bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effect of Tonsillectomy on the Immune System
Authors: Bitar Mohamed A. , Dowli Alexander , Mourad Marc 
Published: February 2015

ObjectiveParents of children undergoing tonsillectomy often ask about its effect on their child’s immunity. To answer this question, we conducted a thorough review of the literature, including an unpublished study we previously conducted.MethodA Medline search was conducted. All articles up to January 2012 addressing the effect of tonsillectomy on the immune system were included. No exclusion criteria were used. We previously studied 19 patients undergoing total or partial tonsillectomy. Preoperative and postoperative serum and saliva immunoglobulin levels were taken.ResultsWe reviewed 27 articles, published between 1971 and 2010, including 1665 patients (aged 1.5 to 45 years). The studies looked at different parameters, for example, serum immunoglobulins, salivary immunoglobulins, and delayed hypersensitivity test. The lack of standardization of diagnostic tools, follow‐up duration, indication for tonsillectomy, and patients’ ages precluded a meta‐analysis. Six studies (722 patients) found that tonsillectomy negatively affects the immune system, while 21 studies (943 patients) showed no effect. In our study, there was statistically nonsignificant decrease in secretory IgA level after both total (178.02 to 95.01 µg/mL) and partial (197.24 to 111.34 µg/mL) tonsillectomy.ConclusionThough the reviewed studies had variability in many aspects, one is more likely to believe that tonsillectomy has no significant effect on the immune system. Articles supporting this conclusion were more recent and had a more comprehensive assessment of the immune system.
The Role of Direct Laryngoscopy in Hospitalized Croup
Authors: Hede Sannya V. , Ongkasuwan Julina 
Published: February 2015

ObjectiveProvide insight into: 1) The frequency of viral vs bacterial hospitalized croup at Texas Children’s Hospital. 2) The epidemiology of hospitalized croup. 3) The efficacy of applying operative direct laryngoscopy and bronchoscopy (DL and B) in the detection of other significant respiratory pathology.MethodA retrospective chart analysis of 345 patients with the coded diagnosis of croup at TCH between 2003 and 2011 was carried out. Patients with tracheostomy, epiglottitis, and non‐respiratory complications were excluded from the study. Patient information from children with a DL and B was compared to those without the procedure and tabulated into diagnostic and therapeutic criteria. DL and B findings were categorized as normal, grade 1 (< 50% subglottic obstruction), grade 2 (50‐70%), grade 3 (70‐90%), or grade 4 (> 90%).ResultsOf the 345 patients, 125 were girls (36.2%) and 224 were boys (64.9%; mean age, 3.25 years). Of these, 25 patients (7.25%) underwent operative endoscopy. Of these 25, 7 were girls and 18 were boys. Twenty‐three of 25 were of viral origin and 2 of 25 were of bacterial origin. Ten patients were febrile and 11 patients had abnormal oxygen saturation values. Of the 25 cases analyzed, DL and B findings changed management once.ConclusionMild airway abnormalities are common in children with hospitalized croup and cannot be ruled out based on history. The data suggests that in absence of risk factors, the incidence of a significantly abnormal finding is quite low. A predictive model based on this evidence will be discussed.
Traits of Mitochondrial Deafness in a National Repository
Authors: Yelverton Josh. C. , Amos Kathleen , Nance Walter E. , Pandya Arti , Dodson Kelley M. 
Published: February 2015

Objective1) Characterize the mitochondrial sequence variants present in a national hereditary deafness DNA repository. 2) Define clinical presentation and audiometric characteristics of the various subgroups.MethodRetrospective record review of 86 patients with mitochondrial sequence variants compiled in a national hereditary deafness DNA repository from 1997‐2008.ResultsOf the 86 patients with mitochondrial sequence variants, 21 (24.4%) had the m. 7445A>G mutation, 18 (20.9%) had the m.1555 A>G, 18 (20.9%) had the m.961 T>G mutation, and 29 (33.7%) had a different mutation at the m961 position, most of which (62%) were the m. 961delT+C(n) variant. The majority of patients had bilateral severe to profound hearing loss. Fifty‐three (62%) patients were female and a family history of hearing loss was documented in 60 (69.7%) patients. Deafness was diagnosed before 3 years old in 26 patients.ConclusionMitochondrial deafness can be caused by a variety of genetic mutations with a wide spectrum of clinical presentations. Because of the increased aminoglycoside susceptibility in some forms, it is important to make an accurate diagnosis prior to exposure.
Unusual Tumors of the Jaws in Children
Authors: Perry Katherine , Chang Alice J. , Ambro Bryan T. , Strome Scott E. , Pereira Kevin D. 
Published: February 2015

