bluuebunny/crossref_metadata_2025_split huggingface dataset:
Extent of pelvic lymphadenectomy in women with squamous cell carcinoma of the uterine cervix: Is there any prognostic value?
Authors: Fregnani José Humberto Tavares Guerreiro , de Oliveira Latorre Maria do Rosário Dias , Novik Pablo Roberto , Lopes Ademar , de Oliveira Júnea Cáris , Tsunoda Audrey Tieko , Soares Fernando Augusto 
Published: February 2009

AbstractBackground and ObjectivesSome authors states that the removal of lymph node would only contribute towards assessing the lymph node status and regional disease control, without any benefit for the patients' survival. The aim of this paper was to assess the influence of the number of surgically dissected pelvic lymph nodes (PLN) on disease‐free survival.MethodsRetrospective cohort study on 42 women presenting squamous cell carcinoma (SCC) of the uterine cervix, with metastases in PLN treated by radical surgery. The Cox model was used to identify risk factors for recurrence. The model variables were adjusted for treatment‐related factors (year of treatment, surgical margins and postoperative radiotherapy). The cutoff value for classifying the lymphadenectomy as comprehensive (15 PLN or more) or non‐comprehensive (<15 PLN) was determined from analysis of the ROC curve.ResultsFourteen recurrences (32.6%) were recorded: three pelvic, eight distant, two both pelvic and distant, and one at an unknown location. The following risk factors for recurrence were identified: invasion of the deep third of the cervix and number of dissected lymph nodes <15.ConclusionsDeep invasion and non‐comprehensive pelvic lymphadenectomy are possible risk factors for recurrence of SCC of the uterine cervix with metastases in PLN. J. Surg. Oncol. 2009;100:252–257. © 2009 Wiley‐Liss, Inc.
Clinical significance of gastric outlet obstruction on the oncologic and surgical outcomes of radical surgery for carcinoma of the distal stomach
Authors: Park Seong‐Heum , Mok Young‐Jae , Kim Jong‐Han , Park Sung‐Soo , Kim Seung‐Joo , Kim Chong‐Suk 
Published: February 2009

AbstractBackground and ObjectivesTo determine the significance of gastric outlet obstruction (GOO) on the outcomes of radical surgery for distal gastric cancer.MethodsThree hundred seventy‐one patients who underwent radical surgery for advanced gastric cancer arising at the distal stomach were categorized into two groups according to the presence of GOO, that is, 59 patients with GOO and 312 patients without. Clinicopathologic variables, postoperative morbidity and mortality, recurrence pattern, and survival outcomes of the two groups were compared.ResultsDistal gastric carcinoma with GOO was usually diagnosed at a more advanced stage with aggressive pathologic features. GOO adversely affected overall survival after radical surgery with an odds ratio of 2.068 (P < 0.001). In patients with recurrent diseases, patients with GOO had higher rate of locoregional recurrence after radical surgery (P = 0.021). High‐grade postoperative complications occurred at similar rates in both groups (P = 0.539).ConclusionsThe presence of GOO is an independent prognostic factor after radical surgery for advanced distal gastric cancer and provide additional information for identifying patients at higher risk of recurrence and pattern of recurrence during follow‐up. Radical surgery in patients with GOO can be performed with acceptable morbidity and mortality. J. Surg. Oncol. 2009;100:215–221. © 2009 Wiley‐Liss, Inc.
PTSD in Vietnamese Americans following Hurricane Katrina: Prevalence, patterns, and predictors
Authors: Norris Fran H. , VanLandingham Mark J. , Vu Lung 
Published: February 2009

AbstractOne year after Hurricane Katrina devastated New Orleans, we assessed 82 adults from a population‐based sample of the Vietnamese American community who had participated in a larger study of immigration weeks before the disaster. Although 21% met criteria for partial posttraumatic stress disorder (PTSD), only 5% of the sample met all PTSD criteria. Avoidance/numbing symptoms did not form a coherent cluster and were seldom confirmed, but intrusion, arousal, and interference were common. Severity of exposure to the floodwaters, property loss, and subjective trauma were independently related to PTSD symptoms. Symptoms were highest among participants who were low in acculturation or who had high Katrina exposure in combination with prolonged stays in transition camps during emigration.
Outcome of patients after treatment for a squamous cell carcinoma of the oropharynx
Authors: Röösli Christof , Tschudi Dominique C. , Studer Gabriela , Braun Julia , Stoeckli Sandro J. 
Published: February 2009

