bluuebunny/crossref_metadata_2025_split huggingface dataset:
Symptom fluctuation in bulimia nervosa: relation to menstrual-cycle phase and cortisol levels
Authors: LESTER N. A. , KEEL P. K. , LIPSON S. F. 
Published: February 2003

Background. Individuals with bulimia nervosa report significant symptom fluctuation, and some studies have suggested a premenstrual exacerbation of binge frequency. The purpose of this study is to explore the hormonal correlates of symptom fluctuation in bulimia nervosa.Method. For five consecutive weeks (one full menstrual cycle), eight women with bulimia nervosa and eight non-eating-disordered control women collected morning saliva samples and recorded several mood characteristics; the bulimic women also recorded binge and purge episodes. Subsequently, salivary cortisol and androgen levels were determined by radioimmunoassay.Results. Bulimic symptoms were exacerbated in both the mid-luteal and premenstrual phases, when compared with the follicular and ovulatory phases (F(3,21)=3·76, P=0·026; contrast analysis t(7)=3·47, P<0·01). Fluctuation in cortisol was closely correlated with fluctuation of bulimic symptoms, with elevated cortisol secretion following symptom exacerbation (r(24)=0·64, P=0·001).Conclusions. Bulimic symptom fluctuation appears to be related to two hormonal phenomena – phase of the menstrual cycle and cortisol secretion – with menstrual-cycle phase influencing bulimic symptom severity, and bulimic symptom severity effecting increases in cortisol secretion. Improved understanding of the hormonal causes and consequences of symptom fluctuation may lead to improved psychological and pharmacological treatments for bulimia nervosa.
Double-blind controlled investigation of bilateral prefrontal transcranial magnetic stimulation for the treatment of resistant major depression
Authors: LOO C. K. , MITCHELL P. B. , CROKER V. M. , MALHI G. S. , WEN W. , GANDEVIA S. C. , SACHDEV P. S. 
Published: February 2003

Background. The efficacy and safety of bilateral prefrontal repetitive transcranial magnetic stimulation (rTMS) for treating resistant major depression were examined in a double-blind, placebo-controlled study.Method. Nineteen medication-resistant depressed subjects were randomly assigned to 3 weeks of active or sham rTMS. Effects on mood and neuropsychological function were assessed.Results. Both groups improved significantly in mood over the 3 weeks, but there was no significant difference between active and sham treatments. There were no significant neuropsychological effects.Conclusions. Bilateral rTMS was not superior to sham in treating resistant depression in this pilot study, but caused no neuropsychological impairment.
Source monitoring and memory confidence in schizophrenia
Authors: MORITZ S. , WOODWARD T. S. , RUFF C. C. 
Published: February 2003

Background. The present study attempted to extend previous research on source monitoring deficits in schizophrenia. We hypothesized that patients would show a bias to attribute self-generated words to an external source. Furthermore, it was expected that schizophrenic patients would be over-confident regarding false memory attributions.Method. Thirty schizophrenic and 21 healthy participants were instructed to provide a semantic association for 20 words. Subsequently, a list was read containing experimenter- and self-generated words as well as new words. The subject was required to identify each item as old/new, name the source, and state the degree of confidence for the source attribution.Results. Schizophrenic patients displayed a significantly increased number of source attribution errors and were significantly more confident than controls that a false source attribution response was true. The latter bias was ameliorated by higher doses of neuroleptics.Conclusions. It is inferred that a core cognitive deficit underlying schizophrenia is a failure to distinguish false from true mnestic contents.
Feline Cystic Thymoma: A Clinicopathologic, Immunohistologic, and Electron Microscopic Study of 14 Cases
Authors: Patnaik AK , Lieberman PH , Erlandson RA , Antonescu C 
Published: February 2003

