bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prognostic markers in stage I oral cavity squamous cell carcinoma
Authors: Dunkel Johannes , Vaittinen Samuli , Grénman Reidar , Kinnunen Ilpo , Irjala Heikki 
Published: August 2013

Objectives/HypothesisEarly‐stage oral squamous cell carcinoma (OSCC) treatment is based on anatomic location, clinical TNM staging, and histological grade. It is a heterogeneous disease group. Classification of patients with OSCC by immunohistochemical analysis of established oncoproteins and evaluate disease course was our primary objective. Characterization of stage I OSCC patients in Southwest Finland was our secondary objective.Study DesignImmunohistochemical analysis of tumor specimens and retrospective analysis of patient data of the patient treated in Turku University Hospital for T1N0M0 OSCC during the years 2000‐2004.MethodsParaffin‐embedded tumor specimens from 35 OSCC patients were collected and analyzed for HIF‐1α, CD44, p16, Ki67, and podoplanin by immunohistochemistry and correlated with clinical findings.ResultsTumoral CD44 and HIF1‐α expression levels, in combination, predicted 5‐year disease‐free survival. Reduced expression of CD44 and elevated expression of HIF1‐α is associated with the lowest probability of disease‐free survival compared to the population as a whole (P < .001 in Kaplan‐Meier analysis). Patients with grade I tumors demonstrated improved disease‐specific survival compared to those with grade II tumors (P = .027). No association was seen between p16 expression, Ki67 labeling index, or podoplanin expression and prognosis in our 35 specimens.ConclusionsHIF‐1α and CD44 immunohistochemical detection could potentially serve as a prognostic tool in therapy selection for early‐stage OSCC. Laryngoscope, 123:2435–2441, 2013
Outcome of a multimodality approach to the management of idiopathic subglottic stenosis
Authors: Nouraei S. A. R. , Sandhu G. S. 
Published: August 2013

Objectives/HypothesisTo assess the results of treating idiopathic subglottic stenosis (ISS), determine predictors of treatment success and outcome, and better define roles and limitations of endoscopic and open surgery.Study DesignProspective observational study.MethodsFifty‐four consecutive patients were treated between 2004 and 2012. Patient, stenosis and treatment details, complications, open surgery rates, and outcomes were recorded. Regression analyses were used to identify predictors of endoscopic treatment success; treatment frequency; and functional outcomes in airway, dyspnea, voice, and swallowing domains.ResultsAll patients were female and mean age at diagnosis was 48 ± 12 years. Symptoms‐to‐diagnosis latency was 21 ± 20 months. There were 10 concomitant glottic and subglottic stenoses. Most lesions were Myer‐Cotton grade 3 (48%). Overall, 78% of patients were managed endoscopically. Treatment included intralesional corticosteroids, laser surgery, balloon dilation, and temporary silastic stenting in selected cases. Annual intervention rate was 1.07 ± 0.79. Mean follow‐up was 45 months. Factors associated with intervention frequency were stenosis location and severity. Twelve patients underwent anteroposterior laryngotracheal reconstruction with biological inhibition. This resulted in disease remission in all patients with subglottic stenosis, and in most patients with concomitant glottic and subglottic stenosis. Patients with total laryngotracheal stenosis required ongoing treatment for glottic disease. All patients maintained prosthesis‐free airways, but in one patient this required a laryngectomy. Most patients achieved good functional outcomes. Stenosis location was the only independent predictor of dyspnea and voice outcomes.ConclusionsISS can be effectively treated with endoscopic surgery or a bespoke open reconstructive procedure that does not compromise on female voice quality.Level of Evidence4. Laryngoscope, 123:2474–2484, 2013
Obesity and the risk of chronic rhinosinusitis, allergic rhinitis, and acute otitis media in school‐age children
Authors: Sidell Douglas , Shapiro Nina L. , Bhattacharyya Neil 
Published: August 2013

