bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prophylaxis of oral mucositis associated with chemoradiotherapy for oral carcinoma by Azelastine hydrochloride (Azelastine) with other antioxidants
Authors: Osaki Tokio , Ueta Eisaku , Yoneda Kazunori , Hirota Jusui , Yamamoto Tetsuya 
Published: February 2007

AbstractBackground. One of the dose‐limiting adverse effects of chemoradiotherapy is mucositis, especially oral mucositis. Prophylaxis of severe mucosal reaction would allow application of aggressive chemoradiotherapy to malignancies.Methods. Sixty‐three patients who received inductive concomitant chemoradiotherapy with cobalt 60 (60Co1 ∼ 30 Gy), peplomycin (PLM, ∼ 38 mg), and 5‐fluorouracil (5‐FU, ∼3,500 mg) were included in this study. From the start of therapy to the disappearance of oral erosion, 37 patients received daily doses of Azelastine (2 mg) + vitamin C (500 mg) + vitamin E (200) + glutathione (200 mg) (azelastine group), whereas the other 26 patients received the same regimen without azelastine (control group). The severity of oral mucositis in both groups was evaluated periodically.Results. At 10 Gy with 15 mg PLM and 1,250 mg 5‐FU, grade 1 mucositis (redness of the oral mucosa) was induced in 14 patients in the control group and five patients in the Azelastine group. At 20 Gy with 30 mg PLM and 2,500 mg 5‐FU, grade 2 (erosion with mild irritation) and grade 3 (extensive erosion with marked irritation) stomatitis were observed in 9 and 3 of the control patients and 5 and 1 in the Azelastine group, respectively. At the completion of treatment, mucositis in 21 patients in the Azelastine group remained at grade 1 or grade 2, whereas grades 3 and 4 (ulceration with severe contact pain) mucositis were observed in 6 and 10 patients, respectively. However, in the control group, grades 1 and 2 were observed in only 2 and 3 cases, whereas grades 3 and 4 stomatitis were induced in 6 and 15, respectively. Azelastine suppressed neutrophil respiratory burst both in vivo and in vitro, and also suppressed cytokine release from lymphocytes. However, neutrophil superoxide dismutase (SOD) activity was negligibly suppressed.Conclusion. A regimen including Azelastine, which suppresses reactive oxygen production and stabilizes cell membranes, may be useful for the prophylaxis of mucositis due to chemoradiotherapy. © 1994 John Wiley & Sons, Inc.
An unusual case of synchronous thyroid and parathyroid adenomas
Authors: Huston Butch M. , Landas Steve K. 
Published: February 2007

AbstractA 52‐year‐old woman was evaluated for an enlarging neck mass. Fine‐needle aspirate contained Hürthle cells and thyroidectomy revealed two separate thyroid morphologically similar lesions. Immunohistochemical studies confirmed diagnoses of separate Hürthle cell thyroid and oxyphil parathyroid adenomas. Diagnostic pitfalls and the role of immunohistochemistry in diagnosis are discussed. © 1994 John Wiley & Sons, Inc.
4NQO carcinogenesis: A mouse model of oral cavity squamous cell carcinoma
Authors: Hawkins Brian L. , Heniford Briana W. , Ackermann Douglas M. , Leonberger Michael , Martinez Serge A. , Hendler Fred J. 
Published: February 2007

AbstractBackground. A murine model of oral cavity carcinogenesis is needed to study the molecular aspects of malignant transformation. 4‐Nitroquinoline‐1‐oxide (4NQO), a water‐soluble carcinogen, produces squamous cell carcinoma in rodents. Protocols were designed to investigate the temporal aspects of neoplastic transformation.Methods. 4NQO was applied topically to mouse palates for up to 16 weeks. Mice were observed and killed from 24 to 49 weeks.Results. A spectrum of lesions ranging from atypia to moderately differentiated invasive squamous cell carcinoma (SCC) was produced. The severity of the lesions corresponded to the duration of treatment and the length of observation. There was no gross or microscopic evidence of an inflammatory reaction to 4NQO. The lesions were focal and normal mucosa predominated in the treated mice.Conclusion. 4NQO reliably produced preneoplastic and malignant oral cavity lesions, which morphologically and histologically mimic human head and neck cancer. Lesions develop long after 4NQO exposure and without an inflammatory response. Thus, the model should be useful for molecular analysis of neoplastic transformation. © 1994 John Wiley & Sons, Inc.
Recurrence of laryngeal or hypopharyngeal primary tumor after radical neck dissection for postradiotherapy neck nodal metastases
Authors: Ho Chiu M. , Lam Kam H. , Wei William I. , Lam Lai K. , Yuen Po W. 
Published: February 2007

