bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gerbilline Cholesteatoma Development Part III. Increased Proliferation Index of Basal Keratinocytes of the Tympanic Membrane and External Ear Canal
Authors: Steven P. Tinling , Richard A. Chole 
Published: July 2006

OBJECTIVETo quantify the rate of basal cell division for keratinizing epithelium (KE) of the tympanic membrane (TM) and external ear canal (EAC) in spontaneous and induced gerbilline cholesteatomas.STUDY DESIGN AND SETTINGCholesteatomas (3 spontaneous and 5 by induction) were labeled with tritiated thymidine for autoradiography and a KE proliferation index (PI) was determined. The PI was defined as the average number of labeled cells/mm overall and per anatomic region.RESULTSFor all regions combined, the PI was 27.3 in ears with cholesteatoma and 4.1 in normal ears (P < 0.0001). Additionally, there were significant regional differences in the PI in both normal ears and ears with cholesteatoma.CONCLUSIONThe KE of cholesteatomas in gerbils proliferates at approximately 7 times the rate measured in control ears.SIGNIFICANCEHyperproliferation of keratinocytes is a causative factor in the development and progression of spontaneous and experimental cholesteatomas in gerbils.
Long‐Term Results with Operated Sinus Tympani Retraction Cholesteatoma
Authors: Leonetti John P. , Marzo Sam J. , Beauchamp Mary M. , Jellish W. Scott 
Published: July 2006

OBJECTIVESUtilizing an endaural approach, we described the surgical treatment of 29 cases of sinus tympani retraction cholesteatoma in 1996. The purpose of this paper is to provide long‐term results in this group of patients.STUDY DESIGN AND SETTINGA retrospective chart analysis of 29 previously reported patients was undertaken in an effort to identify hearing results and the risk of cholesteatoma recurrence following sinus tympani retraction surgery.RESULTSThe follow‐up period ranged from 9 to 16 years (mean of 13.2 years). Speech discrimination (SD) and conductive hearing (CH) decline occurred in 23 of 28 patients, but only on the average of 5.6% and 9 dB throughout the speech frequencies, respectively. Speech discrimination and conductive hearing improved in 5 of 28 patients; one patient was lost to follow‐up. One patient developed a recurrent cholesteatoma requiring a canal wall—down mastoidectomy.CONCLUSIONSThe endaural approach for sinus tympani cholesteatoma provided stable hearing in most of the patients in this series. One cholesteatoma recurrence required conversion to a canal wall—down mastoidectomy. This developed in a noncompliant patient, whose pars tensa retraction deepened as a result of failure to have his ventilation tube replaced. Semiannual office visits are recommended in patients who undergo this otologic approach for sinus tympani cholesteatoma.
Amplification of CCND1, EMS1, PIK3CA, and ERBB Oncogenes in Ethmoid Sinus Adenocarcinomas
Authors: Gonzalo Nazar , María V. González , Juana María García , José L. Llorente , Juan P. Rodrigo , Carlos Suárez 
Published: July 2006

OBJECTIVEAssess the amplification of CCND1, EMS1, PIK3CA, ERBB1, and ERBB2 oncogenes in ethmoid sinus adenocarcinomas.STUDY DESIGN AND SETTINGTissue samples from 13 primary ethmoid adenocarcinomas and 2 recurrences were studied at Hospital Central de Asturias, Oviedo, Spain, between July 1998 and February 2002. A semiquantitative evaluation of CCND1, EMS1, PIK3CA, ERBB1, and ERBB2 amplification was performed by multiplex polymerase chain reaction.RESULTSThree (23%) cases presented CCND1 amplification, one of them with a concurrent PIK3CA amplification. EMS1 was amplified in the 2 studied recurrences. ERBB1 was amplified in 1 case (8%), whereas none presented ERBB2 amplification. Oncogenic amplifications were only detected in advanced (stage III) tumors; however, no prognostic value could be shown for them.CONCLUSIONSCCND1, EMS1, PIK3CA, and ERBB1 amplifications are uncommon and appear to be late events in the development of ethmoid sinus adenocarcinoma.SIGNIFICANCENew information on the carcinogenesis of this infrequent sinonasal tumor is presented.
Inflammatory Pseudotumor Involving the Skull Base: Response to Steroid and Radiation Therapy
Authors: Lee Dong Kyung , Cho Yang‐Sun , Hong Sung Hwa , Chung Won Ho , Ahn Yong Chan 
Published: July 2006

