bluuebunny/crossref_metadata_2025 huggingface dataset:
Co-activator p120 is increased by gonadotropins in the rat ovary and enhances progesterone receptor activity
Authors: Yoshino Miki , Mizutani Tetsuya , Yamada Kazuya , Yazawa Takashi , Ogata-Kawata Hiroko , Sekiguchi Toshio , Kajitani Takashi , Miyamoto Kaoru
Published: October 2006

Background

Ovarian follicular development is primarily dependent on pituitary gonadotropins. Identification of gonadotropin-inducible genes in the ovary is one of the effective approaches for the study of follicular development. In this study we identify rat homologue of p120, a nuclear transcription co-activator, as one of the FSH inducible genes in the rat granulosa cells.

Methods

A full-length cDNA encoding rat p120 was cloned, and expression of the gene in the ovary was examined by Northern blotting. Tissue localization of p120 was examined by in situ hybridization. Cellular functions of p120 were studied by co-transfection of rat p120 gene together with estrogen receptor (ER)-alpha, ER-beta, androgen receptor (AR), or progesterone receptor (PR) genes.

Results

A full-length cDNA encoding rat p120 was characterized as a protein with 957 amino acid residues. Rat p120 was expressed ubiquitously, but strongly in the ovary and the testis. Expression of p120 mRNA was also induced in vivo by PMSG or PMSG/hCG treatment. Strong expression of p120 mRNA was observed in the granulosa cells of pre-ovulatory large antral follicles. Progesterone receptor was co-localized with p120 in the large antral follicles. Co-transfection experiments revealed that rat p120 activated AR, ER-alpha, ER-beta, and PR in the presence of their respective ligands.

Conclusion

These observations suggest that rat p120 is strongly induced in the ovarian granulosa cells, and may work together with PR in the granulosa cells of ovulatory follicles to promote the ovulation process.
Multiple endocrine neoplasia type 1
Authors: Marini Francesca , Falchetti Alberto , Monte Francesca Del , Sala Silvia Carbonell , Gozzini Alessia , Luzi Ettore , Brandi Maria Luisa
Published: October 2006

Multiple Endocrine Neoplasia type 1 (MEN1) is a rare autosomal dominant hereditary cancer syndrome presented mostly by tumours of the parathyroids, endocrine pancreas and anterior pituitary, and characterised by a very high penetrance and an equal sex distribution. It occurs in approximately one in 30,000 individuals. Two different forms, sporadic and familial, have been described. The sporadic form presents with two of the three principal MEN1-related endocrine tumours (parathyroid adenomas, entero-pancreatic tumours and pituitary tumours) within a single patient, while the familial form consists of a MEN1 case with at least one first degree relative showing one of the endocrine characterising tumours. Other endocrine and non-endocrine lesions, such as adrenal cortical tumours, carcinoids of the bronchi, gastrointestinal tract and thymus, lipomas, angiofibromas, collagenomas have been described. The responsible gene, MEN1, maps on chromosome 11q13 and encodes a 610 aminoacid nuclear protein, menin, with no sequence homology to other known human proteins. MEN1 syndrome is caused by inactivating mutations of the MEN1 tumour suppressor gene. This gene is probably involved in the regulation of several cell functions such as DNA replication and repair and transcriptional machinery. The combination of clinical and genetic investigations, together with the improving of molecular genetics knowledge of the syndrome, helps in the clinical management of patients. Treatment consists of surgery and/or drug therapy, often in association with radiotherapy or chemotherapy. Currently, DNA testing allows the early identification of germline mutations in asymptomatic gene carriers, to whom routine surveillance (regular biochemical and/or radiological screenings to detect the development of MEN1-associated tumours and lesions) is recommended.
Steroidogenic Acute Regulatory Protein (StAR): Evidence of Gonadotropin-Induced Steroidogenesis in Alzheimer Disease
Authors: Webber Kate M , Stocco Douglas M , Casadesus Gemma , Bowen Richard L , Atwood Craig S , Previll Laura A , Harris Peggy LR , Zhu Xiongwei , Perry George , Smith Mark A
Published: October 2006

Background

Alzheimer disease (AD) is clinically characterized by progressive memory loss, impairments in behavior, language and visual-spatial skills and ultimately, death. Epidemiological data reporting the predisposition of women to AD has led to a number of lines of evidence suggesting that age-related changes in hormones of the hypothalamic-pituitary-gonadal (HPG) axis following reproductive senescence, may contribute to the etiology of AD. Recent studies from our group and others have reported not only increases in circulating gonadotropins, namely luteinizing hormone (LH) in individuals with AD compared with control individuals, but also significant elevations of LH in vulnerable neuronal populations in individuals with AD compared to control cases as well as the highest density of gonadotropin receptors in the brain are found within the hippocampus, a region devastated in AD. However, while LH is higher in AD patients, the downstream consequences of this are incompletely understood. To begin to examine this issue, here, we examined the expression levels of steroidogenic acute regulatory (StAR) protein, which regulates the first key event in steroidogenesis, namely, the transport of cholesterol into the mitochondria, and is regulated by LH through the cyclic AMP second messenger pathway, in AD and control brain tissue.