Objectives/HypothesisTo determine if obesity is a significant risk factor for acute otitis media (AOM), allergic rhinitis (AR), or chronic rhinosinusitis (CRS) in children and to understand the potential otolaryngological implications of childhood obesity.Study DesignCross‐Sectional Analysis.MethodsThe 2006 and 2008 the Medical Expenditure Panel Survey was utilized to identify school‐aged children with AOM, AR, and/or CRS. Risk factors for the diagnoses extracted included standard demographics and the presence or absence of obesity. Multivariate analyses were conducted for associations between childhood obesity and AOM, AR, and CRS.Results42.1 million (95% CI, 40.4–44.2) school‐age children (unweighted N = 10623) were sampled in 2006 and 2008. There was a slight male predominance (51.0% [95% CI, 49.8–52.2]). Of these patients, 2.2 million (95% CI 1.9–2.4) received a diagnosis of AOM, 4.0 million (95% CI 3.6–4.4) received a diagnosis of AR, and 1.7 million (95% CI 1.4–1.9) received a diagnosis of CRS. Approximately 9.3 million (95% CI 8.7–10.0) children were obese, representing 22.2% (95% CI 21.0–23.3) of the U.S. population (age 6–17). Utilizing an adjusted multivariate model, childhood obesity was found to be associated with AOM (odds ratio, 1.44; [95% CI 1.08–1.93]; P = 0.033). Significant associations between obesity and AR (OR 1.14; [95% CI 0.88–1.47]; P = 0.60) or obesity and CRS (OR0.73; [95% CI 0.48–1.10]; P = 0.79) were not identified.ConclusionChildhood obesity appears to be associated with the development of AOM; however, an association between obesity and AR or CRS was not demonstrated. Given that in the United States nearly one‐fourth of all children seeking health care are obese, these data may have important preventative care implications.Level of Evidence2C. Laryngoscope, 123:2360–2363, 2013
Use of pressure‐volume loops for physiological assessment of adult laryngotracheal stenosis
Authors: Nouraei S. Mahmoud , Patel Anil , Virk Jag S. , Butler Colin R. , Sandhu Guri S. , Nouraei S. A. Reza 
Published: August 2013

Objectives/HypothesisTo assess the utility of intraoperative pressure‐volume curves as an objective method of physiological disease stratification and outcomes assessment in adult laryngotracheal stenosis.Study DesignProspective observational study.MethodsWe prospectively studied 42 tracheotomy‐free patients undergoing endoscopic laryngotracheoplasty over 18 months. Patient and lesion characteristics were obtained. Dyspnea severity was assessed using the Medical Research Council scale. Preoperative spirometry and intraoperative pulmonary compliance were recorded.ResultsThere were 19 male and 23 female patients, and the mean age at treatment was 44 ± 16 years. There were 14 Myer‐Cotton 1 lesions and 14 and 13 patients had grade 2 or 3 stenoses, respectively. Pulmonary compliance was strongly correlated with anatomical stenosis severity (r = 0.8, P < .0001) and perceptual dyspnea severity (r = 0.73, P < .0001). The strengths of correlation between pulmonary compliance and anatomical stenosis severity was significantly greater than those between forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and peak expiratory flow. The strength of correlation between pulmonary compliance and perceptual dyspnea severity was significantly greater than those between FEV1 and FVC with perceptual dyspnea severity. The two independent determinants of pulmonary compliance were Myer‐Cotton stenosis severity (P < .0001) and patient age (P = .013).ConclusionsPulmonary compliance provides an objective measure of physiological airway impairment. It correlates well with anatomical disease severity and perceptual dyspnea severity. Its more widespread use in adult patients and research into its utility in pediatric airway stenosis is recommended.Level of Evidence4 Laryngoscope, 123:2735–2741, 2013
Pathological study of otitis media with effusion after treatment with intranasal pulmonary surfactant
Authors: Zhu Zheng Hua , Shan Ying Jun , Han Yang , Zhu Li Wei , Ma Zhao Xin 
Published: August 2013

Objectives/HypothesisTo evaluate the histopathological effect of intranasal pulmonary surfactant (PS) on the eustachian tube (ET) in guinea pigs with otitis media with effusion (OME).Study DesignRandomized control trial.MethodsNonviable heat‐killed Hemophilus influenzae solution was injected into the tympanum of guinea pigs by a trans‐eardrum approach to establish OME. Guinea pigs were divided into four groups: normal controls (group A), untreated OME (group B), saline‐treated (group C), PS‐treated (group D). The response threshold of the guinea pigs was measured by auditory brainstem response (ABR), and data were analyzed by one‐way analysis of variance. The histopathological changes in the osseous, cartilaginous, and muscular portions of the ET were observed systematically by light microscopy.ResultsThe ABR threshold in OME group B was raised significantly compared with normal group (A). The response in saline‐treated group C was not statistically significantly different compared with OME group B. Seven days after intranasal dripping of pulmonary surfactant in PS‐treated group D, the response threshold showed at statistically significant decrease compared with OME B and saline‐treated C groups. In OME group B and saline‐treated group C, mucosa showed swelling with goblet cell hyperplasia, and cilia were irregularly arranged. In PS‐treated group D, there was slight mucosal swelling with fewer goblet cells, and cilia were regularly arranged, similar to the normal group A.ConclusionsThe findings of the study indicate that intranasal pulmonary surfactant drops have protective and hyposecretory effects on the mucociliary system of the ET in guinea pigs suffering from OME.Level of EvidenceNA. Laryngoscope, 123:3148–3155, 2013
Juvenile nasopharyngeal angiofibroma
Authors: Chan Kenny H. , Gao Dexiang , Fernandez Patrick G. , Kingdom Todd T. , Kumpe David A. 
Published: August 2013