OBJECTIVETo evaluate the response to steroid and radiation therapy in inflammatory pseudotumor (IPT) involving the skull base.STUDY DESIGN AND SETTINGEight patients with IPT of the skull base were evaluated. Six patients were diabetic. All patients underwent initial high‐dose steroid therapy. Seven of 8 patients underwent subsequent low‐dose steroid maintenance. Additional low‐dose radiation therapy was performed in 6 patients. We reviewed the medical records and radiologic findings of the patients to evaluate their responses to the steroid and radiation therapy.RESULTSIn all patients, the initial response to steroid therapy was fair. However, 7 patients showed symptom recurrence after cessation of steroid therapy. In 5 of 6 patients, low‐dose radiation therapy resulted in recurrence. On follow‐up MRI, none of the patients showed complete remission of the disease.CONCLUSIONThis study shows aggressive clinical behavior of IPT involving the skull base and its poor response to steroid therapy and low‐dose radiation therapy. For improving control, more aggressive initial efforts including high‐dose radiation therapy with or without concurrent steroid therapy might play a role.EBM rating: C‐4
Cross‐Linked Hyaluronan‐Coated Stents in the Prevention of Airway Stenosis
Authors: Sondrup Cole , Liu Yanchun , Shu Xiao Zheng , Prestwich Glenn D. , Smith Marshall E. 
Published: July 2006

OBJECTIVEThis project studies the use of airway stents coated with a cross‐linked derivative of hyaluronan (HA) in a rabbit airway model of subglottic stenosis (SGS).STUDY DESIGN AND SETTINGAn acute subglottic mucosal injury and airway stent placement design were used in a rabbit model. Thirty‐six rabbits were randomized to 6 different study groups. Four groups had the subglottic mucosa denuded at the cricoid, and 2 groups received no injury. Airway stents coated with Carbylan‐SX, a cross‐linked derivative of HA, and controls were placed for 3 weeks. After sacrifice at 6 weeks, morphometric measurements of subglottic lumen were taken.RESULTSIn posttraumatic models, no significant differences were seen in airway area measures between groups (P = 0.86). In non‐injury groups, a significant difference between Carbylan‐SX versus non—HA‐derivative‐coated stents was seen (P = 0.05).CONCLUSIONIn this model of acute subglottic mucosal injury, the HA‐derivative—coated stent did not improve healing. However, in the absence of mucosal injury, the Carbylan‐SX film—coated stent yielded significantly larger airway areas compared with a noncoated stent.SIGNIFICANCEStents or endotracheal tubes coated with a cross‐linked derivative of HA may prevent stenosis in patients without airway injury but require long‐term intubation or laryngotracheal stenting.
Reanimation of Paralyzed Laryngeal Muscles by Electrical Stimulation Synchronized with Inspiration
Authors: Chi Fang‐Lu , Jing Jiang‐Hua , Dai Chun‐Fu 
Published: July 2006

