bluuebunny/crossref_metadata_2025_split huggingface dataset:
Amyloidosis: Uncommon Cause of Dysphonia
Authors: Villagomez Vicente , Santos Felicitos , Santos Ramiro , Trevino Jose L. , Cantu Eduardo 
Published: August 2004

ObjectivesCase report of 3 cases of laryngeal amyloidosisMethodsThree cases of localized amyloidosis without systemic disease were identified at Centro Univerisitario de Otorrinolaringologia y Cirugia de Cabeza y Cuello at the Univerisity Hospital in Monterrey Mexico. In each patient the major site of involvement was glottic with small focus in the false vocal folds. Medical workup including full blood count, CSR, urea, electrolytes, ureanalysis, liver function test, chest x‐ray, were performed. Physical examination ruled out systemic disease. Congo red staining confirmed the diagnosis in all surgical specimens.ResultsLocalized laryngeal amyloidosis was identified in 3 patients (2 males and 1 female) with ages ranging from 33 to 67 years. The presenting symptoms including hoarsness, throat soreness, voice breaks, and vocal fatigue. The duration of the symptoms before diagnosis varied from 3 to 12 years. Assesstment of the extent of laryngeal spread of disease included CT scan, complete voice analysis, and videolaryngostroboscopy in all patients. Material for biopsy was obtained by direct laryngoscopy, apple‐green birefringence was seen with congo red stain establishing the histological diagnosis. The 3 patients underwent phonomicrosurgery for removal of the amyloid implantation using cold knife excision.ConclusionLaryngeal amyloidosis is a rare disease with an 8 in 1,000,000 presentation rate. It is more common in males with 3:1 prevalence in the fifth decade. Once the diagnosis is confirmed by congo red staining, it is important to rule out systemic amyloid involvement. It is not necessary to do invasive approach on localized disease. Cold knife excision is still a good method to remove the deposition.
Laryngeal Assessment in Patients with Rheumatic Disease
Authors: Ramos Hugo VL , Pillon Jackeline , Kosugi Eduardo Macoto , Fujita Reginaldo , Barbosa Luiz Henrique F , Neves Luciano R , Pontes Paulo A L 
Published: August 2004

ObjectivesAutoimmune diseases can cause laryngeal involvement with a highly variable course ranging from asymptomatic to severe states. Just few cases have been described since 1959, when the first laryngeal manifestation of systemic lupus erithematosus (SLE) was published. The aim of this article is to identify and to describe laryngeal manifestations of autoimmune diseases.MethodsTransversal study with patients presenting SLE, scleroderma, or undifferentiated connective tissue syndrom (UCTS) at Sao Paulo HospitalUniversidade Federal de Sao Paulo/Escola Paulista de MedicinaSao Paulo, Brazil. These patients underwent otorhinolaryngologic evalution with laryngeal videostroboscopic image.ResultsTwenty‐six patients underwent laryngeal videostroboscopic evaluation. One patient could not support the exam. Eleven of 12 (91.6%) patients with SLE presented edema of interarytenoid tissue. Bamboo nodes, that are yellow transverse submucosal vocal fold deposit lesions, were seen in 03 (25%) patients with SLE. One (8.33%) patient had unilateral sulcus vocalis. All 11 patients with scleroderma presented reflux laryngopharyngitis. Two (18.1%) patients presented dilatation of vocal fold blood vessels and another 2 patients presented vocal fold nodule. Among 3 patients with UCTS, in 2 (66.7%) were seen bamboo nodes and reflux laryngopharyngitis.ConclusionLaryngeal manifestations due to autoimmune diseases were seen in 07 (26.9%) of 26 patients. Bamboo nodes were seen in 5 (19.2%) patients. Almost all patients presented reflux laryngopharyngitis.
Role of Cochlear Implantation in Susac's Syndrome
Authors: Connell Sarah S , Brodie Fernando 
Published: August 2004