Cystic thymoma was diagnosed in 14 cats in a period of 6 years. The most common clinical sign was laboured breathing. The tumours were characterized by various-sized cystic spaces with central vessels. The epithelial cells varied from oval to spindle to polygonal cells enclosing cystic spaces or in pure epithelial cell components. The nuclei of the neoplastic cells had scattered chromatin and small nucleoli. The cytoplasm was pale eosinophilic. The concentration of mature lymphocytes varied from area to area with rare germinal centres. Immunohistochemically, the epithelial cells stained only with AE1/AE3. The central vessels were positive for vimentin, smooth muscle actin, and factor VIII antigen. Electron microscopy revealed that the cyst walls were lined by epithelial cells that were joined by desmosomes, and the walls were well separated from the cystic spaces by a well-defined basement membrane. The neoplastic epithelial cells contained scattered tonofilaments. Three of the cats had metastasis to the lymph nodes and lungs. Two novel cases of ectopic cystic thymoma have also been described. Results of this study reveal that cystic thymoma is uncommon in cats, and that the histomorphologic, immunohistochemical, and electron microscopic features are similar to those of cystic thymoma in humans.
Endoscopic CO2 Laser Excision for Tis, T1, and T2 Glottic Carcinomas: Cure Rate and Prognostic Factors
Authors: Peretti Giorgio , Nicolai Piero , De Zinis Luca Oscar Redaelli , Berlucchi Marco , Bazzana Tullia , Bertoni Filippo , Antonelli Antonino Roberto 
Published: February 2003

We present the results of a retrospective study based on a cohort of 140 patients who underwent endoscopic CO2 laser excision for previously untreated early glottic cancer (21 Tis, 96 T1, and 23 T2). This study used univariate analysis to review the impact on disease‐free survival of 15 factors related to the host, the tumor, and the treatment. Recurrent cancer developed in 28 patients with an average interval to recurrence of 37.5 months. Retreatment consisted of different procedures, including laser excision, partial or total laryngectomy, and/or radiotherapy. The larynx was definitively preserved in 96% of patients. By the end of the study, 14 patients had died, but only 2 of them had died of the disease. Five‐year overall survival and determinate survival were 93% and 98%, respectively. Ultimate local control at 5 years with CO2 laser excision alone was 95% for Tis, 87% for T1, and 91% for T2 lesions. Only involvement of the anterior third of the vocal cord (P = 0.02), involvement of the false vocal cord (P = 0.02), and infiltration of the vocalis muscle (P = 0.004) showed a significant negative impact on disease‐free survival.
Histologic Evaluation of Retrieved Craniofacial Implants
Authors: Bolind Pia , Acton Caroline , Albrektsson Tomas , Bonding Per , Granström Gösta , Johansson Carina , Lindeman Pontus , Mühlbauer Wolfgang , Tjellström Anders 
Published: February 2003

A retrieval study was performed on implants placed extraorally in the craniofacial region. The study included 19 implants retrieved from 16 patients. The implants were all stable at the time of removal. For various reasons, 5 of the implants were never loaded, whereas 14 of the implants had a known loading period of 3 months to 7 years 7 months. The reasons for removal varied but included the following: death in 1 case; poor results of the bone‐anchored hearing aid in 7 cases; host‐related reasons, varying from soft tissue irritation to infection or pain, in 6 cases; change of treatment plan in 1 case; and scheduled direct removal at the time of insertion in 1 case. The results of the histologic evaluation were similar to those reported in retrieval studies of a corresponding design used intraorally.
Immunomodulating Effects of Surgical Intervention in Tumors of the Head and Neck
Authors: Dietz Andreas , Heimlich Florian , Daniel Volker , Polarz Heinrich , Weidauer Hagen , Maier Heinz 
Published: February 2003

The immunomodulating effect of primary surgical intervention in 33 patients with squamous cell carcinoma of the oral cavity, pharynx, and larynx was analyzed prospectively. An operation time of longer than 7 hours was significantly associated with a decrease of total lymphocyte counts, CD4+ T lymphocytes, and CD8+ T lymphocytes. The CD4/CD8 ratio as a marker for the downregulation of the cellular immune response was slightly decreased but still in the normal range. CD4+ lymphocyte counts increased within 7 days, and CD8+ lymphocytes increased 4 weeks after the operation. The in vitro stimulation of the lymphocytes was impaired for 1 to 4 weeks. Release of interleukins, interferon‐γ, and tumor necrosis factor‐α remained low despite the surgical trauma. The decreased lymphocyte counts, especially CD4+ and CD8+ lymphocytes, were significantly associated with duration of operation and volume of blood loss. Extension of trauma, age, type of anesthesia, and type of intensive care intervention were not associated with specific immunomodulating effects. However, these factors might be responsible for suppression of the immune system, which is expressed by lymphocyte depletion, lymphocyte dysfunction, and impaired upregulation of cytokine secretion.
The Nature of Juvenile Nasopharyngeal Angiofibroma
Authors: Liang Jiangang , Yi Zixiang , Lianq Ping 
Published: February 2003