Results

Our data revealed that StAR protein was markedly increased in both the cytoplasm of hippocampal pyramidal neurons as well as in the cytoplasm of other non-neuronal cell types from AD brains when compared with age-matched controls. Importantly, and suggestive of a direct mechanistic link, StAR protein expression in AD brains colocalized with LH receptor expression.

Conclusion

Therefore, our findings suggest that LH is not only able to bind to its receptor and induce potentially pathogenic signaling in AD, but also that steroidogenic pathways regulated by LH may play a role in AD.
Establishment of the epithelial-specific transcriptome of normal and malignant human breast cells based on MPSS and array expression data
Authors: Grigoriadis Anita , Mackay Alan , Reis-Filho Jorge S , Steele Dawn , Iseli Christian , Stevenson Brian J , Jongeneel C Victor , Valgeirsson Haukur , Fenwick Kerry , Iravani Marjan , Leao Maria , Simpson Andrew JG , Strausberg Robert L , Jat Parmjit S , Ashworth Alan , Neville A Munro , O'Hare Michael J
Published: October 2006

Introduction

Diverse microarray and sequencing technologies have been widely used to characterise the molecular changes in malignant epithelial cells in breast cancers. Such gene expression studies to identify markers and targets in tumour cells are, however, compromised by the cellular heterogeneity of solid breast tumours and by the lack of appropriate counterparts representing normal breast epithelial cells.

Methods

Malignant neoplastic epithelial cells from primary breast cancers and luminal and myoepithelial cells isolated from normal human breast tissue were isolated by immunomagnetic separation methods. Pools of RNA from highly enriched preparations of these cell types were subjected to expression profiling using massively parallel signature sequencing (MPSS) and four different genome wide microarray platforms. Functional related transcripts of the differential tumour epithelial transcriptome were used for gene set enrichment analysis to identify enrichment of luminal and myoepithelial type genes. Clinical pathological validation of a small number of genes was performed on tissue microarrays.

Results

MPSS identified 6,553 differentially expressed genes between the pool of normal luminal cells and that of primary tumours substantially enriched for epithelial cells, of which 98% were represented and 60% were confirmed by microarray profiling. Significant expression level changes between these two samples detected only by microarray technology were shown by 4,149 transcripts, resulting in a combined differential tumour epithelial transcriptome of 8,051 genes. Microarray gene signatures identified a comprehensive list of 907 and 955 transcripts whose expression differed between luminal epithelial cells and myoepithelial cells, respectively. Functional annotation and gene set enrichment analysis highlighted a group of genes related to skeletal development that were associated with the myoepithelial/basal cells and upregulated in the tumour sample. One of the most highly overexpressed genes in this category, that encoding periostin, was analysed immunohistochemically on breast cancer tissue microarrays and its expression in neoplastic cells correlated with poor outcome in a cohort of poor prognosis estrogen receptor-positive tumours.

Conclusion

Using highly enriched cell populations in combination with multiplatform gene expression profiling studies, a comprehensive analysis of molecular changes between the normal and malignant breast tissue was established. This study provides a basis for the identification of novel and potentially important targets for diagnosis, prognosis and therapy in breast cancer.
Ancient genomic architecture for mammalian olfactory receptor clusters
Authors: Aloni Ronny , Olender Tsviya , Lancet Doron
Published: October 2006

Background

Mammalian olfactory receptor (OR) genes reside in numerous genomic clusters of up to several dozen genes. Whole-genome sequence alignment nets of five mammals allow their comprehensive comparison, aimed at reconstructing the ancestral olfactory subgenome.

Results

We developed a new and general tool for genome-wide definition of genomic gene clusters conserved in multiple species. Syntenic orthologs, defined as gene pairs showing conservation of both genomic location and coding sequence, were subjected to a graph theory algorithm for discovering CLICs (clusters in conservation). When applied to ORs in five mammals, including the marsupial opossum, more than 90% of the OR genes were found within a framework of 48 multi-species CLICs, invoking a general conservation of gene order and composition. A detailed analysis of individual CLICs revealed multiple differences among species, interpretable through species-specific genomic rearrangements and reflecting complex mammalian evolutionary dynamics. One significant instance involves CLIC #1, which lacks a human member, implying the human-specific deletion of an OR cluster, whose mouse counterpart has been tentatively associated with isovaleric acid odorant detection.

Conclusion

The identified multi-species CLICs demonstrate that most of the mammalian OR clusters have a common ancestry, preceding the split between marsupials and placental mammals. However, only two of these CLICs were capable of incorporating chicken OR genes, parsimoniously implying that all other CLICs emerged subsequent to the avian-mammalian divergence.
Developing Models for Patient Flow and Daily Surge Capacity Research
Authors: Asplin Brent R. , Flottemesch Thomas J. , Gordon Bradley D.
Published: October 2006

Between 1993 and 2003, visits to U.S. emergency departments (EDs) increased by 26%, to a total of 114 million visits annually. At the same time, the number of U.S. EDs decreased by more than 400, and almost 200,000 inpatient hospital beds were taken out of service. In this context, the adequacy of daily surge capacity within the system is clearly an important issue. However, the research agenda on surge capacity thus far has focused primarily on large‐scale disasters, such as pandemic influenza or a serious bioterrorism event. The concept of daily surge capacity and its relationship to the broader research agenda on patient flow is a relatively new area of investigation. In this article, the authors begin by describing the overlap between the research agendas on daily surge capacity and patient flow. Next, they propose two models that have potential applications for both daily surge capacity and hospitalwide patient‐flow research. Finally, they identify potential research questions that are based on applications of the proposed research models.
Impact on Survival of Time From Definitive Surgery to Initiation of Adjuvant Chemotherapy for Early-Stage Breast Cancer
Authors: Lohrisch Caroline , Paltiel Charles , Gelmon Karen , Speers Caroline , Taylor Suzanne , Barnett Jeff , Olivotto Ivo A.
Published: October 2006

Purpose

To determine if time to start of adjuvant chemotherapy after curative surgery influences survival in early-stage breast cancer.

