bluuebunny/crossref_metadata_2025_split huggingface dataset:
Magnetic Resonance Imaging of Micronized Dermal Graft in the Larynx
Authors: Moonis Gul , Dyce Orville , Loevner Laurie A. , Mirza Natasha 
Published: October 2014

Objectives: This study was conducted to evaluate magnetic resonance imaging (MRI) as an objective measure of survival of micronized acellular human dermal graft (Cymetra, LifeCell Corporation) injected into the thyroarytenoid muscle for augmentation of unilateral vocal fold paralysis. Methods: We performed a retrospective review of MRI scans obtained in 6 patients in whom Cymetra was injected into the thyroarytenoid muscle. Gadolinium-enhanced MRI of the larynx was performed 3 days, 1 month, 8 months, 11 months, 15 months, and 21 months after injection. The survival of injected Cymetra was assessed according to information obtained from the MRI scan. Images were also obtained for 1 cm3 of reconstituted Cymetra paste. Results: The identification of Cymetra in the larynx is based on its proteinaceous content. T1-weighted images of the injected material in the true vocal fold showed hyperintense foci corresponding to injected Cymetra. Hyperintense signal was also present on the T2-weighted images. Persistence of the injected Cymetra was readily detectable by MRI for as long as 11 months. Conclusions: Cymetra is a viable treatment option for vocal fold augmentation. The duration of survival of Cymetra (as long as 11 months) makes it a good option in cases in which longer survival of the injectable material is needed.
Laser Microsurgical Bilateral Posterior Cordectomy for the Treatment of Bilateral Vocal Fold Paralysis
Authors: Olthoff Amo , Zeiss Daniel , Laskawi Rainer , Kruse Eberhard , Steiner Wolfgang 
Published: October 2014

Objectives: We performed a prospective study to assess respiratory function and voice quality before and after laser microsurgical bilateral posterior cordectomy performed for chronic airway obstruction in patients with bilateral vocal fold paralysis. Methods: In 17 patients a laser microsurgical posterior cordectomy was performed as an immediate bilateral approach. Roughness, breathiness, hoarseness, and dyspnea were evaluated both subjectively (on a scale from 0 to 3) and objectively (body plethysmography, computerized voice analysis: Göttingen Hoarseness Diagram). Results: After laser surgery, the patients' respiratory function was significantly increased and was sufficient for all activities of daily living. The body plethysmographic measure of airway resistance had superior descriptive power and correlated significantly with the clinical degree of dyspnea (scale 0 to 3). Pretreatment and posttreatment impairment of voice quality was objectively documented with the Göttingen Hoarseness Diagram; the phonatory results measured with it correlated significantly with the subjective clinical evaluation of hoarseness. Aphonia did not occur. Conclusions: A bilateral approach for laser microsurgical posterior cordectomy combines excellent airway improvement and satisfactory voice preservation. In bilateral vocal fold paralysis, pretreatment and posttreatment clinical data should be evaluated by objective measures.
Adenovirus-Mediated Gene Transfer in Olfactory Epithelium and Olfactory Bulb: A Long-Term Study
Authors: Doi Kiyoshi , Nibu Ken-Ichi , Ishida Haruhiko , Okado Haruo , Terashima Toshio 
Published: October 2014

Objectives: We sought to study the spatiotemporal gene expression mediated by adenoviral vector in the olfactory pathways. Methods: The replication-defective adenoviral vector AxCALacZ, which encodes the enzyme Escherichia coli β-galactosidase, was applied to mouse olfactory epithelium by intranasal instillation. Results: The LacZ gene product, β-galactosidase, was expressed not only in the olfactory receptor neurons and their axons, but also in the olfactory bulbs. The first evidence of anterograde labeling was observed at postinfection day (PID) 2. At PID 3, β-galactosidase was strongly expressed in olfactory nerve axons, as well as their terminal glomeruli, in the olfactory bulbs. β-Galactosidase expression persisted up to PID 90, and there was a significant decrease in the number of labeled neurons at PID 30. Conclusions: These results suggest possible long-term effects of adenovirus-mediated gene transfer on the olfactory neurons, as well as the olfactory bulbs.
Diazepam Tolerance Effects on Vestibular Function Testing, Part II: Vestibulo-Ocular Reflex Parameters during Rotational Testing
Authors: Blau Patricia A. , Schwade Nathan , Roland Peter 
Published: October 2014

