bluuebunny/crossref_metadata_2025_split huggingface dataset:
Problems with Reclassification of Insulin-Like Growth Factor I Production and Action Disorders
Authors: Cohen Pinchas 
Published: September 2006

Abstract
Context: Recent developments in the IGF field have raised questions on whether this is the right time to redefine IGF deficiency.
Objective: In this controversy, arguments are made against the need for redefining IGF deficiency at this moment, suggesting instead to wait for further clinical developments.
Case: Although a number of rare case reports of IGF deficiency with precise molecular etiologies have been described, the vast majority of the cases remain clinically defined and without a genetic diagnosis.
Interventions: Because IGF products are now available for clinical use in IGF-deficient patients, we are still using GH stimulation and static IGF levels as our only clinical diagnostic and classification tools.
Positions: We need to develop additional clinical tools, side by side with molecular tools, for the diagnosis and subclassification of IGF deficiency. Chief among these are the IGF-generation test for identification of GH-insensitive patients and genetic panels of polymorphic changes in relevant genes.
Conclusions: Until further progress is made in the clinical classification of IGF deficiency, we should not change the current classification, and, when we do, it should be the responsibility of the relevant societies in the field to conduct a consensus statement on the topic first.
Combined modalities in the prevention of venous thromboembolism: A review of the literature
Authors: Kakkos S K , Caprini J A , Nicolaides A N , Reddy D 
Published: September 2006

Objective Despite recent advances in the field of venous thromboembolism (VTE) prophylaxis and adherence to guideline recommendations, VTE remains a serious problem, especially in high-risk groups. The aim of the present review was to summarize the evidence supporting the use of combined modalities, both physical and pharmacological, in VTE prevention. Methods Using Medline, original studies on the value of combined modalities in VTE prevention were identified. Keywords used for physical methods included elastic stockings and intermittent pneumatic compression, and for pharmacological methods included unfractionated and low molecular weight heparin. Relevant articles from their bibliography were also retrieved. Results Combined pharmacological and physical modalities were more effective than each modality alone in a variety of specialties, including orthopaedic, general and cardiac surgery, as shown by 14 of the 18 randomized or case-control studies retrieved. Mean reduction in VTE incidence was 69% (range 16–100%). Conclusion Combined modalities are more effective than single modalities in VTE prophylaxis. These results endorse their use, especially in high-risk patients, and support this otherwise typical recommendation of the consensus documents on VTE prophylaxis.
Cost-effectiveness of prevention of venous thromboembolism
Authors: Sharp B , Davies A H 
Published: September 2006

Venous thromboembolism (VTE) is a potentially fatal vascular disease that affects more than 170,000 patients in the USA every year. All hospitalized patients are at an increased risk of developing VTE and subsequent pulmonary embolus. There is growing literature concentrating on the cost-effectiveness of preventing VTE occurring. So far recommendations have been conflicting and research has not explored the use of VTE prophylaxis in low-risk patient groups. Comparisons between low-molecular-weight heparins (LMWH) and unfractionated heparins have revealed that LMWHs are superior not only in action but also in cost-effectiveness. In elective surgery, patients who require long-term anticoagulation bridging therapy with LMWH at home have shown comparable safety and efficacy and the method is far less costly than inpatient bridging therapy with unfractionated heparin.
Inhibition as an important part of sensory perception.
Authors: Von Békésy Georg 
Published: September 2006

AbstractINTRODUCTION.Natural science made a big step forward when it was assumed that every phenomenon has a cause. The causality principle completely modified our daily thinking and started to interconnect different phenomena occurring in nature. To find the cause of every happening in nature was the aim of logical thinking. It was quite obvious from the beginning that every phenomenon probably had several causes; but it was further assumed that it was generally one cause which outdid all the others in producing the phenomenon.
Present concepts in cancer and immunologic responses.
Authors: Arena Sebastian 
Published: September 2006