AbstractBackground. When the primary tumor in the larynx or hypopharynx responds well to radiotherapy, nodal metastasis in the neck may persist or recur. The primary site is usually left alone when no lesion is evident, but its long‐term control is uncertain.Methods. Radical neck dissection was performed in 23 patients who had nodal metastasis, while the primary tumor in the larynx or hypopharynx was controlled after radiotherapy. The primary site was left alone and kept under surveillance.Results. Seven patients (30%) had recurrence at the primary site on follow‐up. Two significant risk factors for development of recurrences at the primary site were identified: the neck node staging at presentation (p < 0.03) and presentation with persistent neck lymph nodes (p < 0.03). The 2‐year survival of those patients with recurrences at the primary site was 29%.Conclusion. Radical neck dissection alone was justified, but close surveillance of the primary site after surgery is mandatory, especially for those patients with high‐risk factors.
Large thyroglossal duct cyst with laryngeal extension
Authors: Shaari Christopher M. , Ho Bryan T. , Som Peter M. , Urken Mark L. 
Published: February 2007

AbstractBackground. A thyroglossal duct cyst typically presents as a long‐standing neck mass that becomes symptomatic when inflamed. Hoarseness is an uncommon complaint, and its association may suggest encroachment on and destruction of the larynx. Following removal of the cyst with the Sistrunk procedure, the larynx may need to be reconstructed.Methods. A case is reported of a patient who was initially seen with hoarseness and a long‐standing midline neck mass. Computed tomography (CT) demonstrated a large cystic neck mass that eroded the thyroid cartilage and encroached on the pre‐epiglottic space and right paraglottic space. Although the clinical impression was that of laryngeal neoplasm, the CT diagnosis was that of a cyst. At surgery, a thyroglossal duct cyst was found and successfully removed with the Sistrunk procedure. Because the thyrohyoid membrane and thyroid perichondrium were preserved, the glottis did not require reconstruction. This case is presented and the literature of thyroglossal duct cysts that extend into the larynx is reviewed.Conclusions. The clinical and radiographic criteria that suggest encroachment of a thyroglossal duct cyst on the larynx are reviewed. The management and indications for laryngeal reconstruction are discussed.
Prognostic significance of prostaglandin E2 production in fresh tissues of head and neck cancer patients
Authors: Snyderman Carl H. , Milanovich Michele , Wagner Robin L. , Johnson Jonas T. 
Published: February 2007

AbstractBackground. Immunosuppressive prostaglandins may play a role in the biologic behavior of head and neck cancer. Increased levels of prostaglandin E2 (PGE2) have been measured in squamous cell carcinoma of the head and neck (SCCHN).Methods. To address this question, tissue levels of PGE2 were measured in tumor tissues, normal mucosa, and lymph nodes of 37 patients undergoing tumor resections. Tissue specimens were placed in culture media, and levels of PGE2 released into the supernatant were measured by radioimmunoassay.Results. Tissue levels of PGE2 were significantly greater in tumor and normal mucosal tissues compared to lymph nodes (p = 0.0003). There was no difference between metastatic and tumor‐free lymph nodes. Although tumor tissue levels of PGE2 were not associated with tumor stage, increased levels of PGE2 were associated with increased 2‐year disease‐free survival (p = 0.02).Conclusions. Although PGE2 may have adverse effects on local immune function in tumor tissues, improved survival of patients with increased local PGE2 production may be indicative of an enhanced immunologic response to the tumor which has a favorable impact on outcome. © 1995 Jons Wiley & Sons, Inc.
Supraomohyoid neck dissection as a staging procedure for squamous cell carcinomas of the oral cavity and oropharynx
Authors: Henick David H. , Silver Carl E. , Heller Keith S. , Shaha Ashok R. , El Gady Har , Wolk David P. 
Published: February 2007

