bluuebunny/crossref_metadata_2025_split huggingface dataset:
Can Computed Tomography Characteristics of the Oropharynx in Cancer of Unknown Primary Predict Primary Tumor Site?
Authors: McSpadden Ryan P. , Sullivan Thomas P. , Rosenblum Jordan , Bier‐laning Carol M. 
Published: September 2014

Objectives:(1) Measure axial and coronal parapharyngeal space area (PPSA) and parapharyngeal mucosal thickness (PMT) in patients who present with cancer of unknown primary (CUP). (2) Determine if PPSA and PMT differences between affected and unaffected sides of the oropharynx were found based on site of primary (tonsil vs base of tongue [BOT]) or body mass index (BMI).Methods:Institutional review board–approved retrospective chart and preoperative computed tomography (CT) review of consecutive patients presenting between 2007‐2013 with CUP to a tertiary university hospital. Subjects did not have an identified primary on clinical or imaging examinations including positron emission tomography/CT but did have an identified primary after surgery. Two blinded radiologists reviewed CT scans. Measurements of PPSA and PMT at defined levels in the axial and coronal planes and prediction of the primary site were made. Independent variables were primary tumor site and BMI. Comparisons were made using Student t test.Results:There was no significant difference in PPSA or PMT between the affected and unaffected sides of the oropharynx for the entire group (n = 17, ΔPPSA axial 0 mm2, P =. 5; ΔPPSA coronal 16 mm2, P =. 2; ΔPMT 0.3 mm, P =. 2) or for subgroups based on primary site (tonsil vs BOT) or BMI (≤25, >25). Blinded examiners correctly predicted the primary site in 7/17 (41%) of cases.Conclusions:Differences in axial PPSA and PMT were not useful to predict the primary site in patients with CUP. Although not statistically significant, coronal PPSA in subjects with BMI >25 may be useful in identifying the primary tumor site.
Comparison of Self‐Esteem Status in Aesthetic and Functional Rhinoplasty Patients
Authors: Naraghi Mohsen , Atari Mohammad 
Published: September 2014

Objectives:Self‐esteem is one's attitude toward oneself. It is one of the most important psychological aspects of rhinoplasty. Some findings indicate the improvement of patient self‐esteem after the operation. The aim of this study was to compare self‐esteem in patients seeking aesthetic or functional rhinoplasty.Methods:A total of 45 patients ranging in age from 17 to 36 filled out the Rosenberg Self‐Esteem Scale (RSES) over a 3‐month period. RSES consists of 10 items measuring general self‐esteem. The subjects took a validated form of RSES preoperatively. Twenty‐one aesthetic surgery patients and 21 functional surgery patients had filled out the questionnaire and 3 patients had left it blank.Results:Using t‐test for independent groups, the analysis of the data demonstrated that the mean self‐esteem score in the aesthetic surgery group was significantly lower than that of the functional surgery group (P <. 05). Age, sex, socioeconomic status (SES), and educational backgrounds were analyzed as potential extraneous variables and comparative analysis of each showed no significance between the 2 groups. Cohen's d was also calculated as a measure of effect size (ES). The value of ES measure was high (d = 0.78).Conclusions:The findings of the present study showed that aesthetic rhinoplasty patients had lower self‐esteem in comparison with functional rhinoplasty patients.
Clinical Study of Carcinomas of the External Auditory Canal: Histologic and Treatment Groups
Authors: Hosokawa Seiji , Mizuta Kunihiro , Takahashi Goro , Okamura Jun , Takizawa Yoshinori , Hosokawa Kumiko , Mineta Hiroyuki 
Published: September 2014