Objectives/HypothesisOperative complications and tumor recurrence in juvenile nasopharyngeal angiofibroma (JNA) are measurable and meaningful outcomes. This study aimed to assess the association of these two outcomes to various clinical indices and in particular, vascular determinates.Study DesignRetrospective cohort study.MethodsAn 18‐year retrospective chart review of an academic tertiary center was undertaken. Data from clinical notes, imaging studies, and arteriograms were analyzed.ResultsThirty‐seven male (mean age, 14.4 years) patients were included in the study. Tumor stages included: IA (three), IB (three), IIA (14), IIB (three), IIC (five), IIIA (five), and IIIB (four). Four complications (cerebrospinal fluid leak, cerebral vascular accident, and two transient ocular defects) occurred. Eight recurrences occurred within 24 months following surgery. Complications were associated with estimated intraoperative blood loss (EBL) (P = .045). Tumor recurrence was associated with feeding vessels from the contralateral internal carotid artery (ICA) (P = .017). EBL was significantly associated with surgical technique used. EBL, tumor stage, and tumor vascular supply were significantly associated with each other.ConclusionsVascular factors were associated with JNA complication and tumor recurrence. EBL might affect complications, and contralateral ICA as a feeding vessel might affect recurrence. EBL was influenced by procedure choice and was interrelated to size and vascular supply of the tumor. This study bolsters the need to decrease intraoperative blood loss by preoperative embolization and use of endoscopic removal techniques. Furthermore, when branches of the ICA are found to be feeding vessels, greater surgical attention for a dry surgical field is encouraged.Level of Evidence4 Laryngoscope, 124:672–677, 2014
Ultrasound‐guided core needle biopsy of salivary gland lesions: A systematic review and meta‐analysis
Authors: Witt Benjamin L. , Schmidt Robert L. 
Published: August 2013

Objectives/HypothesisTo obtain summary estimates of the sensitivity and specificity of core needle biopsy for assessment of salivary gland lesions and to investigate sources of variation in accuracy between study locations.Study DesignData sources were PubMed, Embase, CAB Abstracts, CINAHL, BIOSIS, LILACS, PakMediNet, Trip Database, and the National Guideline Clearinghouse. Scopus was used to perform forward (citation) and backward (reference) searches of all potentially relevant studies.MethodsScreening, data extraction, and quality assessment were independently performed by two different assessors. Meta‐analysis was performed using bivariate mixed‐effects binary regression as implemented in Stata 12. Quality assessment was performed using the QUADAS‐2.ResultsThe summary estimates of sensitivity and specificity of core needle biopsy for diagnosis of malignancy were 96% (95% confidence interval [CI] = 87–99) and 100% (95% CI = 84–100), respectively. There was no significant heterogeneity in accuracy between studies. The quality of included studies was high, with low risk of verification bias. The risk of hematoma was 1.6% per procedure.ConclusionsCore needle biopsy has high sensitivity and specificity, and has low risk of complications. There is no significant variation in accuracy between study locations. Laryngoscope, 124:695–700, 2014
The role of indeterminate fine‐needle biopsy in the diagnosis of parotid malignancy
Authors: Fundakowski Christopher , Castaño Johnathan , Abouyared Marianne , Lo Kaming , Rivera Andrew , Ojo Rosemary , Gomez‐Fernandez Carmen , Messinger Shari , Sargi Zoukaa 
Published: August 2013