AbstractBackground. A multi‐institutional retrospective study was performed to evaluate the efficacy of the supraomohyoid neck dissection (SOHND) for detection of occult cervical metastasis in squamous cell carcinoma of the oral cavity and oropharynx.Methods. Seventy‐five previously untreated patients with clinically negative necks were studied. Seventeen (23%) neck specimens revealed occult metastatic disease, and 58 (77%) were histologically negative. Postoperative irradiation was received by 94% of the patients with positive specimens and 22% with negative specimens. Patients were followed until recurrence of neck disease, or for a period of 2 years or longer.Results. Cervical metastasis subsequently developed in 25% of treated positive specimen patients, none of the untreated positive specimen patients, 8% of the treated negative specimen patients, and 11% of the untreated negative specimen patients. The sensitivity of SOHND for cervical metastasis was 82%, negative predictive value 91%, and accuracy 94%.Conclusions. The authors conclude that SOHND is a useful procedure for detection of occult cervical metastatic disease in cancer of the oral cavity and oropharynx. © 1995 Jons Wiley & Sons, Inc.
Tension pneumocephalus following craniofacial resection
Authors: Wanamaker John R. , Mehle Mark E. , Wood Benjamin G. , Lavertu Pierre 
Published: February 2007

AbstractBackground. The craniofacial approach is a reliable method for excising tumors involving the anterior skull base. Advances in technique have minimized complications. Although cerebrospinal fluid leaks and meningitis are well known complications, tension pneumocephalus is not well described. We review two cases and discuss the pathophysiology, clinical manifestations, radiographic features, and treatment of tension pneumocephalus.Methods. Case study. We reviewed the records of all patients who underwent anterior craniofacial resection at our institution, a tertiary care center, from 1976 to 1993. Among 45 patients identified, 2 had tension pneumocephalus.Results. Neurologic deterioration after anterior craniofacial resection occurred in both patients in the immediate postoperative period. Both patients had extradural intracranial air under pressure and were diagnosed with tension pneumocephalus. In one patient, this was treated by needle aspiration followed by catheter drainage, and the second patient was treated with needle aspiration followed by airway diversion. The first patient recovered fully and was discharged on postoperative day 14; the second patient's mental status did not return to the preoperative level, and he was discharged on postoperative day 23 to a rehabilitative facility. Approximately 3 months later, his level of mentation returned to baseline.Conclusions. Tension pneumocephalus is a potentially devastating complication that may occur after craniofacial resection. It requires prompt recognition and treatment to minimize morbidity. © 1995 Jons Wiley & Sons, Inc.
Mesenteric flap in free jejunal transfers: A versatile technique for head and neck reconstruction
Authors: Yamamoto Yuhei , Nohira Kunihiko , Shintomi Yoshihisa , Yoshida Tetsunori , Minakawa Hidehiko , Okushiba Shunichi , Fukuda Satoshi , Inuyama Yukio , Hosokawa Masao 
Published: February 2007

AbstractBackground. The technique of free jejunal transfers has been widely used for pharyngoesophageal reconstruction. However, secondary infectious and fistulous complications may develop in extensive and preoperatively high‐dose irradiated cases.Methods. A generous jejunomesenteric composite graft was harvested and the mesenterium was effectively applied for head and neck reconstruction.Results. The mesenteric flap connected with the revascularized jejunum was used as means for obliterating dead space in the head and neck region, as a cover for the cervical vessels, as a vascularized bolstering for the vascular and enteral anastomoses, or as a vascularized bed for skin grafting when the skin flaps are deficient. Only one small fistula occurred in 10 patients who underwent the mesenteric flap.Conclusions. This versatile technique is expected to reduce the incidence of postoperative complications in pharyngoesophageal reconstruction using free jejunal transfers. © 1995 Jons Wiley & Sons, Inc.
Combined V figure‐shaped scapular osteocutaneous and latissimus dorsi myocutaneous flap for composite mandibular reconstruction
Authors: Yamamoto Yuhei , Nohira Kunihiko , Yamashita Tetsuro , Shintomi Yoshihisa , Hosokawa Masao , Furukawa Hiroshi , Sugihara Tsuneki , Ohura Takehiko 
Published: February 2007

AbstractBackground. As early as 1981, the scapular crest was reported as a versatile donor site of vascularized bone flap. In our institute, much attention has been paid to applying a compound flap based on the subscapular vascular system for composite mandibular reconstruction.Methods. The combined V figure‐shaped scapular osteocutaneous and latissimus dorsi myocutaneous flap has been used for primary or secondary reconstruction of the mandible, intraoral mucosa and/or external skin following major ablation of the malignant tumors in seven patients.Results. There was one total flap failure. Satisfactory results were obtained in the remaining patients.Conclusions. The V figure‐shaped scapular bone flap supplied by the angular branch provides a long rotation arc of vascular pedicle, a long bony segment of more than 14 cm, and a good contour of mental protuberance. The combination of the scapular osteocutaneous flap with latissimus dorsi myocutaneous flap allows reliable reconstruction of massive and three‐dimensional composite mandibular defects. © 1995 Jons Wiley & Sons, Inc.
Epiglottic abscess
Authors: Stack Brendan C. , Ridley Marion B. 
Published: February 2007

