bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cough and Paradoxical Vocal Fold Motion
Authors: Altman Kenneth W. , Simpson C. Blake , Amin Milan R. , Abaza Mona , Balkissoon Ron , Casiano Roy R. 
Published: February 2003

OBJECTIVESThe differential diagnosis and treatment of patients with chronic cough, paradoxical vocal fold motion, and disordered breathing can be a challenge to most practicing otolaryngologists. Tracheobronchial (ie, asthma, bronchitis, and tracheal stenosis), laryngeal (ie, vocal fold paralysis and neoplasms), and rhinologic (ie, allergies and rhinosinusitis) etiologies are commonly diagnosed and treated effectively. However, occasionally one is faced with patients who are refractory to medical treatment and have no obvious rhinologic, laryngeal or pulmonary cause.STUDY DESIGN AND SETTINGWe conducted a review of the literature.METHODSWe present a thorough review of the current medical literature exploring the complex neurologic mechanisms involved in the production of cough and the relationship between gastroesophageal reflux disease, vagal neurapathy, and paradoxical vocal fold motion.RESULTSThe diagnosis and successful treatment of chronic cough can be complex. It requires a thorough understanding of the neurologic mechanisms behind cough excitation and suppression. Successful treatment strategies include aggressive management of the patient's reactive airway disease, gastroesophageal reflux disease, and, in select cases, paradoxical vocal fold motion. This may involve a well‐coordinated effort among pulmonologists, otolaryngologists, gastroenterologists, and speech pathologists.CONCLUSIONGastroesophageal reflux disease, vagal neuropathy, and paradoxical vocal fold motion are additional causes of chronic cough and disordered breathing that need to be considered, in the absence of obvious laryngotracheal and/or rhinologic pathology. A high index of suspicion is essential in making the diagnosis and formulating an effective multidisciplinary treatment plan for these patients.
Prognostic Value of the Blink Reflex in Acoustic Neuroma Surgery
Authors: Darrouzet Vincent , Hilton Malcolm , Pinder Darren , Wang Jio‐Ling , Guerin Jean , Bebear Jean‐Pierre 
Published: February 2003

OBJECTIVEThe study goal was to demonstrate that blink reflex analysis can predict postoperative facial nerve outcome in cerebellopontine angle tumor surgery.STUDY DESIGN, SETTING, AND PATIENTSIn an open and prospective study conducted at a single tertiary care center over 3 years, 91 subjects with a vestibular schwannoma filling the internal auditory meatus were enrolled and operated on via a translabyrinthine approach. The difference in latency of the early response (δR1) of the blink reflex between the pathologic side and the healthy side was calculated in every patient during a complete electrophysiologic examination of the facial nerve performed on the day before surgery.MAIN OUTCOME MEASURESδR1 was compared with the other preoperative data (tumor volume, facial function), with the perioperative observations (difficulties with the dissection of the facial nerve), and especially with the postoperative status after 1 year. The statistical study was conducted using polynomial regression.RESULTSPatients with a negative or zero δR1 have normal facial function at 1 year. For those with a positive δR1 the outcome is not favorable unless the tumor is small. For patients presenting with an immediate complete facial paralysis, the value of δR1 is also indicative of facial function outcome.CONCLUSIONStatistical analysis shows that the blink reflex, through δR1, has an excellent prognostic value in anticipating the difficulties with facial nerve dissection and postoperative facial function after 1 year.
Cystic Cervical Metastases: Incidence and Diagnosis using Fine Needle Aspiration Biopsy
Authors: Sheahan Patrick , O'Leary Gerard , Lee Gary , Fitzgibbon Jim 
Published: February 2003

BACKGROUNDSeventeen patients presenting with a cystic cervical metastasis were identified after either having undergone excision of a cyst, initially diagnosed as a branchial cyst but subsequently found to be malignant, or after having had fluid aspirated from a neck mass that ultimately proved to be malignant while undergoing fine needle aspiration biopsy.METHODSPatients had primary cancer documented at a variety of primary sites, including hypopharynx (3 patients), oropharynx (2 patients), lower lip (2 patients), nasopharynx, supraglottis, oral cavity, and prostate (1 patient each). Six cases (35%) remained occult.RESULTSIn nearly half of the cases (8 of 17), there was no evidence of the primary cancer at presentation. In the same period, 25 branchial cysts were encountered, giving an incidence of unsuspected carcinoma in cervical cysts of 24% (8 of 33).CONCLUSIONIn contrast to previous studies in which smaller numbers of patients underwent the procedure, we found fine needle aspiration to be very helpful in the assessment of these lesions, having a sensitivity of 73% in diagnosing malignancy.
Efficacy of Selective Lymph Node Dissection in Clinically Negative Neck
Authors: Mira Eugenio , Benazzo Marco , Rossi Vanessa , Zanoletti Elisabetta 
Published: February 2003