Objectives/HypothesisTo examine the significance of indeterminate fine needle aspiration biopsy in the diagnosis of parotid gland malignancy.Study DesignRetrospective case series, academic tertiary referral center.MethodsA total of 559 parotidectomies performed between the years of 2005 and 2010 were reviewed, with 56.7% (N = 317) meeting investigation eligibility criteria: primary parotid tumor, availability of fine‐needle aspiration biopsy, intraoperative frozen section, and final pathologic diagnosis. One‐hundred fifteen (n = 115, 36.3%) of the 317 parotid biopsies were interpreted as indeterminate. Clinical history, physical examination, operative findings, and histopathologic characteristics were analyzed. Multiple logistic regression, with deviation from means coding, was used to estimate the odds of malignancy in the indeterminate group and provide a comparison with reference to the average odds of malignancy over the overall sample.ResultsOverall final pathologic distribution of parotid masses (N = 317) was 82.3% benign and 17.7% malignant. Overall final pathologic distribution of parotid masses in the indeterminate group (n = 115) was 31.3% malignant and 68.7% benign. In comparison, the overall group (N = 317) had a decreased comparative percentage of malignant specimens at 17.7%. Interestingly, in the instance of an indeterminate biopsy, the odds of having a malignancy was estimated to increase by 1.98‐fold compared to overall mean odds of malignancy in the sample. Other statistically significant clinical predictors of parotid malignancy included history of prior malignancy, current tobacco user, locally invasive characteristics intraoperatively, and facial nerve involvement intraoperatively.ConclusionsIn the context of an indeterminate fine‐needle aspiration biopsy, an elevated index of suspicion for parotid malignancy may be warranted.Level of Evidence4. Laryngoscope, 124:678–681, 2014
Temporal trends in sleep apnea surgery: 1993–2010
Authors: Ishman Stacey L. , Ishii Lisa E. , Gourin Christine G. 
Published: August 2013

Objectives/HypothesisGrowing evidence supports the use of multilevel surgery to effectively address obstructive sleep apnea (OSA). We sought to characterize changes in the patterns of surgical sleep care over time.Study DesignRepeated cross‐sectional study.MethodsDischarge data from the US Nationwide Inpatient Sample for 232,470 patients who underwent nasal, palatal, or hypopharyngeal procedures for sleep disordered breathing or OSA from 1993 to 2010 were analyzed using cross‐tabulations and multivariate regression modeling.ResultsInpatient sleep surgical procedures increased from 97,363 performed in 1993–2000 to 135,107 in 2001–2010. Sleep surgery in 2001–2010 was associated with increased hypopharyngeal surgery (relative risk ratio [RRR] = 3.6, 95% confidence interval [CI] = 2.6–4.9, P < .001), tongue radiofrequency/midline glossectomy (RRR = 5.1, 95% CI = 3.4–7.5, P < .001), hyoid suspension (RRR = 6.8, 95% CI = 3.8–12.5, P < .001), nasal surgery (RRR = 1.3, 95% CI = 1.1–1.5, P = 0.002), and multilevel surgery (RRR = 5.6, 95% CI = 3.8–9.4, P < .001) and decreased tracheostomy (RRR = 0.58, 95% CI = 0.49–0.68, P < .001) compared to 1993–2000. Patients undergoing sleep surgery in 2001–2010 were more likely to have an OSA diagnosis (RRR = 1.9, 95% CI = 1.4–2.5, P < .001), obesity (RRR = 1.5, 95% CI = 1.4–1.7, P < .001), and advanced comorbidity (RRR = 2.4, 95% CI = 2.0–2.8, P < .001). In 2001–2010, surgeons (>23 cases/yr) in the top‐volume quintile were more likely to perform hypopharyngeal procedures (RRR = 2.4, 95% CI = 1.7–3.4, P < .001,) and to be associated with teaching hospitals (RRR = 1.5, 95% CI = 1.0–2.2, P = 0.034) and less likely to perform tracheostomy (RRR = 0.27, 95% CI = 0.18–0.40, P < .001). However, they represented only 17% of surgeons performing sleep surgery in contrast to surgeons in the bottom‐volume quintile, who performed 35% of cases.ConclusionsThese data reflect changing trends in the surgical management of OSA, with meaningful differences in the type of surgical care provided by high‐volume surgeons and a significant increase in surgical sleep procedures, particularly nasal and hypopharyngeal surgery.Level of Evidence2c Laryngoscope, 124:1251–1258, 2014
A Soft‐Template‐Conversion Route to Fabricate Nanopatterned Hybrid Pt/Carbon for Potential Use in Counter Electrodes of Dye‐Sensitized Solar Cells
Authors: Jang Yu Jin , Jang Yoon Hee , Quan Li Na , Kim Ho‐Cheol , Pyo Seungmoon , Kim Dong Ha 
Published: August 2013

Hybrid Pt(platinum)/carbon nanopatterns with an extremely low loading level of Pt catalysts derived from block copolymer templates as an alternative type of counter electrodes (CEs) in dye‐sensitized solar cells (DSSCs) are proposed. DSSCs employing hybrid Pt/carbon with tailored configuration as CEs exhibit higher short‐circuit current and conversion efficiencies as well as stability with a lapse of time compared with conventional cells on the basis of sputtered Pt thin films, evidencing that the new class of hybrid nanostructures possess high potential for cost‐effective electrodes in energy conversion devices.
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The central oscillatory network of orthostatic tremor
Authors: Muthuraman Muthuraman , Hellriegel Helge , Paschen Steffen , Hofschulte Frank , Reese Rene , Volkmann Jens , Witt K. , Deuschl G. , Raethjen Jan 
Published: August 2013