OBJECTIVETo determine the effects of electrical stimulation on denervated cat posterior cricoarytenoid (PCA) muscle.STUDY DESIGN AND SETTINGThis study was conducted on six cats with PCA muscle denervation. All animals were sacrificed 12 weeks after surgery and the glottal area in the live animals and the fiber diameters of PCA muscle were obtained.RESULTSSignals synchronized with inspiration were recorded and transmitted to stimulate PCA muscle. The abduction of the paralyzed vocal cord during inspiration was observed; this allows enough flow of air through the larynx to maintain the respiration. The stimulated fiber diameters of PCA muscle were different from that of nonstimulated (P< 0.01). Although all denervated muscles were degenerated, electrical stimulation was used to prevent muscular atrophy.CONCLUSIONSThis study indicates that electrical stimulation of the PCA muscle synchronized with inspiration could restore the abduction of a paralyzed vocal cord and prevent the denervated muscles from atrophying.SIGNIFICANCEElectrical stimulation synchronized with inspiration may lead to reanimation of paralyzed laryngeal muscles.
Treatment of Pediatric Suppurative Mastoiditis: Is Peripherally Inserted Central Catheter (PICC) Antibiotic Therapy Necessary?
Authors: Jeremy A. Moore , Julie L. Wei , Holly J. Smith , Matthew S. Mayo 
Published: July 2006

OBJECTIVEA review of the treatment of pediatric acute mastoiditis requiring surgical intervention managed with and without PICC therapy postoperatively.STUDY DESIGN AND SETTINGRetrospective study of 42 cases from 1989 to 2004 treated at a regional children's hospital.RESULTSSixteen patients received postoperative PICC therapy and 26 received a course of oral antibiotics. The PICC group received on average 12.12 days of intravenous antibiotics compared to only 3.53 days for the non‐PICC group (P < 0.001). No differences were observed between the two groups in treatment outcomes. One patient from each group required rehospitalization. One minor complication was experienced in a patient in the PICC group. There were no surgical complications. The total cost for outpatient PICC therapy increased treatment costs by approximately $1500 to $2500.CONCLUSIONSOral antibiotic therapy is sufficient after surgical intervention for acute pediatric suppurative mastoiditis without intracranial complications and does not result in adverse treatment outcome.SIGNIFICANCEUse of PICC therapy after surgical intervention for mastoiditis should be limited.EBM rating: B‐3b
Post—Tympanostomy Tube Otorrhea: A Meta‐Analysis
Authors: Hochman Jordan , Blakley Brian , Abdoh Ahmed , Aleid Hazim 
Published: July 2006

INTRODUCTIONPost—tympanostomy tube otorrhea is the most common complication of tympanostomy tube placement. The incidence of this problem varies from 3.4% to 74%. Trials that study post—tympanostomy tube otorrhea may involve valid randomization “by patient” or “by ear.” In an attempt to define “best practice,” we conduct a meta‐analysis to quantify the benefit of using topical prophylactic antibiotic drops in the postoperative period. We then compare our findings with previous results found in the literature.METHODSWe selected randomized studies for which antibiotic drops had been used for at least 48 hours after tympanostomy tube insertion. Nine studies, 3 “by ear” and 6 “by patient,” met our inclusion criteria. The odds ratio and 95% confidence intervals were calculated for each to conduct the meta‐analysis.RESULTSOverall, prophylaxis appears to be effective at reducing the incidence of post—tympanostomy tube otorrhea. The odds ratios for all studies were less than 1.0. However, none of the 3 “by ear” studies and only 3 of the 6 “by patient” studies were statistically significant. The mean odds ratio was 52%, suggesting that prophylaxis may reduce the incidence of post—tympanostomy tube otorrhea by half.CONCLUSIONThis meta‐analysis suggests that routine post—tympanostomy tube prophylaxis is beneficial, but this finding is dependent on selection criteria used.EBM rating: A‐1a
Hyperostosis May Affect Prognosis after Primary Endoscopic Sinus Surgery for Chronic Rhinosinusitis
Authors: Hyo Yeol Kim , Hun‐Jong Dhong , Hyun Jong Lee , Young‐Jun Chung , Yoo Jeong Yim , Jae‐Won Oh , Seung‐Kyu Chung , Hyung Jin Kim 
Published: July 2006

