bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Personalized Medicine Approach to Treat Malignant Proliferating Trichilemmal Tumors
Authors: Sewell Andrew , Ogbeide Evbu , Issaeva Nataila , Lovly Christine , Boyd Alan , Gilbert Jill , Yarbrough Wendell G. 
Published: February 2015

ObjectiveProliferating trichilemmal tumors (PTT) are rare skin neoplasms arising from the hair root sheath. Although benign, PTT can be recurrent and locally destructive, rarely undergoing malignant transformation into malignant PTT (MPTT), with potential for distant metastases. Current treatments for MPTT are largely anecdotal and poorly validated.MethodWe report a patient who presented with multiple recurrences and distal metastases of MPTT. SNaPShot analysis utilizing multiple PCR was performed on both mediastinal nodes and MPTT neck mass in order to detect cancer‐related mutations. Cell culture and biochemical assays were performed to correlate with clinical response to targeted therapy.ResultsA PIK3CA activating mutation (H1047R) was found in a distant metastasis and local MPTT tissue. Specific activating PIK3CA mutations have been found in many human epithelial tumors, including head and neck squamous cell carcinoma and lung cancer. The reported patient enrolled in a Phase IA trial using BYL719, a selective PI3Kα tyrosine kinase inhibitor. Primary cells derived from the patient tumor were very sensitive to multiple agents targeting the PI3K pathway (eg, PI3K, PI3K/mTOR, and AKT). Five additional patients with PTT from our institution had SNaPShot performed on formalin‐fixed, paraffin‐embedded tissue.ConclusionThere are no suggested treatment guidelines for patients with rare tumors like MPTT. They receive a variety of chemotherapeutic agents based on limited clinical data. We suggest that rare tumors be screened for common oncogenic mutations. This will allow clinicians to personalize medical treatment based on identified dysregulated molecular pathways.
An Exploration of Factors Predicting Malnutrition in Head and Neck Cancer
Authors: Hammerlid Eva B. , Silander Ewa 
Published: February 2015

ObjectiveMalnutrition is common among head and neck cancer patients and it impacts survival and quality of life. This study aims to identify predictors of malnutrition at time of diagnosis in order to enable early nutritional support and prevent malnutrition in patients at risk.MethodA total of 134 patients with advanced oral and pharyngeal cancer were included in the study. Weight, body mass index (BMI), fat‐free mass (FFM), dysphagia, and quality of life were measured at diagnosis and after 6 months. Two definitions for malnutrition were applied: >10% weight loss and BMI <20 after 6 months.ResultsSix months after diagnosis, 66% of the patients were malnourished, applying >10% weightloss definition and 26% applying BMI <20. In multivariate analysis, chemotherapy and high BMI at diagnosis were the strongest predictors of malnutrition, using 10% weight loss definition and low BMI followed by low FFM and dysphagia were the strongest predictors using BMI <20.ConclusionInconsistent predictors were found depending on the definition used for defining malnutrition. Unintended weight loss of more than 10% seems to be the most reasonable definition for malnutrition since this also correlated to a significant loss of FFM, consequently pointing out treatment with chemoradiotherapy as the strongest predictor for malnutrition.
bFGF Redox Signaling in Hypopharyngeal Cancer
Authors: Fennessy Brendan G. , Woolley John F. , Cotter Thomas G. 
Published: February 2015

ObjectiveExamine the role of basic fibroblast growth factor (bFGF) in the generation of reactive oxygen species (ROS) in FaDu pharyngeal carcinoma cell lines. Evaluate the consequences of disrupting bFGF mediated signaling in tumor cells.MethodBasic science study of hypopharyngeal carcinoma from 2010 to 2012. The study subjects were FaDu cell lines. Setting: In vitro. Interventions: Disrupting bFGF signaling. Outcomes Measured: ROS generation, apoptosis.ResultsbFGF and fibroblast growth factor receptor are co‐expressed in FaDu squamous cell carcinoma cells. ROS generation in FaDu cells takes place in response to bFGF stimulation, and is inhibited with a FGF receptor inhibitor, in a NADPH‐oxidase dependent and cyclooxygenase‐independent manner. Disrupting bFGF‐FGFR signaling results in an early strong apoptotic stimulus involving caspase‐3, ‐9, and poly ADP ribose polymerase.ConclusionbFGF‐mediated signaling in hypopharyngeal cancer has an important role in cell survival and proliferation.
Bilateral Water‐Clear Cell Double Parathyroid Adenomas
Authors: Lawton Brian , Nathan Cherie‐Ann O. , Chaudhery Shubnum 
Published: February 2015

