bluuebunny/crossref_metadata_2025_split huggingface dataset:
Equivalent Noise Level Generated by Drilling Onto the Ossicular Chain as Measured by Laser Doppler Vibrometry: A Temporal Bone Study
Authors: Jiang Dan , Bibas Athanasios , Santuli Carlo , Donnelly Neil , Jeronimidis George , O'Connor Alec Fitzgerald 
Published: May 2007

AbstractBackground: Inadvertent drilling on the ossicular chain is one of the causes of sensorineural hearing loss (HL) that may follow tympanomastoid surgery. A high‐frequency HL is most frequently observed. It is speculated that the HL is a result of vibration of the ossicular chain resembling acoustic noise trauma. It is generally considered that using a large cutting burr is more likely to cause damage than a small diamond burr.Aim: The aim was to investigate the equivalent noise level and its frequency characteristics generated by drilling onto the short process of the incus in fresh human temporal bones.Methods and Materials: Five fresh cadaveric temporal bones were used. Stapes displacement was measured using laser Doppler vibrometry during short drilling episodes. Diamond and cutting burrs of different diameters were used. The effect of the drilling on stapes footplate displacement was compared with that generated by an acoustic signal. The equivalent noise level (dB sound pressure level equivalent [SPL eq]) was thus calculated.Results: The equivalent noise levels generated ranged from 93 to 125 dB SPL eq. For a 1‐mm cutting burr, the highest equivalent noise level was 108 dB SPL eq, whereas a 2.3‐mm cutting burr produced a maximal level of 125 dB SPL eq. Diamond burrs generated less noise than their cutting counterparts, with a 2.3‐mm diamond burr producing a highest equivalent noise level of 102 dB SPL eq. The energy of the noise increased at the higher end of the frequency spectrum, with a 2.3‐mm cutting burr producing a noise level of 105 dB SPL eq at 1 kHz and 125 dB SPL eq at 8 kHz. In contrast, the same sized diamond burr produced 96 dB SPL eq at 1 kHz and 99 dB at 8 kHz.Conclusion: This study suggests that drilling on the ossicular chain can produce vibratory force that is analogous with noise levels known to produce acoustic trauma. For the same type of burr, the larger the diameter, the greater the vibratory force, and for the same size of burr, the cutting burr creates more vibratory force than the diamond burr. The cutting burr produces greater high‐frequency than lower‐frequency vibratory energy.
Selective Activation of Cat Primary Auditory Cortex by way of Direct Intraneural Auditory Nerve Stimulation
Authors: Kim Seung‐Jae , Badi Arunkumar N. , Normann Richard A. 
Published: May 2007

AbstractObjectives/Hypothesis: Although cochlear implants have been successfully used by many individuals with profound hearing impairment, limitations still remain with this approach to hearing restoration, including poor stimulation selectivity because of cross‐talk between electrodes and poor low‐frequency percepts. These limitations may be mitigated by direct intraneural stimulation of the auditory nerve by way of an array of penetrating microelectrodes. Such an approach should provide focal stimulation and selective activation of the nerve fibers, thereby minimizing cross‐talk among implanted stimulating electrodes and evoking narrow‐band frequency percepts.Study Design: We investigated the activation of primary auditory cortex evoked by such direct intraneural electrical stimulation of the auditory nerve.Methods: We implanted 11 penetrating microelectrodes in the cat auditory nerve, simulated the nerve by way of these electrodes, and recorded the evoked neuronal activity patterns in cat primary auditory cortex. We compared these activation patterns with acoustically evoked cortical activity patterns obtained in a different animal.Results: Our results showed that direct stimulation of the auditory nerve evoked localized activity patterns in primary auditory cortex similar in spatial extent to those evoked by acoustic stimulation and that the extent of cortical activation by both acoustic and electrical stimuli was graded with stimulus intensity. These results suggest that the implanted electrodes can excite independent and small populations of nerve fibers.Conclusion: This study demonstrates the functional feasibility of direct intraneural auditory nerve stimulation with an array of penetrating microelectrodes and that such an approach could form the foundation for an auditory prosthesis with improved frequency coding.
Cochlear Implantation in the Neurofibromatosis Type 2 Patient: Long‐Term Follow‐up
Authors: Neff Brian A. , Wiet R Mark , Lasak John M. , Cohen Noel L. , Pillsbury Harold C. , Ramsden Richard T. , Welling D Bradley 
Published: May 2007

