bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lipid‐based Nose Ointment for Allergic Rhinitis
Authors: Geisthoff Urban Wilhelm , Blum Andreas , Rupp‐Classen Marianne , Plinkert Peter‐Karl 
Published: November 2005

OBJECTIVETo assess the efficacy of a lipid‐based nose ointment in treating allergic rhinitis.STUDY DESIGN AND SETTINGProspective, open, randomized, controlled clinical study in the outpatient departments of 2 tertiary care centers.RESULTSNo specific adverse effects were observed. The nose ointment under investigation led to a significant improvement in sneezing and nasal itching (17 patients). There was no significant change for nasal congestion and rhinorrhea in the intention‐to‐treat sets. However, there was still a significant drop of the mean relative total symptom score derived from the individual scores. All scores remained unchanged in the untreated control group (16 patients).CONCLUSIONTopical application of the nose ointment as a supportive treatment leads to a significant improvement of symptoms in allergic rhinitis.SIGNIFICANCEThe prevalence of allergic rhinitis is about 10% to 20% in the population. Our study results are encouraging and should be assessed in further research because changes in the therapeutic guidelines may be suggested.
Quality of Life in Prosthetic Voice Users
Authors: Gerwin John M. , Culton Gerald L. 
Published: November 2005

OBJECTIVEThis study was designed to measure the efficacy of prosthetic voice restoration for laryngectomees in relation to various quality‐of‐life parameters.STUDY DESIGN AND SETTINGThe University of Washington Quality of Life Scale, the Functional Assessment of Cancer Therapy Scale, and a demographic data form of our own design were completed by 16 laryngectomees who had undergone prosthetic voice restoration in our private practice by Blom‐Singer methodology.RESULTSMore than 80% of the respondents were positive in their assessment of each category on all three surveys.CONCLUSIONProsthetic voice restoration in private practice resulted in achieved expectations, satisfaction with speech, and good quality of life as measured by physical, functional, social, and emotional well‐being parameters.SIGNIFICANCELaryngectomees may be offered prosthetic voice restoration with a high likelihood that they will be satisfied.
The Use of the Ligasure Vessel Sealing System in Parotid Gland Surgery
Authors: Prokopakis Emmanuel P. , Lachanas Vassilios A. , Helidonis Emmanuel S. , Velegrakis George A. 
Published: November 2005

OBJECTIVETo evaluate the role of the Ligasure™ Vessel Sealing System (LVSS; Valleylab, Boulder, CO) in parotid surgery.STUDY DESIGNA prospective study was conducted on 12 consecutive patients undergoing superficial parotidectomy, performed by using the LVSS device as the primary means of ligation. Inclusion criteria included parotid mass with no preoperative suspicion of malignancy, and no extension to the deep lobe of the parotid gland. Efficacy of hemostasis, cut‐closure time, and postoperative complications were assessed. Results were compared with a historical control group, including cases on which the LVSS was not available.RESULTSLVSS proved effective in providing ligation and hemostasis. There was a mean time gain of 52 minutes, compared with our historical control group. No postoperative bleeding, seroma, salivary fistula, or Frey syndrome were observed. One case of transient facial weakness occurred, which was completely resolved within 6 months.CONCLUSIONLVSS is a safe device for parotid gland surgery, providing sufficient hemostasis and reducing operative time.
Spectrum and Management of Deep Neck Space Infections: An 8‐Year Experience of 234 Cases
Authors: Ridder Gerd JÜRgen , Technau‐Ihling Katja , Sander Anna , Boedeker Carsten Christof 
Published: November 2005

OBJECTIVETo study the clinical course and outcome of deep neck infections (DNI), with special emphasis on microbiology and histopathology.STUDY DESIGNTwo hundred thirty‐four patients with DNIs were included in this study. Patients with peritonsillar or dental infections, infections arising from salivary glands, as well as subjects with abscesses caused by neck trauma were excluded.METHODSClinical analysis of all patients with DNIs who were treated between January 1, 1997 and May 31, 2005 in a single center.RESULTSIn 13 patients, the DNI was the first manifestation of a malignant tumor. In 17 cases, the DNI was associated with cat‐scratch disease (CSD). Six patients suffered from tuberculosis, and in another 7, an infected lateral cleft cyst was found. In 176 patients, the origin of DNI remained unclear.CONCLUSIONSOur results demonstrate that CSD, tuberculosis, and malignant tumors must be considered as possible causes of DNIs. The current study represents one of the largest series of DNIs in the modern medical literature.
Hemorrhage Risk After Quinsy Tonsillectomy
Authors: Giger Roland , Landis Basile Nicolas , Dulguerov Pavel 
Published: November 2005

