bluuebunny/crossref_metadata_2025_split huggingface dataset:
Generalized anxiety disorder and major depressive disorder comorbidity: an example of genetic pleiotropy?
Authors: Gorwood P. 
Published: January 2004

AbstractGeneralized anxiety disorder (GAD) and major depressive disorder (MDD) are the most common type of anxiety-mood comorbidity. Up to 80% of subjects with lifetime GAD also have a comorbid mood disorder during their lifetime. Many hypotheses have been raised to explain such high comorbidity. Pleiotropy, i.e. a single genetic mutation explains (apparently) different disorders, is one of them and is hereby reviewed. Importance and reliability of GAD and MDD comorbidity (1); Evidence in favour of co-aggregation of GAD and MDD within families (the risk of one disorder in a proband increasing the risk for the other in relatives) (2); substantial heredity for both disorders according to twin studies with evidence for genetic correlation of unity between the two disorders (3); existence of numerous mechanisms (4) potentially linking the two disorders to common vulnerability genes, are all in accordance with such a hypothesis. Some examples of potentially shared mechanisms (such as CRF dysregulation or abnormal transcription factors) and possible common vulnerability genes (for example, the serotonin transporter gene) are given to highlight the pleiotropy hypothesis.
Safety Review of Benzalkonium Chloride Used as a Preservative in Intranasal Solutions: An Overview of Conflicting Data and Opinions
Authors: Marple Bradley , Roland Peter , Benninger Michael 
Published: January 2004

BACKGROUNDFor most multiuse aqueous nasal, ophthalmic, and otic products, benzalkonium chloride (BKC) is the preservative of choice. The American College of Toxicology has concluded that BKC can be safely used as an antimicrobial agent at concentrations up to 0.1%. BKC has been in clinical use since 1935 and is contained in a wide variety of prescription and over‐the‐counter products. However, over the past several years there have been conflicting reports of damage to human nasal epithelia and/or exacerbation of rhinitis medicamentosa associated with intranasal products containing BKC.OBJECTIVEWe sought to review the published literature and determine whether there is sufficient, clinically significant data that would confirm that intranasal products containing BKC are likely to damage human nasal epithelia or exacerbate rhinitis medicamentosa.METHODSA literature search was conducted for in vivo and in vitro studies that evaluated the effects of BKC on human nasal epithelia.RESULTSA total of 18 studies (14 in vivo, 4 in vitro) were identified that evaluated short‐ and long‐term exposure of concentrations of BKC in concentrations ranging from 0.00045% to 0.1%. Eight studies, including a 6‐month and 1‐year long‐term treatment study, demonstrated no toxic effects associated with BKC, indicating that BKC was neither harmful to nasal tissue nor prone to exacerbate rhinitis medicamentosa. Furthermore, of the 10 studies that concluded that BKC resulted in degenerative changes in human nasal epithelia (eg, ciliary beat frequency, ciliary morphology, mucociliary clearance, epithelial thinning and/or destruction) or that BKC exacerbates rhinitis medicamentosa, only 2 (it was 2 according to the Results section) of these studies were supported by statistically significant differences between BKC and placebo or active control groups were compared. It is important to note that in both of these studies, the protocol incorporated the use or oxymetazoline in some or all of the subjects. Oxymetazoline is associated with rhinitis medicamentosa.CONCLUSIONIntranasal products containing the preservative BKC appear to be safe and well tolerated for both long‐ and short‐term clinical use.
Injection Snoreplasty: Investigation of Alternative Sclerotherapy Agents
Authors: Brietzke Scott E. , Mair Eric A. 
Published: January 2004

OBJECTIVEPalatal sclerotherapy with sodium tetradecyl sulfate (“injection snoreplasty”) was recently introduced as a safe and effective treatment for primary snoring. However, multiple other sclero‐therapy agents also have excellent safety records and documented efficacy in the head and neck. Widely available and inexpensive agents were evaluated as potential palatal sclerosing agents for the treatment of snoring.STUDY DESIGN AND SETTINGA described canine palatal flutter model was used to evaluate the palatal stiffening efficacy of ethanol, doxycycline, and hypertonic saline in comparison to 3% sodium tetradecyl sulfate (STS) and a negative control (normal saline). Based on the animal study results, a human pilot study with ethanol was performed with subjective and objective data.RESULTSEthanol was found to be equally effective as 3% STS in the canine model. Doxycycline was effective but less so, and hypertonic saline was comparatively ineffective. Palatal injection in human patients with 50% ethanol was found to produce equivalent subjective and objective snoring efficacy and equivalent pain and recovery time compared with 3% STS. However, there was a higher rate of transient palatal fistula with ethanol. CONCLUSIONS AND SIGNIFICANCE: Injection snoreplasty with 50% ethanol is equally efficacious compared with 3% STS. There could be a higher fistula rate with the use of ethanol, although this complication has been self‐limited and transient in every case.
Acoustic Pharyngometry Patterns of Snoring and Obstructive Sleep Apnea Patients
Authors: Kamal Ibrahim 
Published: January 2004

