bluuebunny/crossref_metadata_2025_split huggingface dataset:
Local excision of carcinoma of the rectum: Indications
Authors: Killingback Mark 
Published: September 2005

AbstractTo discuss indications for local excision of adenocarcinoma of the low rectum, two different series of patients were analysed. Series I consisted of 60 patients treated by local excision from 1969 to 1985 in whom local recurrence developed. Series II consisted of 59 patients who underwent resection for non high grade tumors ≤3.5 cm from 1980 to 1990 in whom lymph node spread was studied. A distinction is made between tumors which are obvious cancers and malignant polyps, and the discussion of indications for local excision is orientated to the former. The results of local excision have been disappointing but a number of compromise selections for local excision have been necessary. Endorectal ultrasound has emerged as the most important method of assessing the depth of invasion of the tumor. Stratifying the depth of the tumor is at present the most important prognostic indicator for lymph node metastasis and local recurrence in non high grade tumors. If the muscle layer is invaded by tumor, local metastasis will occur in 17% of patients. It is likely that only tumors involving superficial layers of muscle are suitable for local excision, but this needs further study. Mucinous carcinomas and the presence of lymphatic invasion are contra‐indications to local excision. The shape and size of tumors are not independent prognostic indicators. The techniques available for local excision alter the indications. Salvage operations for recurrence after local excision have proved disappointing.
Endocavitary irradiation in the conservative treatment of adenocarcinoma of the low rectum
Authors: Papillon J. , Berard Ph. 
Published: September 2005

AbstractEarly T1 and small T2 low rectal cancers may be controlled by endocavitary irradiation using the 50 kV Philips machine. The ambulatory treatment performed in the out‐patient department consists of 4 applications within 6 weeks. Iridium‐192 implant performed under local anesthesia is useful in many cases to give a booster dose to the tumor bed. In a series of 312 patients followed for >5 years, the rates of local and nodal failure were 4.5% and 3.8%, respectively. The rate of death from cancer was 7.7%. After local excision endocavitary irradiation may be used as adjuvant therapy but it is safer to combine external beam and endocavitary irradiation. In the particular case of very poor risk patients with T2 or T3 tumors of the lower third of the rectum, a short course of external beam irradiation (30 Gy within 12 days) followed 2 months later by endocavitary irradiation may be a reliable procedure to prevent permanent colostomy in cases selected according to the patient's condition and the features of the residual disease. Of 67 patients followed for >5 years, 3 patients died of distant metastasis and 5 patients died of local failures. These data, based on close collaboration with surgeons, suggest a reappraisal of the role of radiation therapy in the conservative management of rectal cancer.
Excision of the rectum with colonic J pouch‐anal anastomosis for adenocarcinoma of the low and mid rectum
Authors: Berger A. , Tiret E. , Parc R. , Frileux P. , Hannoun L. , Nordlinger B. , Ratelle R. , Simon R. 
Published: September 2005

AbstractThe results of rectal excision with colonic pouch‐anal anastomosis are reviewed from a series of 162 patients covering 7 years. All patients have been operated upon in the same institution and consecutively. The follow‐up is now sufficient to allow an accurate evaluation of the outcome of the patients. The main goal of this study was to provide a detailed report of the functional results. Continence was satisfactory in 96% of the patients, with either a perfect continence or minor troubles that would not have been detectable other than by a rigorous questioning. The mean number of bowel movements was 2 per 24 hours. Fragmentation of the defecation and urgency were absent. Twenty‐five per cent of the patients had to elicit the evacuation of the reservoir with a suppository or an enema. Improvement of function yielded by a reservoir over straight colo‐anal and low colo‐rectal anastomoses are significant and, as suggested by manometric studies, are directly related to the restoration of a reservoir function.
Improved stabilization of conventional (brooke) ileostomies with the stapler technique
Authors: Ecker Karl W. , Schmid Thomas , Xu Han S. , Feifel Gernot 
Published: September 2005

