bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tumor Volume as a Prognostic Factor in Oropharyngeal Squamous Cell Carcinoma Treated With Primary Radiotherapy
Authors: Been Mark J. , Watkins Joanna , Manz Ryan M. , Gentry Lindell R. , Leverson Glen E. , Harari Paul M. , Hartig Gregory K. 
Published: February 2009

AbstractObjectives/Hypothesis: Tumor volume has been demonstrated to play a prognostic role in many head and neck cancers. The purpose of this study was to conduct an institutional review analyzing the correlation between tumor volume and locoregional control of oropharyngeal squamous cell cancer treated with primary radiotherapy.Study Design: Retrospective institutional chart analysis.Methods: Seventy‐nine patients from 1991 to 2005 with primary T1 to T4 oropharyngeal squamous cell carcinoma (base of tongue, n = 31; soft palate, n = 1; tonsils, n = 47) were treated with primary radiotherapy. Tumor volumes were measured from pretreatment computerized tomography scans by two observers. Three‐dimensional tumor volumes were calculated using a computer digitizer for each computed tomography slice showing the primary lesion. Survival analysis, using the methods of Kaplan and Meier, was performed to assess whether tumor volume, Tumor, Node, Metastasis classification, tumor stage, or location were associated with locoregional failure.Results: Tumor volume did not significantly correlate with locoregional failure (observer 1, P = .6244; observer 2, P = .5612). There was a high interobserver correlation (r = 0.98970). Univariate analysis did, however, demonstrate a significant difference in locoregional failure between T4 tumors and all other T stages (T1 vs. T4, P = .0107; T2 vs. T4, P = .0004; T3 vs. T4, P = .0155). Nodal status, tumor stage, and location did not significantly correlate with locoregional failure rate.Conclusions: Tumor volume does not appear to play a significant role in predicting locoregional recurrence for patients with primary squamous cell cancer of the oropharynx treated with primary radiotherapy. However, T4 status was predictive of poor locoregional control.
Reconstruction of the Through‐and‐Through Anterior Mandibulectomy Defect: Indications and Limitations of the Double‐Skin Paddle Fibular Free Flap
Authors: Deleyiannis Frederic W.‐B. , Rogers Carolyn , Ferris Robert L. , Lai Stephen Y. , Kim Seungwon , Johnson Jonas 
Published: February 2009

AbstractObjectives/Hypothesis: The purpose of this report is to describe our recent experience using a double‐skin paddle fibular free flap (DSPFFF) for reconstruction of the through‐and‐through anterior mandibulectomy defect and to present a reconstructive algorithm based on the extent of lip and mental skin resection.Study Design: Retrospective review of 10 consecutive patients with through‐and‐through anterior mandibulectomy defects.Methods: Outcomes that were examined included methods of reconstruction based on the cutaneous defect, flap complications, fistula rate, and donor site complications.Results: Seven patients were reconstructed with a DSPFFF. For lip reconstruction, two patients were also concomitantly reconstructed with Karapandzic or lip advancement flaps. Three patients were reconstructed with both a fibular free flap and a second free flap (1 radial forearm fasciocutaneous flap and 2 anterolateral thigh flaps). The transverse dimensions of the DSPFFFs were as great as 15 cm. None of the patients developed a fistula. All free tissue transfers were successful. One patient developed partial loss of the fibular skin paddle used for submental skin replacement.Conclusions: DSPFFF is a safe and reliable way to reconstruct an anterior through‐and‐through mandibular defect. Indications for using a DSPFFF are 1) a cutaneous defect that lies at or below the plane of the reconstructed mandible, 2) a transverse width of the oral mucosa and cutaneous defect that does not exceed 15 cm (the approximate distance from the mid‐calf to the anterior midline), and 3) a lip defect that, if present, can be reconstructed with local flaps.
Life‐Threatening Posttonsillectomy Hemorrhage
Authors: Windfuhr Jochen P. , Schloendorff Georg , Baburi Diwa , Kremer Bernd 
Published: February 2009