OBJECTIVEThe goal of this study was to investigate the nature of juvenile nasopharyngeal angiofibroma.STUDY DESIGNTwenty‐five excised tumors were studied morphologically to confirm the histopathologic features of the tumor.METHODSParaffin sections of all tumor specimens were stained with hematoxylin‐eosin for elastic fiber, polyclonal antibody to factor VIII—related antigen and monoclonal antibodies to smooth muscle actin, estrogen receptor, and progesterone receptor. A quantitative assessment of the vascular component changes was also performed in 14 cases. Ultrathin sections of 5 tumors were studied electromicroscopically. Particular attention was paid to the progressive changes of both vascular and fibrous components as well as their mutual relationship.RESULTS(1) Beneath the endothelium of the vascular component, there was a thin layer of spindle cells; these cells had a positive reaction for smooth muscle actin, thus proving to be pericytes. (2) The actively proliferating site of the tumor was usually at the peripheral portion, with abundant vascular element lined by plump endothelial cells. (3) At the central and base locations, the growth of tumor tissue usually appeared to be in a relatively resting state. The vascular component decreased in amount as the extracellular collagenous fibers increased.CONCLUSIONSBecause of the bicellular mixed composition of the vascular component and the tendency of synchronous maturation of both vascular and fibrous elements, it is suggested that juvenile nasopharyngeal angiofibroma is similar to most hemangiomas by nature and is likely a vascular hamartoma or a pathologic and reactive proliferation of vessels.
Factors Affecting Wound Infection Rates in Head and Neck Surgery
Authors: Coskun Hakan , Erisen Levent , Basut Oguz 
Published: February 2003

PURPOSEThis study was planned with 2 goals in mind: to evaluate the efficacy of prolonged and 1‐day antibiotic regimens for prophylaxis and to evaluate the effect of various factors such as neck dissection, localization and stage of tumor, type of laryngectomy, and history of prior radiotherapy, tracheotomy, and diabetes mellitus on postoperative wound infection rates.METHODS AND MATERIALIn this study, 408 head and neck procedures (201 clean and 207 clean‐contaminated) performed at our institution were retrospectively reviewed.RESULTSProlonged and 1‐day antibiotic regimens for both clean and clean‐contaminated procedures were similar in efficacy (7% vs 3% for clean procedures [P = 0.165] and 30% vs 28% for clean‐contaminated procedures [P = 0.777]). The wound infection rate was higher (13%) after clean radical neck dissections versus other clean procedures (1%) (P = 0.001). For clean‐contaminated procedures, factors affecting postoperative wound infection rates were performance of bilateral neck dissections (P = 0.014), disease stage (P = 0.002), type of laryngectomy (P = 0.002), and history of prior tracheotomy (P = 0.006).
Intranasal Anatomy of the Nasolacrimal Sac in Endoscopic Dacryocystorhinostomy
Authors: Wormald Peter John , Kew Jacqueline , Van Hasselt Andrew 
Published: February 2003

Intranasal surface anatomy is fundamental to the technique of endoscopic dacryocystorhinostomy. In the current literature the lacrimal sac is described as being situated anterior to the anterior end of the middle turbinate with between 0% and 20% of the sac above the insertion of the middle turbinate on the lateral nasal wall (the axilla of the middle turbinate). The aim of this study was to use CT dacryocystograms (DCGs) and CT scans to establish the relationship of the lacrimal sac to the lateral nasal wall. Forty‐seven individual lacrimal sacs were measured in relation to the common canaliculus, and 76 were measured in relation to the insertion of the middle turbinate. Measurements taken from the long axis of the sac showed the mean height of the sac above the middle turbinate insertion was 8.8 mm (SD = 0.2, 95% Cl = 1.3) and below it was 4.1 mm (SD = 2.3, 95% Cl = 1.1). The average measurement of the sac above the common canaliculus on CT DCGs was 5.3 mm (SD = 1.7, 95% Cl = 0.56), whereas the average measurement below the common canaliculus was 7.7 mm (SD = 2, 95% Cl = 1.3) (n = 47 CT DCGs). The findings in this study show that a major portion of the sac is located above the insertion of the anterior end of the middle turbinate and, in addition, that a significant part of the sac lies above the entry point of the common canaliculus. Knowledge of these findings can ensure that the sac is adequately exposed during dacryocystorhinostomy by removal of sufficient bone and mucosa above the anterior insertion of the middle turbinate. (Otolaryngol Head Neck Surg 2000;123:307‐10.)
Tracheotomy Complications: A Retrospective Study of 1130 Cases
Authors: Goldenberg David , Ari Eliav Gov , Golz Avishay , Danino Joshua , Netzer Avriam , Joachims Henry Zvi 
Published: February 2003

