bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of Microvascular Density in Nonlocalizing Parathyroid Sestamibi Scans
Authors: Peters Glenn , Kulbersh Brian , Mantle Belinda , Bell Walter , Grizzle William , Rosenthal Eben 
Published: February 2009

AbstractObjectives: Sestamibi scans for localization of abnormal parathyroid glands in patients with hyperparathyroidism are widely used at many institutions. Minimally invasive parathyroid surgery demands accurate preoperative localization imaging; however, nonlocalizing sestamibi scans occur in 15% of patients with primary hyperparathyroidism. It remains unknown why some sestamibi scans fail to localize. We hypothesize that an increase in microvascular density (MVD) within an adenoma will result in rapid tracer washout and a subsequent nonlocalizing scan. This study investigates the role of MVD in sestamibi localization.Study Design: Retrospective chart review with immunohistochemical staining and data analysis.Methods: Medical records of 83 patients who had a sestamibi scan for evaluation of primary hyperparathyroidism and underwent initial parathyroidectomy from 2000 to 2002 were retrospectively reviewed. Patients' age, sex, preoperative imaging results, operative procedure, gland weight, and histologic findings were collected. Immunohistochemistry was performed to assess MVD.Results: Of the 75 preoperative sestamibi scans used, 51 patients had a localizing scan, and 24 were nonlocalizing. Localizing sestamibi scans for primary hyperparathyroidism demonstrated a sensitivity of 94% and specificity of 85%. By identifying multiglandular hyperplasia, nonlocalizing sestamibi scans produced a sensitivity of 83%. The localizing group had a greater percentage of solitary adenomas (94%) compared with the nonlocalizing group (15.6%) (P < .001). The mean gland weight for the nonlocalizing group was less than 398 g compared with the localizing groupweight of 1,113 g (P < .001). The mean MVD for localizing scan group was 229 vessels per high‐power field,and the mean for the nonlocalizing scans was 213 vessels per high‐power field (P = .2).Conclusions: MVD does not predict whether sestamibi scans are localizing or nonlocalizing.
Static Facial Suspension With Surgisis ES (Enhanced Strength) Sling
Authors: Leventhal Douglas D. , Pribitkin Edmund A. 
Published: February 2009

AbstractBackground: Static suspension procedures stabilize and support paralyzed facial muscles and enhance facial symmetry, appearance, mastication, and speech production in patients with facial palsy. A variety of autografts and allografts have been used for static facial suspension, but each has its limitations, and few studies document the efficacy or benefit of one substance over another. Xenograft tissue scaffoldings potentially offer both the compatibility of autografts and the convenience of allografts.Objective: Pilot study to evaluate efficacy of Surgisis ES (Enhanced Strength) static facial suspension in a series of six patients with facial paralysis.Methods: Retrospective chart review, illustrative case series, and review of the literature.Results: Six patients with facial paralysis were treated with the Surgisis ES facial sling procedure. Four patients achieved satisfactory results after the initial procedure. One patient was displeased with the esthetic outcome and required a revision procedure to increase the tautness of the implant. In the initial four cases, the sling was tunneled subcutaneously and sutured to the muscle. In two cases, the sling was tunneled subcutaneously and subperiosteally, thereby suspending all the soft tissue in the midface.Conclusion: Static facial suspension with Surgisis ES improved cosmesis and function in this limited pilot study. In particular, a two‐plane dissection technique provided excellent results. Further studies need to be conducted to evaluate the ongoing benefit over time.
p75NTR and Sortilin Increase After Facial Nerve Injury
Authors: Provenzano Matthew J. , Xu Ningyong , Ver Meer Mark R. , Clark J Jason , Hansen Marlan R. 
Published: February 2009

