bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Hormonal Association between Estrogen Metabolism and Proliferative Thyroid Disease
Authors: Chan Edwin K. , Sepkovic Daniel W. , Yoo Bowne Helen J. , Yu Guo Pei , Schantz Stimson P. 
Published: May 2006

OBJECTIVETo illustrate a relationship between proliferative thyroid disease and estrogen metabolism through the analysis of urinary estrogen metabolites.STUDY DESIGN AND SETTINGCase‐control study of 49 subjects with proliferative thyroid disorders and matching them to 49 controls. Urinary estrogen metabolite ratios were obtained, measuring 2‐hydroxyestrone, an anti‐proliferative metabolite, to 16α‐hydroxyestrone, a proliferative metabolite. The patients were stratified into low (0 to 1.00), medium (1.01 to 2.00), or high (>2.00) groups according to their estrogen metabolite ratio.RESULTSFifty‐one percent (25 of 49) of the cases had a low 2/16 ratio compared to 31% (15 of 49) in the control group while 20% (10 of 49) of the control group had a high 2/16 ratio as compared to 8% (4 of 49) in the case group (P value < 0.05).CONCLUSIONSIncreased 16α‐hydroxyestrone activity compared to 2‐hydroxyestrone activity appears to be associated with proliferative thyroid disease.SIGNIFICANCEFurther study of estrogen metabolites in relation to proliferative thyroid disease is warranted and may lead to implications for new treatment modalities for proliferative thyroid disease.
Prototype of a Silicon Nitride Ceramic‐Based Miniplate Osteofixation System for the Midface
Authors: Neumann Andreas , Unkel Claus , Werry Christoph , Herborn Christoh U. , Maier Horst R. , Ragoß Christian , Jahnke Klaus 
Published: May 2006

OBJECTIVEThe favorable properties of silicon nitride (Si3N4) ceramics, such as high mean strength level and fracture toughness, suggest biomedical use as an implant material. Minor reservations about the biocompatibility of Si3N4 ceramics were cleared up by previous in vitro and in vivo investigations.STUDY DESIGN AND SETTINGA Si3N4 prototype mini‐fixation system was manufactured and implanted for osteosynthesis of artificial frontal bone defects in 3 minipigs. After 3 months, histological sections, computed tomography (CT) scans, and magnetic resonance imaging (MRI) scans were obtained. Finite element modeling (FEM) was used to simulate stresses and strains on Si3N4 miniplates and screws to calculate survival probabilities.RESULTSSi3N4 miniplates and screws showed satisfying intraoperative workability. There was no implant loss, displacement, or fracture. Bone healing was complete in all animals. The formation of new bone was observed in direct contact to the implants. The implants showed no artifacts on CT and MRI scanning. FEM simulation confirmed the mechanical reliability of the screws, whereas simulated plate geometries regarding pullout forces at maximum load showed limited safety in a bending situation.CONCLUSIONSSi3N4 ceramics show a good biocompatibility outcome both in vitro and in vivo. In ENT surgery, this ceramic may serve as a biomaterial for osteosynthesis (eg, of the midface including reconstruction the floor of the orbit and the skull base). To our knowledge, this is the first introduction of a ceramic‐based miniplate‐osteofixation system. Advantages compared with titanium are no risk of implantation to bone with mucosal attachment, no need for explantation, and no interference with radiologic imaging. Disadvantages include the impossibility of individual bending of the miniplates.
Dysphagia after Sequential Chemoradiation Therapy for Advanced Head and Neck Cancer
Authors: Goguen Laura A. , Posner Marshall R. , Norris Charles M. , Tishler Roy B. , Wirth Lori J. , Annino Donald J. , Gagne Adele , Sullivan Christopher A. , Sammartino Daniel E. , Haddad Robert I. 
Published: May 2006