BACKGROUNDTracheotomy is one of the most frequently performed surgical procedures in the critically ill patient. It is frequently performed as an elective therapeutic procedure and only rarely as an emergency procedure. Complications occur in 5% to 40% of tracheotomies depending on study design, patient follow‐up, and the definition of the different complications. The mortality rate of tracheotomy is less than 2%. Numerous studies demonstrate a greater complication and mortality rate in emergency situations, in severely ill patients, and in small children.METHODSA retrospective study of 1130 consecutive tracheotomies performed during 1 decade (January 1987 through December 1996) is presented. We studied the indications for surgery, the major complications of tracheotomy, and their treatment and outcome. We also noted the overall mortality rate and the specific complications that led to these deaths.RESULTSIn total, 1130 tracheotomies were performed. Major complications occurred in 49 of the cases, and 8 deaths were directly attributed to the tracheotomy. The most common complication was tracheal stenosis, which occurred in 21 cases. Hemorrhage was the second most common complication, which occurred in 9 cases.CONCLUSIONThis is one of the largest series of consecutive tracheotomies compiled. We found a relatively low overall complication and mortality rate compared with other large series. Tracheal stenosis was the most common complication in contrast to other series. Our opinion is that this may reflect tracheal damage originally caused by prolonged intubation before the tracheotomy. We believe that all other complications of tracheotomy may be prevented or minimized by careful surgical technique and postoperative tracheotomy care.
Prevalence of Allergy in Meniere's Disease
Authors: Derebery M. Jennifer , Berliner Karen I. 
Published: February 2003

OBJECTIVES:The goal of this study was to determine the prevalence of allergy in a population of patients with Meniere's disease.METHODS:A survey was mailed to all patients with Meniere's disease seen at our institution from 1994 to July 1998 (n = 1490). As a control group, 172 patients with otologic problems other than Meniere's disease completed the same survey.RESULTS:Of 734 respondents with Meniere's disease, 59.2% reported possible airborne allergy, 40.3% had or suspected food allergies, and 37% had had confirmatory skin or in vitro tests for allergy. These prevalence rates were significantly higher than those found in the control group, of which 42.7% reported having or suspecting airborne allergies and 25% had or suspected food allergies (differences all significant at P ≤ 0.005).CONCLUSION:The prevalence of allergy appears to be much higher in patients with Meniere's disease than in the general population or the population of patients visiting an otologic clinic for other symptoms. (Otolaryngol Head Neck Surg 2000;123: 69‐75.)
Tympanic Membrane Perforation Repair Using Alloderm
Authors: McFeely William J. , Bojrab Dennis I. , Kartush Jack M. 
Published: February 2003

BACKGROUND:Some patients lack quality autologous tissue for tympanic membrane (TM) grafting. AlloDerm (LifeCell Corp, The Woodlands, TX) is a preserved allograft that has been effective in nonotologic applications.OBJECTIVE:The goal of this study was to investigate AlloDerm in the repair of chronic TM perforations. METHODS: Ten adult chinchillas underwent a controlled, 2‐stage procedure for creation and repair of bilateral TM perforations. Myringoplasties were performed. The control side (left) was repaired with autologous fascia; AlloDerm was used in all right ears. Grafts were assessed at 3 to 8 weeks.RESULTS:Complete TM perforation closure was noted in 9 of 10 (90%) control ears and 8 of 10 (80%) AlloDerm‐treated ears. Fascia and AlloDerm integrated consistently with host tissues. No variables demonstrated statistical significance.CONCLUSIONS:AlloDerm appeared to be an ideal substitute for grafting of the TM. It was equally effective as fascia. Clinical trials in human beings appear warranted. Potential health care savings are discussed.
First Place—Resident Basic Science Award 1999: Effects of Leukotriene and Cyclo‐Oxygenase Inhibition on Adaptive Bone Remodeling in the Middle Ear
Authors: Sherman Bret E. , Chole Richard A. 
Published: February 2003