AbstractObjectives: After axotomy, Schwann cells (SCs), required for successful nerve regeneration, undergo a number of cellular changes including dedifferentiation, proliferation, expression of molecules that support axon growth, and apoptosis. This study investigated the role of p75NTR, sortilin, and proneurotrophins in SC survival after facial nerve (FN) axotomy.Study Design: Preliminary animal study.Methods: With use of FN SCs, expression of p75NTR and its coreceptor sortilin were quantified by immunofluorescence on days 12, 22, and 52 after axotomy in vivo and by Western blot in vitro. Contralateral FNs served as a control. SC apoptosis was detected by terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL). To verify a causative role for p75NTR in FN SC death, cultured FN SCs were treated with pro‐nerve growth factor (NGF), and apoptosis was determined by TUNEL.Results: Expression of p75NTR and sortilin increased in FN SCs distal (P < .05) to the axotomy compared with the contralateral controls for all time points. SC apoptosis also significantly increased in the distal segment compared with the contralateral and proximal portions (P < .05). ProNGF, a p75NTR ligand, increased apoptosis and p75NTR expression in primary FN SC cultures.Conclusion: FN axotomy increases p75NTR and sortilin expression in SCs, which correlates with increased apoptosis. These findings suggest roles for p75NTR and sortilin in SC loss after FN injury. Sortilin is a novel target in promoting FN healing after injury.
Differential Capture of Serum Proteins for Expression Profiling and Biomarker Discovery in Pre‐ and Posttreatment Head and Neck Cancer Samples
Authors: Freed Gary L. , Cazares Lisa H. , Fichandler Craig E. , Fuller Thomas W. , Sawyer Christopher A. , Stack Brendan C. , Schraff Scott , Semmes O John , Wadsworth J Trad , Drake Richard R. 
Published: February 2009

AbstractIntroduction: A long‐term goal of our group is to develop proteomic‐based approaches to the detection and use of protein biomarkers for improvement in diagnosis, prognosis, and tailoring of treatment for head and neck squamous cell cancer (HNSCC). We have previously demonstrated that protein expression profiling of serum can identify multiple protein biomarker events that can serve as molecular fingerprints for the assessment of HNSCC disease state and prognosis.Methods: An automated Bruker Daltonics (Billerica, MA) ClinProt matrix‐assisted laser desorption/ionization time‐of‐flight (MALDI‐TOF) mass spectrometer was used. Magnetic chemical affinity beads were used to differentially capture serum proteins prior to MALDI‐TOF analysis. The resulting spectra were analyzed using postprocessing software and a pattern recognition genetic algorithm (ClinProt 2.0). An HNSCC cohort of 48 sera samples from 24 patients consisting of matched pretreatment and 6 to 12 month posttreatment samples was used for further analysis. Low‐mass differentially expressed peptides were identified using MALDI‐TOF/TOF.Results: In the working mass range of 1,000 to 10,000 m/z, approximately 200 peaks were resolved for ionic bead capture approaches. For spectra generated from weak cation bead capture, a k‐nearest neighbor genetic algorithm was able to correctly classify 94% normal from pretreatment HNSCC samples, 80% of pretreatment from posttreatment samples, and 87% of normal from posttreatment samples. These peptides were then analyzed by MALDI‐TOF/TOF mass spectometry for sequence identification directly from serum processed with the same magnetic bead chemistry or alternatively after gel electrophoresis separation of the captured proteins. We were able to compare this with similar studies using surface‐enhanced laser desorption ionization (SELDI)‐TOF to show this method as a valid tool for this process with some improvement in the identification of our groups.Conclusions: This initial study using new high‐resolution MALDI‐TOF mass spectrometry coupled with bead fractionation is suitable for automated protein profiling and has the capability to simultaneously identify potential biomarker proteins for HNSCC. In addition, we were able to show improvement with the MALDI‐TOF in identifying groups with HNSCC when compared with our prior data using SELDI‐TOF. Using this MALDI‐TOF technology as a discovery platform, we anticipate generating biomarker panels for use in more accurate prediction of prognosis and treatment efficacies for HNSCC.
Benign Calcified Thyroid Cyst With Skin Sinus Formation
Authors: Pal Indranil , Sengupta Subhabrata , Ramaswamy Balakrishnan , Saha Somnath 
Published: February 2009

AbstractObjectives: To present a rare case of calcified thyroid cyst with discharging neck sinus and its probable explanation.Materials and Methods: A 75‐year‐old male patient presented to the outpatients department who had had thyroid swelling for the last 50 years and a discharging neck sinus from the swelling with ulceration and fungation of the adjoining area for the last year.Results: An X‐ray of the soft tissue of the neck showed tracheal shift to the right and irregular calcification of the left lobe of the thyroid. Fine needle aspiration cytology (FNAC) of the left lobe yielded little material with inflammatory cells as the swelling was too hard to be easily penetrated with a needle. FNAC of the right lobe revealed a picture similar to adenomatous goiter. A subtotal thyroidectomy was performed and the histopathologic report was suggestive of multinodular goiter with dystrophic calcification.Conclusion: Though the clinical features of the patient mimicked malignant change in a pre‐existing adenomatoid goiter, histopathologically, it was found to be a calcified thyroid cyst. Probable explanation is given in the “Discussion” section.
Standardized Video‐Endoscopy and Surgical Field Grading Scale for Endoscopic Sinus Surgery: A Multi‐Centre Study
Authors: Athanasiadis Theodore , Beule Achim , Embate Jose , Steinmeier Elke , Field John , Wormald P J. 
Published: February 2009