ABSTRACTOrthostatic tremor (OT) is a movement disorder of the legs and trunk that is present in the standing position but typically absent when sitting. The pathological central network involved in orthostatic tremor is still unknown. In this study we analyzed 15 patients with simultaneous high‐resolution electroencephalography and electromyography recording to assess corticomuscular coherence. In 1 patient we were able to simultaneously record the local field potential in the ventrolateral thalamus and electroencephalography. Dynamic imaging of coherent source analysis was used to find the sources in the brain that are coherent with the peripheral tremor signal. When standing, the network for the tremor frequency consisted of unilateral activation in the primary motor leg area, supplementary motor area, primary sensory cortex, two prefrontal/premotor sources, thalamus, and cerebellum for the whole 30‐second segment recorded. The source coherence dynamics for the primary leg area and the thalamic source signals with the tibialis anterior muscle showed that they were highly coherent for the whole 30 seconds for the contralateral side but markedly decreased after 15 seconds for the ipsilateral side. The source signal and the recorded thalamus signal followed the same time frequency dynamics of coherence in 1 patient. The corticomuscular interaction in OT follows a consistent pattern with an initially bilateral pattern and then a segregated unilateral pattern after 15 seconds. This may add to the feeling of unsteadiness. It also makes the thalamus unlikely as the main source of orthostatic tremor. © 2013 International Parkinson and Movement Disorder Society
Quantification of cerebellar hemispheric purkinje cell linear density: 32 ET cases versus 16 controls
Authors: Louis Elan D. , Babij Rachel , Lee Michelle , Cortés Etty , Vonsattel Jean‐Paul G. 
Published: August 2013

ABSTRACTAlthough essential tremor (ET) is among the most prevalent neurological diseases, its precise pathogenesis is not understood. Purkinje cell loss has been observed in some studies and is the focus of interest and debate. Expressing these data as Purkinje cells/layer length allows one to adjust for the inherent curved nature of the cerebellar folia. Capitalizing on the Essential Tremor Centralized Brain Repository, we quantified Purkinje cell linear density in cases versus controls. Free‐floating 100‐μm parasagittal cerebellar hemispheric sections were subjected to rabbit polyclonal anti‐Calbindin D28k antibody, and 10 random fields/brain were selected for quantification of Purkinje cells/mm−1 Purkinje cell layer. Purkinje cell linear density was lower in 32 ET cases than in16 controls (1.14 ± 0.32 vs. 1.35 ± 0.31/mm−1, P = 0.03). Purkinje cell linear density was inversely associated with torpedo count (r = −0.38, P = 0.028). The current sample of ET cases demonstrates a reduction in Purkinje cell number relative to that of controls. Greater Purkinje cell axonal remodeling (torpedoes) was found in individuals who had the most Purkinje cell drop out. The role of Purkinje cell loss in the pathogenesis of this disorder merits additional study. © 2013 International Parkinson and Movement Disorder Society
Multicenter trial of the proficiency of smart quantitative sensation tests
Authors: Dyck Peter J. , Argyros Barbara , Russell James W. , Gahnstrom Linde E. , Nalepa Susan , Albers James W. , Lodermeier Karen A. , Zafft Andrew J. , Dyck P. James B. , Klein Christopher J. , Litchy William J. , Davies Jenny L. , Carter Rickey E. , Melton L. Joseph ,   members of the Cl versus NPhys Trials (Appendix)
Published: August 2013

ABSTRACTIntroduction: We assessed proficiency (accuracy and intra‐ and intertest reproducibility) of smart quantitative sensation tests (smart QSTs) in subjects without and with diabetic sensorimotor polyneuropathy (DSPN). Methods: Technologists from 3 medical centers using different but identical QSTs independently assessed 6 modalities of sensation of the foot (or leg) twice in patients without (n = 6) and with (n = 6) DSPN using smart computer assisted QSTs. Results: Low rates of test abnormalities were observed in health and high rates in DSPN. Very high intraclass correlations were obtained between continuous measures of QSTs and neuropathy signs, symptoms, or nerve conductions (NCs). No significant intra‐ or intertest differences were observed. Conclusions: These results provide proof of concept that smart QSTs provide accurate assessment of sensation loss without intra‐ or intertest differences useful for multicenter trials. Smart technology makes possible efficient testing of body surface area sensation loss in symmetric length‐dependent sensorimotor polyneuropathies. Muscle Nerve 49: 645–653, 2014