ObjectivePresent 3 cases of unusual pediatric jaw tumors, including the first reported case in the literature of an immature teratoma of the maxillary sinus.MethodRetrospective chart review of 3 patients who presented to a tertiary care center with rare jaw tumors over 15 years. Cases include a desmoplastic fibroma of the maxilla, an immature teratoma of the maxillary sinus, and infantile fibromatosis of the mandible. Their clinical presentation, imaging, pathology, treatment, and outcomes are reviewed.ResultsThree unusual pediatric jaw tumors were identified. An 18‐month‐old boy with a desmoplastic fibroma of the left anterior maxilla underwent surgical excision and is disease‐free after 12 months. A 10‐year‐old boy presented with an immature teratoma of the right maxillary sinus and underwent wide surgical resection with primary reconstruction and postoperative chemotherapy. His tumor recurred requiring a maxillectomy after which he remained disease free. A 10‐month‐old boy presented with infantile fibromatosis of the right mandible and underwent surgical resection. His tumor recurred after 4 months requiring a hemi‐mandibulectomy with reconstruction. He has been disease free for 5 years.ConclusionJaw tumors in children are relatively uncommon and have a broad differential diagnosis. We present 3 rare cases, including the first reported case in the literature of an immature teratoma of the maxillary sinus. This case series may help guide care for these complepatients given the paucity of literature.
YouTube as a Source of Pediatric Tonsillectomy Information
Authors: Strychowsky Julie , Nayan Smriti , Maclean Jonathan 
Published: February 2015

ObjectiveTonsillectomy is a common surgery performed on pediatric patients. Patients and their caregivers may search the Internet for information related to this procedure, and YouTube is a popular Web site that they may consult. We investigated YouTube as an information source on pediatric tonsillectomy.MethodYouTube was searched on February 17, 2012, for videos containing relevant information about tonsillectomies in pediatric patients using the keywords pediatric tonsillectomy, tonsillectomy and tonsil surgery. Non‐English videos were excluded. Two physician reviewers watched each video and assessed for content (useful, misleading, personal experience). The StatsDirect software will analyze measures.ResultsThe search for each keyword identified over 2555 videos (pediatric tonsillectomy = 91, tonsillectomy = about 1800, tonsil surgery = 664). The first 200 videos were screened for each keyword on the assumption that most users would not go beyond the first 10 pages. Therefore, 491 videos were screened for inclusion and exclusion criteria, and duplicates were removed. At the time of abstract submission, final data analysis was not yet available. Outcomes included content assessment and characteristics, and video total viewership, number of days since upload, total duration, viewer rating, and source of upload. Reviewer degree of agreement and relevant statistical analysis will be reported.ConclusionYouTube has a substantial number of videos on pediatric tonsillectomy with a variety of content ranging from useful to misleading. Health care professionals must recognize the potential influence that these user‐generated video Web sites may have on the attitudes of patients and their caregivers.
A Case of Atrophic Rhinitis Caused by Klebsiella ozaenae
Authors: Rodgers Brian C. , Baker Kim 
Published: February 2015

ObjectiveTo educate clinicians on the presentation and management of this uncommon pathogen as it pertains to atrophic rhinitis and to review the role of autoimmune tendencies in the development of ozena in this patient with nasal infection by Klebsiella ozaenae.MethodThis case report describes a 17‐year‐old Somalian female with ozena (atrophic rhinitis). She presented to our tertiary care center in Kansas City, Missouri, in November 2011 with classic symptoms of atrophic rhinitis and was diagnosed based on a positive surgical culture of K ozanae. She was noted to have bilateral middle turbinate destruction preoperatively and has been treated thus far with serial surgical debridements, topical nasal rinses and an oral fluoroquinolone. We are measuring cure of her disease with multiple parameters including improved nasal obstruction (symptomatic), endoscopic documentation of resolution of rhinitis, and pathologic/microbiologic confirmation of cure.ResultsOur patient experienced temporary relief of her symptoms after endoscopic debridement. Recurrence of her symptoms was delayed by topical nasal rinses and steroids. A prolonged course of therapy with an oral fluoroquinolone augmented by serial nasal debridements was necessary to obtain resolution of her disease.ConclusionManagement of atrophic rhinitis in the setting of K ozaenae infection is a multidisciplinary approach between surgical specialists and infectious disease specialists. Autoimmune factors may play a role in development and severity of this disease.
A Rare Case of a Second Primary Nasopharyngeal Angiofibroma
Authors: Torre Carlos A. , Busquets Jose M. 
Published: February 2015

