bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Adenotonsillectomy on Behavior in Children With Sleep‐Disordered Breathing
Authors: Li Hsueh‐Yu , Huang Yu‐Shu , Chen Ning‐Hung , Fang Tuan‐Jen , Lee Li‐Ang 
Published: July 2006

AbstractObjectives/Hypothesis: Children with sleep‐disordered breathing may experience behavioral and learning problems such as inattentiveness and hyperactivity. The aim of this study was to measure the impact of adenotonsillectomy on sleep‐related adverse events and behavioral problems in children with sleep‐disordered breathing.Method: This prospective and interventional study enrolled 40 sleep‐disordered breathing children (mean age, 8.4 ± 1.6 years) with hypertrophic tonsils and adenoids. All patients completed two polysomnographies, tests of variables of attention (TOVAs), and Child Behavior Checklists, one at baseline and the other 6 months after adenotonsillectomy.Results: The apnea–hypopnea index (P < .001), TOVA scores (P < .001), and 8 of 9 individual domains of the Child Behavior Checklist scores (P < .05) significantly improved after surgery. However, the change in the apnea–hypopnea index was not negatively correlated with TOVA score (r = −0.17, P = .38).Conclusion: Adenotonsillectomy could significantly improve behavior (TOVA) scores, but the improvement may not simply be attributable to changes in sleep apnea events.
Distributions of Cervical Lymph Node Metastases in Oropharyngeal Carcinoma: Therapeutic Implications for the N0 Neck
Authors: Lim Young Chang , Koo Bon Seok , Lee Jin Seok , Lim Jae‐Yol , Choi Eun Chang 
Published: July 2006

AbstractObjectives: This study sought to investigate the patterns and distributions of lymph node metastases in oropharyngeal squamous cell carcinoma (SCC) and improve the rationale for elective treatment of N0 neck.Materials and Methods: One hundred four patients with oropharyngeal SCC who underwent neck dissection between 1992 and 2003 were analyzed retrospectively. All patients had curative surgery as their initial treatment for the primary tumor and neck. A total of 161 neck dissections on both sides of the neck were performed. Therapeutic dissections were done in 71 and 5 necks and elective neck dissection was done on 33 and 52 necks on the ipsilateral and contralateral sides, respectively. Surgical treatment was followed by postoperative radiotherapy for 78 patients. The follow‐up period ranged from 1 to 96 months (mean, 30 months).Results: Of the 161 neck dissection specimens evaluated, 90 (56%) necks were found to have lymph node metastases found by pathologic examination. These consisted of 76 (73% of 104 necks) of the ipsilateral side and 14 (25% of 57 necks) of the contralateral side dissections. The occult metastatic rate was 24% (8 of 33) of ipsilateral neck samples and 21% (11 of 52) of contralateral neck samples. Of the 68 patients who had a therapeutic dissection on the ipsilateral side and had lymphatic metastasis, the incidence rate of level IV and level I metastasis was 37% (25 of 68) and 10% (7 of 68), respectively. Isolated metastasis to level IV occurred on the ipsilateral side in three patients. There were no cases of isolated ipsilateral level I pathologic involvement in an N‐positive neck or occult metastasis to this group. The incidence rate of level IV metastasis in patients with ipsilateral nodal metastasis was significantly higher in base of tongue cancer (86% [6 of 7]) compared with tonsillar cancer (34% [20 of 59]) (P = .013). Patients with level IV metastasis had significantly worse 5‐year disease‐free survival rates than patients with metastasis to other neck levels (54% versus 71%; P = .04).Conclusion: These results suggest that elective N0 neck treatment in patients with oropharyngeal SCC, especially base of tongue cancer, should include neck levels II, III, and IV instead of levels I, II, and III.
Pediatric Laryngotracheal Obstruction: Current Perspectives on Stridor
Authors: Bent John 
Published: July 2006