AbstractObjective: To evaluate the long‐term hearing outcomes of neurofibromatosis type 2 (NF2) patients with cochlear implants.Methods: Retrospective analysis of cochlear implant performance in NF2 patients using open‐ and closed‐set speech perception testing.Results: Patients with NF2‐associated bilateral vestibular schwannomas frequently become profoundly deaf. The aim of surgical resection should be to preserve serviceable hearing in at least one ear; however, this goal can be difficult to achieve. Frequently, tumor size or poor preoperative hearing status can require a surgical approach that leaves the patient with a profound, bilateral sensorineural hearing loss. If the cochlear nerve is preserved anatomically after vestibular schwannoma surgery, and if promontory stimulation confirms the functionality of the cochlear nerve, then cochlear implantation is an excellent option to restore hearing. We present six cochlear implant patients with NF2 who attained a significant improvement in open‐ and closed‐set speech understanding with a mean follow‐up of 7.9 (range: 5–13) years after surgery. In all but one case, the hearing results did not deteriorate over the follow‐up period.Conclusion: Early surgical intervention for vestibular schwannomas in NF2 patients when the cochlear nerve can be spared is an important consideration to allow for possible cochlear implantation. A 6‐ to 8‐week recovery period for the anatomically intact cochlear nerve may be necessary to obtain a positive promontory stimulation response following tumor resection and should be performed prior to cochlear implantation.
Does Suture Material and Technique Really Matter? Lessons Learned From 800 Consecutive Blepharoplasties
Authors: Joshi Arjun S. , Janjanin Sasa , Tanna Neil , Geist Craig , Lindsey Charlie 
Published: May 2007

AbstractObjectives: The purpose of this study was to evaluate established suture materials and techniques for blepharoplasty closure and evaluate for any differences in rates of complications between these groups.Study Design and Methods: This was a prospective study of a large sequential series of patients undergoing upper blepharoplasty who were treated by the same senior author over a 5‐year period. Patients were assigned one of four techniques for closure of the incision based on the senior author's experience. After 6 weeks, rates of complications and revisions were noted and addressed. Satisfaction rates were noted at 3 months.Results: In the group whose incisions were closed with running subcuticular polypropylene (Prolene), 5 (2.5%) presented with milia, and 11 (5.5%) had a standing cone deformity (SCD). Use of running cutaneous locked Prolene resulted in 8 patients (17%) with milia and 2 patients (4.4%) requiring revision of a SCD. Use of a running 6‐0 plain gut suture resulted in 12 patients (6.7%) with milia and 5 patients (2.8%) with unsightly scarring. In the group whose incisions were closed with running 6‐0 fast‐absorbing gut, 10 patients (2%) presented with milia, and there were no scar revisions. There were statistically significant differences between the groups with respect to formation of milia, scarring, and persistent erythema (P < .008).Conclusions: Blepharoplasty is a safe and effective procedure that can be performed successfully with several established techniques. In our experience, closure with two interrupted 6‐0 Prolene sutures and a running 6‐0 fast‐absorbing gut resulted in the lowest rates of complications and revisions.
The Ductal Stretching Technique: An Endoscopic‐Assisted Technique for Removal of Submandibular Stones
Authors: Nahlieli Oded , Shacham Rachel , Zagury Ami , Bar Tal , Yoffe Boris 
Published: May 2007

