M. , Merkx Matthias A. W. , Postema Ernst J. , Oyen Wim J. G. , van den Hoogen Frank J. A. 
Published: April 2006

AbstractObjective: With improved diagnostic imaging techniques, it remains difficult to reduce occult metastatic disease in oral squamous cell carcinoma (SCC) to less than 20%. Therefore, supraomohyoid neck dissection (SOHND) still is a valuable staging procedure in these patients.Methods: Patients with clinically and ultrasonographically staged cN0 SCC of the oral cavity underwent FDG‐PET before SOHND. Histologic examination of neck dissection specimens was used as a “gold standard.”Results: Twenty‐eight consecutive patients were included, representing 30 necks. Occult metastatic disease was found in 30% of SOHND specimens. Average diameter of metastatic deposits was 4.3 mm. Sensitivity, specificity, and accuracy of FDG‐PET was 33%, 76%, and 63%, respectively.Conclusions: In patients with cN0 SCC of the oral cavity, FDG‐PET does not contribute to the preoperative workup. FDG‐PET does not replace SOHND as a staging procedure.
Opposing effects of arsenic trioxide on hepatocellular carcinomas in mice
Authors: Liu Bing , Pan Shangha , Dong Xuesong , Qiao Haiquan , Jiang Hongchi , Krissansen Geoffrey W. , Sun Xueying 
Published: April 2006

Arsenic trioxide (As2O3) is a potent antitumor agent used to treat acute promyelocytic leukemia (APL) and, more recently, solid tumors. However, the dose of As2O3 required to suppress human xenographs in mice is markedly higher than that used to treat APL in humans. Paradoxically, low doses of As2O3 stimulate angiogenesis, which might be expected to promote tumor growth. Clearly, appropriate dosages of As2O3 are required to treat human patients to avoid toxicity and undesirable side effects. In the present study, we investigated As2O3 with respect to its toxicity and effects on tumor growth, angiogenesis and cell apoptosis using H22 hepatocellular carcinoma (HCC) cells in a mouse model of HCC. As2O3 inhibited tumor growth and angiogenesis, and enhanced tumor cell apoptosis at doses greater than 1 mg/kg, but mice lost weight and failed to thrive at doses of 4 mg/kg and greater. In contrast, low doses (<1 mg/kg) of As2O3 promoted tumor growth, upregulated the expression of vascular endothelial growth factor and tumor angiogenesis, and had no effect on tumor cell apoptosis. In vitro studies demonstrated that As2O3 inhibited the proliferation of H22 tumor cells and bovine aortic endothelial cells, and induced their apoptosis in a dose‐ and time‐dependent fashion, suggesting that the mechanism of As2O3‐mediated inhibition of tumor growth is due to direct effects of the drug on both tumor cells and endothelia. In summary, different doses of As2O3 have opposing effects on tumor growth and angiogenesis. The results demonstrate that As2O3 has a narrow window of therapeutic opportunity with respect to dosage, and that low doses of the drug as used in metronomic therapy should be used with extreme caution. (Cancer Sci 2006; 97: 675–681)
Comparison of school nurse and auxologist height velocity measurements in school children with short stature. (The Hackney Growth Initiative)
Authors: MAJROWSKI W. H. , HEARN S. , ROHAN C. , JENKINS S. , COTTERILL A. M. , SAVAGE M. O. 
Published: April 2006

SummarryTo examine the possible use of height velocity (HV) as a growth screening tool, annual HV data calculated from height measurements made by school nurses were compared with those based on an auxologist's measurements in 20 short school children. The subjects were 12 primary school children (seven girls, five boys) with a mean (± SD) age of 5·9(0·6) years and eight secondary school children (six girls, two boys) with a mean (± SD) age of 11·8 (0·4) years. Heights were measured by the school nurses, separated by an interval of 1 year. Mean HV of the primary school children when assessed by school nurses was 5·92 cm/year compared with 5·97 cm/year when assessed by the auxologist. Mean (± SD) HV standard deviation score (HVSDS) was 0·03 (0·97) and 0·10 (1·15) respectively. Mean HV of the secondary school children when assessed by school nurses was 6·04 cm/year compared with 5·63 cm/year when assessed by the auxologist. Mean (± SD) HVSDS was −0·8 (2·1) and −1·21 (1·54) respectively. Of eight children (three primary, five secondary) identified by the auxologist as having HV < 25th centile of Tanner and Whitehouse standards only four were identified by school nurses (one primary, three secondary). One child identified by school nurses to have HV < 25th centile was found by the auxologist to be above the 25th centile. We conclude that HV assessment may fail to identify significant pathology in the community and that accurate height measurement rather than HV should be the principal referral criterion.
Allergy in the newborn: skin test reactions confirmed by the Prausnitz‐Küstner test at birth
Authors: KAUFMAN HERBERT S. 
Published: April 2006

