bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Animal Models for Head and Neck Cancer Cachexia
Authors: Cannon Trinitia , Couch Marion , Yin Xiaoying , Guttridge Denis , Lai Victor , Shores Carol 
Published: February 2009

AbstractObjectives/Hypothesis: Despite its negative impact on cancer patients, there are few animal models of cancer cachexia. Our hypothesis was that different human cell lines would variably induce cachexia.Study Design: Prospective animal study.Methods: We established two xenograft models in athymic mice and compared these with a cachexigenic cell line, the murine adenocarcinoma 16 (MAC16) cell line. Eight‐week‐old female, athymic mice were injected with human head and neck cell lines (JHU022, JHU012) and the MAC16 cell line. Body weight, food intake, body composition, leg weights, serum cytokines, and lipid mobilizing factor (LMF) were compared.Results: Mean food intake for all groups was equivalent. Mean percent change in body weight after 18 days was 18%, 19%, 12%, and 3% for control, JHU012, JHU022, and MAC16 experimental groups, respectively. Both JHU022‐ and MAC16‐injected mice showed wasting even when tumor burden was low. In contrast, mice injected with JHU012 developed larger tumors yet lacked evidence of cachexia. These mice demonstrated loss of lean body mass but not fat mass. Serum cytokine levels for interleukin (IL)‐1α and IL‐1β were elevated in JHU022‐bearing mice, whereas IL‐1α, IL‐6, interferon (IFN)‐γ, and tumor necrosis factor alpha (TNF)‐α were elevated in MAC16‐bearing mice. LMF was present in both the JHU022 and JHU012 cell lines.Conclusions: The JHU022 cell line caused more severe cachexia than the JHU012 cells, suggesting these cell lines may be used to further study cancer cachexia. IL‐1α and IL‐1β in the JHU022 model may be mediators of cachexia, whereas TNF‐α, IFN‐γ, and IL‐6 may be mediators in MAC16‐induced cachexia.
Cervical Discitis and Epidural Abscess After Tonsillectomy
Authors: Curry Joseph M. , Cognetti David M. , Harrop James , Boon Maurits S. , Spiegel Joseph R. 
Published: February 2009

AbstractApproximately 6 weeks after an uncomplicated tonsillectomy for chronic tonsillitis, a 37‐year‐old woman presented to our emergency department with complaints of odynophagia and cervical pain persistent since surgery. Computed tomographic and magnetic resonance imaging revealed cervical spinal osteomyelitis with epidural abscess at C2 to 3. The patient underwent treatment with intravenous antibiotics, operative debridement, and cervical spinal stabilization. She recovered with no neurologic deficit.Conclusions: Significant infectious complications of tonsillectomy are uncommon, and cervical spinal osteomyelitis and epidural abscess are exceptionally rare occurrences. In the presence of prolonged pain and dysphagia, imaging can be considered to evaluate for such sequelae.
Human Nasal Turbinates as a Viable Source of Respiratory Epithelial Cells Using Co‐Culture System Versus Dispase Dissociation Technique
Authors: Noruddin Nur Adelina Ahmad , Saim Aminuddin B. , Chua Kien Hui , Idrus Ruszymah 
Published: February 2009

AbstractObjective: To compare a co‐culture system with a conventional dispase‐dissociation method for obtaining functional human respiratory epithelial cells from the nasal turbinates for tissue engineering application.Methods: Human respiratory epithelial cells were serially passaged using a co‐culture system and a conventional dispase‐dissociation technique. The growth kinetics and gene expression levels of the cultured respiratory epithelial cells were compared. Four genes were investigated, namely cytokeratin‐18, a marker for ciliated and secretory epithelial cells; cytokeratin‐14, a marker for basal epithelial cells; MKI67, a proliferation marker; and MUC5B, a marker for mucin secretion. Immunocytochemical analysis was performed using monoclonal antibodies against the high molecular‐weight cytokeratin 34βE12, cytokeratin 18, and MUC5A to investigate the protein expression from cultured respiratory epithelial cells.Results: Respiratory epithelial cells cultured using both methods maintained polygonal morphology throughout the passages. At passage 1, co‐cultured respiratory epithelial showed a 2.6‐times higher growth rate compared to conventional dispase dissociation technique, and 7.8 times higher at passage 2. Better basal gene expression was observed by co‐cultured respiratory epithelial cells compared to dispase dissociated cells. Immunocytochemical analyses were positive for the respiratory epithelial cells cultured using both techniques.Conclusion: Co‐culture system produced superior quality of cultured human respiratory epithelial cells from the nasal turbinates as compared to dispase dissociation technique.
Treatment of Ménière's Disease by Low‐Dosage Intratympanic Gentamicin Application: Effect on Otolith Function
Authors: Helling Kai , Schönfeld Uwe , Clarke Andrew H. 
Published: February 2009

