bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Significance of Salivary CD44sol Levels in Laryngeal Carcinomas
Authors: Trapasso Serena , Aragona Teodoro , Franco Teresa , Allegra Eugenia 
Published: September 2014

Objectives:Describe our results about the clinical significance of salivary CD44sol levels in laryngeal carcinomas and analyze its emerging role as a diagnostic and prognostic factor.Methods:The study design was prospective. Patients with laryngeal cancer were selected and recruited at the Division of Otolaryngology, University of Catanzaro, from January to December 2012. Patients with benign head and neck disease were also included as a control group. For each patient, clinical‐anamnestic data were collected in a database. The data were recorded relating to any disease recurrence and locoregional or distant metastases detected during the follow‐up, every 3 months. The sampling of undiluted saliva was performed the day before surgery and during the follow‐up, every 3 months. Salivary CD44sol levels were determined using the enzyme‐linked immunosorbent assay method.Results:In patients with laryngeal carcinoma, salivary CD44sol levels were significantly higher than those in the control group (P <. 001). There is significant reduction in salivary CD44sol levels observed during the follow‐up at 3 and 6 months (P <. 04 and P <. 0002, respectively) when compared with those at the time of diagnosis of laryngeal cancer.Conclusions:In a previous study, we demonstrated that CD44sol can be an effective biological marker with useful application for early detection and screening in laryngeal cancer. The analysis of the obtained data shows that the Elisa CD44sol determination can represent a promising prognostic test.
Clinical Study of Surgical Resection for Pulmonary Metastasis of Head and Neck Cancer
Authors: Uwa Nobuhiro , Terada Tomonori , Sagawa Kosuke , Kida Kota , Sakagami Masafumi 
Published: September 2014

Objectives:Although chemotherapy is a common treatment for pulmonary metastasis of head and neck cancer, the prognosis is still poor. This study aimed to examine and evaluate the efficacy of surgical resection for pulmonary metastasis of head and neck cancer.Methods:A total of 15 patients who had undergone 19 resections were examined at our hospital between 2005 and 2012. The patients were followed up for at least 22 months after the surgery, or until their death, with a median period of 36 months. Among the 15 patients, 11 had squamous cell carcinoma, 3 had adenoid cystic carcinoma, and one had malignant melanoma.Results:Of the 19 resections, partial lung resection was performed in 13 cases, lobectomy in 4, and segmentectomy in 2. Video‐assisted thoracic surgery was performed in all cases. The mean surgical time, operative blood loss, and length of postoperative hospital stay were 104 minutes, 64 mL, and 7.8 days, respectively. Only 1 patient showed deterioration of the postoperative performance status. For patients with squamous cell carcinoma, the number of pulmonary metastases was 2 or less at the preoperative evaluation. The 3‐ and 5‐year disease‐specific survival rates after surgical resection in patients with squamous cell carcinoma were 54.6% and 20.5%, respectively. All patients with adenoid cystic carcinoma and malignant melanoma have survived to date.Conclusions:Lung surgical resection can be considered as one of the effective treatments for pulmonary metastasis of head and neck cancer to improve patient prognosis, with minimal invasion and complications.
A Double‐Blind, Randomized, Placebo‐Controlled Clinical Trial Evaluating Fibrin Sealant in Thyroidectomy Closure
Authors: Fuller Colin W. , Gillespie M. Boyd , Nguyen Shaun A. , Jones Taylor , Hornig Joshua D. 
Published: September 2014