BACKGROUNDThe goal of the study was to evaluate the incidence and possible predictive factors of post‐tonsillectomy hemorrhage (PTH) in patients with peritonsillar abscess, treated by acute abscess tonsillectomy.METHODSA retrospective cohort study was performed on 205 patients who underwent bilateral abscess tonsillectomy under general anesthesia. Age, sex, smoking habits, history of recurrent tonsillitis or prior peritonsillar abscess, current medical treatment, side of the peritonsillar abscess, initial treatment, surgeon's experience, procedure duration, intra‐ and postoperative anti‐inflammatory medications, and side of bleeding were analyzed.RESULTSBleeding occurred in 27 patients (13%). Ipsilateral hemorrhage was observed in 8 patients (4%) and contralateral hemorrhage in 19 patients (9%). The higher incidence of PTH in the side contralateral to the abscess was found to be statistically significant (P = 0.02). Male gender (P = 0.042), smoking (P = 0.009), and aspirin intake (P = 0.008) were statistically significant factors associated with an increased PTH risk.CONCLUSIONThe risk of bleeding following abscess tonsillectomy seems higher than reported in elective tonsillectomy. This high incidence is mainly due to patients with prior aspirin intake or to bleeding in the side contralateral to the abscess. Postoperative bleeding could be reduced by performing a unilateral acute abscess tonsillectomy in selected patients. An algorithm is proposed for the management of peritonsillar abscess based on age, prior history of pharyngo‐tonsillar infections, aspirin intake, and clinical improvement after initial drainage and antibiotherapy.
Dentigerous Cysts Presenting as Head and Neck Infections
Authors: Smith Joseph L. , Kellman Robert M. 
Published: November 2005

OBJECTIVETo describe dentigerous cysts presenting as head and neck infections.STUDY DESIGN AND SETTINGRetrospective analysis of 327 charts with an admitting diagnosis of head and neck infection, deep neck space infection, and dentigerous cysts treated at a tertiary care hospital between 1975 and 2004. RESULTS: Seven patients were identified who had dentigerous cysts that presented as head and neck infections. Six of these patients had recurrent infections at the same site and one was diagnosed with a submasseteric space abscess. The incidence of head and neck infections with dentigerous cysts as the underlying causative pathology was 2.1%.CONCLUSIONHead and neck infections with dentigerous cysts as underlying pathology are more common than perceived.SIGNIFICANCETypically not considered as sources of infection, dentigerous cysts must be considered in cases of head and neck infection.
Management of Bilateral Benign Paroxysmal Positional Vertigo
Authors: Kaplan Daniel M. , Nash Michel , Niv Alexander , Kraus Mordechai 
Published: November 2005

ObjectiveTo describe a series of patients with bilateral benign paroxysmal positional vertigo (BiBPPV), with respect to demographics, management, and outcome.MethodsAll patients who were identified and treated for BiBPPV in a previous 36‐month period with a minimal follow‐up period of 6 months were included. Patients were treated with Epley's maneuver (EM) on the side that was more symptomatic and that had a greater velocity and amplitude of tortional nystagmus. Patients were re‐treated according to symptoms and findings on follow‐up visits.ResultsTen patients were identified with BiBPPV. Most patients complained of nonlocalized positional vertigo and unsteadiness. Four were males and 6 were females, and the mean age was 54 years. There was a positive history of recent head trauma in 4 of the patients. All patients recovered after performing a mean of 2.6 EMs during a 3‐month period. One patient experienced unilateral recurrence and was re‐treated successfully.ConclusionBiBPPV has typical characteristics and can be managed successfully with EM, performed on the more symptomatic side, followed by repeated treatments as needed.Ebm Rating: C© 2005 American Academy of Otolaryngology‐Head and Neck Surgery Foundation, Inc. All rights reserved.
PPAR Activation and Decreased Proliferation in Oral Carcinoma Cells With 4‐HPR
Authors: Harris George , Ghazallah Raed Abu , Nascene David , Wuertz Beverly , Ondrey Frank G. 
Published: November 2005

