bluuebunny/crossref_metadata_2025_split huggingface dataset:
Proteomics Blood Testing to Distinguish Chronic Rhinosinusitis Subtypes
Authors: Das Subinoy , Maeso Patricia A. , Becker Adam M. , Prosser John D. , Adam Bao‐Ling , Kountakis Stilianos E. 
Published: November 2008

AbstractObjectives: To evaluate the potential of surface enhanced laser desorption/ionization time‐of‐flight mass spectrometry (SELDI‐TOF‐MS) proteomic profiling of serum samples to distinguish chronic rhinosinusitis subtypes.Study Design: Translational study of serum samples from prospectively enrolled patients undergoing sinus surgery.Methods: Patients undergoing endoscopic sinus surgery for chronic rhinosinusitis with nasal polyposis were prospectively enrolled in an ongoing, institutional review board approved proteomics study. SELDI‐TOF‐MS was performed on 42 serum samples in patients with chronic rhinosinusitis with nasal polyposis (15 patients diagnosed with allergic fungal rhinosinusitis, 10 patients with Samter's triad, and 17 with chronic rhinosinusitis with nasal polyposis). Classification tree analysis on protein spectra developed from peaks detected in the 0 to 100 kD range was performed to identify disease subtypes.Results: SELDI‐TOF‐MS correctly identified patients with allergic fungal rhinosinusitis from serum samples with 84% sensitivity and 90% specificity, and correctly identified patients with Samter's triad with 88% sensitivity and 88% specificity in two subtype comparison groups. SELDI‐TOF‐MS correctly identified patients with allergic fungal rhinosinusitis with 76% sensitivity and 82% specificity, and correctly identified patients with Samter's triad with 80% sensitivity and 90% specificity in three subtype comparison groups.Conclusion: The study provides molecular evidence that allergic fungal rhinosinusitis is a discrete subtype of chronic rhinosinusitis. SELDI‐TOF‐MS is a promising technology that could lead to the development of a rapid blood test, to identify severe chronic rhinosinusitis subtypes. Further investigation into the utility of this technology is warranted.
Treatment of Sinus Headache as Migraine: The Diagnostic Utility of Triptans
Authors: Kari Elina , DelGaudio John M. 
Published: November 2008

AbstractObjective: To determine the response rate to triptans in alleviating “sinus headache” in patients with endoscopy‐ and computed tomography (CT)‐negative sinus examinations.Study Design: Prospective clinical trial.Methods: Patients who presented to a tertiary care center Otolaryngology Department with primary complaints of facial pain, pressure, or headache localized over the area of the sinuses, and a self‐ or physician‐diagnosis of “sinus headache” were enrolled. Patients underwent directed history, physical examination, rigid nasal endoscopy, a sinus CT scan, and completed a headache questionnaire. Those patients that had negative findings were treated empirically with triptans. Patients completed a headache diary for each headache, using a visual analogue scale to rate the headache before and after triptan use. Response was considered as significant improvement (greater than 50% reduction of pain), partial (25–50% reduction), and no response.Results: Fifty‐four patients were enrolled. Thirty‐eight (69%) completed follow‐up, 63% were women. The mean age was 41 years (23–70). Thirty‐one patients (82%) had significant reduction of headache pain with triptan use. Thirty‐five patients (92%) had a significant reduction in headache pain in response to migraine‐directed therapy. Seventeen patients (31%) withdrew or failed to follow‐up, often reluctant to accept a diagnosis of migraine.Conclusions: This study demonstrated that the demographics of patients with self‐described “sinus headaches” who did not have findings of sinusitis on endoscopy and CT scan closely reflected the demographics of patients afflicted with migraines. It also showed that 82% of these patients had a significant response to empiric treatment for sinus headaches with triptans. These findings support that “sinus headaches” may represent migraines, and response to triptans may aid in diagnosis.
Management of Spontaneous Cerebrospinal Fluid Otorrhea
Authors: Kutz Joe Walter , Husain Inna Athar , Isaacson Brandon , Roland Peter S. 
Published: November 2008

