bluuebunny/crossref_metadata_2025_split huggingface dataset:
Longitudinal Follow‐Up of Adductor Spasmodic Dysphonia Patients After Botulinum Toxin Injection: Quality of Life Results
Authors: Paniello Randal C. , Barlow Jamie , Serna Jannie S. 
Published: February 2009

AbstractObjective: Botulinum toxin injections are used routinely to treat patients with adductor spasmodic dysphonia. After an initial “breathy phase,” most patients experience improvement for a few weeks to months and then a gradual decline until their next injection. In this study, voice‐related quality of life (VRQOL) data were collected at 4 week intervals through one to three injection cycles in an attempt to quantify the proportion of each cycle during which patients experience meaningful benefit.Study Design: Prospective, nonrandomized case series.Methods: Patients receiving stable‐dose botulinum injections for adductor spasmodic dysphonia were invited to participate. Voice recordings and clinical outcomes data were collected by telephone every 4 weeks throughout each injection cycle. Quality of life data were normalized for cycle length and interpolated to generate composite curves.Results: Twenty‐two patients completed data collection for at least one full injection cycle. The average cycle was 25.9 weeks; the mean age was 59.8 years. On a 100‐point scale, the total VRQOL scores peaked at 77.4, at 30% of the cycle, then gradually declined. The social‐emotional (SE) subscale scores were significantly better than the physical subscale scores (P < .05). The total VRQOL score exceeded 75 during only 14% of the cycle (52.6% for SE subscores, 0% for physical subscores). If the threshold is lowered to 70, the total VRQOL exceeded this level during 54.6% of the cycle (69.6% for SE subscores, 44.1% for physical subscores). For the 11 patients completing three full injection cycles, there were no significant differences between the three cycles, and the mean VRQOL scores were similar to the values given above. At the beginning and end of each cycle, the total VRQOL scores averaged 52.8 (56.0 for SE subscale, 50.7 for physical subscale).Conclusion: Although botulinum toxin injections provide significant improvement for these patients, the initial breathy phase and the late declining phase add up to a significant proportion of each cycle spent with a reduced quality of life. At best, the total VRQOL averaged below 80%. This longitudinal study provides a unique look at the effect of this condition and its treatment on these patients' lives. A suitable long‐term treatment for this condition is needed to eliminate the cyclical voice results experienced with the botulinum toxin injection approach.
Molecular Classification of Thyroid Nodules by Cytology
Authors: Pagedar Nitin A. , Chen Daniel H. , Wasman Jay K. , Savvides Panayiotis , Schluchter Mark D. , Wilhelm Scott M. , Lavertu Pierre 
Published: February 2009

AbstractObjectives: Fine needle aspiration (FNA) biopsy of thyroid nodules provides cytologic specimens whose interpretation can direct patients toward either thyroidectomy or observation. Approximately 20% of FNA specimens yield an indeterminate result. Recent studies have characterized differences in gene expression between benign and malignant conditions, most often using whole tissue. Our goal was to determine the feasibility of quantitative polymerase chain reaction (qPCR)‐based gene expression analysis in cytologic samples. For five genes shown to be over‐expressed in thyroid carcinomas (fibronectin, galectin‐3, Met/HGFR, MUC1, and GA733‐precursor), we compared expression among pathologic states.Study Design: Prospective laboratory analysis of 20 thyroidectomy specimens.Methods: Routine microscopy was performed. Cytologic samples were obtained from the dominant nodules, and RNA was extracted. Preliminary analysis using fluorometry and reverse‐transcriptase (RT)‐PCR was performed. Expression levels of the test genes in nodules and from control samples were measured by real‐time qPCR. Fold changes in gene expression were compared.Results: Only one specimen did not yield sufficient intact RNA for gene expression analysis. RT‐PCR revealed satisfactory RNA recovery in all other specimens. qPCR showed significant over‐expression of fibronectin in the papillary carcinomas compared with the goiters (P = .0013), follicular adenomas (P = .0014), and follicular carcinomas (P = .0001). Differences in both fibronectin and MUC1 expression between the follicular carcinomas and the follicular adenomas were also significant (P = .025 and .045, respectively).Conclusions: Cytologic specimens were a satisfactory source of tissue for qPCR‐based gene expression analysis. Both fibronectin and MUC1 were differentially expressed in follicular adenomas and follicular carcinomas, and fibronectin expression differed in papillary carcinomas compared with the other lesions. These results may form the basis of a clinical predictor for lesions with indeterminate or suspicious cytology.
Topical Application of Calcium Channel Blockers to Reduce the Progression of Experimentally Induced Myringosclerosis and Tympanosclerosis
Authors: Selcuk Adin , Akdogan Ozgur , Ozcan Ibrahim , Giray Seren Gulsen , Dere Huseyin , Ozogul Candan 
Published: February 2009