Patients and Methods

A retrospective review was conducted of 2,594 patients receiving adjuvant chemotherapy for stage I and II breast cancer between 1989 and 1998 at the British Columbia Cancer Agency. Relapse-free survival (RFS) and overall survival (OS) were compared among patients grouped by time from definitive curative surgery to start of adjuvant chemotherapy (≤ 4 weeks, > 4 to 8 weeks, > 8 to 12 weeks, and >12 to 24 weeks).

Results

RFS and OS were similar for women starting chemotherapy up to 12 weeks after surgery. OS hazard ratio (univariate) for initiation of chemotherapy more than 12 weeks compared with 12 weeks or less after surgery was 1.5 (95% CI, 1.07 to 2.10; P = .017). Five-year OS rates were 84%, 85%, 89%, and 78%, (log-rank P = .013); RFS rates were 74%, 79%, 82%, and 69% (log-rank P = .004) for patients starting chemotherapy 4 weeks or fewer, more than 4 to 8 weeks, more than 8 to 12 weeks, and more than 12 to 24 weeks after surgery, respectively. In multivariate analysis, independent prognostic factors were grade, size, nodal status, estrogen receptor, age, and lymphatic and/or vascular invasion. Initiation of adjuvant chemotherapy more than 12 weeks from surgery remained significantly associated with inferior survival, with a hazard ratio of 1.6 (95% CI, 1.2 to 2.3; P = .005).

Conclusion

This retrospective analysis suggests that adjuvant chemotherapy is equally effective up to 12 weeks after definitive surgery but that RFS and OS appear to be compromised by delays of more than 12 weeks after definitive surgery.
In memorian
Authors: Jackson Chevalier
Published: October 2006

Like a Hick'ry cog, In the old mill wheel; He did his part, As his turn came round
Rhinoscleroma of the lower respiratory tract
Authors: Holinger Paul H. , Gelman Howard K. , Wolfe Charles K.
Published: October 2006

Rhinoscleroma is a chronic granulomatous disease of the respiratory tract endemic to Eastern Europe and Central America which is being recognized with increasing frequency in other countries, including the United States. It was initially described as a lesion of the nose and upper respiratory tract, but is now known to involve the larynx, trachea and bronchi as well to cause slowly progressive asphyxia.

Eleven cases of rhinoscleroma with varying degrees of involvement of the lower respiratory tract (larynx, trachea and bronchi) are presented. Present day treatment is both medical, consisting primarily of streptomycin and tetracycline, and endoscopic dilatation.

Prolonged medication with careful dose control is necessary. Lower respiratory tract involvement should be considered in patients with chronic destructive granulomatous nasal pathology. This should be especially emphasized if they have an Eastern European or Central American background, or have travelled in these areas in which rhinoscleroma is endemic.
Inverting papilloma of the nose and paranasal sinuses
Authors: Suh Ku W. , Facer George W. , Devine Kenneth D. , Weiland Louis H. , Zujko Richard D.
Published: October 2006

Inverting papilloma of the nose and paranasal sinuses has been classified as a true neoplasm by most authors. It is distinct from the ordinary nasal polyps in that it has a different cause, different histologic features, a higher recurrence rate, and is occasionally associated with carcinoma.

This study includes 57 patients seen over a 30‐year period who had inverting papilloma and for whom the history, clinical and radiologic findings, treatment methods, pathologic sections, and recurrences were analyzed. Features associated with higher recurrence rate were epithelial atypia and extent of lesions. Females showed higher recurrence rates than males. External approaches (lateral rhinotomy) reduced recurrence remarkably compared with transnasal removal (13 percent versus 45 percent).

Four patients had associated carcinoma with inverting papilloma, and more extensive operations were performed in these cases; one patient died of the tumor. Radical aggressive treatment and careful follow‐up are advocated because of the higher recurrence rate after inadequate removal and because of possible malignant transformation.
The jugular bulb: Its anatomic and clinical considerations in contemporary otology
Authors: Graham Malcolm D.
Published: October 2006

Advances in neurotologic diagnosis and surgery has pointed to the need for a complete reassessment of the relationship and significance of the jugular bulb and sigmoid sinus in the temporal bone.

The purpose of this paper is to bring together in a comprehensive, up‐to‐date, and relevant manner knowledge of the jugular bulb and sigmoid sinus.