Objectives:Evaluation of the clinical and pathological factors associated with treatment and outcomes for external auditory canal (EAC) carcinomas.Methods:Over the 20‐year period from 1993 to 2013, a retrospective review of clinical and pathological analysis was performed on 23 patients who were histologically diagnosed with EAC carcinomas and treated at Hamamatsu University Hospital. We evaluated the clinical staging, treatment methods, pathological diagnosis (particularly squamous cell carcinoma [SCC])), and patient outcomes. Main outcome measures included staging, treatment procedures, pathological features, and estimated survival rates.Results:The 5‐year overall survival (OS) of the subjects was 75.2%, and the 10‐year OS was 60.2% with the Kaplan‐Meier method. The prognosis for SCC was poor when compared with other carcinomas (P =. 0462). The prognosis following treatment with surgery alone and following postoperative radiotherapy or chemoradiotherapy was significantly better than for the group of patients with unresectable tumors (P =. 0004 and P =. 0001). There was no significant difference between the 4 tumor stage groups. Information on patients’ survival status was obtained after a median follow‐up period of 57.5 months (range, 7‐151 months).Conclusions:Our survival analysis data for carcinoma of the EAC demonstrates that SCC and unresectable cases are associated with poor outcomes, and outcomes for subjects with operability more closely parallel the survival curves of advanced stage T4 disease. Patients with SCC should be strictly categorized as cases with severe disease.
Comparison of Robotic versus Conventional Lateral Neck Dissection for Differentiated Thyroid Carcinoma
Authors: Tae Kyung , Ji Yong Bae , Song Chang Myeon , Lee Seung Hwan , Park Chul Won 
Published: September 2014

Objectives:In advances in robotic thyroidectomy, we have performed robotic lateral neck dissection by a gasless unilateral axillo‐breast (GUAB) or axillary (GUA) approach for differentiated thyroid carcinoma (DTC) to avoid long visible scars in the neck. The aim of this study is to evaluate technical feasibility and efficacy of robotic lateral neck dissection compared with conventional neck dissection.Methods:We studied 72 patients with DTC who underwent total thyroidectomy with robotic selective neck dissection by GUAB or GUA approach (23 cases) or conventional open neck dissection (49 cases) in the unilateral neck between January 2010 and July 2013.Results:The mean age and body mass index was lower, and female sex was more common in the robotic group compared with the open group (P <. 05). Stage was more advanced in the open group (P <. 05). The mean total operative time was significantly longer in the robotic group (319 ± 65 minutes) than the conventional group (214 ± 110 minutes; P <. 001). The mean number of lymph nodes removed in the lateral compartment was not different between the 2 groups (24.7 ± 11.3 in the robotic group and 30.9 ± 17.7 in the conventional group, P =. 091). The postoperative complication did not differ between the 2 groups. Postoperative cosmetic satisfaction was superior in the robotic group than the conventional group (P <. 05).Conclusions:Robotic lateral selective neck dissection by GUAB or GUA approach is comparable to conventional lateral neck dissection in selected patients with DTC and provides better postoperative cosmesis than conventional neck dissection.
Effect of HPV on Posttreatment Weight in Head and Neck Squamous‐Cell Carcinoma: A Pilot Study
Authors: Zhang Zi , O'Malley Bert W. , Brown Justin C. , Bauml Joshua , Dean Lorraine T. , Weinstein Gregory S. , Schmitz Kathryn H. 
Published: September 2014