AbstractObjectives: This study aimed to evaluate the ability of topically applied calcium channel blockers (diltiazem) to reduce the progression of experimentally induced myringosclerosis and tympanosclerosis.Study Design: Animal model. Experimental prospective study.Methods: The study included 25 adult albino guinea pigs that were bilaterally myringotomized and inoculated with a suspension of Streptococcus pneumonia type 3. The right ears were treated with topical application of diltiazem, and the untreated left ears served as the control group. Otomicroscopy and remyringotomy were conducted every week. One animal was sacrificed after 1 week and the remaining at the end of 6 weeks. Temporal bones were dissected, and tympanic bullae were analyzed with light microscopy.Results: The untreated control ears showed evidence of extensive myringosclerosis on otomicroscopy, and the ears treated with calcium channel blockers did as well although to a lesser degree. Under light microscopy, the lamina propria of both tympanic membranes and middle ear mucosae of the control group exhibited thicker (P < .1 and P < .05, respectively) and larger (P < .01 and P < .01, respectively) sclerotic tissue in comparison with the treatment group.Conclusion: The results suggest that calcium channel blockers had an influence in the prevention of tympanosclerosis.
Diagnostic Accuracy of Peak Nasal Inspiratory Flow and Rhinomanometry in Functional Rhinosurgery
Authors: Bermüller Christian , Kirsche Hanspeter , Rettinger Gerhard , Riechelmann Herbert 
Published: February 2009

AbstractObjectives: Sensitivity and specificity of active anterior rhinomanometry (RMM) and peak nasal inspiratory flow (PNIF) in the diagnosis of functionally relevant structural nasal deformities should be assessed. The reference standard was clinical judgment based on all clinical data available.Study Design: Prospective study of diagnostic accuracy at a tertiary rhinologic referral center.Methods: RMM and PNIF were performed on 53 patients with symptomatic nasal stenosis and 40 healthy volunteers. Cut‐offs for RMM and PNIF were defined by receiver operating characteristic analysis.Results: A cut‐off between normal and pathological of 700 mL/second for RMM at a transnasal pressure difference of 150 Pa, and of 2,000 mL/second (120 l per minute) for PNIF was calculated. No significant differences in terms of sensitivity of RMM and PNIF (0.77 vs. 0.66), specificity (0.8 vs. 0.8) and diagnostic accuracy (0,79 vs. 0.72) were found.Conclusion: RMM and PNIF provide valuable information to support clinical decision making. However, with both methods, approximately 25% of symptomatic patients with functionally relevant nasal structural deformity were not detected. A negative test outcome of RMM or PNIF does not exclude a functionally relevant nasal stenosis.
Effect of Proton Pump Inhibitor Pantoprazole on Growth and Morphology of Oral Lactobacillus Strains
Authors: Altman Kenneth W. , Chhaya Vina , Hammer Neal D. , Pavlova Sylvia , Vesper Benjamin J. , Tao Lin , Radosevich James A. 
Published: February 2009

