bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tongue Base Ultrasound: A Diagnostic Tool for Predicting Obstructive Sleep Apnea
Authors: Lahav Yonatan , Rosenzweig Eyal , Heyman Zehava , Doljansky Julia , Green Amit , Dagan Yaron 
Published: October 2014

Objectives: We assessed the value of an ultrasound (US) examination in the diagnostic workup of patients with sleep-related breathing disorders by correlating US measurements with known parameters for the presence and severity of obstructive sleep apnea. Methods: Forty-one male patients who complained of snoring and/or daytime somnolence participated. The diagnostic protocol included history-taking, physical examination, polysomnography, and transcervical US examination of the tongue. The US results were compared with all of the other parameters. Results: The US imaging was reliable for demonstrating anatomic structures of the tongue base, discriminating between muscle, mucosa, and blood vessels. The lingual arteries were clearly visualized entering the tongue base at its lower lateral borders. There was a significant relationship between the severity of sleep-related breathing disorders (measured by polysomnography) and the width of the lower tongue base (measured as the distance between the lingual arteries). The distance between the lingual arteries also correlated with physical examination findings and patient complaints of daytime somnolence and the sensation of choking during the night. Conclusions: Tongue base width, measured by US, may influence the severity of obstructive sleep apnea. This is the first demonstration of the possible role of US examination, an inexpensive, noninvasive, and non-irradiating office procedure, in the diagnostic workup for sleep-related breathing disorders.
Effects of Transforming Growth Factor-β1 on Human Vocal Fold Fibroblasts
Authors: Branski Ryan C. , Barbieri Silvia S. , Weksler Babette B. , Saltman Benjamin , Krishna Priya , Kraus Dennis H. , Broadbelt Nalini V. , Chen Jie , Poppas Dix P. , Felsen Diane 
Published: October 2014

Objectives: We studied the effect of transforming growth factor (TGF)–β on immortalized human vocal fold fibroblasts. Methods: Normal human vocal fold fibroblasts were subjected to sequential lentiviral transduction with genes for human telomerase (hTERT) and SV40 large T antigen in order to produce an “immortalized” cell line of normal phenotype. After confirmation of vocal fold fibroblast transfection, these cells, referred to as HVOX, were treated with various concentrations of exogenous TGF-β1 and assayed for collagen secretion, migration, and proliferation. In addition, components of the TGF-β signaling pathway were examined in this cell line. Results: TGF-β stimulated collagen secretion and migration without altering proliferation of HVOX. HVOX constitutively expressed type I and II TGF-β receptors, as well as messenger RNA for the Smad signaling proteins and for all TGF-β isoforms. Exogenous TGF-β1 induced temporally dependent alterations in Smad2 and Smad3 gene expression. TGF-β increased Smad7 expression at both 4 and 24 hours. Prolonged exposure to TGF-β decreased TGF-β1 gene expression. Conclusions: Insight into the underlying pathophysiology of vocal fold fibrosis is likely to yield improved therapeutic strategies to mitigate vocal fold scarring. Our data suggest that TGF-β signaling may be both paracrine and autocrine in this vocal fold fibroblast cell line, and we therefore propose that TGF-β may be a reasonable target for therapies to prevent and/or treat vocal fold fibrosis, given its putative role in both acute and chronic vocal fold injury, as well as its effects on vocal fold fibroblasts.
Radiographic Analysis of Cochlear Nerve Vascular Compression
Authors: Clift Julie M. , Wong Robert D. , Carney Gregory M. , Stavinoha Rose C. , Boyev K. Paul 
Published: October 2014

Objectives: We analyzed whether radiographically demonstrated anterior inferior cerebellar artery (AICA) vascular compression of the cochleovestibular nerve in asymmetric hearing loss could be correlated to either the symptomatic ear or to cochlear nerve diameter. Methods: We undertook a retrospective case-control study in which patients were enrolled into a database if audiometry demonstrated asymmetry of 20 dB at one frequency, asymmetry of 10 dB at two frequencies, or a difference of 20% on word recognition scores. If AICA vascular contact was demonstrated on subsequent magnetic resonance imaging of the cerebellopontine angle, patients were included in the study. Patients with vestibular schwannoma or Meniere's disease were excluded. The AICA contact was graded by a blinded neuroradiologist according to criteria proposed by McDermott et al. The cross-sectional area of the cochlear nerve was measured. Results: Symptomatic ears could be correlated to a decreased cochlear nerve diameter, but not to the degree of AICA penetration into the internal auditory canal. Conclusions: AICA vascular compression of the cochleovestibular nerve does not appear to correlate to hearing loss or to cochlear nerve diameter. The finding of decreased cochlear nerve diameter in symptomatic ears implies an alternative mechanism for asymmetric hearing loss.
Audiometric and Vestibular Features in a Second Dutch DFNA20/26 Family with a Novel Mutation in ACTG1
Authors: de Heer Anne-Martine R. , Huygen Patrick L. M. , Collin Rob W. J. , Oostrik Jaap , Kremer Hannie , Cremers W. R. J. 
Published: October 2014

