bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vitamin E Reduces Cisplatin Ototoxicity
Authors: Kalkanis James G. , Whitworth Craig , Rybak Leonard P. 
Published: February 2004

AbstractObjectives/Hypothesis Cisplatin ototoxicity is a major dose‐limiting factor in the treatment of several neoplasms. Vitamin E, a slow‐acting free radical scavenger, has been shown to ameliorate nephrotoxicity and endothelial cell damage in animals receiving cisplatin. The purpose of the study was to determine the effectiveness of vitamin E as an otoprotectant.Study Design Prospective, randomized controlled trial in the rat model.Methods Wistar rats (weight, 261–386 g) were sedated using 172.4 mg/kg intramuscular ketamine and 3.4 mg/kg xylazine. Baseline auditory brainstem response (ABR) testing was performed in response to clicks and 8‐, 16‐, and 32‐kHz tone bursts. After auditory thresholds were determined, the animals received intraperitoneal drug administration according to one of three group classifications. Group 1 received 4 g/kg vitamin E followed after 30 minutes by 16 mg/kg cisplatin. Group 2 received 6 mL/kg soybean oil followed after 30 minutes by cisplatin. Group 3 received soybean oil followed after 30 minutes by 16 mL/kg saline. After 3 days' follow‐up, ABR testing was performed and threshold changes were recorded. Cochleae were removed and processed for scanning electron microscopy after follow‐up auditory testing was carried out.Results Group 2 animals showed marked hearing loss with average threshold shifts of 28.75 ± 2.3 dB for clicks, 30.0 ± 1.9 dB at 8 kHz, 21.25 ± 4.0 dB at 16 kHz, and 45.0 ± 4.2 dB at 32 kHz. No significant loss was observed in group 3 with shifts of 2 ± 1.3 dB, 3 ± 3.0 dB, −2.2 ± 3.1 dB, and −1.1 ± 4.0 dB for clicks and tone bursts at 8, 16, and 32 kHz, respectively. Significant protection was seen in group 1 animals compared with group 2 animals. In the former group, threshold shifts of 12.5 ± 3.1 dB for clicks, 7.5 ± 2.5 dB at 8 kHz, 5.0 ± 3.3 dB at 16 kHz, and 24.4 ± 5.6 dB at 32 kHz were observed. These findings were supported by the scanning electron microscope observations that severe outer hair cell destruction occurred in group 2 rats, whereas outer hair cells were preserved to a much greater extent in the cochleae of rats in group 1 that were pretreated with vitamin E.Conclusion Vitamin E appears to have a protective effect against cisplatin ototoxicity.
Dimensional Stability of the Free Fascia Grafts: A Human Study
Authors: Indorewala Shabbir , Pagare Rajendra , Aboojiwala Shabbir , Barpande Swati 
Published: February 2004

AbstractObjectives/Hypothesis In animals it has been shown that autologous free fascia grafts (fascia lata and temporal fascia) change dimensions during the vital first 5 days of healing. Poor dimensional stability of these grafts can be an important reason for failure of complete closure of tympanic membrane perforations in tympanoplasty operations, particularly in large perforations. Dimensional stability of these fascias has been studied in humans.Study Design Prospectively, 11 patients were studied.Methods Patients who were subjected to open mastoid cavity surgery were included in the study. The mastoid cavity was exteriorized, and the fascia graft was used to seal the perforation and cover a part of the bare mastoid bone in the routine way. At this stage, equally cut pieces of temporal fascia and fascia lata were laid on the remaining part of the bare mastoid bone. The mastoid cavity was then packed with Gelfoam and wound sutured. The pieces of graft material under study were removed after 5 days, leaving the graft used to seal the tympanic membrane perforation undisturbed. The harvested grafts were measured for their dimensional variations, if any.Results It was observed that free autologous temporal fascia grafts exhibited poor dimensional stability as compared with free autologous fascia lata grafts.Conclusion Poor dimensional stability of free temporal fascia grafts as seen in animals was confirmed in the present human study. This poor dimensional stability of temporal fascia grafts might be contributing to failure of closure of tympanic membrane perforations in tympanoplasty.
Prevention of Vocal Fold Scarring by Topical Injection of Hepatocyte Growth Factor in a Rabbit Model
Authors: Hirano Shigeru , Bless Diane M. , Rousseau Bernard , Welham Nathan , Montequin Douglas , Chan Roger W. , Ford Charles N. 
Published: February 2004