Objective1) Describe the pathologic findings of water‐clear cell hyperplasia and adenomas. 2) Understand the clinical presentation of a patient with primary hyperparathyroidism caused by double water‐clear cell parathyroid adenomas.MethodA 66‐year‐old white woman was referred to our clinic with hypercalcemia, osteoporosis, and hyperparathyroidism. Sestamibi scan was nonlocalizing and thyroid ultrasound revealed bilateral thyroid nodules. She underwent total thyroidectomy and bilateral superior parathyroidectomy. The inferior parathyroid glands appeared grossly normal and were left intact.ResultsIntraoperative PTH dropped from 209 to 39.5 and postoperative calciums returned to the normal range. Pathology revealed bilateral superior parathyroid adenomas with the right superior gland weighing 2.14 g and the left weighing 1.27 g. Both glands were consistent with water‐clear cell hyperplasia. The thyroid gland, of which FNA had returned preoperatively as atypia, revealed multinodular goiter.ConclusionWCC hyperplasia is a rare cause of primary hyperparathyroidism. To our knowledge only one other case has been reported that revealed bilateral water‐clear cell parathyroid adenomas. Unlike primary chief cell hyperplasia, WCC hyperplasia is not associated with MEN syndromes, and the incidence has decreased significantly over the past 25 years.
Cancer Knowledge and Screening among American Indians
Authors: Dwojak Sunshine M. , Emerick Kevin S. , Guadagnolo Beverly A. , Sargent Michele , Deschler Daniel G. , Petereit Daniel G. 
Published: February 2015

ObjectiveTo establish the level of awareness of risk factors and early symptoms of head and neck cancer among American Indians (AI) in South Dakota, and to determine if a community‐based head and neck (H&N) cancer screening is an effective method to detect positive findings in this population.MethodThe European Head and Neck Society’s “About Face” survey was augmented with questions on demographics and human papilloma virus (HPV). Surveys were administered at 2 community events, and participants could choose to take part in a H&N cancer screening. Knowledge scores were created for correct responses to H&N cancer questions.ResultsA total of 223 people completed the survey, and 126 participated in the screening: 92% were American Indian, and 32% had pre‐existing knowledge of H&N cancer. Mean knowledge scores were 17 (61%) out of 28. Factors that predicted significantly higher H&N cancer knowledge were having or knowing someone with cancer (P =. 002), race (P =. 02), and education (P =. 002). Fifty‐nine percent of participants had previous awareness of HPV, but only 36% believed that it was associated with H&N cancer. Ten (8%) people had positive findings on examination. The only significant predictor of a positive finding was smoking history, with all 10 findings being current or past smokers (P =. 02).ConclusionThere are gaps in AI knowledge of H&N cancer risk factors and early symptoms, particularly regarding the role of HPV. These results highlight the need for further public education. Community‐based H&N cancer screening in the AI community is an effective means to identify early findings in smokers.
Clinical Thermal Effects of Flexible Fiber CO2 Laser
Authors: Mendelsohn Abie , Remacle Marc J. , Lawson Georges , Bachy Vincent , Weynand Birgit 
Published: February 2015

ObjectiveTo date no clinical investigations have reported on the coagulation effects of flexible fiber CO2 laser delivery to head and neck tissue, the results of which have a direct impact for the progression of transoral laser microsurgery. The objective of the present study was to investigate the histopathologic thermal effects of a flexible fiber CO2 laser delivery system.MethodA prospective histopathologic analysis of 15 consecutive transoral laser microsurgery specimens using the same CO2 fiber system were subjected to dedicated histopathologic analyses. Repeated coagulation depth measurements of 2 independent clinical pathologists were averaged. Specimens were stratified into lymphoid or epitheloid groups for further comparison.ResultsThe mean coagulation depth across all specimens was 81.53 um (SD, 38.73; range, 15.00‐360.34). Although the mean coagulation depth in lymphoid tissues (mean, 75.38 um; SD, 15.91) was elevated over the mean depth of epitheloid tissues (mean, 90.74 um; SD, 31.21), there was no significant difference (P =. 11).ConclusionWith an average coagulation depth of 81.53 um the flexible fiber thermal effect compares favorably to tissue effect of line‐of‐sight lasers. Epitheloid and lymphoid tissues displayed equivalent coagulative effects. To our knowledge, this is the first clinical description of flexible CO2 laser delivery thermal effects of tissues of the head and neck.
CLN Metastasis with Papillary Thyroid Cancer in the Isthmus
Authors: Lee Jin‐Choon , Lee Byung‐Joo , Wang Soo‐Geun , Lim Yun‐Sung , Lee Yoon‐Se 
Published: February 2015