Objectives: We analyzed the phenotype in a 5-generation DFNA20/26 family with a novel missense mutation in the ACTG1 gene (c.151G>A) and compared the findings to previous reports on DFNA20/26 families. Methods: Audiometric data were collected from the family members of a Dutch kindred with the novel ACTG1 mutation. Cross-sectional and/or longitudinal analyses were performed on pure tone and speech audiometry data of the mutation carriers. Age-related typical audiograms were constructed. Vestibular examination was performed in all mutation carriers. Results: Overall, high-frequency hearing impairment, most prominent at ages over 30 years, was observed with a progression rate of 1.1 to 2.1 dB/y, increasing with frequency. It ultimately resulted in residual hearing. Speech recognition scores remained good at given pure tone average (1, 2, and 4 kHz) levels, but were slightly poorer than those at similar levels in a group of patients with presbycusis. Vestibular examination did not reveal any consistent, statistically significant abnormalities. Conclusions: The audiometric phenotype of the Dutch DFNA20/26 family with a novel mutation in ACTG1 was largely consistent with previous reports on DFNA20/26. Considerable variations were found in audiogram configurations within the family. This is the first known DFNA20/26 family that has experienced tinnitus.
Utility of Bronchoscopy for Recurrent Croup
Authors: Chun Robert , Preciado Diego A. , Zalzal George H. , Shah Rahul K. 
Published: October 2014

Objectives: We performed a retrospective review to determine the utility of bronchoscopy in patients with recurrent croup (RC). Methods: Bronchoscopy was performed on 30 patients with a diagnosis of RC (age, 14 months to 13.9 years) over a 2-year period. Results: One third of the patients (33.3%) were found to have airway disorders, including subglottic stenosis (7), subglottic edema (2), and a subglottic cyst (1). Patients with RC who were less than 3 years of age were more likely to have an airway abnormality found on endoscopy (9 of 14 or 64.2%) than were those older than 3 years (1 of 16 or 6.2%; χ2, p < 0.001). There was no statistically significant difference in abnormal findings 1) in patients with RC who had a history of prematurity or prior intubations (χ2, p = 0.17 and p = 0.052, respectively); 2) between infectious and spasmodic croup (χ2, p = 0.794); or 3) by number of croup episodes (χ2, p = 0.300). Two patients required surgical intervention (laryngotracheal reconstruction and marsupialization of a subglottic cyst). Conclusions: Of 30 patients who underwent bronchoscopy for RC, 33% had airway disorders — Mostly children less than 3 years old. We suggest a higher index of suspicion for finding airway disorders in children less than 3 years old with RC and having a lower threshold for performing diagnostic bronchoscopy in this population.
Endoscopic Carbon Dioxide Laser Zenker's Diverticulotomy Revisited
Authors: Kos Martijn P. , David Eric F. , Mahieu Hans F. 
Published: October 2014

Objectives: We assessed the efficacy of endoscopic Zenker's diverticulotomy with the carbon dioxide (CO2) laser and Acuspot and compared it with the historical results of using a CO2 laser without Acuspot and electrocautery diverticulotomy. Methods: Between 1976 and 2005, a total of 229 endoscopic Zenker's diverticulotomies in 189 patients were performed in our institution. Since 1995, micro-endoscopic diverticulotomy with the CO2 laser and Acuspot (MEDCO2A) has been performed in 61 cases. Between 1984 and 1995, micro-endoscopic diverticulotomy with the CO2 laser (MEDCO2) was performed in 113 cases. Before 1984, endoscopic diverticulotomy with electrocautery (EDE) was performed in 55 cases. All patients had radiologically proven Zenker's diverticula. We recorded preoperative and postoperative complaints of dysphagia, the frequency of recurrence in long-term follow-up, postoperative tube feeding, non-oral intake, days of admission, and complications. Results: After operation, dysphagia was absent in 84.6% of MEDCO2A cases, 78.4% of MEDCO2 cases, and 72.0% of EDE cases. Repeat surgery was required in 13.0% of MEDCO2A cases, 19.6% of MEDCO2 cases, and 24.3% of EDE cases. Five patients developed mediastinitis (2 MEDCO2 cases and 3 EDE cases); none died as a consequence. In 1 patient, squamous cell carcinoma was found in the diverticulum. Conclusions: The technological improvement of the CO2 laser with Acuspot has further increased the efficacy of its use over that of methods previously used in our institution. The results and complications rate are comparable to those reported for endoscopic stapler diverticulotomy in the literature.
Biofilm Density in the Pediatric Nasopharynx: Recurrent Acute Otitis Media versus Obstructive Sleep Apnea
Authors: Zuliani Giancarlo , Carlisle Michael , Duberstein Aaron , Haupert Michael , Syamal Mausumi , Berk Richard , Du Wei , Coticchia James 
Published: October 2014

