bluuebunny/crossref_metadata_2025_split huggingface dataset:
How we do it: the Farrior‐Olaizola mastoidectomy technique in the management of squamous chronic otitis media
Authors: Harar R.P.S. , Abramovich S. , Mace A.D. , Panesar J. , Benjamin E. 
Published: May 2005

Keypoints• In the Farrior‐Olaizola mastoidectomy the connection between the antrum and attic is closed with a cartilage plate –‘the antrum exclusion and attic elimination on demand technique’. This prevents future tympanic membrane retraction and recurrent disease.• It is a suitable treatment for most cases of cholesteatoma, including children.• As a canal wall up technique residual disease occurred in 18% of adults and 22% of children in our series. These have been discrete encapsulated epithelial pearls easily removed at the second look stage.• Recurrent disease was uncommon (3.5%).
Activated eosinophils in nasal polyps: a comparison of asthmatic and non‐asthmatic patients
Authors: Bateman N.D. , Shahi A. , Feeley K.M. , Woolford T.J. 
Published: May 2005

Objectives:  There is a recognized clinical association between nasal polyps and asthma. Nasal polyps and the airways of asthmatic patients demonstrate marked eosinophilia suggesting that this inflammatory cell may have a key role to play in both conditions. The objective of this study was to determine whether nasal polyps from patients with asthma had a greater density of activated eosinophils than patients with no associated respiratory disease.Design:  Archived specimens were retrieved from patients who had undergone nasal polyp surgery and their case notes reviewed. Activated eosinophils were identified using immunohistochemistry for a monoclonal antibody to secreted eosinophil cationic protein (EG2).Setting:  Teaching hospital otolaryngology unit.Participants:  Consecutive patients who had undergone nasal polyp surgery in 1994 were recruited. The diagnosis of asthma was based on a documented physician diagnosis and appropriate drug treatment. Twenty‐four asthmatic and 35 non‐asthmatic patients were studied.Main outcome measures:  Eosinophil density was measured using a standardized counting technique.Results:  Asthmatic patients were significantly more likely to have had previous polyp surgery (chi‐square test: P < 0.05). Areas of intense eosinophilia were identified in all samples. There was a significant greater degree of activated eosinophilia in the asthmatic patients (t‐test: P < 0.05).Conclusions:  We have demonstrated a higher number of previous operations in asthmatic patients, and also a greater degree of activated eosinophilia in asthmatic polyps compared with non‐asthmatics. This would suggest that eosinophil activity has a role to play in the pathogenesis of nasal polyps.
Double‐blind randomized controlled study of coblation tonsillotomy versus coblation tonsillectomy on postoperative pain in children
Authors: Arya A.K. , Donne A. , Nigam A. 
Published: May 2005

Objectives:  The purpose of this study was to establish if children experienced any difference in pain, between coblation tonsillectomy and coblation tonsillotomy.Design:  A double‐blind randomized controlled trial was performed.Setting:  District general hospital department of Otolaryngology.Participants:  Eighteen children listed for tonsillectomy were recruited into the study. Each was randomly assigned either tonsillotomy or tonsillectomy in the right tonsil. The contralateral tonsil was removed by the other method. In the first 24‐h period (while in hospital) the children were interviewed at 2, 5, 10 and 24 h to quantify the pain they perceived in right and left sides. There was a four point visual analogue scoring system for monitoring pain. The power of the study was 80%. In this study the patients were their own controls.Main outcome measures:  Visual analogue pain scores were plotted against time and the area under the curves was calculated (AUC).Results:  The AUC mean difference was 0.47. A t‐test for the difference gives a P‐value of 0.85 and a 95% confidence interval for difference is −0.79 to 5.73, which clearly contains zero. Using AUC as a combined pain score there is no statistically significant difference between tonsillotomy and tonsillectomy (power value of 80%).Conclusions:  There is no demonstrable statistical difference between techniques when measuring pain experienced by children in the 24‐h postoperative period.
How we do it: Jain Tonsil ‘A’ Frame – a solution to slipping rods
Authors: Jain K. Parmod 
Published: May 2005

Keypoints• Tonsillectomy is the commonest ENT procedure performed in UK.• A Boyle‐Davis mouth gag with tongue blade is used to keep the mouth open during the surgery.• Draffin bipod rods are commonly used to keep the gag in place.• These rods can slip during the procedure and can cause considerable harm especially when laser is in use.• The tonsil ‘A’ frame is a useful instrument to overcome the disadvantages of other suspension devices.
The use of camera mobile phone to assess emergency ENT radiological investigations
Authors: Eze N. , Lo S. , Bray D. , Toma A.G. 
Published: May 2005

