bluuebunny/crossref_metadata_2025_split huggingface dataset:
International Healthcare and Women: The Roles and Challenges of Women in Sustainable Humanitarian Outreach
Authors: Malekzadeh Sonya , Woodson Gayle E. , Randolph Gregory W. , Nazon Marie‐Maud , Cordes Susan R. , Chandrasekhar Sujana S. 
Published: September 2011

Program DescriptionHumanitarian aid offers human, technological, and financial resources to vulnerable people throughout the world. As health care providers, we strive to provide not only quality medical care, but to establish sustainable programs through our global outreach endeavors. Equipped with the proper resources, women have the power to help whole families and entire communities. Women are at the heart of many community‐based efforts to improve basic education, prevent the spread of disease, and increase access to medical care. This miniseminar focuses on the role of women in the international community as otolaryngologists, educators, community leaders, and patients. Panelists will discuss the challenges, both locally and abroad, facing women in promoting and administering outreach in developing nations. The importance of empowering women around the world by providing support through resources and education will be explored. Successful outreach missions and partnership programs will be presented to highlight the significance of establishing lasting access to health care through education. Panelists will relate their experiences from disparate areas of the world: the Middle East, Haiti, Africa, India, and Central America. Introduction by AAO‐HNS President J. Regan Thomas, MD. Sonya Malekzadeh, MD, and Gregory W. Randolph, MD, will moderate the session which will include four panelists.Educational Objectives1) Comprehend the challenges of women physicians providing sustainable humanitarian aid. 2) Appreciate what it means to be a woman patient in a developing country. 3) Understand the relationship between a US program and a developing country educational program.
An Audit of Clinical Coding in ENT Operations
Authors: Arshad Faisal Ahmed , Mirza Showkat 
Published: September 2011

ObjectivePayment by results was introduced to the UK National Health Service in 2004. Specific payment tariff for ENT departments is determined by clinical code of the patient’s episode. Our aim was to review clinical coding in our department and assess scope for improving accuracy of coding and income tariffs.MethodWe retrospectively reviewed coding of operations over a 4‐month period. A database was obtained including primary operation code and payment tariff. Using a system that grouped operation codes according to anatomic site, we analyzed each case to see if actual code attributed to the procedure could be improved.ResultsOver the 4‐month period there were 930 operations; 866 (93%) were correctly coded with an optimal tariff, 19 (2%) were incorrectly coded giving an excessive total tariff of £24,840, and 45 (5%) were incorrectly coded losing a tariff of £37,381. Therefore, over the 4‐month period, £12,541 was lost due to suboptimal coding.ConclusionA system that groups ENT operation codes according to anatomic regions and procedure types efficiently aids the accuracy and optimization of income tariffs. It may be employed during the clinical coding process as a quality assurance tool.
Detection of SCCA Using Optical Spectroscopy: Site Comparison
Authors: Lee Walter , Afshari Hamid , Ramanujam Nimmi , Beumer Halton W. , Vishwanth Karthik , Puscas Liana 
Published: September 2011

ObjectiveCompare diffuse reflectance spectroscopy signature differences between malignant and nonmalignant mucosal tissue based on primary site of origin (ie, larynx, oropharynx, oral cavity).MethodPanendoscopy with biopsy patients were eligible. Diffuse reflectance spectroscopy (DRS) data were obtained from the tumor site and corresponding normal tissue. Biomarker specific optical absorption data were extracted for malignant and non‐malignant tissues. Specific differences in malignant and non‐malignant tissues were examined based on primary site.ResultsPatients with mucosal squamous cell carcinoma of the head and neck were enrolled in the study. Overall, our data confirm prior findings that statistically significant differences in oxygen saturation (SO2%) (P <. 01) and mean tissue scattering coefficient (MTSC) (P <. 01) exist when comparing malignant and nonmalignant tissue. When stratified by anatomical site, SO2% is more indicative of malignancy than MTSC in the larynx. SO2% and MTSC are equally reflective of malignancy in the pharynx. MTSC is more indicative than SO2% for malignancy in tongue lesions.ConclusionDRS continues to be valid in detecting significant differences between malignant and non‐malignant lesions of the head and neck. DRS biomarkers of SO2% and MTSC data differ in importance according to primary site. This research will improve the ability to detect and monitor malignant mucosal lesions.
Effects of a New PPARgamma Agonist on Tongue Carcinoma Cells
Authors: Koshkareva Yekaterina A. , Daly John 
Published: September 2011