ObjectivesSusac's syndrome is characterized by the triad of branched retinal artery occlusions, cochlear microangiopathy, and encephalopathy. The underlying process is thought to be a small vessel vasculitis causing microinfarcts in the retina, cochlea, and brain. The purpose of this report is to present the applicability of cochlear implantation in Susac's syndrome with associated auditory neuropathy and encephalopathy.MethodsA clinical case review of a 39‐year‐old female with Susac's syndrome is presented. The work‐up and treatment is discussed together with the post‐cochlear implant audiologic assessment. The patient developed bilateral profound sensorineural hearing loss (SNHL), encephalopathy, and retinopathy secondary to Susac's syndrome. After the patient's neurological symptoms stabilized, an otolaryngology consult was obtained. The preoperative audiologic evaluation demonstrated absent ABRs bilaterally and intact OAEs at 2 frequencies in one ear suggesting mixed cochlear damage with additional auditory neuropathy.ResultsDespite the confounding features of residual cognitive deficit and auditory neuropathy, the patient's hearing loss was managed successfully with cochlear implantation. After 6 months with her cochlear implant, the patient had markedly improved hearing in noise testing from 0% to 94% correct and word recognition from 0% to 76% at 60 dB.ConclusionSusac's syndrome is a rare disorder resulting in SNHL, blindness, and encephalopathy. Early angiography to identify branched retinal artery occlusion lends a clue to the diagnosis. Immunosuppressant therapy is necessary to minimize progression of the disease. Cochlear implantation is a viable option for those patients who develop profound sensorineural hearing loss, even with evidence of auditory neuropathy and limited cognitive deficits.
Use of Elastin Patch for Repair of Traumatic Tympanic Membrane Perforation in Chinchillas
Authors: Kim Sam , Esquivel Carlos R , Grafenberg Matthew Ryan 
Published: August 2004

ObjectivesComplications from tympanic membrane perforations range from no symptoms to hearing loss and vertigo. Though different grafting materials have been advocated for surgical repair, the healing time has remained constant. We propose the use of elastin (Oregon Medical Laser Center, Portland, OR) as a grafting material for the repair of traumatic tympanic membrane perforations. Furthermore, utilizing laser albumin soldering (Oregon Medical Laser Center, Portland, OR) in the repair allows exploration of possible immediate functional integrity.MethodsThe protocol used 17 animals (Chinchilla laniger). Three groups were studied: (1) repair with elastin alone, (2) repair with elastin and laser albumin solder and (3) repair with paper patch. Traumatic perforations were made bilaterally in each animal. One side served as the repair group, the other as the control. Tympanograms were used to determine functional integrity immediately following the repair and at the end of 5 weeks. The tympanic membranes were then harvested for histological study.ResultsOf all groups (including controls), only 1 animal showed immediate functional integrity (elastin with laser solder). The delayed tympanograms were more varied. The elastin with and without laser soldering groups had identical results (5 of 6), and compared to their respective controls (2 of 6), showed higher incidence of functional integrity. The paper patch group had similar rates (2 of 5) of integrity compared to their controls (3 of 5).ConclusionAlthough the results of immediate elastin repair with and without laser albumin soldering were not superior to the matched controls, the delayed results show promise for accelerated healing.
Intralesional Cidofovir in Laryngeal Papillomatosis
Authors: Horcasitas Ramon A 
Published: August 2004

ObjectivesThe goal of this study is to determine if the use of Cidofovir injected locally reduces the number of debulking procedures on pediatric patients with recurrente respiratory papillomatosis.MethodsWe injected 37.5 mg of Cidofovir intralesionaly in each patient with a laryngeal gauze 27, each 3 weeks for a total of 5 times on each patients. In each patients Hematic count, Hepatic enzymes, and BUN in each patient was done 1 week after and 1 week before each injection.ResultsWe included 7 patients in a 18‐month period, 6 of the 7 patients have not needed a debulking procedure in the last 10 months, the obstruction and voice improved, 1 of the patients needed 3 more injections, and has not needed another debulking procedure in the last 3 months; none of the patients had any laboratory alteration.ConclusionCidofovir is a drug effective in the treatment of recurrent respiratory papillomatosis, probably reducing the papilomatosis activity in the laringeal tissue.
Tissue Eosinophilia in Chronic Sinusitis
Authors: Yildirim Altan 
Published: August 2004