AbstractObjectives/Hypothesis:To assess how medical advances have impacted the diagnosis, management, and outcomes of pediatric laryngotracheal obstruction, and to describe the advantages of audio‐video documentation of stridorous children.Study Design and Methods:Retrospective.Methods and Materials:268 patients were referred for suspected laryngotracheal obstruction during the 30 months between September 1, 1995 and March 1, 1998: 173 had 206 flexible fiberoptic laryngoscopies, and 160 had 273 direct laryngoscopies. One hundred and forty‐one children were identified with laryngotracheal obstruction, yielding 40 different diagnoses that could be classified into 9 major categories. Thirty‐six children (25.5%) had multiple sites of upper airway obstruction.Results:138 children had follow‐up >1 month. Twelve children died (8.7%), leaving 126 survivors (mean follow‐up = 21.1 months). Outcomes were classified as resolved (44.2%), improved (37.0%), stable (9.4%), failed (0.7%), or death (8.7%). Better outcomes were seen in more readily treated diagnostic categories, such as tracheobronchial foreign body, chronic laryngitis, and suprastomal granulation tissue; laryngeal stenosis, tracheomalacia, and recurrent respiratory papillomatosis, had less favorable outcomes (P<.001). The former group also showed superior outcome compared to laryngomalacia (P<.001) and vocal cord mobility disorders (P= .004). Ninety‐four patients (68.1%) had comorbidities complicating their management. Comorbid conditions were universal among deceased patients and least common in the resolved outcomes category (56.7%), supporting the premise that patients with poor outcomes are more likely to have comorbidities than patients with resolution of laryngotracheal symptoms (P= .034).Conclusions:Audio‐video recording of pediatric laryngotracheal obstruction offers numerous advantages. Children classified into an array of diagnostic categories usually have favorable outcomes, but opportunities for continued advances exist, particularly regarding management of comorbidity and chronic obstruction.
Base of Tongue Schwannoma: A Case Report
Authors: Ying Yu‐Lan Mary , Zimmer Lee A. , Myers Eugene N. 
Published: July 2006

AbstractBoth malignant and benign lesions may be found on the base of the tongue, including metastasis from other sites. Various surgical approaches to the base of tongue have been described. Here, we report a case of a 26‐year‐old woman with a schwannoma in the base of tongue removed through a suprahyoid pharyngotomy approach. The biology and pathology of schwannoma in the oral cavity are discussed. The advantage of the suprahyoid pharyngotomy approach for complete excision of a mass in the base of tongue is demonstrated.
Level V Lymph Node Dissection in Oral and Oropharyngeal Carcinoma Patients with Clinically Node‐Positive Neck: Is it Absolutely Necessary?
Authors: Lim Young Chang , Koo Bon Seok , Lee Jin Seok , Choi Eun Chang 
Published: July 2006

AbstractObjectives: Postoperative shoulder dysfunction has been significantly associated with any dissection of level V secondary to traction or with ischemic injury to the spinal accessory nerve. The aim of this study was to determine whether the dissection of level V lymph node pads is absolutely necessary in therapeutic neck dissection as a treatment for oral and oropharyngeal squamous cell carcinoma (OOSCC) patients with clinically N+ neck.Study Design: Retrospective chart review.Methods: We performed a retrospective analysis of 93 OOSCC patients who underwent surgical treatment of the primary lesion along with a simultaneous comprehensive neck dissection from January 1992 to December 2003. Of these, only one patient had a clinically positive neck node at level V. During the neck dissection, the contents of the level V lymph nodes were dissected, labeled, and processed separately from the remainder of the major neck dissection specimen. We studied the incidence of pathologic metastasis to level V lymph nodes. In addition, we also evaluated several potential risk factors for metastatic disease in the level V lymph nodes such as sex, age, T stage, N stage, histologic grade, and presence of other positive lymph nodes.Results: A total of 96 comprehensive neck dissections were performed in this series. The prevalence of metastases in the level V lymph nodes was 5% (5 of 93) in ipsilateral and 0% (0 of 3) in contralateral necks. One case with clinically positive node at level V had a pathologic positive node in level II, III, IV, and V. Occult metastasis rate of ipsilateral level V was 4% (4 of 92). There was a statistically significant association between level V metastases and a positive N stage above N2b (P = .01). The presence of metastasis in other multiple neck levels, particularly the combined neck levels II, III, and IV, also have a statistically significant association with level V metastasis (P = .023).Conclusion: Level V lymph node pads may be preserved in modified neck dissections on OOSCC patients with clinically N+ neck below the nodal stage N2a.
Otolaryngologists' Responses to Errors and Adverse Events
Authors: Lander Lina I. , Connor Jean Anne , Shah Rahul K. , Kentala Erna , Healy Gerald B. , Roberson David W. 
Published: July 2006