AbstractObjectives/Hypothesis: In rare cases, the intensity of posttonsillectomy hemorrhage (PTH) may become life‐threatening requiring major surgical means and intensive care. This study was conducted to assess the outcome of life‐threatening PTH and its clinical features in a larger patient population.Study Design and Methods: Cases occurring during the clinical career of the authors were collected and added by own expert reports to lawsuits and professional boards in cases who had undergone tonsillectomy elsewhere. PTH resulting in hemorrhagic shock requiring resuscitation, ligature of greater arteries in the neck, tracheotomy, packing of the pharynx, embolization, and/or blood transfusions were labeled as life threatening.Results: Seventy‐nine patients had experienced life‐threatening PTH between 1980 and 2006, comprising 36 children and 39 adults (age not stated for 4 patients). There were 42 female and 34 male patients (gender not stated for 3 patients). Only nine patients experienced primary bleeding, secondary PTH clearly prevailed (n = 70; 89.6%) in this patient population. Single episodes of life‐threatening PTH were reported for 11 cases including two patients with and nine without remaining neurological sequelae. Three of the 11 patients were children (age not stated for 2 patients). Repeated episodes of life‐threatening PTH occurred in 68 patients (32 children) including eight with remaining sequelae.Conclusions: Life‐threatening PTH is an apparently rare, most commonly unpredictable state of emergency requiring a clear management protocol. However, repeated episodes of bleeding classified most clinical courses and should alert the medical staff. Although the bleeding rate after tonsillectomy in children is generally acknowledged to be very low, the rate of life‐threatening PTH is apparently higher than in adults. Gender seems not to be a risk factor. Secondary PTH can no longer be assessed to be less dangerous than primary PTH.
Impact on Quality of Life After Mastoid Obliteration
Authors: Dornhoffer John L. , Smith Jason , Richter Gresham , Boeckmann Jacob 
Published: February 2009

AbstractObjectives/Hypothesis: To understand the long‐term impact on quality of life (QOL) in patients undergoing mastoid obliteration surgery for a chronically draining cavity, using the Glascow Benefit Inventory (GBI) QOL survey, and to correlate these findings to perceived changes in drainage and hearing.Study Design: Retrospective chart review.Methods: Adult patients undergoing mastoid obliteration and restoration of the middle ear space with cartilage reconstruction of the tympanic membrane, with at least 3‐year follow‐up, were contacted by phone to solicit participation. Those who agreed to participate were mailed the GBI and consent documents with a prepaid self‐addressed envelope.Results: Of 80 patients meeting the inclusion criteria, 37 were successfully contacted and agreed to participate, yielding 23 returned questionnaires. The vast majority (19 of 23; 83%) reported improved QOL after surgery, with the most positive effects seen on confidence and social situations, and patients experiencing less inconvenience, self‐consciousness, and embarrassment. Eighty‐three percent reported a perceived improvement in hearing; 74% reported an improvement in drainage. Over 90% would recommend the procedure to a family member. The average score on the GBI was 28.9, and a two‐tailed one‐sample t test showed that mastoid obliteration significantly improved QOL in our patients (t = 4.65, P < .001). There was a fairly good correlation between the perceived improvement in QOL with improvement in hearing and/or drainage.Conclusions: The GBI is a valuable tool for evaluating patient satisfaction after revision surgery for a draining cavity. This information is helpful in understanding the impact of a draining cavity on an individual's life and may be beneficial in preoperative selection and counseling.
Treatment of Base of Tongue Cancer With Paclitaxel, Ifosfamide, and Cisplatinum Induction Chemotherapy Followed by Chemoradiotherapy
Authors: Hancock Samuel Brandon , Krempl Greg A. , Canfield Vikki , Bogardus Carl , Kojouri Kiarash , Kaneaster S K. , Medina Jesus E. 
Published: February 2009