Objectives:  To determine the accuracy of assessment of common ENT emergency radiological investigations using mobile phone digital images.Design:  Prospective case controlled series.Setting:  Tertiary referral otolaryngology centre.Participants:  Fourteen randomly selected patients who underwent emergency ENT radiological investigations over a 1‐month period.Main Outcome Measures:  The accuracy and confidence of six ENT consultants and five specialist registrars in making diagnoses based on a brief history and assessment of CT scans and X‐ray images taken from and transmitted via a mobile phone, compared with examination of the same films on a conventional X‐ray box.Results:  With 14 films, a total of 154 cases were assessed by the 11 subjects. All doctors made the correct diagnosis for every case examined. Overall, the relative confidence of diagnosis was ranked highly for both image media, although the overall confidence of diagnosis using the X‐ray box was significantly greater than the mobile phone (95% CI upper bound = 1.6 lower bound = 0.9; paired t‐test P < 0.0001). The seniority of the clinician did not predict a difference in the confidence of diagnosis (P = 0.3). There is no statistical relationship between confidence of diagnosis of the original films and degradation of film quality on the mobile phone (P = 0.7).Conclusions:  The accuracy and confidence of diagnosis of common ENT emergency radiological investigations using mobile phone digital images seem compatible with X‐ray box. Financially it is a much cheaper than conventional telemedicine technology. It may be used to augment information sent to non‐resident specialists in the management of emergency ENT cases.
Clinical predictors in obstructive sleep apnoea patients with calibrated cephalometric analysis – a new approach1
Authors: Hsu P.P. , Tan A.K.L. , Chan Y.H. , Lu P.K.S. , Blair R.L. 
Published: May 2005

Aim:  Utilization of a new method to accurately quantify differences in cephalometric parameters between obstructive sleep apnoea (OSA) and normal patients, and to identify good predictors for OSA. To illustrate the ethnic differences in cephalometry.Method:  This prospective study involves 106 South‐east Asians. A calibrated catheter is inserted into the upper airway during standard cephalometry to obtain the precise magnification and allow exact measurement of anatomical parameters of cephalometry in both erect and supine positions.Results:  The OSA patients have longer lower‐facial length, narrower skull base, shorter and receding mandible, smaller posterior airway space (PAS), narrower retropalatal space, longer and thicker soft palate, smaller hard and soft palate angles longer tongue length and more inferiorly displaced hyoid. For the palatal level, retropalatal distance of 11.2 mm cut‐off/predictive value for male (receiver operating characteristics (ROC) = 0.8414 with PPV = 77.46, NPV = 90.00) and 5.5 mm for female (ROC = 0.9180 with PPV = 100.00, NPV = 84.21) at erect position were selected. For retrolingual level, erect PAS of 10.1 mm cut‐off/predictive value for male (ROC = 0.7000 with PPV = 78.38, NPV = 37.78), 5.3 mm for female (ROC = 0.7227 with PPV = 75.00, NPV = 75.00) were selected. Our study showed that South‐east Asians have different cephalometric values compared with White people, Black people and Hispanics.Conclusion:  This new method of cephalometry using a calibrated catheter provides an accurate and simple method of obtaining precise cephalometric measurements. There is no cephalometric data on OSA from South‐east Asia available. These results suggested that surgeons managing OSA patients and using cephalometry as a diagnostic method should have a set of normative and OSA cephalometric values that apply to their local populations.
Interobserver reliability in evaluating postural stability between clinicians and posturography
Authors: Loughran S. , Tennant N. , Kishore A. , Swan I.R.C. 
Published: May 2005

Objectives:  To assess the interobserver reliability in assessing postural stability and to compare with results obtained by computerized posturography.Design:  Cross‐sectional study.Setting:  Balance clinic, teaching hospital.Participants:  81 patients attending with a primary complaint of imbalance.Main outcome measures:  Inter‐rater reliability between two clinicians and the modified Clinical Test for the Sensory Interaction on Balance (mCTSIB) as assessed by the Neurocom VSRTM Balance Master platform.Results:  Inter‐rater reliability scores were high (0.53–0.81) for all conditions of the mCTSIB except for the easiest, i.e. firm surface eyes open, where concordance levels were poor to fair.Conclusions:  Overall there was good agreement between observers and the computerized mCTSIB.
The impact of recurrent acute otitis media on the quality of life of children and their caregivers
Authors: Brouwer C.N.M. , Rovers M.M. , Maillé A.R. , Veenhoven R.H. , Grobbee D.E. , Sanders E.A.M. , Schilder A.G.M. 
Published: May 2005