ObjectiveTo investigate the patterns and predictive factors of central lymph node metastasis in patients with papillary thyroid cancer located in the isthmus.MethodRetrospective chart review. We evaluated 447 cases with solitary nodule out of 1257 patients with papillary thyroid cancer who underwent total thyroidectomy with bilateral central lymph node compartment dissection. The patients were analyzed in 2 groups: group I, patients with cancer located in the isthmus (n = 35) and group II, patients with cancer in other regions (n = 412). We evaluated the clinicopathological characteristics and predictive factors and compared the 2 groups.ResultsThe frequency of central lymph node(CLN) involvement was 52.1% (233 cases) in the patients with single nodule of papillary thyroid cancer. The frequency of papillary thyroid cancer located in the isthmus was 7.8% (35 cases). Mean age at diagnosis in group I and II was 45.3 years and 46.2 years, respectively (P =. 892). Size, sex, extrathyroidal extension, and ultrasound findings (eg, marked hypoechoic, taller than wide) showed no significant difference between the 2 groups. CLN metastasis in group I and group II was 62.5% and 56.5%, respectively (P =. 228). Bilateral CLN metastasis was 18.8% in group I and 11.5% in the group II (P =. 067).ConclusionPapillary thyroid cancer located in the isthmus showed a tendency to involve bilateral CLN. In conclusion, it is recommended that bilateral central compartment neck dissection is needed as an appropriate surgical option for papillary thyroid cancer with single nodule located in the isthmus.
Comparative Study of Robotic and Endoscopic Submandibular Gland Resection
Authors: Koh Yoon Woo , Lee Hyoung Shin , Kim Won Shik , Hong HyunJun , Lee So‐Yoon , Chung Hyun Pil , Choi Eun Chang 
Published: February 2015

ObjectiveCompare the short‐term clinicopathologic results of robot‐assisted submandibular gland (SMG) resection and endoscopic SMG resection via the retroauricular approach.Study DesignProspective review of submandibular gland tumor or chronic dialadenitis conducted for 1 year in a tertiary hospital.Subjects StudiedPatients who underwent robotic or endoscopic submandibular gland resection via retroauricular approach. Clinical factors were compared using Mann‐Whitney test.ResultsThe operation was successful in all patients of 2 groups without any significant intraoperative complications or conversion to open surgery. The operating time in the endo group was longer than the robot group (P =. 034). Total amount (P = 1.000) and duration (P =. 801) of drain between the 2 groups showed no significant difference. The mean duration of hospital stay was also comparable between the groups (P = 1.000). No significant difference was observed in the overall perioperative complications between the 2 groups. Patients of both groups showed excellent cosmetic satisfaction and showed no significant difference (P =. 891).ConclusionRobotic and endoscopic SMG resection were both feasible with acceptable perioperative outcomes and excellent cosmetic results. Robot assisted resection showed benefit in shorter operating time.
Diagnosis of Nonrecurrent Laryngeal Nerve by CT Angiography
Authors: Kim JiHoon , Choi Hong‐Shik , Kim Si‐Hong 
Published: February 2015

ObjectiveNonrecurrent laryngeal nerve (NRLN) is found in 0.5% to 1.0% of the entire population. NRLN mostly develops on the right an anomaly of the subclavian artery. Through 3 cases, we report a simple method to diagnose an anomaly of the right subclavian artery with NRLN.MethodCase 1. A 52‐year‐old woman was admitted with a thyroid mass. After a neck CT and fine‐needle aspiration biopsy, she had an operation from thyroid papillary carcinoma. Intraopera‐tively, we found NRLN and preserved it. Case 2. A 33‐year‐old woman visited us with a cervical mass. She was diagnosed with thyroid follicular carcinoma. Intraoperatively, we found NRLN cut. Case 3. A 68‐year‐old woman complained of a recurring thyroid mass. Preoperatively, we predicted NRLN through CT angiography. Intraoperatively, we identified the right NRLN.ResultsIn case 3, NRNL was expected through neck CT angiography. Intraoperatively we could find NRLN more easily than case 1 and 2.ConclusionIf we can predict NRLN preoperatively, it will be possible to preserve NRLN easily. We can differentiate arteria lusoria from normal findings more precisely with neck CT angiography as compared with neck CT. We diagnosed NRLN preoperatively with neck CT angiography, and this was helpful for us to preserve RLN intraoperatively. We report the case that we identified and preserved NRLN more easily by predicting NRLN with neck CT angiography.
Survival following TORS for Oropharyngeal SCC
Authors: Kakarala Kiran , Durmus Kasim , Agrawal Amit , Carrau Ricardo L. , Old Matthew O. , Teknos Theodoros N. , Ozer Enver 
Published: February 2015