SummaryReaginic activity in cord blood with concomitant positive skin tests (confirmed by P‐K testing) is reported for the first time (in a 3‐hr‐oId infant). This case illustrates that the atopic state may be present in the neonate.
The effect of viability or non‐viability of grass pollens on the biological activity of extracts prepared from them
Authors: MILNER F. H. , DYBAS B. , FRASER C. A. 
Published: April 2006

SummaryFreshly dehisced pollens from four common grasses were each divided into two portions. One portion of each was placed in an extracting fluid within 2 hr of being shed (viable pollen) and the other portion was kept at room temperature in a desiccator for 2 weeks (non‐viable pollen) before extraction. The relative skin test activity of each pair of extracts was determined on grass pollen sensitive patients.No significant difference was detected between the extracts of the viable and non‐viable pollens in any of the four species examined.
Effects of injections of allergen extracts on antigenic release of histamine from leucocytes, skin tests and bronchial challenge in allergic children
Authors: SCHUMACHER MICHAEL J. , MAY CHARLES D. 
Published: April 2006

SummaryLeucocyte sensitivity to antigenic release of histamine was determined in allergic children receiving injections of allergen extracts in order to ascertain the frequency of development of complete loss of sensitivity (unresponsiveness). Leucocyte unresponsiveness did not occur in any of eight allergic children given large doses of allergen extracts by an intensive regimen of injections. In only two of twenty‐three children who had received injections of allergen extracts by a customary dosage regimen, were the leucocytes found to be unresponsive to antigenic histamine release. These findings confirm our earlier reports.The incidence of complete loss of leucocyte sensitivity during injection therapy in our studies is lower than reported by others. This is attributed to our employment of a more nearly optimal in vitro system for measurement of antigenic histamine release from leucocytes, thus avoiding the false impression of leucocyte unresponsiveness which can result from use of a less sensitive procedure.Other findings in the present investigation were: (I) concordant fluctuations in leucocyte sensitivity to two unrelated allergens during injections of one of the allergens, indicating non‐specific changes in sensitivity; (2) skin sensitivity and bronchial reactivity were not reduced even with marked decrease in peripheral leucocyte sensitivity; (3) significant decrease in titre of serum complement, as occurs in presence of antigen‐antibody complex reactions.
Hypersensitivity studies in asthmatic patients with broncho‐pulmonary aspergillosis
Authors: TURNER K.J. , OMAHONY JANICE , WETHERALL J. D. , ELDER JANET 
Published: April 2006

SummaryThe serum IgE levels of four patients with allergic bronchopulmonary aspergillosis ranged from 201 to 16,800 I.U./ml. The corresponding mean level for control subjects was 205±68 I.U./ml. A considerable proportion of the patients' serum IgE was found to be specific reagin directed against extracts of Aspergillus fumigatus. Notwithstanding the high levels of reagin, the circulating basophils were relatively insensitive to histamine release with allergen or antiserum to I gE. The effects of steroid therapy may have contributed in part towards this lack of reactivity of the basophiis. Two of the patients showed in vitro evidence of Type IV in addition to in vitro Type I hypersensitivity but did not demonstrate the presence of precipitins to A. fumigatus in their serum, one of these previously having a positive precipitin test. Precipitins were present in the sera of the two other patients, both of whom demonstrated in vivo Type I hypersensitivity. One of these was tested in vitro for Type IV hypersensitivity but was adjudged negative. The sputum of one patient (L.P.) contained fungal mycelia which was conjugated with both IgA and IgE antibodies.
Studies on the stability of diluted allergen extracts using the radioallergosorbent test (RAST)
Authors: FOUCARD T. , BENNICH H. , JOHANSSON S. G. O. 
Published: April 2006

