bluuebunny/crossref_metadata_2025_split huggingface dataset:
Radiotherapy of early glottic cancer
Authors: Harwood Andrew R. , Hawkins Nigel V. , Keane Thomas , Cummings Bernard , Beale Frank A. , Rider Walter D. , Bryce Douglas P. 
Published: October 2009

AbstractPatients (383) with stage Tis, Tla and Tlb NoMo glottic cancer are reviewed. Radiotherapy cured 93% of Tis patients and 86% of Tla and Tlb cases. Of all recurrences, 63% were cured. No patient with stage Tis died as a result of tumor and only 5% of stage Tla and Tlb died from tumor. Involvement of the anterior commissure or both vocal cords did not influence control rates by radiotherapy. Mobility of the vocal cord and size of radiotherapy field were significant factors influencing control by radiotherapy. Late recurrences and/or second primaries in the larynx following radiotherapy are rare. Second primaries in the respiratory tract (especially lung) are common and are as important a cause of death as laryngeal cancer in Tl cases.It is concluded that moderate dose radiotherapy with surgery for salvage is a highly effective method of management for early glottic cancer.
Tonsillar metastasis from carcinoma of the breast with ultrastructural and steroid receptor analyses
Authors: Barton Thomas K. , Kesterson Gregg H. D. , Wellman David , Mccarty Kenneth S. 
Published: October 2009

AbstractAn unusual site of metastasis for mammary carcinoma is presented with an examination of the tumor's histologic and ultrastructural features, as well as its estrogen and progesterone receptor protein content. The importance of careful examination of the tonsillar area is emphasized in this patient in whom the tonsillar metastasis represented the initial indication of breast tumor recurrence. Estrogen and progesterone receptor analyses are utilized both as an aid in identifying the origin of the metastatic tumor focus as well as an aid in selecting therapy.
Extramedullary plasmacytoma of the parotid gland
Authors: Ferlito Alfio , Polidoro Franco , Recher Gianfranco 
Published: October 2009

AbstractA case of solitary extramedullary plasmacytoma of the parotid gland occurring in a 47‐year‐old male patient is reported. Clinical examination failed to reveal evidence of this neoplasm elsewhere in the body. Problems connected with the clinical, pathological and therapeutic aspects of the neoplasm with particular regard to the rare parotid location are taken into consideration. Furthermore, stress is laid on the fact that patients with extra‐medullary plasmacytoma should be thoroughly followed‐up as multiple myeloma may occur even decades later in life. This is the fourth case of extramedullary plasmacytoma located in salivary glands to be reported in the world literature.
Premedication for outpatient adenoidectomy: Comparison between ketamine and pethidine
Authors: Ryhänen Pauli , Kangas Tuula , Rantakylä Sirkka 
Published: October 2009

AbstractA comparison of intramuscular ketamine and pethidine as premedicants was carried out in a series of 32 children under two years of age who were given thiopentone‐N2O‐O2‐, succinyl choline anesthesia for elective outpatient adenoidectomy. Fourteen (87.5%) of the 16 children premedicated with ketamine (3 mg./kg.) were calm or asleep when brought into the operating room as compared to 4 (25.0%) of the 16 children (p <0.001) premedicated with pethidine (1 mg/kg.). Immediate recovery was similar in the groups premedicated with ketamine and pethidine. These two small groups of children did not differ significantly in their emotional state during recovery room observation, nor during the 48 postoperative hours at home, either.It is suggested that ketamine administered intramuscularly is a suitable agent for outpatient premedication of small children because of its rapid action, excellent sedative and analgesic properties and low incidence of side‐effects.
Does intralaryngeal motor nerve sprouting occur following unilateral recurrent laryngeal nerve paralysis?
Authors: Lewis William S. , Crumley Roger L. , Pitcock James K. , Blanks Robert H. I. 
Published: October 2009

AbstractReinnervation of paralyzed intralaryngeal muscles by axonal sprouting from adjacent intact muscles (the phenomenon of muscular neurotization) has been observed, but the source is uncertain. The potential for laryngeal reinnervation of the posterior cricoarytenoid muscle (PCA) from contralateral PCA motor nerve sprouting in a rabbit model was investigated. Unilateral PCA denervation was produced by vagotomy. The rabbits were examined for signs of PCA recovery for up to 6 months using fiberoptic endoscopy, electromyography (EMG), and histology. No return of vocal cord abduction, EMG activity, or any nerve sprouting across the midline from the intact PCA was found. We conclude that there is no significant spontaneous intralaryngeal muscular neurotization to the paralyzed PCA. The clinical ramifications of our data will be discussed.
The benefits of VII‐VII neuroanastomosis in acoustic tumor surgery
Authors: Luetje Charles M. , Whittaker C. Keith 
Published: October 2009