Objectives: We compared the biofilm surface density of adenoids removed from children with recurrent acute otitis media (RAOM) to that of adenoids removed from children with a diagnosis of obstructive sleep apnea (OSA). Methods: We performed a comparative microanatomic study of adenoid mucosa using scanning electron microscopy in patients with diagnoses of RAOM and OSA (27 female and 41 male; age range, 3 months to 15 years). Results: The adenoids removed from patients with RAOM had dense, mature biofilms covering nearly their entire mucosal surfaces. More specifically, the adenoids removed from patients with RAOM had an average of 93.53% of their mucosal surface covered, versus an average of 1.01% coverage on the adenoids removed from patients with OSA. These differences were statistically significant (p < 0.0001). Conclusions: The adenoids removed from patients with RAOM had almost their entire mucosal surface covered with biofilms, versus scant coverage for patients with OSA. Recurrent acute otitis media is notoriously resistant to antibiotic treatment, and aspirates of middle ear fluid repeatedly yield negative cultures. It is these properties that have led biofilms to become increasingly implicated in the pathogenesis of RAOM. Thus, the resistance of biofilms to antimicrobials, together with their planktonic shedding of organisms, may be an important mechanism in the development of RAOM.
Endoscopic Approach for Pituitary Surgery Improves Rhinologic Outcomes
Authors: Graham Scott M. , Iseli Tim A. , Karnell Lucy H. , Clinger John D. , Hitchon Patrick W. , Greenlee Jeremy D. W. 
Published: October 2014

Objectives: We hypothesized that the endoscopic approach to pituitary surgery improves rhinology-specific quality of life and has satisfactory tumor outcomes compared with the open approach. Methods: Cases of pituitary surgery from the Department of Neurosurgery database included an inception cohort of all patients who had endoscopic procedures and consecutive patients who had open procedures between January 1998 and February 2008. The Sino-Nasal Outcome Test-22 was mailed. Results: Since January 1998, 71 endoscopic and 122 open pituitary surgeries had been performed. The mean follow-up was longer for open procedures (49.3 months) than for endoscopic procedures (18.8 months). Recurrence was more common after open surgery (28.4%) than after endoscopic surgery (18.2%; p = 0.219). The most common diagnosis was macroadenoma (77.1% of endoscopic procedures and 93.4% of open procedures). The mean hospital stay was shorter for endoscopic procedures (4.1 days) than for open procedures (6.0 days; p < 0.001). Of patients who presented with visual deterioration, 53.8% with endoscopic surgery and 46.7% with open surgery had improvement. Among patients with normal preoperative hormonal function, 27.5% of patients in the endoscopy group and 29.4% of patients in the open group required medication for more than 2 months after surgery. Complications occurred in 33.3% of endoscopic procedures and 43.4% of open procedures. Cerebrospinal fluid leaks were more common in the endoscopy group (p = 0.035), and diabetes insipidus lasting more than 30 days was more common in the open group (p = 0.017). The mean Sino-Nasal Outcome Test-22 score was lower for patients in the endoscopy group (20.4) than for those in the open group (23.2; p = 0.41). Patients in the endoscopy group had a significantly lower rhinology-specific mean score (6.5) than did patients in the open group (9.2; p = 0.03). Conclusions: The endoscopic approach to pituitary surgery offers tumor outcomes comparable to those of open surgery, with no greater incidence of complications and an improved rhinology-specific quality of life.
Additional Disease Burden from Hay Fever and Sinusitis Accompanying Asthma
Authors: Bhattacharyya Neil , Kepnes Lynn J. 
Published: October 2014

