bluuebunny/crossref_metadata_2025_split huggingface dataset:
Successful treatment of cervical aplasia using a peritoneal graft
Authors: Alborzi S. , Momtahan M. , Parsanezhad M.E. , Yazdani M. 
Published: February 2005

AbstractObjectiveTo evaluate the efficacy of a peritoneal graft for the treatment of cervical aplasia.MethodFour patients with cervical aplasia who had a functioning endometrium and hematometra were recruited for this clinical trial. Through an abdominoperineal approach a plastic stent was inserted between the endometrial cavity and the upper part of the vagina; then, a graft of peritoneum was applied over the stent. In the absence of a vagina, grafts of skin or amniotic membrane were also used. The plastic stent was removed after 1 month in 2 patients and after 1 week in the 2 other patients.ResultAfter more than 1 year of observation the 4 patients had regular menstrual cycles with normal menstruation. Sonographic examinations also showed empty uterine cavities.ConclusionTraditional gynecology textbooks recommend hysterectomy in cases of cervical aplasia. This report presents a new technique with 2 variations using a peritoneal graft. Although both variations were successful in the treatment of cervical aplasia in 4 women, more trials are needed to determine which one should be developed.
Clinical aspects and prognosis of pelvic recurrence of cervical carcinoma
Authors: Kasamatsu T. , Onda T. , Yamada T. , Tsunematsu R. 
Published: February 2005

AbstractObjectiveTo identify which patients with locally recurrent cervical carcinoma are potentially curable.MethodA total of 664 stage IB‐IVA patients were examined following surgery or radiotherapy.ResultAmong the 664 patients, 193 (29%) developed recurrence. Sixty‐seven (35%) of these recurrences were located in the pelvis alone. Among these 67 recurrences, 24 (35%) were central recurrences and the remaining 43 (65%) were pelvic side‐wall recurrences. Of the 24 patients with central recurrences, 8 were salvaged. Of these 8 patients, 3 underwent pelvic exenteration, and 5 received optimal radiotherapy. The recurrent tumor in these 5 survivors who received radiotherapy had consisted of a small (<2 cm) tumor. All 43 patients with pelvic wall recurrence developed progressive disease.ConclusionThe following patients are potentially curable: patients with a resectable, centrally located tumor who are candidates for pelvic exenteration, and patients with a small central recurrence for whom complete radiation therapy is feasible.
Prognostic significance of Langerhans cell infiltration in cancer of the larynx
Authors: Yilmaz Taner , Gedikoglu Gökhan , Çelik Arzu , Önerci Metin , Turan Ergin 
Published: February 2005

OBJECTIVEDetermine the effect on prognosis of Langerhans cell infiltration in cancer of the larynx.STUDY DESIGN AND SETTINGRetrospective review of 72 surgically treated patients with T1–3 lesions. The streptavidin‐biotin method to determine Langerhans cell infiltration, which was graded as 1+, 2+, and 3+.RESULTSA higher degree of Langerhans cell infiltration was significantly associated with less cervical lymph node metastasis, longer disease‐free survival, less locoregional recurrence, and less clinical N‐positivity (P < 0.05). According to multivariant analysis, Langerhans cell infiltration was independently related to disease‐free survival and recurrence (P < 0.05).CONCLUSIONSLangerhans cell infiltration is prognostically important in cancer of the larynx. More intense infiltration is significantly related to prolonged disease‐free survival, less locoregional recurrence, less cervical lymph node metastasis, and less clinical N‐positivity.SIGNIFICANCELangerhans cell infiltration may be determined on a biopsy specimen and this information may be useful in deciding about elective neck dissection. Patients with mild infiltration may have a higher risk of locoregional recurrence, shorter disease‐free survival, and therefore they suggest a poor prognosis.
Hemorrhage following tonsillectomy and adenoidectomy in 15,218 patients
Authors: Windfuhr J. P. , Chen Y. S. , Remmert S. 
Published: February 2005