OBJECTIVETo explore whether the mechanism of action of 4‐hydroxyphenylretinamide (4‐HPR, fenretidine), a synthetic retinoid, involves the functional activation of the nuclear hormone receptor class known as PPARs (peroxisome proliferator‐activated receptors). Also, to examine whether anti‐proliferative effects of this agent in head and neck cancer cells occur at biologically relevant concentrations.STUDY DESIGN/METHODSCA 9–22, NA, and UM SCC 11B cells were treated with 4‐HPR during their log phase growth and functional activation of PPAR γ was evaluated by plate luminometry. Cellular proliferation was analyzed by standard MTT cell proliferation assays and cell counting. Student'sttests were performed for all experiments.RESULTSSignificant dose‐dependent increases in PPAR γ activation occurred in response to 4‐HPR treatment. Proliferation was significantly inhibited by 4‐HPR in a dose‐dependent manner as judged by MTT and cell counting assays. These effects occurred at equimolar concentrations in both types of experiments within a range of clinically achievable doses (1–4 μM) of 4‐HPR.CONCLUSIONS4‐HPR can functionally activate PPAR γ at clinically achievable doses. Decreased cancer cell proliferation secondary to PPAR γ activation has been observed in other malignancies as well as upper aerodigestive cancer. PPAR γ activation by 4‐HPR represents another potential anti‐cancer mechanism of action for this drug.CLINICAL SIGNIFICANCEPPAR γ activation represents a novel target for anti‐cancer therapy for head and neck cancer and the current level of clinical toxicity of 4‐HPR would be judged acceptable to utilize this agent alone or in combination chemotherapy.
Postlaryngectomy Pharyngocutaneous Fistula: Incidence, Predisposing Factors, and Therapy
Authors: Galli Jacopo , De Corso Eugenio , Volante Mariangela , Almadori Giovanni , Paludetti Gaetano 
Published: November 2005

OBJECTIVEThe pharyngocutaneous fistula (PCF) is a serious complication after total laryngectomy, and its etiology is not well understood yet. The aim of our study was to evaluate predisposing factors, incidence, and management of this complication.STUDY DESIGN AND SETTINGThis was a retrospective study of 268 patients who underwent total laryngectomy in our clinic (January 1990‐December 2001). A number of factors potentially predisposing to PCF formation were evaluated.RESULTSA PCF was observed in 16% of patients. Systemic diseases, previous radiotherapy, supraglottic origin of tumor, and concurrent radical neck dissection were significantly associated with PCF. Spontaneous closure was noted in 28 patients, whereas a surgical closure was necessary in 15 patients.CONCLUSIONSIn presence of a specific risk factor, PCF can be expected; nevertheless, its prevention remains very difficult. Moreover, given the high percentage of spontaneous closure, we suggest the “wait and see” approach for 28 days before proceeding with a surgical approach.
Short Hospital Stay After Neck Dissection
Authors: Ha Patrick K. , Couch Marion E. , Tufano Ralph P. , Koch Wayne M. , Califano Joseph A. 
Published: November 2005

OBJECTIVECervical lymphadenectomy is a common adjunctive therapy for the treatment of head and neck malignancies. Postoperative care of otherwise healthy patients with isolated neck dissection or in combination with other procedures often requires limited nursing attention after the first postoperative day. At our institution, patients are often taught to manage their drains and discharged home. Therefore, we sought to characterize the subset of patients who will require only overnight hospital care after neck dissection.STUDY DESIGNWe retrospectively reviewed our experience in a tertiary academic medical center over the past 6 years with patients who underwent neck dissection, isolated or with other procedures, and were sent home by postoperative day 1.RESULTSIn all, 23 of 260 patients were identified (8.8%). Two patients were noted to have postoperative seromas, with no other complications noted.CONCLUSIONWe conclude that short hospital stay after neck dissection is reasonable for the motivated patient without significant comorbidities.SIGNIFICANCEThis is the first study to examine the feasibility of short hospital stay after neck dissection.
Proton Pump (H+/K+‐ATPase) Expression in Human Laryngeal Seromucinous Glands
Authors: Altman Kenneth W. , Waltonen Joshua D. , Hammer Neal D. , Radosevich James A. , Haines G. Kenneth 
Published: November 2005