AbstractObjectives/Hypothesis: To describe the surgical approaches and materials used to repair spontaneous cerebrospinal fluid (CSF) otorrhea of temporal bone origin.Study Design: Retrospective case review at a tertiary academic medical center.Methods: All patients presenting with spontaneous CSF otorrhea or rhinorrhea over a consecutive 8‐year period were included. Clinic charts and operative reports were reviewed to obtain the clinical presentation, examination findings, diagnostic test results, intraoperative findings, operative technique, and postoperative follow‐up. Surgical approach and materials used for repair were determined by the location of the defect(s) and surgeon preference.Results: Seventeen patients underwent 19 operations for repair of spontaneous CSF otorrhea or rhinorrhea. The mean age was 61 years and the male to female ratio was 5:12. All female patients had a body mass index (BMI) greater than 30 mg/kg2. The most common presenting symptom was otorrhea after a myringotomy or placement of a tympanostomy tube. A middle fossa craniotomy was used in 17 approaches. The most common defect sites were located over the tegmen mastoideum and tegmen tympani. Multiple materials were used in most repairs including allogenic bone cement and autologous materials. One patient had persistent otorrhea after a transmastoid approach and required a middle fossa craniotomy to repair a tegmen mastoideum defect.Conclusions: Spontaneous CSF otorrhea is uncommon and often not diagnosed until a myringotomy or tympanostomy tube is placed. The middle fossa craniotomy provides the best exposure for defects involving the middle fossa floor. Both alloplastic and autologous materials are highly successful in repairing the defect(s) responsible for CSF otorrhea. No infections of the alloplastic bone cement occurred in our series.
Malignancies of the Ear in Irradiated Patients of Nasopharyngeal Carcinoma
Authors: Lo Wu‐Chia , Ting Lai‐Lei , Ko Jenq‐Yuh , Lou Pei‐Jen , Yang Tsung‐Lin , Chang Yih‐Leong , Wang Cheng‐Ping 
Published: November 2008

AbstractObjectives/Hypothesis: To report on the clinical profiles and treatment experiences of patients with second primary ear malignancy after treatment of nasopharyngeal carcinoma (NPC).Study Design: Retrospective case series.Methods: A retrospective review of the clinical outcomes and pathology of 11 irradiated NPC patients who subsequently had second primary malignancies of the ear at a single institution.Results: Ten tumors were squamous cell carcinoma and one tumor was chondrosarcoma occurring within the radiation field of previous treatment for NPC. The interval between previous radiotherapy and diagnosis of ear malignancy was 3 to 27 years with a median time of 17 years. Six tumors were located in the external auditory canal, two in the middle ear cavity, two in the periauricular region and one in the mastoid cavity. Four patients underwent surgery, and the other seven patients underwent surgery plus adjuvant radiotherapy. The 3‐year disease‐free and overall survival rates were 30.3% and 20%, respectively.Conclusions: Postirradiated malignancy of the ear is extremely rare, but is one of the causes of death for NPC long‐term survivors despite curative‐intended treatment with surgery plus adjuvant radiotherapy is instituted.
Regeneration of Aged Vocal Fold: First Human Case Treated With Fibroblast Growth Factor
Authors: Hirano Shigeru , Kishimoto Yo , Suehiro Atsushi , Kanemaru Shin‐ichi , Ito Juichi 
Published: November 2008

AbstractBackground/Objectives: Aged vocal folds are characterized by atrophy of the mucosa, which causes dysphonia and is difficult to treat. We have revealed a therapeutic potential of basic fibroblast growth factor (bFGF) for tissue regeneration of the aged vocal fold. We report here the first human case that has been treated with bFGF.Study Design: Institutional review board approved clinical human trial.Methods: A 63‐year‐old man with atrophied vocal folds was treated by local injection of 10 μg of bFGF into the left vocal fold under topical anesthesia. The effects of the injection were examined after 1 to 3 months by videostroboscopy, acoustic and aerodynamic measurements.Results: The atrophy of the vocal fold was improved at 1 week after the injection and glottic gap disappeared. Aerodynamic and acoustic parameters also showed remarkable improvement. These positive effects were maintained up to 3 months.Conclusion: The first case with aged vocal folds treated with bFGF administration is presented. The results are encouraging, suggesting therapeutic effects of bFGF for atrophied vocal folds in human.
Differential Diagnosis of Adductor Spasmodic Dysphonia and Muscle Tension Dysphonia Using Phonatory Break Analysis
Authors: Roy Nelson , Whitchurch Melissa , Merrill Ray M. , Houtz Daniel , Smith Marshall E. 
Published: November 2008

