bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long‐term Results of Labyrinthectomy
Authors: Levine Samuel C. , Glasscock Michael , Mckennan Kevin X. 
Published: September 2006

AbstractTen years after labyrinthectomy, 38 patients responded to a questionnaire. There was a slight decline in relief of vertigo from 93% to 76%. Symptoms following the procedure are discussed. It is believed that the reason for the decline is secondary to the age of the patients, the occasional bilateral nature of Meniere's disease, and possibly post‐surgical neuroma formation. The ramifications of this study are discussed with respect to hearing‐conservation procedures.
The surgical treatment of snoring: A patient's perspective
Authors: Katsantonis George P. , Friedman William H. , Rosenblum Barry N. , Walsh James K. 
Published: September 2006

AbstractAn increasing number of loud snorers seek medical attention because of the social impact of snoring as well as its association with sleep apnea. Uvulopalatopharyngoplasty is reported to reduce or eliminate snoring in the majority of patients; however, little data are available to document the procedure's success.From February 1987 through August 1988, 125 patients underwent uvulopalatopharyngoplasty for habitual snoring; many of these patients had also documented sleep apnea. Of the 74 patients who responded to a postoperative questionnaire, 64 (86.48%) indicated that their snoring was either completely eliminated or markedly reduced. Only two patients reported significant side effects.
Use of modified silicone tracheal cannula for obstructive sleep apnea
Authors: Strauss Melvin 
Published: September 2006

AbstractExperience with the original Montgomery® silicone tracheal cannulas in 47 patients with obstructive sleep apnea has been reported. Further experience with 10 obstructive sleep apnea patients who used modified silicone tracheal cannulas that permit periodic self‐removal, cleaning, and reinsertion was analyzed. Two patients used the tube briefly and without complications. The remaining eight patients used the modified cannula for 18 to 24 months. The average number of office visits following insertion was three. Compared to the original cannulas, there were markedly fewer difficulties with granulations, infection, and tube malposition with the modified cannulas. The improvements make this modified device a useful tool worth further study in obstructive sleep apnea patients requiring tracheostomy.
Fourth branchial pouch sinus: Principles of diagnosis and management
Authors: Godin Michael S. , Kearns Donald B. , Pransky Seth M. , Seid Allan B. , Wilson Doris B. 
Published: September 2006

AbstractThe fourth branchial pouch sinus is a congenital anomaly which most frequently manifests itself by recurrent episodes of neck abscess or acute suppurative thyroiditis. This lesion usually becomes symptomatic before the age of 10 years and is more common than has previously been suspected. It has been found on the left side in 93% of the 28 cases reported in the English literature. Barium swallow during periods of quiescence and nasopharyngoscopy have frequently been successful in identifying the presence of these embryological remnants. Definitive therapy consists of total excision of the sinus tract, which can be facilitated by direct endoscopic placement of a Fogarty® catheter into the sinus lumen before surgical exploration. The embryological basis for the occurrence of these sinuses is discussed.
Evoked otoacoustic emissions in newborn hearing screening
Authors: Bonfils Pierre , Dumont Annie , Marie Philippe , Francois Martine , Narcy Philippe 
Published: September 2006

AbstractEvoked otoacoustic emissions (EOEs) were recorded in a group of normally hearing neonates (n= 100 ears) to study the basic properties of EOEs and the parameters influencing them. The results obtained with EOE recordings were compared with those of behavioral screening investigations. The main properties of EOEs in neonates are: 1. EOEs can be recorded in 98% of the tested ears or neonates; 2. there were no statistically significant variations in EOE detection thresholds of neonates between the ages of 1 and 4 days; 3. no statistical difference in the EOE threshold was found between males and females; 4. all EOEs exhibited a broadband spectrum with high‐component frequencies; 5. EOEs demonstrating narrowband frequency peaks superimposed on the broadband component had detection thresholds lower than EOEs without narrowband frequency peaks. EOEs can be used as a screening test. The main clinical interest of this test is to detect the presence (i.e, normal auditory peripheral function) or the absence (i.e., pathological peripheral auditory function) of EOEs in response to a 30‐dBHL click stimulation. The results of this study have important applications concerning the possible clinical use of EOEs for screening peripheral auditory dysfunction in neonates.
Anatomical perspective, approach, and experience with multichannel intracochlear implantation
Authors: Goycoolea Marcos V. , Muchow David C. , Schirber Carol M. , Goycoolea Hortensia G. , Schellhas Kurt 
Published: September 2006