OBJECTIVERecent pilot research suggested that the H+/K+‐ATPase (proton pump), which is the target of pharmacotherapy for laryngopharyngeal reflux disease (LPRD), is associated with human laryngeal submucosal glands. The hypothesis of this study is that proton pump is expressed in the human larynx, and is not solely associated with the parietal cells of the stomach.METHODSFifteen surgical larynx subjects (27 pathologic specimens) containing seromucinous glands from banked tissue were retrospectively obtained after approval from Human Subjects Committee. Banked human stomach tissue was also obtained for comparative positive and negative controls. Sections were immunostained with two monoclonal antibodies selectively reactive with alpha or beta subunits of the H+/K+‐ATPase (proton) pump.RESULTSIn the human larynx, positive staining was seen in 14 of 15 subjects. Twenty‐six specimens showed consistent staining in the seromucinous cells and ducts for the alpha subunit, and 23 specimens for the beta subunit. Stomach parietal cells exhibited strongly positive staining for both the alpha and beta subunits of the proton pump. There was no staining in stomach cells that were not morphologically consistent with the parietal cell.CONCLUSIONThe H+/K+‐ATPase (proton) pump is present in seromucinous cells and ducts in the human larynx, with some variable expression noted. Proton pump involvement in human laryngeal seromucinous glands may explain heightened laryngeal sensitivity in those patients with chronic laryngitis believed to have LPRD. Also, proton pump inhibitor pharmacotherapy may have a site of action in the human larynx, explaining some of the controversies attributable to LPRD.
Arterial Embolization in the Management of Posterior Epistaxis
Authors: Christensen Nathan P. , Smith Dana S. , Barnwell Stanley L. , Wax Mark K. 
Published: November 2005

OBJECTIVESTreatment of severe epistaxis can encompass many modalities. Control rates with all treatments are good. Morbidity among treatment groups varies. Angiographic embolization is one such method that has a very low complication rate. Over the last 10 years, it has become the preferred treatment at our institution.STUDY DESIGNTertiary medical referral centers: OHSU, Portland VAMC.MATERIALS AND METHODSRetrospective review of 70 patients transferred or admitted with posterior epistaxis and treated with selective angiographic embolization from 1993 to 2002.RESULTSPatients had bleeding for a median of 4.5 days prior to admission. 79% were unilateral. Etiology of bleeding was: idiopathic (61%), previous surgery (11%), anticoagulants (9%), trauma (7%), and other causes (12%). 30% required blood transfusions prior to admission to OHSU (average 4.4 units). No patient required a transfusion postoperatively following angiographic embolization or during their hospitalization. The internal maxillary artery (IMAX) was embolized in 94% (47% unilateral or bilateral IMAX only, 47% unilateral or bilateral IMAX in combination with other vessels, 6% other vessels besides the IMAX). Mean length of stay was 2.5 days. 86% had minor or no complications after the embolization and were discharged within 24 hours. 13% had a major rebleed that required surgical intervention within 6 weeks of the embolization. One patient had a serious neurological complication. Using the data available on 68 of 70 patients, the cost of hospitalization averaged $18,000 with direct costs of embolization averaging $11,000. CONCLUSIONS: Angiographic embolization is a clinically effective treatment for severe epistaxis.
Clinical Prognostic Factors in Malignant Parotid Gland Tumors
Authors: Lima Roberto A. , Tavares Marcos R. , Dias Fernando L. , Kligerman Jacob , Nascimento Marilene F. , Barbosa Mauro M. , Cernea Claudio R. , Soares Jose R. , Santos Izabella C. , Salviano Scheylla 
Published: November 2005

OBJECTIVETo analyze the factors in parotid malignant epithelial tumors influencing recurrences and disease‐specific survival.METHODSWe retrospectively reviewed the files of 150 patients treated at our institution, from 1974 to 1998. Twenty‐four patients were not treated by surgery and were excluded from this study. The remaining 126 patients were treated with surgery and 74 patients had postoperative radiotherapy. Thirty‐three patients were treated with parotidectomy plus neck dissection. Neck lymph node metastasis was found in 22 patients, 5 patients had occult neck metastasis, and 4 periparotid lymph nodes metastasis. The mean age was 49 years old. According to the UICC/1997 TNM Classification, 49 patients were stage I, 27 stage II, 22 stage III, and 28 stage IV. The influence of selected factors on the 10 year disease‐specific survival was analyzed using the Kaplan‐Meier actuarial method and the log‐rank test.RESULTSForty patients had mucoepidermoid carcinoma, 18 patients adenocarcinoma NOS, 18 patients acinic cell carcinoma, 15 patients adenoid cystic carcinoma, 11 patients malignant mixed tumor, 11 patients salivary duct carcinoma, and 13 patients other pathology. Twenty‐five patients had recurrences: 17 had local recurrences, 4 patients had neck recurrences, and 4 were loco‐regional recurrences. Five factors influenced negatively the prognosis: 1) T stage (p.00001), 2) grade (p.00001), 3) + lymph nodes (p.0007), 4) facial nerve dysfunction (p.0001), and 5) age (p.004). Patients with high‐grade tumors and high‐stage tumors had the worst prognosis according to the multivariate analysis. The 10‐year disease‐specific survival was 97% for stage I, 81% for stage II, 56% for stage III, and 20% for stage IV.CONCLUSIONThe grade of the tumor and stage were the most important prognostic factor.
Voice Restoration With the Advantage Tracheoesophageal Voice Prosthesis
Authors: Leder Steven B. , Acton Lynn M. , Kmiecik Joann , Ganz Cindy , Blom Eric D. 
Published: November 2005