AbstractObjectives:This study evaluates the oncologic outcome with regard to survival and locoregional tumor control in a cohort of patients with oropharyngeal squamous cell carcinoma (OPSCC) treated according to a uniform algorithm.Study Design:Retrospective chart review.Methods:A total of 427 consecutive patients with OPSCC were treated from 1990 to 2006. Treatment modalities were surgery alone (n = 102), surgery with adjuvant radio(chemo)therapy (n = 159), and primary radio(chemo)therapy (n = 166). Study endpoints were the five‐year overall survival (OS) and disease‐specific survival (DSS) stratified for primary tumor subsite, stage, T and N category, and age.Results:The five‐year OS and DSS for the entire cohort were 57.9% and 68.6%, respectively. OS and DSS for surgery alone were 70.3% and 76.5%, for surgery with radiation 66.6% and 78.9%, and for primary radiation 40.8% and 52.6%, respectively. Survival was significantly better for low stages (stage I/II vs. III/IV), small tumors (T1/2 vs. T3/4), limited nodal involvement (N0/1 vs. N2/3), and younger age at diagnosis.Conclusions:Together with our previous study on quality of life, we were able to show that our selection process gives excellent oncologic outcome in combination with high levels of function and quality of life. Surgery alone for early OPSCC and surgery followed by radiation for advanced OPSCC remain valuable treatment options. Primary radiochemotherapy is a strong alternative for patients who are not candidates for function‐preserving surgery. Laryngoscope, 119:534–540, 2009
Antibiotics in head and neck surgery in the setting of malnutrition, tracheotomy, and diabetes
Authors: Sepehr Ali , Santos Barbara‐Jean Gutierrez , Chou Chinsui , Karimi Koohyar , Devcic Zlatko , Oels Stefanie , Armstrong William B. 
Published: February 2009

AbstractObjectives/Hypothesis:The objectives of this study are to compare short vs. long antibiotic prophylaxis in the setting of malnutrition, diabetes, and tracheotomy.Study Design:Retrospective chart review.Methods:The charts of 407 patients undergoing clean‐contaminated head and neck surgery were reviewed for disease type, operation performed, length of antibiotic prophylaxis, wound complications, and length of hospital stay. Three intrinsic patient risk factors for infection (malnutrition, diabetes mellitus, and tracheotomy) were evaluated for an effect on the optimal length of antibiotic prophylaxis. The data was statistically analyzed using the two‐tailed Fisher's exact test.Results:Overall, the incidence of infection was 7% in short‐course antibiotics and 13% in long‐course antibiotics (P = .06). The incidence of infection was 18% in malnourished patients and 3% in well‐nourished patients (P < .0001). In malnourished patients, the incidence of infection was 16% in short‐course antibiotics and 19% in long‐course antibiotics (P = 1). The incidence of infection was 11% in diabetics and 23% in nondiabetics (P = .13). In diabetic patients, the incidence of infection was 0% on short‐course antibiotics and 16% on long‐course antibiotics (P = .55). The incidence of pneumonia was 14% in patients with tracheotomy and 5% in patients without tracheotomy (P = .0014). In patients with tracheotomy, the incidence of pneumonia was 8% on short‐course antibiotics and 15% on long‐course antibiotics (P = .6931).Conclusions:Malnutrition and tracheotomy were associated with a higher infection rate while diabetes was not found to be a risk factor. Prolonged antibiotics were not associated with a lower infection rate in the overall group or in any subgroup. Laryngoscope, 119:549–553, 2009
Squamous cell carcinoma associated with intralesional injection of cidofovir for recurrent respiratory papillomatosis
Authors: Lott David G. , Krakovitz Paul R. 
Published: February 2009

AbstractRecurrent respiratory papillomatosis is a common neoplasm of the larynx that may lead to severe, recurrent lesions. Intralesional injection of cidofovir has shown promise as an adjuvant therapy. There is concern for possible malignant transformation with its use but, to our knowledge, this has not been documented in the literature. We report a case of invasive squamous cell cancer arising from squamous papilloma in a patient treated with multiple injections of cidofovir. Although causation is not shown, we believe the association presented is a valuable addition to the literature and an important consideration in the use of cidofovir. Laryngoscope, 119:567–570, 2009
Three‐dimensional tomosynthesis and cone‐beam computed tomography: An experimental study for fast, low‐dose intraoperative imaging technology for guidance of sinus and skull base surgery
Authors: Bachar Gideon , Barker Emma , Nithiananthan Sajendra , Chan Harley , Daly Michael J. , Irish Jonathan C. , Siewerdsen Jeffrey H. 
Published: February 2009