AbstractObjectives: The intratympanic application of a low dosage of gentamicin is increasingly favored as treatment for Ménière's disease. While posttreatment observations have confirmed a long‐term success of the therapy of vertigo attacks, clear differences in the posttreatment recovery interval can be observed. In addition to differences in central‐vestibular compensation, the degree of peripheral vestibular damage, i.e., to the saccule, utricle, and semicircular canal ampullae, varies among patients. This study provides comprehensive pre‐ and posttreatment results from unilateral functional tests of the individual vestibular receptors and of the cochlea in patients with Ménière's disease.Study Design: Prospective clinical study.Methods: Nineteen patients with unilateral Ménière's disease were treated by intratympanic application of gentamicin by injection of 0.3 mL (12 mg) through the tympanic membrane under local anesthesia. Tests were performed immediately previous to treatment and subsequently in the periods 4 to 8 weeks and 12 to 16 weeks after treatment. Unilateral saccular function was tested by means of acoustic‐click, vestibular‐evoked myogenic potentials (VEMP), and unilateral utricular function by subjective visual vertical (SVV) during unilateral centrifugation. Bithermal caloric testing was performed to assess unilateral semicircular canal function.Results: Prior to gentamicin treatment, the caloric response from the diseased ear was normal in 3 patients, below normal in 14 patients, and in 2 cases almost completely absent. VEMP responses could be recorded bilaterally in 13 patients; while in 6, no VEMPs could be measured from the diseased ear. Utricular function measured by SVV estimation was found to be normal in 11 patients and marginally abnormal in 2 patients. In six cases, the SVV was clearly underestimated during centrifugation of the diseased side. The posttreatment findings demonstrate that VEMPs were absent in all treated patients, and the caloric response was abnormally low in all but one case. In contrast, only 12 of 19 patients produced abnormal SVV responses.Conclusion: The results demonstrate that incremental, intratympanic application of gentamicin effectively eliminates semicircular canal and saccular function. In contrast, utricular function appears to be maintained in 30 to 40% of cases.
Scala Tympani Cochleostomy I: Results of a Survey
Authors: Adunka Oliver F. , Buchman Craig A. 
Published: February 2009

AbstractObjective: To assess current surgical techniques for scala tympani cochlear implantation among North American surgeons.Material: A survey was distributed to all cochlear implant surgeons participating in the 2006 William House Cochlear Implant Study Group in Toronto, Canada. Participants were asked to anonymously identify their routine surgical practices. Images of trans‐facial recess approaches to the round window and cochlear promontory were used in a multiple‐choice fashion to assess the surgeon's typical exposure and cochleostomy location. Returned questionnaires were electronically processed and evaluated.Results: Fifty‐five (75%) of 73 returned surveys had adequate data validity and availability. Landmark identification and preferred cochleostomy locations varied greatly. About 20% of surgeons selected cochleostomy locations superior to the round window membrane. Cochleostomy size and location appeared to be influenced by surgical experience and whether or not the round window overhang was drilled off.Conclusion: This survey clearly documents marked variations in surgical techniques for scala tympani cochlear implantation. Future studies should more clearly define the surgical anatomy of this region for appropriate placement of a scala tympani cochleostomy. These findings may ultimately have an impact on hearing and neural preservation cochlear implant surgeries.
Bacteriologic Comparison of Tonsil Core in Recurrent Tonsillitis and Tonsillar Hypertrophy
Authors: Jeong Jin Hyeok , Lee Dong Wook , Ryu Ri A. , Lee Young Sup , Lee Seung Hwan , Kang Jung Oak , Tae Kyung 
Published: February 2009