Objectives: The purpose of this prospective study was to determine whether clinical doses of diazepam (DZ; 10 mg/d) administered for 14 days result in tolerance as measured by the sinuosidal harmonic acceleration (SHA) rotational test. It has been shown that repeated dosing with DZ leads to accumulation and tolerance in outcome measures that assess memory, sedation, and psychomotor tasks. Methods: In a double-blinded, repeated-measures design, 30 normal male subjects who ranged in age from 20 to 36 years were randomly assigned to a placebo group or a DZ group and participated in 6 SHA rotational sessions over a 2-week period. Analysis of drug-placebo differences in percent change from baseline was performed with a 1-way analysis of variance. Results: Vestibulo-ocular reflex gain and phase frequencies at 0.01, 0.02, 0.04, and 0.08 Hz were significant (p < .05) for treatment group. No significant effect was observed for gain and phase frequency at 0.16 Hz — a finding that indicates selective effects on different central nervous system mechanisms. There was no statistical significance for time. Conclusions: Clinically, the DZ subjects' scores remained within the normal ranges for vestibulo-ocular phase and gain, suggesting that patients in whom drug cessation is problematic may not have to discontinue DZ before testing with the SHA rotational system.
Use of Silicone Hearing Aid Mold Material in Laryngotracheal Reconstruction
Authors: Heman-Ackah Yolanda D. , Sataloff Robert T. 
Published: October 2014

Objectives: Endolaryngeal stenting in patients with irregularly shaped larynges can be challenging. In such cases, the use of a moldable yet reasonably rigid endolaryngeal stent is desirable. The purpose of this report is to describe our experience with silicone hearing aid material as a moldable endolaryngeal stent in a patient with an atypically shaped larynx. Methods: A patient with relapsing polychondritis that resulted in complete stenosis of the subglottic airway underwent laryngotracheal reconstruction. Moldable silicone, commonly used to prepare ear canal molds for hearing aids, was molded into the neo-endolarynx to serve as a custom-made endolaryngeal stent. Results: The patient tolerated the moldable silicone stent well and had a patent airway with epithelialization 8 months after removal. Conclusions: Silicone mold material is a suitable substance for endolaryngeal stenting. It conforms to the configuration of the individual's airway, is tolerated well, can be removed relatively easily, and is a useful alternative to prefabricated stents in laryngotracheal reconstruction.
Angular Vestibulo-Ocular Reflex Gains Correlate with Vertigo Control after Intratympanic Gentamicin Treatment for Meniere's Disease
Authors: Lin Frank R. , Migliaccio Americo A. , Haslwanter Thomas , Minor Lloyd B. , Carey John P. 
Published: October 2014

Objectives: The objective of our study was to determine whether angular vestibulo-ocular reflex (aVOR) gains correlated with vertigo control after intratympanic gentamicin treatment for Meniere's disease. Methods: We conducted a prospective study of 18 subjects with unilateral Meniere's disease treated with intratympanic gentamicin injection and followed all subjects for 1 year. We measured the gain of the aVOR elicited by rapid rotary head thrusts in each of the canal planes for each subject before and after treatment with intratympanic gentamicin by using magnetic search coils to record eye movements. Results: During the follow-up period, 11 subjects (“single-treatment group”; 61%) had control of their vertigo with a single gentamicin injection. The remaining 7 subjects (“multiple-treatment group”; 39%) experienced recurrent vertigo that required a second injection of gentamicin at a mean of 6 months after the first treatment. The 11 subjects in the single-treatment group had significantly greater reduction of labyrinthine function after the first treatment, as measured by change in ipsilateral horizontal canal gain, than did the 7 subjects with vertigo recurrence. Changes in caloric asymmetry did not correlate with vertigo control. Conclusions: Our results suggest that successful treatment of Meniere's disease is closely related to attenuation of semicircular canal function as measured by horizontal canal aVOR gains.
Dose Response of Topical Anesthetic on Laryngeal Neuromuscular Electrical Transmission
Authors: Chitkara Ajay , Meyer Tanya , Cultrara Anthony , Blitzer Andrew 
Published: October 2014