AbstractObjectives:To describe three‐dimension (3‐D) tomosynthesis and cone beam computed tomography (CBCT) as an intraoperative imaging system to guide both sinus and skull‐base surgery in a cadaveric model.Methods:Five cadaveric heads underwent baseline CBCT imaging. Surgical targets were resected from each head (uncinectomy, ethmoidectomy, medial maxillectomy, pituitary gland resection, and clivus ablation). Intraoperative imaging was provided so that for a given task, the acquisition arc (θtot = 20°, 45°, 60°, 90°, 178°) of the tomosynthesis scan was fixed. Different heads and tasks were allocated different acquisition angles. There was no limit to the number of scans that could be requested. Residual target was highlighted with 3‐D visualization software.Results:The larger the image acquisition angle, the better the image. Only CBCT (θtot ∼178°) provided nearly isotropic 3‐D spatial resolution and soft‐tissue visibility in all three views. The volume of residual tissue remaining and the volume of adjacent‐normal tissue that was resected were calculated as a function of tomosynthesis angle. For the easier surgical tasks (uncinectomy, ethmoidectomy) the residual tissue was not related to the tomosynthesis angle. However, for the difficult ablative tasks, the image quality became more important and tomosynthesis angle was related to the residual tissue.Conclusions:We describe an intraoperative imaging platform that can deliver near‐real‐time images of the target and related structures with low radiation dose. Tomosynthesis scanning angles higher than 60° provided quantifiable benefits to the surgeon and facilitated total target ablation while helping to spare surrounding structures. Laryngoscope, 119:434–441, 2009
Bisphosphonate‐related osteonecrosis of the skull base
Authors: Khan Aayesha M. , Sindwani Raj 
Published: February 2009

AbstractBisphosphonate‐related osteonecrosis of the jaw (BRONJ) is reported in up to 18.6% of patients treated with intravenous bisphosphonates and can result in significant morbidity. Most cases are managed by oral surgeons with only a handful of reports appearing in the otolaryngology literature. We present a unique case of extensive BRONJ involving the maxilla, sinuses, and skull base, complicated by sinusitis and an intracranial abscess. This is the first description of BRONJ involving the skull base. The pathogenesis and management of this process are reviewed. Laryngoscope, 119:449–452, 2009
Effects of olfactory training in patients with olfactory loss
Authors: Hummel Thomas , Rissom Karo , Reden Jens , Hähner Aantje , Weidenbecher Mark , Hüttenbrink Karl‐Bernd 
Published: February 2009

AbstractObjectives:Olfactory function is known to be modulated by repeated exposure to odors. The aim of this investigation was whether patients with olfactory loss would benefit from “Training” with odors in terms of an improvement of their general olfactory function. It was hypothesized that olfactory Training should produce both an improved sensitivity towards the odors used in the Training process and an overall increase of olfactory function.Study Design:The prospective study was performed in patients with olfactory dysfunction.Methods:One group of patients performed the Training (n = 40), whereas another part did not (n = 16). Exclusion criteria for patients were sinunasal disease. Olfactory training was performed over a period of 12 weeks. Patients exposed themselves twice daily to four intense odors (phenyl ethyl alcohol: rose, eucalyptol: eucalyptus, citronellal: lemon, and eugenol: cloves). Olfactory testing was performed before and after training using the “Sniffin' Sticks” (thresholds for phenyl ethyl alcohol, tests for odor discrimination and odor identification) in addition to threshold tests for the odors used in the training process.Results:Compared to baseline, training patients experienced an increase in their olfactory function, which was observed for the Sniffin' Sticks test score and for thresholds for the odors used in the training process. In contrast, olfactory function was unchanged in patients who did not perform olfactory training. The present results indicate that the structured, short‐term exposure to selected odors may increase olfactory sensitivity. Laryngoscope, 119:496–499, 2009
Short and long‐term usage of a dental device in sleep apnea syndrome
Authors: Peled Eli , Yoffe Naama , Blumenfeld Israel , Peled Nir 
Published: February 2009