AbstractObjectives/Hypothesis Vocal fold scarring disrupts the layer structure of the vocal fold lamina propria that is essential for optimal mucosal vibration. Prevention of vocal fold scarring remains challenging. Hepatocyte growth factor (HGF) has strong antifibrotic activity. The authors' previous studies have found that HGF stimulates hyaluronic acid production and suppresses collagen production from vocal fold fibroblasts, suggesting that HGF has therapeutic potential in prevention of vocal fold scarring. The present study aimed to demonstrate the effects of HGF on vocal fold scarring in an in vivo rabbit model.Study Design Animal experiment.Methods The vocal fold mucosa was stripped unilaterally in 20 rabbits, then HGF or saline (sham‐treated group) was immediately injected into the injured site. At 6 months after the procedure, histological, rheological, and physiological examinations of vibratory behavior were completed.Results Histological examination revealed excessive collagen deposition and disorganized elastin in the sham‐treated group, whereas the HGF‐treated group presented with better wound healing exhibiting less collagen deposition. Contraction of the injured vocal folds observed in the sham‐treated group did not occur in the HGF‐treated group. Rheological data indicated that the HGF‐treated vocal folds were less stiff and viscous compared with the sham‐treated group. Mucosal vibration of HGF‐treated vocal folds appeared much better than the sham‐treated group in terms of phonation threshold pressure, vocal efficiency, mucosal wave amplitude, and glottal closure.Conclusion Hepatocyte growth factor proved to be useful in preventing vocal fold scarring and maintaining viscoelastic shear properties of the vocal fold.
Epiglottitis in the Hemophilus influenzae Type B Vaccine Era: Changing Trends
Authors: Shah Rahul K. , Roberson David W. , Jones Dwight T. 
Published: February 2004

AbstractObjective To describe the epidemiology, natural history, and treatment of epiglottitis in the Hemophilus influenzae type B (Hib) vaccine era.Design Ten‐year retrospective study.Setting Tertiary‐care children's hospital.Patients Nineteen patients with a discharge diagnosis of epiglottitis.Intervention As indicated by the presentation of the patient, including direct laryngoscopy, intubation, intravenous antibiotics, and steroids.Main outcome measures Presentation, management, and microbiology.Results Presenting symptoms included fever, drooling, and hot potato voice. Patients' ages ranged from 15.8 months to 17.5 (mean 8.9) years. From 1992 to 1997, the mean age was 5.8 years; from 1998 to 2002, the mean age was 11.6 years. Sixty‐eight percent of patients were transferred from an outside hospital. A lateral neck radiograph was recorded in 84% of patients. Mean leukocyte count was 16,600. Direct laryngoscopy with intubation was performed in 79%; intubation was for an average of 3.5 days. H. influenzae was cultured in six patients, five of which had up‐to‐date immunizations. The most commonly administered antibiotics were ampicillin/sulbactam and ceftriaxone. Steroids were administered to 63% of patients. Complications included deep neck space infection (2), seizure (1), recurrent illness (1), and vocal granuloma (1). There were no deaths.Conclusion The demographics, causative organisms, and natural history of epiglottitis have changed substantially in the Hib vaccination era. The clinician evaluating and treating patients with epiglottitis should be aware of current trends.
Untreated Chronic Rhinosinusitis: A Comparison of Symptoms and Mediator Profiles
Authors: Kuehnemund Matthias , Ismail Chaim , Brieger Juergen , Schaefer Dirk , Mann Wolf J. 
Published: February 2004