AbstractBackground: Bleeding is a major concern in endoscopic sinus surgery (ESS), as it may impede surgical progress and is often associated with complications. To improve the study and management of intraoperative bleeding, a standardized method of recording bleeding during ESS is needed. The aim of this study was to develop a standardized method of documenting bleeding in ESS and of grading the surgical field.Methods: Bleeding after endoscopic sinus surgery was recorded using video‐endoscopy. Standardized and non‐standardized video‐endoscopies of 20 patients were graded using a previously published grading scale (the Boezaart scale) in randomized order on two different occasions. Effects of standardization on intra‐ and interrater reliability were evaluated.Based on this experience, a new 11‐point surgical field grading scale was developed and simultaneously compared with the six‐point Boezaart scale via means of a DVD in three international centers.Results: Inter and intrarater reliability of the Boezaart and new Wormald scales significantly improved by employing a standardized video‐endoscopy technique. The Wormald scale had significantly higher interrater (0.80 vs. 0.74, P < .001) and intrarater (0.89 vs. 0.83, P < .001) reliability than the Boezaart scale. Linear regression analysis revealed the Wormald scale to be more sensitive to changes in the most common surgical fields experienced in ESS.Conclusion: Standardized video‐endoscopy has been demonstrated to significantly improve reliability and reproducibility of results and is recommended for future work evaluating bleeding in ESS. The new Wormald grading scale has been shown to be an inexpensive, reliable, and sensitive tool to rapidly evaluate intraoperative bleeding in ESS. It overcomes several limitations of the Boezaart scale, enabling us to analyze currently employed and newly developed hemostatic methods and agents.
Sleep Disordered Breathing and Obstructive Sleep Apnea in the Cleft Population
Authors: Muntz Harlan , Wilson Matthew , Park Albert , Smith Marshall , Grimmer J Fredrik 
Published: February 2009

AbstractObjectives/Hypothesis: Children with cleft deformities have the tendency for multilevel airway obstruction. The incidence of sleep disordered breathing (SDB) in this population has not been well studied. This study attempts to describe the high incidence and the results of intervention.Study Design: A three‐year retrospective chart review by a tertiary cleft and craniofacial team.Methods: The symptoms of sleep disordered breathing and polysomnographic data were reviewed and analyzed using descriptive statistics and multivariate analysis.Results: Of the 539 children seen during the period, 120 (22%) had symptoms suggestive of SDB. Twenty‐four of them had a tonsillectomy with or without partial adenoidectomy without polysomnogram (PSG). Sixty‐nine (57%) had a PSG, and 28 (40%) had a follow‐up PSG.Syndromic children had significantly more symptoms of SDB (P < .001) and were more likely to undergo PSG (P < .05). Of those children who underwent a PSG, only six had a normal obstructive apnea–hypopnea index (OAHI) with a mean (±standard deviation) respiratory disturbance index (RDI) of 15.5 (±17.5) and OAHI of 12.05 (±15.57). Post intervention PSG showed significant improvement in RDI (P = .048) and OAHI (P = .012) using a single‐tailed Wilcoxan analysis. Unfortunately, most of these children still had significant sleep apnea. There was also a high percentage of children with periodic leg motion syndrome (24.7%), some of whom also had OSA.Conclusion: There is a high incidence of SDB and definable OSA in the cleft population. Though there is a statistically significant improvement after intervention, some were not cured. Sleep disturbance and OSA is likely under‐reported and treated in the cleft population. PSG should be done more frequently, and post intervention PSG should be strongly considered.
Seeding of Tumor Cells After Fine Needle Aspiration Cytology in Benign Parotid Tumor: A Case Report and Literature Review
Authors: Supriya Mrinal , Denholm Stuart , Palmer Tim 
Published: February 2009