Objectives: Our purpose was to determine the effect of a dose response to decreasing concentrations of topical anesthetic upon laryngeal neuromuscular electrical transmission. Methods: We performed a prospective study at a neurolaryngology referral center. Forty-three patients were divided into 5 groups. Each patient underwent laryngeal electromyography (EMG) of a thyroarytenoid muscle before and 60 seconds after topical laryngotracheal lidocaine hydrochloride, normal saline solution, or nothing was applied. The pretreatment and posttreatment measurements were recorded with the same indwelling EMG electrode. Group 1 (n = 12) received 4% lidocaine, group 2 (n = 9) received 2% lidocaine, and group 3 (n = 8) received 1% lidocaine. Group 4 (n = 5) received topical normal saline solution instead of lidocaine. A fifth group (group 5, n = 9) had 2 EMG recordings measured, each separated by 60 seconds, without topical anesthetic. Results: Groups 1, 2, and 3 showed significant decreases in the maximum peak-to-peak amplitude of the EMG recording (48.5%, 49.7%, 44.7%, respectively). Groups 4 and 5 failed to show a significant change in peak-to-peak amplitude after 60 seconds. There was no dose response change in EMG with decreasing lidocaine concentrations. Conclusions: All concentrations of lidocaine administered in this study decreased the laryngeal neuromuscular electrical transmission as measured by laryngeal EMG. This group of patients did not exhibit any dose response to anesthetic concentration. This finding is clinically significant for both diagnostic and therapeutic uses of laryngeal EMG preceded by administration of topical anesthetic.
Cidofovir Incorporation into Human Keratinocytes with Episomal HPV 16 Results in Nonselective Cytotoxicity
Authors: Spanos William C. , El-Deiry Mark , Lee John H. 
Published: October 2014

Objectives: Recurrent respiratory papillomatosis (RRP) is caused by human papillomavirus (HPV). Surgical excision is the mainstay of treatment; however, medical therapy including cidofovir, a cytosine analog, has been investigated. Human papillomavirus does not encode a viral DNA polymerase, which is the known target of cidofovir in cytomegalovirus infections. Methods: In an effort to better understand the usefulness of cidofovir in the treatment of HPV-related disease, we tested cidofovir's ability to inhibit growth, alter gene expression, and inhibit genome replication. Results: With the use of carbon 14-labeled cidofovir in episomal HPV 16-containing keratinocytes, there was a minimal increase in cidofovir incorporation into episomal DNA versus genomic DNA. Cidofovir decreased the copies of episomal HPV 16 in keratinocytes; however, the copies per cell returned to baseline levels once cidofovir was removed. Expression of a viral oncogene (HPV 16 E6) in transformed keratinocytes with episomal HPV 16 was not decreased by cidofovir. Cytotoxicity in head and neck squamous cell carcinoma lines exposed to cidofovir correlated with cell doubling time, and not with HPV status. Also, tonsil keratinocytes transformed with episomal HPV 16 did not exhibit greater cidofovir-mediated toxicity than did telomerase-transformed keratinocytes. Conclusions: These findings suggest that any potential in vivo benefit of cidofovir therapy results from non–viral-specific cell toxicity at the site of application.
C-C Chemokine Ligand 2 Gene Expression in Nasal Polyp Fibroblasts: Possible Implication in the Pathogenesis of Nasal Polyposis
Authors: Shun Chia-Tung , Lin Sze-Kwan , Hong Chi-Yuan , Kok Sang-Heng , Juan Yun-Hsiang , Wang Chih-Chiang , Hsu Ming-Che , Liu Chia-Ming 
Published: October 2014

