bluuebunny/crossref_metadata_2025_split huggingface dataset:
High Grade Dysplasia: Surveillance, Mucosal Ablation, or Resection?
Authors: Korst Robert J. , Altorki Nasser K. 
Published: November 2003

AbstractBarrett’s esophagus is a common premalignant condition that results from chronic gastroesophageal reflux. High grade dysplasia in the metaplastic esophagus is thought to be the last step in the metaplasia‐to‐carcinoma sequence that characterizes this disease. The management of high grade dysplasia in Barrett’s esophagus is controversial. Some investigators advocate a rigorous endoscopic surveillance program with biopsies, but this approach has been questioned because of its clinical impracticality, high cost, possibility of sampling errors, and difficulty demonstrating effectiveness on a reproducible basis. Others advocate mucosal ablative therapy to eradicate the dysplastic and metaplastic epithelium. This approach, still in its infancy, cannot be accepted as standard therapy at the present time because of limited follow‐up, its questionable ability to completely eradicate the abnormal mucosa, the phenomenon of pseudoregression, and the patients require continued rigorous endoscopic surveillance. Esophagectomy, on the other hand, can be accomplished with a low mortality rate in these patients. We advocate this approach because a large number of them have invasive cancer in the esophagus despite a preoperative diagnosis of only high grade dysplasia. In addition, the 5‐year survival is excellent even if invasive cancer is present, and these patients are liberated from rigorous endoscopic surveillance for the rest of their lives. For patients with high grade dysplasia in Barrett’s esophagus who are poor operative risks, less invasive approaches such as mucosal ablation may play a role, but longer follow‐up information is needed before this technique can be accepted even in this setting.
Collaboration, Communication, Management, and Advocacy: Teaching Surgeons New Skills through the CanMEDS Project
Authors: Frank Jason R. , Langer Bernard 
Published: November 2003

AbstractThe training of future surgeons must evolve in such a way that it ensures that surgical practice meets the needs of modern societies. Many surgical educators and organizations are considering which abilities are critical elements of the education of surgeons for the new millennium. We describe the approach employed by the Royal College of Physicians and Surgeons of Canada (RCPSC), called the Canadian Medical Education Directions for Specialists (CanMEDS) Project. Through this endeavor the RCPSC has adopted a framework of core competencies organized around seven physician “Roles”: Medical Expert, Communicator, Collaborator, Manager, Health Advocate, Scholar, and Professional. We present the development and rationale for this framework and the progress of its implementation in postgraduate surgical training programs across Canada.
Paranasal Sinus Cancer: Caveats and Controversies
Authors: Waldron John , Witterick Ian 
Published: November 2003

AbstractParanasal sinus cancer is a very rare disease. The literature contains numerous small retrospective reports describing the treatment and outcome of these patients. The comparison of patient outcome both within and between these reports is hampered by patient heterogeneity. We have outlined some of the caveats to be kept in mind when interpreting this literature and described some of the resultant controversies. The failure to achieve local control of advanced disease remains a major problem. Strategies for improvement of local control will include advanced surgical techniques with radiation dose escalation using state‐of‐the‐art, high‐precision delivery techniques accompanied by concurrent cytotoxic and/or biologic therapies. The ideal integration of surgery and radiation remains to be defined in the context of contemporary treatment approaches designed to achieve optimum local control and organ preservation.
Pre‐surgery knee joint loading patterns during walking predict the presence and severity of anterior knee pain after total knee arthroplasty
Authors: Smith Anne J. , Lloyd D. G. , Wood D. J. 
Published: November 2003

AbstractThis study tested if abnormal sagittal knee joint loading patterns after total knee arthroplasty (TKA) were present pre‐surgery, and if patterns with higher external knee flexion moments were related to the presence and severity of post‐surgery anterior knee pain. Gait analysis and clinical evaluation were performed on 34 patients (41 arthroplasties) both before and 12–18 months after TKA, and on 20 healthy age‐matched controls at matched velocities. The majority of knees with abnormal flexor or extensor sagittal knee joint loading patterns post‐surgery (18 of 26, 69%) also displayed these patterns pre‐surgery. Knee joint loading in the early mid‐stance phase of walking prior to surgery was identified by stepwise regression as a significant predictor of the presence (exp(β) = 2.9, CI: 1.2–6.8, p = 0.017) and severity of post‐surgery anterior knee pain (R2 = 0.314, p = 0.019). Therefore, the frequency and severity of anterior knee pain after TKA can be partially explained by retained pre‐surgery gait patterns that had higher external flexion moments in the early mid‐stance phase, which place higher forces on the patellofemoral joint. © 2003 Orthopaedic Research Society. Published by Elsevier Ltd. All rights reserved.
FREEDOM TO CHOOSE AND DEMOCRACY
Authors: Przeworski Adam 
Published: November 2003