OBJECTIVETo evaluate potential risk factors and the incidence of bleeding following adenoidectomy or tonsillectomy, with or without adenoidectomy requiring surgical treatment under general anesthesia.STUDY DESIGN AND SETTINGRetrospective chart review of 15,218 patients who underwent surgery between January 1, 1988, and September 30, 2001, at our institution (St. Anna Hospital, Duisburg).RESULTSA total of 229 patients experienced post‐operative bleeding (1.5%). Patients of male gender and 70 years of age or older were significantly at risk for post‐tonsillectomy hemorrhage. The incidence of bleeding increased with age. Of the bleeding episodes, 76% occurred on the day of surgery; immediate abscess‐tonsillectomy was not associated with an increased risk of bleeding.CONCLUSIONSHemorrhage following tonsillectomy and adenoidectomy is rare and predominantly occurs early after surgery. Male patients, 70 years of age or older, infectious mononucleosis, and a history of recurrent tonsillitis were identified as risk factors for post‐tonsillectomy hemorrhage. Delayed hemorrhage has the potential to be life‐threatening.
Facial palsy associated with acute otitis media
Authors: Popovtzer Aron , Raveh Eyal , Bahar Gideon , Oestreicher‐Kedem Yael , Feinmesser Rafael , Nageris Ben I. 
Published: February 2005

OBJECTIVEFacial palsy secondary to acute otitis media is rarely encountered today. The aim of the present study was to review the characteristics of the disease and propose the proper management.STUDY DESIGNFile review.SETTINGUniversity‐affiliated tertiary referral center.MAIN OUTCOME MEASURESDisease course, management and outcome were recorded.RESULTSSixty‐five children with facial palsy were identified, of whom 13 (20%) had acute otitis media. The otitis media preceded the facial palsy in all cases by 1 to 21 days (average 5 days). House‐Brackmann grade ranged from 2 to 5 (average 3.5). The recovery period was varied and unpredictable, ranging in duration from 1 to 180 days (average 68 days). Treatment was conservative, except for insertion of a ventilation tube in 2 cases.CONCLUSIONSConsidering that all the patients recovered, conservative treatment, including myringotomy and intravenous antibiotics, may be the correct approach to facial palsy associated with acute otitis media.
Vocal fold augmentation by autologous fat injection with lipostructure procedure
Authors: Cantarella Giovanna , Mazzola Riccardo F. , Domenichini Elena , Arnone Flavio , Maraschi Barbara 
Published: February 2005

BACKGROUNDFat is theoretically the ideal implant for vocal fold augmentation because it is soft, easily available and biocompatible. However, reabsorption is a frequent cause of long‐term failure.OBJECTIVEWe prospectively tested Coleman's “li‐postructure” technique used for facial recontouring in the treatment of glottic incompetence.STUDY DESIGN AND SETTINGFourteen patients (aged 18–74 years, mean 48) with breathy dysphonia secondary to laryngeal hemiplegia (7) or anatomical defects (7) underwent vocal fold lipoinjection. Fat harvested by liposuction was centrifuged, and the fat cell layer injected into the vocalis muscle. The patients underwent pre‐ and postoperative videolaryngostroboscopy, maximum phonation time (MPT) measurements, GRBAS perceptual evaluations, and Voice Handicap Index (VHI) self‐assessments.RESULTSVoice quality improved soon after surgery and remained stable over 3–26 months (mean 10.6), being confirmed by the GRBAS, MPT and VHI evaluations (P < 0.005). The results were best in the seven patients with paralytic dysphonia.CONCLUSIONLipostructure is a valuable technique for voice rehabilitation in glottic incompetence.
Uncommon anatomic variations in patients with chronic paranasal sinusitis
Authors: Chao Ting‐Kuang 
Published: February 2005

OBJECTIVESome uncommon anatomic variations would be encountered with the increasing number of patients with chronic paranasal sinusitis who have undergone functional endoscopic sinus surgery. The correct identification and proper treatment for these variations are important.STUDY DESIGN AND SETTINGA retrospective study of serial computed tomography scan images was conducted in 100 patients collected randomly. Uncommon anatomic variations were recorded and clinical features were analyzed.RESULTSFive (5%) cases with uncommon anatomic variations were found. These variations included bilateral pneumatization of uncinate process (1%), large uncinate process mimics the middle turbinate (1%), nontraumatic protrusion of orbital contents through dehiscence of lamina papyracea (1%), and nasal septal pneumatization (2%). Two of these 5 cases caused some modifications of routine functional endoscopic sinus surgery procedures and another 2 variants commanded further caution during routine uncinectomy.CONCLUSION AND SIGNIFICANCEUncommon anatomic variations, though unusual, are not rare in chronic paranasal sinusitis patients. Procedures should be tailored for most of these special conditions.
Psychiatric distress amplifies symptoms after surgery for chronic rhinosinusitis
Authors: Davis Greg E. , Yueh Bevan , Walker Edward , Katon Wayne , Koepsell Thomas D. , Weymuller Ernest A. 
Published: February 2005