AbstractAn overall review of the authors' anatomical perspective, approach, and experience with multichannel intracochlear implantation is presented. This report includes pertinent anatomical observations and experimental surgical procedures on fresh temporal bones. Although the scala tym‐pani in the basal turn of the cochlea has an adequate space laterally for the insertion of electrodes, in the upper turns the adequate space is located medially. This is, in practice, the single‐most limiting factor for an electrode, inserted via the round window, to reach the apical turns without damaging the basilar membrane. An experimental surgical procedure is described in which a second electrode is inserted in the middle turn via a mastoidotomy‐tyinpanotomy approach and reaches a point near the apex. Studies of horizontal sections of human temporal bones include a review of potential structures that could be stimulated by the electrical currents generated by electrodes. The wall of the carotid artery, located at 750 μm from the basal turn at the level of the round window niche, is considered a potential structure to be affected by long‐term stimulation. Anatomical principles and surgical considerations for the mastoidotomy‐tym‐panotomy approach are described as an alternative to the facial recess approach. In the authors' experience, this procedure is technically easier, eliminates the possibility of postauricular flap complications, provides a better angle for insertion of electrodes, requires shorter hospitalization, and permits faster recovery than the facial recess approach. The authors' clinical approach, results, and observations are reviewed. Of note is a successful home‐based rehabilitation program.
Ultrastructural studies of the peripheral extensions (dendrites) of type i ganglion cells in the cat
Authors: Goycoolea Marcos V. , Stypulkowski Paul , Muchow David C. 
Published: September 2006

AbstractAn ultrastructural study of peripheral extensions (dendrites) of type I ganglion cells in seven healthy adult cats and one cat that underwent bilateral cochlear injection of neomycin was undertaken. Morphologic evidence revealed that the peripheral process (dendrite) consistently has a smaller diameter than the central process. As the dendrite reaches the cell body, there is a constricted segment with a length that ranges from 10 to 30 μm, and a diameter of 0.5 μm. This region is covered by a continuous myelin sheath that does not thin. The central process (axon) does not have a corresponding constriction, and consists of a myelin covered, smoothly tapered segment that extends to the first axonal node of Ranvier. In the deafened cat, some cell bodies of the surviving ganglion cells appeared to have a residual portion of dendrite. These morphologic characteristics might have physiologic implications both in the mechanisms of normal hearing and in cochlear implantation.
Systemic effects of severe trauma on the function and apoptosis of human skeletal cells
Authors: Eid K. , Labler L. , Ertel W. , Trentz O. , Keel M. 
Published: September 2006

Systemic factors are believed to be pivotal for the development of heterotopic ossification in severely-injured patients. In this study, cell cultures of putative target cells (human fibroblastic cells, osteoblastic cells (MG-63), and bone-marrow stromal cells (hBM)) were incubated with serum from ten consecutive polytraumatised patients taken from post-traumatic day 1 to day 21 and with serum from 12 healthy control subjects. The serum from the polytraumatised patients significantly stimulated the proliferation of fibroblasts, MG-63 and of hBM cells. The activity of alkaline phosphatase in MG-63 and hBM cells was significantly decreased when exposed to the serum of the severely-injured patient. After three weeks in 3D cell cultures, matrix production and osteogenic gene expression of hBM cells were equal in the patient and control groups. However, the serum from the polytraumatised patients significantly decreased apoptosis of hBM cells compared with the control serum (4.3% vs 19.1%, p = 0.031). Increased proliferation of osteoblastic cells and reduced apoptosis of osteoprogenitors may be responsible for increased osteogenesis in severely-injured patients.
Inverted V-shaped high tibial osteotomy compared with closing-wedge high tibial osteotomy for osteoarthritis of the knee
Authors: Aoki Y. , Yasuda K. , Mikami S. , Ohmoto H. , Majima T. , Minami A. 
Published: September 2006