OBJECTIVESAssess impact of sequential chemoradiation therapy (SCRT) for advanced head and neck cancer (HNCA) on swallowing, nutrition, and quality of life.STUDY DESIGNProspective cohort study of 59 patients undergoing SCRT for advanced head and neck cancer. Follow‐up median was 47.5 months.SETTINGRegional Cancer Center.RESULTSMedian time to gastrostomy tube removal was 21 weeks. Eighteen of 23 patients who underwent modified barium swallow demonstrated aspiration; none developed pneumonia. Six of 7 with pharyngoesophageal stricture underwent successful dilatation. Functional Assessment of Cancer Therapy—Head and Neck Scale questionnaires at median 6 months after treatment revealed “somewhat” satisfaction with swallowing. At the time of analysis, 97% have the gastronomy tube removed and take soft/regular diet.CONCLUSIONEarly after treatment dysphagia adversely affected weight, modified barium swallow results, and quality of life. Diligent swallow therapy, and dilation as needed, allowed nearly all patients to have their gastronomy tubes removed and return to a soft/regular diet.SIGNIFICANCEDysphagia is significant after SCRT but generally slowly recovers 6 to 12 months after SCRT.
Does Otitis Media in Early Childhood Affect Reading Performance in Later School Years?
Authors: Golz Avishay , Thomas Westerman S. , Westerman Liane M. , Gilbert David A. , Netzer Aviram 
Published: May 2006

OBJECTIVETo evaluate reading performance in children with recurrent otitis media during childhood once middle‐ear diseases have resolved and the children grew older.STUDY DESIGN AND SETTINGSeventy‐five children with middle‐ear problems during childhood and poor reading performance in first grades and 60 healthy controls free of middle ear diseases were enrolled in the study. All children underwent an otologic and audiologic evaluation followed by reading tests.RESULTSReading performance was not affected once otitis media had been cured and hearing restored; reading scores of the healed children were almost the same as those of the otitis‐free children (3.39% and 3.1%, respectively). Children who still suffer from middle‐ear problems and hearing loss had an average percentage of reading mistakes of 7.3%.CONCLUSIONS AND SIGNIFICANCEOnce children are cured from their middle‐ear diseases and hearing is restored, previously noted reading impairments are no longer evident. Reading is still impaired among children who continue to suffer from middle‐ear problems and hearing loss even when they grow older.
Giant Myxomas of the Maxillofacial Skeleton and Skull Base
Authors: DeFatta Robert J. , Verret Daniel J. , Ducic Yadranko , Carrick Kelley 
Published: May 2006

OBJECTIVESTo review our experience with patients diagnosed with giant myxomas of the maxillofacial skeleton.STUDY DESIGNAll patients undergoing excision of myxomas of the head and neck from September 1998 through September 2003 with a minimum follow‐up of 1 year by the senior author (YD) were included in the study.METHODSA retrospective chart review was conducted to select all patients who met the inclusion criteria. Clinical presentation, preoperative radiology findings, excisions performed, reconstruction, and follow‐up were recorded and reported.RESULTSFour patients were identified who met the inclusion criteria. All underwent wide en bloc excision of the tumor with various reconstructions. Complete resection was achieved in each case, and no patients have had evidence of recurrence.CONCLUSIONSGiant myxomas of the maxillofacial skeleton have been reported to have significant rates of recurrence. Wide en bloc resection with appropriate reconstruction can result in excellent quality of life postoperatively and minimize the risk of recurrence. Lesser resections may not be appropriate especially in giant myxomas because of the potential morbidity that would be associated with a multifocal recurrence.
Comparison of Serum Calcium Change Following Thyroid and Nonthyroid Neck Surgery
Authors: Mehta Nicholas , Watts Nelson B. , Welge Jeffrey A. , Steward David 
Published: May 2006

OBJECTIVECompare serum calcium changes following thyroid and nonthyroid/parathyroid neck surgery.STUDY DESIGNControlled historic cohort study of 190 patients undergoing total thyroidectomy (TT, n = 97), completion thyroidectomy (CT, n = 27), and lateral neck dissection (ND, n = 66).RESULTSEach group experienced significant corrected serum calcium drop pre‐op to POD #1 (mean change (mg/dL) TT = 0.97, CT = 0.79, ND = 0.46; all P < 0.001) with significantly greater drop in TT and CT (P < 0.0001). TT and ND had significantly greater calcium drop from pre‐op to PACU than CT (0.54, 0.43, 0.15; P = 0.04). TT and CT experienced significantly greater calcium drop from PACU to POD #1 than ND (0.45, 0.53, 0.05; P < 0.0001). No significant difference in hypocalcemia rate between TT and CT.CONCLUSIONSPerioperative calcium drop in nonthyroid neck surgery is likely hemodilutional, occurring intraoperatively, whereas in thyroid surgery it likely results from both hemodilution and parathyroid dysfunction with the latter manifesting after PACU. Postoperative calcium monitoring should be similar following total and completion thyroidectomy due to similar rates of hypocalcemia and mean calcium drops.
The Effectiveness of Tonsillectomy and Adenoidectomy in the Treatment of Pediatric Obstructive Sleep Apnea/Hypopnea Syndrome: A Meta‐Analysis
Authors: Brietzke Scott E. , Gallagher Daniel 
Published: May 2006