ObjectiveTo investigate the effects of GW1929, a new specific PPARgamma agonist, on head and neck squamous carcinoma cell proliferation, apoptosis, and invasion.MethodHuman well‐differentiated tongue SCC15 cells were treated with 5, 10, 20 micromolar GW1929, and 1% DMSO in 2% FBS Media (control). Tetrazolilum salt WST‐1 assay was used to assess proliferation. Cell cycle was analyzed with FACS. Caspase3 was measured with Caspase‐Glo3/7 luminescent. RT‐PCR measured metalloproteinase‐9 and tissue inhibitor of metalloproteinase‐1 mRNA to assess anti‐invasive effects.ResultsGW1929 inhibited tumor cell proliferation. At 24, 48, and 72 hours, treatment with 5, 10, and 20 micromolar GW1929 inhibited SCC15 proliferation by 12% to 23%, 17% to 31%, 27% to 45% in a dose‐dependent manner. FACS analysis showed that GW1929 prevented cells from entering S‐phase of cell cycle. Confirming significant cellular apoptosis, levels of caspase 3 were 154%, 163%, 185% of control after a 24‐hour treatment with 5, 10, 20 micromolar GW1929. GW1929 decreased expression of markers of extracellular matrix invasion in a dose‐dependent manner. At 24 hours, levels of MMP‐9 mRNA were decreased up to 2 fold, and levels of TIMP‐1 mRNA were increased up to 2 fold.ConclusionGW1929 is a potential antiproliferative agent, as evidenced by its pro‐apoptotic, anti‐proliferative, and anti‐invasive effect on squamous carcinoma of the tongue.
EGF‐SubA Is Cytotoxic to Laryngeal SCC Cells
Authors: Jaiswal Vibha , Behrendt Anna , Backer Joseph , Boyd Mark T. , Aslam Mohammed , Jones Terence 
Published: September 2011

Objective1) Examine the effect and mechanism of action of EGF‐SubA on laryngeal (LSCC) cells. EGF‐SubA is a novel cytotoxic drug that promotes cleavage of GRP‐78, a key component of the unfolded protein response. 2) Examine the interaction of EGF‐SubA with clinically relevant modalities: cisplatin and gamma radiation in LSCC cells.MethodIn vitro cytotoxicity was determined for a panel of 7 LSCC lines of varying p53 status using MTT assays. For studies of EGF‐SubA combined with cisplatin or gamma radiation, apoptosis was also determined by flow cytometry. Clonogenic assays were used to determine the effect of combining EGF‐SubA with gamma radiation.ResultsEGF‐SubA is cytotoxic to LSCC (laryngeal squamous cell carcinoma) cells at picoMolar concentrations, regardless of p53 status in lines derived from primary tumor sites and from metastases. The cytotoxic effects of EGF‐SubA are not rapid and do not depend upon apoptosis. EGF‐SubA acted as a radiosensitizing agent when used in combination with gamma radiation producing a 30% reduction in the surviving fraction at 2Gy. Furthermore, EGF‐SubA evoked at least an additive cytotoxic effect when used in combination with cisplatin. Flow cytometry demonstrated that in contrast to EGF‐SubA alone, both combined treatments induced apoptosis.ConclusionIn vitro EGF‐SubA is highly cytotoxic to LSCC cells at picoMolar concentrations, and while the mechanism of cell death of EGF‐SubA alone is unclear, combinations of EGF‐SubA with genotoxic agents potently induce apoptosis.
Esthesioneuroblastomas in an Asian Population: Similarities and Differences
Authors: Chua Dennis Yu Kim , Ho Rachel , Goh Christopher 
Published: September 2011

ObjectiveEsthesioneuroblastomas is an uncommon malignant tumor of the olfactory neuroepithelium in the white population. However, in our series with predominantly Asian patients, it is the most common anterior skull base malignancy requiring a craniofacial resection.MethodTwenty‐four patients who underwent craniofacial resections for malignant anterior skull base tumors and were diagnosed with esthesioneuroblastomas were recruited in this prospective study over a 10‐year period. All patients were operated on by the same surgeon with the same technique.ResultsTwenty‐four out of 48 patients with anterior skull base malignancies had esthesioneuroblastomas. The mean age of patients with esthesioneuroblastomas was 53 years old with no bimodal distribution. Most patients were Chinese (92%) with a male predominance (62%). Major complication rate was 13% and we had 1 unrelated perioperative mortality. Fifty percent of our patients had either local or regional recurrence. Three patients passed away in our series from tumor‐unrelated reasons. Two‐thirds of the patients in our series are alive more than 5 years after the initial diagnosis. The overall 5 year survival rate was 86%.ConclusionThe predominant malignant anterior skull base tumor requiring a craniofacial resection was an esthesioneuroblastoma (50%). This is much more common than described in other series. There is a good curability with this tumor, with most patients surviving well beyond 5 years.
FMISO‐PET Is a Predictor of Survival Prognosis in Head and Neck Squamous Cell Carcinoma
Authors: Kikuchi Masahiro , Fujiwara Keizo , Senda Michio , Yasushi Naito , Shinohara Shogo , Yamane Tomohiko 
Published: September 2011