Should democracts value the freedom to choose? Do people value facing distinct choices when they make collective decisions? ‘Autonomy’ – the ability to participate in the making of collective decisions – is a paltry notion of freedom. True, democrats must be prepared that their preferences may not be realized as the outcome of the collective choice. Yet democracy is impoverished when many people cannot even vote for what they most want.‘The point is not to be free, but to act freely.’ Rosa Luxemburg
Aphids do not avoid resistance in Australian lupin (Lupinus angustifolius, L. luteus) varieties
Authors: Edwards O.R. , Ridsdill-Smith T.J. , Berlandier F.A. 
Published: November 2003

AbstractLaboratory bioassays and field trials were used to characterize resistance to three aphid species (Myzus persicae (Sulzer), Acyrthosiphon kondoi Shinji, Aphis craccivora (Koch) in two aphid-resistant varieties (Kalya, Tanjil) and one susceptible variety (Tallerack) of Lupinus angustifolius L., and in one resistant variety (Teo) and one susceptible variety (Wodjil) of L. luteus L. Host selection tests in the glasshouse showed that alates of all three species preferred L. luteus to L. angustifolius, but provided no evidence that alates selected susceptible varieties over resistant. These results were supported by a field trial, which showed no difference in the number of colonizing A. kondoi alates collected from the resistant and susceptible lines of each lupin species, but there were significantly more late-instar nymphs and apterous adults on the susceptible lines. In laboratory host suitability experiments, there was much greater suppression of aphid growth and survival on Teo than on Kalya and Tanjil. In field trials, the numbers of aphids were generally lower on resistant compared to susceptible lines of both lupin species with one notable exception: M. persicae numbers were not lower on the resistant variety Tanjil compared to the susceptible variety Tallerack (L. angustifolius). These results suggest that the resistance mechanisms in both lupin species do not affect the selection of hosts by colonizing aphids, but rather are affecting the growth, survival and possibly reproduction of aphids after settling.
MUC5AC mucin release from human airways in vitro: Effects of indomethacin and Bay X1005
Authors: Roger Patricia , Gascard Jean-Pierre , Bara Jacques , de Montpreville Vincent Thomas , Brink Charles 
Published: November 2003

Background: Increased secretion of mucus is a hallmark of many respiratory diseases and contributes significantly to the airflow limitation experienced by many patients. While the current pharmacological approach to reducing mucus and sputum production in patients is limited, clinical studies have suggested that drugs which inhibit the cyclooxygenase and/or 5‐lipoxygenase enzymatic pathways may reduce secretory activity in patients with airway disease.Aim: This study was performed to investigate the effects of indomethacin (cyclooxygenase inhibitor) and Bayx1005 (5‐lipoxygenase inhibitor) on MUC5AC release from human airways in vitro.Methods: An immunoradiometric assay was used to determine the quantities of MUC5AC present in the biological fluids derived from human airways in vitro. The measurements were made with a mixture of eight monoclonal antibodies (MAbs; PM8) of which the 21 M1 MAb recognized a recombinant M1 mucin partially encoded by the MUC5AC gene.Results: The quantities of MUC5AC detected in the biological fluids derived from human bronchial preparations were not modified after treatment with indomethacin (cyclooxygenase inhibitor) and/or an inhibitor of the 5‐lipoxygenase metabolic pathway (BAY x1005).Conclusion: These results suggest that the cyclooxygenase and 5‐lipoxygenase metabolic pathways play little or no role in the release of MUC5AC from human airways.
Biosynthesis and Control of Mosquito Gut Proteases
Authors: Borovsky Dov 
Published: November 2003