OBJECTIVEPresent and evaluate the currently available literature reporting on the effectiveness of adenotonsillectomy (T/A) in treating obstructive sleep apnea/hypopnea syndrome (OSAHS) in uncomplicated pediatric patients.STUDY DESIGN AND SETTINGSystematic review of the literature and meta‐analysis of the reduction of the polysomnogram (PSG)‐measured Apnea Hypopnea Index (AHI events/hour) resulting from T/A and the overall success rate of T/A in normalizing PSG measurements (%).RESULTSFourteen studies met the inclusion criteria. Mean sample size was 28. All were case series (level 4 evidence). The summary change in AHI was a reduction of 13.92 events per hour (random effects model 95% CI 10.05–17.79, P < 0.001) from T/A. The summary success rate of T/A in normalizing PSG was 82.9% (random effects model 95% CI 76.2%–89.5%, P < 0.001).CONCLUSION/SIGNIFICANCET/A is effective in the treatment of OSAHS. However, success rates are far below 100%, which could have far‐reaching pediatric public health consequences.
Taste Disturbance after Uvulopalatopharyngoplasty for Obstructive Sleep Apnea
Authors: Li Hsueh‐Yu , Lee Li‐Ang , Wang Pa‐Chun , Hsiao Han‐Ren , Hsu Chung‐Yao , Chen Ning‐Hung , Fang Tuan‐Jen 
Published: May 2006

OBJECTIVESThis study investigated factors that may attribute to taste disturbance (TD) following uvulopalatopharyngoplasty (UPPP) for obstructive sleep apnea (OSA).STUDY DESIGNThis longitudinal intervention study enrolled 108 patients who received UPPP for OSA. Patients who reported TD in the postoperative questionnaire were examined using the three‐drop‐method gustatory function test (GFT).RESULTSThe GFT revealed that 5 patients (4.6%) reporting TD lost at least one of the four basic tastes 3 months after surgery. Deficiency of sweet sense was the most common type of TD (80%). The use of electrocautery for developing the uvulopalatal flap was the only significant predictor that may attribute to TD (odds ratio: 14.1). Repeating the GFT 9 months after operation showed a restoration of tastes in 4 patients.CONCLUSIONSDevelopment of the uvulopalatal flap using electrocautery may increase the likelihood of postoperative TD. Patients with taste disturbance after UPPP may eventually recover their taste function over time.
Thermal Welding versus Bipolar Tonsillectomy: A Comparative Study
Authors: Karatzias George T. , Lachanas Vassilios A. , Sandris Vassilios G. 
Published: May 2006

OBJECTIVETo compare thermal welding tonsillectomy (TWT) with bipolar electrocautery tonsillectomy (BET) procedure.STUDY DESIGN AND SETTINGA prospective randomized study was conducted on 150 consecutive adult patients undergoing tonsillectomy. Indications included chronic tonsillitis and obstructive sleep apnea syndrome. Exclusion criteria included peritonsillar abscess history, bleeding disorders, and any other procedure together with tonsillectomy. Patients were randomly assigned to TWT or BET groups. Intraoperative bleeding, operative time, postoperative pain, complication rates, and return to normal diet were evaluated.RESULTSIn the TWT group there was no measurable intraoperative bleeding, while mean bleeding for BET group was 16 mL. No significant difference regarding mean operative time was noticed. Mean postoperative pain score and mean time for return to normal diet were significantly lower in the TWT group. Primary hemorrhage occurred in 1 subject of the BET group. Secondary postoperative hemorrhage was noticed in 1 subject of the TWT group and 3 subjects of the BET group.CONCLUSIONThermal welding tonsillectomy procedure provides sufficient hemostasis, lower postoperative pain, and quick return to normal diet.
Hearing Aids: A Review of What's New
Authors: Kim Harold H. , Barrs David M. 
Published: May 2006

OBJECTIVETo review the recent innovations in hearing aid technology.STUDY DESIGNReview of the literature.SETTINGPrivate tertiary referral otology/neurotology practice.RESULTSRecent innovations including digital signal processing (DSP), directional microphone technology, and open mold hearing aid fitting have resulted in improved satisfaction with current hearing aids.CONCLUSIONCurrent hearing aid technology with its innovations better meet needs of individuals who are hard of hearing.SIGNIFICANCEThe image commonly held of hearing aids by the general public is a negative one that can be improved with greater education.
Prioritization of congenital cardiac surgical patients using fuzzy reasoning – a solution to the problem of the waiting list?
Authors: Holzer Ralf , Ladusans Ed , Kitchiner Denise , Peart Ian , Gladman Gordon , Miles Gail 
Published: May 2006