ObjectiveEvaluate the usefulness of [18F]fluoromisonidazole ([18F]FMISO)‐positron emission tomography (PET) prior to treatment of head and neck squamous cell carcinoma.MethodWe evaluated 30 lesions from 17 patients with HNSCC underwent pretreatment FMISO‐PET. SUVmax and tumor‐to‐muscle ratios (TMR) were measured as hypoxia indicators and tumors were defined as hypoxic or normoxic. Between the hypoxic tumor group and the normoxic tumor group, local control rates with radiotherapy and survival prognosis were compared.ResultsRadiotherapy outcome: Local control rates with radiotherapy (20‐month median follow‐up duration) were significantly lower for the hypoxic tumor group using either SUVmax or TMR as the hypoxic indicator (P =. 02 and. 04‐respectively). Patient Prognosis (operation or radiotherapy): No significant difference was found between the hypoxic and the normoxic patient groups for event‐free survival rate (12‐month median follow‐up duration) using either SUVmax or TMR as the hypoxic indicator (P =. 07 and. 13, respectively). On the other hand, disease specific survival rate (21‐month median follow‐up duration) was significantly lower in the hypoxic group defined by SUVmax (P =. 04), but was not by TMR (P =. 57).ConclusionThe current results suggest that the radiotherapy outcome and survival prognosis (operation or radiotherapy) in HNSCC may be predicted by carrying out [18F]FMISO ‐PET/CT before treatment.
Frontal Mucocoeles: The Frontal Pick
Authors: Herman Philippe , Verillaud Benjamin , Tran Hugo , Ruellan Katell , Sauveget Elisabeth , Ba‐Huy Patrice Tran , Kania Romain E. 
Published: September 2011

ObjectiveTreatment of frontal mucocoeles through an endoscopic approach is a cornerstone of minimally invasive surgery. However lysis of the posterior wall of the frontal sinus may provide significant morbidity. The focus of this study is to propose an algorithm to select mucocele drainage versus sinus obliteration.MethodRetrospective review based on 37 cases of frontal mucocoeles with erosion of the posterior wall treated from 2000 to 2009.ResultsWhile most of the cases with extensive posterior wall lysis have been successfully addressed through minimal invasive treatment, two patients presented with a “frontal pick” (ie, localized posterior wall deformity). The first patient underwent intractable CSF rhinorrhea 3 months after endoscopic marsupialization of the cyst. A “frontal pick” could be visualized, which had torn open the dura due to the relief of mucocele counterpressure. A subfrontal approach allowed obliteration of the sinus and performance of a duraplasty. The second patient was identified and successfully approached subfrontally, which allowed dissection of the frontal pick.ConclusionWhen posterior wall of the frontal sinus results in a sharp‐angled deformity of the posterior wall, then endoscopic marsupialization may result in CSF rhinorrhea due to tearing of the dura after relieving the counter pressure exerted by the mucocele. A sinus obliteration should then be performed.
Gene Silencing with siRNA Targeting E6/E7 against HPV‐HNSCC
Authors: Adhim Zainal , Kawabata Masato , Otsuki Naoki , Morishita Naoya , Nibu Ken‐Itchi , Shirakawa Toshiro 
Published: September 2011