OBJECTIVETo investigate the independent effect of hyperostosis on outcome after endoscopic sinus surgery (ESS) in patients with chronic rhinosinusitis (CRS).STUDY DESIGN AND SETTINGThe medical records of 81 consecutive patients who had undergone primary ESS for CRS were reviewed retrospectively. Sinus CT scans were evaluated for the presence of hyperostosis to investigate the association with postoperative outcomes. The independent effect of hyperostosis on surgical outcome was analyzed, controlling for possible confounding factors with a multiple logistic regression model.RESULTSSixty percent of the patients showed hyperostosis, and there was a statistically significant association between the hyperostosis and postoperative outcome (P = 0.035, χ2 test), which was confirmed after adjustment for the possible confounding factors (P = 0.048, odds ratio [OR] = 3.19, logistic regression analysis).CONCLUSIONSOur study suggests that patients with CRS who have hyperostosis may have a poorer surgical outcome than those without hyperostosis.EBM rating: B‐2b
Outpatient Tonsillectomy in Children: A Systematic Review
Authors: Brigger Matthew T. , Brietzke Scott E. 
Published: July 2006

OBJECTIVETo evaluate the level of evidence regarding the safety of outpatient pediatric tonsillectomy.STUDY DESIGN AND SETTINGThe medical literature addressing outpatient pediatric tonsillectomy was systematically reviewed. The level of evidence was assessed, and data were pooled.RESULTSSeventeen articles met inclusion criteria. Each article suggested that outpatient tonsillectomy was safe. The overall level of evidence was fair (grade B —). Pooled data analysis in the perioperative period showed a complication rate estimate of 8.8% (95% confidence interval [CI], 5.5%–12.1%; P ≤ 0.001) and an unplanned admission rate estimate of 8.0% (95% CI, 5.3%‐10.7%; P ≤ 0.001). Subgroup analysis suggests that children under age 4 are at a higher risk of complications in the perioperative period with an odds ratio of 1.64 (95% CI, 1.16–2.31).CONCLUSIONThe level of evidence supporting the safety of outpatient pediatric tonsillectomy is fair. The analyzed data show a higher rate of early complications and unplanned admissions in children under age 4.SIGNIFICANCEThe current evidence supports the practice of outpatient tonsillectomy in properly selected children.EBM rating: A‐1a
Quality of Life and Complications Following Image‐Guided Endoscopic Sinus Surgery
Authors: Abtin Tabaee , Amy K. Hsu , Mark G. Shrime , Scott Rickert , Lanny Garth Close 
Published: July 2006

OBJECTIVESTo compare the quality of life (QOL) outcome and incidence of complications following image‐guided versus non–image‐guided endoscopic sinus surgery (ESS).STUDY DESIGNThe operative, office, and hospital charts of patients who underwent primary ESS for chronic sinusitis by a single surgeon with (2002–2005) or without (1997–2002) image guidance were reviewed for patient demographics, incidence of complications, and revision procedures. A telephone survey was used to administer the QOL survey to both cohorts.RESULTSIn comparing patients who underwent image‐guided (60) versus non–image‐guided surgery (179), respectively, there was no statistically significant difference in the incidence of major intraoperative complications (6.6% vs 5.6%), major postoperative complications (5% vs 3.9%), revision procedures (6.6% vs 7.3%), and postoperative SNOT‐20 symptom scores (23.6 vs 23.4). A higher incidence of intraoperative cerebrospinal fluid leak was noted in the non–image‐guided group (0% vs 2.2%).CONCLUSIONSOur study does not demonstrate an improvement in the incidence of complications, need for revision procedures, or quality‐of‐life outcome for patients undergoing primary ESS for chronic sinusitis. The use of image guidance may result in a lower incidence of skull base trauma and cerebrospinal fluid leak.EBM rating: B‐2b
Passive Smoke Exposure as a Risk Factor for Airway Complications during Outpatient Pediatric Procedures
Authors: Jones Dwight T. , Bhattacharyya Neil 
Published: July 2006