Objectives:Evaluate the advantages and disadvantages of Evicel fibrin sealant when used in thyroid surgery closure, taking into account the following endpoints: postoperative drain output, time to drain removal, length of admission, and adverse events.Methods:From June 2010 to January 2014, an institutional review board–approved prospective, randomized, double‐blind study of Evicel versus a saline control was conducted on 70 subjects receiving total thyroidectomy or hemithyroidectomy. Twenty‐eight received Evicel and 27 received saline; data from 15 subjects were eliminated due to protocol violations. The mean age was 50.3 (range, 21 to 73).Results:Comparisons of baseline characteristics, including age, sex, and type of surgery, revealed successful subject randomization. There was no significant difference in drain output between Evicel (median [interquartile range]: 96.3 mL [73.3‐139.3 mL]) and placebo (120.0 mL [68.8‐161.5 mL], P =. 334). Drain time (37.9 hours [25.2‐48.7 hours] vs 43.6 hours [37.6‐58.1 hours]) and hospital stay (45.5 hours [33.4‐53.8 hours] vs 50.9 hours [44.1‐69.4 hours]) were also shorter for Evicel, but again these differences were not significant (P =. 101 and. 526, respectively). For the subjects undergoing total thyroidectomy, there was a significant reduction in drain output (103.5 mL [80.0‐138.6 mL] vs 150.0 mL [120.0‐188.5 mL], P =. 035) and drain time (40.3 hours [26.2‐49.1 hours] vs 47.1 hours [42.0‐67.8 hours], P =. 035) with Evicel. Hospital stay in this subgroup was shorter with Evicel (50.3 hours [43.6‐54.9 hours] vs 59.4 hours [48.4‐70.6 hours]), but this result was not significant (P =. 246). No outcomes were significant in the hemithryoidectomy subgroup. Nine adverse events occurred in the Evicel group compared to 3 for placebo (P =. 101).Conclusions:Evicel sealant appears to be a safe, effective method to reduce serous drain output following total thyroidectomy but has a limited role in hemithyroidectomy due to low levels of baseline drain output.
Effect of Anesthesia on Morphoproteomic Expression Profile of Oral Cavity and Oropharyngeal Squamous Cell Carcinoma
Authors: Ferrell Jay , Cattano Davide , Brown Robert , Patel Chirag B. , Karni Ron J. 
Published: September 2014

Objectives:Head and neck squamous cell carcinoma (HNSCC) has an unfortunately high rate of recurrence. Recent evidence suggests that the type of anesthesia used during surgery may affect a tumor's molecular biology, thereby influencing its response to treatment. In this pilot study, we test the hypothesis that different forms of anesthesia will affect the differential expression of several pro‐survival cellular proteins in HNSCC utilizing morphoproteomic analysis.Methods:Between September 2013 and January 2014, 10 patients underwent surgical resection of previously untreated oral cavity and/or oropharyngeal SCCA. Preoperatively they were randomized to receive either sevoflurane (n = 5) or total intravenous anesthesia (n = 5). Immunohistochemistry of pre‐ and postprocedural tumor tissue was performed using the following markers: HIF‐1A, HIF‐2A, SIRT‐1, mTOR, FASn, COX‐2, c‐MET, pAKT, NFkB, and pp38. Morphoproteomic scoring by a blinded pathologist was then employed to evaluate for differences in expression between the 2 groups.Results:Differential expression of several proteins was observed between the 2 groups. Specifically, sevoflurane was associated with increased protein expression in postprocedural tissue. Moreover, correlative analysis demonstrated an association between increased expression of several markers and specific tumor features (eg, perineural invasion).Conclusions:While only preliminary, our results suggest that the form of anesthesia used during surgery may affect the molecular biology of HNSCC. This study represents one of the first to evaluate the effects of anesthesia on the molecular biology of HNSCC in vivo. However, larger, prospective studies are needed to better evaluate the effect of anesthesia on the postoperative outcomes of HNSCC.
Comprehensive Repair of the Nasal Valve in the Management of Obstructive Sleep Apnea
Authors: Shuaib Stefan W. , Stupak Howard D. 
Published: September 2014

Objectives:To analyze whether the nasal valve cartilage repositioning procedure described here results in a significant improvement in patients with obstructive sleep apnea (OSA).Methods:This is a prospective case series conducted at a university public hospital from 2011 to 2014. Adult patients who had OSA, nasal obstruction with valve collapse, and body mass index less than 30 were included in the study. All patients had a cartilage repositioning L‐strut septoplasty via full transfixion incision. Specifically, the septal dorsum is exposed, released from the upper lateral cartilages and bony septum, and repositioned in the midline and fixated to the nasal spine, thus restoring the L‐strut position. In addition, the nasal sidewalls were repaired using the Alar™ endonasal stent device to reposition the upper lateral and lower lateral cartilage after release into positions of increased overlap, thus increasing the diameter of the nasal valve. Preoperative and postoperative (3 months) polysomnograms were obtained. Statistical analysis using the paired t‐test was used to determine significance.Results:Fifteen patients were included in this study. Average apnea‐hypopnea index (AHI) scores preoperatively were 24. Postoperative AHI scores averaged to 13, a reduction of 54% (P =. 04). Only 3 out of 15 patients showed no improvement.Conclusions:The comprehensive repair of the nasal valve including repair of the nasal sidewalls and septal L‐strut can significantly improve the severity of OSA for select patients. This is a fast and minimally invasive approach to consider in patients with OSA and nasal valve collapse.
Endotracheal Tube Displacement during Neck Extension in Thyroid Surgery
Authors: Sharma Sunil D. , Kumar Gaurav , Jovaisa Tomas , Kaddour Hesham 
Published: September 2014