Surgical waiting lists are of high importance in countries, where the national health system is unable to deliver surgical services at a rate that would allow patients to avoid unnecessary periods of waiting. Prioritization of these lists, however, is frequently arbitrary and inconsistent.The objective of our research was to analyze the medical decision-making process when prioritizing patients with congenital cardiac malformations for cardiac surgical procedures, identifying an appropriate representation of knowledge, and transferring this knowledge onto the design and implementation of an expert system (“PrioHeart”).The medical decision-making process was stratified into three stages. The first was to analyze the details of the procedure and patient to define important impact factors on clinical priority, such as the risk of adverse events. The second step was to evaluate these impact factors to define an appropriate “timing category” within which a procedure should be performed. The third, and final, step was to re-evaluate the characteristics of individual patients to differentiate between those in the same timing category.We implemented this decision-making process using a rule-based production system with support for fuzzy sets, using the FuzzyCLIPS inference engine and expert system shell as a suitable development environment for the knowledge base.The “PrioHeart” expert system was developed to give paediatric cardiologists a tool to allow and facilitate the prioritization of patients on the cardiosurgical waiting list. Evaluation of “PrioHeart” on limited sets of patients documented appropriate results of prioritization, with a significant correlation between the prioritization made using “PrioHeart” and those results obtained by the individual consultant specialist.We conclude that our study has demonstrated the feasibility of using an expert system approach with a fuzzy, rule-based production system to implement the prioritization of cardiac surgical patients. The approach may potentially be transferable to other medical subspecialities.
Capillary Hemodynamics and Oxygen Pressures in the Aging Microcirculation
Authors: POOLE DAVID C. , BEHNKE BRAD J. , MUSCH TIMOTHY I. 
Published: May 2006

ABSTRACTHealthy aging acts to redistribute blood flow (Q̇) and thus O2 delivery (Q̇O2) among and within the exercising muscles such that Q̇O2 to highly oxidative muscle fibers may be compromised. Within the microcirculation of old muscles capillary hemodynamics are altered and the matching of Q̇O2 to oxidative requirements (V̇O2) is impaired such that at exercise onset the microvascular O2 pressure falls below that seen in their younger counterparts. This is important because the microvascular O2 pressure denotes the sole driving force for blood‐myocyte O2 transfer and any compromise may slow V̇O2 kinetics and reduce exercise tolerance. This review considers the microcirculatory evidence for a reduced perfusive (Q̇O2) and diffusive O2 flux within aged muscle and highlights the pressing need for intravital microscopy studies of the muscle microcirculation during exercise.
α‐Adrenergic Control of Skeletal Muscle Circulation at Rest and During Exercise in Aging Humans
Authors: DINENNO FRANK A. , JOYNER MICHAEL J. 
Published: May 2006

ABSTRACTAging is associated with many changes in autonomic nervous system function that often lead to impairments in the normal ability to respond to physiological stressors commonly encountered in daily life. In addition, many of these chronic age‐related changes in autonomic‐circulatory function can potentially predispose the older adult to elevated risk for acute and chronic cardiovascular complications. One of the most pronounced and repeatable findings with respect to changes in the autonomic nervous system with human aging is the progressive increase in basal muscle sympathetic nerve activity (MSNA) directed to skeletal muscle vascular beds. Although the mechanism(s) underlying this sustained age‐associated increase in MSNA are not completely understood, several changes in sympathetic α‐adrenergic function occur with age. In this review, the authors discuss how aging affects (1) α‐adrenergic control of skeletal muscle vascular tone under resting conditions and the differences that exist in this control of the upper and lower limbs (forearm vs leg circulation); (2) vasoconstrictor responsiveness to endogenous norepinephrine release, as well as the specific responsiveness of postjunctional α1‐ and α2‐adrenergic receptors; and (3) sympathetic α‐adrenergic control of muscle blood flow and vascular tone during exercise in humans. Further, they discuss how these changes in sympathetic α‐adrenergic control of skeletal muscle blood vessels have important physiological and clinical implications for the aging human.
Vasodilation and Vascular Control in Contracting Muscle of the Aging Human
Authors: PROCTOR DAVID N. , PARKER BETH A. 
Published: May 2006

