bluuebunny/crossref_metadata_2025_split huggingface dataset:
Unexpected Results Using Rapid Intraoperative Parathyroid Hormone Monitoring during Parathyroidectomy for Primary Hyperparathyroidism
Authors: Emmolo Ignazio , Corso Herbert Dal , Borretta Giorgio , Visconti Gianluca , Piovesan Alessandro , Cesario Flora , Borghi Felice 
Published: May 2005

AbstractRapid intraoperative parathyroid hormone (RIOPTH) monitoring predicts complete removal of all hypersecreting tissue by means of a significant parathyroid hormone (PTH) decrease. In this study we have tried to provide an explanation for some unexpected results of RIOPTH monitoring observed during a series of 125 conventional parathyroidectomies for primary hyperthyroidism, discussing the possible consequences on the surgical strategy. Three main groups can be recognized: (1) spikes: a PTH increase 10 minutes after removal of the diseased gland was observed in three patients; (2) false‐negative results: six patients showed an inadequate PTH decreases at 10 minutes, three of them resulting in cure at 20 minutes (all six patients were cured at follow‐up); (3) false‐positive results: five patients with multiglandular disease showed a PTH decrease to a cure level despite excision of one adenoma only (in two of these patients a 20‐minute sample showed a PTH increase soon after manipulation of the second adenoma). We concluded that the spike, almost certainly a consequence of manipulating the adenoma, when detected should be considered the “true” baseline value. False‐negative results are to some extent related to undetected spikes. The assay used for RIOPTH determination and PTH half‐life variability may also play a role. A false‐negative result usually prolongs the surgical time. False‐positive results are usually related to a double adenoma, one functionally prevailing over the other. Because in our experience manipulation of the second adenoma brought a PTH increase detected with RIOPTH monitoring, we believe that the second adenoma should be excised.
Active Antigen‐specific Immunotherapy of Melanoma: from Basic Science to Clinical Investigation
Authors: Spagnoli Giulio C. , Adamina Michel , Bolli Martin , Weber Walter P. , Zajac Paul , Marti Walter , Oertli Daniel , Heberer Michael , Harder Felix 
Published: May 2005

AbstractAdvanced‐stage melanoma here dismal prognosis, and novel therapeutic approaches are urgently required. The possibility of taking advantage of the immune response of patients for its treatment has been an appealing concept for almost a century. Only during the last decade, however, has the molecular identification of tumor‐associated antigens (TAAs) offered the possibility of vaccinating patients (e.g., active induction of TAA‐specific immune responses). Active antigen‐specific immunotherapy (AASIT) is currently being investigated in a number of clinical centers as a treatment option for advanced‐stage melanoma. A large number of melanoma TAAs have been molecularly characterized and are being used in vaccination trials in various molecular forms and according to various immunization protocols. Here we provide a short overview on melanoma TAAs, the technologies currently in use to induce specific cytotoxic T‐lymphocyte (CTL) responses in vivo, and their monitoring. We also propose a tentative AASIT agenda for the next few years, aiming at improving the capacity to induce and monitor TAA‐specific immune responses and to verify their clinical effectiveness.
Cochlear implantation in patients with osteogenesis imperfecta
Authors: Streubel Sven‐Olrik , Lustig L. R. 
Published: May 2005

OBJECTIVEHearing loss has been shown to occur in 42% to 58% of patients with osteogenesis imperfecta (OI), with deafness arising in 25% to 60% of the patients. Implantation in patients with OI is relatively rare, with only 4 prior single case reports published in the English‐language literature. The goal of this study was to evaluate the feasibility and functional outcome of cochlear implantation in 2 patients with OI tarda type I with profound sensorineural hearing loss.STUDY DESIGNCase series.SETTINGThe implantations were performed in a tertiary academic referral center (Johns Hopkins University).RESULTSThough promontory vascularity was encountered, full insertion of a normal cochlear implant array could be achieved in both cases. One‐year postimplant scores demonstrated 20 to 40 dB hearing thresholds, Consonant‐Nucleus‐Consonant Test word scores of 54% and 70%, Consonant‐Nucleus‐Consonant Test phoneme scores of 75% and 83%, Hearing in Noise Test scores of 76% and 99%, and Central Institute of the Deaf Sentence Score sentence scores of 99% and 100%, for patients 1 and 2, respectively.CONCLUSIONSCochlear implantation in patients with OI is not only technically possible but the results are similar to implant outcomes for patients with sensorineural hearing loss from a variety of other causes. EBM rating: C (Otolaryngol Head Neck Surg 2005;132:735‐40.)
Benign positional vertigo after cochlear implantation
Authors: Limb C. J. , Francis H. F. , Lustig L. R. , Niparko J. K. , Jammal H. 
Published: May 2005