OBJECTIVEThe purpose of this study was to evaluate the efficacy of selective neck dissection (SND) for elective treatment of the clinically negative neck in head and neck squamous cell carcinoma (SCC).METHODSA retrospective review was undertaken on 91 previously untreated patients with T1–4 SCC of oral cavity (23), oropharynx (5), hypopharynx (7), larynx (56), and clinically negative neck (NO), undergoing 126 SND from January 1990 to March 1999 at a single institution. Twenty‐five patients received postoperative radiation therapy on the basis of histologic evidence of >2 positive nodes, extracapsular spread (ECS), and/or the presence of advanced primary lesion.RESULTSOn pathologic examination the average number of lymph nodes was 20.5 per neck, occult disease was detected in 14 (11.11%) of 126 necks; of necks with positive nodes, 6 (42.85%) of 14 had ECS. The median follow‐up was 36 months. Overall recurrence rate (local, regional, and distant) was 12.8% (11 of 91). Recurrent disease developed in the neck of one patient, outside the dissected field. There was no difference in recurrence rate between pN0 and pN+ patients, as well as between pN+ with or without ECS. Overall survival rate was 84% (77 of 91), with a statistically significant difference between pN0 and pN+ necks.CONCLUSIONSND seems to be a pragmatic approach that is as effective as comprehensive procedures for staging and treating the clinically negative neck.
Muscle Tension Dysphonia as a Sign of Underlying Glottal Insufficiency
Authors: Belafsky Peter C. , Postma Gregory N. , Reulbach Todd R. , Holland Bradford W. , Koufman James A. 
Published: February 2003

BACKGROUNDHyperkinetic vocal function (muscle tension dysphonia) may be an indication of underlying glottal insufficiency. In the face of an organic voice disorder such as presbylaryngis or vocal fold paresis. Hyperkinetic laryngeal behaviors may be used to achieve glottal closure. Such compensatory laryngeal behaviors may mask the correct underlying diagnosis.OBJECTIVEWe sought to evaluate the association between vocal fold bowing due to presbylaryngis and abnormal muscle tension patterns (MTPs).METHODSOne hundred consecutive volunteers >40 years old were prospectively evaluated. All underwent a comprehensive head and neck examination that included transnasal fiberoptic laryngoscopy with videostroboscopy. Abnormal MTPs were compared in subjects with and without vocal fold bowing.RESULTSThe mean age of the cohort was 61 years. Eighty‐four percent (42 of 50) of the male subjects and 60% (30 of 50) of female subjects had evidence of vocal fold bowing. Of the 72 patients with bowing, 94% (68 of 72) had abnormal MTPs. Compared with subjects without vocal fold bowing, persons with bowing were 17 times more likely to exhibit abnormal MTPs (P < 0.001).CONCLUSIONSAbnormal MTPs are common in persons with underlying glottal insufficiency. Patients with vocal fold bowing are 17 times more likely to exhibit abnormal MTPs (95% confidence interval, 4.9 to 59.4). Clinicians should be aware that compensatory hyperkinetic laryngeal behaviors may mask an underlying organic condition.
Robot‐Assisted Stapedotomy: Micropick Fenestration of the Stapes Footplate
Authors: Rothbaum Daniel L. , Roy Jaydeep , Stoianovici Dan , Berkelman Peter , Hager Gregory D. , Taylor Russell H. , Whitcomb Louis L. , Francis Howard W. , Niparko John K. 
Published: February 2003

OBJECTIVEMicropick fenestration of the stapes footplate, a difficult step in stapedotomy, was selected for trials evaluating the potential for robotic assistance (RA) to improve clinical measures of surgical performance.STUDY DESIGNIn a surgical model of stapedotomy, we measured accuracy of fenestration to a desired point location and force applied to the stapes footplate. Performance variables were measured for 3 experienced and 3 less–experienced surgeons.RESULTSRA significantly reduced the maximum force applied to the stapes footplate. For fenestration targeting, RA significantly improved accuracy for less–experienced surgeons and significantly worsened targeting for more‐experienced surgeons.CONCLUSIONSRA significantly improves performance for micropick fenestration in a surgical model of stapedotomy. For certain tasks, RA differentially affects performance for users of different experience levels.CLINICAL SIGNIFICANCEThese are the first results showing quantitative improvements in performance during simulated ear surgery using RA and differential effects of RA on performance for users of different experience levels.
The Effect of Ankyloglossia on Speech in Children
Authors: Messner Anna H. , Lalakea M. Lauren 
Published: February 2003