Objective:  To assess the quality of life of 384 Dutch children aged 1–7 years with recurrent acute otitis media (AOM), and compare it with that of children from four reference populations: (i) children from a general population; (ii) children with mild‐to‐moderate asthma, (iii) children with mild‐to‐moderately severe chronic illness, and (iv) US children with persistent or recurrent otitis media.Design:  Survey.Setting:  A general and an academic hospital (study population of children with recurrent AOM, n = 384); general population (n = 225 and 117); primary care (children with asthma, n = 64); community care (children with chronic illness, n = 82); and a general hospital (children with persistent or recurrent otitis media, n = 169).Participants:  A total of 384 children aged 1–7 years who had experienced at least two episodes of AOM in the preceding year and their caregivers.Main outcome measures:  Generic and disease‐specific quality of life as judged by the children's caregivers. Age‐adjusted total and subscale scores were compared with those of the reference populations.Results:  For all generic questionnaires, children with recurrent AOM had poorer scores than children from the general population. Quality of life of children with four or more episodes of AOM in the preceding year was poorer than that of children with two to three episodes.Children with recurrent AOM scored lower on the health‐related questionnaire than children with mild‐to‐moderately severe chronic illness. Quality of life of the present study population was similar to those of children with asthma and US children with chronic otitis media with effusion or recurrent AOM.Conclusion:  Recurrent AOM has a considerable negative impact on the quality of life of children and causes concern to their caregivers. These effects are proportional to the severity of the condition. Professionals involved in the care of children with OM should be aware that OM not only affects physical functioning but also general well‐being of the child and its family. These outcomes should therefore be included in the evaluation of the child with otitis media both in the clinical and research setting.
Prognostic significance of p27Kip1, p45Skp2 and Ki67 expression profiles in Merkel cell carcinoma, extracutaneous small cell carcinoma, and cutaneous squamous cell carcinoma
Authors: Fernández‐Figueras M T , Puig L , Musulen E , Gilaberte M , Ferrándiz C , Lerma E , Ariza A 
Published: May 2005

Aims:  To compare the immunohistochemical expression of prognostic markers p27Kip1, p45Skp2 and Ki67 in Merkel cell carcinoma (primary neuroendocrine carcinoma of the skin, MCC), small cell neuroendocrine carcinoma of lung and urinary bladder (SNC), and cutaneous squamous cell carcinoma (SCC).Methods and results:  Immunohistochemistry was performed using antibodies directed against p27Kip1, p45Skp2 and Ki67 on 72 tumour cases: 24 MCC, 25 SCC, and 23 SNC (15 from the lung and eight from the urinary bladder). Percentages of positive cells were determined for each marker and statistically analysed. Expression profiles on MCC and SCC were significantly different for all three markers. MCC and SNC exhibited significant similarities in their p27Kip1 and p45Skp2 expression profiles. In contrast, MCC and SNC differed significantly in their Ki67 proliferation indices, which were much higher in SNC. Additionally, MCC cases showed an association between increased proliferation indices and the appearance of local recurrence(s) and/or metastases.Conclusion:  The immunohistochemical profile of MCC differs from that of SCC, in spite of their common oncogenesis and the supposed metaplastic origin of MCC, and resembles that of SNC, except for Ki67 levels, which were higher in the latter (characterized by greater biological aggressiveness). High levels of Ki67 also appear to be a prognostic factor in MCC.
Sox2 expression in human stomach adenocarcinomas with gastric and gastric‐and‐intestinal‐mixed phenotypes
Authors: Tsukamoto T , Mizoshita T , Mihara M , Tanaka H , Takenaka Y , Yamamura Y , Nakamura S , Ushijima T , Tatematsu M 
Published: May 2005