AbstractObjectives: Proton pump inhibitors (PPI) used to suppress acid secretion in the stomach are among the most widely prescribed medications. There is emerging evidence of proton secretion elsewhere in the aerodigestive tract, and acidic microenvironments are integral to oral flora such as Lactobacillus. The hypothesis of this study is that the growth rate and morphology of oral Lactobacillus strains are effected by PPIs.Methods: Nineteen different strains of Lactobacilli were inoculated in microtiter plates at pH of 4.5 to 6.5 and exposed to twofold dilutions of pantoprazole at a range of 2.5 mg/mL to 2.5 μg/mL. Bacterial growth was monitored, and the minimum inhibitory concentration (MIC) of the drug was determined for the strains most sensitive to pantoprazole.Results: In the unexposed (control) group, nine Lactobacilli strains were affected by pH changes from 6.5 to 4.5. In the group exposed to pantoprazole, 9 of the 19 Lactobacilli strains were found to have an MIC below 625 μg/mL, with L. plantarum 14917 being the most sensitive (MIC = 20 μg/mL). In some strains, such as L. s. salivarius 11741, Gram‐staining revealed conformational changes in the bacteria when grown in the presence of pantoprazole.Conclusion: Growth rates and morphology of oral Lactobacillus are affected by the pH of the environment. Pantoprazole at supraphysiologic doses further affects growth rates and conformation in some strains.Significance: The balance of oral flora and upper digestive tract homeostasis may be affected by unexpected targets of PPI pharmacotherapy, with possible unanticipated consequences.
Isolated Bilateral Facial Paralysis Revealing AIDS: A Unique Presentation
Authors: Abboud Olivier , Saliba Issam 
Published: February 2009

AbstractHIV is a recognized etiologic agent in the development of peripheral facial paralysis (PFP). In most cases, the paralysis appears in the acute phase of the HIV infection, and its prognosis is similar to Bell's palsy. Other etiologic agents are generally involved in the development of the paralysis in the later stages of the disease. Bilateral facial palsy is a rare clinical entity in HIV infection. Only 19 cases have been reported. A case of facial diplegia revealing AIDS is described in this review. To the best of our knowledge, this is the first report of such an advanced state of the disease in a previously asymptomatic patient.
Treatment Outcomes for Radiotherapy Alone are Comparable With Neoadjuvant Chemotherapy Followed by Radiotherapy in Early‐Stage Nasopharyngeal Carcinoma
Authors: Song Chang Hoon , Wu Hong‐Gyun , Heo Dae Seog , Kim Kwang Hyun , Sung Myung‐Whun , Park Charn Il 
Published: February 2009

AbstractObjectives:To analyze the impact of neoadjuvant chemotherapy (CT) on the treatment of early‐stage nasopharyngeal carcinoma (NPC) as compared with radiotherapy (RT) alone.Methods:We analyzed retrospectively the outcome of 60 previously untreated and histologically confirmed early‐stage NPC patients treated with either RT alone or with neoadjuvant CT followed by RT (CT/RT) at the Seoul National University Hospital between 1986 and 2004. Neoadjuvant CT consisted of three cycles with 5‐fluourouracil and cisplatin. RT was given to the nasopharynx and neck nodes. The median dose to the primary site, involved nodes, and elective nodes was 70.2 Gy, 63 Gy, and 45 Gy, respectively. According to the 1997 American Joint Committee on Cancer staging system, 9 patients had stage I or IIA disease, and 22 patients had stage IIB disease in the RT group. For the CT/RT group, 8 patients had stage I or IIA disease, and 21 patients had stage IIB disease. The median follow‐up for all patients was 124.5 (range, 5–239) months.Results:The 5‐year locoregional failure‐free (LRFF), distant metastasis‐free (DMF), disease‐free survival (DFS), and overall survival (OS) rate was 84%, 93%, 81%, and 84% for the RT group and 77%, 86%, 71%, and 79% for the CT/RT group, respectively. There were no significant differences in LRFF (P= .728), DMF (P= .433), DFS (P= .562), and OS (P= .625) rates between the RT and CT/RT groups. Multivariate analysis revealed that delaying RT for more than 81 days was significantly associated with an increased risk of locoregional failure in the subgroup of patients with stage IIB disease (P= .044).Conclusions:In our retrospective analysis, the use of neoadjuvant CT showed no additional benefit to treatment with RT alone. Neoadjuvant CT may cause deleterious effect on stage IIB disease by delaying RT.
The Prognostic Impact of Extent of Bone Invasion and Extent of Bone Resection in Oral Carcinoma
Authors: Patel Rajan S. , Dirven Richard , Clark Jonathan R. , Swinson Brian D. , Gao Kan , O'Brien Christopher J. 
Published: February 2009