BACKGROUNDPsychiatric disorders are associated with increased symptom burden when combined with chronic medical conditions. However, there are no reports of how psychiatric distress influences outcomes with surgical treatment for chronic rhinosinusitis (CRS). We hypothesized that subjects with psychiatric distress (somatization, anxiety, and depression) would report more severe long‐term sinus symptoms and worse quality of life (QOL) than subjects without psychiatric distress.METHODSThis is a community‐based, prospective, observational cohort study of patients diagnosed with CRS presenting for surgery. Patients were interviewed before surgery; CT scans were reviewed, and questionnaires were completed about sinusitis‐related symptoms (SNOT‐16), general health status and QOL (SF‐36), and psychiatric distress (BSI and PHQ). Outcomes were also assessed 1, 3, 6, and 12 months postoperatively.RESULTSNinety‐five patients had complete records for analysis. Psychiatric distress was prevalent, with 31% screening positive for somatization, 17% positive for anxiety, and 25% positive for depressive disorders. Subjects with somatization had significantly worse SNOT‐16 scores at each time point compared with those without somatization (P < 0.05). Subjects with depression reported more severe symptoms at 6 and 12 months after surgery than those without depression (P < 0.05). The presence of somatization preoperatively was also independently associated with worse symptom severity 12‐months after surgery, even after adjusting for prior sinus surgery, CT stage, Charlson Index, and deviated septum. In addition, subjects with psychiatric distress reported significantly worse SF‐36 physical and mental component summary scores 12‐months after surgery than subjects without psychiatric distress.CONCLUSIONSPsychiatric distress is associated with worse reported sinus symptoms and lower QOL throughout surgical management of chronic rhinosinusitis. Despite this, subjects with psychiatric distress report a similar degree of improvement in sinus symptoms after surgery compared with those without distress.CLINICAL SIGNIFICANCEPsychiatric distress should be considered in patients with persistent symptoms after surgery. Psychiatric distress should also be considered in efforts to design a chronic sinusitis staging system.
Opening plugged tympanostomy tubes: Effect of inner diameter and shaft length
Authors: Mehta Ajay J. , Stevens Gary R. , Antonelli Patrick J. 
Published: February 2005

OBJECTIVETo determine whether tympanostomy tube (TT) inner diameter or shaft length impacts the rate of mucoid plug clearance.STUDY DESIGN AND SETTINGEx vivo model. Silicone TTs with different inner‐diameters (ID) and shaft‐length (SL) pairings (1.14 mm ID × 12 mm SL versus 1.14 mm ID × 1 mm SL; 1.14 mm ID × 4.8 mm SL versus 1.32 mm ID × 4.8 mm SL) were plugged with middle‐ear mucus (n = 15 per group) and placed in a model ear chamber. Ofloxacin otic solution was instilled into the chamber to cover the plugged TT, and the time to clearance of each plug was recorded.RESULTSTTs with larger IDs (P = 0.019) and greater SLs (P = 0.033) cleared plugs more rapidly. However, the difference in the percentage of tubes that unplugged was not significant (P = 0.151).CONCLUSIONSRate of ex vivo TT plug clearance may be altered by changing TT ID and SL.
Development of questionnaires to measure patient preferences for intranasal corticosteroids in patients with allergic rhinitis
Authors: Meltzer Eli O. , Hadley James , Blaiss Michael , Benninger Michael , Kimel Miriam , Kleinman Leah , Dupclay Leon , Garcia Jorge , Leahy Michael , Georges George 
Published: February 2005

OBJECTIVETo develop a questionnaire to evaluate preferences for attributes of intranasal corticosteroids (INSs) in clinical trials with allergic rhinitis (AR) patients.STUDY DESIGN AND SETTINGEstablished questionnaire development practices were used, including performance of a literature review and use of patient and physician focus groups, cognitive debriefing interviews, and pilot testing before validation.RESULTSFindings from patient and physician focus groups suggest that sensory attributes are relevant to AR patients when choosing INSs. Physician focus groups identified the need for 2 distinct preference instruments, a clinical trial patient preference questionnaire (CTPPQ) and a clinical practice preference questionnaire (CPPPQ). A pilot study suggests that the CTPPQ is capable of discriminating between 2 INSs in the clinical trial setting.CONCLUSIONSInitial findings suggest that items in the CTPPQ and CPPPQ are easy to understand and relevant to patients. Further validation studies with larger sample sizes are needed to assess the psychometric properties of both questionnaires. EBM rating: B‐20.
Polysomnography indexes are discordant with quality of life, symptoms, and reaction times in sleep apnea patients
Authors: Weaver Edward M. , Woodson B. Tucker , Steward David L. 
Published: February 2005