AbstractObjective:To assess the efficacy, the compliance, and the complications of the anterior mandibular positioning (AMP) device in obstructive sleep apnea syndrome (OSA) patients.Material & Methods:Polysomnographic sleep studies were performed on 38 patients before and two weeks (± 3 days) after continuous use of the AMP device. Twenty patients also underwent polysomnographic follow‐up recordings after 1 year.Results:The mean apnea‐hypopnea index (AHI) before treatment was 35.6 ± 17.7 and decreased significantly to 22.7 ± 15.8 after 2 weeks of treatment (p = 0.01). The mean AHI after 1 year of usage was 25.3 ± 12.9, differing significantly from the pretreatment AHI (p = 0.01). Seventy‐one percent of patients used the device for 18.4 months (range 12–27). One‐year clinical evaluation showed preserved dental status, preserved action of the masticatory muscles, and preserved function of the temporo‐mandibular joint (TMJ). Eleven (29%) of the patients did not use the AMP device because of TMJ pain and/or unsatisfying results.Conclusions:The AMP device is well tolerated in 76% of patient. When tolerated, its compliance and efficiency are preserved across the year without long‐term oral and jaw dysfunctions. Laryngoscope, 119:585–588, 200
Laryngeal presentation of systemic apolipoprotein A‐I–derived amyloidosis
Authors: Hazenberg Aldert J. C. , Dikkers Frederik G. , Hawkins Philip N. , Bijzet Johan , Rowczenio Dorota , Gilbertson Janet , Posthumus Marcel D. , Leijsma Martha K. , Hazenberg Bouke P. C. 
Published: February 2009

AbstractObjective:To study the clinical and pathological characteristics of two patients with laryngeal apolipoprotein A‐I (apoA‐I)‐derived (AApoAI) amyloidosis with the apolipoprotein A‐I variants Leu174Ser and Leu178Pro, respectively. The latter variant has not been associated with amyloid before.Study Design:Descriptive report of two patients who presented with laryngeal amyloid presumed to be of localized AL type, but in who further assessments demonstrated systemic amyloidosis.Methods:The larynx was examined by videolaryngostroboscopy. The voice was analyzed with the GRBAS system, phonation times, and phonetography. Laryngeal biopsies were stained with Congo red and analyzed immunohistochemically. Organ function was assessed and tissue involvement by amyloid further determined by rectal biopsy, abdominal fat tissue aspirate, and serum amyloid P component scintigraphy.Results:The appearance of the laryngeal amyloid was unusual in both patients, occurring as small, irregular floppy proliferations affecting the borders of both vocal folds. Amyloid was stained with antibodies to apoA‐I and not with antibodies to immunoglobulin light chains. The 45‐year‐old woman with the previously described amyloidogenic apoA‐I Leu174Ser variant had possible involvement by amyloid in joints, peripheral nerves, and heart. Whereas in the 67‐year‐old man with apoA‐I Leu178Pro there was a clinical suggestion of autonomic and cardiac amyloid and histological corroboration of systemic amyloidosis in abdominal fat.Conclusions:Laryngeal symptoms may be the presenting feature of hereditary systemic AApoAI amyloidosis, and comprehensive investigations including apoA‐I genotyping are warranted in patients who present with apparently localized laryngeal amyloidosis. The distinctive appearance of the amyloidotic vocal folds described here may further signal the possibility of hereditary AApoAI type. Laryngoscope, 119:608–615, 2009
The candy smell test: A New Test for Retronasal Olfactory Performance
Authors: Renner Bertold , Mueller Christian A. , Dreier Juergen , Faulhaber Stefanie , Rascher Wolfgang , Kobal Gerd 
Published: February 2009