ObjectiveReport patient characteristics and oncologic results of transoral robotic surgery (TORS) for oropharyngeal squamous cell carcinoma (OPSCC).MethodRetrospective review of 52 patients who underwent TORS with neck dissection and postoperative adjuvant treatment as indicated for OPSCC within a prospective single‐arm cohort study at an academic medical center. Tumor stage, human papillomavirus (HPV) status, pathology (margin status, nodal status, extracapsular spread), and survival data were collected.ResultsForty‐two patients had HPV testing with 36 patients being HPV positive (85.7%). Most patients presented with advanced stage disease: 40 patients (76.9%) stage IV and 6 patients (11.5%) stage III. Mean length of follow‐up was 21 months. Overall survival at 1 and 2 years was 97.9% and 72.7%, respectively, and disease‐specific survival at 1 and 2 years was 100% and 84.2%, respectively. There were 2 local recurrences (3.8%), 3 regional recurrences (5.8%), and 2 distant recurrences (3.8%). Subset survival analysis based on HPV status is presented along with predictors of survival in multivariate analysis.ConclusionOncologic outcomes are promising for patients with advanced OPSCC treated with TORS and postoperative adjuvant therapy as indicated. Further prospective study stratified by HPV status is needed to determine the role of TORS in the management of these patients.
Bone Morphogenic Protein (rhBMP‐2) Repair of Alveolar Clefts
Authors: Wudel Justin M. , Valdez Sondra , Perkins Jonathan N. , Blanchard Ashley , Allen Gregory C. 
Published: February 2015

ObjectiveAn alternative to autogenous bone grafting for maxillary alveolar cleft repair is the application of recombinant human bone morphogenic protein in a collagen sponge matrix. Our aim was to quantify bone growth, examine parental satisfaction following the procedure, and evaluate dental/orthodontic outcomes for patients who underwent rhBMP‐2 alveolar cleft repair.MethodA retrospective review was performed on all patients who underwent alveolar cleft repair at a tertiary children’s hospital from 2007‐2010. Satisfaction questionnaires were completed by parents, dentists, and orthodontists. Degree of bone fill was determined by independent grading of postoperative Panorefilms.ResultsThirty‐two of the 42 patient cohort had postoperative Panorefilms. Independent grading demonstrated 36.7% had >75% of the alveolar cleft filled, 47.8% had 50%‐75% filled, and 17.3% had <50% filled. Mean length of follow‐up was 24.4 months. One minor complication of bony overgrowth into the nasal cavity was reported. Parent and patient satisfaction regarding surgical outcome was 93.3% and 83.3% respectively. Of dentist respondents, 77.8% reported that the bone quality and alveolar ridge mucosal repair allowed for dental treatment. Of orthodontist respondents, 87.5% reported the graft enabled treatment, and 68.7% felt the graft prevented tooth root exposure and resorption.ConclusionAlveolar cleft repair using rhBMP‐2 provides adequate bone growth to support dental and orthodontic treatment with minimal complications, while alleviating the need for autogenous bone grafting and its morbidity. In addition, the majority of patients and parents are highly satisfied with the surgical outcome.
Extraesophageal Reflux: Throat and Gastrointestinal Patients
Authors: Powell Jason , Nikkar Ali , Doyle Jill , Wilson Janet A. 
Published: February 2015