OBJECTIVEAnatomic narrowing of the pharyngeal airway increases the relative negative pressure generated during inspiration, thus affecting the dynamic behavior of the upper airway. The aim of this work was to measure pharyngeal area in snoring patients with and without obstructive sleep apnea (OSA), as categorized by polysomnography and by acoustic pharyngometry, and to analyze the different curve patterns obtained from patients of both groups.METHODSWe examined 50 snorers who were divided into 2 groups matched for age, gender, and body mass index.RESULTSMean Apnea Index (AI) in nonapneic snorers (group 1) was 4, and mean pharyngeal area was 2.41 cm2. In snoring patients with OSA (group 2), mean AI was 25.9 with a mean pharyngeal area of 1.589 cm2(P< 0.001). In both groups, the dependent variable (AI) can be predicted from a linear relation with the independent variable (pharyngeal area) with normality and constant variance tests passed. In group 1, the resulting curve can be 1 of 2 types depending on the relative area of the pharyngeal segment to the velopharyngeal area. In group 2, the curve pattern can be categorized into 3 patterns depending on the possible pathology of pharyngeal obstruction.CONCLUSIONThe acoustic reflection technique is reproducible, noninvasive, and free from potential side effects. The good correlation between AI and pharyngeal area adds to the potential of acoustic pharyngometry. Careful study of the pharyngeal cross‐sectional area and curve topography may give a good idea about the site of upper airway obstruction.
Nasopharyngeal Granulomatous Inflammation and Tuberculosis Complicating Undifferentiated Carcinoma
Authors: Chan Amy B. W. , Ma Tony K. F. , Yu Brian K. H. , King Ann D. , Ho Fiona N. Y. , Tse Gary M. K. 
Published: January 2004

OBJECTIVEFour cases of nasopharyngeal granulomatous inflammation after radiotherapy for undifferentiated carcinoma were analyzed for tuberculosis, and the histologic features were compared. STUDY DESIGN AND SETTING: We conducted a retrospective study with analysis of tuberculosis by Ziehl Neelsen staining and polymerase chain reaction analysis for Mycobacterium tuberculosis DNA on histologic materials.ResultsThree patients had previous nasopharyngeal undifferentiated carcinoma, one had previous metastatic undifferentiated carcinoma to cervical lymph nodes, and all patients received similar radiotherapy regimen. The light microscopic features were similar with epithelioid histiocytes and granulomas with Langhan's giant cells. In 3 cases, acid‐fast bacilli were identified by Ziehl Neelsen stain, and 1 was negative. The results of 2 cases were confirmed by polymerase chain reaction analysis for Myocbacterium tuberculosis DNA.CONCLUSIONGranulomatous reaction after radiotherapy of nasopharyngeal undifferentiated carcinoma can be caused by tuberculosis.SIGNIFICANCEDiligent search for organisms in postirradiation granulomatous inflammation is warranted to avoid missing an occult tuberculosis infection.
Total Ossiculoplasty with Footplate Removal
Authors: Berenholz Leonard , Lippy William H. 
Published: January 2004

OBJECTIVEWe reviewed the results and management of cases in which total ossiculoplasty requires footplate removal.STUDY DESIGN AND SETTINGWe conducted a retrospective review of 10 patients who underwent total ossiculoplasty with footplate removal between 1999 and 2002. These 10 patients represented 5.4% of those undergoing stapedectomy (n = 91) and ossiculoplasty (n = 93) during these years at a tertiary otologic referral center.RESULTSA total of 10 patients were evaluated, with a mean 17‐month follow‐up. Closure of air‐bone gap (ABG) to within 20 dB was achieved in 6 of 10 patients (60%). Mean postoperative ABG was 21.7 dB (500 to 4000 Hz) with an average 4‐frequency pure tone improvement of 20.7 dB. Operative findings included extensive tympanosclerosis, partial obstruction of oval window by facial nerve, and changes from prior surgery. There were no patients with postoperative sensorineural hearing loss.CONCLUSIONSThe need to open the footplate in cases of total ossiculoplasty is uncommon. This may be accomplished with good improvement in hearing with minimal risk.
Radiofrequency Soft Palate Procedure in Snoring: Influence of Energy Delivered
Authors: Kania Romain E. , Schmitt Emmanuel , Petelle Boris , Meyer Bernard 
Published: January 2004