AbstractObjective: The purpose of this study was to describe an innovative surgical technique for the removal of posterior and hilar stones of the submandibular salivary duct.Methods: Between 1999 and 2005, 172 patients who had sialolithiasis of the submandibular duct were treated primarily by transoral incision and marsupialization of the duct and salivary gland. The ductal stretching technique involved endoscopic location of the stone, incision of the oral mucosa above the duct, isolation of the duct from the surrounding tissues, stretching of the duct, ductal incision above the calculus, sialolithotomy, and insertion of a drain.Results: Forty‐one patients with stones located in the posterior aspect of the duct were symptom‐free and stone free after the procedure. One hundred and five patients with stones located in the hilum were treated with a success rate of 98%. Twenty‐six patients with multiple stones in the hilar region were treated with a success rate of 81%. The overall success rate of the procedure was 96%. In 48 patients (28%), an additional undetected stone was diagnosed by endoscopy after the removal of the stone in the hilum. In 62 patients (36%), strictures were diagnosed endoscopically posterior to the stone. Lingual nerve paresthesia occurred in one patient, who recovered completely.Conclusion: The ductal stretching technique is recommended as the procedure of choice in cases with posterior and hilar stones more than 5 mm in diameter to avoid surgical removal of the salivary gland.
Outcome of Endoscopic Treatment of Adult Postintubation Tracheal Stenosis
Authors: Nouraei S A. Reza , Ghufoor Khalid , Patel Anil , Ferguson Tina , Howard David J. , Sandhu Guri S. 
Published: May 2007

AbstractObjectives/Hypothesis: To assess the results of primary endoscopic treatment of adult postintubation tracheal stenosis, to identify predictors of a successful outcome, and better define the scope and limitations of minimally‐invasive surgery for this condition.Methods: Sixty‐two consecutive patients treated between April 2003 and 2006 with initial endoscopic surgery were prospectively studied. Patient and lesion characteristics, treatment details, complications, decannulation, and open surgery rates were recorded. Actuarial analysis and Cox regression were used to identify predictors of decannulation and freedom from external surgery.Results: There were 34 male patients and the average age was 45 ± 16 years. The average stenosis height was 18 mm (range: 5–55 mm), and 82% of lesions were Myer‐Cotton grades III or IV. Lesion height and intubation‐to‐treatment latency independently predicted success of endoscopic surgery. Ninety‐six percent of patients with lesions <30 mm in height were treated endoscopically, but the success rate fell to 20% for lesions longer than 30 mm. Patients with recalcitrant lesions underwent airway augmentation (n = 11) or resection (n = 3), with a 79% success rate. All patients were decannulated, but some, predominantly morbidly obese patients, required long‐term stents for dynamic airway compromise. Ninety‐eight percent of re‐interventions occurred within 6 months.Conclusions: Minimally invasive treatment is effective in postintubation airway stenosis and obviates the need for open cervicomediastinal surgery in most patients. Patients with old and long lesions are less likely to be cured endoscopically. For most patients in this subgroup, endoscopic surgery makes airway augmentation a viable, less invasive alternative to resection. Patients were unlikely to require further therapy after 6 months of symptom‐free follow‐up.
Oropharyngeal Foreign Body After Attempted Nasal Intubation: A Case of Traumatic Middle Turbinectomy
Authors: Scott Andrew R. , Gray Stacey T. 
Published: May 2007

AbstractA nasopharyngeal airway, or nasal trumpet, is an adjunctive airway device used to bypass upper airway obstruction at the level of the oral cavity or oropharynx. Although nasal trumpet placement on an awake patient may be uncomfortable, there are no reports of significant trauma from insertion. We present an unusual case of middle turbinate avulsion presenting as a foreign body in the oropharynx after several attempts at placement of a nasopharyngeal airway in an unconscious patient. We hope to raise awareness that nasal intubation in patients with altered consciousness can result in significant nasal trauma, especially after multiple attempts have failed.
Sensitivity of human cells bearing oncogenic mutant kit isoforms to the novel tyrosine kinase inhibitor INNO‐406
Authors: Pan Jingxuan , Quintás‐Cardama Alfonso , Manshouri Taghi , Cortes Jorge , Kantarjian Hagop , Verstovsek Srdan 
Published: May 2007