Objectives: We sought to determine the additional disease burden imparted by sinusitis and hay fever (allergic rhinitis) to patients with asthma. Methods: Patients with a diagnosis of asthma, hay fever, or sinusitis were extracted from the National Health Interview Survey for the 1997 to 2006 adult sample. Disease groups consisting of patients with asthma alone, asthma + hay fever, asthma + sinusitis, and asthma + hay fever + sinusitis were assembled. Disease groups were then compared according to total health-care visits per year, emergency room visits per year, health-care spending per year, and number of workdays lost per year to determine the disease burden. Results: We identified 11,813 patients (mean age, 45.5 years) who reported active asthma with or without hay fever or sinusitis comorbidity. Of these, 5,931 patients (50%) were identified with asthma alone, 1,134 (10%) with combined asthma + hay fever, 2,461 (21%) with asthma + sinusitis, and 2,287 (19%) with combined asthma + hay fever + sinusitis. Patients with asthma + sinusitis and those with asthma + sinusitis + hay fever had more total health-care visits and emergency room visits than did those with asthma alone (p < 0.001). All three groups with comorbidities had higher health-care expenditures than did the group with asthma alone (p ≤ 0.002). Patients with asthma + sinusitis and those with asthma + hay fever + sinusitis missed more workdays than did patients in the group with asthma alone (10.0 and 13.1 versus 7.2, respectively; p < 0.001). Comorbid hay fever alone did not increase workdays lost (6.6 days; p = 0.983). Conclusions: The additional disease burden of sinusitis on asthma is greater than that of hay fever. These data highlight the importance of identifying comorbid diagnoses with asthma.
Locus for Familial Migrainous Vertigo Disease Maps to Chromosome 5q35
Authors: Bahmad Fayez , DePalma Steven R. , Merchant Saumil N. , Bezerra Roberta L. , Oliveira Carlos A. , Seidman Christine E. , Seidman Jonathan G. 
Published: October 2014

Objectives: Migrainous vertigo (episodic vertigo associated with migraine) is sometimes inherited as an autosomal dominant trait. However, neither disease genes nor loci that might be responsible have been reported. We sought to map the genetic locus for familial migrainous vertigo in a 4-generation family and to define the progression of disease in this family. Methods: We studied 23 members in a family in whom migrainous vertigo was inherited as an autosomal dominant trait. Clinical information obtained included case histories and results of otolaryngological, neurologic, audiometric, and imaging evaluations. Genome-wide linkage analysis was performed with Affymetrix Genechip Human Mapping 10K microarrays. Genotyping of family members' DNA with microsatellite markers was used to further assess candidate loci identified from the whole-genome scan. Results: Of 23 family members, 10 suffered from migrainous vertigo beginning after 35 years of age. Migraine headaches usually preceded the onset of vertigo by 15 to 20 years. Longitudinal audiometric studies over 12 years showed stable, high-frequency sensorineural hearing loss consistent with presbycusis. Low-frequency or fluctuating hearing loss was not observed. The results of vestibular testing and imaging studies were unremarkable. Genetic analysis defined a 12.0 MB interval on chromosome 5q35 between loci rs244895 and D5S2073 that contained the disease gene (logarithm of odds score, 4.21). Conclusions: We report the first locus for familial migrainous vertigo, which mapped to 5q35.
Pepsin in Nonacidic Refluxate Can Damage Hypopharyngeal Epithelial Cells
Authors: Johnston Nikki , Wells Clive W. , Samuels Tina L. , Blumin Joel H. 
Published: October 2014

Objectives: Studies using combined multichannel intraluminal impedance with pH monitoring reveal a role for nonacidic reflux in laryngopharyngeal symptoms and injury. We have discovered that pepsin is taken up by laryngeal epithelial cells by receptor-mediated endocytosis. This finding reveals a novel mechanism by which pepsin could cause cell damage, potentially even in nonacidic refluxate. The objective of this study was to determine whether pepsin, at pH 7.4 and thus in nonacidic refluxate, causes cell damage. Methods: Cultured hypopharyngeal epithelial (FaDu) cells were exposed to human pepsin (0.1 mg/mL) at pH 7.4 for either 1 hour or 12 hours at 37°C and analyzed by electron microscopy, cytotoxicity assay, and SuperArray. Results: We report mitochondrial and Golgi complex damage in cells exposed to pepsin at neutral pH, observed by electron microscopy. We also report cell toxicity of pepsin at pH 7.4, measured by a cytotoxicity assay. Furthermore, using SuperArray, we found that pepsin at pH 7.4 significantly alters the expression levels of multiple genes implicated in stress and toxicity. Conclusions: These findings are perhaps the first to explain why many patients have symptoms and injury associated with nonacidic reflux, and could have important implications for the development of new therapies for reflux, such as pepsin receptor antagonists and/or irreversible inhibitors of peptic activity.
Profound Mixed Hearing Loss: Bone-Anchored Hearing Aid System or Cochlear Implant?
Authors: Verhaegen Veronique J. O. , Mulder Jef J. S. , Mylanus Emmanuel A. M. , Cremers W. R. J. , Snik Ad F. M. 
Published: October 2014