OBJECTIVEDetermine if passive smoke exposure (PSE) increases airway complications during outpatient mask anesthesia procedures in children.METHODSA prospective cohort of children who underwent surgical procedures under mask anesthesia was studied with the American Thoracic Society children's questionnaire on environmental and respiratory factors. Double‐blinded outcomes with respect to adverse airway events were recorded both intraoperatively and in the recovery room for patients with and without passive smoke exposure. Multivariate comparisons assessing the likelihood of these airway complications were conducted between the PSE and nonexposed groups.RESULTSOf 405 children, 168 (41.5%) had PSE. The incidence of airway complications during anesthesia or postanesthetic recovery was higher for all outcome measures for PSE children (all P ≤ 0.005), except for recovery room breath holding (P = 0.086). Intraoperative laryngospasm and airway obstruction were 4.9 and 2.8 times more likely with PSE, respectively.CONCLUSIONSPSE significantly increases the risk of anesthesia‐related airway complications during outpatient pediatric procedures.EBM rating: A‐1b
The Role of Gastric Helicobacter Pylori Infection in Laryngopharyngeal Reflux Disease
Authors: Ercan İIbrahim , Çakir Burak Ömür , Uzel Tulin Çentürk , Sakiz Damlanur , Karaca Çetin , Turgut Suat 
Published: July 2006

OBJECTIVESTo investigate the role of Helicobacter pylori (H pylori) infection in laryngopharyngeal reflux (LPR).STUDY DESIGNA prospective multidisciplinary clinical study.METHODSForty‐four adult patients who applied to our ENT clinic with LPR symptoms were evaluated. Then these patients underwent upper gastrointestinal system endoscopy and double probe pH monitoring. In addition, during the endoscopy multiple biopsies from the stomach were obtained to detect H pylori.RESULTSResults from 32 LPR positive patients were assessed (10 male and 22 female). There were no statistically significant differences between the presence of H pylori and sex, age, degree of gastritis and esophagitis, and also the number of reflux, fractional acid exposure time regarding proximal probe readings. Similarly for both proximal and distal probe readings, the average score of esophageal acid clearance was not statistically significant (P > 0.05). In addition, no statistically significant difference was found between the presence of H pylori and GERD (P > 0.05).CONCLUSIONSThe results of this study demonstrated that there is no relationship between gastric H pylori infection and LPR.EBM rating: B‐3b
The Relationship Between Somatic Growth and In Vivo Esophageal Segmental and Sphincteric Growth in Human Neonates
Authors: Gupta Alankar , Jadcherla Sudarshan Rao 
Published: July 2006

ABSTRACTBackground:Measurement of aerodigestive tract length is an important determinant for accurate placement of esophageal probes and gavage tubes at the desired location. The relationship of esophageal body, upper esophageal sphincter (UES) and lower esophageal sphincter (LES) lengths with somatic growth in neonates is not well understood.Objectives:Our objectives were to (1) evaluate a relationship between segmental esophageal lengths and somatic growth parameters and (2) ascertain the relationship between segmental esophageal lengths and gestational age (GA) and postmenstrual age (PMA) in preterm and full‐term born human neonates.Design/Methods:One hundred esophageal manometry studies were performed in 75 infants (30‐60 weeks PMA) and the high‐pressure zones of LES and UES identified. The distance from nares to LES and from nares to UES, esophageal body length, length of UES and LES derived from the manometry studies were correlated with somatic growth parameters. Growth rate of different esophageal segments was also determined in 26 subjects that underwent longitudinal studies. Analysis of variance and linear regression analysis were performed.Results:Seventy‐five neonates of 23.0‐40.6 weeks gestational age (0.6‐4.4 kg) were studied at 29.1‐58.6 weeks PMA (1.0‐6.4 kg). Significant correlation (P < 0.001) of PMA and physical growth parameters with the growth of nares‐LES (R2 = 0.8), esophageal body length (R2 = 0.6) and nares‐UES (R2 = 0.4) were noted. Nares‐to‐LES length increased at a rate of 0.25 cm/wk PMA during 33.0‐36.0 weeks of age.Conclusions:In vivo esophageal segmental lengths correlated strongly with somatic growth parameters and PMA in neonates. We speculate that this approach has many practical applications with the use of esophageal probes and catheters.
Nutritional Approach to Restore Impaired Intestinal Barrier Function and Growth After Neonatal Stress in Rats
Authors: García‐Ródenas Clara L. , Bergonzelli Gabriela E. , Nutten Sophie , Schumann Alexandra , Cherbut Christine , Turini Marco , Ornstein Kurt , Rochat Florence , Corthésy‐Theulaz Irène 
Published: July 2006