AbstractObjectives: Muscle tension dysphonia (MTD) can masquerade as adductor spasmodic dysphonia (ADSD) leading to diagnostic confusion. Intraword phonatory breaks have been offered as the sine qua non of ADSD, however, little is known regarding the presence of phonatory breaks in MTD. This investigation assessed the diagnostic worth of acoustic analysis of phonatory breaks as a possible objective test to distinguish ADSD from MTD.Study Design: Case‐control comparison.Methods: Voice samples from patients with confirmed ADSD (n = 41) and MTD (n = 59) were analyzed acoustically to determine the presence, frequency, and duration of phonatory breaks—defined as complete interruption of phonation within a word. Estimates of sensitivity, specificity, positive and negative predictive value, and likelihood ratios were calculated to determine the precision and worth of phonatory break analysis as a clinical diagnostic test.Results: 1) Individuals with ADSD showed a significantly higher number of phonatory breaks as compared with MTD. 2) All measures of diagnostic precision varied according to both duration and frequency of phonatory breaks, with separation of males and females leading to different diagnostic test performance results.Conclusions: The results suggest that phonatory break analysis offers promise as an objective test to distinguish ADSD from MTD, with respectable diagnostic precision, especially among men. Automation of the acoustic analysis procedure should be explored.
Early Mortality Rate of Morbidly Obese Patients after Tracheotomy
Authors: Darrat Ilaaf , Yaremchuk Kathleen 
Published: November 2008

AbstractObjectives: To 1) determine the early mortality rate (within 30 days) of morbidly obese patients after tracheotomy; 2) determine the difference between the mortality rate after tracheotomy of morbidly obese patients and patients who are not morbidly obese; and 3) determine the difference between the mortality rate after tracheotomy adjusted for case mix index (CMI) of morbidly obese patients and patients who are not morbidly obese.Study Design: Retrospective cohort study of 278 patients who had undergone a tracheotomy by the otolaryngology head and neck surgery department from 2004 to 2006. The patients were subdivided into two groups: 1) body mass index (BMI) <35 (n = 229) and 2) BMI ≥35 (morbidly obese) (n = 49).Methods: Charts reviewed for age, sex, weight, height, BMI, indication for tracheotomy, date of tracheotomy, type of tracheotomy, date of discharge, date of death, length of hospital stay, and CMI.Results: There is a trend toward significance (P = .09) between the mortality rate after tracheotomy of morbidly obese patients (29%) and patients who are not morbidly obese (18%). There is less significance between the adjusted mortality rate based on CMI after tracheotomy when the patient population is divided into morbidly obese patients and patients who are not morbidly obese (P = .12).Conclusion: The mortality rate after tracheotomy of morbidly obese patients is greater than patients who are not morbidly obese.
Revision Laryngeal Surgery for the Suboptimal Injection of Calcium Hydroxylapatite
Authors: Chheda Neil N. , Rosen Clark A. , Belafsky Peter C. , Simpson C Blake , Postma Gregory N. 
Published: November 2008

AbstractObjective: The objective of this study was to describe the management of suboptimal injection of calcium hydroxylapatite during augmentation laryngoplasty.Study Design: A retrospective review was conducted at four Voice and Swallowing centers to identify patients who had a suboptimal injection of calcium hydroxylapatite during augmentation laryngoplasty.Results: Five patients (ages 19–75) were identified with an impaired voice secondary to a superficial injection of calcium hydroxylapatite or over‐medialization of the true vocal fold. All patients underwent revision surgery with all experiencing subjective and objective improvement.Conclusion: Microflap excision can lead to successful return of vibratory function after a suboptimal injection of calcium hydroxylapatite. Complete control of the initial injection is paramount to avoiding this complication.
Avoiding Early Revision Rhytidectomy: A Biomechanical Comparison of Tissue Plication Suture Techniques
Authors: White Jeremy B. , Barraja Mathieu , Mengesha Tewodros , Bose Sumit , Ashktorab Samaneh , Bahn Ryan , Vallance Ryan , Lindsey William H. 
Published: November 2008