AbstractEarlier investigations of the proteases that digest the blood meal in mosquitoes identified the midgut epithelial cells as the source of the main blood digesting protease, trypsin. Surgical manipulations and cytoimmunochemical studies indicated that trypsin in the mosquito is not stored in the epithelial cells as an inactive enzyme, but is synthesized, activated and released into the gut lumen after the blood meal. Using molecular biology techniques the major trypsin genes have been sequenced and some information on the transcription factors that regulate the induction of the genes have been reported. Although all the hormone(s) and the factors that are responsible for the induction of trypsin biosynthesis are not known, the termination of trypsin biosynthesis is controlled by a decapeptide hormone; trypsin modulating oostatic factor (TMOF) that is secreted by the mosquito ovary. Genetic engineering and expression of TMOF in bacteria, yeast and algae is emerging as a potential future larval control of mosquitoes in the field. IUBMB Life, 55: 435‐441, 2003
Auditory Findings in Patients with Maternally Inherited Diabetes and Deafness Harboring a Point Mutation in the Mitochondrial Transfer RNALeu (UUR) Gene
Authors: Yamasoba Tatsuya , Oka Yoshitomo , Tsukuda Katsunori , Nakamura Masaichi , Kaga Kimitaka 
Published: November 2003

AbstractFive patients with sensorineural hearing loss, who harbored a point mutation in the mitochondrial transfer RNA (tRNA) gene tRNALeu (UUR), from five unrelated family pedigrees were examined. In these families diabetes and deafness were maternally inherited. Bilateral hearing was more severely impaired at higher frequencies. Audiometric test results revealed that hearing loss involved the cochlea. Hearing gradually deteriorated; the progression rate ranged from 1.5 to 7.9 dB per year. Proportion of mutant mitochondrial DNAs (mtDNAs) in the leukocytes was not related to the rate or degree of hearing loss, although hearing loss appeared at a younger age in patients with higher heteroplasmy. We speculate that after the proportion of damaged mtDNAs, mostly as a result of mutation, exceeds the expression threshold for deficiencies in mitochondrial protein synthesis and oxygen consumption, a drop in adenosine triphosphate level could lead to an imbalance of ion concentration, resulting in cell death in the cochlea.
Endoscopic Sinus Surgery in the Developmentally Delayed Child
Authors: Ramadan Hassan H. , Rosen David 
Published: November 2003

AbstractFunctional endoscopic sinus surgery (FESS) has gained widespread support as the treatment of choice for chronic sinusitis in children. Seven developmentally delayed children were evaluated for chronic sinusitis with symptoms of cough, chronic rhinorrhea, and head banging because of pain. All seven were nonresponsive to repeated courses of oral and sometimes intravenous antibiotics; computed tomography scans on all revealed sinus disease. FESS was performed on all of them. Three children had marked respiratory difficulty at the end of the procedure, with two requiring reintubation. Two children were not able to take oral feedings postoperatively. Because of the complicated postoperative course, a second‐look procedure was performed in only two children. We believe that FESS for developmentally delayed children should be tailored accordingly and that a second‐look procedure should not be a routine.
Effects of Middle Ear Oxygen and Carbon Dioxide Tensions on Eustachian Tube Ventilatory Function
Authors: Shupak Avi , Tabari Reza , Swarts J. Douglas , Bluestone Charles D. , Doyle William J. 
Published: November 2003

AbstractThe objective of this study was to determine the effect of middle ear (ME) gas composition on eustachian tube ventilatory function (ETVF). ETVF was evaluated by using forced‐response and inflation‐deflation tests in four alert cynomolgus monkeys during test sessions with different gas compositions. The ME was flushed with one of the four gas mixtures: 1. air; 2. 12% oxygen, 88% nitrogen; 3. 100% oxygen; and 4. 5% carbon dioxide, 21% oxygen, and 74% nitrogen before and during testing. The results documented lower opening, steady‐state, and closing pressures, lower passive and active resistance, and greater dilatory efficiency following ME flushes with the hypercarbic and hypoxic gas mixtures when compared to the others. Also, for applied ME overpressure, the maximum pressure change during a swallow, the average pressure drop for all swallows, and the percentage of the applied pressure equalized were greater under hypoxic and hypercarbic conditions. These results show that ME gas composition affects ETVF and support feedback modulation of ME pressure regulation.
Laryngotracheal Reconstruction Using Microplates in a Porcine Model With Subglottic Stenosis
Authors: Mitskavich Mary T. , Rimell Frank L. , Shapiro Andrew M. , Christopher Post J. , Kapadia Silloo B. 
Published: November 2003