SummaryAllergen extracts from birch pollen, timothy pollen and horse dandruff were investigated. The influence of storage time, volume of extract in the vial and various additives on the potency of diluted extracts was tested with the radioallergosorbent test (RAST). The potency of diluted pollen extracts was found to decrease more rapidly than the potency of diluted dandruff extracts. The differences in allergen activity seen in RAST between freshly diluted extracts and stored extract dilutions were roughly reproducible in skin tests and histamine release tests from passively sensitized chopped human lung. The higher allergen stability of the dandruff extracts could, at least in part, be explained by the higher protein content of these extracts. An adsorption of allergen to the glass wall was shown to be the most probable cause to the more rapid decrease of allergen activity seen in pollen extracts stored in vials only partly filled. With addition of 0.2% Tween 20 after storage the potency of the extracts became almost equivalent to that of corresponding dilutions stored in filled vials.
A study of a population of house dust mite in its natural environment
Authors: HUGHES A. MARGARET , MAUNSELL KATE 
Published: April 2006

SummaryA study was made of the house dust mite, Dermatophagoides pteronyssinus, in its natural surroundings for a year. Records of the relative humidity inside and outside the bed and of the temperature outside the bed were kept. An estimate of the number of mites on the surface of the mattress was made by brushing the mattress dust into a container at monthly intervals and then counting the mites. Suction cleaning of the mattress was also carried out to ascertain whether it is possible to control the number of mites by such measures. It was found that suction cleaning and brushing of the mattress considerably reduced the numbers of live and dead mites. The number of live mites remained low during the winter, but increased during the late spring and summer when temperature and relative humidity became higher. It is suggested that, for effective control, cleaning of mattresses should be carried out more frequently in the spring and summer than in the winter.Records of the relative humidity inside and outside the bed confirmed the fact that when a bed is occupied the relative humidity falls, but attains equilibrium with the surrounding air again soon after the occupant has left the bed.
Follow‐up of a group of workers exposed to dusts containing derivatives of Bacillus subtilis
Authors: WATT A. , MORLEY R. , GREENBERG M. , FOX A. J. 
Published: April 2006

SummarySix rounds of investigations at 6‐monthly intervals of ventilatory capacity, skin sensitivity and respiratory symptoms were carried out together with serological studies on a group of workers intermittently exposed to Bacillus subtilis derivatives containing proteolytic enzyme while compounding washing powder. 369 sets of readings of ventilatory capacity were made on seventy‐seven males and 180 sets of readings on forty‐one females. Overall, with change of employment and improvement in industrial hygiene, ventilatory capacity measurements improved.Subjects who became prick test positive, as a group showed a decrease in the ratio of observed to expected FEV1 significantly greater than for the prick test negative group.There was no significant excess of symptoms developing in the prick test positive group during the course of the survey though smokers and those with previous dust exposure had a higher number of symptoms than non‐smokers and those not exposed to other dusts respectively.A serological study of nine subjects initially prick test positive to B. subtilis who subsequently varied their skin reactions, showed them to have low levels of IgE and predominantly normal ventilatory capacities.
Hyposensitization with Dermatophagoides pteronyssinus in house dust allergy: a controlled study of clinical and immunological effects
Authors: D'SOUZA M. F. , PEPYS J. , WELLS I. D. , TAI E. , PALMER F. , OVERELL B. G. , McGRATH I. T. , MEGSON M. 
Published: April 2006

SummaryA double‐blind statistically controlled study was carried out on ninety‐six patients with Type I allergy to D. pteronyssinus and a history of perennial asthma and/or rhinitis. Forty‐eight received injections of an extract of Dermatophagoides pteronyssinus and forty‐eight controls received injections of carbol saline. Both groups were closely comparable in all respects. Ninety‐one were available for assessment, forty‐six controls, and forty‐five treated.The D. pteronyssinus treated group showed a statistically significant decrease in nasal sensitivity to the mite extract after treatment and recorded less asthma, less use of drugs and an increased clinical tolerance of household dust.A significant rise in specific IgE to D. pteronyssinus was found in twenty‐three out of forty (58%) of the treated compared with eight out of forty‐one (20%) of the controls and a rise in total IgE in twenty out of forty (50%) of the treated compared with nine out of thirty‐nine (23%) of the control group.Specific IgG antibodies to D. pteronyssinus were found prior to treatment in twelve out of thirty‐nine (30%) of controls and twelve out of forty (31%) of the treated group. There was a significant increase in the number of patients with specific IgG antibody after injections of D. pteronyssinus extract as compared with the controls. This increase was associated with clinical improvement which occurred mainly in subjects who showed a decrease, little change or an increase of less than 30% in specific IgE antibody. In those with an increase of more than 30% in specific IgE antibody there was no evidence of clinical improvement even if specific IgG was produced.Diminished release of histamine from leucocytes was found after treatment in six out of ten treated compared with three out of eleven controls. There were, however, no differences between treatment and control groups in lymphocyte transformation and the liberation of leucocyte inhibitory agents.Clinical improvement was significantly better in those treated patients who gave strong nasal and skin reactions before treatment than in those with weak nasal and skin reactivity, who were no different from the controls.
Treatment of seasonal allergic rhinitis with 2% sodium cromoglycate (BP) solution
Authors: BLAIR HENRY , HERBERT RODNEY L. 
Published: April 2006