Objectives:Evaluate how much the endotracheal tube moves on neck extension in patients undergoing elective thyroid surgery and whether this is affected by body mass index (BMI) or neck length.Methods:Prospective study of 20 patients undergoing thyroidectomy during a 4‐month period in 2013‐2014. Patient demographics, BMI, collar size, sterno‐mental distance, and sterno‐cricoid distance were recorded. The electromyography endotracheal tubes used in thyroid surgery were marked at 1 cm, and the distance was noted in the neutral and extended (30° as tolerated) neck positions.Results:The mean age of patients was 46.4 years (range 26‐68 years). There were 18 female and 2 male patients. The mean BMI was 28.2 (range, 20.1‐32.6) and mean sterno‐mental distance was 15.2 cm (range, 9.8‐20.4 cm). The mean upward displacement of the endotracheal tube during neck extension was 22.2 ± 7.6 mm. Patients with a larger BMI (>25) had a significantly smaller amount of tube displacement than patients with a smaller BMI (<25; 17.1 ± 7.3 mm vs 24.5 ± 8.1 mm, P =. 02) and patients with a smaller neck length (sterno‐mental <12 cm) had a significantly smaller amount of tube displacement than those with a larger neck length (sterno‐mental distance >12 cm; 18.2 ± 6.9 mm vs 24.6 ± 7.1 mm, P =. 04).Conclusions:Neck extension results in upward displacement of the endotracheal tube. The amount of displacement is significantly lower in patients with a larger BMI or shorter neck length, possibly due to the limitation of neck extension in these patients. This has particular relevance for thyroidectomy patients in whom accurate positioning of the tube is essential for nerve monitoring.
Factors Affecting the Likelihood of Undergoing Transoral Robotic Surgery for Head and Neck Cancer
Authors: Squires Lane D. , Steele Toby O. , Biron Vincent L. , Luu Quang K. , Farwell D. Gregory , Bewley Arnaud F. 
Published: September 2014

Objectives:Evaluate whether patient demographics and hospital characteristics are associated with a patient's likelihood of undergoing transoral robotic surgery (TORS) for head and neck cancer.Methods:A cross‐sectional analysis of 13,193 patients who were admitted to US hospitals in 2009 and 2011 with a primary diagnosis of head and neck cancer was performed using data from the Nationwide Inpatient Sample. A multinomial logistic regression model was used to calculate the likelihood of undergoing TORS based on age, sex, race, household income quartile, insurance status, hospital size, hospital region, and hospital teaching status.Results:A total of 181 patients underwent TORS for head and neck cancer in the years 2009 and 2011. With regard to demographic factors, Hispanic patients and those within the lowest 2 income quartiles were significantly less likely to undergo TORS when compared with white patients and those within the highest income quartile (odds ratio [ORs] 0.27 confidence interval [CI; 0.09‐0.80], 0.48 CI [0.29‐0.80], 0.54 CI [0.34‐0.87]). With regard to hospital characteristics, patients treated at hospitals in the northeast and south and those treated at nonteaching hospitals were significantly less likely to undergo TORS than those treated at hospitals in the west and those treated at teaching hospitals (ORs 0.48 CI [0.31‐0.73], 0.43 CI [0.28‐0.64], 0.27 [0.16‐0.44]). There were no significant differences found between patients of different age groups or patients treated at different sized hospitals.Conclusions:Racial, socioeconomic, and regional disparities exist in the availability of TORS to head and neck cancer patients.
Factors Influencing Sialocele or Salivary Fistula Formation Post‐parotidectomy
Authors: Britt Christopher J. , Stein Andrew P. , Hartig Gregory K. 
Published: September 2014