Objective1) Present what is to our best knowledge the first reported case of a patient with a contralateral second primary angiofibroma. 2) Discuss the details of the clinical presentation, workup, and management of this patient.MethodThis is a case report of a 24‐year‐old man presenting with a contralateral second primary angiofibroma 5 years after endoscopic removal of the primary tumor. His medical charts from 2005 until present time were reviewed.ResultsNasopharyngeal angiofibromas can receive their blood supply from bilateral carotid systems. Also, a case of a patient with bilateral angiofibromas was previously reported in the literature. Our case is different in that it deals with a contralateral second primary angiofibroma. Before endoscopic removal of the first angiofibroma, angiography confirmed that its main feeder came from the ipsilateral internal carotid artery system. When the tumor recurred it involved the contralateral external carotid system. With all these factors considered, we excluded the possibility of this being a case of recurrent angiofibroma, even though this possibility was originally considered.ConclusionWe present a case of a contralateral second primary angiofibroma diagnosed 5 years after endoscopic removal of the original primary tumor. This is to our knowledge the first case of such nature reported in the English literature.
Hyperbaric Oxygen versus Steroid on Facial Nerve Injury
Authors: Toros Sema Z. , Karaca Çiğdem T. , Güneş Pembegül , Oysu Cagatay , Ertugay Çiğdem K. , Naiboğlu Barış 
Published: February 2015

ObjectiveOur aim in this experimental study was to evaluate the effects of hyperbaric oxygen (HBO), methylprednisolone (MP), and combined HBO‐MP treatments on traumatic facial nerve regeneration by histopathological examination of the facial nerve in rats.MethodFour groups of rats were created with 5 subjects in each group after exposure to facial nerve injury: group 1 (HBO), group 2 (control), group 3 (HBO‐MP), and group 4 (MP). Sacrified specimens were examined according to axonal degeneration, vascular congestion, macrovacuolization, axon diameter, and the thickness of myelin sheath.ResultsThere was significant difference regarding axonal degeneration, vascular congestion, and axon diameter between group 3 (combined HBO‐MP) and the control group. Besides lesser axonal degeneration and vascular congestion, larger diameter of axons were observed in group 3 (combined HBO‐MP). There was significant difference regarding vascular congestion and axon diameter between group 4 (MP) and the control group. Furthermore, we observed thicker myelin and lesser axonal degeneration in group 3 (combined HBO‐MP) in comparison to the group 4 (MP). However, there was no significant difference in the histopathological findings between group 1 (HBO) and the control group.ConclusionThe histopathological results in our study suggested that the combination therapy with HBO and MP had additive beneficial effect on the regeneration of facial nerve in an experimental animal model and may provide better treatment outcomes than isolated MP or HBO therapy.
Alternaria Inhibits Defense Mechanism for Virus Infection
Authors: Wada Kota , Kobayashi Takao , Matsuwaki Yoshinori , Arai Chiaki , Kita Hirohito , Moriyama Hiroshi , Edamatsu Hideo 
Published: February 2015

ObjectiveIt has been suggested that fungi may have trigger effects for CRS. It was reported that PBMCs from CRS patients produced IL‐5, IL‐13 and INF‐gamma by Alternaria. Kobayashi reported that Alternaria produced potent Th2‐like adjuvant effects in the airway. We hypothesized that Alternaria inhibits Th1‐type defense mechanisms against virus infection.MethodThe functional responses were assessed by expression of cell surface molecules by FACS (MHC Class II, CD40, CD80, CD86, OX40L and CCR7). IL‐6, IP‐10, and I‐TAC were measured by ELISA kits (R&D Systems). TLR3 mRNA and protein expression were detected by real time–PCR and Western blotting.ResultsAlternaria and Poly I:C induced surface molecules of MHC Class II, CD40, CD80, CD86, OX40L, and CCR7 and IL‐6 production in a concentration‐dependent manner. But, Alternaria significantly inhibited IP‐10, I‐TAC, and IFN‐gamma production induced by Poly I:C. TLR3 mRNA expression and protein production by Poly I:C were significantly inhibited by Alternairia. It was considered that these reactions were caused by heat‐resistance and over 100 molecular weight substance from Alternaria.ConclusionFrom these results, it was found that the presence of Alternaria inhibited a production of IFN‐gamma by inhibiting expression of TLR3 and inhibited a production of IP ‐10 and I‐TAC. Alternaria inhibits defense mechanisms against virus infection. It was suggested that Alternaria caused suppression for innate immune systems.
An Esthesioneuroblastoma Mimicking a Fibro‐osseous Lesion
Authors: Thompson Christopher F. , Bhuta Sunita , Suh Jeffrey D. 
Published: February 2015