AbstractFine needle aspiration cytology (FNAC) is generally considered a safe, sensitive, and specific diagnostic tool and is widely used for various clinical indications. However, some authors have raised concerns regarding the possibility of tumor cell seeding along the needle track. We present to our knowledge the first case of tumor seeding after FNAC of a benign parotid tumor. This is followed by a review of the literature on tumor seeding after aspiration with fine needles of 20 gauge and smaller and the implications for clinical practice.
Relationship Between Obesity, Obstructive Sleep Apnea, and Spontaneous Cerebrospinal Fluid Otorrhea
Authors: LeVay Adam J. , Kveton John F. 
Published: February 2009

AbstractObjectives/Hypothesis: To investigate the relationship between obesity, obstructive sleep apnea (OSA), and spontaneous cerebrospinal fluid (CSF) otorrhea.Study Design: Retrospective review of patients presenting with the diagnosis of CSF otorrhea during a 15‐year period to a tertiary care medical center.Methods: Patient records were reviewed and the following data were extracted: age, sex, height, weight, past medical/surgical history, laterality of otorrhea, findings at operation, and method of repair. Otorrhea was considered spontaneous in the absence of trauma, otologic surgery, infection, and neoplasm.Results: Of the 29 adult patients identified, 14 patients presented with CSF otorrhea that was spontaneous in nature. The average body mass index among these patients was 35.2 ± 8, which was higher than the average in the nonspontaneous group, 28.5 ± 5 (P = .01). Diagnoses of OSA were also more common in the spontaneous group (n = 4) compared with the nonspontaneous group (n = 0). One case of bilateral spontaneous CSF leaks was recorded. The majority of patients were repaired with hydroxyapatite cement through a transmastoid approach. There were no recurrences.Conclusions: In this series, patients with spontaneous CSF otorrhea were more likely to be severely and morbidly obese than were patients with nonspontaneous otorrhea. OSA was also more common in these patients. The findings from this study support an association between obesity and spontaneous CSF leaks. Patients presenting with spontaneous CSF otorrhea should therefore be screened for OSA and signs of increased intracranial pressure.
Computational Modeling of Upper Airway Before and After Adenotonsillectomy for Obstructive Sleep Apnea
Authors: Mihaescu Mihai , Murugappan Shanmugam , Gutmark Ephraim , Donnelly Lane F. , Kalra Maninder 
Published: February 2009

AbstractAdenotonsillectomy, the first‐line surgical treatment for obstructive sleep apnea (OSA) in children, is successful in only 50% of obese children. Computational fluid dynamics tools, which have been applied to differentiate OSA patients from those without OSA based on the airway flow characteristics, can be potentially used to identify patients likely to benefit from surgical intervention. We present computational modeling of the upper airway before and after adenotonsillectomy in an obese female adolescent with OSA. The subject underwent upper airway imaging on a 1.5 Tesla magnetic resonance imaging (MRI) scanner, and three‐dimensional airway models were constructed using airway boundary coordinates from cross‐sectional MRI scans. Our results using computational simulations indicate that, in an obese child, the resolution of OSA after adenotonsillectomy is associated with changes in flow characteristics that result in decreased pressure differentials across the airway walls and thus lower compressive forces that predispose to airway collapse. Application of such findings to an obese child seeking surgical treatment for OSA can potentially lead to selection of the surgical procedure most likely to result in OSA resolution. Effective intervention for OSA in this high‐risk group will result in reduction in morbidity and the public health concerns associated with OSA.
Free Posterior Tibial Flap for Head and Neck Reconstruction After Tumor Expiration
Authors: Ng Raymond W. M. , Chan Jimmy Y. W. , Mok Vivian , Wei William I. 
Published: February 2009

AbstractBackground: Similar to the radial forearm flap, free tissue transfer of a fasciocutaneous flap is possible if the septocutaneous perforators of the posterior tibial vessels are preserved.Objective: The authors report their clinical experience on using the free posterior tibial flap for primary reconstruction of head and neck defects after tumor extirpation.Methods: Eleven patients were included between October of 2005 and March of 2007. Patients' clinical and demographic data were collected. The flap harvesting results and outcomes were retrospectively reviewed. Representative cases are presented for illustration.Result: There were nine men and two women, and their ages ranged from 34 to 83 (mean, 60.3) years. The flaps measured from 6 × 9 cm to 8 × 12 cm. Two cutaneous perforators were included in the majority of cases. The average flap thickness was 0.7 cm, and the average pedicle length was 14 cm. Flap survival was 100%. Skin grafts of all donor sites healed well. All patients were ambulatory early in the postoperative period, and there was no distal limb ischemia or cold intolerance on follow‐up. Four patients needed postoperative adjuvant radiotherapy.Conclusion: Our study demonstrates that the posterior tibial flap is a safe and reliable flap for reconstruction of head and neck defects after tumor expiration. It has all the comparable properties of a radial forearm flap. In addition, a larger area of skin can be removed, and the graft donor site is less conspicuous.
Effects of Ototopical Antihistamine on Otitis Media in an Allergic Rat
Authors: Cutler Jeffrey L. , Labadie Robert F. 
Published: February 2009