Objective1) Investigate whether siRNA selectively alters viral gene expression and cellular proliferation of HNSCC containing HPV16. 2) Compare the effectiveness of siRNA for E6 and that of E7 on the inhibition of cellular proliferation and induction of apoptosis in HNSCC.MethodHNSCC (UM‐SCC47) and Cervical Cancer (Caski) cell lines were used for this study and have been confirmed to contain HPV16. Expressions of HPV oncogene E6/E7 and their cellular targets p53 and pRb were evaluated by real‐time PCR, western‐blotting and immunofluorescence. The cellular‐proliferation and apoptosis by in vitro cytotoxicity assay and flow‐cytometry.ResultsHPV16 E6 and E7 oncogenes were down‐regulated by either HPV16 E6 or E7 siRNAs, respectively. Furthermore, reduction of E6 and E7 oncogenes expression up‐regulated the expression of P53 and pRb protein, and induced apoptosis in both UM‐SCC47 and Caski Cells. In UM‐SCC47 (E6/E7 siRNA groups), real‐time PCR analysis showed that the levels of E6 (P =. 005/P =. 027) and E7 (P =. 002/P =. 011) mRNA were significantly down‐regulated compared with those of control groups. The inhibition of cellular proliferation and induction of apoptosis in combination of E6 and E7 siRNA groups was higher than that of E6 or E7 siRNA group alone and control.ConclusionIntroduction of HPV16 E6/E7 siRNA might be a potentially potent and specific approach to inhibit proliferation and induce apoptosis of HNSCC containing HPV16 cell lines. For clinical we are currently preparing to test the effects of HPV16 E6/E7 siRNA on xenograft of HNSCC containing HPV16 cell lines.
Endonasal Endoscopic Repair of Orbital Floor Defects
Authors: Ângelo Pedro , Ribeiro Helena G. , Filipe Joana , Subtil João , Dinis Paulo Borges , Oliveira Matos Teresa M. 
Published: September 2011

ObjectiveWe have previously published an endonasal endoscopic technique of inferior orbital floor reconstruction, for the surgical management of the “silent sinus syndrome” and “blow‐out” orbital fractures. Based on the same principles, we present an alternative version of the technique with the advantage of an “overlay” approach to the bone defect.MethodAfter creating a large middle meatal antrostomy, an autologous septal bone graft is placed over the orbit floor defect, in the subperiostal plane between orbital contents and bony floor, through an incision on the lamina papyracea.ResultsAt long‐term follow‐up we achieve, in most, if not all, cases, resolution of enophthalmos and ipsilateral chronic maxillary sinus atelectasis, with minimal morbidity.ConclusionThis technique provides excellent functional and aesthetic results in the surgical reconstruction of the orbit floor.
HPV and Its Role in Anterior Oral Cavity Dysplasia
Authors: Cashman Emma , Bin‐Woo Sook 
Published: September 2011

Objective1) Access the role of HPV in anterior oral cavity dysplasia in a sample population. 2) Review the literature with respect to the role of HPV as a potential marker of propensity for malignant transformation.MethodTissues were obtained from the department of oral pathology, Brigham and Women’s hospital, Harvard Medical School. DNA was extracted using lysis buffer and proteinse K. Detection of HPV 6/11, 16, 18 was performed by PCR using E6 gene region primers. PCR were hybridized with type‐specific probes and visualized with alkaline‐phosphatase immunoassay.ResultsA total of 18 patients with moderate (13/18) and severe (5/18) dysplasia. Mean age was 59.6 years (range, 36‐79 years). All patients were smokers. HPV DNA was detected in (18/18) 100% of samples.ConclusionDetermination of HPV status in OPC is recognized as a valuable prognostic indicator. However, HPV has rarely been identified in dysplasia of the anterior oral cavity. Recent studies provide conflicting results. Our results and meta‐analysis of the literature suggest a potential role.
HPV and Other Risk Factors: Oropharyngeal Tumor Survival
Authors: Kaschke Oliver , Zakarneh André , Knoedler Maren , Zimmermann Ulrike , Woelke Katharina , Keilholz Ulrich 
Published: September 2011

ObjectiveOropharyngeal carcinomas are associated with tobacco smoking and alcohol but also HPV infection. HPV‐associated carcinomas have a more favorable prognosis in contrast to tobacco‐ and alcohol‐induced carcinomas. Frequency and outcome of HPV‐associated oropharyngeal carcinomas (tonsils and base of tongue) in a cohort with high prevalence of smoking are reported.MethodA group of 114 patients with oropharyngeal squamous cell carcinomas (60 tonsil tumors, 54 base of tongue tumors) was controlled. Surgery, chemoradiation, or radiotherapy was performed according to the stage of disease. Complete follow‐up was obtained in fall 2010. Histologic slides were retrieved and stained for p16 as HPV association indicator.ResultsAll 114 patients (81% smokers, 64% tumors stained positive for p16, tonsils 73%, base of tongue 54%). With a median follow‐up of 28 months, 31 patients had disease progression and 39 patients died. Three‐year PFS rates were 79% and 52% in patients with p16+ vs p16‐ tumors (P =. 001 by log‐rank test). In Cox regression analysis, only stage and p16 were independent prognostic factors. For PFS p16 had a hazard ratio (HR) of 0.44% (95% CI, 0.25 to 0.78).ConclusionEven in a European population with high prevalence of tobacco smoking, p16 positivity remains a strong favorable and independent risk factor, as has previously been shown in US cohorts with far lower smoking prevalence.
HPV E6/E7 mRNA Expression in Oropharyngeal Carcinoma
Authors: Hasegawa Masahiro , Meda Hiroyuki , Agena Shinya , Suzuki Mikio 
Published: September 2011