AbstractObjectives/Hypothesis: To assess the efficacy of paclitaxel, ifosfamide, and cisplatinum induction chemotherapy plus concurrent chemoradiation in the treatment of stage III and IV base of tongue cancer.Study Design: Subgroup analysis of patients with base of tongue cancer enrolled in a single‐institution prospective phase II trial, evaluating an organ‐preservation approach in the treatment of locally advanced head and neck cancer.Methods: Eighteen patients with tumors ranging from stage T2–T4, any N, or M0 were treated with a protocol of induction chemotherapy, with Taxol, ifosfamide, cisplatin every 21 days for up to three cycles. If the primary tumor exhibited a complete or partial response, patients were treated with radiation and weekly taxol and carboplatin for 7 weeks. Surgery was used for those with less than partial response or disease progression. Neck dissection was performed in cases with clinical or radiological evidence of persistent disease in the neck 6 to 8 weeks after completion of treatment.Results: Sixteen patients were male and two were female; the average age was 55 years (range, 43–65). Fifteen patients had stage IV disease and three had stage III disease. Of the 18 patients initially enrolled, 17 patients had a complete response. All 17 patients had no evidence of loco‐regional disease at a median follow‐up of 29.6 months. Only 1 of them developed distant metastases 30 months after completion of treatment. Three patients required permanent percutaneous endoscopic gastrostomy tubes because of severe dysphagia associated with concurrent chemoradiation.Conclusions: The treatment regimen studied is remarkably effective in stage III and IV base of tongue cancer with 100% of patients completing the protocol alive to date. Although some patients required persistent percutaneous endoscopic gastrostomy use, no patient experienced significant enough toxicity during the protocol to delay or withdraw from treatment.
Cyclic Adenosine Monophosphate Regulation of Ion Transport in Porcine Vocal Fold Mucosae
Authors: Sivasankar Mahalakshmi , Nofziger Charity , Blazer‐Yost Bonnie 
Published: February 2009

AbstractObjectives/Hypothesis: Cyclic adenosine monophosphate (cAMP) is an important biological molecule that regulates ion transport and inflammatory responses in epithelial tissue. The present study examined whether the adenylyl cyclase activator, forskolin, would increase cAMP concentration in porcine vocal fold mucosa and whether the effects of increased cAMP would be manifested as a functional increase in transepithelial ion transport. Additionally, changes in cAMP concentrations following exposure to an inflammatory mediator, tumor necrosis factor‐α (TNFα) were investigated.Study Design: In vitro experimental design with matched treatment and control groups.Methods: Porcine vocal fold mucosae (N = 30) and tracheal mucosae (N = 20) were exposed to forskolin, TNFα, or vehicle (dimethyl sulfoxide) treatment. cAMP concentrations were determined with enzyme‐linked immunosorbent assay. Ion transport was measured using electrophysiological techniques.Results: Thirty minute exposure to forskolin significantly increased cAMP concentration and ion transport in porcine vocal fold and tracheal mucosae. However, 30‐minute and 2‐hour exposure to TNFα did not significantly alter cAMP concentration.Conclusions: We demonstrate that forskolin‐sensitive adenylyl cyclase is present in vocal fold mucosa, and further, that the product, cAMP increases vocal fold ion transport. The results presented here contribute to our understanding of the intracellular mechanisms underlying vocal fold ion transport. As ion transport is important for maintaining superficial vocal fold hydration, data demonstrating forskolin‐stimulated ion transport in vocal fold mucosa suggest opportunities for developing pharmacological treatments that increase surface hydration.
Meta‐analysis: nitroglycerin for prevention of post‐ERCP pancreatitis
Authors: BANG U. C. , NØJGAARD C. , ANDERSEN P. K. , MATZEN P. 
Published: February 2009

SummaryBackground  Acute pancreatitis after ERCP is a severe side effect.Aim  To evaluate the preventive effect of nitroglycerin on post‐ERCP pancreatitis by a meta‐analysis of randomized clinical studies.Methods  We searched on Pubmed, Embase, Cochrane Library and all abstracts presented at Digestive Disease Week and United European Gastrointestinal Week from 2004 to 2008. We used the MeSH terms ‘pancreatitis’ together (AND) with the terms: ‘glyceryl trinitrate’, ‘glyceryl dinitrate’, ‘isosorbide dinitrate’ or ‘nitroglycerin’.Results  Five clinical studies evaluating the incidence of post‐ERCP pancreatitis after administration of nitroglycerin were identified. Meta‐analysis including all five studies showed a relative risk (RR) of 0.61 (95% CI; 0.44, 0.86) with the number needed to treat (NNT) of 26 (95% CI: 16, 82). Three studies evaluated nitroglycerin administered by a dermal patch reaching together an RR of 0.66 (95% CI; 0.43, 1.01). The use of nitroglycerin is associated with a significantly increased risk of hypotension (RR 2.25) and headache (RR 3.64). No difference in mortality was observed.Conclusions  Overall, our meta‐analysis supports the use of nitroglycerin in the prevention of post‐ERCP pancreatitis, but administration of nitroglycerin by the dermal route, which is the preferred route of administration, did not reach statistical significance.
Diversity, ecology and evolution of groundwater copepods
Authors: GALASSI DIANA M. P. , HUYS RONY , REID JANET W. 
Published: February 2009