AbstractMany of us in clinical medicine, who deal with cancer, often become frustrated with the way malignancies behave in different individuals, and even the change of behavior of a specific malignancy in the same host. This reflects a lack of knowledge on our part of the basic abnormality in cancer. Herein are reviewed some of the present concepts which investigators are exploring, in order to unravel the mystery, or mysteries of cancer.
Audio‐visual aids in the teaching of otolaryngology.
Authors: Alberti Peter W. R. M. 
Published: September 2006

AbstractNew methods of teaching are in vogue. The vigorous growth of medical faculties in North America and Europe has left in its wake thousands of hours of new teaching time, brilliant concepts which can be translated into classroom and bedside instruction only by hard work. It has given rise to a search for new methods of presentation of facts and ideas.
Carcinoma of the supraglottis and tongue treated by supraglottic laryngectomy and mandibular swing.
Authors: Shumrick Donald A. 
Published: September 2006

AbstractINTRODUCTION. In 1968, in the United States alone, 860 people died each day of cancer. This amounts to over 300,000 deaths a year. In 1969, it is estimated that over 915,000 persons will suffer from cancer and 600,000 new cases will be diagnosed.1 Except for cancer of the lung, pancreas and leukemia, cancer rates in general are leveling. Recent declines in the incidence of cancer of the stomach and uterus are apparently being partially replaced by increases in malignancies of the lip, tongue, floor of mouth, pharynx and larynx. The significance of cancers in these areas becomes apparent when one recalls that over 14,000 people will die of these lesions this year. Not only is there a steady increase in the overall number of cancers of the oral cavity and pharynx, but in the last 10 years, the incidence in females has increased by 8 percent and this alarming rise appears to be continuing. We, then, must increase not only our vigilance but also our armentarium to treat these devastating malignancies. The basic premise should be twofold: to cure the patient of his malignancy and to preserve as much physiologic function as possible but in so doing, not compromise the first premise.
Vertex response: Influence of lesions in the auditory system
Authors: Townsend Gary L. , Cody D. Thane R. 
Published: September 2006

AbstractThe principal value of specialized audiologic techniques lies in early diagnosis of retrocochlear lesions, which in turn minimizes technical difficulties in the surgical removal of acoustic neuromas; however, despite a wide battery of audiometric tests, the otolaryngologist too often has difficulty in distinguishing between cochlear and retrocochlear lesions. Johnson1 observed deviations in one or more respects from the classic audiometric findings in almost half of the cases of acoustic neuroma that he studied. Other audiologists2 have encountered similar problems.
Post diphtheria polyneuritis: Three case reports
Authors: Dietze William E. , Sudderth Jerry F. 
Published: September 2006

AbstractThe purpose of this paper is to present three patients; two with proven diphtheria and one with suspected diphtheria, who developed neuritis following their infections. The pathogenesis and the pathophysiology of post diphtheritic polyneuritis is discussed. The necessity for differentiating this condition from post infectious neuritis of other etiologies is stressed since early treatment with antitoxin will affect the course of the disease.
The effects of hypothyroidism on the ears of cats and squirrel monkeys: A pilot study
Authors: Withers Ben T. , Reuter S. Harold , Janeke Johan B. 
Published: September 2006

AbstractEleven animals (five cats and six squirrel monkeys) were studied before and after being rendered hypothyroid by, surgical excision or radioactive ablation of the thyroid gland. Blood chemistry studies, before ablation and after, proved the presence of hypothyroid state. Audiometric studies by the behaviorally trained avoidance technique and electronystagmograms indicated hypoactivity regarding hearing and labyrinthine function. In one cat given thyroid hormone to full compensation level, the high frequency hearing loss returned to normal.Studies of temporal bone specimens of the five cats: hypothyroid, thyroid compensated, and control, microscopically showed no morphological alterations. Presumably functional changes were due to biochemical involvement which failed to show as a morphological one.
Maxillary sinus malignancy
Authors: Schechter Gary L. , Ogura Joseph H. 
Published: September 2006