ObjectivesTo analyze histopathologically mucosal inflammation and tissue eosinophilia of the osteomeatal complex of the patients with chronic rhinosinusitis and to assess these findings in relation to CT scores.MethodsThe mucosa of the osteomeatal complex of 31 consecutive patients obtained during endoscopic sinus surgery were stained by hematoxylin and eosin. Total inflammatory cells and eosinophils were quantified. The preoperaative CT scans were scored by staging system of LundMacKay.ResultsWe have found a significant correlation between the tissue eosinophilia and the total inflammatory cells count of tissue (r = 0.36; P = 0.041). But there were no significant correlation either between the tissue eosinophilia and CT scores (r = 0.34; P = 0.058) or between the total inflammatory cells count of tissue and CT scores (r = 0.10; P = 0.564).ConclusionEosinophilic infiltration seems to be the denominator in chronic rhinosinusitis. But CT findings did not correlated with the extent of mucosal inflammation or with the eosinophilic infiltration.
Postoperative Mucocele in a Pediatric Patient
Authors: Tiu Jeremy Jonathan , Ramadan Hassan H 
Published: August 2004

ObjectivesPostoperative mucocele formation is a known and late complication of endoscopic sinus surgery in adults. Occurrence in the pediatric population, however, is rare and not reported in the American literature. We report a case of a mucocele in a child after endoscopic sinus surgery.MethodsA 9‐year‐old female presented with a 1‐month history of proptosis. She denied any headache, eye pain, visual disturbance, nasal obstruction, or rhinorrhea. A CT scan of the orbits revealed a 2.1 ± 1.7 cm expansile soft tissue mass within the left anterior ethmoid air cells, with displacement and thinning of the lamina papyracea. She had a history of endoscopic sinus surgery 3 1/2 years ago.ResultsShe underwent endoscopic exam under general anesthesia and a large mucopyocele was identified, involving the ethmoid sinus and left medial orbital wall. The lamina papyracea was eroded. Endoscopically the mucopyocele was removed. The patient did well postoperatively. At 3 weeks follow‐up, her proptosis was improved and there was no evidence of synechia.ConclusionPediatric mucoceles of the paranasal sinuses are a rare entity with little reported in the literature. Furthermore, there are no studies in the American literature describing postendoscopic sinus surgery mucoceles in children. With the increasing numbers of pediatric endoscopic sinus procedures, there needs to be an awareness of this entity as a long‐term postoperative complication. Treatment of mucoceles in children has been described, and like adults, endoscopic drainage is recommended.
Noradrenaline represses PPAR (peroxisome-proliferator-activated receptor) γ2 gene expression in brown adipocytes: intracellular signalling and effects on PPARγ2 and PPARγ1 protein levels
Authors: LINDGREN Eva M. , NIELSEN Ronni , PETROVIC Natasa , JACOBSSON Anders , MANDRUP Susanne , CANNON Barbara , NEDERGAARD Jan 
Published: August 2004

PPAR (peroxisome-proliferator-activated receptor) γ is expressed in brown and white adipose tissues and is involved in the control of differentiation and proliferation. Noradrenaline stimulates brown pre-adipocyte proliferation and brown adipocyte differentiation. The aim of the present study was thus to investigate the influence of noradrenaline on PPARγ gene expression in brown adipocytes. In primary cultures of brown adipocytes, PPARγ2 mRNA levels were 20-fold higher than PPARγ1 mRNA levels. PPARγ expression occurred during both the proliferation and the differentiation phases, with the highest mRNA levels being found at the time of transition between the phases. PPARγ2 mRNA levels were downregulated by noradrenaline treatment (EC50, 0.1 μM) in both proliferative and differentiating cells, with a lagtime of 1 h and lasting up to 4 h, after which expression gradually recovered. The down-regulation was β-adrenoceptor-induced and intracellularly mediated via cAMP and protein kinase A; the signalling pathway did not involve phosphoinositide 3-kinase, Src, p38 mitogen-activated protein kinase or extracellular-signal-regulated kinases 1 and 2. Treatment of the cells with the protein synthesis inhibitor cycloheximide not only abolished the noradrenaline-induced down-regulation of PPARγ2 mRNA, but also in itself induced PPARγ2 hyperexpression. The down-regulation was probably the result of suppression of transcription. The down-regulation of PPARγ2 mRNA resulted in similar down-regulation of PPARγ2 and phosphoPPARγ2 protein levels. Remarkably, the level of PPARγ1 protein was similar to that of PPARγ2 (despite almost no PPARγ1 mRNA), and the down-regulation by noradrenaline demonstrated similar kinetics to that of PPARγ2; thus PPARγ1 was apparently translated from the PPARγ2 template. It is suggested that β-adrenergic stimulation via cAMP and protein kinase A represses PPARγ gene expression, leading to reduction of PPARγ2 mRNA levels, which is then reflected in down-regulated levels of PPARγ2, phosphoPPARγ2 and PPARγ1.
Transcriptional repression of the CTP:phosphocholine cytidylyltransferase gene by sphingosine
Authors: RYAN Alan J. , FISHER Kurt , THOMAS Christie P. , MALLAMPALLI Rama K. 
Published: August 2004