Objectives:Unlike head and neck squamous cell carcinoma (HNSCC) caused by tobacco and alcohol use, human papillomavirus (HPV)–related HNSCC has better survival outcomes. The aim of our study was to determine if post‐treatment weight change was different between HPV positive and negative oral tongue and oropharyngeal squamous cell carcinoma (OPC) patients.Methods:We conducted a retrospective cohort study. Oral tongue and OPC patients with initial surgery or radiation/chemotherapy in 2010 were identified using the University of Pennsylvania Tumor Registry. Those with p16 testing as a surrogate marker for high‐risk HPV were enrolled. Patient characteristics at diagnosis were collected, and the outcomes were mean weights at pretreatment and 0‐6, 6‐12, 12‐18, and 18‐24 month posttreatment visits.Results:We identified 50 survivors with p16 testing and follow‐up weights. Seventy‐four percent (n = 37) were p16‐positive. Compared with p16‐negative patients, p16‐positive patients were significantly more likely to be younger (56 ± 11 vs 72 ± 12, P =. 0001), at AJCC TNM stage 4 (72% vs 27%, P =. 010), and have higher mean weights at pretreatment and all posttreatment visits (P <. 05). Mean weights at pretreatment and posttreatment 0‐6, 6‐12, 12‐18, and 18‐24 month follow‐up visits were 164 ± 40, 160 ± 40, 159 ± 39, 160 ± 38, and 154 ± 35 pounds, respectively, in p16‐negative patients, but were 194 ± 47, 171 ± 38, 172 ± 39, 174 ± 44, and 187 ± 53 pounds, respectively, in p16‐positive patients, which improved from 0‐6 to 18‐24 month visits.Conclusions:Although the traditional post‐treatment weight loss was still seen in p16‐negative patients, p16‐positive patients were able to gain weight during 24‐month post‐treatment follow‐up after the initial rapid posttreatment weight loss.
The Effect of Intraoperative Hetastarch Administration on Microvascular Surgical Outcomes
Authors: Galloway Tabitha L. , Castellano Alexa , Jorgensen Jeffrey B. 
Published: September 2014

Objectives:The plasma volume expander hetastarch has a suggested subclinical toxicity that increases activated partial thromboplastin time and decreases Factor VIII of the coagulation cascade. The goal of this study was to determine if free tissue transfer patients who received hetastarch intraoperatively had a decreased risk of developing microvascular anastomotic venous thrombosis.Methods:The records of all patients undergoing free tissue transfer between January 1, 2009, and May 1, 2013, were selected for retrospective chart review. Background data including patient demographics, surgical indications, and free flap types were collected. Intraoperative medication records were analyzed to determine hetastarch administration. The primary outcome evaluated was anastomotic venous thrombosis. Secondary outcomes assessed included anastomotic arterial thrombosis, hematoma formation, and flap failure.Results:During the collection period, a total of 106 patients received hetastarch intraoperatively as a plasma volume expander, compared with 43 who did not. No statistical difference was demonstrated between groups with regard to demographic information, surgical indications, and free flap types. There was no significant difference between groups in the rate of venous thrombosis (P = 1.000), arterial thrombosis (P = 1.000), hematoma formation (P =. 4392), or flap failure (P =. 5571).Conclusions:This study demonstrates that the intraoperative administration of hetastarch during free tissue transfer procedures does not significantly decrease the rate of postoperative venous thrombosis, arterial thrombosis, or free flap failure and, despite its anticoagulatory effects, does not significantly increase the rate of hematoma formation. Therefore, we conclude that utilization of intraoperative hetastarch does not significantly impact the complication rate of microvascular anastomoses.
EGR‐1 Regulates Radiation‐Induced Apoptosis in Human Head and Neck Squamous Cell Cancer
Authors: Cho Wan Seok , Lee Jae Hun , Yoon Tae Mi 
Published: September 2014