ObjectiveDiagnosis and management of EER remains controversial. We have validated a reliable Comprehensive Reflux Symptom Scale (CReSS) incorporating 34 possible symptoms of EER and gastroesophageal reflux disease (GERD). We aimed to compare CReSS in healthy volunteers, throat clinic attenders, and a heterogeneous group referred for upper gastrointestinal (GI) endoscopy.MethodThe CReSS was administered to 532 participants: 103 healthy volunteers, mean age 55 years, 39% male, 15% smokers; 175 throat clinic attenders, mean age 56 years, 37% male, 11% smokers; and 254 attenders for GI endoscopy, mean age 58 years, 41% male, 14% smokers. Regular recent antacid use was recorded.ResultsThe mean CReSS total was 6.5 (SD 8.14) in volunteers, significantly lower (P <. 001) than in throat 32.19 (SD 22.37) or GI patients 39.67 (SD 26.14). CReSS totals were independent of age. All items were endorsed by at least 17% of throat patients, 30% of GI patients. The top symptoms in throat patients were throat clearing, hoarseness, globus, and mucus (62%‐82% endorsement); 48 were on regular antireflux medication, and more of this subgroup had heartburn (75%), than of those who were not (38%). Eighty‐six percent of the 148 GI patients on antireflux therapy also experienced heartburn, but only 56% of the remainder.ConclusionEER and GERD symptoms are incompletely understood and imperfectly responsive to antireflux therapy. The broad endorsement of all CReSS items by both patient groups supports recent evidence for an EER‐GERD disease continuum. Back pain emerges as an under‐recognized reflux symptom. Over‐restrictive questionnaires reinforce speculative concepts of reflux disease.
Helicobacter pylori Is Present in Head and Neck Cancer Lesions
Authors: Lechner Matthias , Rees Louisa , Cogan Tristan A. , Weinberger Paul , Birchall Martin A. 
Published: February 2015

ObjectiveTo investigate the presence of Helicobacter pylori (H pylori), a key pathogen in chronic gastritis and recognized as a major cause of gastric cancer, in cancer samples and adjacent normal tissues of the head and neck region.MethodTwenty‐eight fresh‐frozen HNSCC samples and 11 biopsies from normal tissue were obtained from fully informed and consented patients at GSHU. From 8 of these cancer samples adjacent normal tissue was available. FISH using a probe for H pylori was used to examine sections of these samples and enumerate the bacterium.ResultsThe average number of H pylori per biopsy section was significantly higher in the SCC group (P <. 03) than controls for all sites examined. Most interestingly, in paired SCC and adjacent normal biopsies from the same patient the average number of H pylori per biopsy was significantly higher in the SCC tissue compared with the adjacent normal tissue (P <. 006). These data indicate that H pylori shows a numerical and spatial association with squamous cell cancer lesions of the head and neck.ConclusionThe fact that H pylori is present in higher numbers in the tumor tissue compared with adjacent tissue and tissue obtained from healthy individuals suggests either a predisposition for the colonization of SCC with H pylori, or a causative role for the bacterium in cancer at these sites.
Office‐Based Injection Laryngoplasty with Hyaluronic Acid Gel
Authors: Upton David , Johnson Matthew , Zelazny Sherri , Dailey Seth H. 
Published: February 2015

ObjectiveMany injectables are available for vocal fold augmentation, but the role of Juvederm Ultra Plus hyaluronic acid gel has not been well examined. This study was conducted to assess the safety and clinical effectiveness of office‐based injection laryngoplasty of Juvederm Ultra Plus gel in patients with glottic insufficiency (GI).MethodProspective case series of 27 patients with GI treated with unsedated office‐based injection laryngoplasty of Juvederm Ultra Plus gel over a 20 month period. Preinjection acoustic and aerodynamic measures, Voice Handicap Index, Glottal Function Index, and Dysphonia Severity Index were compared with values recorded at 1 and 4 months postinjection.ResultsData for 26 patients were available for follow‐up analysis at 1 month, and 12 patients’ data were available at 4 months. Etiologies of GI included presbylaryngis (n = 11), unilateral vocal fold paralysis (n = 10), scar (n = 2), and others (n = 5). Eighty‐nine percent underwent transoral injection, and 11% received transcervical injections. Significant improvements compared to preinjection levels (P <. 03) were shown in all outcome measures at 1 and 4 months, respectively. Although there were no procedural complications, 1 patient required intravenous steroid therapy for temporary glottic inflammation that resolved without permanent sequelae.ConclusionThe injection of Juvederm Ultra Plus gel is a safe procedure that allows for reliable improvements in objective and subjective outcome measures of vocal function in patients with GI provided the surgeon remains alert for the possibility of postprocedural injection site inflammation.