We compared the results ten years after an inverted V-shaped high tibial osteotomy with those of a historical series of conventional closing-wedge osteotomies. The closing-wedge series consisted of 56 knees in 51 patients with a mean follow-up of 11 years (10 to 15). The inverted V-shaped osteotomy was evaluated in 48 knees in 43 patients at a mean follow-up of 14 years (10 to 19). All the patients were scored using the Japanese Orthopaedic Association rating scale for osteoarthritis of the knee and radiological assessment. The pre-operative grade of osteoarthritis was similar in both groups. Post-operatively, the knee function score was graded as satisfactory in 63% (35) of the closing-wedge group but in 89% (43) of the inverted V-shaped osteotomy group. Post-operative radiological examination showed that delayed union and loss of correction occurred more often after a closing-wedge osteotomy than after an inverted V-shaped procedure. Our study suggests that the inverted V-shaped osteotomy may offer more dependable long-term results than traditional closing-wedge osteotomy.
The outcome of total hip replacement in obese and non-obese patients at 10- to 18-years
Authors: McLaughlin J. R. , Lee K. R. 
Published: September 2006

We studied a consecutive series of 285 uncemented total hip replacements in 260 patients using the Taperloc femoral component and the T-Tap acetabular component. The outcome of every hip was determined in both living and deceased patients. A complete clinical and radiological follow-up was obtained for 209 hips in 188 living patients, followed for a mean of 14.5 years (10 to 18.9). They were divided into two groups, obese and non-obese, as determined by their body mass index. There were 100 total hip replacements in 89 patients in the obese cohort (body mass index ≥ 30 kg/m2), and 109 in 99 non-obese (body mass index < 30 kg/m2) patients. A subgroup analysis of 31 patients of normal weight (body mass index 20 kg/m2 to 25 kg/m2) (33 hips) and 26 morbidly obese patients (body mass index ≥ 35 kg/m2) (30 hips) was also carried out. In the obese group five femoral components (5%) were revised and one (1%) was loose by radiological criteria. Femoral cortical osteolysis was seen in eight hips (8%). The acetabular component was revised in 57 hips (57%) and a further 17 (17%) were loose. The mean Harris hip score improved from 52 (30 to 66) pre-operatively to 89 (49 to 100) at final follow-up. Peri-operative complications occurred in seven patients (7%). In the non-obese group six (6%) femoral components were revised and one (1%) was loose. Femoral cortical osteolysis occurred in six hips (6%). The acetabular component was revised in 72 hips (66%) and a further 18 (17%) were loose. The mean Harris hip score increased from 53 (25 to 73) prior to surgery to 89 (53 to 100) at the time of each patient’s final follow-up radiograph. No statistically significant difference was identified between the obese and non-obese patients with regards to clinical and radiological outcome or complications. The subgroup analysis of patients of normal weight and those who were morbidly obese showed no statistically significant difference in the rate of revision of either component. Our findings suggest there is no evidence to support withholding total hip replacement from obese patients with arthritic hips on the grounds that their outcome will be less satisfactory than those who are not obese.
Outcomes of subcapital cuneiform osteotomy for the treatment of severe slipped capital femoral epiphysis after skeletal maturity
Authors: Biring G. S. , Hashemi-Nejad A. , Catterall A. 
Published: September 2006