OBJECTIVETo identify patients who underwent cochlear implantation (CI) and who subsequently developed benign positional vertigo (BPV) after the procedure and to identify any contributing factors.STUDY DESIGN AND SETTINGAcademic tertiary referral center. Cochlear implant recipients’ medical records were retrospectively reviewed to identify patients with both vertigo and, more specifically, BPV. Preoperative, intraoperative, and postoperative factors were studied vis‐à‐vis the development of BPV.RESULTSBPV was newly diagnosed in 12 patients after CI. The etiology of hearing loss included presbycusis (16.6%), autoimmune inner ear disease (16.6%), congenital hearing loss (41.6%), Meniere's disease (8.3%), prematurity (8.3%), and idiopathic factors (8.3%). The onset of BPV varied after the procedure (mean ± SD, 292 ± 309 days). BPV symptoms did not affect implant performance. All patients were treated for BPV by Epley's maneuver and vestibular exercises. Symptoms disappeared in 11 patients and persisted in 1.CONCLUSIONSBPV is an uncommon development after CI, although it occurs more frequently than in the general population. Two theories are proposed: the introduction of bone dust into the labyrinth and the dislodging of otoconia during surgery. The diagnosis, treatment, and prognosis of BPV after CI do not differ from those for non‐CI‐associated BPV.SIGNIFICANCEDizziness after CI usually develops as a result of vestibular hypofunction. BPV, which is a hyperfunctioning form of vestibular dysfunction, should be recognized as a possible sequelae of CI. (Otolaryngol Head Neck Surg 2005;132:741‐5.)
Adult acute epiglottitis: Experiences in a Taiwanese setting
Authors: Chang Yen‐Liang , Lo Shih‐Hung , Wang Pa‐Chun , Shu Yu‐Hsiang 
Published: May 2005

OBJECTIVEAcute epiglottitis is a potentially disastrous disease seen occasionally in otolaryngology emergency service. This study reports our experiences in managing adult patients with acute epiglottitis in a Taiwanese setting.STUDY DESIGNAdmission medical records from 46 adult patients with acute epiglottitis over a period of 8 years in a tertiary referral otolaryngology service were retrospectively reviewed.RESULTSNo mortality was reported; 4 (8.7%) patients were supported by artificial airway. A total of 16 (34.8%) patients had comorbid conditions; hypertension and diabetes mellitus were the most common systemic diseases. Patients who needed artificial airway support tended to have more systemic comorbidities (P = 0.001) and a higher level of hyperglycemia (P = 0.004) than those who did not need airway support. The incidences of drooling, stridor/dyspnea, and muffled voice were significantly higher in the airway‐supported group (P < 0.05). Stridor/dyspnea is a reliable clinical predictor of airway compromise (odds ratio 2.94; P = 0.0277).CONCLUSIONDyspnea is a warning sign of impending airway collapse during an episode of acute epiglottitis. Adult patients with more systemic comorbidities might bear higher risk of airway compromise; the role of diabetes mellitus can't be overlooked. (Otolaryngol Head Neck Surg 2005;132:689‐693.)
Nitric oxide level in the nasal and sinus mucosa after exposure to electromagnetic field
Authors: Yariktas Murat , Doner Fehmi , Ozguner Fehmi , Gokalp Osman , Dogru Harun , Delibas Namik 
Published: May 2005