AbstractThe rate of functional complications of conventional (Brooke) ileostomy is high and endangers the complete postoperative rehabilitation of the patients. About half of these complications (retraction with/without stenosis, intermittent recession, and prolapse) occur within the classical prominent stoma and are caused by displacement of the serosa surfaces. We have stabilized conventional ileostomies in 39 patients with rows of staples placed paramesenterially and longitudinally. The ileum was everted in the classical way in the primary construction of ileostomies in 19 patients. On the other hand, in 11 patients the prominence of the stoma was established by pulling the ileum out through the previously plane‐sutured stoma. In addition, 9 patients with ileostomies which were not primarily stabilized were corrected with the stapler technique to treat complications. With follow‐up ranging from 0.2 years to 4.2 years, there have been no complications due to sliding of the nipple in these 39 patients. In contrast, there were complications in 37% of 38 patients with non‐stabilized ileostomies with follow‐up to the second postoperative year. It was more easily reproducible, more exact, and less traumatic to create the stoma prominence by pulling the intestine out from a primarily plane stoma than with classical eversion. With use of the stapler in repairing complications, local ileostomy constructions were no longer required in every second patient. Consequently, a Brooke ileostomy can be constructed more easily with the stapler technique, ensuring long‐term function or restoration of function.
Paleoproductivity evolution off central Chile from the Last Glacial Maximum to the Early Holocene
Authors: Romero Oscar E. , Kim Jung-Hyn , Hebbeln Dierk 
Published: September 2005

AbstractA geochemical and paleontological reconstruction of paleoproductivity, upwelling intensity and sea surface temperature (SST) off central Chile at 35°S (GeoB3359-3) reveals marked changes from the Last Glacial Maximum (LGM) through the Early Holocene. Surface-water productivity was determined by the interaction between the atmospheric (the Southern Westerlies) and oceanographic (the Antarctic Circumpolar Current, ACC) systems from the LGM through early Termination I (TI). The northward shift of the climate zones during the LGM brought the ACC, as the main macronutrient source, closer to the GeoB3359-3, SST lowered, and surface water productivity and accumulation rates of biogenic components enhanced. With the poleward return of the Southern Westerlies and the ACC, the subtropical high-pressure system became the dominant atmospheric component southward till 35°S during the late TI and Early Holocene and caused surface water productivity to increase through enhanced upwelling.
management issues in radiotherapy physics: a census of heads of radiotherapy physics in the nhs
Authors: thomas d. w. 
Published: September 2005

an investigation of human resource issues in radiotherapy physics services in the nhs, including an evaluation of the extent to which the management of human resources was strategic, was undertaken as part of mba level research by a radiotherapy clinical scientist. the research incorporated a telephone census of heads, or acting heads, of radiotherapy physics services. this census looked at the establishment and scale of radiotherapy physics services, issues around recruitment and flexibility, business management, strategy and strategy formation and human resource management practices.a 96% response rate was obtained with 55 out of a potential population of 57 subjects participating in the survey. it was found that at the time of the survey, 11.0% of all radiotherapy physicist posts were vacant. this was due predominantly to recruitment difficulties. furthermore, 42% of radiotherapy physicists in post were relatively inexperienced, having spent less than 6 years in the discipline. eighty-seven per cent of services had re-graded radiotherapy physicist posts in order to recruit. additionally, 53% of services had changed their skill mix by increasing the ratio of technologists to physicists. fifty-nine per cent of those services did so because of difficulties in recruiting radiotherapy physicists.whereas 38 respondents (69% of total) said they had a human resource strategy linked to the service's business strategy, only 12 respondents (22% of total) claimed to undertake appraisal and training needs analyses coupled with personal development plans and continuing professional development. relatively little succession planning was undertaken, and only 14 services (26% of total) had well-developed succession plans.recommendations are made as to how human resource management in nhs radiotherapy physics services could be more strategic.
Superantigens and Chronic Rhinosinusitis: Detection of Staphylococcal Exotoxins in Nasal Polyps
Authors: Seiberling Kristin A. , Conley David B. , Tripathi Anju , Grammer Leslie C. , Shuh Lydia , Haines G Kenneth , Schleimer Robert , Kern Robert C. 
Published: September 2005