AbstractThis report deals with the survival and failures of 50 patients with malignancies of the maxillary sinus. The clinical, surgical, pathology, and survival characteristics of this series are tabulated, using the TNM classification system. Forty‐one patients in the group had epidermoid cancers. The overall four‐year survival of the patients in this series is 34 percent. The following is a breakdown of survival according to the TNM classification.1. T‐1 (eight patients) 85.7 percent2. T‐2 (five patients) 100.0 percent3. T‐3 (six patients) 50.0 percent4. T‐4, including those with nodes and distant metastases (31 patients) 4.0 percentLocal recurrence was the major cause of treatment failure in this series. An analysis of the local recurrence failures, correlating the surgical pathology with the clinical classification, demonstrates that the advanced lesions (T‐3 and T‐4) and poorly differentiated tumors have the greatest chance of local recurrence. It is recommended that the latter group of cases receives an aggressive course of postoperative radiotherapy based on detailed pathology evaluation of the resected specimen. The liberal use of drainage procedures, radiotherapy, and cryotherapy for palliation is suggested.
The presence of melanocytes in the human larynx
Authors: Goldman Joseph L. , Lawson William , Zak Frederick G. , Roffman Jeffrey D. 
Published: September 2006

AbstractDuring the study of serially sectioned cancerous and irradiated larynges, a unique case of extensive melanosis of the laryngeal mucosa was encountered. While pigmented neoplasms in the larynx had been reported repeatedly, to our knowledge the presence of melanocytes had not been demonstrated at that site; consequently, we initiated a study to ascertain whether melanocytes were present in the human larynx as an explanation for the histogenesis of these neoplasms.We adopted the technique of Epstein for stripping the laryngeal mucosa, and of Nigogosyan and coworkers for embedding and sectioning the ribbons of tissue. In an ongoing study, using non‐selected adult larynges removed at autopsy, scattered foci of melanocytes were found in an appreciable number of Caucasian and Negro specimens. With the Masson‐Fontana silver procedure for melanin, they appear as dendritic cells containing black granular pigment, situated in the basal layer of the squamous epithelium and subjacent connective tissue.While the origin of melanomas from pigment containing cells in the skin, eye and leptomeninges is well established, the histogenesis of those tumors arising in non‐integumentary and extra‐ocular sites remains obscure, because with few exceptions melanocytes have not been demonstrated in these organs.Melanocytes have been observed in the esophagus, oral cavity, vagina, and now larynx. Theories attempting to explain their presence at nonectodermal sites include the migration of melanoblasts with mesoderm to visceral sites, the transformation of neural crest elements into melanocytes and nevus cells, as well as the metaplasia of both squamous and glandular epithelium into pigment producing cells.
Nasal and paranasal sinus polyps ‐ A suspected new etiological co‐factor
Authors: Neely John G. , Doggett Robert G. , Harrison G. M. 
Published: September 2006

AbstractSeventeen adult patients with nasal or paranasal sinus polyposis were studied in an attempt to determine whether there was any relationship between them and children with cystic fibrosis.The oyster gill cilia inhibition test, commonly used to detect the “C.F. factor” in the serum of cystic fibrosis patients (homozygous) and their parents (heterozygous), was applied to these 17 patients.Fourteen of the 17 patients had the “C.F. factor” in their serum. There would appear to be some relationship between cystic fibrosis and adult nasal and paranasal sinus polyposis; however, it is too early to draw any strong conclusions to this affect.
Basal cell carcinoma: Treatment by the mohs technique
Authors: Robins Perry , Amonette Rex 
Published: September 2006

AbstractA basal cell epithelioma presents a therapeutic problem when it recurs or when it is located in difficult to treat head and neck regions. Mohs' chemosurgery is a useful and highly effective technique for dealing with these cases. This is a staged procedure which utilizes application of a chemical fixative agent, scalpel excision, and microscopic study of the tissue. In addition to accuracy, the Mohs technique offers the advantage of conservation of valuable tissues. The chemosurgical technique is described and illustrated in detail with presentation of three typical cases.
Chondrosarcomas of the facial region
Authors: Gallagher T. M. , Strome Marshall 
Published: September 2006