AbstractBackground: Manipulation and suspension of the superficial musculoaponeurotic system (SMAS) is performed by 74% of rhytidectomy surgeons. Multiple variations in suture techniques are employed in this task, but they have never been evaluated for differences in their ability to withstand stress.Objective: To compare the biomechanical properties of two different suture techniques that are used in SMAS plications during rhytidectomy: a double‐layered running locking (DRL) stitch and multiple horizontal mattress stitches.Methods: Fourteen horizontal mattress plications, in rows of six sutures, and comparable lengths of 16 DRL stitch plications of pig skin samples, were stressed using a tensometer with grip displacement increasing at a constant rate of 0.5 cm/Min. The required force to cause plication failure was recorded for each sample at three suture break points.Results: There was no significant difference between the two groups in the force required to cause the initial suture failure. Unlike the horizontal mattress plication, an initial break seemed to cause minimal to no distortion of the DRL tissue plication. When results were normalized by the initial break forces to account for small variations in tissue properties, the force ratio required to cause a second suture break was significantly larger in the DRL group than in the horizontal mattress technique. This is evidenced by the average second to first break force ratios of 1.62 vs. 1.13 for the DRL and horizontal mattress stitches, respectively, with a P‐value of .60. The mean ratios of third to first break forces for the DRL and horizontal mattress groups were 2.08 and 0.91, respectively, with a P‐value of .08.Conclusion: The DRL stitch requires more force than the horizontal mattress stitch to cause significant failure of tissue plication. This technique may enable plastic surgeons to avoid early revision rhytidectomy due to suture failure, and to create a long‐lasting, youthful cosmetic result.
Two Leucine-Rich Repeat Receptor Kinases Mediate Signaling, Linking Cell Wall Biosynthesis and ACC Synthase in Arabidopsis
Authors: Xu Shou-Ling , Rahman Abidur , Baskin Tobias I. , Kieber Joseph J. 
Published: November 2008

Abstract
The plant cell wall is a dynamic structure that changes in response to developmental and environmental cues through poorly understood signaling pathways. We identified two Leu-rich repeat receptor-like kinases in Arabidopsis thaliana that play a role in regulating cell wall function. Mutations in these FEI1 and FEI2 genes (named for the Chinese word for fat) disrupt anisotropic expansion and the synthesis of cell wall polymers and act additively with inhibitors or mutations disrupting cellulose biosynthesis. While FEI1 is an active protein kinase, a kinase-inactive version of FEI1 was able to fully complement the fei1 fei2 mutant. The expansion defect in fei1 fei2 roots was suppressed by inhibition of 1-aminocyclopropane-1-carboxylic acid (ACC) synthase, an enzyme that converts Ado-Met to ACC in ethylene biosynthesis, but not by disruption of the ethylene response pathway. Furthermore, the FEI proteins interact directly with ACC synthase. These results suggest that the FEI proteins define a novel signaling pathway that regulates cell wall function, likely via an ACC-mediated signal.
The accuracy of the FIB‐4 index for the diagnosis of mild fibrosis in chronic hepatitis B
Authors: MALLET V. , DHALLUIN‐VENIER V. , ROUSSIN C. , BOURLIERE M. , PETTINELLI M. E. , GIRY C. , VALLET‐PICHARD A. , FONTAINE H. , POL S. 
Published: November 2008

SummaryBackground  The Fib‐4 index is a simple and inexpensive biomarker to delineate liver fibrosis in chronic hepatitis C.Aim  To assess the accuracy of the FIB‐4 index in chronic hepatitis B.Methods  We compared the FIB‐4 index with 138 synchronous liver biopsies and with 372 synchronous FibroTest performed either in France or in an endemic area (Mayotte, an overseas collectivity of France).Results  The FIB‐4 index allowed the correct identification of patients with nil‐to‐moderate fibrosis with an area under the receiving operating characteristic curve of 0.81 (P < 0.001), increasing as a function of the length of the liver biopsy (up to 0.94 for liver biopsies ≥20 mm). A cut‐off value ≤1.45 differentiated moderate fibrosis from severe fibrosis with a negative predictive value of 86%, a sensitivity of 71.1% and a specificity of 73.1%. Beyond 1.45, the FIB‐4 index was not informative. The FIB‐4 index was more precise than the AST‐to‐platelet ratio index and correlated with the FibroTest in 89% of the cases (κ = 0.27, P < 0.001) to exclude severe fibrosis.Conclusion  The FIB‐4 index is a simple, accurate and inexpensive method to exclude significant liver fibrosis in chronic hepatitis B, a major advantage in HBV‐endemic developing countries.
Symptoms in patients on long‐term proton pump inhibitors: prevalence and predictors
Authors: RAGHUNATH A. S. , HUNGIN A. P. S. , MASON J. , JACKSON W. 
Published: November 2008