ABSTRACTObjectives:Psychological stress during the neonatal period results in intestinal barrier dysfunction and growth alterations later in life. We aimed to restore impaired barrier function and growth rate by a nutritional intervention.Methods:Male rat pups (n = 84) were assigned to 1 of 2 rearing conditions from postnatal day (PND) 2 to PND14: S, separated 3 h/d from their mothers, or H, 15 min/d handled controls. From PND15 to PND35, rats received a control diet or a similar diet adapted to contain arachidonic and docosahexaenoic acids, galacto‐ and fructo‐oligosaccharides and Lactobacillus paracasei NCC2461.Results:Maternal separation had only a minor impact on the measured gut barrier parameters at PND15, whereas it severely affected them at PND35. At this age, intestinal permeability to macromolecules was higher, mucin content in small intestinal tissues was lower and microbiota composition was altered in S compared with H animals. Feeding the adapted diet normalized the intestinal permeability, although it did not restore intestinal mucin content or microbiota. In addition, the adapted diet improved the growth rate recovery of the S animals after weaning and resulted in increased villus length in small intestine.Conclusion:Our results suggest that an adapted diet containing specific long‐chain polyunsaturated fatty acids, prebiotics and probiotics can revert the negative imprinting of neonatal stress on both intestinal barrier function and growth.
Impact of Pretransplant Growth Retardation in Pediatric Liver Transplantation
Authors: Barshes Neal R. , Chang I‐Fen , Karpen Saul J. , Carter Beth A. , Goss John A. 
Published: July 2006

ABSTRACTObjective:Malnutrition frequently complicates end‐stage liver disease and orthotopic liver transplantation (OLT) in pediatric patients. Pretransplant malnutrition has been associated with increased post‐OLT mortality and length of stay in adults. The relationship between pre‐OLT nutritional status and post‐OLT outcomes in pediatric liver transplant recipients, however, is not well studied.Methods:The records of 65 pediatric patients who underwent OLT at a single institution were reviewed. Univariate analyses were used to investigate the relationship between anthropomorphic data (expressed as z‐scores) and post‐OLT hospital length‐of‐stay, hospital costs and clinical outcomes. A multivariate model was then used to identify peri‐OLT variables independently correlated with post‐OLT length‐of‐stay.Results:A decreased height z‐score was correlated with an increased post‐OLT hospital length‐of‐stay (r = −0.30; P = 0.015) and increased hospital costs (r = −0.49; P = 0.0004). The mean length‐of‐stay was 20.5 days for patients with a height z‐score of <−1.5 and 10.7 days for patients with a height z‐score of >1.5 (P = 0.038). Likewise, hospital costs were about $40,000 higher (25% increased) for patients with growth retardation. A weak direct correlation was seen between weight z‐score and post‐OLT length‐of‐stay (r = 0.18; P = 0.15). Height z‐score, biliary atresia and pre‐OLT protime were independently and significantly correlated with post‐OLT length‐of‐stay in a multivariate model.Conclusions:Height z‐score is a better indicator of pretransplant malnutrition than weight z‐score. Pretransplant growth retardation is associated with increased post‐OLT hospital length‐of‐stay and increased hospitalization costs.Abbreviations: OLT, orthotopic liver transplantation‐PELD, Pediatric End‐Stage Liver Disease Model.