AbstractObjectives:To develop and validate an olfactory test kit suitable for children and adults based on retronasal smelling of aromas combined with a sweet taste. Moreover, to explore the age limit at which olfactory testing is feasible and to extend the normative database for the validated “Sniffin' Sticks” test regarding children of younger ages.Study Design:Randomized three‐way crossover study in healthy children and adults.Methods:The newly developed Candy Smell Test (CST, 23 aromatized sorbitol candies) was presented using a four‐alternative, forced‐choice procedure. First, 353 healthy subjects (230 children and 123 adults) were investigated in three separate sessions with the CST and the validated “Sniffin' Sticks” (composed of odor threshold, discrimination, and identification tasks). Both tests were then compared in 124 patients with olfactory disorders.Results:Test‐retest reliability showed good reproducibility of the data obtained with the CST on 2 days (r287 = 0.75, P < .001). Test results correlated significantly with the “Sniffin' Sticks” score (r366 = 0.84, P < .001), although the CST proves to be much easier. The age limit for obtaining valid data was 7 years for both tests. The cutoff limit for the CST scores to separate normosmics from dysosmics was a score of 16 or less out of 23. Anosmia (cutoff score ≤13) was detected with a sensitivity of 94% and a specificity of 83%.Conclusions:The CST is an easy‐to‐use, reliable, and fast test of retronasal olfactory performance suitable for the screening of smell function in children above the age of 6 years and adults. Laryngoscope, 119:487–495, 2009
Acute radiographic workup of blunt temporal bone trauma: Maxillofacial versus temporal bone CT
Authors: Dempewolf Ryan , Gubbels Sam , Hansen Marlan R. 
Published: February 2009

AbstractObjectives/Hypothesis:To evaluate the radiographic workup of blunt temporal bone trauma and determine the utility of maxillofacial computed tomography (CT) versus temporal bone CT in identifying carotid canal fractures.Study Design:Retrospective review.Methods:The charts of 227 patients evaluated at a level I trauma center receiving a temporal bone CT for blunt head trauma within 48 hours of admission were reviewed. Acute evaluation findings and complications were noted. Sensitivity, specificity, positive predictive value, and negative predictive (NPV) value were calculated for maxillofacial CT's ability to identify carotid canal fractures compared to temporal bone CT.Results:One hundred forty fractures were found. Physical exam findings of blood in the external auditory canal as the sole finding, and blood in the external auditory canal with associated hemotympanum were significantly associated with absence and presence of fracture respectively. The sensitivity and specificity of maxillofacial CT for identifying carotid canal fractures, when compared to temporal bone CT, were 90.3% and 94.4% respectively (NPV > 95%). Only 6% of all patients either did have or should have had their management changed based on the temporal bone CT findings. All of these changes were regarding further workup for blunt carotid artery injury.Conclusions:A combination of helical computed tomography and physical exam findings can allow for judicious use of temporal bone CTs when no maxillofacial CT is indicated. Temporal bone CTs rarely change acute management. But when they do, it is in regard to the need for further workup of possible vascular injury. Lastly, maxillofacial CTs are adequate for identifying carotid canal fractures. Laryngoscope, 119:442–448, 2009
Audiometric pattern as a predictor of cardiovascular status: Development of a model for assessment of risk
Authors: Friedland David R. , Cederberg Christopher , Tarima Sergey 
Published: February 2009

AbstractObjectives/Hypothesis:This study hypothesizes that low‐frequency hearing loss is associated with underlying cardiovascular disease. The objective of this study was to use a mathematical model of hearing thresholds to predict cardiovascular status.Study Design:Logistic regression analyses of audiometric and cardiovascular data obtained through retrospective chart review. Application of a derived mathematical formula to a distinct prospectively enrolled cohort.Methods:Cardiovascular status was determined for a cohort of 1,168 patients seen in the audiology division. Associations between audiogram pattern and cardiovascular variables were tested with the Mantel‐Haenszel statistic controlling for age and gender. Logistic regression models were developed incorporating cardiovascular risk factors and audiogram pattern. The models were applied to a separate cohort of 90 subjects recruited from cardiology and geriatric medicine clinics in whom audiograms were performed.Results:A significant association was found between low‐frequency hearing loss and cardiovascular disease and risk factors. When controlling for age, hypertension, diabetes, smoking, and hyperlipidemia, low‐frequency presbycusis was significantly associated with intracranial vascular pathology such as stroke and transient ischemic attacks. Significant associations were also seen with peripheral vascular disease, coronary artery disease, and a history of myocardial infarction. A mathematical formula using audiometric pattern and medical history to predict the probability of cardiovascular diseases and events was developed and tested.Conclusions:Audiogram pattern correlates strongly with cerebrovascular and peripheral arterial disease and may represent a screening test for those at risk. Patients with low‐frequency hearing loss should be regarded as at risk for cardiovascular events, and appropriate referrals should be considered. Laryngoscope, 119:473–486, 2009