SummaryForty patients with seasonal allergic rhinitis, not responding to antihistamines, were treated for 6 weeks, beginning 1 June 1972, with either a 2% solution of sodium cromoglycate or placebo in a double blind group comparative trial. The solution was administered intranasally by means of a spray pack. There was a statistical significance in favour of the active material (P<0.025) with regard to the success or failure.
Relationship between rifampicin‐dependent antibody scores, serum rifampicin concentrations and symptoms in patients with adverse reactions to intermittent rifampicin treatment
Authors: O'MAHONY MARY GABRIEL , KAR CHEW WING 
Published: April 2006

SummaryTwelve patients receiving intermittent treatment with rifampicin for pulmonary tuberculosis, who had developed rifampicin‐dependent antibodies were studied. Ten of the twelve patients had also developed adverse reactions to the drug at the time the study was done. After a dose of the drug, blood samples were taken from each patient at regular intervals for the assessment of rifampicin‐dependent antibodies by a semi‐quantitative method, and for the measurement of serum rifampicin concentrations. Clinical details of any adverse reactions which occurred were also recorded at these set times. Serum rifampicin concentrations were at their highest from 1 to 12 hr after a dose, and during this same period the rifampicin‐dependent antibody score was reduced. Adverse reactions, when they occurred, coincided with the period of high serum rifampicin concentration and low antibody score. Whether or not these findings are of immunological significance is discussed.
The airways response to phenylephrine after blockade of alpha and beta receptors in extrinsic bronchial asthma
Authors: PATEL K. R. , KERR JAMES W. 
Published: April 2006

SummaryPhenylephrine, a powerful alpha receptor stimulant, has been shown to cause a significant fall in the FEV1 and SGaw in six patients with extrinsic bronchial asthma after prior beta blockade with propranolol. In contrast, propranolol or phenylephrine after prior beta blockade failed to effect a significant change in the FEV1 and SGaw in five normal subjects. The phenylephrine effect can be completely inhibited by alpha receptor blocking drugs, phenoxybenzamine and thymoxamine. These observations suggest that the bronchomotor tone in asthma is largely controlled by the sympathetic activity and that there are alpha receptors in the human airways which in the presence of beta blockade can be stimulated to give bronchoconstriction.
Genetics of atopic allergy and reagin production
Authors: LEVINE B. B. 
Published: April 2006

SummaryCertain allergic diseases appear to be associated in certain individuals and families. These are asthma (both allergic and intrinsic), allergic rhinitis, atopic eczema and possibly vasomotor rhinitis, urticaria and bonafide food allergy. Multiple factors, both genetic and environmental are involved in the generation of these diseases.Recent studies have demonstrated two distinct kinds of genetic controls of IgE antibody formation in inbred mice. One of these has also been shown to exist in man, and appears necessary but not sufficient for the generation of ragweed hay fever. This is the Ir‐antigen E gene(s) which permits the individual to recognize low concentrations of antigen E as antigens.Atopic diseases are based on many genetic and environmental factors. Some factors are unique for individual diseases, and some (one or a small number) are probably common to all. The latter are not clearly appreciated as yet, although mucosal permeability factors and B‐adrenergic blockade factors have been suggested.Understanding of the genetic controls of atopy will require studies on the many individual factors involved in atopy, their function, their genetic transmission and their interplay in the causation of atopic diseases.
A double blind controlled trial of house mite fortified house dust vaccine in childhood asthma
Authors: TAYLOR BRENT , SANDERS STUART S. , NORMAN A. P. 
Published: April 2006

SummaryA double blind controlled trial of a house mile fortified house dust vaccine was carried out in forty‐two asthmatic patients between the ages of 6 and 15 years. Improvement in height and weight was shown in eight of twenty‐one children receiving the active therapy compared with one of twenty‐one children receiving placebo injections. No difference between the two groups was shown by respiratory function testing or chest examination.