OBJECTIVEThe purpose of this study was to examine the changes in nitric oxide (NO) level in the nasal and paranasal sinus mucosa after exposure radiofrequency electromagnetic fields (EMF).STUDY DESIGN AND SETTINGThirty male Spraque‐Dawley rats were randomly grouped as follows: EMF group (group I; n, 10), EMF group in which melatonin received (group II; n, 10) and the control (sham operated) group (group III; n, 10). Groups I and II were exposed to a 900 MHz. Oral melatonin was given in group II. Control rats (group III) were also placed in the tube as the exposure groups, but without exposure to EMF. At the end of 2 weeks, the rats were sacrificed, and the nasal and paranasal sinus mucosa dissected. NO was measured in nasal and paranasal mucosa.RESULTSThe nasal and paranasal sinus mucosa NO levels of group I were significantly higher than those of the control group (group III) (P < 0.05). However, there was no statistically significant difference between group II and the control group (group III) regarding NO output (P > 0.05).CONCLUSIONExposure to EMF released by mobile phones (900 MHz) increase NO levels in the sinus and nasal mucosa.SIGNIFICANCEIncreased NO levels may act as a defense mechanism and presumably related to tissue damage. In addition, melatonin may have beneficial effect to prevent these changes in the mucosa. (Otolaryngol Head Neck Surg 2005; 132: 713‐6.)
Use of Mimix hydroxyapatite bone cement for difficult ossicular reconstruction
Authors: Goebel Joel A. , Jacob Abraham 
Published: May 2005

OBJECTIVETo describe the advantages of using MimixTM hydroxyapatite (HA) bone cement in reconstructing a variety of ossicular chain abnormalities.STUDY DESIGN AND SETTINGCase series at a tertiary medical center.RESULTSTwenty‐five cases of HA reconstruction are included in this series (ages 23‐74; mean, 47 years). The examples presented include (1) HA as the sole reconstructive material for incus erosion, (2) HA for securing a total or partial ossicular replacement prosthesis, (3) incus augmentation after crimping for revision stapedotomy with incus erosion, (4) HA in primary stapedotomy to fix the crimped prosthesis to an intact incus, and (5) other unique situations. Preoperative and postoperative audiograms were evaluated for 4‐tone pure tone average (PTA), speech reception thresholds, word recognition scores, and air‐bone gaps (AB gaps). Mean follow‐up was 11 months (range 2 to 22 months). The mean PTA improved from 57 dB to 37 dB, whereas the mean AB gaps decreased from 33 dB to 16 dB. There were no cases of infection or extrusion.CONCLUSIONSHydroxyapatite bone cement is an excellent adjunct or alternative to ossiculoplasty with preformed prostheses. Easily malleable, rapidly setting, and rapidly hardening, Mimix is particularly well suited for middle ear work.SIGNIFICANCEDefinitive fixation with bone cements during difficult ossicular chain reconstruction may ensure a more enduring successful outcome. (Otolaryngol Head Neck Surg 2005; 132:727‐34.)
Reliability of cochlear implants
Authors: Maurer Jan , Marangos Nicolaos , Ziegler E. 
Published: May 2005

BACKGROUNDThe long‐term reliability of cochlear implants over time is an important issue for patients and cochlear implant teams. The calculation of cumulative survival rates including all hard failures of cochlear implants is suitable to report objectively about cochlear implant reliability.METHODSThis is a report of 192 cochlear implants from different manufacturers in adults (n = 58) and children (n = 134).RESULTSThe overall cumulative implant survival rate was 91.7% for a period of 11 years. The main reasons for hard failures were design errors of the products and direct or indirect trauma to the cochlea implant site (especially in children) with consecutive breaks of the implant body or electrodes.CONCLUSIONSTo improve our knowledge about reliability of cochlear implants more studies on cumulative long time survival of cochlear implants are needed, where functional failures and complications for whatever reason (design, mechanical, electronic, medical) are included. Cochlear implant reliability data should be considered during the choice of an implant for each individual patient. (Otolaryngol Head Neck Surg 2005;132:746‐50.)
Virtual endoscopy of laryngeal carcinoma: Is it useful?
Authors: Magnano Mauro , Bongioannini Guido , Cirillo Stefano , Regge Daniele , Martinich Laura , Canale Giovanni , Lerda Walter , Bona Galvagno Maurizio , Taranto Fausto 
Published: May 2005

OBJECTIVETo compare virtual endoscopy (VE) with flexible endoscopy in patients with cancer of the larynx.STUDY DESIGN AND SETTINGSThis prospective study includes 24 patients with proven cancer of the larynx. Patients underwent spiral CT according to our standard protocol for upper airway imaging. This same set of axial scans was transferred to a dedicated workstation to obtain VE images. Results of VE were compared with the findings of flexible endoscopy.RESULTSQuality of the examination was good in 96% of the patients. VE identified all exophytic lesions. Two small flat lesions could be observed as slightly enhanced plaques only on the axial scans. Subglottic extension was correctly demonstrated in all cases by associating VE to the axial scans.CONCLUSIONVE shows high sensitivity in the identification of exophytic lesions of the larynx and can establish relationships between cancer and nearby structures. It can be performed in the presence of severe stenosis and does not require sedation and additional scanning. On the other hand, VE show limits in the identification of flat lesions and does not allow biopsies and functional imaging to be performed.SIGNIFICANCEVE is a useful tool for staging and presurgery treatment of cancer of the larynx.
Oropharyngoesophageal scintigraphy in the diagnostic algorithm of laryngopharyngeal reflux disease: A useful exam?
Authors: Galli Jacopo , Volante Mariangela , Parrilla Claudio , Rigante Mario , Valenza Venanzio 
Published: May 2005

