bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adjunctive citalopram is effective on hallucinations and depersonalization symptoms: a case report
Authors: Di Michele Vittorio , Bolino Francesca 
Published: April 2004

The treatment of depressive symptoms in patients affected by schizophrenia is often a concern for clinicians [2] due to potential interaction, in terms of safety and efficacy. Citalopram seems to be a safe SSRI as adjunctive treatment to Olanzapine because of the lack of interactions. We report a serendipitous finding showing that the adjunction of Citalopram to Olanzapine, led to disappearence of residual hallucinations and depersonalization symptoms in a few weeks.Mr A is a 27-year-old male, living in the community, with a 4-year history of schizophrenia,. He was treated with low doses of Olanzapine (10 mg/daily) since 2000 because of an intolerance to dose increments (weight gain and mydriasis).The persistence of sporadic hallucinations (commenting voices) and depersonalization symptoms (when he walked alone he felt his self leaving the body) was well tolerated by the patient. The social functioning was satisfactory: he had a protected job and was involved in a comprehensive rehabilitation programme.
Mode of delivery for breech presentation in grandmultiparous women
Authors: Kumari A.S. , Grundsell H. 
Published: April 2004

AbstractObjectives: To compare maternal and neonatal outcomes of planned vaginal delivery vs. elective cesarean delivery for breech presentation at term. Methods: Retrospective study of term breech deliveries from January 1997 through December 2000. A group of 128 women for whom vaginal delivery was planned was compared with a group of 122 women who had an elective cesarean delivery with regard to neonatal mortality and morbidity (birth trauma, birth asphyxia, hyperbilirubinemia, and duration of stay in the neonatal intensive care unit) and maternal morbidity (infections, hemorrhage, hysterectomy, deep venous thrombosis, and pulmonary embolism). Results: There was no difference in neonatal mortality and morbidity between the two groups (13.0% vs. 9.4%). There were fewer maternal complications in the planned vaginal group than in the elective cesarean group (5.5% vs. 18%; P<0.01). In the planned vaginal delivery group 70% of multiparas and 85% of grandmultiparas were delivered vaginally compared with 50% of nulliparas. Conclusions: In breech presentations at term vaginal delivery can be achieved in 85% of grandmultiparas without significant neonatal morbidity. Elective cesarean section is associated with increased maternal morbidity compared with planned vaginal delivery.
The creation and projection of ambiophonic and geometrical sonic spaces with reference to Denis Smalley's Base Metals
Authors: LOTIS THEODOROS 
Published: April 2004

This article suggests a framework for the articulation of ambiophonic and geometrical spaces in electroacoustic composition and performance. Space-ambiophony explores the global perception of space, which is derived from the archetypal perception of surrounding environments. The term applies to usually large-scale observation but it can also include shifts in the listener's attention from gestalt perception to micro-structural observation. A spatial analysis of Smalley's Base Metals demonstrates the methods by which space-ambiophony is integrated into the composition. In space-geometry, relations and analogies are established between composed sonic events and principles of geometry and stereometry. Three primordial geometrical elements, drawn from Wassily Kandinsky's theoretical work on painting, serve as metaphorical cells for the construction and projection of this type of space: the point, the line and the plane.The interaction between the acoustic qualities of listening spaces, the configuration of loudspeakers, the composed space (sonic trajectories, background, foreground) and its projection by the interpreter in a concert, are all issues that occupy parts of the article.
Patient Perception of Comorbid Conditions After Acoustic Neuroma Management: Survey Results From the Acoustic Neuroma Association
Authors: Ryzenman John M. , Pensak Myles L. , Tew John M. 
Published: April 2004