OBJECTIVEWe tested whether polysomnography (PSG) indexes were associated with sleepiness, quality of life, or reaction times at baseline and as outcome measures following surgical or sham treatment for patients with obstructive sleep apnea syndrome (OSAS).STUDY DESIGN AND METHODSMild‐moderate OSAS subjects were measured before and 8 weeks after surgical or sham treatment in this prospective longitudinal study. Measures included standard PSG indexes, sleepiness, quality of life, and reaction times. Associations were examined with Spearman correlations and multivariate linear regression.RESULTSCorrelations between baseline PSG and non‐PSG measures ranged from −0.22 to 0.25 (n, 87 subjects; mean correlation, 0.00 ± 0.11), with one positive association significant of 56 tested (arousal index and SF36 Mental Component Summary, r, 0.25; P = 0.03). Correlations between change in PSG and non‐PSG measures ranged from −0.37 to 0.35 (n, 54 subjects; mean correlation, −0.05 ± 0.19), with no significant positive association of 56 tested. Regression analyses confirmed these results.CONCLUSIONSPSG indexes are not consistently associated with sleepiness, quality of life, or reaction time, both at baseline and as outcome measures in patients with mild‐moderate OSAS. PSG indexes may not quantify some important aspects of OSAS disease burden or treatment outcome. Clinically important outcomes should be measured directly. EBM rating: A.
The Cooperative Outcomes Group for ENT: A multicenter prospective cohort study on the effectiveness of medical and surgical treatment for patients with chronic rhinosinusitis
Authors: Witsell David L. , Stewart Michael G. , Monsell Edwin M. , Hadley James A. , Terrell Jeffrey E. , Hannley Maureen T. , Holzer Susan Sedory 
Published: February 2005

OBJECTIVETo assess outcomes for patients with chronic rhinosinusitis.STUDY DESIGN AND SETTINGProspective, multicenter study; 31 otolaryngologists enrolled 276 adult patients with chronic rhinosinusitis; patients completed surveys at 3‐month intervals, and physicians provided clinical and treatment data. The primary outcome measure was the Chronic Sinusitis Survey‐Duration (CSS‐D).RESULTSOne hundred seventeen adult patients completed 12‐month follow‐up. Most patients reported sinus symptoms lasting longer than 3 years (74%). Patients showed significant improvement (group P < 0.0001) in the CSS‐D score at each follow‐up interval. Baseline CSS‐D (P < 0.0001), surgical intervention (P < 0.003), and Lund‐McKay score (P < 0.04) were predictive of clinical success in regression analysis.CONCLUSIONSPatients referred to an otolaryngologist have a severe sinus illness. Treatment by an otolaryngologist was associated with significant improvement in sinus‐related symptoms.SIGNIFICANCEThe study demonstrated the feasibility of multicenter outcome studies in chronic rhinosinusitis and generated testable hypotheses for future investigation. EBM rating: C.
The Cooperative Outcomes Group for ENT: A multicenter prospective cohort study on the outcomes of tympanostomy tubes for children with otitis media
Authors: Witsell David L. , Stewart Michael G. , Monsell Edwin M. , Hadley James A. , Terrell Jeffrey E. , Yueh Bevan , Rosenfeld Richard M. , Hannley Maureen T. , Holzer Susan Sedory 
Published: February 2005

OBJECTIVEOutcomes for patients with otitis media were assessed in this prospective, multicenter study.STUDY DESIGN AND SETTINGThirty‐one otolaryngologists enrolled 272 pediatric patients with otitis media; caregivers completed surveys at 3‐month intervals, and clinical and treatment data was also collected. The Otitis Media 6 (OM‐6) was the primary outcome measure.RESULTSOne hundred seventy‐seven patients (mean age 2.0 years) completed 3‐month follow‐up. One hundred thirty‐seven patients underwent tympanostomy tube placement. Large improvements in disease‐specific quality of life (QOL) were seen up to 9 months of follow‐up. Baseline OM‐6 score was the best predictor of clinical success in regression modeling.CONCLUSIONSPatients referred to an otolaryngologist for treatment of otitis media see large improvements in disease‐specific QOL regardless of treatment rendered.SIGNIFICANCEThe study demonstrates the feasibility of multicenter outcomes studies and confirms appropriate triage of patients with otitis media into surgical versus medical interventions. EBM rating: C.
Neurogenic double‐peaked vasoconstriction of human gastroepiploic artery is mediated by both α1‐ and α2‐adrenoceptors
Authors: Fukui Daisuke , Yang Xiao‐Ping , Chiba Shigetoshi 
Published: February 2005