SummaryBackground  Symptom control in primary care patients on long‐term proton pump inhibitor (PPI) treatment is poorly understood.Aim  To explore associations between symptom control and demographics, lifestyle, PPI use, diagnosis and Helicobacter pylori status.Methods  A cross‐sectional survey (n = 726) using note reviews, questionnaires and carbon‐13 urea breath testing. Determinants of symptom control [Leeds Dyspepsia Questionnaire (LDQ), Carlsson and Dent Reflux Questionnaire (CDRQ), health‐related quality‐of‐life measures (EuroQoL: EQ‐5D and EQ‐VAS)] were explored using stepwise linear regression.Results  Moderate or severe dyspepsia symptoms occurred in 61% of subjects (LDQ) and reflux symptoms in 59% (CDRQ). Age, gender, smoking and body mass index had little or no influence upon symptom control or PPI use. Average symptom scores and PPI use were lower in patients with non‐ulcer dyspepsia and gastro‐protection than gastro‐oesophageal reflux disease (GERD) and uninvestigated dyspepsia. H. pylori infection was associated with lower reflux symptom scores only in patients with GERD and uninvestigated dyspepsia. EQ‐5D was not able to discriminate between diagnostic groups, although the EQ‐VAS performed well.Conclusions  A majority of patients suffered ongoing moderate or severe symptoms. GERD and uninvestigated dyspepsia were associated with poorer long‐term symptom control; H. pylori appeared to have a protective effect on reflux symptoms in these patients.
Quantitative colonoscopic evaluation of relative efficiencies of an immunochemical faecal occult blood test and a sensitive guaiac test for detecting significant colorectal neoplasms
Authors: ROZEN P. , LEVI Z. , HAZAZI R. , WAKED A. , VILKIN A. , MAOZ E. , BIRKENFELD S. , NIV Y. 
Published: November 2008

SummaryBackground  The guaiac faecal occult blood test (G‐FOBT), HemoccultSENSA, is sensitive for significant neoplasms [colorectal cancer (CRC), advanced adenomatous polyps (AAP)], but faulted by non‐specificity for human haemoglobin (Hb). Quantified, Hb‐ specific, immunochemical faecal occult blood tests (I‐FOBT) are now used.Aims  To (i) compare I‐FOBT and G‐FOBT efficacy in identifying significant neoplasms and colonoscopy needs for positive tests and (ii) examine number of I‐FOBTs needed and test threshold to use for equivalent or better sensitivity than G‐FOBT and fewest colonoscopies for positive tests.Methods  Three daily G‐FOBTs and I‐FOBTs were collected and analysed in 330 patients scheduled for colonoscopy.Results  Colonoscopy found significant neoplasms in 32 patients, 6 CRC, 26 AAP. G‐FOBT, sensitivity and specificity were 53.1% (17 neoplasms) and 59.4%, resulting in 8.1 colonoscopies/neoplasm. One I‐FOBT having ≥50 ngHb/mL of buffer provided equivalent sensitivity but 94.0% specificity, resulting in 2.1 colonoscopies/neoplasm. By analysing the higher of two I‐FOBTs at 50 ngHb/mL threshold, sensitivity increased to 68.8% (22 neoplasms, P = 0.063), specificity fell to 91.9% (P < 0.001), but still required 2.1 colonoscopies/neoplasm.Conclusions  In this population, quantified I‐FOBT had significantly better specificity than G‐FOBT for significant neoplasms, reducing the number of colonoscopies needed/neoplasm detected. Results depend on the number of I‐FOBTs performed and the chosen development threshold.
Long‐term follow‐up of a population based cohort with monoclonal proteinaemia
Authors: Schaar Cees G. , Le Cessie Saskia , Snijder Simone , Franck Paul F. H. , Wijermans Pierre W. , Ong Cisca , Kluin‐Nelemans Hanneke 
Published: November 2008

SummaryProspective studies on the risk of malignant transformation in patients with monoclonal gammopathy of undetermined significance (MGUS) and factors predictive of survival are lacking. The Dutch Comprehensive Cancer Centre West, comprising 1·6 million inhabitants, initiated a prospective hospital‐based cohort study on 1464 patients with newly diagnosed M‐proteinaemia, median age 73 (17–103) years. M‐protein related diagnoses, patients’ characteristics, laboratory investigations, bone marrow examinations and skeletal X‐rays were registered with a yearly follow‐up. Main endpoints were death, or new diagnoses of multiple myeloma and non‐Hodgkin lymphoma. Kaplan–Meier survival curves were compared with age‐ and gender‐matched survival data from the total Dutch population. Cumulative malignant transformation was corrected for death using a competing risk model. Risk factors for transformation or death were analyzed by univariate and multivariate analyses. In 1007 MGUS‐patients, malignant transformation was associated with rising M‐protein levels, IgA and IgM isotype and occurred at a yearly rate of 0·4%. All MGUS patients survived less than a matched cohort of the Dutch population, even in the absence of M‐protein‐associated comorbidity. Serum albumin levels at entry appeared highly predictive for survival. M‐proteinaemia is not an innocent symptom. Although malignant transformation occurs rarely, survival is shortened irrespective of comorbidity.