OBJECTIVETo evaluate the role of oropharyngoesophageal scintigraphy in the diagnostic approach to patients with laryngopharyngeal reflux (LPR).STUDY DESIGNForty‐one patients with chronic laryngopharyngeal symptoms and a control group of 15 healthy volunteers were examined. All subjects underwent standard oropharyngoesophageal scin‐tigraphy. The following parameters were considered: activity‐time curves, presence of double peaks and reduced slope in oropharyngeal phase, presence of accelerated or slowed esophagogastric transit, persistence of radioactive material on the pharyngeal or esophageal mucosa, and presence of gastroesophageal reflux (GER) under exercise.RESULTSThere were objective signs of laryngeal reflux in 80.5% of the patients. In 82.9%, scintigraphy documented several associated morphofunctional pathologic patterns: positive GER test (61.0%), presence of double peaks (36.6%), indirect signs of pharyngoesophageal inflammation (31.7%), hypotonic lower esophageal sphincter (17.1%), and slowed esophageal clearance (9.8%).CONCLUSIONSOropharyngoesophageal scintigraphy may be used as preliminary examination in outpatients with signs and symptoms of LPR. Cases of classic gastroesophageal reflux disease could be separated from those of LPR disease and therefore submitted to more invasive instrumental examinations. (Otolaryngol Head Neck Surg 2005;132: 717‐21.)
Inpatient management of epistaxis: Outcomes and cost
Authors: Goddard John C. , Reiter Evan R. 
Published: May 2005

OBJECTIVEEvaluate treatments for epistaxis.STUDY DESIGN AND SETTINGRetrospective review of Nationwide Inpatient Sample (1998‐2000).RESULTSA total of 9778 admissions with admitting diagnosis “epistaxis” were identified. Among admissions involving 1 treatment, 454 (9.6%) received arterial ligation, 94 (2.0%) embolization, and 4188 (88.4%) nasal packing. There were no differences in length of stay, transfusions, complications, or deaths between groups (all P >0.05). Mean total hospital charges were $6,282 for the packing group, $12,805 for the ligation group, and $17,517 for the embolization group; differences between ligation and packing groups, and embolization and packing groups demonstrated significance (P >0.05).CONCLUSIONSNasal packing is used commonly for epistaxis that requires inpatient management. Although embolization and arterial ligation are associated with higher hospital charges, complications, transfusion rates, and lengths of stay are similar. Further studies are needed to quantify other outcome measures, such as recurrence rates and patient quality of life.SIGNIFICANCENasal packing is associated with lower hospital charges and similar complication rates as arterial ligation or embolization. (Otolaryngol Head Neck Surg 2005;132:707‐12.)
Schizophrenia and quality of life
Authors: Katschnig Heinz 
Published: May 2005

Objective: The purpose of this paper is to examine critically results of quality‐of‐life research in schizophrenic patients living in the community. Method: Based on the relevant literature results of specific studies are discussed in the light of the methodological problems of assessing quality of life in these people. Results: Subjectively assessed quality of life was found to be higher in the less educated and in female patients, and when a sense of control is experienced. If negative or extrapyramidal symptoms are experienced and stigmatization is perceived, subjective quality of life is reported as being poorer. These results are discussed in view of the additional needs and fewer resources of this population, their stigma‐dilemma and their occasional difficulties in adequately assessing quality of life. Conclusion: It is argued that subjective and quantitative measures of quality of life in schizophrenic patients should be supplemented by external assessment and qualitative methods.
Onset and early course as determinants of the further course of schizophrenia
Authors: Häfner H. 
Published: May 2005