Summary1. With few exceptions, copepods dominate over other crustacean and non‐crustacean invertebrate groups in ground water. They have colonised a vast array of habitats in continental ground waters, where they are represented by over 1000 species in six orders: Platycopioida, Misophrioida, Calanoida, Cyclopoida, Harpacticoida, Gelyelloida. However, members of only the last four orders entered genuine fresh ground water.2. Stygobiotic copepods show a wide range of morphological and physiological adaptations to different groundwater habitats. They frequently exhibit simplifications in body plans, including reductions in appendage morphology, which is regarded as a result of paedomorphic heterochronic events.3. Copepod distributions at small spatial scales are most strongly affected by habitat type and heterogeneity, with sediment grain size and availability of organic matter being important habitat characteristics. Large‐scale spatial distributions (biogeographical) are mainly related to past geological, climatic and geographical processes which occurred over medium to long time scales.4. Such processes have affected colonisation patterns and diversification of copepods in ground water, leading to a number of phylogenetic and distributional relicts and a high degree of endemism at different taxonomic levels. This is reflected in the composition of groundwater copepod communities characterised by distantly related species in the phylogenetic tree.5. Copepods dominate the species richness of groundwater fauna in all regions and on all continents where more than cursory surveys have been carried out, i.e. in Europe, North and Latin America as well as in Australia.6. Species‐specific microhabitat preferences, high proportions of local endemics, high proportions of phylogenetic and distributional relicts, and higher‐level taxonomic diversity are all factors suggesting that copepods are a useful indicator group of overall species richness for defining conservation priorities in ground water.
Deadly combination of genes and drought: increased mortality of herbivore‐resistant trees in a foundation species
Authors: STHULTZ CHRISTOPHER M. , GEHRING CATHERINE A. , WHITHAM THOMAS G. 
Published: February 2009

AbstractCurrent climate models predict a shift to warmer, drier conditions in the southwestern US. While major shifts in plant distribution are expected to follow these climate changes, interactions among species and intraspecific genetic variation rarely have been incorporated into models of future plant distributions. We examined the drought‐related mortality of pinyon pine (Pinus edulis) in northern Arizona focusing on trees that showed genetically‐based resistance or susceptibility to a nonlethal herbivore, the shoot‐boring moth, Dioryctria albovittella. Because moth resistant trees have outperformed susceptible trees during 20 years of study, and herbivory has been shown to increase drought related mortality, we expected higher mortality rates in susceptible trees. However, our field observations and greenhouse experiments showed several unexpected patterns relevant to understanding the consequences of climate change: (1) The mortality of adult P. edulis resistant to the moth was three times higher than the mortality of trees susceptible to the moth. (2) Over a few years, differential mortality caused a shift in stand structure from resistant dominated to equality (3 : 1 resistant : susceptible to 1 : 1). (3) Adult moth resistant trees suffered significantly greater water stress than adult moth susceptible trees, suggesting that variation among the two groups in drought tolerance may be a mechanism for differential mortality. (4) When grown under drought conditions in the greenhouse, seedlings from resistant mothers died sooner than seedlings from susceptible mothers. These data support the hypothesis that drought can act as an agent of balancing selection and that drought resistance is a heritable trait. Taken together, our findings suggest that genetic variation in a population can be an important factor in determining its response to future climate change, and argue for the inclusion of genetics into models developed to understand the consequences of climate change.
Using functional traits to predict grassland ecosystem change: a mathematical test of the response‐and‐effect trait approach
Authors: KLUMPP KATJA , SOUSSANA JEAN‐FRANÇOIS 
Published: February 2009