The anatomy of the bulb and sinus is discussed and selected temporal bone sections presented to illustrate the varying locations of the jugular bulb. Considerations in differential diagnosis are presented and examples of surgical procedures are discussed wherein the jugular bulb was encountered and the methods of management are detailed in these instances.
A study of nasal airway function in the postoperative period of nasal surgery
Authors: Sherman Allen H.
Published: October 2006

One hundred fifty‐seven consecutive nasal surgery cases were followed for a minimum of one year or more. Ten cases were considered to have unsatisfactory mechanical airways, caused either by return of the original pathology (alar collapse or atrophic rhinitis) or by inadequate mechanical results.

Nineteen cases in which the mechanical airways were satisfactory had soft tissue obstruction secondary to chronic inferior turbinate congestion.

The effects of nasal allergy and the trauma of postnasal packing on chronic congestion of the turbinates are tabulated according to the type of surgery performed and results discussed.
Glottic and subglottic stenosis from endotracheal intubation
Authors: Hawkins Donald B.
Published: October 2006

As a result of increased use of prolonged endotracheal intubation, complications of intubation are now being seen more often. Stenosis of the airway may develop at the level of the glottic or subglottic larynx, or in the trachea. Discussions of management do not always distinguish clearly between laryngeal stenosis and tracheal stenosis. Yet, these are two separate entities. Discussions of laryngeal stenosis usually deal with subglottic stenosis, with less emphasis on obstruction at the glottic level.

Of 20 patients, 14 adults and six children, with stenosis of the larynx secondary to intubation, we were successful in establishing adequate airways in 16. An analysis of these 20 patients leads to the following conclusions:

Scarring in the glottic posterior commissure between the arytenoid cartilages is a frequent cause of laryngeal stenosis after intubation.

Endoscopic management can be successful in many cases if it is started early enough, and repeated as often as is necessary. The earlier it is begun, the better the results will be.

Indwelling stents which are extremely valuable in laryngeal stenosis from external trauma, may not be as useful in stenosis from endotracheal tube trauma.
Mucormycosis
Authors: Eisenberg Lee , Wood Terry , Boles Roger
Published: October 2006

Three cases of mucormycosis are presented; two with unusual aspects: One with previously unreported involvement of the mandible, and one presenting as a cavernous sinus thrombosis.

Review of the literature reveals a limited number of survivors. Survival in two of the cases presented here suggests that early diagnosis, aggressive therapy with surgery, and amphotericin B should improve the prognosis.
Spontaneous and traumatic perilymph fistulas
Authors: Althaus Sean R.
Published: October 2006

Clinicians have been aware of the problem of post‐stapedectomy peri‐lymph fistulas for some time. The existence of non‐surgical oval and round window fistulas has been known and was first described in detail by Fee in 1968. This paper concerns a small series of patients with spontaneous and traumatic perilymph fistulas. Five oval window fistulas and one round window fistula are reported. Clinical features, audiometric, radiographic and vestibular findings are discussed.

The etiology of traumatic and spontaneous fistulas is not well understood, but seems to bear a relationship to sudden increases in intracran‐ial pressure transmitted to the inner ear through the cochlear aqueduct. Middle ear pressure changes, as seen in acoustic or barotrauma, may also cause these leaks.

Indications for surgery and techniques of perilymph fistula identification and repair are discussed in the paper. Surgical correction led to relief of vertigo in 80 percent of patients in this series, and significant hearing improvements were seen in 50 percent of the patients.

In evaluating patients with sudden sensori‐neural hearing loss, or persistent vestibular symptoms following head or ear trauma, the otologist should keep in mind the possibility of a perilymph fistula and actively investigate these patients. Evidence presented in this paper and in the literature suggests that identification and correction of spontaneous and traumatic perilymph fistulas can lead to resolution of vestibular symptoms and improved hearing in a significant number of patients with these lesions.
Auditory symptoms associated with herpes zoster or idiopathic facial paralysis
Authors: Byl Frederick M. , Adour Kedar K.
Published: October 2006

Auditory symptoms (hyperacusis, tinnitus, decreased hearing) have long been recognized to accompany herpetic or idiopathic facial paralysis. Twenty‐nine percent of 1,080 patients with idiopathic facial paralysis and 37 percent of 172 with herpes zoster oticus facial paralysis had auditory symptoms. Abnormal related sensori‐neural hearing loss was documented in only 11 of these 377 patients with auditory complaints. All of the 11 had a diagnosis of herpes zoster oticus.

Sensori‐neural hearing loss occurs in only about 6.5 percent of patients with herpes zoster facial paralysis, and no confirmed case of such loss in idiopathic facial paralysis has been reported. In patients presenting with sensori‐neural hearing loss accompanying facial paralysis believed to be idiopathic, herpes zoster should be suspected even in the absence of vesicles. Factors favorable for recovery of auditory function include age 64 years or younger, mild initial hearing loss, a cochlear pattern of hearing loss, and absence of vertigo. Recovery of auditory function does take place; however, a high‐tone sensori‐neural loss may persist except in younger patients.
Ossicular transplants: Histologic findings in Animals and Man
Authors: Linthicum Fred H.
Published: October 2006

Numerous papers have been published in the past 15 years in which the authors attempted to predict the results of surgical procedures on humans by analyzing the findings in animals undergoing similar procedures. Our experience in analyzing animal and human temporal bones indicates that conclusions drawn on this basis are frequently invalid.