AbstractObjective: The prognostic impact of mandibular invasion by oral squamous cell carcinoma (SCC) is controversial. The objective of this study was to assess the effect that extent of bone invasion has on recurrence and survival in patients treated with marginal and segmental mandible resection.Study Design: A retrospective cohort study of patients whose clinicopathologic information had been collected prospectively into a dedicated head and neck database.Methods: Local control and disease‐specific survival were retrospectively reviewed in 111 patients (median follow‐up, 44 months) with oral SCC undergoing marginal or segmental mandibulectomy.Results: Bone invasion was present in 46% of marginal and 94% of segmental resections. Five‐year local control was similar following marginal (83%) and segmental mandibulectomy (86%). There was no correlation with presence or extent of bone invasion. Survival at 5 years was 71% and this correlated with bone invasion and involved margins (P < .05), but not with extent of mandible invasion or resection.Conclusions: Marginal mandibulectomy does not adversely alter outcome in selected patients with bone invasion provided margins are not compromised.
Free‐Flap Head and Neck Reconstruction and Quality of Life: A 2‐Year Prospective Study
Authors: Bozec Alexandre , Poissonnet Gilles , Chamorey Emmanuel , Casanova Cédric , Vallicioni Jacques , Demard François , Mahdyoun Pouya , Peyrade Frédéric , Follana Philippe , Bensadoun René‐Jean , Benezery Karen , Thariat Juliette , Marcy Pierre‐Yves , Sudaka Anne , Dassonville Olivier 
Published: February 2009

AbstractObjectives: This prospective study was designed to evaluate quality of life (QOL) after free‐flap head and neck reconstruction.Study Design: Prospective study.Methods: Between January 2004 and December 2005, a total of 95 patients underwent microvascular reconstruction of the head and neck at our Institution (Centre Antoine‐Lacassagne, Nice, France) and were initially included in this study. The European Organization for Research and Treatment of Cancer (EORTC) Core Quality of Life Questionnaire and the EORTC Head and Neck Cancer Quality of Life Questionnaire were completed before surgery, and at 6 and 12 months thereafter. Sixty‐five patients completed the questionnaires on at least two of the assessment dates. Predictive factors of Quality of Life (QOL) scores at 6 months were researched among the following: age, sex, comorbidity, radiotherapy, tumor recurrence, tumor stage, and type of surgery.Results: Global QOL remained stable over time. Physical, social, and role functioning deteriorated significantly after treatment. Pain decreased markedly. Social eating, senses, and speech difficulties increased significantly at 6 months, but stabilized between 6 and 12 months. Problems concerning mouth opening and social contact augmented progressively until the 12th postoperative month. Sex, type of surgery, and radiotherapy were the main factors influencing QOL 6 months after treatment.Conclusions: Despite some functional impairments, global QOL was preserved after major head and neck ablative surgery and microvascular free‐flap reconstruction.
Recurrent Respiratory Papillomatosis: A Review
Authors: Derkay Craig S. , Wiatrak Brian 
Published: February 2009

AbstractRecurrent respiratory papillomatosis (RRP), which is caused by human papillomavirus types 6 and 11, is the most common benign neoplasm of the larynx among children and the second most frequent cause of childhood hoarseness. After changes in voice, stridor is the second most common symptom, first inspiratory and then biphasic. Less common presenting symptoms include chronic cough, recurrent pneumonia, failure to thrive, dyspnea, dysphagia, or acute respiratory distress, especially in infants with an upper respiratory tract infection. Differential diagnoses include asthma, croup, allergies, vocal nodules, or bronchitis. Reports estimate the incidence of RRP in the United States at 4.3 per 100,000 children and 1.8 per 100,000 adults. Infection in children has been associated with vertical transmission during vaginal delivery from an infected mother. Younger age at diagnosis is associated with more aggressive disease and the need for more frequent surgical procedures to decrease the airway burden. When surgical therapy is needed more frequently than four times in 12 months or there is evidence of RRP outside the larynx, adjuvant medical therapy should be considered. Adjuvant therapies that have been investigated include dietary supplements, control of extra‐esophageal reflux disease, potent antiviral and chemotherapeutic agents, and photodynamic therapies; although several have shown promise, none to date has “cured” RRP, and some may have serious side effects. Because RRP, although histologicallybenign, is so difficult to control and can cause severe morbidity and death, better therapies are needed. The potential for a quadrivalent human papilloma vaccine is being explored to reduce the incidence of this disease.
Immunodefense of the Round Window
Authors: Engmér Cecilia , Laurell Göran , Bagger‐Sjöbäck Dan , Rask‐Andersen Helge 
Published: February 2009