Objectives:Determine if the extent of parotidectomy or other patient or tumor characteristics influence the rate of sialocele or salivary fistula formation after parotidectomy.Methods:A retrospective chart review was performed for all patients who underwent parotidectomy at the University of Wisconsin from 1994 to 2013. Patients who developed a sialocele or salivary fistula at any time postoperatively were identified. Age, sex, area and size of defect, body mass index (BMI), and rate of malignancy were evaluated to assess any relationship to these complications.Results:A total of 771 patients underwent parotidectomy at our institution from 1994 to 2013. Of these, 75 (9.7%) developed a sialocele or salivary fistula. Sialoceles or salivary fistulas developed in 96% (72/75) within 1 month post‐parotidectomy, and none developed after 6 months. Age, sex, BMI, and histology were not associated with sialocele or salivary fistula formation. Extent of parotidectomy was quantified through assessment of surgical volume of tissue removed. The average volume of tissue removed was 37.8 cubic centimeters (cc) (range 0.2‐277 cc; 95% confidence interval [28.4 cc, 47.2 cc]). Sixty‐four patients (85.3%) underwent superficial parotidectomy, 7 (9.3%) underwent total parotidectomy, and extent of surgery was not documented in 4 patients (5.3%). 2 patients (2.7%) underwent revision surgery. Of patients who underwent superficial parotidectomy, 28 (43.8%) were complete superficial parotidectomy and 23 (35.9%) were partial inferior superficial parotidectomy.Conclusions:Sialocele is an uncommon complication post‐parotidectomy. Contrary to other studies, we observed that sialocele formation does not depend on amount of parotid tissue removed, site of parotidectomy, gender, age, BMI, or rate of malignancy.
Fluorescently Labeled Peptide Highlights Degenerated Facial Nerve Branches during Surgery
Authors: Hussain Timon , Mastrodimos Melina , Raju Sharat C. , Glasgow Heather L. , Whitney Michael , Nguyen Quyen T. 
Published: September 2014

Objectives:Nerve degeneration after transection decreases intraoperative visibility under white light (WL), complicating repair and increasing the risk of additional injury to surrounding tissue. We previously described F‐NP41, a fluorescently‐labeled peptide which highlights peripheral nerves following systemic injection. In this study, we analyzed whether F‐NP41 highlights degenerated nerves and evaluated the use of additional fluorescence guidance in delayed facial nerve repair procedures.Methods:Degenerated distal facial nerve branches were imaged under WL and with fluorescence after systemic F‐NP41 application 1, 2, 3, 6, and 9 months (n = 4 per time point) after main branch transection. Nerve to non‐nerve tissue contrast was compared. Facial nerve repair surgeries with a cable graft were performed 6 weeks after transection, using WL alone (n = 9) or additional fluorescence guidance (n = 10). Time to nerve identification and total operating time were measured; postoperative functional recovery was assessed weekly by quantitative measurement of whisker movement for 6 weeks.Results:Nerve to non‐nerve tissue contrast was increased >2‐fold using fluorescence imaging versus WL at all time points (P <. 001). Fluorescence guidance decreased time to intraoperative nerve stump identification by 39% (P <. 0001). Postoperative functional recovery was similar for both groups after 6 weeks, although the rate of recovery tended to be increased after surgery with fluorescence guidance.Conclusions:F‐NP41 significantly improves intraoperative visualization of degenerated nerves in mice up to nine months following injury compared with WL alone. The use of F‐NP41 decreases intraoperative time to nerve identification by nearly 40%, thus reducing operating time and potentially improving functional recovery.
Endonasal Septal Perforation Repair Using an Interpositional Porcine Dermal Collagen Implant
Authors: Amin Nikul , Syed Irfan , Hunter Benjamin , Roberts David N. 
Published: September 2014

Objectives:Describe our novel minimally invasive technique for closure of nasal septal perforations.Methods:We describe our experience in a series of patients from 2 London teaching hospitals treated using the same surgical technique. Closure of the defect was undertaken using one inferiorly based nasal floor mucosal flap and a contra‐lateral superiorly based vascularized septal mucosal flap. This was achieved by a closed endonasal approach with a porcine dermal collagen sheet interpositional graft (Permacol) placed on the more concave side of the perforation. The mucosal flaps are used to cover the repair and sutured in place.Results:Septal perforations of up to 2‐cm diameter were successfully repaired in greater than 90% of cases over a 36‐month follow‐up period.Conclusions:Our novel technique has proved effective in closure of septal perforations. Permacol is a durable graft, utilizing acellular cross‐linked collagen matrix, used commonly in abdominal hernia repair. We found Permacol to be a biocompatible graft with the ability to resist dessication if there is slow re‐epithelization or partial exposure, making it a robust and easy to use interpositional graft with no morbidity from graft harvesting. The use of local intranasal mucosal advancement flaps allows a minimally invasive approach without any external incisions or scars. Potential limitations are the size of the pedicled flaps for very large perforations, or the lengths of the flaps for very anterior defects. For the majority of septal perforations the authors feel this technique offers an effective minimally invasive option with low morbidity.
Free Flap Outcomes in Previously Irradiated Patients: A Meta‐analysis
Authors: Kennedy Aimee , Watson Sydeaka , Langerman Alexander 
Published: September 2014