The activity of the novel tyrosine kinase inhibitor INNO‐406 against human cells with mutated KIT was investigated. Human mast cell (HMC)‐1.1 cells with juxtamembrane domain mutation V560G, and HMC‐1.2 cells with both V560G and the kinase domain mutation D816V, were treated with INNO‐406 (0.02–5.00 µM) or imatinib for 72 h. INNO‐406 and imatinib were equipotent against HMC‐1 cells regarding cell proliferation (IC50 51 nM and 75 nM, respectively), inhibition of KIT phosphorylation, and induction of apoptosis. In contrast, neither drug was effective against HMC‐1.2 cells at the dose range tested. The present results suggest clinical potential for INNO‐406 in KIT V560G‐expressing malignancies. (Cancer Sci 2007; 98: 1223–1225)
Rate of detoxification service use and its impact among a cohort of supervised injecting facility users
Authors: Wood Evan , Tyndall Mark W. , Zhang Ruth , Montaner Julio S. G. , Kerr Thomas 
Published: May 2007

ABSTRACTBackground  Vancouver, Canada recently opened a medically supervised injecting facility (SIF) where injection drug users (IDU) can inject pre‐obtained illicit drugs. Critics suggest that the facility does not help IDU to reduce their drug use.Methods  We conducted retrospective and prospective database linkages with residential detoxification facilities and used generalized estimating equation (GEE) methods to examine the rate of detoxification service use among SIF participants in the year before versus the year after the SIF opened. In secondary analyses, we used Cox regression to examine if having been enrolled in detoxification was associated with enrolling in methadone or other forms of addiction treatment. We also evaluated the impact of detoxification use on the frequency of SIF use.Results  Among 1031 IDU, there was a statistically significant increase in the uptake of detoxification services the year after the SIF opened. [odds ratio: 1.32 (95% CI, 1.11–1.58); P = 0.002]. In turn, detoxification was associated independently with elevated rates of methadone initiation [relative hazard = 1.56 (95% CI, 1.04–2.34); P = 0.031] and elevated initiation of other addiction treatment [relative hazard = 3.73 (95% CI, 2.57–5.39); P < 0.001]. Use of the SIF declined when the rate of SIF use in the month before enrolment into detoxification was compared to the rate of SIF use in the month after discharge (24 visits versus 19 visits; P = 0.002).Conclusions  The SIF's opening was associated independently with a 30% increase in detoxification service use, and this behaviour was associated with increased rates of long‐term addiction treatment initiation and reduced injecting at the SIF.
Genetic and environmental influences on the relationship between peer alcohol use and own alcohol use in adolescents
Authors: Fowler Tom , Shelton Katherine , Lifford Kate , Rice Frances , McBride Andrew , Nikolov Ivan , Neale Michael C. , Harold Gordon , Thapar Anita , Van Den Bree Marianne B. M. 
Published: May 2007

ABSTRACTAims  Genetically influenced aspects of adolescent behaviour can play a role in alcohol use and peer affiliation. We explored the correlations between friends' alcohol use and adolescent own use with a genetically sensitive design.Design  Genetic and environmental factors were estimated on adolescent reports of their friends' alcohol use and their own use and problem use of alcohol. The correlations between the genetic and environmental factors that influence friends' alcohol use and adolescent own alcohol use and problem use were also estimated.Participants  A total of 862 twin pairs aged 11–17 years sampled from the UK population‐based Cardiff Study of All Wales and North‐west of England Twins (CaStANET).Measurements  Data on adolescent own alcohol use and problem use and the alcohol use of their three best friends were obtained using self‐report questionnaires.Findings  A significant genetic influence was found on adolescent friends' alcohol use (about 30%). Significant correlations of 0.60 and 0.70 were found between the genetic influences on friends' alcohol use and adolescents' own use and problem use of alcohol. Common environmental influences were almost completely correlated for friends' alcohol use and adolescents' own alcohol use and problem use (0.91 and 0.94).Conclusions  There is considerable overlap in the common environmental and genetic factors that contribute to the relationship between adolescents' own alcohol use and that of their friends. These findings contribute to understanding of the mechanisms by which friends' alcohol use influences adolescent drinking behaviour.
Effectiveness of individually tailored smoking cessation advice letters as an adjunct to telephone counselling and generic self‐help materials: randomized controlled trial
Authors: Sutton Stephen , Gilbert Hazel 
Published: May 2007