AbstractObjectives/Hypothesis Since the early 1990s, the knowledge of inflammatory mediators involved in chronic rhinosinusitis has increased extensively. However, until the present no data on trends in mediator levels in the natural course of the exacerbation‐free interval of chronic rhinosinusitis have been published. The purpose of the study was to examine how levels of inflammatory mediators and clinical findings in chronic rhinosinusitis relate over time in the absence of acute exacerbation.Study Design Prospective study.Methods The authors investigated 12 untreated patients with chronic rhinosinusitis and repeated clinical examinations and measurements of inflammatory mediators in the nasal mucosa (messenger RNA [mRNA]of interleukin‐1β; interleukins 3, 5, 6, and 8 [IL‐3, IL‐5, IL‐6, and IL‐8]; interferon gamma; tumor necrosis factor‐α [TNF‐α]; monocyte chemotactic proteins 1, 3, and 4 [MCP‐1, MCP‐3, and MCP‐4]; and granulocyte‐macrophage colony‐stimulating factor [GM‐CSF]), as well as measurements of peptido‐leukotriene [PLT] and prostaglandin E2 [PGE2]) in nasal secretion over a period of 4 weeks.Results Clinically speaking, the symptom score significantly improved over the period of 4 weeks, whereas other clinical parameters (computed tomography score, endoscopy score, rhinomanometric values, saccharine transport time, ciliary beat frequency, and olfaction) varied insignificantly. Regarding proinflammatory and inflammatory mediators, only mRNA of IL‐1β, IL‐6, IL‐8, MCP‐1, and TNF‐α were detected in relevant amounts in nasal mucosa, and their levels decreased only insignificantly over the 4‐week period. In nasal secretion, a slight decrease of PGE2 and PLT levels was observed over the same time period.Conclusion Subjective symptoms may show a spontaneous improvement of approximately 25% in patients with so‐called “stable” chronic rhinosinusitis over a 4‐week period, whereas objective clinical parameters vary insignificantly. Messenger RNA of IL‐1β, IL‐6, IL‐8, MCP‐1, and TNF‐α, as well as PLT and PGE2 levels, are detectable and appear to play a role in the persistence of inflammation in chronic rhinosinusitis. Their levels decrease only insignificantly over time, even in the absence of acute exacerbation of disease, possibly rendering the mucosa more prone to recurrent acute episodes.
Nonsyndromic 35 delG Mutation of the Connexin 26 Gene Associated With Deafness in Syndromic Children: Two Case Reports
Authors: Venail Frédéric , Roux Anne‐Françoise , Pallares‐Ruiz Nathalie , Claustres Mireille , Blanchet Patricia , Gardiner Quentin , Mondain Michel 
Published: February 2004

AbstractObjectives/Hypothesis Several genetic diseases, such as velocardiofacial syndrome Del(22q11) and Down syndrome, are associated with hearing impairment.Study Design Case reports.Methods The authors reported two cases of hearing‐impaired children, one with Del (22q11) and one with Down syndrome, both with bilateral nonevolutive profound sensorineural deafness. Because of unusual features of their deafness and familial history, genetic evaluation was proposed. A homozygous 35delG mutation on the Connexin 26 gene was found in both children (DFNB1 phenotype).Results A review of the reported otological features of Del (22q11) and Down syndrome showed that sensorineural deafness is rare and seldom profound. The authors found no evidence for a genetic link between Del(22q11) or Down syndrome and 35delG mutation on the Connexin 26 gene.Conclusion The case reports reveal a coincidental association between DFNB1 and a multiple congenital anomaly syndrome. The clinician must be aware of this type of association to manage genetic counseling, appropriate otological care, and suitable treatment.
Delayed Nerve Repair Is Associated With Diminished Neuroenhancement by FK506
Authors: Brenner Michael J. , Fox Ida K. , Kawamura David H. , Yu Vivian M. , Lowe James B. , Hunter Daniel A. , Mackinnon Susan E. 
Published: February 2004

AbstractObjectives/HypothesisThe immunosuppressive agent FK506 has been shown in many studies to enhance nerve regeneration and to accelerate functional recovery after immediate nerve repair. However, in clinical practice the diagnosis and treatment of patients with peripheral nerve injuries is often delayed. The study investigated whether FK506 would retain its neuroregenerative properties when nerve repair and initiation of FK506 therapy were delayed for 7 days.Study DesignIn vivo laboratory study.MethodsThirty‐two Lewis rats underwent tibial nerve transection and were randomly assigned to four experimental groups: immediate repair with FK506 treatment, immediate repair without FK506 treatment, 7‐day delayed repair with FK506 treatment, and 7‐day delayed repair without FK506 treatment. Treated animals received daily subcutaneous injections of 2 mg/kg FK506. Serial walking track measurements were performed at 14, 16, and 18 days after nerve repair. On day 18 after repair, peripheral nerves were injected with a fluorescent tracer for retrograde labeling. On day 21, peripheral nerves and spinal cords were harvested for histomorphometric analysis and motor neuron cell body counts, respectively.ResultsAnimals that underwent immediate repair with FK506 had significantly higher fiber counts and percentages of nerve than the other three groups (P< .05) but did not show statistically significant earlier functional recovery. The remaining three groups had intermediate levels of nerve regeneration that were not significantly different. Retrograde abled motor neurons counts were decreased in animals with delayed nerve repair that received no FK506 (P< .05).ConclusionIn a rat tibial nerve transection model, the neuroregenerative effects of FK506 diminished markedly when repair and initiation of FK506 therapy were delayed by 7 days.
Does Cerumen Have a Risk for Transmission of Hepatitis B?
Authors: Kalcioglu M. Tayyar , Durmaz Riza , Ozturan Orhan , Bayindir Yasar , Direkel Sahin 
Published: February 2004