AbstractObjectives: Although many bacteriology studies on tonsillar diseases have been completed, all have been confined to children and were characterized by a paucity of cases. The purpose of this study was to analyze the underlying bacterial pathogens in tonsillar disease.Methods: A retrospective study was performed on 824 patients who underwent elective tonsillectomy with or without adenoidectomy. We analyzed the differences between the bacterial pathogens in recurrent tonsillitis and tonsillar hypertrophy with regard to age, season, and antibiotic sensitivity.Results: Among 824 cases, 966 bacterial strains from the tonsil core were isolated. In recurrent tonsillitis, Staphylococcus aureus was the most common pathogen (30.3%), followed by Haemophilus influenzae (15.5%) and group A β‐hemolytic Streptococcus (Streptococcus pyogenes, 14.4%). In patients over 14 years of age, quite differently from other age groups, Klebsiella pneumoniae was isolated at a significantly higher percentage. In tonsillar hypertrophy, H. influenzae was isolated most commonly (31.4%) regardless of age, followed by S. pyogenes (24.2%), S. aureus (22.9%), and Streptococcus pneumoniae (12.6%). Furthermore, mixed infection was common because of its high resistance to penicillin. In both groups, S. pneumoniae was more common in younger patients, whereas K. pneumoniae was relatively common in adults. We found no differences in the detection rate by season; however, H. influenzae was frequently isolated in the tonsillar hypertrophy group regardless of seasonal variations. We also found no difference in the antibiotic sensitivity between the two groups; however, strains resistant to penicillin were relatively prevalent and showed a high sensitivity to third‐generation cephalosporin.Conclusions: We observed some differences in the types of bacteria in the tonsillar core between the recurrent tonsillitis and tonsillar hypertrophy groups. Our study indicates that essential bacteria have been changing and, thus, we need to change our choice of antibiotics.
Imaging of the Pediatric Airway Using Optical Coherence Tomography
Authors: Ridgway James Matthew , Ahuja Gurpreet , Guo Shuguang , Su Jianping , Mahmood Usama , Chen Zhongping , Wong Brian 
Published: February 2009

AbstractObjectives: Optical coherence tomography (OCT) is an imaging modality that uses a broadband light source to produce high‐resolution cross‐sectional images in living tissue (8–20 μm). A prospective study of normal, benign, and pathologic tissues in the pediatric airway was conducted to assess the utility of OCT technology in characterizing the microanatomy of the pediatric upper aerodigestive tract in vivo.Study Design: Prospective clinical trial.Materials and Methods: Fifteen patients from 1 to 17 years of age underwent surgical endoscopy and OCT for various airway disorders. OCT imaging was performed at a frame rate of 1 Hz using a 1.3‐μm broadband light source to produce images 1.6 × 6 mm in vertical and horizontal dimensions. The epithelium, lamina propria, and unique tissue microstructures were visualized and then measured using digital micrometry. Direct comparison of OCT images with endoscopic photography was performed.Results: Systematic imaging of the oral cavity, oropharynx, hypopharynx, and larynx was performed in all 15 patients. Normal microstructures identified included papillae, ducts, glands, and vessels, whereas pathologic conditions included distinct zones of mature scar, granulation tissue, edema, ulceration, and papillomatosis. Endoscopic photographs were well correlated with OCT images.Conclusions: OCT is capable of obtaining high‐resolution microanatomy images of pediatric airway in vivo tissue. OCT clearly identifies the epithelium and lamina propria while providing detailed structural information on normal and diseased tissues. OCT is a promising emerging imaging modality for use in current pediatric patient populations.
Nasal Valve Suspension Revisited
Authors: Nuara Michael J. , Mobley Steven Ross 
Published: February 2009

AbstractObjectives: Nasal valve suspension (NVS) is a simple technique to correct nasal valve obstruction or collapse by providing a lateral vector of pull on the nasal sidewall. The purpose of this research was to review our experience with NVS in a cohort of patients with nasal valve collapse, including a subset of patients with facial paralysis. The objectives were to determine patient satisfaction and complication rates after NVS.Study Design: A retrospective review of patients 18 years and older who had NVS from 2003 to 2006 with a follow‐up of at least 1 month was performed.Methods: Data were collected on diagnosis, surgical outcomes, complications, and treatments required. Complications included adverse outcomes, infections, and the need for repeat surgery or treatments.Results: In 17 charts reviewed, 9 patients (53%) had nasal valve collapse as a result of facial paralysis, and 8 (47%) had previous nasal surgery. Follow‐up ranged from 1 to 30 months, with a mean of 16.5. Moderate to complete resolution of obstruction was reported by 82% of patients, or for 88% of procedures. Sustained relief was observed in two of eight patients who had previous nasal surgery and six of nine who had no previous nasal surgery (P = .1). Infection occurred in four (24%) patients and five (21%) total suspensions and ranged from 1.5 to 7 months. Six (35%) patients experienced a loss of suspension at 6 to 22 months.Conclusions: NVS is a technically straightforward, relatively reversible procedure particularly useful in the patient with facial paralysis. The efficacy is excellent in the short term yet appears to diminish with time.
Symptom Outcomes in Endoscopic Sinus Surgery: A Systematic Review of Measurement Methods
Authors: Chester Alexander C. , Sindwani Raj 
Published: February 2009