AbstractThe role of plant community structure and plant functional traits for above‐ and belowground carbon (C) fluxes was studied for 2 years in a mesocosm experiment with grassland monoliths, using continuous gas exchange measurements and soil analyses. Here we test the response‐and‐effect trait hypothesis, by applying a mathematical framework used to predict changes in C fluxes after a change in disturbance through the community response (R) and effect (E) traits. Monoliths were extracted from two contrasted long‐term field treatments (high vs. low grazing disturbance) and exposed to both low and high (simulated grazing) disturbance during a 2 years experiment. Carbon dioxide exchanges were measured continuously in an open flow system. Net ecosystem productivity and ecosystem C balance were positively correlated at low disturbance with plant species richness. Aboveground net primary productivity (ANPP) and soil C sequestration were, however, unrelated to these variables. Community aggregated leaf (specific leaf area, leaf dry‐matter content) and root and rhizome (specific length, tissue density, diameter) traits responded (R) significantly to changes in disturbance, indicating an increased dominance of conservative plant growth strategies at low compared with high disturbance. Applying the mathematical framework, ANPP was predicted by distribution of leaf traits within the community (functional divergence), while mean root and rhizome traits had significant effects (E) on soil C sequestration, irrespective of the experimental disturbance and of the year. According to highly significant linear regression models, between 6% and 61% of the transient changes in soil C sequestration resulted from community root and rhizome (response‐and‐effect) traits after a change in disturbance.
Factors affecting between‐lake variation in the occurrence of epidermal papillomatosis in roach,Rutilus rutilus(L.)
Authors: Korkea‐aho T L , Vainikka A , Kortet R , Taskinen J 
Published: February 2009

AbstractThe theory of island biogeography predicts that the probability of a species occupying an island depends on a dynamic equilibrium between extinction and colonization. Epidermal papillomatosis is a disease manifesting as skin tumours on fish. We studied the factors affecting the occurrence of the disease in roach,Rutilus rutilus(L.), in 34 lakes. The results of discrimination analysis suggest that maximum depth, percentage of the drainage area of the lake covered by lakes in the vicinity and altitude best identified diseased lakes. Comparison of diseased and non‐diseased lakes revealed that lake area could also be regarded as a variable contributing to the occurrence of the disease. The sampling date, proportion of males and mean length of fish did not discriminate between the lakes. The probability of the disease occurring was highest in large, deep, low‐altitude lakes which had a high percentage of lakes in their vicinity. Thus, the results indicate that the colonization and extinction processes probably contribute to the occurrence of papillomatosis in roach, as predicted by the theory. Furthermore, the large natural variation in the occurrence of the disease could mask possible environmental effects and between‐lake comparisons should be interpreted with caution when using the fish‐papillomatosis system as an indicator of environmental stress.
Antibody response of two populations of common carp, Cyprinus carpio L., exposed to koi herpesvirus
Authors: St‐Hilaire S , Beevers N , Joiner C , Hedrick R P , Way K 
Published: February 2009

AbstractCommon carp, Cyprinus carpio L., exposed to koi herpesvirus (KHV) may become persistently infected and populations containing such virus‐infected individuals may transmit the virus to other fish when co‐habited. Detection of virus‐infected fish in a population is thus critical to surveillance and control programmes for KHV. A study was therefore designed to detect anti‐KHV serum antibodies, with an enzyme‐linked immunosorbent assay, in common carp following experimental exposures to KHV under varying environmental conditions. The study determined that a proportion of fish within a population experimentally exposed to KHV (at least 10–25%) develop high antibody titres (1/1600 or greater) to the virus, and this immunological response was detectable for several months (observed at the termination of the experiments at 65, 46 and 27 weeks post‐exposure). Furthermore, this response was detected in one population of fish that did not succumb to a high level of mortality when maintained at water temperatures that were non‐permissive for KHV. Elevating the water temperatures to permissive conditions for KHV resulted in recurrence of disease despite the presence of anti‐virus antibodies, suggesting that serum antibodies alone are not protective under the conditions of our trials.