AbstractObjective/Hypothesis: The role of infectious agents in the etiology of chronic rhinosinusitis with nasal polyposis (CRSwNP) remains unclear. Recent studies have provided indirect evidence of exposure to staphylococcal exotoxins in the blood and polyp tissue of patients with CRSwNP. These exotoxins have the capacity to act as superantigens, bypassing normal antigen processing and directly stimulating a massive inflammatory response. The objective of the study was to analyze mucus and polyp tissue samples from patients with CRSwNP for the presence of staphylococcal exotoxins.Study Design: Prospective study.Methods: Tissue and mucus samples were obtained from 42 patients undergoing endoscopic sinus surgery for chronic rhinosinusitis and 11 normal control patients. Twenty‐nine of 42 patients had chronic rhinosinusitis with bilateral nasal polyposis, 2 had antrochoanal polyps, and 11 had chronic rhinosinusitis without nasal polyps. Eleven patients without chronic rhinosinusitis or polyps served as normal control patients. Specimens were analyzed for the presence of five staphylococcal exotoxins (SEA, SEB, SEC, SED, and toxic shock syndrome toxin type 1 [TSST‐1]) using enzyme‐linked immunosorbent assay (ELISA). Histological analysis of specimens and mean eosinophil counts were correlated with the presence of toxin.Results: At least one toxin was detected in 14 of 29 patients with bilateral nasal polyposis. Nine of the 14 patients also had positive findings for additional toxins. The dominant histological pattern in the CRSwNP patient group was polypoid mucosa with edema, which was found in both ELISA‐positive and ELISA‐negative patients. Mean eosinophil counts tended to be higher in ELISA‐positive patients with polyps compared with patients without toxin detection. No toxin was detected in the 11 specimens taken from normal control patients. Only 1 of the 13 patients with CRS without polyps had positive ELISA results for toxin.Conclusion: The current study demonstrates the presence of superantigen toxins in 14 of 29 patients with CRSwNP, with SEB and TSST‐1 being the most common. Further studies are necessary to correlate the presence of toxin with the pathological changes present in polyp tissue.
Behavioral Assessment of Prelingually Deaf Children Before Cochlear Implantation
Authors: Horn David L. , Pisoni David B. , Sanders Mary , Miyamoto Richard T. 
Published: September 2005

AbstractObjectives/Hypothesis: To determine whether scores from a behavioral assessment of prelingually deafened children who present for cochlear implant surgery are predictive of audiological outcomesStudy Design: Retrospective review of longitudinal data collected from 42 children with prelingual hearing loss who presented for a cochlear implant before age 5 years.Methods: The Vineland Adaptive Behavioral Scales (VABS) was administered during the preimplant workup. Standardized scores reflect daily living skills, socialization, and motor development compared with a normative sample. Regression analyses were conducted to determine whether any subject variables were related to VABS scores. Mixed‐model analyses were computed to determine whether preimplant VABS scores were predictive of longitudinal spoken‐language data obtained after cochlear implant surgery.Results: Motor scores tended to be higher than nonmotor scores. Nonmotor scores were significantly lower than the normative mean and decreased with testing age. Children with acquired deafness demonstrated lower motor scores than children with congenital causes. Children with higher motor scores demonstrated significantly higher performance on language, vocabulary, and word recognition tests than children with lower motor scores. Nonmotor domains were not as robustly related to spoken‐language measures, although similar trends were observedConclusion: Profound deafness and language delay may confound the assessment of daily living skills and socialization in the population studied. Motor development appears to proceed normally in prelingually deafened children and is a preimplant predictor of spoken‐language outcome in young infants and children with cochlear implants, a finding consistent with the large body of work establishing links between perceptual‐motor and language development.
Neuro‐otologic Surgery through Minimally Invasive Retrosigmoid Approach: Endoscope Assisted Microvascular Decompression, Vestibular Neurotomy, and Tumor Removal
Authors: Miyazaki Hidemi , Deveze Arnaud , Magnan Jacques 
Published: September 2005