AbstractBackground. Epiglottitis is more commonly seen in children less than 6 years of age, although this entity has also been well described among adults. A coalescence of infection of the epiglottis, or epiglottic abscess, has been infrequently reported in series of epiglottitis. Risk factors for epiglottic abscess include adult age at onset, diabetes, and the presence of a foreign body.Methods. Case study.Results. We present a case of a woman with a 4‐day history of febrile illness, odynophagia, and an altered voice. Clinical examination and computed tomography (CT) demonstrated an epiglottic abscess. The patient underwent direct laryngoscopy, intubation, drainage of abscess, and intravenous antibiotics.Conclusions. The diagnosis of epiglottic abscess should be considered in adult patients initially seen with odynophagia and dysphonia. Principles of treatment include airway management, antibiotics, and surgical drainage. © 1995 Jons Wiley & Sons, Inc.
Anomalies of forearm vascular anatomy encountered during elevation of the radial forearm flap
Authors: Funk Gerry F. , Valentino Joseph , McCulloch Timothy M. , Graham Scott M. , Hoffman Henry T. 
Published: February 2007

AbstractBackground. The radial forearm flap has gained considerable popularity over the past 10 years. With the increasing number of forearm flaps being used in head and neck reconstruction, it is likely that anomalous forearm vascular anatomy will be encountered by more head and neck surgeons performing this procedure.Methods. We reviewed our experience with 52 forearm flaps; four different anomalies of forearm vascular anatomy were encountered in four patients. In this article we present each of our cases and discuss the incidence, preoperative diagnosis, and recommended management of these and the more common forearm vascular anomalies.Results. The anomalies encountered in our series include: one case of distal takeoff of the radial artery deep to the pronator teres muscle, two cases of a superficial dorsal antebrachial artery, one case of bilateral hypoplastic ulnar arteries, and one case of high takeoff of the radial artery.Conclusions. There are a number of anomalies of forearm vascular anatomy of clinical significance to the surgeon performing these procedures. Most of these anomalies can be identified with a careful preoperative examination. Surgeons performing this procedure should be familiar not only with the normal vascular anatomy of the forearm flap, but also with the more common anatomic variants. Failure to recognize or appropriately manage these anomalies of forearm vascular anatomy may result in a compromised surgical outcome. © 1995 Jons Wiley & Sons, Inc.
Hypothyroidism in association with systemic amyloidosis
Authors: Rich Michael W. 
Published: February 2007

AbstractBackground. Systemic amyloidosis leads to functional compromise of various organs through infiltration of these tissues by amyloid protein. The majority of affected patients develop infiltration of the thyroid gland; yet thyroid dysfunction rarely occurs.Methods and Results. Described herein is a case of hypothyroidism occurring in a patient with amyloid goiter. An alternative explanation for her hypothyroidism could not be determined by histologic or serologic evaluation. Hormonal assays were consistent with progressive hypothyroidism in spite of oral and, finally, parenteral replacement therapy. A review of the literature describes other cases of thyroid dysfunction reported in patients with systemic amyloidosis.Conclusions. This case illustrates how amyloid infiltration may be a cause of hypothyroidism in patients with systemic amyloidosis. Therefore, all patients who develop a goiter, including those with systemic amyloidosis, must be screened for thyroid dysfunction. When a physician diagnoses the patient with hypothyroidism, that physician must be aware of potential pitfalls in the administration of thyroxine replacement as outlined below.
Intracranial extension of sphenoid sinusitis
Authors: Xenos Chris , Rosenfeld Jeffrey V. , Kleid Stephen M. 
Published: February 2007