ABSTRACTThere is accumulating evidence in humans that the control of blood flow to dynamically contracting skeletal muscle is altered with normal aging. Despite some inconsistencies in the literature, most healthy older subject groups studied to date (∼55–75 years) exhibited attenuated leg blood flow responses to moderate intensity leg exercise in comparison to younger (∼20–30 years) controls. In most cases, older subjects also have higher arterial perfusion pressures at rest and at any submaximal workload than their younger counterparts, suggesting a heightened level of vasoconstriction in the legs that could result from structural and/or functional alterations within the arterial vasculature. The influence of age on vasodilator responsiveness in the contracting limbs of humans remains an open question, with reports of blunted, similar, and augmented increases in local vascular conductance during graded exercise in older vs. younger adults. Recent results from the authors' laboratory suggest that the ability of vascular smooth muscle in the legs to dilate in response to physiological and pharmacological stimuli is relatively well preserved with advancing age in men; however, a sex difference may exist in that older estrogen‐deficient women exhibit blunted leg vasodilator responses compared to younger women. Potential mechanisms underlying altered vascular control within the resistance vasculature of contracting muscles of older men and women remain to be determined, but could include (1) fewer, smaller, and/or stiffer vessels, (2) impaired endothelium‐dependent vasodilation, (3) augmented sympathetic vasoconstriction, (4) alterations in metabolic or myogenic control, and (5) reduced effectiveness of the skeletal muscle pump. Systematic research involving both humans and animal models will be necessary to fully elucidate the mechanisms underlying compromised muscle blood flow in old age.
Aging‐Induced Adaptations of Microvascular Reactivity
Authors: MULLER‐DELP JUDY M. 
Published: May 2006

ABSTRACTControl of blood flow to skeletal muscle depends on the vasomotor tone present in the resistance vasculature. Although muscle blood flow has been shown to decline with advancing age, our knowledge of how alterations of reactivity of the resistance vasculature contribute to reduced delivery or altered distribution of blood in the aged is limited. Recent work has demonstrated that age alters the reactivity of resistance arteries and arterioles from skeletal muscle, and that impairment of both vasodilator and vasoconstrictor responses occurs with advancing age. The alterations in cellular mechanisms that contribute to age‐related impairment of vasoreactive responses encompass both the vascular endothelium and smooth muscle, and differ in muscles of varying function and fiber type. Current research suggests that some degree of age‐induced endothelial dysfunction occurs in resistance arteries and arterioles from most skeletal muscle; however, the severity of endothelial impairment appears greater in resistance arteries and arterioles from highly oxidative locomotory muscles. Age‐related impairment of vasoconstrictor responses to metabolites and endogenous constrictor agents has also been documented. These age‐related reductions in vasoreactivity that occur in the skeletal muscle resistance vasculature may contribute to inadequate delivery or distribution of blood flow during exercise and ultimately be a factor in loss of exercise capacity that occurs with advancing age.
Challenges and strategies for Chinese university journals
Authors: Shuhua Wang , Hengjun Wang 
Published: May 2006

ABSTRACTBoth the shift from a planned economy to a market economy system and the advent of the information era pose great challenges to Chinese university journals. The strategy of the Chinese government is to improve the system of university journals by encouraging mergers and partnerships with the aim of reducing the number of titles while improving their overall quality. The specific case of a geosciences journal demonstrates that Chinese university journals do have the ability to meet the challenges they face.
The International Consortium for the Advancement of Academic Publication — an idea whose time has come (finally!)
Authors: Sosteric Michael 
Published: May 2006

ABSTRACTThe scholarly communication process is undergoing change and evolution. New initiatives and new approaches have been emerging for some time. This article outlines one Canadian initiative. The International Consortium for the Advancement of Academic Publication (ICAAP) provides a unique and low‐cost publication alternative for those seeking to move outside the commercial mainstream of scholarly journal publication. A brief history of ICAAP and an account of its theoretical and political rationale are provided
After the goldrush — the golden age of reference linking
Authors: Rapple Charlie 
Published: May 2006

ABSTRACTReference linking is emerging as a key differentiator in the evaluation of online content. However, many publishers find themselves unfamiliar with the buzzwords, unsure of the technologies and overwhelmed by the concepts involved. This article provides a simple overview of the evolution of linking technology, reviews the current situation and suggests some requirements for continued development. The practical benefits to various groups within the information community, along with their potential responsiblities, are addressed.