AbstractObjectives: The objectives of this study were to describe otolaryngologists' emotional reactions to errors and adverse events, their efforts to take responsibility, and their attempts to implement improvements.Study Design and Methods: A retrospective, anonymous survey of 2,500 U.S. otolaryngologists who were members of the American Academy of Otolaryngology–Head and Neck Surgery about errors in their practice was conducted. Respondents were asked whether an error had occurred in their practice in the past 6 months and, if so, to describe the error, its consequences, and any corrective actions taken. Two aspects of these reports stood out, which were beyond the scope of the original study: the respondents' emotional responses and their corrective actions.Results: The response rate was 18.6%. Two hundred ten (45%) respondents reported a total of 212 analyzable error reports and 230 corrective actions. Corrective actions included disclosure to the patient (20 [9%]), ameliorating the consequences of the event to the patient (107 [50%]), personal practice changes (14 [7%]), improvements in the respondent's practice or department (60 [28%]), and hospitalwide or broader corrective actions (19 [9%]). Emotional reactions to errors and adverse events were reported by 22 (10%) otolaryngologists, including regret, embarrassment, guilt, anxiety, loss of temper, and irritation. Legal action was mentioned by five physicians (2%).Conclusions: Otolaryngologists took actions not only to treat their patients, but also to improve patient care in their practice, department, hospital, or community. Emotional reactions to errors and adverse events are common and need to be addressed in medical training and practice.
Tongue‐Base Suspension in Conjunction with Uvulopalatopharyngoplasty for Treatment of Severe Obstructive Sleep Apnea: Long‐Term Follow‐Up Results
Authors: Vicente Eugenio , Marín José M. , Carrizo Santiago , Naya M J. 
Published: July 2006

AbstractObjectives/Hypothesis: To evaluate the usefulness of tongue‐base suspension (TBS) in addition to uvulopalatopharyngoplasty (UPPP) in the treatment of obstructive sleep apnea syndrome (OSAS).Study Design: Long‐term prospective case series.Setting: University tertiary care medical center.Methods: Fifty‐five consecutive patients with severe OSAS (apnea‐hypopnea index [AHI] 52.8 ± 14.9 events/hr) with multilevel upper airway obstruction who refused treatment with continuous positive airway pressure underwent UPPP plus TBS with the Repose system. All patients were evaluated before surgery by clinical history, Epworth Sleepiness Scale (ESS), fiberoptic nasopharyngoscopy with Müller maneuver, and nocturnal polysomnography (PSG). After 3 years of surgery, all patients were re‐evaluated at the clinic and had ESS test and full PSG. Surgical success was defined when the ESS dropped bellow 11, and the AHI decreased below the threshold of 20 events per hour of sleep and at least 50% from the preoperative valueResults: There were 42 (78%) patients in which the AHI score decreased more than 50%, the AHI was lower than 20 events/hr in the PSG, and the ESS was lower than 11 after 3‐years of follow‐up (surgical success index). Logistic regression analysis demonstrated that body mass index at baseline was the only variable with significant statistical power to predict surgical success (odds ratio 0.85; 0.73–0.95, 95% confidence interval, P < .01)Conclusion: When associated with UPPP, the TBS technique performed with the Repose system demonstrates a surgical success of up to 78% for patients with severe OSA who refused nasal continuous positive airway pressure.
Eosinophilic Mucus Chronic Rhinosinusitis: Clinical Subgroups or a Homogeneous Pathogenic Entity?
Authors: Pant Harshita , Kette Frank E. , Smith William B. , Macardle Peter J. , Wormald Peter J. 
Published: July 2006

AbstractBackground: Eosinophilic mucus chronic rhinosinusitis (EMCRS) can be subclassified using the criteria of detection of fungi in eosinophilic mucus and systemic fungal allergy. Allergic fungal sinusitis (AFS), a subgroup of EMCRS characterized by the presence of fungal allergy, is proposed to be an immunoglobulin (Ig)E‐driven disease, distinct from other EMCRS subgroups. However, our recent studies cast doubt on the central pathogenic role of allergy in AFS. The purpose of this study was to examine the clinical features of EMCRS patients from the different subcategories to determine the relevance of this classification system.Method: The demographic, clinical, and immunologic characteristics of the EMCRS subgroups were examined prospectively and compared with three control groups: healthy volunteers, allergic rhinitis with fungal allergy, and chronic rhinosinusitis without eosinophilic mucus.Results: EMCRS patients with allergy were younger than those without. There was no significant difference in clinicopathologic parameters between EMCRS subgroups. As a single group, EMCRS had a more severe sinus disease compared with chronic rhinosinusitis patients.Conclusions: AFS was not clinically distinct from other subgroups of EMCRS. However, eosinophilic mucus may mark a more severe and distinct form of sinus disease.
Influence of Previous Radiotherapy on Free Tissue Transfer in the Head and Neck Region: Evaluation of 455 Cases
Authors: Klug Clemens , Berzaczy Dominik , Reinbacher Heidrun , Voracek Martin , Rath Thomas , Millesi Werner , Ewers Rolf 
Published: July 2006