Objectives:(1) Understand the types of complications affecting head and neck free flap reconstructions. (2) Compare the incidence of flap complications between patients with and without prior irradiation.Methods:Systematic review and meta‐analysis of all studies of head and neck free flap reconstructions between January 1993 and October 2013. Studies that included separate data for patients with and without prior irradiation were analyzed for differences in demographics, flap type, and complications using Poisson regression and odds ratios.Results:Fourteen studies encompassing 701 free flaps in irradiated patients and 328 free flaps in nonirradiated patients were included. The 2 groups were comparable in age (P =. 45), sex (P =. 45), and types of reconstructions. Postoperative complications such as complete flap failure (incidence rate ratio [95% confidence interval] 1.10 [0.59‐2.05]; P =. 74), fistula (1.93 [0.23‐16.19]; P =. 24), dehiscence (1.45 [0.70‐2.97]; P =. 15), infection (1.43 [0.37‐5.34]; P =. 46), vascular thrombosis (2.24 [0.20‐24.46]; P =. 27), hematoma (1.98 [0.312‐12.57]; P =. 27), partial flap loss (2.38 [0.334‐17.02]; P =. 18), and other complications including vascular compromise and hardware/bone exposure (1.33 [0.63‐2.78]; P =. 41) were not statistically different between the 2 groups. However, previously irradiated patients demonstrated a higher overall complication rate (46.3% vs 30.5%; 1.57 [1.02‐2.41]; P =. 001) when all complications were considered together.Conclusions:Head and neck free flap reconstruction in irradiated patients carries an increased risk of complications. The largest effect sizes were seen in risk of fistula, vascular thrombosis, hematoma, and partial flap loss, although these did not individually reach statistical significance. However, overall flap survival was similar in patients with and without radiation.
Towards gene therapy for EBV-associated posttransplant lymphoma with genetically modified EBV-specific cytotoxic T cells
Authors: Ricciardelli Ida , Blundell Michael Patrick , Brewin Jennifer , Thrasher Adrian , Pule Martin , Amrolia Persis J. 
Published: September 2014

Key Points
EBV-CTLs resistant to calcineurin inhibitors mediate durable, potent antitumor responses despite immunosuppression in a murine model of PTLD. This approach improves immunotherapy efficacy with EBV-CTLs for PTLD after SOT and obviates need for immunosuppression withdrawal.
Impact of acute and chronic graft-versus-host disease on human B-cell generation and replication
Authors: Glauzy Salomé , Soret Juliette , Fournier Isabelle , Douay Corinne , Moins-Teisserenc Hélène , Peffault de Latour Régis , Maki Guitta , Robin Marie , Socié Gérard , Toubert Antoine , Clave Emmanuel 
Published: September 2014

Key Points
B-cell neogenesis is decreased independently by both aGVHD and cGVHD. B cells during GVHD undergo a higher number of cell divisions related, in the chronic form, to a higher BAFF/CD19 ratio.
Multi-objective multi-item solid transportation problem with fuzzy inequality constraints
Authors: Chakraborty Dipankar , Jana Dipak Kumar , Roy Tapan Kumar 
Published: September 2014

Abstract
Zimmermann (Int. J. Gen. Syst. 2:209-215, 1976) first introduced the concept of fuzzy inequality in the field of linear programming problem (LPP). But this concept is hardly used in any real life applications of LPP. So, in this paper, a multi-objective multi-item solid transportation problem (MMSTP) with fuzzy inequality constraints is modeled. Representing different preferences of the decision maker for transportation, three different types of models are formulated and analyzed. Fuzzy inequality solid transportation problem is converted to parameter solid transportation problem by an appropriate choice of flexible index, and then the crisp solid transportation problem is solved by the algorithm (Cao in Optimal Models and Methods with Fuzzy Quantities, 2010) for decision values. Fuzzy interactive satisfied method (FISM), global criterion method (GCM) and convex combination method (CCM) are applied to derive optimal compromise solutions for MMSTP by using MatLab and Lingo-11.0. The models are illustrated with numerical examples and some sensitivity analysis is also presented.