AbstractObjectives/Hypothesis:Based on survey results of the Acoustic Neuroma Association, the patient ratings of the most difficult aspects of acoustic neuroma management were reported and a review of the literature was made regarding comorbid conditions associated with acoustic neuroma treatment and their impact on patient quality of life.Study Design:Cohort study of 1940 patients who were members of the Acoustic Neuroma Association.Methods:A detailed questionnaire was mailed to 2372 members of the Acoustic Neuroma Association to identify preoperative and postoperative symptoms, complications, and long‐term effects on physical and psychosocial function. For 1940 respondents (81.8%) who reported the “most difficult aspect of the AN [acoustic neuroma] experience,” the responses were analyzed by tumor size, surgical approach, and patient age and sex. Statistical analysis was performed using SPSS software.Results:Respondents reported that the most difficult aspect of the acoustic neuroma experience was hearing loss (25.8%), followed by facial weakness (17.9%), eye problems (10.8%), and headache (10.5%). In order of frequency, men reported hearing loss, balance problems, perioperative surgical experience, and eye and facial weakness, and women reported hearing loss, facial weakness, eye problems, and headache. Facial weakness was a morbidity more often reported for men and women who had large tumors, who were young, or who had undergone the retrosigmoid approach. Balance dysfunction was significant in patients older than 75 years of age. In patients with small tumors, headaches and balance problems were frequently reported.Conclusion:In the large cohort study of patients with acoustic neuroma, perceptions regarding the impact of treatment illustrated why it is incumbent on physicians to understand the sentiments of patients with acoustic neuroma when counseling them and recommending optimal management strategies.
Chronological Changes of Hearing in Pediatric Patients with Large Vestibular Aqueduct Syndrome
Authors: Lai Chien‐Chung , Shiao An‐Suey 
Published: April 2004

AbstractObjectives: To describe the chronologic changes of hearing in patients with large vestibular aqueduct syndrome (LVAS) and identify the prognostic factors.Study Design: A retrospective chart‐review study.Methods: Twelve consecutive patients with LVAS were recruited at Taipei Veterans General Hospital between July 1986 and July 2000. The records of serial pure‐tone audiogram and high‐resolution computer tomography were collected. The chronologic figures of pure‐tone average (PTA) were sketched. The investigated variables included sex, laterality and type of hearing loss (HL), size of vestibular aqueduct, and the chronologic changes and configurations of hearing. Data were analyzed statistically.Results: The degree of HL in early childhood was from moderate to profound. The worst hearing could be estimated by the hearing level in early childhood. Sixteen of 24 ears were stable. Bilateral, chronologically stepwise‐downhill hearing occurred in only one patient (1/12) during the follow‐up period. Chronologically, high‐tone hearings were worse than those of low‐tone, but fluctuations of high‐tone hearing were smaller than those of low‐tone. The sizes of vestibular aqueduct were predictive of the density of major depression and its depth.Conclusions: LVAS, a congenital disease, is characterized by fluctuating sensorineural HL. Most hearing at PTA remained stable at least in one ear chronologically. The standard deviation of hearing at 500 Hz was the only prognostic factor for the progression of PTA. An enlarged vestibular aqueduct affects fluctuations of hearing, but the pathogenesis of HL still remains unclear and deserves further investigations.
Laser Myringotomy versus Ventilation Tubes in Children with Otitis Media with Effusion: A Randomized Trial
Authors: Koopman Jan Pieter , Reuchlin A. G. (Nees) , Kummer Eelco E. , Boumans Leon J. J. M. , Rijntjes Evert , Hoeve L. J. (Hans) , Mulder Paul G. H. , Blom Henk M. 
Published: April 2004

AbstractObjectives: Insertion of ventilation tubes in children with otitis media with effusion (OME) is an accepted and common treatment procedure. The majority of patients require general anesthesia. Although laser myringotomy can be performed in local anesthesia, evidence is lacking that this treatment modality is an alternative for tubes, and outcome predictors for laser myringotomy are not available.Study Design: Prospective randomized trial.Methods: We screened 1,403 children with chronic OME that were indicated for placement of ventilation tubes. In the eligible patients, we performed laser myringotomy in one ear and placed a tube in the other ear, both within the same patient. Follow‐up was scheduled each month for 6 months. Success was defined as absence of effusion or aural discharge. A logistic regression model was used with success of the therapy as binary outcome. This model was based on base‐line variables, asked for in a parent's questionnaire.Results: Two hundred eight children received the allocated intervention, and no complications occurred. The mean closure time of the laser perforation was 2.4 weeks, and the mean patency time of the ventilation tube was 4.0 months. The mean success rate was 40% for laser and 78% for tubes. Ten known variables were found to predict middle ear status after therapy.Conclusion: Laser myringotomy is a safe but less‐effective procedure than insertion of a ventilation tube in the treatment of chronic OME. The prognostic model enables the otolaryngologist to choose the surgical treatment for the child that benefits most: laser myringotomy or ventilation tube.
A Laryngeal Dissection Station: Educational Paradigms in Phonosurgery
Authors: Dailey Seth H. , Kobler James B. , Zeitels Steven M. 
Published: April 2004