Objective1) Present the unique radiology and pathology of a coarsely calcified pediatric esthesioneuroblastoma (ONB) that was incorrectly suggested preoperatively to be a fibro‐osseous tumor. 2) Review the clinical presentation, radiographical and pathological findings, treatment, and prognosis of ONBs.MethodThe PubMed database was searched from 1958 to 2011, limited to the English language, using keywords esthesioneuroblastoma, radiology, and calcification.ResultsEsthesioneuroblastomas present with nasal obstruction, pain, hyposmia and epistaxis. Imaging shows a destructive, soft tissue mass without calcifications. Treatment includes surgery, radiation and chemotherapy. Ten year survival is significantly decreased in Hyams high‐grade pathological tumors. We present a 12 year‐old female with Kadish C and Dulguerov‐Calcaterra T3N0M0 esthesioneuroblastoma that on CT and MRI revealed a coarsely calcified 3.8 × 3.5 × 4.1 cm mass involving the right nasal vault and paranasal sinuses. Due to the extensive calcifications, it was incorrectly suggested preoperatively to be a fibro‐osseous lesion. She underwent endoscopic‐assisted resection with postoperative radiation and is disease‐free 9 months post‐treatment.ConclusionOur case highlights a unique radiographic presentation of esthesioneuroblastoma and emphasizes that this uncommon neuroectodermal malignant tumor always be in the differential for unilateral nasal cavity lesions. Optimal treatment requires a multidisciplinary approach and long‐term clinical surveillance is essential.
IgG4‐Related Sialadenitis: Pearls and Pitfalls in Management
Authors: Ohta Nobuo , Kurakami Kazuya , Suzuki Yusuke , Ishida Akihiro , Kakehata Seiji 
Published: February 2015

ObjectiveA new concept of IgG4‐related sialadenitis characterized by high serum IgG4 levels and tissue infiltration of IgG4‐expressing plasmacytes has recently been proposed. To determine appropriate serum levels of IgG4 for monitoring disease activity, a total of 36 serum samples and 8 tissue samples from patients with IgG4‐related sialadenitis were studied.MethodThe patient group consisted of 6 men and 4 women with an average age of 60 years (range, 47 to 74 years). Serum levels of IgG4 and the density of IgG4‐positive plasmacytes in affected tissues were studied.ResultsAll patients had elevated serum IgG4 levels (>135 mg/dL), and IgG4‐positive plasmacytes (IgG4+ plasma cells/IgG+ plasma cells >50%) were observed in the involved salivary glands. Six patients with IgG4‐related sclerosing sialadenitis with high IgG4/IgG ratios and prominent infiltration of IgG4‐positive plasmacytes in the involved salivary glands had systemic complications, including pancreatitis, retroperitoneal fibrosis, and/or inflammatory pseudotumor of the lung after swelling of the salivary glands. All 6 of these patients were successfully treated with systemic corticosteroids.ConclusionIn the 6 patients with systemic complications, treatment with systemic corticosteroids reduced the salivary gland enlargement and lowered serum IgG4 concentrations. These results suggest that IgG4 levels and IgG4/IgG ratios may be used as additional indicators of disease activity and as biomarkers for potential life‐threatening complications.
Effect of Caffeic Acid on Nasal Polyp Derived Fibroblasts
Authors: Hong Sung M. , Lee Heung‐Man , Chung Seung W. , Park H. , Cho Jung S. , Um Ji Y. , Lee Hye R. 
Published: February 2015