Aims:  Other than ectopic expression of intestinal transcription factors, Cdx1 and Cdx2, the molecular mechanisms underlying gastric and intestinal phenotypes of human stomach adenocarcinomas have yet to be clarified in detail. We have reported that Sox2, an HMG‐box gastric transcription factor, is expressed in normal gastric mucosa and down‐regulated in intestinal metaplasia.Methods and results:  We analysed mRNA levels of Sox2 and other differentiation markers in 50 surgically resected stomach adenocarcinomas, immunohistochemically classified into gastric (G), gastric‐and‐intestinal (GI)‐mixed, solely intestinal (I), and null (N) types. Sox2 was found to be transcribed in G and GI‐mixed type adenocarcinomas in accordance with MUC5AC and MUC6 expression, while Cdx1 and Cdx2 were up‐regulated in GI‐mixed and I types along with the expression of MUC2 and villin. In the N type, both gastric and intestinal transcription factors were suppressed. Immunohistochemistry confirmed expression of Sox2 in MUC5AC+ lesions and Cdx2 localization together with MUC2. A stomach adenocarcinoma cell line, KATOIII, demonstrated both MUC5AC and Sox2, although MUC5AC mRNA was not detected in the Sox2+ AGS cell line.Conclusions:  Sox2 may play an important role in maintaining a gastric phenotype in stomach cancers as well as in normal tissue, in cooperation with other cofactor(s).
Effectiveness of single‐ versus multiple‐visit endodontic treatment of teeth with apical periodontitis: a systematic review and meta‐analysis
Authors: Sathorn C. , Parashos P. , Messer H. H. 
Published: May 2005

AbstractAim  The clinical question this review aimed to answer is: does single‐visit root canal treatment without calcium hydroxide dressing, compared to multiple‐visit treatment with calcium hydroxide dressing for 1 week or more, result in a lower healing (success) rate (as measured by clinical and radiographic interpretation)?Methodology  CENTRAL, MEDLINE, EMBASE and HEALTH STAR databases were used. Reference lists from identified articles were scanned. A forward search was undertaken on the authors of the identified articles. Papers that had cited these articles were also identified through Science Citation Index to identify potentially relevant subsequent primary research.Review methods  The included studies were randomized controlled clinical trials (RCTs) comparing healing rate of single‐ and multiple‐visit root canal treatment in humans. The outcome measured was healing of radiographically detectable lesions. Data in those studies were independently extracted.Results  Only three RCTs were identified and included in the review, covering 146 cases. Sample size of all three studies was small; none demonstrated a statistically significant difference in healing rates. Risk differences of included studies were combined using the inverse variance‐weighted method (RDPooled = −6.3%; 95% CI: −20.3–7.8).Conclusion  Based on the current best available evidence, single‐visit root canal treatment appeared to be slightly more effective than multiple visit, i.e. 6.3% higher healing rate. However, the difference in healing rate between these two treatment regimens was not statistically significant (P = 0.3809).
Growth at high pH increases Enterococcus faecalis adhesion to collagen
Authors: Kayaoglu G. , Erten H. , Ørstavik D. 
Published: May 2005

AbstractAim  To evaluate the effect of growth at pH levels from 7.1 to 9.5 on the adherence of Enterococcus faecalis to bovine serum albumin (BSA) and collagen type I.Methodology  Enterococcus faecalis strain A197A was grown in broth of adjusted pHs varying between 7.1 and 9.5. Aliquots of bacterial suspensions were added to wells coated either with BSA or with collagen type I. Bacteria adhering to the surfaces were stained with crystal violet. Spectrophotometric measurements of the dissolved stain were used to assess the number of bacteria adhering to the surfaces. The data obtained were analysed using the Kolmogorov–Smirnov test, Levene's test and Student's t‐test, with α = 0.05 as the level for statistical significance.Results  The adhesion of E. faecalis to BSA‐coated surfaces decreased inversely with alkalinity of the growth medium. The pH 7.1‐grown bacteria bound to BSA significantly more than the other BSA groups. On the contrary, the adhesion to collagen type I‐coated surfaces of bacteria grown at pH 8.0 and 8.5 was significantly greater than for those grown at pH 7.1.Conclusions  A minor increase in pH up to 8.5, which may be a consequence of insufficient treatment with alkaline medicaments such as calcium hydroxide, increases the collagen‐binding ability of E. faecalis, in vitro. This can be a critical mechanism by which E. faecalis predominates in persistent endodontic infections.
Endodontic complications after plastic restorations in general practice
Authors: Whitworth J. M. , Myers P. M. , Smith J. , Walls A. W. G. , McCabe J. F. 
Published: May 2005