We reviewed temporal bones of monkeys and cats that had had a variety of surgical procedures. There is much more middle ear fibrosis, particularly in the epitympanum, in these animals than one finds in human temporal bones. In a number of animals in which middle ear procedures were performed, hydrops of the inner ear or labyrinthitis occurred. This has not been the experience in human middle ear surgical procedures.

An extensive review of the literature indicates that most investigators are of the same opinion. However, there are still those who are performing experiments using ossicular transplants, stapedectomy techniques, etc., who attempt to correlate the findings in animals in anticipation of what the same procedures might do to the human middle and inner ear.

It appears from our experience, and that of many other investigators, that the ultimate fate of ossicular repositioning and transplantation in various animals cannot be used to predict what might happen in human beings.
Frontal sinus trauma: Experimental reconstruction with proplast
Authors: Schenck Nicholas L. , Tomlinson Michael J.
Published: October 2006

Trauma has become the most common pathologic entity requiring operative intervention in the frontal sinus. Treatment has evolved from simple open drainage to ablation with reconstruction at a later date. Methyl‐methacrylate, currently the most widely used alloplastic material, has inherent disadvantages such as two‐stage reconstruction, difficulty in handling and molding, and susceptibility to trauma.

The present investigation evaluates Proplast(r), a biocompatible Teflon fluorocarbon polymer implant, in one and two‐stage frontal reconstruction following traumatic defects to the canine frontal sinus. Following the loss of anterior or posterior frontal bone, Proplast(r) provided excellent cosmetic reconstruction over a period of one year. Resistance to infection was good, reaction with dura and brain was absent, and cerebrospinal fluid leaks sealed rapidly. In contrast to other alloplastic materials, rapid vasculariza‐tion and collagen ingrowth lead to stabilization rather than sequestration.

Several advantages over alloplastic and metallic implants may give Proplast(r) a unique potential in operative cranioplasty.
Contribution to therapy of dysphonia plica ventricularis
Authors: Kosokovic Franjo , Vecerina Santa , Cepelja Ivanka , Konic Vera
Published: October 2006

Excision of the hypertrophic ventricular folds was performed in 35 patients by means of laryngomicroscopy. In most of our patients this therapy promptly resulted in a clear voice. Correlating the laryngomicroscopic finding and the histological picture we were able to classify hypertrophy of the ventricular folds into three stages, each of which presents with a characteristical clinical and histological picture and thus requires appropriate therapy. In Stage I the histological changes are reversible and conservative phoniatric therapy leads to success relatively quickly. In the second stage histological changes may also be reversible, and the prolonged and persistent phoniatric therapy leads to success but we prefer micro‐surgical excision because of the direct effect. In Stage III, however, we found irreversible histological changes in the sense of connective hyper‐plasia which prompted us to conclude that microsurgical excision alone may lead to regression of the hoarseness.
Effect of radiation therapy on facial nerve cable autografts
Authors: Mcguirt W. F. , Mccabe B. F.
Published: October 2006

Facial nerve cable autografts were performed on 20 cats with 10 animals receiving 6,000 Rads of postoperative irradiation over six weeks. Testing by clinical appearance, pontograms, and axon counts showed no statistical difference in the operated only and the operated plus irradiated groups. Pontograms illustrated the clinical observance of spasticity, delay and weakness often seen after grafting. This animal work tends to verify the clinical impression that in patients requiring postoperative irradiation for a malignancy necessitating excision and grafting of the facial nerve, anticipated results should be equivalent to the facial nerve cable autografts without postoperative irradiation.
Laryngeal involvement in von recklinghausen's disease: A case report and review of the literature
Authors: Chang‐Lo Mary
Published: October 2006

A case of neurofibromatosis involving the larynx is added to the 19 previously reported cases; furthermore, it represents the only reported case of plexiform ganglioneurofibroma of the larynx in Von Recklinghau‐sen's disease. The reported cases of neurofibromatosis with laryngeal involvement in the world literature are discussed and summarized. The main clinical symptoms are dyspnea, dysphonia and dysphagia which occasionally require tracheotomy when the condition is recognized. Elective surgical excision is the treatment of choice.
Management of malignancy of the temporal bone
Authors: Gacbk Richard R. , Goodman Max
Published: October 2006

An analysis was made of 31 patients with malignancy of the temporal bone treated at Massachusetts Eye and Ear Infirmary between 1959 and 1975. Treatment modalities included: partial temporal bone resection, subtotal temporal bone resection, total temporal bone resection, radical mas‐toidectomy followed by radiation therapy, radiation therapy alone, and chemotherapy. When tumor was limited to the external ear canal, partial temporal bone resection was effective in 10 out of 11 patients. When tumor involved the middle ear, subtotal temporal bone resection cured 3 out of 5 patients, and radical mastoidectomy followed by radiation therapy cured 5 out of 12 patients. Total temporal bone resection and chemotherapy failed to cure a patient each, but radiation therapy alone was successful in controlling tumor in one patient.
Problems of diagnosis in the evaluation of mediastinal sarcoidosis
Authors: Welsh Louis W. , Welsh John J.
Published: October 2006

The diagnosis of sarcoidosis can be established when the case meets the criteria of clinical course, radiologie findings, and supportive histology.