AbstractObjectives/Hypothesis Chronic hepatitis B virus infection is a significant worldwide health problem. It affects 350 to 400 million people. The patients with chronic hepatitis B virus infection have a significant risk for the development of cirrhosis or hepatocellular carcinoma. Full awareness of the mechanisms of transmission can allows susceptible individuals to refrain from this infection. Cerumen has never been studied as a route for hepatitis B transmission. The aim of the study was evaluate the importance of cerumen in transmission of hepatitis B virus infection.Study Design This study was performed on forty patients with confirmed hepatitis B virus infection.Methods Forty cerumen specimens collected from the patients with hepatitis B virus DNA in their sera were prospectively analyzed for the presence of hepatitis B virus DNA by real‐time polymerase chain reaction.Results Eleven of 40 cerumen specimens (27.5%) were positive for hepatitis B virus DNA, with counts ranging from 4.2 × 102 to 4.7 × 106 copies per sample. There was positive correlation between hepatitis B virus DNA concentrations of serum and cerumen. Half of hepatitis B e antigen (HBeAg)–positive patients had detectable hepatitis B virus DNA levels (5.7 × 102 to 4.7 × 106 copies) in cerumen specimens, whereas 12.5% of cerumen specimens from anti‐HBe–positive patients had hepatitis B virus DNA levels (4.2 × 102 to 7.0 × 103 copies).Conclusion Cerumen can be a potential source of transmission. Therefore, this route should be investigated in further studies for horizontal, nosocomial, and occupational transmission of hepatitis B.
Mal de Debarquement and Posture: Reduced Reliance on Vestibular and Visual Cues
Authors: Nachum Zohar , Shupak Avi , Letichevsky Vadim , Ben‐David Jacob , Tal Dror , Tamir Ada , Talmon Yoav , Gordon Carlos R. , Luntz Michal 
Published: February 2004

AbstractObjective The neural mismatch theory assumes that the intersensory conflicts leading to motion sickness are resolved by changes in the relative weighting of the various senses that contribute to orientation. If this sensory rearrangement persists after disembarkment, it might result in mal de debarquement (MD): ataxia and a rocking sensation sometimes felt after landing. The objective of the present study was to examine possible changes in sensory organization in naval crew members with differing susceptibility to MD with computerized dynamic posturography (CDP).Study Design Cross‐sectional parallel‐group design.Methods Seventeen subjects susceptible to MD (SMD) and 17 subjects nonsusceptible to MD (NSMD) (healthy male volunteers aged 18–22) participated in the study. CDP was performed twice with each subject, before and immediately after sailing, using the EquiTest system (NeuroCom, Inc., Clackamas, OR).Results The SMD group showed a significant reduction in their scores on sensory organization tests 3, 4, and 5 after sailing. Sensory pattern analysis revealed reduced use of inputs from the vestibular and visual systems to maintain balance. Prolonged latencies of the motor responses to unexpected pitch perturbations were also recorded in the postsailing CDP of the SMD group. Reduced performance on the presailing CDP task, which presents the greatest challenge to the vestibular system, was found to control for the presence of MD postsailing.Conclusions The results show that MD is associated with postural instability, slower motor reflexes, and larger sways in response to abrupt changes in the body's center of gravity. These findings may be explained by under reliance on vestibular and visual inputs and increased dependence on the somatosensory system for the maintenance of balance.
Nasal Fractures: The Taming of the Shrewd
Authors: Fernandes Sylvester Valentine 
Published: February 2004