OBJECTIVEWe wanted to determine whether ankyloglossia is associated with articulation problems and the effect of frenuloplasty on speech and tongue mobility.STUDY DESIGNWe conducted a prospective study of 30 children aged 1 to 12 years with ankyloglossia undergoing frenuloplasty. Outcomes were assessed by measurements of tongue mobility, speech evaluation, and parent questionnaires.RESULTSMean tongue protrusion improved from 14.2 mm preoperatively to 25.8 mm postoperatively (P < 0.01). Similarly, mean tongue elevation improved from 5.2 to 22 mm (P < 0.01). Preoperative speech pathology evaluation documented articulation problems thought due to ankyloglossia in 15 of 21 children. Postoperative evaluation in 15 of these children showed improvement in articulation in 9, no change in 4 who had normal speech preoperatively, and an ongoing articulation disorder in 2. Parent perception of speech intelligibility on a scale of 1 to 5 improved from 3.4 to 4.2 (P < 0.01).CONCLUSIONTongue mobility and speech improve significantly after frenuloplasty in children with ankyloglossia who have articulation problems.
A Comparison of Screening Methods in School‐Aged Children
Authors: Krueger Wesley W. O. , Ferguson Ladonna 
Published: February 2003

OBJECTIVEWe sought to compare the findings of 3 different hearing screening methods in school‐aged children.STUDY DESIGN AND SETTINGProspective testing of second‐ and third‐grade students in their schools was carried out.METHODSThree hundred children (599 ears) were screened by using 3 test modalities, pure‐tone audiometry, distortion product otoacoustic emissions (DPOAE), and tympanometry.RESULTSAll of the tests were normal in 532 ears (89%), and all were abnormal in 12 ears (2%). Tympanometry yielded the most abnormalities (8.3%), and pure‐tone testing demonstrated the fewest (3.3%), with a positive rate of 6.3% for DPOAE testing. False‐positive rates were 1.2%, 4.2%, and 6.4% for pure tones, DPOAE, and tympanometry, respectively, when normal results on pure‐tones or DPOAE were taken to represent true hearing.CONCLUSION/SIGNIFICANCEWe continue to recommend pure‐tone testing as an effective screening method, with follow‐up by using otoacoustic emissions in those who fail the pure‐tone test.
Multichannel Cochlear Implantation in Radical Mastoidectomy Cavities
Authors: Pasanisi Enrico , Vincenti Vincenzo , Bacciu Andrea , Guida Maurizio , Berghenti Teresa , Barbot Anna , Zini Carlo , Bacciu Salvatore 
Published: February 2003

OBJECTIVEWe report on our experience in cochlear implantation in patients with radical mastoidectomy cavities.STUDY DESIGN, SETTING, AND METHODSRetrospectively, records of patients from the Department of Otolaryngology, University of Parma between December 1991 and March 2000 were reviewed, and 6 postlingually deafened adults who received a cochlear implant in a radical cavity were identified. Speech performances were evaluated in terms of bisyllabic word and sentence recognition and common phrase comprehension.RESULTSTo date, with a follow‐up of 1 to 9 years, no patient has experienced extrusion of electrodes or other local or intracranial complications. Mean bisyllabic word and sentence recognition scores were 74% and 80%, respectively. Mean comprehension score for common phrases was 86%.CONCLUSIONBy obliterating and isolating the radical mastoidectomy cavity from the outer environment, patients who previously had undergone radical surgery of the middle ear can be safely implanted with satisfactory hearing results.Multichannel cochlear implantation (CI) is a treatment accepted worldwide for patients with total or profound deafness. In the presence of normal temporal bone anatomy, CI surgery is a safe and relatively simple procedure with a low complication rate.1–3 However, some conditions, such as malformations of the middle or inner ear, cochlear ossification, chronic otitis media, and previous middle ear surgery, represent a technical challenge to CI surgeons.Patients with a bilateral radical mastoidectomy cavity who are otherwise suitable for implantation represent a certainly more problematic group to manage than the “standard” CI patients. Under these circumstances, various potential problems must be considered: extrusion of the electrode array by breakdown of the thin epithelial lining of the mastoid cavity, risk of recurrent cholesteatoma, and possibility of spreading of inflammation to the implant with potential labyrinthitis and meningitis.During recent years various surgical strategies have been proposed in the literature to avoid such complications. Many surgeons suggested overcoming these problems by performing an obliterative technique,4–6 whereas others preferred to maintain the benefits of an open technique7 or to rehabilitate the cavity8; it has also been suggested that the cavity be bypassed via a middle cranial fossa approach.9We describe the experience at the CI Center of the University of Parma in managing 6 CI patients with radical mastoidectomy cavities.
Potential theory on Lipschitz domains in Riemannian manifolds: The case of Dini metric tensors
Authors: Mitrea Marius , Taylor Michael 
Published: February 2003