OBJECTIVEWe conducted a retrospective study to evaluate the influence of amount of energy delivered during radiofrequency procedure for soft palate reduction in snoring, to improve the cure rate.METHODSConsecutive patients with chronic disruptive snoring presenting to our department were successively treated in an outpatient procedure. A visual analog scale was used to assess the severity of snoring by the bed partner and the pain by the patient, before treatment and after each treatment session. The soft palate was divided into 3 treatment sites: middle, lateral right, and lateral left. Any mucosal injury of the soft palate was classified as a complication.RESULTSForty‐3 patients were classified into 2 groups according to energy assignment. The total amount of energy delivered was 1250 J in group 1 (n = 15) and 1500 J in group 2 (n = 28). Energy was predominantly distributed in the middle of the soft palate in group 1 (550 J) and group 2 (800 J). After each treatment session, the 1500‐J delivery of radiofrequency energy (total per session) led to a better snoring grading reduction in comparison with the 1250‐J delivery with a significant difference after 2 treatment sessions (P < 0.05). The mean pain score and the incidence rate of complications per treatment were not statistically different in comparing both groups.CONCLUSIONBetter snoring scores can be expected by increasing radiofrequency energy applied to the soft palate. Further randomized long‐term investigations are required to confirm that the cure rate can be improved when increasing energy with a suitable distribution and good clinical tolerance.
Localization and Level of Expression of β‐Catenin in Human Laryngeal Squamous Cell Carcinoma
Authors: Lopez‐Gonzalez Jose Sullivan , Cristerna‐Sanchez Lissete , Vazquez‐Manriquez Maria Eugenia , Jimenez‐Orci Gonzalo , Aguilar‐Cazares Dolores 
Published: January 2004

OBJECTIVEWe studied the participation of β‐catenin in the histologic differentiation of laryngeal squamous cell carcinomas.STUDY DESIGN AND SETTINGAt the National Institute of Respiratory Diseases, a tertiary referral center, localization and level of expression of β‐catenin were compared between normal epithelium (15 cases) and primary tumors in different degrees of differentiation (38 cases), using an immunohistochemical procedure.RESULTSCell membrane staining of β‐catenin was observed in normal epithelium and in well and moderately differentiated carcinomas. Cytoplasmic redistribution was observed in poorly differentiated carcinomas. Loss of β‐catenin correlated with tumor dedifferentiation.CONCLUSIONReduction of cell membrane β‐catenin expression correlated with tumor dedifferentiation.SIGNIFICANCELoss of β‐catenin may lead to diminishing the strength of the intercellular adhesion system, thereby promoting the invasive phenotype of the squamous cell carcinoma of the larynx.
The Role of the Genial Bone Advancement Trephine System in Conjunction with Uvulopalatopharyngoplasty in the Multilevel Management of Obstructive Sleep Apnea
Authors: Miller Frank R. , Watson Daniel , Boseley Mark 
Published: January 2004

OBJECTIVESThe successful surgical management of obstructive sleep apnea (OSA) requires surgical procedures that address both retropalatal and retrolingual airway obstruction. The Genial Bone Advancement Trephine (GBAT) system is a new, 1‐step system that allows for isolation and advancement of the genioglossus muscle via a guided trephine system. The purpose of this project was to describe our experience using the GBAT system to perform genioglossus advancement (GGA) in conjunction with uvulopalatopharyngoplasty (UPPP) in the surgical management of OSA.STUDY DESIGN: Retrospective analysis of 35 consecutive patients undergoing GGA using the GBAT system in conjunction with UPPP for the management of OSA during a 3‐year period (1999 to 2002).RESULTS: Twenty‐four patients had complete preoperative and postoperative polysomnographic data. A 70% reduction in the Respiratory Disturbance Index (RDI) and Apnea Index (AI) in the preoperative versus postoperative PSG (RDI, 52.9 ± 17.1 versus 15.9 ± 7.5; AI, 20.1 ± 6.7 versus 6.1 ± 4.5; P ≤ 0.0001). The lowest oxygen desaturation increased from 80% to 88% (P = 0.0002), and the posterior airway increased from 7.9 to 12.6 mm (P < 0.0001). With a surgical cure defined as a greater than 50% reduction in the RDI and a final postoperative RDI of less than 20 events per hour, the true surgical cure rate was 67% (16 of 24 patients).CONCLUSIONS: The GBAT system performed in conjunction with UPPP can produce significant reductions in RDI and AI while improving the oxygen desaturation and enlarging the posterior airway space. The effective cure rates using the GBAT system are in agreement with previous reports in the literature using various GGA techniques. The GBAT may have some advantages in terms of simplicity and safety.
The Risk of Aspiration of Pureed Food as Determined by Flexible Endoscopic Evaluation of Swallowing with Sensory Testing
Authors: Perlman Philip W. , Cohen Manderly A. , Setzen Michael , Belafsky Peter C. , Guss Joel , Mattucci Kenneth F. , Ditkoff Michael 
Published: January 2004