The contribution of postjunctional P2X receptors and subtypes of α‐adrenoceptors to vasoconstrictor responses following periarterial electrical nerve stimulation (PNS, 30 s trains of pulses at a frequency of 2, 4 or 8 Hz) was investigated in human gastroepiploic arteries.
The vasoconstrictor response to PNS at a stimulation of 4 or 8 Hz was a two‐peaked response, whereas at a frequency of 2 Hz it appeared only as a late peak. All vasoconstrictions evoked by PNS were abolished by phentolamine, a nonselective α‐adrenoceptor inhibitor, but not by α,β‐methylene ATP, a P2X receptor‐desensitizing agent.
The early peak to PNS at 4 or 8 Hz was abolished by prazosin, an α1‐adrenoceptor antagonist, while the late one still remained, although it was markedly inhibited. The responses remaining after prazosin were blocked by rauwolscine. The vasoconstrictor response to PNS at 2 Hz was not affected by prazosin (0.1 μM), but was abolished by rauwolscine (0.1 μM), an α2‐adrenoceptor antagonist.
OPC‐28326(10 μM), a newly developed vasodilator, which preferentially exerts its antagonistic actions on the α2B‐ and α2C‐adrenoceptors, significantly reduced the noradrenaline‐induced vasoconstriction in the absence or presence of prazosin. OPC‐28326 had a greater inhibitory effect on the late peak evoked by PNS than the early one. The neurogenic responses remaining after OPC‐28326 were abolished by prazosin.
The present results suggest that sympathetic vasoconstriction of the human gastroepiploic artery is mediated by both α1‐ and α2‐adrenoceptors postjunctionally, but not by P2X receptors. The α2‐adrenoceptors may be preferentially activated at a low frequency of stimulation, which induces a constriction more slowly than that by α1‐adrenoceptors. The existence of α2‐adrenoceptors may cause an enhancement of α1‐adrenoceptor‐induced responses.

British Journal of Pharmacology (2005) 144, 737–742. doi:10.1038/sj.bjp.0705975
Cardioprotective effect of an endothelin receptor antagonist during ischaemia/reperfusion in the severely atherosclerotic mouse heart
Authors: Gonon Adrian T , Bulhak Alexander , Bröijersén Anders , Pernow John 
Published: February 2005

Endothelin (ET) receptor antagonists are cardioprotective during myocardial ischaemia and reperfusion through a nitric oxide (NO)‐dependent mechanism. The aim of the present study was to investigate whether the ET receptor antagonist, bosentan, is cardioprotective in atherosclerotic mice.
Buffer‐perfused hearts from apolipoprotein E/LDL receptor double knockout (KO) and wild‐type (WT) mice were subjected to global ischaemia and reperfusion.
Following reperfusion, the recovery of rate–pressure product (RPP; left ventricular developed pressure (LVDP) × heart rate) was equally impaired in WT and KO mice given vehicle (34±8 and 29±9%, respectively). The ETA/ETB receptor antagonist bosentan (10 μmol l−1) improved recoveries to 57±10% in WT and to 68±10% in KO mice (P<0.01). Similar effects were observed for the recovery of left ventricular end‐diastolic pressure (LVEDP), developed pressure and dP/dt.
Bosentan improved the recovery of coronary flow in both KO and WT mice. Recovery of coronary flow was significantly higher in the KO mice given bosentan (135±15%) than in the WT group (111±12%; P<0.01). ET‐1 (1 nmol l−1) impaired recovery of coronary flow in both WT and KO mice though this effect was more pronounced in the KO mice (P<0.01).
Coronary outflow of NO during reperfusion was enhanced in both KO and WT mice following bosentan administration.
The ETA/ETB receptor antagonist bosentan protects the atherosclerotic mouse heart from ischaemia/reperfusion injury. The observation that ET receptor blockade and stimulation have a greater effect on coronary flow in atherosclerotic hearts indicates an increased activation of the ET system in atherosclerotic coronary arteries.

British Journal of Pharmacology (2005) 144, 860–866. doi:10.1038/sj.bjp.0706117