AbstractObjective: To determine the type and prevalence of measurement methods used to analyze symptom outcomes after endoscopic sinus surgery (ESS).Data Sources: Data were derived from PubMed, MEDLINE, EMBASE, Web of Science, Cochrane databases, Google Scholar, and manual searches.Study Selection: All English‐language studies consisting of more than 10 adult patients from January 1980 to December 2006 reporting ESS symptom outcome results were reviewed. Studies of radical surgery and studies involving patients with significant comorbidities were excluded.Results: The ESS symptom outcome results of 29,333 patients were reported in 204 studies. Symptom outcome was determined by survey instruments in 47 (23.0%) studies and individual symptom scoring in 63 (31%) studies. Of 18 validated instruments used, almost two thirds of studies that reported results by survey measures used the following three instruments: Chronic Sinusitis Survey (12 studies), Sinonasal Outcome Test‐20 (11 studies), and Medical Outcomes study 36‐Item Short‐Form Health Survey (10 studies). The percentages of studies that reported specific results of the 1997 American Academy of Otolaryngology–Head Neck Surgery Rhinosinusitis Task Force (RSTF) chronic rhinosinusitis symptom criteria varied as follows: facial pain/pressure, 35%; facial congestion/fullness, 10%; nasal obstruction/blockage, 42%; nasal discharge/purulence/discolored postnasal discharge, 47%; hyposmia/anosmia, 35%; fever, 2%; halitosis, 4%; fatigue, 11%; dental pain, 3%; cough, 10%; and ear pain/pressure/fullness, 6%.Conclusions: ESS symptom outcome is assessed inconsistently by numerous measures. Individual report‐ ing of all RSTF chronic rhinosinusitis symptom criteria, as recommended by the RSTF and by subsequent consensus conferences, is rarely noted. Many RSTF symptom criteria are seldom studied.
Evaluation of a Particle Repositioning Maneuver Web‐Based Teaching Module
Authors: Beyea Jason Atkins , Wong Eric , Bromwich Matthew , Weston W Wayne , Fung Kevin 
Published: February 2009

AbstractObjectives/Hypothesis: To compare the pass rate of residents performing the Particle Repositioning Maneuver (PRM) after one of three interventions: 1) small group PRM instruction (SG); 2) standard classroom instruction (CI); and 3) Web‐based learning module (WM). We hypothesize that our Web‐based learning module is more effective than CI and as effective as SG.Study Design: Prospective randomized control trial.Methods: The study population includes all family medicine residents at the University of Western Ontario. On day 0, all subjects were tested. Residents were then randomized to one of three intervention groups: 1) SG, 2) CI, or 3) WM. On day 7, the residents were again tested. Observers were blinded to the intervention type. Testing (day 0 and day 7) was performed using the DizzyFIX (Clearwater Clinical Ltd., London, Ontario, Canada), a pass/fail test, and evaluation by a trained observer (correct or incorrect).Results: There were no statistically significant differences in pass rates between the three groups before the interventions (DizzyFIX: P = .2096, observer: P = .3710). After the interventions, DizzyFIX testing pass rates were 50.0% SG, 60.0% CI and 100.0% WM (P = .3564). Observer testing pass rates were 85.7% SG, 28.6% CI, and 83.3% WM (P = .0431).Conclusions: This study demonstrated that our Web‐based learning module for the PRM is comparable to small‐group clinical instruction, and superior to standard classroom instruction for teaching the PRM when evaluated by a trained observer.
Transforming Growth Factor β and Wound Healing in Human Cholesteatoma
Authors: Huisman Margriet A. , de Heer Emile , Dijke Peter Ten , Grote Jan J. 
Published: February 2009