AbstractObjective/Hypothesis: The aim of this retrospective cohort study was to investigate the effect of prior radiotherapy (XRT) on the outcome of microvascular free tissue transfer in the head and neck region.Methods: Four hundred fifty‐five patients, subdivided into three groups, were analyzed. Groups I (no previous XRT, n = 110), II (previous radiochemotherapy with 50 Gy focus dosage in the primary treatment regime for oral cancer, n = 322), and III (secondary reconstruction after XRT‐induced complications, n = 23) were compared regarding flap success rate, postoperative complications, postoperative mortality, duration of intensive care (DOIC), and hospitalization (DOH).Results: Flap success did not differ significantly across groups (I: 95.5%, II: 93.2%, III: 91.3%. Risk of postoperative complications was significantly lower for group I (12.7%) compared with groups II (23.9%) and III (39.1%). DOIC and DOH were significantly shorter for patients in group I than for those in groups II and III.Conclusions: XRT before free tissue transfer does not significantly increase flap loss or postoperative mortality but does increase postoperative complications and length of hospitalization.
Formation of the Arabidopsis Pentatricopeptide Repeat Family
Authors: Rivals Eric , Bruyère Clémence , Toffano-Nioche Claire , Lecharny Alain 
Published: July 2006

Abstract
In Arabidopsis (Arabidopsis thaliana) the 466 pentatricopeptide repeat (PPR) proteins are putative RNA-binding proteins with essential roles in organelles. Roughly half of the PPR proteins form the plant combinatorial and modular protein (PCMP) subfamily, which is land-plant specific. PCMPs exhibit a large and variable tandem repeat of a standard pattern of three PPR variant motifs. The association or not of this repeat with three non-PPR motifs at their C terminus defines four distinct classes of PCMPs. The highly structured arrangement of these motifs and the similar repartition of these arrangements in the four classes suggest precise relationships between motif organization and substrate specificity. This study is an attempt to reconstruct an evolutionary scenario of the PCMP family. We developed an innovative approach based on comparisons of the proteins at two levels: namely the succession of motifs along the protein and the amino acid sequence of the motifs. It enabled us to infer evolutionary relationships between proteins as well as between the inter- and intraprotein repeats. First, we observed a polarized elongation of the repeat from the C terminus toward the N-terminal region, suggesting local recombinations of motifs. Second, the most N-terminal PPR triple motif proved to evolve under different constraints than the remaining repeat. Altogether, the evidence indicates different evolution for the PPR region and the C-terminal one in PCMPs, which points to distinct functions for these regions. Moreover, local sequence homogeneity observed across PCMP classes may be due to interclass shuffling of motifs, or to deletions/insertions of non-PPR motifs at the C terminus.
Hydrogen/deuterium‐exchange (H/D‐Ex) of PPARγ LBD in the presence of various modulators
Authors: Hamuro Yoshitomo , Coales Stephen J. , Morrow Jeffrey A. , Molnar Kathleen S. , Tuske Steven J. , Southern Mark R. , Griffin Patrick R. 
Published: July 2006

AbstractA nuclear receptor, peroxisome proliferator‐activated receptor γ (PPARγ), is a ligand‐dependent transcription factor involved in glucose homeostasis and adipocyte differentiation. PPARγ is the molecular target of various natural and synthetic molecules, including anti‐diabetic agents such as rosiglitazone. Amide hydrogen/deuterium‐exchange (H/D‐Ex), coupled with proteolysis and mass spectrometry, was applied to study the dynamics of the PPARγ ligand binding domain (LBD) with or without molecules that modulate PPARγ activity. The H/D‐Ex patterns of ligand‐free PPARγ LBD show that the ligand binding pocket of LBD is significantly more dynamic than the rest of the LBD. Presumably, the binding pocket is intrinsically disordered in order to accommodate different ligands. The presence of two full agonists (rosiglitazone and GW1929), a partial agonist (nTZDpa), and a covalent antagonist (GW9662), changed the dynamics/conformation of PPARγ LBD and slowed the H/D exchange rate in various regions of the protein. The full agonists slowed the H/D exchange more globally and to a greater extent than the partial agonist or the antagonist, indicating that the full agonist stabilizes the PPARγ LBD more than the partial agonist or the antagonist. One interesting observation is that the two full agonists significantly stabilized helix 12 while the partial agonist and the antagonist did not perturb the H/D exchange of this region. The results showed that the change in protein dynamics induced by ligand binding may be an important factor for the activation of genes and that H/D‐Ex is a useful method for analyzing the biological activity of drug leads.
Atomic‐resolution crystal structure of Borrelia burgdorferi outer surface protein A via surface engineering
Authors: Makabe Koki , Tereshko Valentina , Gawlak Grzegorz , Yan Shude , Koide Shohei 
Published: July 2006