We reviewed prospectively, after skeletal maturity, a series of 24 patients (25 hips) with severe acute-on-chronic slipped capital femoral epiphysis which had been treated by subcapital cuneiform osteotomy. Patients were followed up for a mean of 8 years, 3 months (2 years, 5 months to 16 years, 4 months). Bedrest with ‘slings and springs’ had been used for a mean of 22 days (19 to 35) in 22 patients, and bedrest alone in two, before definitive surgery. The Iowa hip score, the Harris hip score and Boyer’s radiological classification for degenerative disease were used. The mean Iowa hip score at follow-up was 93.7 (69 to 100) and the mean Harris hip score 95.6 (78 to 100). Degenerative joint changes were graded as 0 in 19 hips, grade 1 in four and grade 2 in two. The rate of avascular necrosis was 12% (3 of 25) and the rate of chondrolysis was 16% (4 of 25). We conclude that after a period of bed rest with slings and springs for three weeks to gain stability, subcapital cuneiform osteotomy for severe acute-on-chronic slipped capital femoral epiphysis is a satisfactory method of treatment with an acceptable rate of complication.
A knee-sparing distal femoral endoprosthesis using hydroxyapatite-coated extracortical plates
Authors: Gupta A. , Pollock R. , Cannon S. R. , Briggs T. W. R. , Skinner J. , Blunn G. 
Published: September 2006

We used a knee-sparing distal femoral endoprosthesis in young patients with malignant bone tumours of the distal femur in whom it was possible to resect the tumour and to preserve the distal femoral condyles. The proximal shaft of the endoprosthesis had a coated hydroxyapatite collar, while the distal end had hydroxyapatite-coated extracortical plates to secure it to the small residual femoral condylar fragment. We reviewed the preliminary results of this endoprosthesis in eight patients with primary bone tumours of the distal femur. Their mean age at surgery was 17.years (14 to 21). The mean follow-up was 24 months (20 to 31). At final follow-up the mean flexion at the knee was 102° (20° to 120°) and the mean Musculoskeletal Tumour Society score was 80% (57% to 96.7%). There was excellent osteointegration at the prosthesis-proximal bone interface with formation of new bone around the hydroxyapatite collar. The prosthesis allowed preservation of the knee and achieved a good functional result. Formation of new bone and remodelling at the interface make the implant more secure. Further follow-up is required to determine the long-term structural integrity of the prosthesis.
Outcome of Charnley total hip replacement across a single health region in England
Authors: Allami M. K. , Fender D. , Khaw F. M. , Sandher D. R. , Esler C. , Harper W. M. , Gregg P. J. 
Published: September 2006

Using the Trent regional arthroplasty register, we analysed the survival at ten years of 1198 consecutive Charnley total hip replacements carried out across a single health region of the United Kingdom in 1990. At ten years, information regarding outcome was available for 1001 hips (83.6%). The crude revision rate was 6.2% (62 of 1001) and the cumulative survival rate with revision of the components as an end-point was 93.1%. At five years, a review of this series of patients identified gross radiological failure in 25 total hip replacements which had previously been unrecognised. At ten years the outcome was known for 18 of these 25 patients (72%), of whom 13 had not undergone revision. This is the first study to assess the survival at ten years for the primary Charnley total hip replacement performed in a broad cross-section of hospitals in the United Kingdom, as opposed to specialist centres. Our results highlight the importance of the arthroplasty register in identifying the long-term outcome of hip prostheses.
Single-stage revision of peri-prosthetic infection following total elbow replacement
Authors: Gille J. , Ince A. , González O. , Katzer A. , Loehr J. F. 
Published: September 2006

This study reviews the predisposing features, the clinical, and laboratory findings at the time of diagnosis and the results of single-stage revision of prosthetic replacement of the elbow for infection. Deep infection occurred in six of 305 (1.9%) primary total elbow replacements. The mean follow-up after revision was 6.8 years (6 months to 16 years) and the mean age at the time of revision was 62.7 years (56 to 74). All six cases with infection had rheumatoid arthritis and had received steroid therapy. The infective organism was Staphylococcus aureus. Four of the six elbows had a developed radiolucency around one component or the other. Successful single-stage exchange arthroplasty was carried out with antibiotic-loaded cement in five of the six cases. In one, the revision prosthesis had to be removed following recurrence of the infection. The functional result was good in three elbows, fair in one, poor in one and fair in the resection arthroplasty.
The impact of tobacco use and body mass index on the length of stay in hospital and the risk of post-operative complications among patients undergoing total hip replacement
Authors: Azodi O. Sadr , Bellocco R. , Eriksson K. , Adami J. 
Published: September 2006