When there is variation from the established criteria and the clinical course of age, systemic evidence of disease or the radiologie findings of unilateral or solitary adenopathy are encountered, then ongoing evaluation is necessary to identify a possible second disease existence.

Cases have been presented which indicate some problem requiring further investigative studies before acceptance of the diagnosis of sarcoidosis.
Surgical management of ménière's disease with the endolymphatic subarachnoid shunt: A five‐year study
Authors: Glasscock Michael E. , Miller Gale W. , Drake Fred D. , Kanok Montra M.
Published: October 2006

The majority of individuals with Ménière's Disease can be successfully managed by medical means; however, there are some patients who become refractory to this form of therapy. It is this group of patients who are candidates f or some type of surgical procedure. This paper reviews 109 patients who underwent 112 endolymphatic subarachnoid shunt procedures for the control of their Ménière's Disease. Medical therapy, indications for surgery, surgical technique, results, and complications are covered in detail.
The operation and death of henry schliemann
Authors: Mcgovern Francis H.
Published: October 2006

Henry Schliemann's reputation as an archeologist, a linguist, a financial genius and a scholar, is seldom recognized by Americans. His discovery of the ruins of Troy changed Homeric myths and legends into history and made him the founder of Aegean archeology.

Recent popular books on Schliemann sketchily describe his otologic problems which eventually led to his death of an otogenic brain abscess.

From a number of bibliographic sources, the details of Schliemann's ear history and the final months of his illness are recounted. The important information of Schliemann's ear operation by the famous Professor Swartze is presented.
Posterior table fractures of the frontal sinus: Ii. Clinical aspects
Authors: Hybels Roger L.
Published: October 2006

The evaluation of fractures involving the frontal sinus is important since significant complications can occur acutely or many years following injury. Thorough roentgenographic analysis, with special emphasis on the status of the nasofrontal duct, is required. The extent of soft tissue injury cannot be used as a guide. Furthermore, the proper treatment of fractures involving the posterior table has been controversial. In general, all fractures of the posterior table should be explored. Complete neurological evaluation is necessary and an observation period of approximately 48 hours is recommended prior to surgery. A coronal incision is suggested since a craniotomy can be performed with the exposure obtained. In selected patients, conservative treatment may be warranted but close follow‐up with serial X‐rays is necessary.

Primary adipose obliteration of the injured sinus is recommended as treatment since complications are eliminated by a single operation which is cosmetically acceptable. This is supported by existing clinical series and experimental evidence. Adipose tissue possesses certain advantages which make it the tissue of choice for obliteration. Infection involving the implanted fat does not appear to be a significant problem. Bony fragments of the posterior table may safely be left in place. Dural lacerations occurring immediately behind the posterior table can be managed through the sinus without the necessity of craniotomy.
Temporal bone histopathology of paget's disease with sensorineural hearing loss and narrowing of the internal auditory canal
Authors: Applebaum Edward L. , Clemis Jack D.
Published: October 2006

A temporal bone report is presented of a patient with progressive sen‐sorineural hearing loss and advanced Paget's disease involving the skull. The histopathology reveals Pagetic bone invading the internal auditory canal and compressing the cochlear division of the VHIth cranial nerve resulting in severe neural degeneration. There are no other histopathologic abnormalities present in the cochlea to explain the hearing loss. A low‐frequency conductive hearing loss was also present, but no histopathologic correlate could be identified.
Eosinophilic granuloma in the head and neck: A five year review with report of an instructive case.
Authors: Cinberg James Z.
Published: October 2006

Head and neck symptoms occurred in 87% of patients (14 of 16) with eosinophilic granuloma seen in a 5 year period. Two patients with head and neck disease died (14% mortality). Both had concomitant pituitary disease. The underlying pathology was discovered in each instance only after a year of extensive diagnostic effort.

The specific problems in diagnosis and treatment are apparent in the case report of an initially misdiagnosed patient.

The following recommendations are suggested to optimize the care of such patients. Eosinophilic granuloma must be suspected in a variety of clinical settings. Radiography is the only helpful noninvasive study and definitive diagnosis depends on microscopic tissue examination. Patients with symptoms of pituitary disease pose a frustrating diagnostic problem because of the inaccessibility of the location for pathologic study. In contrast, the head and neck, ear, nose and throat are easily biopsied and comprise the region most frequent'y involved. A careful examination of this area is mandatory in all patients with symptoms consistent with eosinophilic granuloma intracranially or elsewhere if the disease is to be diagnosed and treated without delay.
Endoscopic examination of corrosive injuries of the upper gastrointestinal tract.
Authors: Welsh John J. , Welsh Louis W.
Published: October 2006

The authors present the case histories of five patients who have sustained corrosive injuries of the upper gastrointestinal tract. Flexible endoscopic examination was successfully carried out in each patient to assess the extent of the injury and anticipate further therapeutic needs. Three patients sustained major gastric lesions, i.e., strictures or bleeding following the ingestion of alkali, acids, or phenol, and one instance of esophageal stricture was recognized. The endoscopic observation of antral gangrene was inexorably followed by antral stricture requiring surgical management. One fatality followed rigid esophagoscopic examination which resulted in esophageal perforation.
Fibro‐optic study of pharyngeal airway during sleep in patients with hypersomnia obstructive sleep‐apnea syndrome.
Authors: Borowiecki Bernard , Pollak Charles P. , Weitzman Elliot D. , Rakoff Saul , Imperato Joseph
Published: October 2006

Pharyngeal airway during sleep was observed with help of Fibro‐optic flexible bronchoscope and cineradiography in 10 adult patients with Hypersomnia Sleep‐Apnea (HSA) syndrome.