Objectives:(1) Investigate that early growth response‐1 (EGR‐1) expression is expressed in human head and neck squamous cancer (human HNSCC). (2) Evaluate whether EGR‐1 affects radiation‐induced apoptosis in human HNSCC and would thus serve as the proper prognostic biomolecular marker of radiation therapy.Methods:The protein expression of EGR‐1 by immunohistochemistry was investigated in human HNSCC tissues. EGR‐1 expression was evaluated at different time points after irradiation in human HNSCC cell lines. To evaluate the impact of EGR‐1 knock‐down on radiation‐induced apoptosis of human HNSCC cell lines, cell apoptosis assays using small‐interfering RNA were performed. Western blot analysis was used to assess alteration in apoptosis related protein expression after irradiation in human HNSCC cell lines.Results:EGR‐1–positive immunoreactions were observed relative to adjacent mucosal tissue in 15 tissues (58.6%) of 28 human HNSCC tissues. After 5Gy and 8Gy irradiation, EGR‐1 increased with peak activation at 2 hours. The cleaved caspase 3, cleaved caspase 7, and cleaved PARP were increased at 2 hours after irradiation. Proapoptotic protein Bax was increased at 2 hours after irradiation. EGR‐1 knock‐down cells displayed decreased radiation‐induced apoptosis, compared with control cells in cell apoptosis assay. Cleaved caspase 3, cleaved caspase 7, cleaved PARP, and Bax activation was decreased by EGR‐1 knock‐down after irradiation.Conclusions:EGR‐1 had abundant expression in human HNSCC tissue. EGR‐1 knock‐down decreased radiation‐induced apoptosis through caspase 3, caspase, 7, PARP, and Bax. EGR‐1 may play an important role in treatment response after radiation therapy in human HNSCC.
Endoscopic Endonasal Transphenoidal Approach for Pituitary Adenomas: Outcomes of Our Center
Authors: Correia Isabel A. , Sousa Heredio , Sousa Vítor , Sagarribay Amets , Barros Ezequiel 
Published: September 2014

Objectives:Report the results of a consecutive series of patients who underwent an endoscopic endonasal transphenoidal approach (EETA) for resection of a pituitary adenoma.Methods:A retrospective review of patients who underwent EETA at our center between 2010 and 2013, in a collaboration between head and neck surgeons and neurosurgeons, and a description of the technique used.Results:Nineteen patients underwent an EETA for removal of a pituitary adenoma. Decreased visual acuity or a visual field defect was the presenting complaint in 63.2% patients and headache in 26.3%. Nonfunctioning adenoma was the most frequent (52.6%). Sixteen (84.2%) patients had a macroadenoma (>1 cm) and 3 (15.8%) had a microadenoma (<1 cm). The overall postoperative cerebrospinal fluid leak rate was 5.3%. Other perioperative complications were epistaxis (5.3%), postsurgical hematoma (5.3%) with urgent evacuation, and meningitis (5.3%). The rate of gross total ressection was 70% in patients with nonfunctioning adenomas. The remission rate of secretory adenomas was 75%. Of the patients presenting with visual symptoms, 91.7% improved or normalized.Conclusions:EETA is an excellent alternative to other classic approaches for pituitary adenoma, providing similar results with less morbidity. It allows a better panoramic visualization of sellar and parasellar spaces and a better preservation of the normal anatomy and physiology of nasal cavity. This minimally invasive approach is now the standard of care in transasal pituitary surgery. Our outcomes, including remission and complication rates, are comparable with those reported in previous series of endoscopic and microscopic approaches.
Expression of Livin and the Inhibition of Tumor Progression by Livin Silencing in Laryngohyopharyngeal Cancer
Authors: Yoon Tae Mi , Cho Wan Seok , Lee Jae Hun , Lee Dong Hoon , Lee Joon Kyoo , Lim Sang Chul 
Published: September 2014