AbstractDivision of the seventh nerve during acoustic tumor removal cannot always be avoided. Direct VII‐VII neuroanastomosis is superior to any other neuroanastomosis for facial reanimation. Rerouting of the seventh nerve from the mastoid and neuroanastomosis can be accomplished primarily at the initial surgery. This study reviews 19 patients with a follow‐up of greater than 18 months who underwent the procedure at the time of tumor removal because of seventh nerve involvement by tumor, intentional sacrifice or, rarely, unintentional division. A House class IV result or better, without the twelfth nerve neurological deficit produced by a VTI‐XII neuroanastomosis, was achieved in 16 of 19 patients. Although the technique is not new, surgeons unprepared to manage this surgical complication at primary tumor removal should either learn the technique, work with an associate who can do so, or be prepared to call in someone else to do it.
The clinical differentiation between vocal cord paralysis and vocal cord fixation using electromyography
Authors: Rontal Eugene , Rontal Michael , Silverman Bruce , Kileny Paul R. 
Published: October 2009

AbstractWith newer techniques for laryngeal intervention, it becomes a practical necessity to understand whether an immobile cord is due to neurogenic dysfunction or cricoarytenoid fixation. An objective test for this differentiation is laryngeal electromyography, which can be done as an office procedure with a minimum of discomfort. Our experience in a clinical setting has shown laryngeal electromyography to be efficient in accurately assessing the neuromuscular status of the intrinsic laryngeal musculature.
A technique for displaying the entire nerve branching pattern of a whole muscle: Results in 10 canine posterior cricoarytenoid muscles
Authors: Drake William , Li Youzhu , Rothschild Michael A. , Wu Bei‐Lian , Biller Hugh F. , Sanders Ira 
Published: October 2009

AbstractThere is anatomical and histological evidence for three functionally distinct muscle bellies in the canine posterior cricoarytenoid (PCA) muscle. This study attempted to define the exact nerve branching pattern to each muscle belly in 10 dogs using a modification of Sihler's neural staining technique. The results are presented here as photographs and schematic nerve maps which illustrate the following points. 1. the final terminal branches within the PCA do correspond to the three bellies of the PCA; 2, the initial nerve branch to the PCA is usually composed of multiple fascicles which rearrange before their final branching to the three bellies; 3. there is tremendous variability of the nerve branching patterns including bilateral asymmetry within the same animal; 4. the terminal branching within each belly can be surprisingly complex and contain multiple anastomoses; 5. the fast‐ and slow‐twitch bellies of the PCA have different terminal branching patterns. These results support the functional subdivision of the canine PCA into three distinct neuromuscular compartments. This microanatomical technique appears useful for studying the basic neuromuscular organization of laryngeal muscles and their developmental and pathological changes.
Ear foreign‐body removal: A review of 98 consecutive cases
Authors: Bressler Kyle , Shelton Clough 
Published: October 2009

AbstractAlthough patients with external auditory canal foreign bodies present frequently, there is scant literature on the topic other than case reports. A study of 98 consecutive patients referred over a 1‐year period to otolaryngologists at a large urban county hospital was undertaken. Fifty‐seven percent of these patients were over 12 years of age. A data form was completed by the otolaryngology resident removing the foreign body. Fifty‐three percent of the cases had undergone one or more previous attempts at removal prior to the otolaryngologist's attempt, usually by an emergency room physician. Method of removal included use of a microscope in only 6% of previous attempts, while otolaryngologists used a microscope in 91%. Canal wall lacerations were present in 48% of patients following previous attempts at removal by other health‐care professionals, but were found in only 4% of removals by an otolaryngologist. Recommendations include use of a microscope for removal and referral to an otolaryngologist if the foreign body is not readily removed by the primary‐care physician.
Middle ear disease in young children with sensorineural hearing loss
Authors: Brookhouser Patrick E. , Worthington Don W. , Kelly William J. 
Published: October 2009