Objectives: We evaluated 5 patients who were changed over from a Baha Cordelle to a cochlear implant (CI). Moreover, the level of phoneme score was determined at which a Baha Cordelle user was better helped with a CI. Methods: We offer descriptive case reports and a retrospective evaluation of speech recognition in Baha Cordelle users and CI users. Results: In the CI users with noncompromised cochleas, the 10th percentile of the aided phoneme score in quiet at 65 dB sound pressure level (PS65) was 42%. We consider this PS65 as the cutoff level for switching from a Baha Cordelle to a CI. When patients with mixed hearing loss were using the Baha Cordelle, the PS65 of 42% was obtained at a mean sensorineural hearing loss component of about 70 dB hearing level (HL). This 70–dB HL component was used to consider Baha Cordelle users for cochlear implantation. The results of the 5 patients support these transition criteria. Conclusions: A CI is a valuable option in patients with mixed hearing loss when the sensorineural hearing loss component exceeds 70 dB HL or when the PS65 with a Baha Cordelle is less than about 40%. In such patients, the implantation procedure should be individualized on the basis of the clinical findings in the middle ear and mastoid cavity.
Anatomic Study of Middle Fossa Approach Landmarks Using an Image Guidance System
Authors: Pons Yoann , Lombard Bertrand 
Published: October 2014

Objectives: We sought to verify the relevance and reliability of the main temporal bone anatomic landmarks commonly used for the middle fossa approach and to test the use of digital technology to perform an accurate analysis of these landmarks. Methods: Ten fresh cadaveric temporal bones (5 heads) were analyzed by both computed tomographic imaging and dissection procedures, with the help of an image guidance system (DigiPointeur). Eight landmarks, which were selected for their wide citation in the otoneurosurgical literature, were studied. Results: Of the 8 landmarks studied, we obtained results similar to previously published data for 2 (the distance between the temporal squama and the internal auditory meatus [IAM] fundus, and the distance between the top of the anterior semicircular canal [ASCC] arch and the IAM fundus), but divergent measurements for the other 6 (the distance between the temporal squama and the arcuate eminence; the distance between the top of the ASCC arch and the cochlear promontory; the IAM roof thickness; the angle formed by the ASCC arch plane orientation and the IAM axis; the angle formed by the head of the malleus, the geniculate ganglion, and the IAM fundus; and the correspondence between the arcuate eminence and the top of the ASCC arch). Conclusions: The use of an image guidance system allowed us to make sharp and precise measurements of the main anatomic landmarks used during a middle fossa approach. We found 6 measurements to be different from those reported in previously published data out of the 8 landmarks studied.
Age-Associated Changes in the Expression and Deposition of Vocal Fold Collagen and Hyaluronan
Authors: Ohno Tsunehisa , Hirano Shigeru , Rousseau Bernard 
Published: October 2014

Objectives: We investigated age-associated changes in the expression and deposition of collagen and hyaluronan (hyaluronic acid; HA) in aged vocal folds. Methods: Thirty Sprague-Dawley rats were involved in this study. For gene expression analyses, 15 animals were divided into 3 age groups of young (2 month), adult (9 month), and elderly (18 month) rats. Real-time polymerase chain reaction testing was used to quantify the messenger RNA expression of procollagen types I and III, matrix metalloproteinases 2 and 9, and HA synthases 1, 2, and 3. The remaining 15 animals were divided into 3 similar age groups and underwent histologic analyses designed to investigate age-associated changes in the deposition of collagen and HA. Results: The results revealed down-regulated expression of procollagen types I and III, matrix metalloproteinases 2 and 9, and HA synthases 1, 2, and 3 in adult and elderly vocal folds, compared to young vocal folds. Histologically, staining of collagen was dense in the vocal folds of adult and elderly rats, and HA was less dense in the vocal folds of adult and elderly rats than in young rats. Conclusions: A slowdown in the expression of procollagens and matrix metalloproteinases was associated with dense collagen in aged vocal folds, as observed in elderly humans. A similar decrease in the expression of genes that code for HA synthase was consistent with a low density of extracellular matrix HA in the vocal folds of elderly rats.