AbstractA systematic analysis using serial sectioning of the round window membrane (RWM) in the cynomolgus monkey was performed. Light and transmission electron microscopy (LM and TEM) revealed that the RWM rim may be endowed with gland‐like structures with glyco‐protein material secernated into the window niche. This was detected in one third of the specimens. The secreted material displayed waste material and scavenger cells. There was also a rich network of capillaries, lymph channels, and sinusoidal veins containing leukocytes. Their abluminal surfaces displayed mature plasma cells and monocytes. These findings suggest that in certain primates the middle ear may have developed specific immunoprotective means for disposal of foreign and noxious substances before they reach the inner ear.
Flexible Endoscopic Clip‐Assisted Zenker's Diverticulotomy: The First Case Series (With Videos)
Authors: Tang Shou‐jiang , Jazrawi Saad F. , Chen Edward , Tang Linda , Myers Larry L. 
Published: February 2009

AbstractBackground: In treating Zenker's diverticulum (ZD), there are potential risks associated with performing flexible endoscopic diverticulotomy without suturing or stapling. We recently introduced flexible endoscopic clip‐assisted diverticulotomy (ECD) in treating ZD by securing the septum prior to dissection.Objective: To evaluate the feasibility and safety of ECD for complete septum dissection.Study Design: Case series at an academic center. Seven consecutive patients (mean age 71 y; range 48–91 y) with symptomatic ZD of various craniocaudal sizes based on radiographic measurements (mean 2.6 cm; range 0.8 cm–4.5 cm) were included. The mean depth of the septum was 1.73 cm (range 0.3 cm–3.1 cm). The mean duration of symptoms was 4.8 years (range 0.5–10 y).Methods: After endoclips were placed on either side of the cricopharyngeal bar, the septum was dissected between these two clips down to the inferior end of the diverticulum with a needle‐knife. Procedures including “one‐step ECD” (n = 1), “stepwise ECD” (n = 3), and “bottom ECD” (n = 2) were performed based on the septum depth of the ZD during endoscopy. ECD was not performed on one patient due to severe mucosal fragility of the esophageal inlet. Iatrogenic blunt dissection of the septum by the endoscopic hood occurred secondary to patient retching during the procedure. Main outcome measurements were symptom resolution and complications.Results: All patients (n = 6) who underwent ECD had complete resolution of esophageal symptoms at a minimum 6‐month follow‐up. There were no procedural complications. The patient who did not undergo ECD developed an esophageal perforation. She was managed conservatively without surgical intervention. On follow‐up, her dysphagia was completely resolved.Conclusions: ECD is feasible, safe, and effective for complete septum dissection. ECD and endoscopic stapler‐assisted diverticulotomy are complimentary rather than competing strategies in approaching ZD. Study limitations include the case series design and limited follow‐up period.
Human Nasal Cartilage Ultrastructure: Characteristics and Comparison Using Scanning Electron Microscopy
Authors: Holden Paul K. , Liaw Li‐Huei , Wong Brian J.‐F. 
Published: February 2009

AbstractObjectives/Hypothesis: Human nasal cartilage is hyaline cartilage, although the function and loads placed on it are different depending on the location. We hypothesized that important differences exist between the nasal septal cartilage and lower lateral cartilage (LLC) ultrastructures. Such differences would be important in the field of cartilage engineering.Methods: Ten specimens (6 septum and 4 LLC) of cartilage from patients undergoing nasal surgery (rhinoplasty or septoplasty) were obtained and examined using scanning electron microscopy. Micrographs were then analyzed and measured using photograph analysis software.Results: The collagen fibers of septal cartilage were found to be arranged in a mesh framework, with larger lacunae and thicker fibers measuring 3.18 μm (standard deviation = 0.75 μm), with a 99.9% confidence interval of 2.74 to 3.54 μm. LLC fibers, on the other hand, were arranged in less‐organized sheets, with fibrous extensions, and had fewer, narrower lacunae. The fibers from the LLC averaged 2.29 μm, with a 99.9% confidence interval of 1.17 to 3.42 μm.Conclusions: Significant ultrastructural differences exist between the cartilage of the nasal septum and LLC. These are almost certainly the result of their embryologic origins and different forces placed on the structures they support. A less‐organized pattern with smaller collagen fibers is present in the LLC versus the more‐organized, layered, thicker collagen fibers of the septum. These differences may prove to be critical in the future of cartilage engineering.