We examined the effects of the bioactive lipid, sphingosine, on the expression of the rate-limiting enzyme involved in surfactant phosphatidylcholine synthesis, CCTα (CTP:phosphocholine cytidylyltransferase α). Sphingosine decreased phosphatidylcholine synthesis by inhibiting CCT activity in primary alveolar type II epithelia. Sphingosine decreased CCTα protein and mRNA levels by approx. 50% compared with control. The bioactive lipid did not alter CCTα mRNA stability, but significantly inhibited its transcriptional rate. In murine lung epithelia, sphingosine selectively reduced CCTα promoter-reporter activity when transfected with a 2 kb CCTα promoter/luciferase gene construct. Sphingosine also decreased transgene expression in murine type II epithelia isolated from CCTα promoter-reporter transgenic mice harbouring this 2 kb proximal 5′-flanking sequence. Deletional analysis revealed that sphingosine responsiveness was mapped to a negative regulatory element contained within 814 bp upstream of the coding region. The results indicate that bioactive sphingolipid metabolites suppress surfactant lipid synthesis by inhibiting gene transcription of a key surfactant biosynthetic enzyme.
Atrial natriuretic peptide levels in adult patients before and after surgery for correction of atrial septal defects: relationship with atrial arrhythmias
Authors: ERBAY Ali R. , YILMAZ Mehmet B. , BALCI Mustafa , SABAH Irfan 
Published: August 2004

In the present study, we have examined whether increased N-ANP (N-terminal pro-ANP) levels before and after surgery in patients with ASD (atrial septal defect) along with echocardiographic findings provide a better insight into the pathophysiology and increased morbidity and mortality following corrective surgery. Eighteen adult ASD patients (&gt;20 years of age; six male and 12 female) with shunts (Qp/Qs≥2, where Qp/Qs is the pulmonary blood flow/systemic blood flow) had complete echocardiographic, clinical and laboratory parameters evaluated before and 6 months after surgery. Eight age- and sex-matched individuals (three male and five female) were enrolled as a control group. Blood samples for N-ANP analysis were obtained in both groups. N-ANP levels in the peripheral blood sample from ASD patients before surgery were significantly higher than those in the control group. In patients with ASD, mean N-ANP levels obtained from the pulmonary artery were significantly higher than that obtained from the peripheral vein. RA (right atrial) area, adjusted for body surface area, and RA long-axis and short-axis measurements were significantly higher in the patient group than the control group. N-ANP was correlated significantly with these parameters. Following corrective surgery, N-ANP values and RA area, RA long-axis and short-axis normalization decreased significantly and were accompanied by a decrease in systolic mean pulmonary artery pressure. N-ANP levels were normalized following septal closure in most patients, except in those with atrial fibrillation attacks following corrective surgery. In conclusion, we have shown correlations among variables indicating changes in the architecture of the right atrium along with temporal changes in ANP providing insights into the pathophysiology of post-operative atrial arrhythmias.
Other people, other drugs: the policy response to petrol sniffing among Indigenous Australians
Authors: D'ABBS PETER H. , BRADY MAGGIE 
Published: August 2004