We carried out a retrospective cohort study of 3309 patients undergoing primary total hip replacement to examine the impact of tobacco use and body mass index on the length of stay in hospital and the risk of short term post-operative complications.Heavy tobacco use was associated with an increased risk of systemic post-operative complications (p = 0.004). Previous and current smokers had a 43% and 56% increased risk of systemic complications, respectively, when compared with non-smokers. In heavy smokers, the risk increased by 121%. A high body mass index was significantly associated with an increased mean length of stay in hospital of between 4.7% and 7%. The risk of systemic complications was increased by 58% in the obese. Smoking and body mass index were not significantly related to the development of local complications.Greater efforts should be taken to reduce the impact of preventable life style factors, such as smoking and high body mass index, on the post-operative course of total hip replacement.
Secreted Frizzled-Related Protein 4 Is a Negative Regulator of Peak BMD in SAMP6 Mice
Authors: Nakanishi Rika , Shimizu Motoyuki , Mori Masayuki , Akiyama Haruhiko , Okudaira Shuzo , Otsuki Bungo , Hashimoto Maiko , Higuchi Keiichi , Hosokawa Masanori , Tsuboyama Tadao , Nakamura Takashi 
Published: September 2006

Abstract
We segregated a QTL for peak BMD on Chr 13 by generating congenic sublines of the senescence-accelerated mouse SAMP6. Sfrp 4 within this locus was responsible for lower BMD of SAMP6.
Introduction: Our genome-wide linkage study using SAMP6 and SAMP2 showed a significant quantitative trait locus (QTL) for peak BMD on chromosome (Chr) 13. To verify the gene that regulates peak BMD, we generated a congenic strain, P6.P2-Pbd2b, which carried a 15-cM SAMP2 interval on an osteoporotic SAMP6 background, and showed that this Pbd2 locus increased peak BMD in SAMP6.
Materials and Methods: To narrow down this interval, we generated a new congenic subline P6.P2–13. We studied the effect of this locus on morphological and histomorphological features in vivo and on osteoblasts in vitro. The levels of expression of all genes in the segregated interval were examined, and we clarified the effect of the candidate gene, secreted frizzled-related protein (Sfrp4), on osteoblasts in vitro.
Results: The new congenic strain, P6.P2–13, retained the 2.4-Mb SAMP2 interval on the SAMP6 background, and 11 genes existed in this interval. In morphometrical analysis, P6.P2–13 increased the bone area fraction (BA/TA) by 6.6% at the diaphysial cortex (p &lt; 0.001) and increased the trabecular bone volume (BV/TV) by 54.2% at the distal metaphysis (p &lt; 0.05) in the femora compared with those of SAMP6. The bone formation rate of P6.P2–13 was markedly increased at the periosteal surface of femoral cortex and that was caused by a higher proliferation rate of osteoblasts in P6.P2–13 compared with those in SAMP6. Quantitative RT-PCR analysis of calvaria tissue showed ∼40-fold higher levels of expression of Sfrp4 in SAMP6 than in P6.P2–13. Taken together with the result that recombinant Sfrp4 suppressed the proliferation of osteoblasts, we hypothesized that Sfrp4 inhibited the proliferation of osteoblasts through its antagonistic effect on Wnt signaling. TCF/β-catenin–dependent reporter activity in osteoblasts derived from SAMP6 showed lower responsiveness for the Wnt ligand, Wnt3A, than that in osteoblasts from P6.P2–13.
Conclusions: In SAMP6 mice, Sfrp4 negatively regulates bone formation and decreases BMD through the inhibition of Wnt signaling.