AbstractObjectives: To introduce a new tool for phonosurgical training and education. A multitude of innovations in complex laryngeal surgery has catalyzed new educational initiatives. Establishing dexterity in phonomicrosurgery is often difficult to achieve while working on patients because of the narrow margin for success. Furthermore, laryngoplastic phonosurgery and open partial laryngectomy require sophisticated knowledge of precise anatomic relationships, which can be difficult to express in images. Finally, many teaching programs do not have a high volume of these procedures, and there is a significant need to transmit this information in continuing education courses.Study Design: Prototype design.Methods: A laryngeal dissection station (LDS) was designed to facilitate the acquisition of high‐level procedural skill sets for both transoral and transcervical techniques.Results: This LDS can be used in existing temporal‐bone laboratories by using cadaveric larynges. A rectangular frame supports two adjustable holders, one for the larynx and one for the examining speculum of a laryngoscope. Procedures are performed with the larynx fixed in space by a novel fixator. Variation in position and orientation of the components affords simulation of both microlaryngoscopy and open surgery. The dissection station can accommodate virtually any laryngoscope, regardless of size or shape.Conclusions: This training apparatus should facilitate laryngeal surgical instruction in residency training and continuing medical education. This device and others like it can help establish clinical competency in laryngology, should this become necessary in future educational models of residency training and recertification.
Adaptation of the Horizontal Vestibuloocular Reflex in Pilots
Authors: Lee Moon Young , Kim Min Sun , Park Byung Rim 
Published: April 2004

AbstractObjectives/Hypothesis: The vestibular function in pilots has been reported as being different to that in other, normal subjects. However, there is little evidence as to why and when this occurs, and its cause is still in doubt. The aim of this study was to evaluate changes in vestibular function in student pilots attending an elementary flight course, and in other active pilots, through the use of the slow harmonic acceleration (SHA) test and to verify the occurrence and timing of any vestibular function changes.Study Design: Cross‐sectional and prospective group design.Methods: The six study groups were control, student pilots before and after flight training, and three groups of active pilots classified according to flight time. Gain, phase, and symmetry of horizontal eye movements induced by sinusoidal harmonic acceleration test were investigated.Results: There were significantly higher gain values in all active pilot groups as compared with the control group at frequencies above 0.04 Hz, and in student pilots after flight training, as compared with before training at 0.01, 0.04, and 0.08 Hz. However, there were no significant differences in gain values among the three groups of active pilots or between gain values in student pilots before flight training and those of the control group. We could not find any reliable relationship between vestibuloocular reflex (VOR) function changes and other factors such as age, height, and weight.Conclusions: We suggest that these results might be explained by adaptations caused by VOR plasticity rather than habituation and that flight training might be responsible for the modulation of the vestibular function in pilots.
Human Cortical Motor Representation of the Larynx as Assessed by Transcranial Magnetic Stimulation (TMS)
Authors: Rödel Ralph M.W. , Olthoff Arno , Tergau Frithjof , Simonyan Kristina , Kraemer Dorit , Markus Holger , Kruse Eberhard 
Published: April 2004