AbstractCurrent techniques of laryngotracheal reconstruction require a choice between prolonged stenting (conventional technique) or short‐term stenting with maintenance of sedation and paralysis until the airway has stabilized(single‐stage laryngotracheal reconstruction). An alternative method is proposed using microplates to provide immediate airway stabilization without stenting. This study was designed to evaluate the long‐term effects of microplate repair of stenosis of the subglottis and trachea on the growing larynx. Subglottic stenosis was produced in piglets using a transoral endoscopic technique. Eight animals underwent repair of the stenosis using an anterior cricoid split with microplate distraction and stabilization of the cricoid cartilage and first tracheal ring. The distraction was maintained and airway growth continued for the duration of this study. However, with growth of the larynx the plates migrated away from their original position. In 50% of the animals followed up for 90 days the plates migrated into the airway lumen. This study suggests that rigid distraction of the stenotic airway with microplates is a viable alternative to more traditional methods of repair. However, plate removal at some interval after surgery is required in the growing larynx in order to prevent migration of the plate into the airway.
Pneumatized Superior Turbinate as a Cause of Referred Migraine Headache
Authors: Clerico Dean M. 
Published: November 2003

AbstractThree patients with typical (common) migraine unresponsive to conventional therapy were evaluated with complete otolaryngologic examination, diagnostic nasal endoscopy, and coronal sinus computed tomography (CT). Enlargement of the superior turbinate due to pneumatization, with accompanying mucosal contact, was found in each case. Application of topical or injected anesthetic to the superior turbinate lessened or relieved headache, and subsequent endoscopic sinonasal surgery succeeded in providing significant headache relief (follow‐up of 6 to 14 months). This is the first report of superior turbinate variations/abnormalities causing migraine, or indeed any type of headache. A discussion of the mechanism of referred pain from mucosal contact is offered after a discussion of each case.Laryngoscope, 106:874‐879, 1996
Regulation of Transforming Growth Factor‐β1‐Mediated Apoptosis in Head and Neck Squamous Cell Carcinoma
Authors: Duffey Dianne C. , Calcaterra Thomas C. , Lichtenstein Alan K. 
Published: November 2003

AbstractThe apoptotic cell death in Cal‐27 cells induced by exposure to transforming growth factor‐β1 was inhibited by the endonuclease inhibitor aurintricarboxylic acid (ATA) in a concentration‐dependent fashion. In vitro studies of cytotoxicity, DNA fragmentation, and protein synthesis by Cal‐27 cell lines were performed. Inhibition of cytotoxicity as well as endonucleolytic DNA cleavage was detected. ATA did not inhibit cytotoxicity either via transforming growth factor cell‐surface‐receptor alteration or by inhibition of macromolecular synthesis. ATA‐sensitive events occurred late during treatment. These data suggest that endonucleolytic DNA cleavage is a mandatory event leading to cell death in this system.Laryngoscope, 106:889‐894, 1996
The Importance of Mandibular Position in Microvascular Mandibular Reconstruction
Authors: Li, Kasey K. , Cheney Mack L. , Teknos Theodoros N. 
Published: November 2003

AbstractThe challenge of mandibular reconstruction rests in the difficulty of re‐creating the intricate three‐dimensional relationship of the oral cavity, thereby ensuring occlusal relationships, oral competence, and facial contour. Recent advances in microvascular surgery have made reliable transfer of autologous tissue possible, but successful reconstruction depends on accurate insetting of the bone flap.The authors reviewed their five years of experience with mandibular reconstruction and found six patients with a poor reconstructive result secondary to improper insetting of the bone flap. Anteromedially rotated and free‐floating proximal mandibular segments appeared to be the most significant contributor to incorrect placement of the bone flap. Based on their findings, the authors devised a simple technique for stabilizing proximal mandibular segments.Laryngoscope, 106:903‐907, 1996
Residual Mesenchyme in Temporal Bones of Children
Authors: Kasemsuwan Lalida , Schachern Patricia , Paparella Michael M. , Le Chap T. 
Published: November 2003