Objectives:Livin, a member of the inhibitors of apoptosis protein family, is expressed in various cancers and is associated with tumor progression. However, there is no report about the significance of Livin in laryngohypopharyngeal sqaumous cell carcinoma (LHSCC). In this study, we evaluated the expression of Livin in human LHSCC and investigated whether Livin knockdown using small interfering‐RNA (siRNA) affects tumor aggressiveness in LHSCC cells.Methods:Livin expression in human LHSCC tissues was detected by immunohistochemistry. The relationships between Livin expression and clinicopathologic variables were analyzed. Livin specific siRNA was used to silence the endogenous Livin gene expression in SNU1041 and PCI1 human LHSCC cell lines. Cell invasion, cell migration, and cell apoptosis assays were performed to assess the impact of Livin on cancer cell behavior in human LHSCC cells.Results:High immunoreactivity of Livin was observed in 22 (36.7%) of the 60 LHSCC tissues relative to adjacent normal mucosa. In the positive Livin expression group, distant metastasis tended to occur frequently, but the difference was not statistically significant (P =. 06). Livin knockdown by siRNA induced cell apoptosis through activation of caspase 3, caspase 7, and poly ADP ribose polymerase in LHSCC cells. Livin knockdown also resulted in significantly reduced cell invasion and migration in LHSCC cells.Conclusions:These results suggest that Livin silencing mediated siRNA may be associated with the reversal of invasive capacity in LHSCC.
Factors Associated with the Use of Intensity‐Modulated Radiotherapy for Head and Neck Cancer
Authors: Chen Michelle M. , Roman Sanziana A. , Sosa Julie A. , Judson Benjamin L. 
Published: September 2014

Objectives:(1) Describe temporal trends in the use of postoperative intensity‐modulated radiotherapy (IMRT) for head and neck cancer treatment. (2) Determine factors associated with the utilization of IMRT.Methods:A retrospective analysis of the National Cancer Database (2003‐2011) was used to identify 45,154 adult head and neck cancer patients who had postoperative radiotherapy (RT) and to examine demographic, geographic, socioeconomic, and clinical characteristics. Our main outcome of interest was the receipt of IMRT. Statistical analysis included χ2 tests, Student t tests, and multivariate regression.Results:From 2003 to 2011, the proportion of patients who had postoperative IMRT increased from 14.2% to 69.2%. Compared with those who had non‐IMRT, patients who had IMRT were more likely to be <55 years old (58.4% vs 66.7%, P <. 001), white (87.4% vs 89.6%, P <. 001), privately insured (45.5% vs 53.3%, P <. 001), in the West (15.6% vs 16.7%, P <. 001) or Midwest (25.8% vs 32.8%, P <. 001), and in receipt of concurrent chemotherapy (38.9% vs 60.5%, P <. 001). On multivariate analysis, private insurance, white race, Midwest and West locations, human papillomavirus positivity, concurrent chemotherapy, and academic centers were independently associated with the receipt of IMRT.Conclusions:IMRT has become the primary modality of delivery for postoperative RT in head and neck cancer patients. Results demonstrate racial, regional, and hospital‐level variation in the receipt of IMRT, suggesting heterogeneity in practice patterns across the United States.
Familial Hypocalciuric Hypocalcemia: Pitfalls and Implications for the Parathyroid Surgeon
Authors: Luk Lauren J. , Shindo Maisie L. , Madison Dana 
Published: September 2014

Objectives:Modifications to the Guidelines for the Management of Asymptomatic Primary Hyperparathyroidism (2008) eliminated the recommendation for routine 24‐hour urine calcium collection. Surgeons are now seeing an increasing number of referrals for surgical evaluation of hyperparathyroidism without this test that can help differentiate between primary hyperparathyroidism (PHPT), a surgical disease and familial hypocalciuric hypercalcemia (FHH), a medical disease. We will review the characteristics of our cohort of FHH patients and describe findings that should raise suspicion for this diagnosis.Methods:Subjects were evaluated at Oregon Health and Science University from 2011 to 2013. Retrospective chart review was performed of a cohort of 11 patients with FHH confirmed by calcium‐creatinine clearance ratio (CCCR) and/or CASR gene mutation.Results:All patients had CCCR of <0.015, In 8 patients imaging studies could not localize an adenoma, and 6 patients reported a family history of hypercalcemia.Conclusions:FHH is a benign, autosomal dominantly inherited disorder from heterozygous mutations in the calcium sensing receptor gene, resulting in lifelong hypercalcemia and relative hypocalciuria. Suspicion for FHH is raised with the presence of long‐term hypercalcemia, a positive family history of hypercalcemia, and inability to localize an adenoma on imaging studies. Further evaluation is indicated including a 24‐hour urine calculation of the calcium creatinine clearance ratio (CCCR). Significant clinical overlap with PHPT presents certain diagnostic challenges. Additionally, we report novel CASR mutations clinically associated with FHH, highlighting the broad spectrum of this disorder. Heightened awareness of the diagnostic criteria for FHH should decrease the incidence of unnecessary surgeries performed.
Fine‐Needle Aspiration Cytology Can Be Used to Diagnose Carotid Body Tumors with Good Accuracy
Authors: Nicoli Taija K. V. , Green James A. , Deery Alastair , Lee Michael S. W. 
Published: September 2014