AbstractObjectives: To analyze characteristic features and details on motor‐evoked potentials (MEPs) of the cricothyroid and vocalis muscles from single‐pulse cortical transcranial magnetic stimulation (TMS) in normal subjects to characterize cortical motor representation of laryngeal muscles.Study Design: Prospective, experimental investigation on healthy volunteers.Method: MEPs of the cricothyroid and vocalis muscles elicited by cortical TMS with a figure–8‐shaped coil were investigated in two groups of six healthy subjects each, with special regard to MEP amplitude as a function of the coil position on the head surface along the interaural line.Results: Bilateral reproducible responses of the cricothyroid and the vocalis muscles could be observed in all subjects. For the cricothyroid muscle, maximal responses were obtained at mean stimulus positions of 7.5 ± 1.4 cm (contralateral) and of 7.3 ± 1.3 cm (ipsilateral), respectively. For the vocalis muscle, we found maximal responses at mean stimulus positions of 10.3 ± 1.9 cm (contralateral) and of 9.6 ± 1.6 cm (ipsilateral), respectively. Despite a considerable overlap of these coil positions, from which reproducible MEPs could be elicited in both groups of the laryngeal muscles, statistically significant separation of the cricothyroid‐and vocalis‐associated cortical representation areas was possible.Conclusions: Our observations point to two different cortical motor representation areas, with the cricothyroid muscle‐related area being located more medially.
Evaluation of the Medical and Surgical Treatment Of Chronic Rhinosinusitis: A Prospective, Randomised, Controlled Trial
Authors: Ragab Sameh M. , Lund Valerie J. , Scadding Glenis 
Published: April 2004

AbstractObjectives: To conduct the first prospective, randomized, controlled trial evaluating and comparing the medical and surgical treatment of polypoid and nonpolypoid chronic rhinosinusitis (CRS).Materials and Methods: Ninety patients with CRS were equally randomized either to medical or surgical therapy. All patients underwent pre‐ and posttreatment assessments of visual analogue score (VAS), the Sinonasal Outcome Test‐20 (SNOT‐20), the Short Form 36 Health Survey (SF‐36), nitric oxide (NO), acoustic rhinometry, saccharine clearance time (SCT), and nasal endoscopy. Each patient had three assessments: before starting the treatment, after 6 months, and, finally, after 1 year.Results: Both the medical and surgical treatment of CRS significantly improved almost all the subjective and objective parameters of CRS (P < .01), with no significant difference being found between the medical and surgical groups (P > .05), except for the total nasal volume in CRS (P < .01) and CRS without polyposis (P < .01) groups, in which the surgical treatment demonstrated greater changes.Conclusion: CRS should be initially targeted with maximal medical therapy (e.g., a 3 month course of a macrolide antibiotic, douche, and topical steroid), with surgical treatment being reserved for cases refractory to medical therapy. The presence of nasal polyps is not a poor prognostic factor for the efficacy of CRS therapy, either surgical or medical.
Effects of External Beam Radiation in the Rat Tibial Nerve after Crush, Transection and Repair, or Nerve Isograft Paradigms
Authors: Myckatyn Terence M. , Brenner Michael , Mackinnon Susan E. , Chao Clifford K. , Hunter Daniel A. , Hussussian Christopher J. 
Published: April 2004

AbstractIntroduction: In head and neck surgery, radiation therapy is often administered to an injured nerve. Previous studies have examined the effects of either preoperative or postoperative radiation on nerve regeneration in rodents. In these studies, histomorphometric analysis was performed up to 8 month postoperatively. Given the exceptional neuroregenerative capacity of rodents, significant differences in nerve regeneration may go undetected if nerves are evaluated at such distant postoperative time points. This study is designed with a more appropriate model and investigates the effects of radiation after three common nerve injury paradigms.Methods: Sixty‐four Lewis rates were randomized to 8 groups corresponding to uninjured, tibial nerve crush, transection and repair, or reconstruction with isografts. Half of the animals in each of these paradigms (n = 8 per group) were treated with 10 Gy of external beam radiation to the site of nerve injury at 7 days postoperatively. On postoperative day 28, functional recovery and histomorphometric assessment was performed.Results: For a given paradigm of nerve injury, no significant differences in nerve fiber number, neural density, neural debris, or fiber width were noted between the control and radiated groups, and radiation did not affect functional recovery.Conclusion: Radiation had no discernible effect on nerve regeneration or functional recovery in the rodent nerve injury models studied. All assessments were made at time points suitable for detecting differences in nerve regeneration between groups. These findings suggest that administration of radiation to fields containing injured peripheral nerve is unlikely to adversely affect functional outcomes.
Bone‐Anchored Hearing Aid: Comparison of Benefit by Patient Subgroups
Authors: McLarnon Claire M. , Davison Tom , Johnson Ian J. M. 
Published: April 2004