We study the applicability of the method of layer potentials in the treatment of boundary value problems for the Laplace-Beltrami operator on Lipschitz sub-domains of Riemannian manifolds, in the case when the metric tensor

g

j
k

d

x
j

⊗
d

x
k

g_{jk} dx_j\otimes dx_k

has low regularity. Under the assumption that
\[

|

g

j
k

(
x
)
−

g

j
k

(
y
)

|

≤
C

ω
(

|

x
−
y

|

)
,

|g_{jk}(x)-g_{jk}(y)|\leq C\,\omega (|x-y|),

\]
where the modulus of continuity

ω
\omega

satisfies a Dini-type condition, we prove the well-posedness of the classical Dirichlet and Neumann problems with

L
p

L^p

boundary data, for sharp ranges of

p
p

’s and with optimal nontangential maximal function estimates.
Genome-Scale Reconstruction of the Saccharomyces cerevisiae Metabolic Network
Authors: Förster Jochen , Famili Iman , Fu Patrick , Palsson Bernhard Ø. , Nielsen Jens 
Published: February 2003

The metabolic network in the yeast Saccharomyces cerevisiaewas reconstructed using currently available genomic, biochemical, and physiological information. The metabolic reactions were compartmentalized between the cytosol and the mitochondria, and transport steps between the compartments and the environment were included. A total of 708 structural open reading frames (ORFs) were accounted for in the reconstructed network, corresponding to 1035 metabolic reactions. Further, 140 reactions were included on the basis of biochemical evidence resulting in a genome-scale reconstructed metabolic network containing 1175 metabolic reactions and 584 metabolites. The number of gene functions included in the reconstructed network corresponds to ∼16% of all characterized ORFs in S. cerevisiae. Using the reconstructed network, the metabolic capabilities of S. cerevisiae were calculated and compared with Escherichia coli. The reconstructed metabolic network is the first comprehensive network for a eukaryotic organism, and it may be used as the basis for in silico analysis of phenotypic functions.[Supplemental material is available online at www.genome.org. The detailed genome-scale reconstructed model ofSaccharomyces cerevisiae can be found athttp://www.cpb.dtu.dk/models/yeastmodel.html orhttp://geneticcircuits.ucsd.edu/organisms/yeast.html.]
Linkage Disequilibrium and Haplotype Diversity in the Genes of the Renin–Angiotensin System: Findings From the Family Blood Pressure Program
Authors: Zhu Xiaofeng , Yan Denise , Cooper Richard S. , Luke Amy , Ikeda Morna A. , Chang Yen-Pei C. , Weder Alan , Chakravarti Aravinda 
Published: February 2003

Association studies of candidate genes with complex traits have generally used one or a few single nucleotide polymorphisms (SNPs), although variation in the extent of linkage disequilibrium (LD) within genes markedly influences the sensitivity and precision of association studies. The extent of LD and the underlying haplotype structure for most candidate genes are still unavailable. We sampled 193 blacks (African-Americans) and 160 whites (European-Americans) and estimated the intragenic LD and the haplotype structure in four genes of the renin–angiotensin system. We genotyped 25 SNPs, with all but one of the pairs spaced between 1 and 20 kb, thus providing resolution at small scale. The pattern of LD within a gene was very heterogeneous. Using a robust method to define haplotype blocks, blocks of limited haplotype diversity were identified at each locus; between these blocks, LD was lost owing to the history of recombination events. As anticipated, there was less LD among blacks, the number of haplotypes was substantially larger, and shorter haplotype segments were found, compared with whites. These findings have implications for candidate-gene association studies and indicate that variation between populations of European and African origin in haplotype diversity is characteristic of most genes.[The sequence data described in this paper are available in GenBank under the following accession nos: AGT, MIM 106150; Renin, MIM 179820;ACE, MIM 106180; Angiotensin receptor I, MIM 106165. Supplementary material is available online athttp://www.genome.org.]
A Complexity Reduction Algorithm for Analysis and Annotation of Large Genomic Sequences
Authors: Chuang Trees-Juen , Lin Wen-Chang , Lee Hurng-Chun , Wang Chi-Wei , Hsiao Keh-Lin , Wang Zi-Hao , Shieh Danny , Lin Simon C. , Ch'ang Lan-Yang 
Published: February 2003