ObjectiveAlthough patients with human papillomavirus (HPV)‐positive oropharyngeal carcinoma (OC) respond well to radiation therapy and have good prognosis, HPV integration in OC has not yet been fully analyzed. Therefore, we aimed to clarify the correlation between HPV infection or integration and prognosis of OC in a prospective study setting.MethodFrom 2006 to 2010, 56 patients with OC participated in the study. All patients were treated with 70 Gy concurrent chemoradiotherapy (CCRT). If OC did not show a partial or complete response at 40‐Gy irradiation, radical resection for residual tumor was performed.ResultsA total of 26 patients (46.4%) had HPV‐positive OC, and 70% of HPV‐16‐positive OC cases showed integration with the host genome. Control samples obtained from chronic tonsillitis patients showed 1 of 47 specimens as positive for HPV. Patients with high HPV load also showed E6/E7 mRNA expression. Recurrent‐free survival at 3 years was 100% in HPV‐positive cases and 88.9% in HPV‐negative cases. Cases with HPV integration or E6/E7 mRNA expression tended to respond well to CCRT in spite of advanced tumor extensions.ConclusionAlthough HPV testing is useful for OC, HPV integration or E6/E7 mRNA expression is a more specific marker for predicting a fair response to CCRT and good prognosis. These findings also indicate that HPV plays a key role in the development and extension of OC.
Hybrid Tracheostomy: A Safe, Effective Compromise
Authors: Makowski Renee Lynn , Moe Kris S. 
Published: September 2011

Objective1) Describe a minimally invasive hybrid tracheostomy technique that combines the advantages of open and percutaneous techniques. 2) Compare the safety of hybrid tracheostomy to a historical cohort of open tracheostomy.MethodWe developed a rapid, efficacious technique of hybrid tracheostomy (HT), combining the advantages of standard (ST) and percutaneous (PT) techniques. This paper will review 173 patients, then describe the technique and present an outcome study and cohort comparison demonstrating the procedure’s efficacy.ResultsHT uses a minimal approach similar to the percutaneous procedure but provides an open surgical view of the airway to ensure safety. It is significantly more rapid than PT, and bronchoscopy is not required. The typical procedure duration for resident surgeons performing HT ranges from 4 to 7 minutes. There were no intra‐operative complications in the HT or ST groups. In a cohort of 15 cases matched for statistical assessment, there was no significant difference in postoperative bleeding, infection or accidental decannulation rates. There were no complications requiring operative intervention.ConclusionHT appears to be more efficacious than either PT or ST. It provides the excellent airway control and visualization of ST, while being similarly or less invasive than PT. In our experience, there were no significant complications with either technique.
Impact of Age on Chemotherapy Response in Head and Neck Cancer
Authors: Cashman Emma , Lorch Jochen , Posner Michael 
Published: September 2011

Objective1) Determine if an association exists between age and overall survival (OS) and progression‐free survival (PFS) in induction chemotherapy (IC) for head and neck cancer (HNC). 2) Compare age‐specific response to 2 different chemotherapy regimen in HNC.MethodA total of 501 patients enrolled on TAX 324 study (1999 to 2003) were evaluated. Patients had nonmetastatic, unresectable stage III/IV HNC. A total of 255 patients received IC with docetaxel, cisplatin, 5FU (TPF), and 246 received cisplatin, 5 fluorouracil (PF). The cohort was split into 2 groups; 55 years.ResultsFisher exact test and general linear model approach compared clinical and demographic characteristics between treatment arms. Kaplan‐Meir method estimated OS and PFS. Stepwise Cox regression modeled OS and PFS functions. A total of 249 patients were 55 years, 127 were assigned to TPF arm and 125 to PF arm, Total failures reached statistical significance between the 2 arms; there were 50 total failures in the TPF arm and 58 in the PF arm (0.65, 0.42‐0.98; 0.04).ConclusionOur study contradicts the small amount of published evidence on age‐specific responses to chemotherapy regimen in breast, prostate, and lung cancer. It is the first study of its kind evaluating the role of age in overall survival in chemotherapy in HNC.