OBJECTIVEThis study evaluates the risk of aspiration of pureed foods in patients with dysphagia with increasing sensory deficits of the hypopharynx with intact versus impaired pharyngeal muscular tone (pharyngeal squeeze).STUDY DESIGNTwo hundred four dysphagic patients underwent flexible endoscopic evaluation of swallowing with sensory testing and were prospectively divided into 3 groups, with normal, moderate, and severe sensory deficits. Each group was divided into those with normal and those with impaired pharyngeal squeeze. Subjects were given pureed food boluses and were evaluated for aspiration.RESULTSThere was a significant difference in the incidence of aspiration of pureed foods for normal and moderate sensory loss when comparing normal and impaired pharyngeal squeeze (P < 0.001, Fisher exact test). There was no significant difference in the severe sensory loss group. In both the normal and impaired pharyngeal squeeze groups, there was no significant difference in aspiration as the sensory deficit increases.CONCLUSIONSPatients with impaired pharyngeal squeeze at different levels of sensory deficits are at significantly greater risk for aspiration of pureed foods compared with those with normal squeeze. However, as sensory deficits increased, the patients did not show a significant increase in aspiration. The aspiration of pureed foods may depend more on muscle tone of the hypopharynx than on sensation. Dysphagic patients who are given a pureed diet to prevent aspiration may still be at risk for aspiration. This may be easily predicted by the use of flexible endoscopic evaluation of swallowing with sensory testing in conjunction with evaluation of pharyngeal muscle tone. (Otolaryngol Head Neck Surg 2004;130:80‐3.)
Techniques of Intranasal Steroid Use
Authors: Benninger Michael S. , Hadley James A. , Osguthorpe J. David , Marple Bradley F. , Leopold Donald A. , Derebery M. Jennifer , Hannley Maureen 
Published: January 2004

OBJECTIVEThe effectiveness of topical intranasal steroids (INS) sprays for the treatment of allergic and nonallergic rhinitis may be limited by lack of instruction in the optimal spray technique. To determine whether the technique used affects the efficacy and safety of the product, this review of evidence had the goal of identifying and establishing a preferred method of applying INS sprays.STUDY DESIGNA MEDLINE search of pertinent literature on 7 INS and 1 intranasal antihistamine spray preparations conducted with the use of appropriate search terms, yielded an initial 121 articles, 29 of which were identified as appropriate for review and grading for quality of evidence.RESULTSThe analysis provided no definitive evidence regarding how best to instruct patients to use INS or antihistamine spray devices.CONCLUSIONSOn the basis of a lack of clear evidence regarding instructions to maximize efficacy and safety of these drugs, the panel recommended a 7‐step standard technique. (Otolaryngol Head Neck Surg 2004;130:5–24.)
The Fate of the Tumor Remnant after Less‐than‐Complete Acoustic Neuroma Resection
Authors: Bloch Dov C. , Oghalai John S. , Jackler Robert K. , Osofsky Monica , Pitts Lawrence H. 
Published: January 2004