AbstractObjective: Cholesteatoma is a nonmalignant, destructive lesion of the temporal bone that gradually expands and causes complications by the erosion of the adjacent bony structures. The consequences can be as severe as facial paralysis and intracranial complications. Until now, surgery has been the only treatment of choice. The pathogenesis of cholesteatoma remains controversial. Current concepts postulate that cholesteatoma may be a wound‐healing process, although formal proof is lacking as of yet. Several reports provide evidence for the involvement of transforming growth factor (TGF)β in both normal and abnormal wound healing.Study Design: The expression of TGFβ, the activated form of its intracellular effector, phosphorylated‐Sma‐Mad (pSmad)2, its natural inhibitor, Smad7, and target gene extra domain A‐positive fibronectin (EDA‐FN) were examined.Methods: Quantitative immunohistochemical analysis was performed using an image analysis system.Results: In 12 cholesteatoma and control samples, protein expressions showed consistent relationships among TGFβ, nuclear pSmad2, and Smad7. We found concordant expressions of TGFβ and nuclear pSmad2 in cholesteatoma epithelium and its control. Epithelial Smad7 expression was significantly reduced in cholesteatoma when compared with control epithelium (P = .04). In cholesteatoma extracellular matrix (ECM), a significantly increased TGFβ, and nuclear pSmad2 was demonstrated (P < .01). Smad7 expression in the ECM was comparable in cholesteatoma and its control. EDA‐FN deposition in cholesteatoma ECM was excessive, whereas EDA‐FN expression was absent in controls.Conclusion: Our results confirm reports of in vitro experiments and support the concept that cholesteatoma behaves as a chronic wound healing process.
Feasibility of Flap Reconstruction in Conjunction With Intraoperative Radiation Therapy for Advanced and Recurrent Head and Neck Cancer
Authors: Most Michael D. , Allori Alexander C. , Hu Kenneth , Urken Mark L. , Persky Mark S. , Sessions Roy B. , Nussbaum Moses , Harrison Louis B. , Frank Douglas K. , Smith Mark L. 
Published: February 2009

AbstractBackground: Radiation is a known risk factor for poor wound healing. Patients undergoing intraoperative radiation therapy (IORT) typically receive higher cumulative doses to their wound beds than patients treated with conventional radiation therapy. We review our experience with IORT in patients undergoing resection of head and neck cancer and flap reconstruction. Logistics of delivery and outcomes are discussed.Methods: A retrospective chart review was performed on all patients at Beth Israel Medical Center who underwent IORT for head and neck cancer between 2000 and 2007. Twenty‐one patients receiving 22 treatments involving flap reconstruction were identified. The results of these reconstructions were evaluated for complications and functional outcome.Results: All patients had complex surgical wounds of the face, upper aerodigestive tract, or neck who received IORT in conjunction with pedicled or free flap closure. Twenty‐five flaps in 21 patients were performed in the setting of IORT. All patients received between 10 and 15 Gy of IORT administered directly to the wound bed. There were no perioperative mortalities. Wound breakdown occurred in three cases, all of which were treated successfully by operative revision. Functionally, most patients did well and performed similarly to historic controls for their type of reconstruction.Conclusions: Reconstruction using flaps in the context of IORT can be achieved with expectation of good wound healing in the majority of cases despite heavy cumulative doses of radiation to recipient wound beds.
Preparation Techniques for the Injection of Human Autologous Cartilage: An Ex Vivo Feasibility Study
Authors: Noordzij J Pieter , Cates Justin M. , Cohen Seth M. , Bennett Marc L. , Ries W M. Russell , Russell Paul T. , Haynes David , Garrett C Gaelyn , Ossoff Robert H. 
Published: February 2009

AbstractObjectives: To determine the optimum donor site and preparation technique for injecting human autologous cartilage as a potentially permanent implant material for vocal fold medialization.Study Design: Prospective ex vivo experimental model.Methods: Human nasal septal and auricular cartilage was obtained from eight surgical cases after institutional review board approval. The auricle and nasal septum were chosen as potential donor sites because of ease of accessibility, volume of cartilage potentially available, and minimal subsequent cosmetic deformity after the tissue harvesting procedure. Various preparation techniques readily available in most operating rooms were tested for their efficacy in generating an injectable cartilage slurry. The various cartilage slurries were injected through sequentially smaller needles and examined cytologically.Results: The best injection properties for both nasal septal and auricular cartilage were obtained by drilling the cartilage down with a 5 mm otologic cutting bur, which allowed free passage through an 18 gauge needle. Cytologic examination of drilled septal cartilage showed good uniformity of cartilage pieces with a mean largest dimension of 0.44 ± 0.33 mm, and 33% of lacunae contained viable‐appearing chondrocytes. Cytologic examination of drilled auricular cartilage was similar, exceptonly 10% of lacunae were occupied by chondrocytes. Other techniques tested (knife, morselizer, and cartilage crusher) did not yield injectable cartilage slurries.Conclusions: Both nasal septal and auricular cartilage can be prepared for injection via an 18 gauge needle using a cutting otologic bur. Further testing of in vivo viability and long‐term volume retention is needed.