Abnormal bone remodeling is associated with important otolaryngologic diseases. In such diseases, the mechanisms of osteoclastic control underlie the pathologic processes. It is known that strain applied to auditory bullae induces bone resorption—an effect mediated by prostaglandins and blocked by cyclo‐oxygenase inhibitors. It is also known that cyclo‐oxygenase inhibition shunts arachidonic acid into alternate metabolic pathways, mainly the lipoxygenase pathway with leukotriene production. The role of these metabolites in adaptive bone remodeling is unknown. Using the gerbilline bulla as a model, we infused BW755c (dual lipoxygenase/cyclo‐oxygenase inhibitor) and L‐663,536 (5‐lipoxygenase inhibitor) into animals undergoing middle ear pressurization. After 7 days, the bulla bones were harvested, and osteoclasts were quantified histomorphometrically. The results showed that neither treatment altered pressure‐induced resorption. However, BW755c significantly increased resorption in unpressurized bone when compared with control values. Because BW775c blocks both lipoxygenase and cyclo‐oxygenase pathways, the results suggest an alternate pathway in middle ear bone resorption.Otosclerosis, cholesteatoma, Paget's disease of bone, osteogenesis imperfecta, and chronic otitis media are important otologic diseases with pathologies linked to inappropriate bone remodeling.1 In these diseases, the mechanisms of osteoclastic recruitment and activation must underlie the bone resorption associated with each condition. Numerous effectors have been implicated as modulating the local recruitment and activation of osteoclasts. One group of effectors, the metabolites of arachidonic acid (AA), has been shown to exert significant effects on osteoclastic bone resorption both in vivo and in vitro.2
Round Window Membrane Permeability to Transforming Growth Factor‐α: An in Vitro Study
Authors: Witte Mark C. , Kasperbauer Jan L. 
Published: February 2003

OBJECTIVE:Recent studies have identified the capacity of transforming growth factor‐α (TGF‐α) to stimulate mammalian labyrinthine hair cell regeneration after acute ototoxic damage. Augmenting hair cell regeneration with such growth factors may have a role in potentiation of recovery of cochlear function after hair cell injury. Transtympanic application of aqueous solutions to the round window membrane (RWM) has proved successful as a drug delivery route. The purpose of this study was to test the permeability of the mammalian RWM to TGF‐α in an inexpensive and reliable in vitro model.METHODS:Guinea pig RWM niches were harvested and transferred to a 2‐chamber apparatus, and TGF‐α was applied to the middle‐ear side of the chamber. ELISAs of TGF‐α were measured at intervals during a 96‐hour period.RESULTS:Aliquots taken during a 96‐hour interval demonstrated passage of TGF‐α in concentrations sufficient to stimulate hair cell regrowth.CONCLUSIONS:The apparatus allows study of RWM permeability to other substances and provides a basic model for study of RWM physiology. TGF‐α is able to pass through a mammalian RWM.
Efficacy of Immunotherapy Based on Skin End‐Point Titration
Authors: Krouse John H. , Krouse Helene J. 
Published: February 2003

OBJECTIVEThe purpose of this study is to examine the efficacy of skin end‐point titration (SET) as a method of assessing skin responsiveness, selecting antigens, and initiating treatment for successful inhalant immunotherapy.STUDY DESIGNThis study is a prospective, randomized, controlled, double‐blind investigation. Eighteen patients were randomly assigned to 1 of 2 groups: an experimental group treated for all positive antigens, and a control group treated for all positive antigens, with the exception of the study antigens. Quality of life was assessed with 3 dependent measures, and response to nasal challenge and nasal endoscopic evaluations were conducted. Ten patients completed the 6‐month study.RESULTSThere were significant improvements in the emotional component of sinus‐related disability, in response to nasal challenge, and in the endoscopic appearance of the mucosa, regardless of patient group. There was a trend toward improved quality of life among experimental subjects.CONCLUSIONSSET‐based immunotherapy reduces self‐rated disability over time. In addition, SET‐based immunotherapy allows decrease in nasal reactivity and normalizes the endoscopic appearance of the nose.