AbstractOuter surface protein A (OspA) from Borrelia burgdorferi has an unusual dumbbell‐shaped structure in which two globular domains are connected with a “single‐layer” β‐sheet (SLB). The protein is highly soluble, and it has been recalcitrant to crystallization. Only OspA complexes with Fab fragments have been successfully crystallized. OspA contains a large number of Lys and Glu residues, and these “high entropy” residues may disfavor crystal packing because some of them would need to be immobilized in forming a crystal lattice. We rationally designed a total of 13 surface mutations in which Lys and Glu residues were replaced with Ala or Ser. We successfully crystallized the mutant OspA without a bound Fab fragment and extended structure analysis to a 1.15 Å resolution. The new high‐resolution structure revealed a unique backbone hydration pattern of the SLB segment in which water molecules fill the “weak spots” on both faces of the antiparallel β‐sheet. These well‐defined water molecules provide additional structural links between adjacent β‐strands, and thus they may be important for maintaining the rigidity of the SLB that inherently lacks tight packing afforded by a hydrophobic core. The structure also revealed new information on the side‐chain dynamics and on a solvent‐accessible cavity in the core of the C‐terminal globular domain. This work demonstrates the utility of extensive surface mutation in crystallizing recalcitrant proteins and dramatically improving the resolution of crystal structures, and provides new insights into the stabilization mechanism of OspA.
The use of near‐infrared spectroscopy in skin care applications
Authors: Kilpatrick‐Liverman LaTonya , Kazmi Perveen , Wolff Elizabeth , Polefka Thomas G. 
Published: July 2006

Background: Near‐infrared (NIR) spectroscopy was used to document the skin water content as a function of product usage and changes in the % relative humidity (%RH) in vitro and in vivo. The objective of the investigation was to determine if the NIR could provide comparable skin water content information as that obtained using gravimetric, conductivity, or visual assessment methods without having to invoke complex chemometric calculations.Methods: NIR data were obtained using an NIR5000 spectrophotometer with a fiber optic probe (Smartprobe™) attachment to complete the clinical studies and a Direct Contact™ Analyzer module to carry out the in vitro experiments. Conductivity measurements were completed using the Skicon® 200, which measures conductance at a fixed frequency of 3.5 MHz. Three moisturization‐based clinical studies were carried out assessing the NIR's ability to detect skin hydration changes. In Clinical Study A, NIR and Skicon data were collected for panelists who had only washed their outer calf with water over a 4‐week period. During this time, the daily average %RH was recorded. In Clinical Study B, 10% solutions of glycerin, choline chloride, and the sodium salt of pyrrolidone carboxylic acid were applied to the panelist's outer calf and biophysical measurements were completed to assess the hydration and desorption properties of these humectants. In Clinical Study C, a 10% solution of choline chloride was applied to panelist's outer calf and the cumulative effect of using this product was evaluated over a 3‐week period. For all in vitro studies, porcine skin was used as the substrate.Results: Comparable NIR, Skicon, and visual dryness results were obtained for most of the product usage‐based clinical experiments completed. However, the NIR was particularly more effective at detecting skin water content differences as a function of %RH changes. In the absence of abrupt (>50%) relative humidity variations, there was a direct correlation between the NIR readings and the %RH (R2=0.83) unlike what was observed for the Skicon measurements (R2=0.22).Conclusions: NIR spectroscopy demonstrated the changes in the skin water content as a function of product usage; the results were consistent with those obtained using the Skicon conductivity meter and visual dryness assessment scores. More importantly, the differences detected were obtained without having to use chemometric manipulations in the data analysis as is the common practice. Of all the methods used, the NIR gave the best linear regression for %RH‐induced skin water content changes.