The results of the study suggest that the structures involved in production of airway obstruction in the patients with HSA syndrome are the muscles of velopharyngeal sphincter and tongue. The laryngeal airway was not obstructed during the episodes of apnea.
A case against nasal packing.
Authors: Stucker F. J. , Ansel D. G.
Published: October 2006

Nasal packing is included in most technical descriptions of septal and rhinoplasty surgery with little accompanying discussion of its indications and possible pitfalls.

We believe that routine nasal packing is not an innocuous step. There are certain specific indications for its use but these are uncommon. We suggest that exclusion of packing is a wiser alternative in routine procedures.

Over 800 cases of nasal surgery have been reviewed with fewer than 9% requiring packing. The indications for such packing are described as are the alternatives. Problems and complications attendant with its routine use are explored.
Tympanoplasty using homograft tympanic membranes and ossicles
Authors: Campbell Emmett E.
Published: October 2006

The use of homograft materials in reconstructive, mastoid, and middle ear surgery is increasing. Not only are they useful and practical, but they also do the job well in both anatomical and functional restoration. Many encouraging reports have been written to support their use. Their advantages, in the opinion of the author, outweigh their cost since they can offer a more efficient, versatile, and better method of restoration of hearing in tympanoplasty surgery.
Otospongiosis (otosclerosis): Polytomographic and histologic correlation
Authors: Applebaum Edward L. , Shambaugh George E.
Published: October 2006

The Temporal Bone Laboratory of Northwestern University Medical School has three sets of temporal bones from patients who had antemortem polytomographic examinations resulting in a diagnosis of otospongiotic involvement of the cochlea. One of these cases was thought to have been an example of pure cochlear otospongiosis. The other two cases were patients with clinical (stapedial) otospongiosis, and their polytomograms were interpreted as unilateral otospongiosis with involvement of the basal turn of the cochlea.

In the first set of temporal bones, no otospongiosis was present. In the other two sets, the otospongiotic lesion did not involve the cochlea, and a contralateral otospongiotic lesion was present that had not been seen on the polytomograms.

Caution must be exercised in the interpretation of subtle polytomographic changes noted in the cochlear capsule and restraint used in the X‐ray diagnosis of pure cochlear otospongiosis until there is evidence of correlation with pathological material.
Angiography in the diagnosis and management of extracranial vascular lesions of the head and neck
Authors: Overholt Steven L. , Gado Mokhtar , Sessions Donald G. , Ogura Joseph H.
Published: October 2006

The angiographic features of various lesions of the head and neck are presented. Angiographically, cavernous hemangiomas display large venous lakes with calcified phleboliths. Arteriovenous malformations reveal massive tumor stain with well delineated feeding vessels from multiple systems. Chemodectomas and juvenile nasopharyngeal angiofibromas are clearly vascular with homogenous tumor staining in the capillary phase. Angiography of cavernous hemangioma, AVM, chemodectoma, and angiofibroma is diagnostic and may preclude the need for tissue biopsy.

Angiographically neurilemmomas are less vascular with non‐homogenous tumor stain. Carcinomas are typically avascular.

The use and benefits of arterial embolization in the management of these lesions is presented.
The use of cyanoacrylate in transsphenoidal hypophysectomy
Authors: Young William C. , Gates George A.
Published: October 2006

In an attempt to find a better technique for immediate control of CSF rhinorrhea following transsphenoidal hypophysectomy, a tissue adhesive, ethyl 2‐cyanoacrylate, has been used in 28 consecutive operations. The physical properties of the adhesive, its theoretical advantages, and our results are discussed.
Procedures for preparation of otological and audiological data for computer analysis
Authors: White Thomas P. , Uhler Lloyd M.
Published: October 2006

Extensive amounts of clinical data exist in the files of facilities providing otological and audiological services. Because of the considerable time involved in manual analysis, some departments are beginning to consider the use of computers for analyzing the data. It is often assumed that this data can simply be submitted to a computer center for analysis. This, however, is not the case. A careful series of planned procedures must be undertaken before information can be submitted and analyzed. This paper illustrates the procedural steps necessary to permit the utilization of a computer system for analysis of clinical data. The feasibility of the use of these procedures in the examination of otological and audiological data is considered.
Recurrence as a mode of determining efficacy in treatment of carcinoma of the larynx
Authors: Graeber Geoffrey M. , Oates Richard P. , Reed George F.
Published: October 2006

A study population of 374 patients with cancer of the larynx was evaluated, treated, and followed at yearly intervals up to a maximum of 18 years post‐diagnosis. Of these, 348 received definitive therapy to attempt to eradicate their disease and were followed for recurrence and presence of cancer at death. In Stages I, II, and III recurrence of disease appears to be a very good indicator of therapeutic efficacy. Stage I carcinomas of the larynx should be treated with radiation as the proportions of patients with recurrences were the same for both primary surgical or radiation therapy. In Stages II and III, primary surgical therapy significantly lowered the proportion recurring when compared with primary radiation therapy. In Stage IV carcinomas of the larynx, both survival and recurrence accurately reflect therapeutic efficacy since most patients suffer recurrence of their carcinoma and die of the disease.
The relationship between adience‐abience scale scores and judged communication proficiency of alaryngeal speakers
Authors: Goldstein Lewis P. , Salmon Shirley J.
Published: October 2006