AbstractAim  To test the hypothesis that dentine and pulp protection by conditioning‐and‐sealing is no less effective than using a conventional calcium hydroxide lining.Methodology  A cohort of healthy adults requiring a new or replacement restoration in a posterior tooth was recruited in six general practices. All procedures received local Ethics Committee approval. Exclusion criteria included signs and symptoms of pulp necrosis or inflammation, and patients unable to commit to a long‐term trial. Cavity preparations were randomized to receive a calcium hydroxide lining or conditioning‐and‐sealing with a smear‐removing bonding system. Choice of bulk restorative material (composite resin or amalgam) was at the discretion of the dentist. The key outcome measure was evidence of pulpal breakdown identified at unscheduled (emergency) or scheduled recall examinations. Postoperative sensitivity was recorded on 100 mm VAS at 24 h, 4 days and 7 days. Pulp status was assessed at 6, 12, 24 and 36 month recall, and at any emergency recall appointment. The relationship between pre‐treatment and treatment variables and pulp breakdown was assessed by logistic regression (P = 0.05).Results  A total of 602 teeth were recruited, with comparable numbers of cavities lined (288, 47.8%) or conditioned and sealed (314, 52.2%). The majority (492, 81.7%) were replacement restorations, and amalgam was the most common bulk restorative material (377, 62.6%). A total of 390 (64.8%) restored teeth were reviewed at 6 months, 307 (51%) at 12 months, 363 (60.3%) at 24 months, and 279 (46.3%) at 36 months post‐restoration. Sixteen cases of pulp breakdown were identified within 36 months of restoration placement, 11 presenting as emergencies and five detected at routine recall examination. Logistic regression showed that preoperative pain, cavity treatment by lining or conditioning‐and‐sealing and the use of rubber dam isolation had no association with pulp breakdown. Pulp breakdown was associated with deep or pulpally exposed cavities (P < 0.001, odds ratio 7.8) and with composite rather than amalgam restorations (P = 0.001, odds ratio 2.13). Re‐coding to identify teeth with pulp exposures revealed that pulpal exposure was the key determinant of adverse pulp outcomes (P < 0.0001, odds ratio 28.4) and that composite resin restorations were again more likely to be associated with pulp breakdown than amalgam (P = 0.017, odds ratio 3.92).Conclusions  Considered within the context of routine primary dental care,

Dentists can be confident that pulps will be equally well protected from post‐restorative breakdown up to 36 months by calcium hydroxide lining and conditioning‐and‐sealing with adhesive resins.
Residual dentine thickness appears to be a key determinant of pulp responses after restorative dental treatment.
In deep and pulpally exposed cavities in posterior teeth, composites were associated with more pulpal breakdown than amalgams.
The Balearic Islands: a reservoir of cpDNA genetic variation for evergreen oaks
Authors: López‐de‐Heredia Unai , Jiménez Pilar , Díaz‐Fernández Pedro , Gil Luis 
Published: May 2005

AbstractAim  To analyse the role of the Balearic Islands as a refuge area for evergreen Quercus (cork oak: Quercus suber L., holm oak: Q. ilex L., kermes oak: Q. coccifera L.), by using molecular, historical and palaeobotanical data.Location  The Western Mediterranean Basin (Balearic Islands, eastern Iberia, Provence, Sardinia, Corsica, Sicily, Malta, Italy, Northern Africa).Methods  We sampled 108 populations and used the PCR‐RFLP technique with five universal cpDNA primers to define haplotypes in the sampled populations. Diversity, differentiation parameters and spatial analysis of the populations, using a spatial version of amova, were linked to the geological history of the Western Mediterranean Basin in order to explain the present spatial pattern of the evergreen Quercus populations in the Balearics.Results  Evergreen Quercus cpDNA shows a complex structure, with remnants of ancient diversity in the Balearics. Balearic populations of holm oak are related to Iberian populations, while for cork and kermes oaks, we found both Tyrrhenian and Iberian haplotypes.Main conclusions  The complex spatial patterns of cpDNA in Balearic evergreen Quercus appears explicable in terms of a combination of physical (vicariance and long distance dispersal) and biological (introgressive hybridization) factors. The Balearics constitute a glacial refuge area and a reservoir of genetic variation with traces of ancient diversity from Messinian–Pliocene stages.