AbstractEarly identification of children with sensorineural hearing loss (SNHL), coupled with the provision of appropriate conventional amplification constitute important elements of a (re)habilitative strategy. Often overlooked, however, is the problem posed by recurrent and chronic middle ear disease in the child with coexisting SNHL. This study focuses on 437 (237 boys and 200 girls) consecutive patients with bilateral SNHL, in the moderate range or poorer, who were diagnosed prior to age 5 years at Boys Town National Research Hospital. The mean threshold shift with effusion was 25.0 dB at 250 Hz, 28.5 dB at 500 Hz, 29.5 dB at 1000 Hz, 24.5 dB at 2000 Hz, and 27.5 dB at 4000 Hz. During a median follow‐up period of 3.21 years, 154 (35.2%) of these children required surgical placement of tympanostomy tubes because of the severity of middle ear disease and its impact on auditory acuity. Accurate determination of the degree and audiologic configuration of a SNHL may be seriously hindered by a coexisting middle ear effusion. If initial findings indicate the presence of a middle ear effusion, measures of auditory function must be repeated after the effusion has been resolved by medical and/or surgical intervention.
Facial nerve morbidity following parotid surgery for benign disease: The cleveland clinic foundation experience
Authors: Mehle Mark E. , Kraus Dennis H. , Wood Benjamin G. , Benninger Michael S. , Eliachar Isaac , Levine Howard L. , Tucker Harvey M. , Lavertu Pierre 
Published: October 2009

AbstractStandard surgical management for benign tumors of the parotid gland requires either superficial, subtotal, or total parotidectomy with preservation of the facial nerve. Although this approach is effective in minimizing recurrence, the resultant facial nerve morbidity is seldom addressed.Two hundred fifty‐six consecutive patients who underwent parotid surgery for benign neoplasia at this institution in the past 15 years are reviewed, with attention to postoperative facial nerve function. Immediate dysfunction was frequently encountered (46.1%), but permanent dysfunction was uncommon (3.9%). The incidence of long‐term dysfunction may be higher in revision cases and when an extended (total or subtotal) parotidectomy is performed.
Facial nerve monitoring in surgery for congenital auricular atresia
Authors: Meiteles Lawrence Z. , Linstrom Christopher J. 
Published: October 2009

AbstractSurgery for congenital auricular atresia places the facial nerve at risk because of its potential aberrancy; iatrogenic facial paralysis is a well‐known potential risk.Five cases of congenital auricular atresia are presented. All patients had intraoperative monitoring of the facial nerve. The facial nerve was found to be abnormally displaced, usually due to hypoplasia of the tympanic ring. Preoperative and postoperative facial nerve function was unchanged by surgery.Facial nerve monitoring is an important adjunct in congenital ear surgery because it allows for early and precise identification of the nerve in the absence of normal surgical landmarks and provides for continuous monitoring of the nerve.
The changing clinical presentation of acoustic tumors in the MRI era
Authors: Selesnick Samuel H. , Jackler Robert K. , Pitts Lawrence W. 
Published: October 2009

AbstractThe application of magnetic resonance imaging (MRI) scanning in the diagnosis of acoustic neuroma (AN) has increased the relative incidence of smaller tumors and has impacted on the typical clinical presentation of AN patients. The charts of 126 patients treated at the University of California, San Francisco for newly diagnosed AN from 1986 to 1990 were reviewed. Twenty‐four percent of tumors fell into the smallest size category (<1 cm); this was a substantial improvement over earlier series. However, 16% of tumors remained undiagnosed until they achieved large size (>3 cm). The incidence of hearing loss, dysequilibrium, headache, facial numbness, and diplopia all increased with increasing tumor size, while the incidence of vertigo decreased. Diagnosticians should not overemphasize “typical” symptom complexes, as substantial variability in clinical manifestations exists. An improved awareness by clinicians of the variability of AN presentation will improve diagnostic efficiency and continue the trend toward earlier diagnosis of these lesions.
Merkel cell carcinoma: An aggressive skin neoplasm
Authors: Bielamowicz Steven , Smith Damon , Abemayor Elliot 
Published: October 2009