AbstractBackground. The incidence of sphenoid sinusitis has decreased significantly since the pre‐antibiotic era. Intracranial complications from isolated sphenoid sinusitis are rare but have a high morbidity and mortality.Methods. A case of intracranial extension of sphenoid sinusitis in a 64‐year‐old woman is reported.Results. A 64‐year‐old woman was initially seen unconscious with bacterial meningitis and cerebrospinal fluid (CSF) fistula. Imaging suggested sphenoid sinusitis with intracranial extension. She underwent a sinus drainage procedure, was placed on antibiotic therapy, and underwent a definitive sphenoid sinus obliteration. The patient made a satisfactory recovery.Conclusions. Despite the low incidence of intracranial complications of sphenoid sinusitis, the potential morbidity and mortality from such complications is high. We advocate aggressive management consisting of antibiotic therapy, sinus drainage, and definitive CSF fistula repair. © 1995 Jons Wiley & Sons, Inc.
Adverse aspects of small thyroid cancer and need for treatment
Authors: Rosen Irving B. , Azadian Abbas , Walfish Paul G. 
Published: February 2007

AbstractBackground. Small, well‐differentiated thyroid cancer (tumor <1.5 cm) is frequently dismissed as biologically inconsequential, although varied reports have offered differing experiences.Methods. A total of 382 thyroid cancer patients were reviewed. Of these, 99 patients had tumors that were < 1.5 cm. Thirty‐five patients in this group with positive nodes, extrathyroidal invasion, or metastatic disease were studied.Results. Thirty‐five patients (one‐third of the <1.5 cm group) showed other sites of involvement: nodes, 28; lung, 1; muscle, 7; nerve, 5; and bone, 2. Six patients had residual cancer following surgery. Surgery included thyroidectomy and neck dissection as well as orthopedic procedures for metastatic bone disease. Radioiodine ablation was used in 33 patients, external radiation in 5. Thirty‐one patients are well without disease, 3 are alive with disease, 1 died of disease.Conclusions. Small, well‐differentiated thyroid cancer is infrequently aggressive, but it may be a source for metastatic morbidity and recurrence and can be viewed as potentially lethal. Need for treatment should not be ignored based solely on the size of the tumor. © 1995 Jons Wiley & Sons, Inc.
Maneuver to assist examination of the hypopharynx
Authors: Purser Simon , Antippa Phillip 
Published: February 2007

AbstractBackground. The lower hypopharynx, lying posterior to the larynx, is not usually assessable during outpatient examination. A maneuver was developed to assist flexible endoscopic examination of this region. The discomfort experienced by fifty consecutive patients undergoing the maneuver was assessed together with the view obtained.Method. Fifty patients assigned scores from 0 to 10 to the discomfort experienced during manual anterosuperior traction applied to the prelaryngeal skin, together with two other commonly performed procedures. The view obtained in the last 30 patients was assessed.Results. The mean discomfort score for the maneuver was 3.77, compared with 3.84 and 5.94 for the other two procedures.A view to the cricoarytenoid joint or below was obtained in 60% of the patients assessed.Conclusions. We conclude that the maneuver is well tolerated and results in a useful view of the hypopharynx in the majority of patients.No prior report of this maneuver has been found in the literature.
Mortality in the pediatric patient with tracheotomy
Authors: Dutton Jay M. , Palmer Phyllis M. , McCulloch Timothy M. , Smith Richard J. H. 
Published: February 2007

AbstractBackground. The mortality rate of children with tracheotomies is estimated to be between 11% and 40%, although the incidence of tracheotomy‐related deaths is only between 0% and 3.4%. The purpose of this report was to analyze the mortality rate in children with tracheotomies.Methods. A review of the medical records of children at the University of Iowa Hospitals and Clinics who underwent tracheotomy over a 15‐year period ending in 1989 was performed. Data were analyzed in 5‐year time blocks (Block 1, 1975 to 1979; Block 2, 1980 to 1984; and Block 3, 1985 to 1989).Results. Fifty‐two patients died with tracheotomy tubes in place. In 4 patients, the cause of death was tracheotomy related. Three of these patients were under 5 years of age and died secondary to tracheotomy tube displacement or obstruction; one patient, an 18‐year‐old, developed a fatal tracheotomy‐related vascular hemorrhage. The average age of patients who died with tracheotomies decreased significantly from Block 1 to Block 3; in Block 3, mean age at the time of tracheotomy was significantly lower in patients who died than in patients who survived. A comorbidity score (CS) based on the number of airway diagnoses showed that higher CSs were associated with a poorer prognosis.Conclusions. Mortality does not seem to be strongly related to the presence of the tracheotomy tube. Overall, two diagnostic groups were found to be independently associated with a poorer prognosis, ie, mechanical ventilation and pulmonary disease. Tracheotomies performed to provide airway access during other surgical procedures were associated with a better prognosis. © 1995 Jons Wiley & Sons, Inc.