OBJECTIVESWe sought to determine the recurrence rate after near‐total and subtotal resection of acoustic neuroma.STUDY DESIGN, SETTING, AND PATIENTSWe conducted a retrospective chart review of a total of 79 patients: 50 with near‐total resections (remnant ≤ 25 mm2 and ≤ 2 mm thick) and 29 with subtotal resections (any larger remnant). Surgical approach included 5 middle fossa, 17 retrosigmoid, and 57 translabyrinthine.MAIN OUTCOME MEASURESRecurrence was defined as documented tumor growth by serial imaging or the recommendation for further treatment after a single scan. No recurrence was defined as no visible tumor on imaging for a minimum follow‐up time of 3 years or tumor remnants that remained unchanged on serial scans (mean, 5‐year follow‐up).RESULTSFifty‐two patients were included in the study group. Recurrences were seen in 1 (3%) of 33 patients who had a near‐total resection compared with 6 (32%) of 19 patients who had a subtotal resection. After adjustment for follow‐up time and large tumor size, the odds ratio for recurrence was 12 times larger for subtotal than for near‐total resections (P = 0.033). All recurrences were seen following the translabyrinthine approach in the mid‐cerebellopontine angle. None were encountered in the internal auditory canal. The mean time interval from surgery to the detection of a recurrence was 3 years (range, 1 to 5 years).CONCLUSIONSThe recurrence rate when performing a near‐total resection is low but is substantially higher with a subtotal resection. Recurrences can be detected within the first 5 postoperative years. We recommend near‐total resection in any patient if needed to preserve neural integrity. Subtotal resection is best avoided whenever possible; however, adjunctive treatment with stereotactic radiotherapy may be considered.
Further evidence of the multi-dimensionality of hallucinatory predisposition: factor structure of a modified version of the Launay-Slade Hallucinations Scale in a normal sample
Authors: Larøi Frank , Marczewski Philippe , Van der Linden Martial 
Published: January 2004

AbstractRecent years has seen an increasing interest in the hallucinatory experience, including investigations of its phenomenological prevalence and character both in pathological and normal (predisposed) populations. We investigated the multi-dimensionality of hallucinatory experiences in 265 subjects from the normal population, who completed a modified version of the Launay-Slade Hallucinations Scale. Principal components analysis was performed on the data. Four factors were obtained loading on items reflecting (1) sleep-related hallucinatory experiences (2) vivid daydreams (3) intrusive thoughts or realness of thought and (4) auditory hallucinations. The results offer further evidence of the multi-dimensionality of hallucinatory disposition in the normal population. Directions for future research in hallucinatory predisposition are discussed.
VHF wind‐profiler data as a teaching aid
Authors: Pavelin E. G. , Wang C‐G. , Browning K. A. , Berrisford P. , Hoskins B. J. 
Published: January 2004

AbstractData from a VHF wind‐profiling radar are being used as a teaching aid in the Department of Meteorology at the University of Reading. An example is given of data obtained during the passage of a train of baroclinic waves which shows how the radar, together with output from weather‐forecast models, can vividly illustrate processes occurring over a range of scales. Copyright © 2003 Royal Meteorological Society.
A simple approach for combining seasonal forecasts for southern Africa
Authors: Klopper E. , Landman W. A. 
Published: January 2004

AbstractCurrently the South African Weather Service (SAWS) compiles seasonal rainfall and temperature outlooks by combining output from various models in a subjective manner. A group of scientists discusses the forecasts from a variety of models and then decides, from these discussions, what the strongest climate signal is. A map is drawn to represent the ‘gut feeling’ from the specialists based on the results from the various models. Although the models used are all scientifically sound, the compilation of the outlook remains subjective. In order to compile a single probability forecast out of the many different model outputs an objective method has to be implemented. This paper proposes such a method. The results were tested during the December–January–February season over a retroactive period from 1991/92 to 1999/2000. Results show that a combination of different models consistently delivers a more skilful forecast than any individual model on its own. Copyright © 2003 Royal Meteorological Society.
Evaluation of a frost accumulation model
Authors: Knollhoff D. S. , Takle E.S. , Gallus W.A. , Burkheimer D. , McCauley D. 
Published: January 2004

AbstractFormation of frost on paved surfaces presents a potential hazard to the motoring public in cold climates. Temperatures of the paved surface are not measured routinely by the National Weather Service and are not part of public forecasts of winter conditions, yet highway maintenance personnel must make frost suppression and anti‐icing decisions based on expectations of future paved‐surface temperatures. The Road Weather Information System measures road surface, air and dew‐point temperatures, road surface conditions, and wind data at numerous locations in the state of Iowa and reports the data in real‐time to maintenance offices. A model based on simple concepts of moisture flux to the surface was developed that uses data from roadway weather stations or forecasts of dew‐point temperature, air temperature, surface temperature and wind speed to calculate frost accumulation on bridge decks in Iowa. The analysis showed that the model has sufficient accuracy to be used as an operational tool for assessing frost accumulation on bridge decks. A logistical regression procedure was developed to determine the probability that a maintenance worker will observe frost for a given calculated frost depth. Copyright © 2003 Royal Meteorological Society.