DNA is a universal language encrypted with biological instruction for life. In higher organisms, the genetic information is preserved predominantly in an organized exon/intron structure. When a gene is expressed, the exons are spliced together to form the transcript for protein synthesis. We have developed a complexity reduction algorithm for sequence analysis (CRASA) that enables direct alignment of cDNA sequences to the genome. This method features a progressive data structure in hierarchical orders to facilitate a fast and efficient search mechanism. CRASA implementation was tested with already annotated genomic sequences in two benchmark data sets and compared with 15 annotation programs (10 ab initio and 5 homology-based approaches) against the EST database. By the use of layered noise filters, the complexity of CRASA-matched data was reduced exponentially. The results from the benchmark tests showed that CRASA annotation excelled in both the sensitivity and specificity categories. When CRASA was applied to the analysis of human Chromosomes 21 and 22, an additional 83 potential genes were identified. With its large-scale processing capability, CRASA can be used as a robust tool for genome annotation with high accuracy by matching the EST sequences precisely to the genomic sequences.[Supplementary material is available online at http://www.genome.organdhttp://crasa.sinica.edu.tw/bioinformatics/Supplementary.htm.]
Complex Events in the Evolution of the Human Pseudoautosomal Region 2 (PAR2)
Authors: Charchar Fadi J. , Svartman Marta , El-Mogharbel Nisrine , Ventura Mario , Kirby Patrick , Matarazzo Maria R. , Ciccodicola Alfredo , Rocchi Mariano , D'Esposito Maurizio , Graves Jennifer A. Marshall 
Published: February 2003

The 320-kb human pseudoautosomal region 2 (PAR2) at the tips of the long arms of the X and Y chromosomes is thought to have been duplicated onto the Y chromosome recently in primate evolution. The four genes within PAR2 have been proposed to constitute two zones with different base ratios and transcription, one of which was added recently to the X chromosome. To test this hypothesis, we cloned and mapped PAR2 genes in other species, the lemur, the cat, and a marsupial, the tammar wallaby. None of the human PAR2 genes colocalized with human PAR1 genes in the marsupial genome, confirming that the human PAR1 and PAR2 evolved independently. Of the four PAR2 genes, only SYBL1 was located on the X chromosome in all species, including marsupials, so it was part of the ancient X. HSPRY3 localized to the X in all the eutherians, but not marsupial, so it must have been added to the X 80–130 million years ago. CXYorf1 was present on the X in primates and also in mouse, but autosomal in wallaby, suggesting a later addition 70–130 million years ago, and IL9R was on the X only in primate, suggesting addition 60–70 million years ago. The results therefore demonstrate that at least two independent additions were necessary for PAR2 evolution. The present gene order on the human X also requires two inversions. The complicated evolutionary pathway supports the hypothesis that terminal interchromosomal rearrangements are common in regions unpaired at meiosis.[The sequence data from this study have been submitted to GenBank under accession nos. AF544202, AF544203, AF544204, and AF544205.]
Coexpression of Neighboring Genes in Caenorhabditis Elegans Is Mostly Due to Operons and Duplicate Genes
Authors: Lercher Martin J. , Blumenthal Thomas , Hurst Laurence D. 
Published: February 2003

In many eukaryotic species, gene order is not random. In humans, flies, and yeast, there is clustering of coexpressed genes that cannot be explained as a trivial consequence of tandem duplication. In the worm genome this is taken a step further with many genes being organized into operons. Here we analyze the relationship between gene location and expression in Caenorhabditis elegans and find evidence for at least three different processes resulting in local expression similarity. Not surprisingly, the strongest effect comes from genes organized in operons. However, coexpression within operons is not perfect, and is influenced by some distance-dependent regulation. Beyond operons, there is a relationship between physical distance, expression similarity, and sequence similarity, acting over several megabases. This is consistent with a model of tandem duplicate genes diverging over time in sequence and expression pattern, while moving apart owing to chromosomal rearrangements. However, at a very local level, nonduplicate genes on opposite strands (hence not in operons) show similar expression patterns. This suggests that such genes may share regulatory elements or be regulated at the level of chromatin structure. The central importance of tandem duplicate genes in these patterns renders the worm genome different from both yeast and human.[Supplemental material is available online at http://www.genome.org.]