Objectives: Recruitment of macrophages is essential to the pathogenesis of nasal polyps (NP), since this disease is inflammation-related. In this study, the effects of tumor necrosis factor α (TNF-α) on the expression of C-C chemokine ligand 2 (CCL2) in fibroblasts derived from nasal polyps (NPFs) were investigated. The roles of cyclooxygenase (COX) 2 and prostaglandins in the mediation of TNF-α–stimulated CCL2 gene expression were also investigated. Methods: Northern blot analysis was used to study the expression of CCL2 and c-Fos in cultured NPFs. An electrophoretic mobility shift assay was used to explore the interactions between activator protein 1 (AP-1) and DNA. Immunohistochemistry was used to explore the in vivo expressions of COX-2, CCL2, and CD68 in NPs. Results: The Northern blot analysis showed that TNF-α stimulated the expression of CCL2 and COX-2 genes, and the synthesis of CCL2 messenger RNA was COX-2-dependent. A transient elevation of c-Fos and c-Jun messenger RNAs was induced by TNF-α, whereas COX-2 inhibitors NS-398 and meloxicam abolished the up-regulation of c-Fos. The electrophoretic mobility shift assay revealed that TNF-α triggered AP-1 and DNA binding and again, NS-398 and meloxicam inhibited this reaction via reducing c-Fos synthesis. Curcumin (AP-1 inhibitor) markedly suppressed the TNF-α–induced CCL2 expression. The immunohistochemical staining of NP surgical specimens also revealed an intimate alignment between CCL2-positive fibroblasts and CD-68-positive macrophages. Conclusions: These data suggest that NPFs may contribute to NP development by synthesizing CCL2 to promote macrophage recruitment. Furthermore, COX-2 facilitates CCL2 transcription in NPFs via a c-Fos and AP-1 signaling pathway.
Efficacy of a Cochlear Implant Simultaneous Analog Stimulation Strategy Coupled with a Monopolar Electrode Configuration
Authors: Xu Li , Zwolan Teresa A. , Thompson Catherine S. , Pfingst Bryan E. 
Published: October 2014

Objectives: The present study was performed to evaluate the efficacy and clinical feasibility of using monopolar stimulation with the Clarion Simultaneous Analog Stimulation (SAS) strategy in patients with cochlear implants. Methods: Speech recognition by 10 Clarion cochlear implant users was evaluated by means of 4 different speech processing strategy/electrode configuration combinations; ie, SAS and Continuous Interleaved Sampling (CIS) strategies were each used with monopolar (MP) and bipolar (BP) electrode configurations. The test measures included consonants, vowels, consonant-nucleus-consonant words, and Hearing in Noise Test sentences with a +10 dB signal-to-noise ratio. Additionally, subjective judgments of sound quality were obtained for each strategy/configuration combination. Results: All subjects but 1 demonstrated open-set speech recognition with the SAS/MP combination. The group mean Hearing in Noise Test sentence score for the SAS/MP combination was 31.6% (range, 0% to 92%) correct, as compared to 25.0%, 46.7%, and 37.8% correct for the CIS/BP, CIS/MP, and SAS/BP combinations, respectively. Intersubject variability was high, and there were no significant differences in mean speech recognition scores or mean preference ratings among the 4 strategy/configuration combinations tested. Individually, the best speech recognition performance was with the subject's everyday strategy/configuration combination in 72% of the applicable cases. If the everyday strategy was excluded from the analysis, the subjects performed best with the SAS/MP combination in 37.5% of the remaining cases. Conclusions: The SAS processing strategy with an MP electrode configuration gave reasonable speech recognition in most subjects, even though subjects had minimal previous experience with this strategy/configuration combination. The SAS/MP combination might be particularly appropriate for patients for whom a full dynamic range of electrical hearing could not be achieved with a BP configuration.
Laryngeal Epithelial Defenses against Laryngopharyngeal Reflux: Investigations of E-Cadherin, Carbonic Anhydrase Isoenzyme III, and Pepsin
Authors: Gill Gulnaz A. , Johnston Nikki , Buda Andrea , Pignatelli Massimo , Pearson Jeffrey , Dettmar Peter W. , Koufman Jamie 
Published: October 2014

Objectives: This is the third annual report of an international research network studying the cellular impact of laryngopharyngeal reflux (LPR) on laryngeal epithelium. The objective of this study was to investigate the presence of E-cadherin (epithelial cadherin; the intercellular junctional complex protein) in relation to the presence of (intracellular) pepsin and carbonic anhydrase isoenzyme III (CAIII). Methods: Fifty-four laryngeal biopsy specimens from 18 LPR patients were studied by immunohistochemistry and Western blotting for pepsin, E-cadherin, and CAIII. These data were compared to those from normal control subjects analyzed in another research study. Results: Intracellular pepsin was detected in LPR patients, but not in controls. E-cadherin expression was reduced in patients with LPR. Carbonic anhydrase III expression was not found in the vocal fold or in the majority of samples taken from the ventricle of LPR patients and was inversely associated with E-cadherin membranous expression. Conclusions: The findings of depleted E-cadherin and CAIII and the presence of pepsin appear to correlate with LPR. The reduced protective response indicated by the reduced expression of CAIII may play an important role in the disruption of the intercellular barrier associated with the down-regulation of E-cadherin.
Immunohistochemical Analyses of MUC5AC Mucin Expression in Sinus Mucosa of Children with Sinusitis and Controls
Authors: Peña Maria T. , Aujla Pawandeep K. , Patel Kantilal M. , Zalzal George H. , Rose Mary C. 
Published: October 2014