OBJECTIVESTo determine whether the Blom‐Singer indwelling Advantage tracheoesophageal voice prosthesis (TEP) extends prosthesis life span significantly in patients with documented premature device failure due to fungal colonization.STUDY DESIGN AND SETTINGData were collected in a prospective manner on a total of 42 standard indwelling TEP users who exhibited early device failure, that is, between 2 weeks and 6 months, due to fungal colonization of the flap valve despite appropriate use of oral antifungal agents. There were 29 men and 13 women, whose ages ranged from 36 years 10 months to 86 years 8 months.METHODSBaseline data were derived from the average number of days 3 previous standard indwelling prostheses functioned before leaking. An Advantage indwelling TEP was placed after the third change, oral antifungal agents stopped, and routine care implemented, that is, flush and brush the device in situ twice each day. Each participant was assigned to 1 of 3 groups. Group 1 had device failure equal to or less than 2 months (n = 12). Group 2 had device failure between 2 and 4 months (n = 19). Group 3 had device failure between 4 and 6 months (n = 11).RESULTSGroups 1 and 2 exhibited significantly longer device life span, that is, 77 and 82 days, respectively (P < 0.01), and group 3 exhibited device life span that was longer but not significantly so, that is, 12 days (P > 0.05), after the change from standard to Advantage TEP. Individual data indicated that the majority of participants, that is, 32 of 42 (76.2%), experienced longer device life span after changing to the Advantage prosthesis. Specifically, 9 of 12 (75.0%) users in group 1, 17 of 19 (89.5%) users in group 2, and 6 of 11 (54.5%) users in group 3 exhibited longer device life span. The combination of using an Advantage TEP, discontinuing oral antifungal agents, and reducing the number of both TEP changes and clinic visits resulted in overall cost benefits for both the user and the health care system. The cost benefit for group 1 was $520.00; group 2, $393.00; and group 3, $204.25.CONCLUSIONSThe Advantage TEP extended device life span significantly for standard indwelling device users with documented premature device failure due to fungal colonization, reduced costs associated with tracheoesophageal voice restoration rehabilitation, and enhanced user satisfaction by eliminating use of oral antifungal agents and reducing clinic visits.SIGNIFICANCEUse of an Advantage indwelling voice prosthesis is warranted from both cost and user satisfaction perspectives when early and repeated device failure occurs as a result of fungal colonization.
Vegetation Change in the Coastal-Lowland Rainforest at Avai'o'vuna Swamp, Vava'u, Kingdom of Tonga
Authors: Fall Patricia L. 
Published: November 2005

AbstractAvai'o'vuna Swamp, a small coastal wetland in Vava'u, Kingdom of Tonga, produced a 4500-year pollen and sediment record. Results are: (1) a mid-Holocene sea level highstand is confirmed for Tonga between about 4500 and 2600 14C yr B.P.; marine clay contains pollen from mangroves (Rhizophora mangle), coastal forest trees (Barringtonia asiatica and Cocos nucifera), and rainforest trees (Alphitonia, Rhus, Hedycarya and Calophyllum). (2) Microscopic charcoal first appeared at 2600 14C yr B.P., coincident with the arrival of Polynesians. (3) Cocos, Pandanus, Excoecaria, Macaranga, and Elaeocarpaceae pollen reflects the establishment of a mixed coastal-lowland rainforest in the last 2500 years. (4) The loss of Hedycarya, Elaeocarpus, Calophyllum, and Guettarda and the reduction of Terminalia and taxa in the Papilionaceae family by about 1000 years ago may be due to habitat destruction and the loss of dispersal capabilities of some species through the extinction of the two largest pigeons in Tonga.