AbstractObjectives: The objective of this study was to describe and evaluate the efficacy of the endoscope assisted minimally invasive retrosigmoid approach.Study Design: Retrospective study and literature review.Methods: From December 1993 to December 2004, a total of 1,177 cases of endoscope assisted minimally invasive retrosigmoid approach were performed at the Otorhinolaryngology unit of Hopital Nord in Marseille. By using this approach, we performed microvascular decompression for hemifacial spasm and trigeminal neuralgia, vestibular neurotomy for refractory Ménière's disease with repeated attacks of dizziness, and tumor removal of acoustic neurinoma. We examined the results and postoperative complications.Results: All the results were positive, and we did not experience any mortal complications. The most common complication was cerebrospinal fluid leakage, encountered in 42 (3.6%) cases.Conclusions: We believe that the combination of an endoscope and microscope that provides accurate information with low invasion is becoming indispensable for these types of operations, which are in the category of functional surgery. We report the merits and significance of the approach of combining the endoscope and microscope and discuss the operational technique to perform a minimally invasive surgery as an oto‐neurosurgeon.
Mild Hypothermia Protects Auditory Function During Cochlear Implant Surgery
Authors: Balkany Thomas J. , Eshraghi Adrien A. , Jiao He , Polak Marek , Mou Caihong , Dietrich Dalton W. , Van De Water Thomas R. 
Published: September 2005

AbstractObjective/Hypothesis: Loss of auditory function after cochlear implant (CI) electrode insertion occurs in two stages in the laboratory rat. An immediate loss is followed by a progressive loss over 7 days. Similar stages of acute and progressive neuronal loss occur after trauma in the central nervous system where hypothermia has been shown to have a protective effect. We hypothesize that hypothermia has a similar protective effect against loss of auditory function caused by CI electrode insertion trauma.Methods: Thirty rats underwent surgery in one cochlea; the contralateral ear was an unoperated control. In the normothermia group, CI electrode insertion trauma was generated with rectal temperature maintained at 37°C throughout the experiment. In the mild hypothermia group, electrode trauma was generated with rectal temperature lowered to 34°C. In the surgical control group, mock surgery was performed at 37°C. Multiple frequency auditory brainstem response (ABR) and distortion product otoacoustic emission (DPOAE) testing of all ears was performed before surgery, immediately afterward, and on postoperative days 3, 5, and 7.Results: Both ABR and DPOAE testing demonstrated partial loss of auditory function after electrode insertion trauma. However, the hypothermia group had significantly less functional loss in the immediate stage and no significant loss in the progressive stage.Conclusion: Mild hypothermia protects auditory function during CI electrode insertion.
Orientation of the Manubrium Mallei: Inexplicably Widely Variable
Authors: Todd N Wendell 
Published: September 2005

AbstractBackground: There is no consensus why the manubrium of the malleus, as viewed clinically through the external ear canal, generally points downward and posteriorly.Objectives: To depict the alignment of the handle of the malleus, viewed clinically through the external auditory canal, relative to the zygomatic arch, the Frankfort plane, and a visual plane proxy and relative to the horizontal semicircular canal. Also, to assess bilateral symmetry and manubrium alignment relative to mastoid pneumatization.Study Design: Postmortem anatomic dissection of 41 bequeathed adult crania without clinical otitis.Methods: The line of the manubrium as viewed through the external ear canal was measured relative to the Frankfort plane, to a proxy of the visual plane, and to the zygomatic arch. Mastoid sizes were determined radiographically. In a subset of 10 crania additionally studied by computed tomography, the manubrium position was checked relative to the horizontal semicircular canal.Results: Relative to the zygomatic arch and Frankfort and visual planes, the range of manubrium angles was at least 45 degrees. Bilateral symmetry was found, each r 0.38 or greater (P < .05). Relative to the horizontal canals, the range of manubrial angles was 30 degrees, with symmetry suggested. Alignment did not correlate with mastoid pneumatization.Conclusion: Manubrium orientation as viewed through the external auditory canal is not obviously explicable. The wide variety of manubrium orientations may explain the manubrium‐stapes offset that perplexes manubrium‐stapes surgical constructions.
“Window Shade” Tympanoplasty for Anterior Marginal Perforations
Authors: Schraff Scott , Dash Nariman , Strasnick Barry 
Published: September 2005