Fifteen esophageal speakers and 15 artificial larynx speakers were administered the Hutt Adaptation of the Bender‐Gestalt Test (HABGT): Adience‐Abience Scale. Adience was defined as the individual's tendency to be motivated to adapt to new experiences that effect his physical functioning. Conversely, abience was defined as the individual's tendency to avoid or be inhibited from adapting to new experiences that effect his physical functioning. Audio‐tape recordings were made of each speaker and used to determine verbal communication proficiency by six speech pathologists. Results indicated that the HABGT: Adience‐Abience Scale was able to differentiate between the two groups of alaryngeal speakers, as well as relate to their verbal communication proficiency.
Symposium: Value and cost analysis of recent ear tests. Considerations in clinical application of electrocochleography in 1978
Authors: Nadol Joseph B.
Published: October 2006

The role of elecrococholeography as a practical clinical tool in the evaluation of otologica disorders is discussed with examples drawn from the author's experience. The current use of electrococheography may be divided into three categories: 1. It may be used to assess periperal auditory functionin children of patients with neurologic or psuchiatric disorders that perclude valid behavioural audiometry. 2 It may be used jto determine the sites such as miniere's in which realiable behabvioural audiometry is usually possible. In the first two categories, electrocochleography provides important clinical information of high validity with klow risk so that objective therapeutic dicisions can be made concerning amplificatino and habilitation of a hearing handicapped patient. In some cases this information may not be achieve in any other way. For the third category, howeverj, although interesting and potentially usefully be made without electococheleographic data.As More patient with these disorders are studied with electrocolcheography on a research basis, it is possibel that the pathophysilogy of some of the more vaxing otologic disorders will become clearer. Perhaps in the future the need for differentela diagnostic information will justify the routine clinical applicatio of electrococheography in some of these disorders.
Symposium: Otologic surgery reassessment after 25 years. Management of the totally disabled middle ear
Authors: Mcgee T. Manford
Published: October 2006

A short review of past techniques and materials used in treating the totally disabled middle ear is presented. Basic principles to be observed in management of this problem are discussed and the method of middle ear rehabilitation using the double layer Silastic technique is introduced. Cases (231) are reviewed with comments on the functional results achieved. It is concluded that a reliable total ossicular replacement prosthesis has yet to be produced.
Protocol for determining the auditory percepts of electrical stimulation of the cochlea
Authors: Michelson Robin P. , Schubert Earl , Walsh Sheila , White Mark
Published: October 2006

The percepts of electrical stimulation of the auditory nerve can best be determined in man. An eight channel bipolar electrode array has been developed which allows discreet stimulation of segments of auditory nerve via the scala tympani. In addition, a programmable stimulator has been developed which allows the delivery of different waveforms and stimulus patterns. Hopefully this will begin to allow the generation of the elements of speech.
Otitis media and the immotile cilia syndrome
Authors: Jahrsdoerfer Robert , Feldman Phillip S. , Rubel Edwin W. , Guerrant John L. , Eggleston Peyton A. , Selden Robert F.
Published: October 2006

The immotile cilia syndrome appears to be a congenital defect in the ultrastructure of cilia that renders them incapable of movement. Respiratory tract cilia and sperm are predominantly affected. Bronchiectasis, sinusitis and male sterility are the main clinical findings. Situs inversus may be found. To these findings can be added otitis media.

The defect appears to be a complete or partial absence of dynein arms which are believed to be essential for generating movement of cilia or sperm tails. Six patients suspected of having immotile cilia were compared to six patients in a control group. In affected patients, no cilia movement in the middle ear or nasopharynx was observed using the operating microscope. Electron microscopy of cilia from the mucosa of the middle ear and nasopharynx appeared to confirm the ultrastructural defect in two of six patients suspected of having the syndrome.
Computed tomography of the larynx
Authors: Bergman Alan B. , Neiman Harvey L. , Warpeha Raymond L.
Published: October 2006

The normal computed tomographic anatomy of the larynx and surrounding structures is illustrated and discussed. An attempt is made to distinguish various types of tissues in cross‐sectional display. The advantages of computed tomography over other modalities used for imaging the laryngeal region include the capacity to depict structural relationships in cross‐section, to better define cartilaginous involvement by adjacent neoplasms, and to identify vascular components with contrast enhancement. The clinical application of computed tomography with respect to radiation therapy treatment planning of laryngeal tumors is an important feature of this imaging technique.
Evaluation of otic drops on infection and healing of traumatic tympanic membrane perforations
Authors: Fry Terry L. , Chen Benjamin , Fischer Newton D. , Pharr Scott Y.
Published: October 2006

Guinea pigs were used to compare the efficacy of three commercially available otic preparations in treating traumatic tympanic membrane perforations. The results suggest that a clear, viscous solution of low pH will significantly reduce the incidence of infection and will not retard subsequent membrane healing.