ABSTRACTObjective  To evaluate the effectiveness of individually tailored smoking cessation advice letters as an adjunct to telephone counselling and generic self‐help materials.Design  Randomized controlled trial.Setting  The UK Quitline.Participants  A total of 1508 current smokers and recent ex‐smokers.Interventions  The control group received usual care (telephone counselling and an information pack sent through the post). The intervention group received in addition a computer‐generated individually tailored advice letter.Main outcome measures  All outcomes were assessed at 6‐month follow‐up. The primary outcome measure was self‐reported prolonged abstinence for at least 3 months. Secondary outcomes were self‐reported prolonged abstinence for at least 1 month and 7‐day and 24‐hour point‐prevalence abstinence.Results  For the sample as a whole, quit rates did not differ significantly between the two conditions. However, among the majority (n = 1164) who were smokers at baseline, quit rates were consistently higher in the intervention group: prolonged abstinence for 3 months, 12.2% versus 9.0% [odds ratio (OR) = 1.40, 95% confidence interval (CI) = 0.96–2.04, P = 0.080); prolonged abstinence for 1 month, 16.4% versus 11.3% (OR = 1.53, 95% CI = 1.09–2.15, P = 0.013); 7‐day point‐prevalence abstinence, 18.9% versus 12.7% (OR = 1.59, 95% CI = 1.15–2.19, P = 0.004); 24‐hour point‐prevalence abstinence, 20.9% versus 15.4% (OR = 1.45, 95% CI = 1.07–1.96, P = 0.015).Conclusions  The results for the smokers are encouraging in showing a small but useful effect of the tailored letter on quit rate. Versions of the tailoring program could be used on the web and in general practices, pharmacies and primary care trusts.
Stability of subtypes of natural recovery from alcohol dependence after two years
Authors: Bischof Gallus , Rumpf Hans‐Jürgen , Meyer Christian , Hapke Ulfert , John Ulrich 
Published: May 2007

ABSTRACTAims  The lack of consistent findings in studies on natural recovery from alcohol dependence may reflect heterogeneous subgroups according to social support and problem severity. In a previous report, we identified the following groups: high severity of dependence, low alcohol‐related problems and low social support (low problems–low support: LPLS), high severity of dependence, high alcohol‐related problems and medium social support (high problems–medium support: HPMS) and high social support, late age of onset, low severity of dependence and low alcohol‐related problems (low problems–high support: LPHS). However, little is known about the trajectories of these groups. The aim of the present study is to analyse the stability of these three groups report on longer‐term outcomes.Design and participants  A cohort of initially untreated remitters recruited through media solicitation (n = 178) was followed‐up after 24 months.Measurements  Personal interviews using standardized instruments including social support together with interview data from collaterals.Results  Differences between the cluster groups in social support diminished over time; however, even at follow‐up, LPLS revealed less social support by friends when compared to LPHS and showed significant higher rates of relapse and utilization of formal help than did HPHS and LPHS.Conclusions  Data show that the interplay between psychosocial resources and substance‐related problems may still account for differences in trajectories of naturally remitted individuals in a 2‐year follow‐up.
Equity of access to treatment, and barriers to treatment for illicit drug use in Australia
Authors: Digiusto Erol , Treloar Carla 
Published: May 2007

ABSTRACTAims and design  This study investigated equity of access to treatment and barriers to treatment for illicit drug use, using Andersen's behavioural model of health service utilization.Setting and participants  The study involved 492 drug users who had received treatment and 193 who had not.Measurements  Participants were interviewed to gather data relating to 19 predisposing, need and enabling variables.Findings  Never‐treated participants exhibited less need for treatment than those who had received treatment. They experienced less negative emotion, used their main drug less often, had fewer drug‐related health problems and fewer drug‐using friends, were less likely to have blood‐borne virus infections and were more likely to be using drugs for ‘fun’. They also had more negative attitudes towards drug treatment staff, were less likely to believe that appropriate treatment was available and less likely to believe that professional help was necessary to get off drugs. Prevalence of physical and mental health problems was high in both groups.Conclusions  The study documented significant unmet treatment need and identified several sources of inequity and barriers to treatment that would be amenable to policy and service development. Drug user organizations and peer educators and motivational interventions in primary care settings should be utilized to market the nature and benefits of treatment effectively, and to address the causes of drug users' negative attitudes towards treatment.