Objectives:(1) Name the 4 most common locations of head and neck paragangliomas (HNPGs). (2) Describe 2 pathological and 2 radiological tools used in the diagnosis of HNPGs (with their respective diagnostic accuracy rates).Methods:The purpose of this study was to record the diagnostic accuracy of fine needle aspiration cytology (FNAC) in the diagnosis of different types of HNPG. We retrospectively collected data on all HNPGs diagnosed in our institution between January 1986 and April 2013. We recorded patient demographic factors along with diagnostic and clinical details.Results:Altogether 35 HNPGs were seen and treated in our institution in the studied period. In 15 (43%) cases FNAC was used as the first line diagnostic tool with or without ultrasound (USS) guidance. Radiological imaging (USS/computed tomography/magnetic resonance imaging) always accompanied FNAC. In the remaining 57%, clinical assessment alone or in combination with core biopsy accompanied radiological imaging. Eight (53%) out of 15 HNPGs were diagnosed correctly with FNAC; all those were carotid body tumors (CBTs). Of the rest, 1 false diagnosis of microfollicular oncolytic thyroid lesion was histologically a combined thyroid paraganglioma (PG) and Hurtle cell adenoma. One patient was treated conservatively and 4 inconclusive samples were histologically a laryngocele, a CBT, a jugular PG, and a combined CBT + contralateral PG with intracranial extension. For 1 patient full FNAC details were not available.Conclusions:FNAC can diagnose CBTs with good diagnostic accuracy. HNPGs arising in other regions of the head and neck can be challenging to diagnose without histopathologic and immunohistochemical tools.
Four‐Year Experience of Day Case Hemithyroidectomy: Patient‐Reported Outcomes
Authors: McCaffer Craig J. , Douglas Catriona M. , Kasbaker Anand , Crosbie Robin , Blaeco David , Kang Swee W. 
Published: September 2014

Objectives:Assess the safety, patient satisfaction, and outcome of day case hemithyroidectomy in our department.Methods:A prospective audit of all patients undergoing hemithyroidectomy in a single institution over a 3‐year period. All patients who undergo a hemithryoidectomy in our department have a bilateral superficial cervical block using 20 mL of 0.25% chirocaine, 10 mL of xylocaine with 1% adrenaline, and minimal opioid use. Bipolar dissection is used with meticulous hemostasis to avoid the use of a drain. All patients are reviewed 1 week postoperatively, and patient satisfaction questionnaires are completed.Results:One hundred fifty patients had a hemithyroidectomy over the 4‐year period. Average age was 49 years (21‐77). Male to female ratio was 3.9:1. Average length of stay was 0.47 days (0‐6). Eighty‐one percent of patients had their operation performed as a day case. The main reasons for patients not having surgery performed as a day case were patient choice, social reasons, and medical complications postoperatively. There were no hematomas requiring a return to theater and no drains inserted. No patient required readmission after discharge. Average patient satisfaction score for those discharged as a day case was 9.09 (0: not satisfied to be discharged as a day case ‐ 10: very satisfied to be discharged as a day case). Average pain score day 1 postop was 3 (0: no pain at all ‐ 10: worst pain imaginable).Conclusions:Day case hemithyroidectomy is very agreeable to patients and if appropriate analgesia is used then the postoperative pain is minimal.