AbstractObjectives/Hypothesis: The osseointegrated bone‐anchored hearing aid, using the Branemark system, is well established and has proven benefit. The aim was to study quality of life benefits within patient subgroups using the validated Glasgow Benefit Inventory (GBI).Study Design: Retrospective questionnaire study.Methods: Ninety‐four consecutive patients were enrolled into the study. Mean patient age was 49 years, with a female‐to‐male ratio of 1.1:1. Patient subgroups were discharging mastoid cavities, chronic active otitis media, congenital ear problems, otosclerosis, and acoustic neuroma and other unilateral hearing losses.Results: The response rate was 73%. The score for total benefit of bone‐anchored hearing aid fitting for the entire group was +33.3 (95% confidence interval [CI], 25–42). Glasgow Benefit Inventory scores for each subgroup were all greater than +20. The congenital atresia group scored highest with +45 (95% CI, 28–61). Variation in benefit across the subgroups has been demonstrated. Fitting of BAHA following acoustic neuroma surgery was shown to be of benefit with a score of +22.2. General benefits scored highest in all subgroups compared with physical and social benefits.Conclusion: The study demonstrated the differences in benefit within patient subgroups. Its results can be used to give patients a predictive value at the time of preoperative counseling. The study identified congenital ear disorders as the group likely to obtain maximal benefit. Notably, for the first time, the study demonstrated the documented benefit of restoring stereo hearing to patients who have acquired unilateral hearing loss following acoustic neuroma surgery using a BAHA.
Primary Parotid Malignoma Surgery in Patients With Normal Preoperative Facial Nerve Function: Outcome and Long‐Term Postoperative Facial Nerve Function
Authors: Guntinas‐Lichius Orlando , Klussmann Jens Peter , Schroeder Ulla , Quante Gero , Jungehuelsing Markus , Stennert Eberhard 
Published: April 2004

AbstractObjectives/Hypothesis: Most patients with primary parotid cancer present with normal facial nerve function. The common surgical strategy for these patients is to perform a parotidectomy with facial nerve preservation. Nevertheless, the functional outcome for the facial nerve and oncological outcome is unclear.Study Design: Medical records of 211 patients treated from 1986 to 2000 in an university hospital were reviewed. One hundred seven patients with primary surgery for primary parotid cancer and long‐term follow‐up were analyzed retrospectively.Methods: The characteristics, treatment, and oncological outcome were evaluated using hospital chart data. All patients with postoperative facial paresis were had follow‐up with electromyography until recovery or permanent paresis became apparent.Results: Ninety‐one patients had a normal preoperative function. Facial nerve preservation during surgery by total parotidectomy was possible in 79 patients, whereas in 28 patients a radical parotidectomy was necessary. Otherwise, the oncological characteristics of both groups were not different. Directly after total parotidectomy, half of the patients presented a facial paresis but only two patients (2%) developed a permanent partial paresis. The 5‐year disease‐free rate and the 5‐ and 10‐year survival rates were 65%, 83%, and 54%, respectively. After radical parotidectomy, the results were not significantly different. The 5‐year disease‐free rate and the overall 5‐ and the 10‐year survival rates were 56%, 62%, and 42%, respectively.Conclusion: Treatment of primary parotid cancer with preoperatively normal facial nerve function by standardized parotidectomy and precise microsurgical preservation of the facial nerve is often possible. This approach demonstrates favorable oncological results with a low level of long‐term facial nerve morbidity.