Objectives: The purpose of this study was to analyze MUC5AC protein expression in sinus mucosal specimens of children with and without chronic sinusitis. Methods: Morphometric, histologic, and immunohistochemical analyses were carried out on sinus mucosa of 7 children with chronic sinusitis and 6 children without sinusitis. Results: MUC5AC protein was expressed in a subset of goblet cells in the surface epithelium, but not in the submucosal glands in either pediatric population. The number of goblet cells that expressed MUC5AC mucin was not significantly different in patients with and without chronic sinusitis. All specimens had similar numbers of goblet cells in the surface epithelium. Conclusions: The data demonstrate that neither goblet cell hyperplasia nor increased MUC5AC expression occurs in the sinus mucosa of children with chronic sinusitis. This suggests that in contrast to asthma, in which goblet cell hyperplasia is present in the lower respiratory tract, mucus hypersecretion in pediatric chronic sinusitis may involve other secretory cells, eg, submucosal glandular cells, and mucins secreted by these glandular cells.
Morphological and Histologic Examination of the Epiglottis: Implications for Improving Epiglottic Closure Technique
Authors: Yokoyama Shuji , Kano Makoto , Watanabe Mutsumi , Ogawa Hiroshi , Omori Koichi 
Published: October 2014

Objectives: We conducted a histologic examination and measured the tension on the epiglottis to determine how dehiscence of the epiglottis can be prevented after epiglottic closure surgery. Methods: We classified configurations of the epiglottis into flat, intermediate, and omega types and studied the histology of each type. We also measured the tension in each of these 3 morphological types on 4 regions of the epiglottis (upper, middle, and lower points, and the cuneiform tubercle) at 3 different times: before incision, after median incision, and after reversed-Y incision. Results: No histologic differences were evident among the epiglottic types. In the flat and intermediate types, the tension measured before incision decreased significantly upon completion of the median incision at every point. In these 2 types, the reversed-Y incision resulted in a further significant decrease in tension at the middle and lower points. In the omega type, the tension was low before incision and was not significantly reduced by either incision. Conclusions: We demonstrated that a median incision alone effectively decreased tension sufficiently to prevent dehiscence. The reversed-Y incision was even more effective for decreasing tension at the middle and lower points.
Preoperative Predictive Factors for Hearing Preservation in Vestibular Schwannoma Surgery
Authors: Rohit  , Piccirillo Enrico , Jain Yogesh , Augurio Angela , Sanna Mario 
Published: October 2014

Objectives: We performed a retrospective chart review to evaluate the various predictive factors for postoperative hearing preservation in the surgical management of vestibular schwannoma. Methods: Of 792 patients operated on for vestibular schwannoma between April 1987 and July 2002, 107 were candidates for hearing preservation surgery. These patients were divided into group 1 (hearing preserved) and group 2 (hearing not preserved), and both of these groups were evaluated for age, sex, pure tone average, sound discrimination score, tumor size, and auditory brain stem response parameters. A corrected χ2 test and a corrected t-test were used for statistical analysis. Multiple regression analysis was further done to evaluate independent predictive factors, either alone or in combination. The results were evaluated by use of the modified Sanna classification and the guidelines of the American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS). Results: Preoperative pure tone average and tumor size were the 2 predictive factors in our study. A Pearson correlation test showed that there was no multicollinearity between the factors. On multiple regression analysis by backward elimination of nonsignificant factors, we found that tumor size is an independent predictive factor for postoperative hearing. According to the modified Sanna classification, postoperative hearing was preserved in 11.2% of patients (equivalent to class A of AAO-HNS guidelines). Conclusions: In our series, preoperative pure tone average and tumor size were found to be predictors of postoperative hearing levels.