ObjectivesCaffeic acids are known to have anti‐oxidant, anti‐inflammatory, immunomodulatory, and tissue reparative effects. The purposes of this study were to determine the effect of caffeic acid on transforming growth factor (TGF)‐β1‐induced myofibroblast differentiation and collagen production, and to determine whether caffeic acid is involved in the antioxidant effect.MethodNasal polyp‐derived fibroblasts (NPDFs) were pre‐treated with caffeic acid (5‐25 µM) for 2 hours and stimulated with TGF‐β1 (5 ng/mL) for 24 hours. The expression of α‐SMA, collagen types I and III, and Nox4 mRNA was determined by a reverse transcription‐polymerase chain reaction, and the expression of α‐SMA protein was determined by immunofluorescence microscopy. The amount of total soluble collagen production was analyzed by the Sircol collagen dye‐binding assay. The reactive oxygen species (ROS) generated by NPDFs were determined using 2′,7′‐dichlorfluorescein‐diacetate. siNox4 was used to determine the effect of Nox4.ResultsThe expression of α‐SMA and production of collagen were significantly increased following TGF‐β1 treatment. In contrast, the level of expression of α‐SMA and the level of production of collagen were decreased by pre‐treatment with caffeic acid. The activation of Nox4 and the subsequent production of ROS were also reduced by pre‐treatment with caffeic acid. The expression of α‐SMA was prevented by inhibition of ROS generation with siNox4.ConclusionCaffeic acid may inhibit TGF‐β1‐induced differentiation of fibroblasts into myofibroblasts and collagen production by regulating NADPH oxidase‐derived ROS.
Endoscopic Marsupialization of Maxillary Odontogenic Cysts
Authors: Jain Kunal S. , Goyal Parul 
Published: February 2015

ObjectiveManagement of maxillary odontogenic cysts consists of transoral resection or curettage. Large lesions require extensive dissection, leading to perioperative morbidity and need for extensive reconstruction. 1) Describe the use of transnasal endoscopic marsupialization for the management of maxillary odontogenic cysts. 2) Understanding this approach can minimize morbidity with effective treatment.MethodCase series. Endoscopic sinus surgical techniques were used to treat large benign maxillary odontogenic cysts in five patients between June 2008 and October 2011.ResultsPatients underwent endoscopic marsupialization after creation of a wide maxillary antrostomy. Molars associated with the cystic lesions were displaced into portions of the maxillary sinus in 2 cases. The molars were dissected and removed through the transnasal dissection in each of these cases. Histological and radiological findings were consistent with 1 odontogenic keratocyst, 3 dentigerous cysts, and 1 radicular cyst. The lesions were able to be marsupialized endoscopically with relief of the patient’s initial symptoms and no recurrence. Follow‐up has shown an excellent functional outcome in all cases.ConclusionBenign maxillary odontogenic cysts can be effectively treated using transnasal endoscopic approaches. The techniques are less invasive and can reduce morbidity compared to transoral techniques.
Endoscopic Repair of CSF Fistulas and Meningoencephaloceles
Authors: Emmanuelli Juan , Avellan Irene , Sanchez Mariana 
Published: February 2015

ObjectiveSpontaneous CSF fistulas are related with an alteration of the embryologic closure of the skull base, from a simple thinning of the duramater in the cribriform area or the fontanel to a meningoecephalocele anywhere in the skull base. Endoscopic skull base surgery has improved tremendously the morbidity and the postoperative care in these patients, in relation with a craniotomy. We present our experience in the Domingo Luciani Hospital and in Sanatrix Clinic treating these patients endoscopically with excellent results, without intensive care unit and just one day in the hospital.MethodFifteen patients were operated with spontaneous CSF leak from 2004 to 2011, 4 of them were meningo or meningoencephaloceles, and the location were 1 in the frontal sinus, 1 in the lateral wall of the sphenoid, 6 in the cribriform plate, 5 in the fovea etmoidalis, and 2 in that planum sphenoidale.ResultsThe fistulas were repaired either with free graft, 1 layer or with 2 layers, cartilage and middle turbinate mucoperiosteum; just in 1 case we delivered a septal flap. Of the 15 patients, 13 resolved the leak completely, without any morbidity. In 2 of them the leak reappears when they stop the postoperative medication, with 86.7% success rate.ConclusionEndoscopic repair of the CSF fistulas is safe, reliable, with little morbidity and with a very short stay in the hospital.