AbstractThe role of mesenchyme in the temporal bone is still poorly understood. A microscopic study of residual mesenchyme was undertaken in temporal bones of children from birth to 5 years of age. Residual mesenchyme was found to be located in the mastoid antrum and epitympanum more often than in the mesotympanum. The amount of mesenchymal tissue remaining in the temporal bones decreased with increasing age. Persistence of mesenchyme in the temporal bone was related to congenital morphologic ear anomalies and syndromes. There was also an association evident with pulmonary disease, but not with congenital heart defects. Persistent mesenchyme was also found to be significantly associated with chronic middle ear inflammation, and in cases of unilateral otitis media the ear with otitis media had more residual mesenchyme than the non‐otitis media ear.
Parathyroid Visualization With Cibacron Blue/BB5‐G1
Authors: King Raymund C. , Mills Stanley L. , Medina Jesus E. 
Published: November 2003

AbstractBB5‐G1 is a murine monoclonal antibody with proven affinity for human parathyroid tissue. The authors conjugated BB5‐G1 to cibacron blue, a watersoluble dye, in an attempt to enhance intraoperative parathyroid visualization. Athymic nude mice possessing intramuscularly implanted human parathyroid tissue were infused with the conjugate, then surgically explored. Intraoperative findings were video‐captured, then analyzed by three independent observers and by computer, generating subjective and objective data quantifying parathyroid visualization. Parathyroid tissue implants were stained and were easily visualized. The implants in the test mice displayed higher computer‐generated color intensity ratings (mean, 10.25 units) compared to control mice (mean, 6.10 units) (p<0.5). Histologic sections confirmed the presence of dye and antibody within parathyroid tissue. This represents the first study to use such a conjugate to selectively enhance parathyroid visualization.
Laser‐Assisted Uvulopalatoplasty With Nd:YAG Laser for Sleep Disorders
Authors: Hanada Takehiro , Furuta Shigeru , Tateyama Toshiro , Uchizono Akihiro , Seki Daihachiro , Ohyama Masaru 
Published: November 2003

AbstractWe evaluated the apnea index (AI), the oxygen saturation above 95% (SA95), the lowest oxygen saturation (LSAT), and snoring before and after laser‐assisted uvulopalatoplasty (LAUP) in 106 patients with obstructive sleep apnea syndrome (n=59) or snoring (n=47). Type 1 LAUP was performed in 42 patients and type 2 LAUP in 64 patients. A 50% or greater reduction in AI was observed in 15 patients (35.7%) who underwent type 1 LAUP and 37 patients(57.8%) who underwent type 2 LAUP. Snoring was diminished in 18 (51.4%) of 35 patients who underwent type 1 LAUP and 30 (55.6%) of 54 patients who underwent type 2 LAUP. SA95 and LSAT showed no difference. No serious complications such as significant bleeding, postoperative episodes of asphyxia, nasopharyngeal stenosis, or nasal regurgitation were observed. LAUP was an effective outpatient treatment.
Detection of Epstein‐Barr Virus in Salivary Gland Specimens from Sjögren's Syndrome Patients
Authors: Merne Marina E.T. , Syrjänen Stina M. 
Published: November 2003

AbstractThe cause of Sjögren's syndrome remains unclear, but several environmental and genetic factors have been implicated. The Epstein‐Barr virus(EBV), among others (e.g., cytomegalovirus, human herpesvirus 6, and retroviruses), has been widely studied in connection with Sjögren's syndrome without conclusive results. To determine the role of EBV infection in patients with Sjögren's syndrome, the presence of EBV deoxyribonucleic acid (DNA) in major and minor salivary gland biopsy specimens was investigated by means of sulfur 35 in situ hybridization and polymerase chain reaction. Additionally, the presence of latent virus proteins EBV latent membrane protein and Epstein‐Barr nuclear antigen 2 was analyzed by immunohistochemical methods. Viral DNA, detected by in situ hybridization, was found in 19% of patients with a diagnosis of Sjögren's syndrome and in 3% of controls. All tissues studied were found to be negative for EBV DNA by polymerase chain reaction. EBV latent membrane protein‐positive staining was seen in 17% of patients and 22% of control subjects, while Epstein‐Barr‐positive staining was found in 25% of patients and 39% of controls. The low frequency of EBV DNA detected in the biopsy specimens does not indicate that the virus itself is the cause of Sjögren's syndrome. However, the possibility that the virus acts as a cofactor cannot be ruled out.