AbstractMerkel cell carcinoma (MCC) is an aggressive skin neoplasm of neuroendocrine origin. To clarify those factors important in improving survival, we retrospectively reviewed the charts of all patients with Merkel cell carcinoma treated at two tertiary referral centers. Eighty percent of the patients with stage I disease were initially treated with local therapy alone, while all of the patients with stage II disease were treated with local and regional therapy. The overall survival rate for all patients was 64%. Regardless of stage, patients treated with local excision alone had a 52% 5‐year survival rate, while patients treated with local excision and lymph node dissection had an 87% survival rate. We conclude that the aggressive nature of this tumor warrants radical therapy.
Prediction of facial nerve function following acoustic neuroma resection using intraoperative facial nerve stimulation
Authors: Silverstein Herbert , Willcox Md Thomas O. , Rosenberg Seth I. , Seidman Michael D. 
Published: October 2009

AbstractMethods of monitoring the facial nerve during posterior fossa surgery continue to evolve. In an effort to predict acute and final facial nerve function following acoustic neuroma resection, the lowest current applied to the facial nerve at the brainstem necessary to elicit facial muscle response was measured using strain gauge and electromyographic facial nerve monitors. A retrospective analysis of 121 patients who had undergone acoustic neuroma surgery was performed. Sixty‐five patients had intraoperative facial nerve monitoring and 44 had sufficient data for inclusion in this study. The acute and final facial nerve functions, according to the House‐Brackmann classification, were assessed with regard to intraoperative stimulation‐current thresholds. Nineteen of 20 patients who required 0.10 mA or less to elicit a facial muscle response had a House‐Brackmann grade I facial nerve outcome. The upper limit of the 95% confidence interval of stimulation threshold for patients with a final grade I facial nerve function is 0.17 mA. All of the patients in this study, with stimulation thresholds ranging up to 0.84 mA, had a final grade III or better result. A poor outcome in our series, a final grade III facial nerve function, is best predicted by a poor acute result, specifically an acute grade VIA facial nerve function. We suggest that it is possible to predict the facial nerve function based on intraoperative threshold testing.
Bioresorbable screws for facial bone reconstruction: A pilot study in rabbits
Authors: Kellman Robert M. , Huckins Sean C. , King Jennifer , Humphrey David , Marentette Lawrence , Osborn David C. 
Published: October 2009

AbstractRigid fixation using plates and screws is an accepted mode of repair for facial fractures and osteotomies. To avoid potential complications associated with metal implants, bioresorbable implants are being developed. A study was performed to assess the strength over time of three bioresorbable polymeric screws for facial bone reconstruction. Screws of each polymer type and a titanium control were implanted in the periorbital bones of eight rabbits. Rabbits were euthanized at various time intervals. Pull‐out testing and histological analysis were performed. Results showed varying degrees of resorption and screw pull‐out strength dependent on time and polymer type, and no change in the control. This study demonstrates that bioresorbable screws can be used in bone, although the optimal choices for human implantation are yet to be determined.
Temporal bone imaging for cochlear implantation
Authors: Seidman David A. , Chute Patricia M. , Parisier Simon 
Published: October 2009

AbstractComputerized tomography (CT) imaging of the inner ear structures is helpful when evaluating a patient for cochlear implantation. The accuracy of CT scan imaging in determining the presence of cochlear ossification was assessed. A retrospective study of 104 implant patient charts, operative reports, and CT scans was performed. The CT scan was in agreement with the operative findings in 78% of patients included in the study. Twenty‐two percent were found to have ossification at surgery which was not detected radiographically. One patient with extensive otospongiosis and an obstructed cochlea on CT scan had a patent cochlea demonstrated by magnetic resonance imaging (MRI) which was corroborated at surgery. In 32 children with postmeningitic hearing loss, the CT scan had only a 53% accuracy in assessing cochlear ossification. Since 69% of these patients were found to have some degree of cochlear ossification, otologists should expect to encounter some degree of bony obstruction within the basal turn of the cochlea even when the CT scan is normal. Nevertheless, cochlear implantation can successfully be performed in these cases.
Treatment of aphthous ulcers in AIDS patients
Authors: Friedman Michael , Brenski Taylor A. Lisa 
Published: October 2009