AbstractObjectives/Hypothesis: Anterior marginal perforations of the tympanic membrane often present a reconstructive challenge to the otolaryngologist. Poor surgical outcomes are often due to inadequate exposure, a lack of residual tympanic membrane, impaired vascular supply, and delayed healing. This study reports on the success of the “window shade” technique, combining aspects of both the traditional underlay and overlay tympanoplasty techniques, for the management of anterior marginal tympanic membrane perforations.Study Design: Retrospective review of patients undergoing window shade tympanoplasty from July 1, 1994, to July 1, 2003, at a tertiary care referral center.Methods: Only patients found to have anterior tympanic membrane perforations and who underwent a window shade tympanoplasty were included in the study. Tympanoplasty success rate was studied by examining postoperative complications of recurrent perforation, tympanic membrane lateralization, or anterior blunting.Results: The authors identified 164 patients who underwent window shade tympanoplasty during the study period. The overall success rate for tympanic membrane repair was 94.5%. There were no cases of tympanic membrane lateralization or significant blunting. The average healing time was 4 weeks. The surgical technique is described in detail.Conclusion: The window shade tympanoplasty is an excellent surgical option for repair of anterior marginal perforations of the tympanic membrane.
Carcinoid Tumor of the Middle Ear: Clinical Features, Recurrences, and Metastases
Authors: Ramsey Mitchell J. , Nadol Joseph B. , Pilch Benjamin Z. , McKenna Michael J. 
Published: September 2005

AbstractObjective: Present four new cases of carcinoid tumor of the middle ear, two of which developed late recurrences and regional metastases. Review the literature to identify the clinical features, rate of recurrence, and incidence of metastasis of carcinoid tumor of the middle ear.Study Design: Retrospective chart review.Setting: Tertiary referral hospital.Patients: Eligibility criteria consist of a diagnosis of carcinoid tumor of middle ear.Intervention: Surgical excision of primary and metastatic disease.Main Outcome Measure: Clinical characteristics, rate of recurrence, and incidence of metastasis of carcinoid tumor of the middle ear.Results: Forty‐six patients with carcinoid tumor of the middle ear are included in this report, 42 patients were identified from a review of the literature, and 4 new patients are presented. The most common presenting symptom was hearing loss. Surgical excision was the treatment with radical mastoidectomy being the most common procedure. Ten (22%) patients developed locally recurrent disease, and four (9%) developed regional metastases.Conclusions: Carcinoid tumor of the middle ear is an infrequent cause of a middle ear mass, with only 46 cases published. Despite previous assertions of benignancy, the findings of this study suggest that carcinoid tumor of the middle ear is indeed a potential low‐grade malignancy with documented metastatic potential. Almost all middle ear adenomatous tumors (“adenoma” and “carcinoid”) show evidence of neuroendocrine differentiation, and so at least some middle ear carcinoids (“adenomas”) appear to represent well‐differentiated neuroendocrine carcinomas. Presentation and symptoms are consistent with a middle ear mass and rarely include carcinoid syndrome. Surgical treatment is recommended and tailored to the extent of disease. Patients with carcinoid tumor of the middle ear require indefinite follow‐up for possible recurrence or metastasis.
Oropharyngeal Complications Of Suspension Laryngoscopy: A Prospective Study
Authors: Rosen Clark A. , Filho Pedro A. Andrade , Scheffel Lucia , Buckmire Robert 
Published: September 2005

AbstractObjective: This study was designed to evaluate the oropharyngeal complications of suspension laryngoscopy (SL).Methods: We prospectively analyzed 56 consecutive SLs for intervention‐related complications. Oropharyngeal symptoms and physical examination abnormalities were recorded before and after SL. SL‐related problems were graded in severity and followed over time (weekly) until resolution was achieved. All patients had SL with either a gallows suspension or a manual technique and not a rotation‐oriented (fulcrum) laryngoscope holding device.Results: Oropharyngeal minor complications after SL occurred at a rate of 37.5%, and all these were temporary. No dental injuries occurred in the study cohort. There were no major complications after SL. Minor alterations related to taste occurred in 18% of the patients, 16% of patients had subjective swallowing complaints, and 12.5% had partial tongue numbness. Average duration of the post‐SL complaints was 11 (6–34) days. A correlation between duration of suspension, size of laryngoscope, and risk of developing a minor oropharyngeal complication was present.Conclusion: SL carries a higher risk for lingual and glossopharyngeal nerve injuries than previously recognized. All of these complications were temporary. On the basis of comparison with historic data, SL by gallows suspension technique may pose a lower risk of dental injuries. This information should be used to improve preoperative SL patient education and informed consent.