AbstractThis paper examines the policy response of Australian governments to petrol sniffing in Indigenous communities from the 1980s until the present. During this period, despite the formation of numerous inquiries, working parties and intergovernmental committees, there has been little accumulation of knowledge about the nature and causes of sniffing, or about the effectiveness of interventions. Policies are fragmentary; programmes are rarely evaluated, and most rely on short‐term funding. The paper sets out to explain why this should be so. It draws upon a conceptual framework known as ‘analytics of government’ to examine the ways in which petrol sniffing comes to the attention of government agencies and is perceived as an issue; the mechanisms deployed by governments to address petrol sniffing; ways in which knowledge about sniffing is generated; and the underlying assumptions about people that inform policy‐making. Drawing upon case studies of policy responses, the paper argues that a number of structural factors combine to marginalize petrol sniffing as an issue, and to encourage reliance on short‐term, one‐off interventions in place of a sustained policy commitment. Four recommendations are advanced to help overcome these factors: (1) agreements should be reached within and between levels of government on steps to be taken to reduce risk factors before the eruption of petrol‐sniffing crises; (2) the evidence base relevant to petrol sniffing (and other inhalants) should be improved by funding and directing one or more existing national drug research centres to collate data on inhalant‐caused mortality and morbidity, and to conduct or commission research into prevalence patterns, effectiveness of interventions and other gaps in knowledge; (3) the current pattern of short‐term, pilot and project funding should be replaced with longer‐term, evidence‐based interventions that address the multiple risk and protective factors present in communities; and (4) insistence by governments that communities must take ‘ownership’ of the problem should be replaced by a commitment to genuine partnerships involving governments, non‐government and community sectors.
Naltrexone maintenance for heroin dependence: uptake, attrition and retention
Authors: TUCKER THAMIZAN K. , RITTER ALISON J. , MAHER CLAIRE , JACKSON HENRY 
Published: August 2004

AbstractWith naltrexone registered only recently in Australia in 1999, it is important to examine the rate of uptake of naltrexone treatment, early attrition and retention rates during treatment, in order to inform the way naltrexone is used in Australian practice. Of 317 people screened for the study, 97 participants were recruited post‐withdrawal from opiates and were inducted to naltrexone after a period of at least 5 days of abstinence. While in treatment, participants received a 50‐mg dose of naltrexone daily, with daily dispensing for the first 7 days, and weekly dispensing for the following 11 weeks. For the naltrexone‐treated sample as a whole, the rate of uptake of naltrexone treatment was 30%, with 30% retained in treatment for the entire 12‐week program. Attrition from treatment was found to be steady throughout the 12 weeks. The authors conclude that further research is required to improve withdrawal and naltrexone induction techniques and to improve medication compliance and treatment retention.
The Countess of Huntingdon's Connexion
Authors: Harding Alan 
Published: August 2004

Abstract
The Countess of Huntingdon’s Connexion has been one of the neglected strands in the eighteenth-century Evangelical Revival. This is surprising, since the Connexion was one of the most significant of the non-Wesleyan groups within the Revival. Its importance lay less in its ministry to the upper classes, than as a grass-roots religious movement. It had its own training college (one of the first such institutions in England specifically directed to the development of ministerial skills) and formed a network of chapels across the country. Like Wesley, Lady Huntingdon started her religious life as a member of the Church of England, and clergymen played an important part in her Connexion throughout her life. But events led the Connexion to secede from the Established Church and to establish its own ordination and articles of religion. Through its preachers, congregations, and example, the Connexion made a significant contribution to the revival of Dissent in England in the late eighteenth century. This book examines in detail how the Connexion worked: who its preachers were, where their hearers came from, how chapels came to be built, and who provided the money. It examines the relations between the Connexion and other religious groupings: with the Church of England, with Dissent, with other Calvinist evangelicals, and with the Wesleyans. It shows a popular religious movement in operation, and thereby provides an important insight into English religious life at the time.
Florida's Pension Election: From DB to DC and Back
Authors: Milevsky Moshe A. , Promislow S. David 
Published: August 2004

AbstractDuring the year 2002, the State of Florida's 600,000 public employees were given the choice of converting their traditional defined benefit (DB) pension plan into an individual‐account defined contribution (DC) plan with full control over asset allocation and investment decisions. To mitigate some of the risk and uncertainty in the decision, the State granted each employee electing the DC plan an additional option to switch back (i.e., change their mind once) at any point prior to retirement. This option has been labeled the 2nd election by the State and the cost of reentry is fixed at the accumulated benefit obligation of their pension entitlement, which is the present value of the life annuity. Our article presents some original analytic insights relating to the optimal time and financial value of this unique 2nd election. Although our model is deterministic in nature, we believe that it provides a number of intuitive insights that are quite robust. Our results can be contrasted with Lachance, Mitchell, and Smetters (2003). We estimate that the increase in retirement wealth that arises from having the 2nd election is equivalent to at most 30 percent in future value, and only when utilized optimally. Furthermore, for most State employees above the age of 45, the 2nd election has little economic value because the DB plan dominates the DC plan from day one. Of course, it remains to be seen what percent of Florida's 600,000 employees will elect to behave rationally with their newfound pension autonomy.