AbstractObjective/Hypothesis Closed reduction of nasal fractures has not been a satisfactory approach. Graduated protocols yield better results. Because a significant proportion of these closed reduction patients refuse a second operation, would it be better to resort to a full septorhinoplasty at the first operation and therefore decrease the post first operation deformity rate?Study Design Retrospective review of patients treated by the closed reduction technique and with a full septorhinoplasty approach.Methods Thirty‐four patients treated by the closed reduction technique were surveyed by telephone, and thus only patient satisfaction, which is usually higher in most studies, was allowed to influence the outcome. In another study, 52 patients treated with a full septorhinoplasty were reviewed by the surgeon.Results Sixty‐two percent of the closed reductions had esthetic or obstructive concerns. Of these with esthetic or obstructive concerns, 62% will not have a second operation for correction. Only 11.5% of those undergoing a full septorhinoplasty had esthetic concerns.Conclusion It may be necessary to adopt an early full septorhinoplasty approach in the initial treatment of nasal fractures to reduce the post first operation deformity/obstruction rates.
Pain perceptions, emotions and gender
Authors: Bendelow Gillian 
Published: February 2004

AbstractThis research explores the relationship between perceptions of pain and the social characteristics of the individual, with a focus on the role of gender in the process, with an emphasis on the meaning of ‘lay’ understanding of the phenomena of pain. In order to broaden the definition of pain a multi‐method form of enquiry was adopted and significant gender differences were found in the emphasis on the role of the emotions and the social expectations of the ability to cope in experiences and perceptions of pain. Analysis of the qualitative fieldwork revealed how experiences of pain incorporate feelings and vulnerabilities, existential and religious beliefs as well the sensory components. The attribution, by both sexes, of the superior capacities of women in coping with pain are linked to their biological and reproductive functioning, but are underpinned by cultural expectations of roles and socialisation. The ‘findings’ of the study both reflect the particular experiences of people living in a multi‐racial inner‐city area, and provide a basis for developing new approaches to the understanding of pain, and the relationships between pain, gender, culture and embodiment.
Talking delicacy: speaking about sexuality during gynaecological consultations
Authors: Weijts Wies , Houtkoop Hanneke , Mullen Patricia 
Published: February 2004

AbstractAlthough survey research has shown that both parties in medical consultations have difficulties with discussing issues relating to sexuality, little is known about how talk about sexuality is actually organised in medical consultations. Drawing, in part, on methods from conversation analysis, the present study reveals how both patients and physicians in gynaecological consultations mark potentially delicate matters by ‘expressive caution’, represented by delays, avoidances and depersonalisations. This expressive caution is co‐operatively accomplished between the professional and the client. It will be shown that a detailed analysis of how talk is produced in consultations can generate findings relevant to medical practice.
Patient participation in decision‐making and consent to treatment: the case of general surgery
Authors: Meredith Philip 
Published: February 2004

AbstractRecent political initiatives have sought to encourage patients to seek increased participation in decision‐making on treatments. In NHS surgical care, the consent process begins most commonly with an outpatients consultation within which the implicit rules of communication and participation are conveyed to patients by the setting, and the routines of the service providers. The signing of the consent form just prior to surgery while on the ward tends to be a re‐affirmation of the strengths and weaknesses of the relationship established there and the discourse on which it is based.The reflections of surgical patients and staff reported here suggest that politico‐legalistic measures to encourage and increase patient participation in surgical decision‐making will continue to be frustrated. This may occur not simply because of a natural desire on the part of surgeons to reaffirm established professional rights to control the form and content of consultations, but because more demanding patients will disrupt the methods by which surgeons and other service providers have been able to fulfil the demands for patient throughput which a pressured health care system places on them.
Controlling the ‘bed state’: negotiating hospital organisation
Authors: Green Judith , Armstrong David 
Published: February 2004

AbstractThis paper examines hospital staff's reports of the ‘problem’ of the acute emergency admission. It is argued that from the initial framing of the problem in terms of crisis and efficiency, through to the apparent solution in a management regime of Bed Management, an important aspect of the organisation of the hospital was achieved. This aspect of organisation stressed the ascendancy of the hospital as the main unit of organisation ‐ together with its associated management regimes ‐ against the more local configuration of the hospital's wards which traditionally had formed the basis of clinical power.
Coping with change: physicians in prepaid practice
Authors: Budrys Grace 
Published: February 2004

AbstractThis paper examines the efforts of physicians to cope with changing role expectations particularly the integration of gatekeeping expectations. The subjects of the study are US physicians who are members of a prepaid practice group that is affiliated with a Health Maintenance Organisation. The respondents say that they are committed to gatekeeping; however, they complain about the frustrations associated with this function. They differ in the extent to which they complain. The paper focuses on factors which account for this variation. Two factors are discussed in detail ‐ specialty differences and structural characteristics associated with the office site. The discussion begins with a review of the general sociological literature which employs the gatekeeping concept.