AbstractFrom 1987 to 1992, 240 acquired immunodeficiency syndrome (AIDS) patients with oral, laryngeal, and pharyngeal ulcers were evaluated. In 180 patients, ulcers resolved in less than 2 weeks without treatment. Of the 60 patients whose ulcers persisted for more than 2 weeks, 24 were culture positive for herpes simplex virus, Cryptococcus organisms, cytomegalovirus, or Mycobacterium organisms and were treated accordingly. The remaining 36 patients were diagnosed as having major aphthous ulcers. The usual sites for these ulcers were the floor of the mouth, tonsillar fossa, and epiglottis. The most common symptoms were pain and weight loss. The patients were treated with intralesional injection with triamcinolone acetonide and examined weekly. Ulcers were reinjected biweekly as needed. Response to treatment was evaluated by pain relief, ulcer healing, and weight gain. All patients reported pain relief within 2 days of initial injection. Most had marked reduction in ulcer size and subsequent weight gain, and many experienced total resolution of symptoms and complete healing.
Analysis of intrabolus forces in patients with zenker's diverticulum
Authors: Mcconnel Fred M.S. , Hood Dozier , Jackson Keith , O'Connorn Aine 
Published: October 2009

AbstractThis report presents 10 patients with Zenker's diverticulum who were evaluated with simultaneous solid‐state manometry and fluoroscopy. With this method, intrabolus forces are determined. Each patient had abnormal intrabolus forces regardless of the size of the diverticulum and cricopharyngeal muscle dysfunction. In the literature, there has been conflicting manometry results when studying Zenker's diverticulum. The use of analysis of intrabolus forces increases the sensitivity of manometric evaluation. This study establishes pressure abnormality in the pharyngoesophageal segment of patients with Zenker's diverticulum. The pathogenesis of Zenker's is presented based on these findings.
Reduction of streptomycin‐induced acute and chronic toxicities
Authors: Doretto M. C. , Marseillan R. F. , Pinto‐Gonçalves R. , Oliveira J. A. A. , Corrado A. P. 
Published: October 2009

AbstractThe acute and chronic toxicities of streptomycin sulfate (SS) and of the streptomycin hydrochloride‐calcium chloride complex (SCC) were compared. The LD50 determined in mice was significantly higher for SCC than for SS. Chronic toxicity was evaluated by recording the nystagmus induced by damped torsion pendulum in rabbits. SS and SCC treatments (200 mg/kg intramuscularly of absolute streptomycin base) decreased the duration, the maximal frequency, and the total number of beats of nystagmus. However, SCC‐induced changes were significantly lower than SS‐induced ones. The extent of the lesion in the crista ampullaris was evaluated by light and electron microscopy and was correlated with the electrophysiological findings. Because the authors also demonstrated that there are no differences in the antibacterial effects of these salts, SCC may have a place in long‐term streptomycin treatment.
Structure‐property investigations on a laser beam welded dissimilar joint of aluminium AA6056 and titanium Ti6Al4V for aeronautical applications. Part II: Resistance to fatigue crack propagation and fracture
Authors: Vaidya W. V. , Horstmann M. , Ventzke V. , Petrovski B. , Koçak M. , Kocik R. , Tempus G. 
Published: October 2009

AbstractInvestigations were continued on the dissimilar laser beam welds of AA6056 and Ti6Al4V, fabricated by inserting Ti‐sheet into the profiled Al‐sheet and melting AA6056 alone. By using microstructure, hardness and strength as the criteria, sites exhibiting non‐uniform microstructure and localized plastic deformation due to strength mismatch were investigated in two orientations: • crack parallel to the weld and • crack perpendicular to the weld for fatigue crack propagation and fracture toughness at room temperature. Effect of temper of AA6056 on these properties was studied for two conditions; welding in T4 followed by post weld heat treatment T6, and welding in T6 and naturally aged for a defined period. The orientation “crack parallel to the weld” was investigated in 3 locations on the side of AA6056: the interface and the two changeovers on the Al‐side. Firstly, between the fusion zone and the heat affected zone (3 mm from the interface) and secondly, between (primary) heat affected zone and towards the base material (7 mm from the interface). Although brittle intermetallic TiAl3 had been formed at the interface, uncontrolled separation or debonding at the interface was not observed. Insofar the bond quality of the weld was good. However, the ranking of interface was the lowest since fatigue crack propagation was relatively faster than that in the fusion zone and heat affected zone, and fracture toughness was low. Therefore, unstable fatigue crack propagation is observed when the crack propagates perpendicular to the weld from AA6056 towards Ti6Al4V. The results have shown that the dissimilar joints exhibit improved performance when laser beam welded in the T6 condition.