Objective: First treatment contact is preceded by a lengthy prodromal and psychotic prephase. We analysed the occurrence of symptoms and disabilities prior to first contact and their consequences for medium‐term illness course. Method: A population‐based sample of 232 first episodes of schizophrenia was studied retrospectively using the IRAOS and compared with matched peers from the population of origin. Further illness course was studied prospectively at six cross‐sections over 5 years from first admission onwards. Results: Three quarters showed a prodromal phase of 5 years (mean) and a 1‐year accumulation of psychotic symptoms. First to appear were depressive and negative symptoms and early signs of cognitive and social impairment. Social disability emerged 4 to 2 years before first contact. Further illness course was determined by stage of social development at psychosis onset with the consequence of a significantly poorer course for men than women because of men's earlier illness onset. Symptomatology, type of onset, age and gender influenced social course via stage of social development and, additionally, via young men's socially adverse illness behaviour. Conclusion: Social course is determined by individual stage of social development at illness onset and by early illness course. Therefore, early detection and intervention are needed.
Long‐term course in schizophrenia: concepts, methods and research strategies
Authors: Gaebel W. , Frommann N. 
Published: May 2005

Objective: This paper summarizes current knowledge about course and outcome in schizophrenia by selecting particular information and by drawing conclusions in the light of theoretical and methodological considerations, in order to illustrate future research strategies, as well as to consider novel targets of treatment. Method: Based on examples from the literature the concepts of course and outcome as well as intervening factors of course and outcome are discussed by considering study results within their methodological and theoretical framework restrictions. Results: The heterogeneity of the disorder, manifest in its variable phenomenology, illness course, treatment response and outcome, complicates research but at the same time offers clues to elucidate the heterogeneity of aetiology and pathogenesis. The search for intervening factors and predictors is of particular interest in order to explore the illness mechanisms. Conclusion: Future research should focus on the biopsychosocial determinants of course and outcome in methodologically improved long‐term studies.
The interactive developmental model revisited
Authors: Strauss John 
Published: May 2005

Objective: To provide a more adequate method for integrating our understanding of biological, psychological and social factors in schizophrenia, new concepts and a broader view of scientific method are required. This report aims to describe steps towards these concepts and methods. Method: Using experiences from a range of research, clinical, and general life encounters, the author reviews assumption about objectivity and science in the mental health field where human experience is a crucial source of data and concepts. Results: These experiences indicate that the more complex concepts of intentionality, emotional experience and expression, and the concept of experience have been largely ignored in much schizophrenia research and theory. Conclusion: Some approaches to overcoming this lack are suggested.
Large-Scale Identification of Expressed Sequence Tags Involved in Rice and Rice Blast Fungus Interaction
Authors: Jantasuriyarat Chatchawan , Gowda Malali , Haller Karl , Hatfield Jamie , Lu Guodong , Stahlberg Eric , Zhou Bo , Li Huameng , Kim HyRan , Yu Yeisoo , Dean Ralph A. , Wing Rod A. , Soderlund Carol , Wang Guo-Liang 
Published: May 2005

Abstract
To better understand the molecular basis of the defense response against the rice blast fungus (Magnaporthe grisea), a large-scale expressed sequence tag (EST) sequencing approach was used to identify genes involved in the early infection stages in rice (Oryza sativa). Six cDNA libraries were constructed using infected leaf tissues harvested from 6 conditions: resistant, partially resistant, and susceptible reactions at both 6 and 24 h after inoculation. Two additional libraries were constructed using uninoculated leaves and leaves from the lesion mimic mutant spl11. A total of 68,920 ESTs were generated from 8 libraries. Clustering and assembly analyses resulted in 13,570 unique sequences from 10,934 contigs and 2,636 singletons. Gene function classification showed that 42% of the ESTs were predicted to have putative gene function. Comparison of the pathogen-challenged libraries with the uninoculated control library revealed an increase in the percentage of genes in the functional categories of defense and signal transduction mechanisms and cell cycle control, cell division, and chromosome partitioning. In addition, hierarchical clustering analysis grouped the eight libraries based on their disease reactions. A total of 7,748 new and unique ESTs were identified from our collection compared with the KOME full-length cDNA collection. Interestingly, we found that rice ESTs are more closely related to sorghum (Sorghum bicolor) ESTs than to barley (Hordeum vulgare), wheat (Triticum aestivum), and maize (Zea mays) ESTs. The large cataloged collection of rice ESTs in this study provides a solid foundation for further characterization of the rice defense response and is a useful public genomic resource for rice functional genomics studies.