AbstractLess than 100 chondrosarcomas originating in the facial skeleton have been reported. Information regarding chondrosarcomas in the facial region is fragmentary. The largest series collected transcend a long period of time containing changes in surgical technique and philosophy. Precedence for therapy and prognostic information is not readily available. Three patients with facial chondrosarcomas are reported. All were diagnosed within a four‐year time span. The aforementioned adequately depict the protean manifestations of this tumor and the aggressive therapy required. Correlation is made with the existing body of information regarding this entity.
Meniere's disease and otosclerosis (without oval window involvement)
Authors: Cole James M. , Funkhouser George 
Published: September 2006

AbstractIt is our opinion that otosclerosis is a not infrequent cause of sensorineural hearing loss starting between the late teens and early 60's and, if suspected, that polytome X‐rays of the labyrinth can give valuable confirmatory evidence. We have approximately 250 polytome X‐ray examinations in our clinic which show evidence of otosclerosis with pure or predominant sensori‐neural hearing loss. We have been particularly interested in a group of 25 patients with signs and symptoms of Méniére's disease with polytome X‐ray evidence of otosclerosis of the labyrinthine capsule. They all have had typical acute rotary vertigo with nausea and vomiting, fluctuating sensori‐neural hearing loss of the end‐organ type,. and all have been studied extensively audiometrically. All have at least some degree of bilateral involvement. Seven have siblings either with Méniére's disease or adult onset sensori‐neural hearing loss of the end‐organ type.We feel it is of considerable practical importance to identify Méniére's disease when it occurs in association with labyrinthine capsule otosclerosis, because we have a strong impression that sodium fluoride in 60 mg. per day doses for one to two years tends to arrest progression of the hearing loss and to reduce or eliminate recurring bouts of acute vertigo. Occasionally, when hydrops is a factor in the sensori‐neural hearing loss, we have seen distinct hearing improvement after starting sodium fluoride treatment. (Two case reports are presented in the complete paper with audiograms and medial and lateral oblique polytome views of the labyrinth showing otosclerosis.) When otosclerosis and Méniére's disease are associated there usually seems to be bilateral involvement. These constitute about 10 percent of our cases of Méniére's disease and most patients with unilateral involvement show no X‐ray evidence of otosclerosis. The majority of patients having signs and symptoms of bilateral Méniére's disease that we have studied, have had polytome X‐ray evidence of otosclerosis. We do not feel that we have conclusively proven an association between the observed bilateral Méniére's disease and the suspected labyrinthine otosclerosis. The final proof will depend on post mortem histo‐pathologic study of these temporal bones, and we hope that this material will be available in the future.
Stapedectomy with malleus homograft in the fenestration ear: A Method for Restoration of Hearing in the Fenestration Ear
Authors: Tabb Harold G. 
Published: September 2006

AbstractA method for restoration of hearing in the fenestration ear is presented which consists of implanting a tailored malleus homograft between the manubrium in the drum and a vein grafted oval window following total stapedectomy.Twelve out of 14 cases followed from six months to four years closed the bone‐air gap within 20 db. Two cases were failures, with one of these a dead ear. None of the cases extruded the homograft malleus. Hearing has been maintained at the serviceable level in 70 percent of the cases for a period up to four years.Results have been promising enough to continue the use of this technique.
Symposium on prophylaxis and treatment of middle ear effusions.: Ii. Eustachian tube function and middle ear pressures as they influence susceptibility to disease
Authors: Proud G. O. 
Published: September 2006

AbstractThe bursting pressure necessary to rupture the tympanic membrane of cats and guinea pigs was determined by increasing and decreasing the intrabullar pressures and by increasing and decreasing the pressures in the external auditory canal after the bulla was vented to the outside. The average pressures in all experiments varied from 100 to 180 mm. Hg. Such pressures are far greater than the fall in intrabullar pressure which occurs following ligation of the eustachian tube in cats. It is suggested that drumhead perforations in humans with serous otitis may be due to smaller diminished tympanic pressures over a long period of time, leading to retraction pocket, entrapment of debris, and development of an expanding epithelial‐lined cyst.
Symposium on prophylaxis and treatment of middle ear effusions.: Iv. Physiology of the eustachian tube in the pathogenesis and management of middle ear effusions
Authors: Bluestone Charles D. , Paradise Jack L. , Beery Quinter C. 
Published: September 2006