AbstractObjectives/Hypothesis: A reliable model of allergy has been created in the Brown Norway rat. In this model, allergen presentation to the middle ear causes functional disruption of the eustachian tube, predisposing to the development of otitis media with effusion. The purpose of this study was to study the effects of ototopical antihistamine on lipopolysaccharide (LPS)‐induced otitis media in the allergic rat model.Study Design: Prospective animal‐based research study.Methods: Fifteen (n = 15) rats were made allergic via sensitization to ovalbumin (OVA) by subcutaneous injection and randomized into three groups: saline (SAL) + LPS, olopatadine (OLO) + LPS, and azelastine (AZE) + LPS. Allergic rats were transtympanically injected with OVA 24 hours prior to challenge, creating a subclinical inflammatory response in which there is no visible middle ear effusion. Thirty‐five microliters of test substance (SAL + LPS, OLO + LPS, or AZE + LPS) were injected into the middle ear at 0, 2, and 4 hours. Effusion was collected at 2, 4, and 6 hours. Statistical analysis was performed on effusion volume and albumin concentration.Results: Significant increase in effusion volume with respect to time was noted for the SAL + LPS group, whereas the AZE + LPS group demonstrated a decrease. Intergroup comparison revealed a significant decrease in effusion volume at hour 6, with both AZE and OLO less than LPS alone. A significant decrease in albumin concentration over time was noted in the AZE group. Intergroup comparison revealed a significant difference inalbumin concentration at hour 6, with OLO significantly lower than LPS.Conclusions: Ototopical antihistamines are effective in reducing effusion volume and albumin concentration in LPS‐induced otitis media in an allergic rat model. This finding supports the hypothesis that ototopic antihistamines may prove effective in treating patients with allergy‐induced eustachian tube dysfunction.
Nasal Polyposis in Churg‐Strauss Syndrome
Authors: Bacciu Andrea , Buzio Carlo , Giordano Davide , Pasanisi Enrico , Vincenti Vincenzo , Mercante Giuseppe , Grasselli Chiara , Bacciu Salvatore 
Published: February 2009

AbstractObjectives: Churg‐Strauss syndrome (CSS) is a systemic vasculitic disorder of unknown etiology that affects small‐to‐medium‐size blood vessels. Patients affected by CSS frequently show ear, nose, and throat manifestations, which are often present at the time of disease onset. The purpose of this study was to determine the frequency of nasal polyposis in a series of 29 patients with CSS and to correlate the nasal findings to the total health situation of these patients.Study Design: Retrospective analysis.Setting: Department of Otolaryngology and Department of Clinical Medicine, Nephrology and Health Science, University of Parma.Methods: Twenty‐nine patients with CSS were identified. Of the 29 patients, 17 (58.6%) had nasal polyposis and were enrolled in this study. The nasal polyps were graded according to the Lund and Mackay endoscopic and radiological classifications.Results: At diagnosis, endoscopic intranasal evaluation identified nasal polyposis of grade 3 in nine cases (52.9%), grade 2 in six cases (35.2%), and grade 1 in the remaining case (5.8%). After corticosteroid and immunosuppressive therapy, clinical remission was achieved in 14 patients (82.3%), whereas 3 patients experienced a relapse. Posttreatment endoscopic evaluation showed a permanent disappearance (grade 0) of nasal polyps in eight patients (47%). The other nine patients (52.92%) were found to have a small polyp situated in the middle meatus (grade 1).Conclusions: Nasal polyposis in patients with CSS may represent the initial phase of the syndrome, though patients often have concurrent pulmonary disease. Corticosteroid therapy either alone or combined with immunosuppressive drugs usually yielded improvement or stabilization.