AbstractEustachian tube function studies were carried out in patients with concurrent or recent middle ear effusions. Radiographic techniques were employed in assessing tubal response to liquid flow. Studies of air flow and air pressure were carried out using a Madsen bridge, and depended on the presence of either a perforation or a tympanostomy tube.Most of the Eustachian tubes studied showed varying degrees of obstruction or abnormal distensibility or both, often depending on the direction of flow, or on whether pressures were increased or reduced.Quite apart from other factors which may contribute to intrinsic oxextrinsic obstruction of the Eustachian tube, its compliance appears to play an important role in determining its function. In particular, compli. ance appears to be an important factor in the response of the Eustachian tube to increased positive or to negative pressures.Elimination of the causes of both nasal obstruction and abnormal nasopharyngeal secretions may alleviate problems in the function of the Eustachian tube which seem attributable to increased tubal compliance.
High dose pre‐operative radiotherapy and surgery for cancer of the larynx.
Authors: Constable William C. , Marks Richard D. , Robbins Jeffrey P. , Fitz‐Hugh G. Slaughter 
Published: September 2006

AbstractHigh dose pre‐operative radiotherapy has played an increasing role in the treatment of advanced cancer of the larynx at the University of Virginia Hospital since 1966. The results of treatment of 72 cases treated in this fashion are compared with 151 cases treated by surgery alone. Employing the actuarial method for calculating survival, there would appear to be a distinct improvement in the group receiving pre‐operative radiotherapy. Local recurrence was reduced to 15 percent following radiotherapy from a level of 30 percent with surgery alone; however, this is a retrospective study, and the two groups are not strictly comparable by age, sex and race. Comparison by stage demonstrates that the more advanced cases received pre‐operative radiotherapy. Morbidity from the combined approach was not increased with a dose of 5,000 rads delivered in five weeks.
Correction of saddle nose deformity
Authors: Sessions Donald G. , Stallings James O. 
Published: September 2006

AbstractSelection of the procedure for correction of saddle nose deformity should be determined by the severity of the deformity. Cartilage inlay grafts are satisfactory in the repair of minor supratip depressions. Moderate deformity of the cartilaginous septum is readily reconstructed by transposition of the upper lateral cartilages. Marked saddle nose deformity with destruction of large portions of the cartilaginous and bony nasal septum requires bone grafting procedures.
Temporal bone fractures: Three identical cases of lateral middle ear fractures with facial nerve injury and conductive hearing loss
Authors: Leonard James R. , Belafsky Mark L. 
Published: September 2006

AbstractDuring the past two years at Thomas Jefferson University Hospital the authors have encountered three identical cases of middle ear injuries and their treatment has been so alike that we believe they merit general discussion. These patients illustrate the basic pathology of middle ear fractures in association with skull trauma, and in addition, emphasize the transtympanic approach in the surgical repair. In the past there has been some hesitancy about operating on temporal bone fractures in the acute period. The authors wish to use the following three cases to illustrate the early surgical approach to temporal bone fractures with associated facial nerve injury.It is our belief that the transcanal route is an excellent one for isolated middle ear fractures with concomitant facial nerve palsy when there is normal tearing on the involved side. We also believe that these middle ear fractures should be explored at the earliest possible time, as soon as general status of the patient will allow. We have some hesitancy about performing the standard incus body‐to‐head transposition for ossicular chain reconstruction because of the close proximity of the exposed facial nerve to the repositioned incus. We worry about pressure of this incus should it become displaced postoperatively onto this bare facial nerve. There is also difficulty experienced with this approach if re‐exploration is indicated. The tympano‐meatal flap must be elevated off the facial nerve, a procedure not without its own inherent dangers.