bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prognostic Impact of Primary Tumor Volume in Patients With Nasopharyngeal Carcinoma Treated by Definitive Radiation Therapy
Authors: Shen Chunying , Lu Jiade Jay , Gu Yajia , Zhu Guopei , Hu Chaosu , He Shaoqin 
Published: February 2009

AbstractObjectives/Hypothesis: Tumor burden has been confirmed as one of the important indicators in disease control after treatment for various types of malignancies. This report aims to document the value of the primary tumor volume of nasopharyngeal carcinoma [gross tumor volume of the primary site (GTV‐P)] in predicting the treatment outcome after high‐dose definitive radiation therapy.Study Design: A total of 154 patients with nasopharyngeal carcinoma were prospectively treated with accelerated hyperfractionated radiotherapy alone to a total dose of 78 Gy/60 fractions/6 weeks (biological effective dose = 88.2 Gy).Methods: Patients were assessed for local control, disease‐free survival and distant failure free survival. The GTV‐P was calculated by summation of area technique after delineation of the primary tumor contours on computed tomography images.Results: The median GTV‐P was 14.5 mL for T1, 23.3 mL for T2, 35.8 mL for T3, and 50.9 mL for T4 diseases (P < .05). With a median follow‐up of 61 months, the 5‐year local failure‐free rate, disease‐free survival and distant failure‐free survival rates were 89.4% versus 48.9% (P = .002), 56.6% versus 0% (P = .001), and 66.9% versus 16.5% (P = .0001), respectively, for patients whose GTV‐P were ≤60 mL and >60 mL. Multivariate analysis revealed that GTV‐P is an independent prognostic factorfor local control (hazard ratio = 3.568, P = .035). There fore, the GTV‐P was significantly associated with the treatment outcome after high‐dose radiation delivered in accelerated hyperfractionated schedule for nasopharyngeal cancer patients.Conclusions: Tumor volume is a reliable indicator for supplementing the T classification of the Tumor, Node, Metastasis staging system for predicting local control after definite radiation therapy.
Laser Disruption of Biofilm
Authors: Krespi Yosef P. , Stoodley Paul , Hall‐Stoodley Luanne 
Published: February 2009

AbstractObjectives/Hypothesis: To demonstrate the capability of a fiber‐based Q‐switched Nd:YAG laser (ARCLaser, Nuremberg, Germany and Valam, Orangeburg, NY) to disrupt biofilm.Study Design: Biofilms were grown in broth for 72 hours prior to the experiment. A clinical otorrhea isolate from Pseudomonas aeruginosa was used. Biofilms were placed in MatTek culture plates, on stainless steel screws, tympanostomy tubes, and polyethylene terephthalate (PET) sutures.Methods: Culture plates, stainless steel screws, tympanostomy tubes, and PET sutures were used for the laser disruption of biofilm experiments. Q‐switched Nd:YAG laser pulses were delivered on biofilms using shockwave probes originally designed for cataract surgery. The thin laser fiber tip was targeted against a titanium target, creating the production of plasma and resulting in a shockwave effect.Results: Biofilm areas were imaged before, during, and after laser application using a confocal microscope. The biofilm was imaged growing on the glass/plastic step of the plates, in the grooves of the threads of the screws, over the tympanostomy tube, and on the PET suture. During laser treatment, a time‐lapse function was used to capture the results. As a result of laser‐generated shockwaves, the biofilm was initially seen to oscillate and eventually break off with individual pulses. Large and small pieces of biofilm were totally and instantly removed from the surface to which they were attached in a matter of a few seconds.Conclusions: We were able to effectively disrupt Pseudomonas aeruginosa biofilms in vitro using a miniature Q‐switched Nd:YAG laser, thin fibers, and special probes that generated plasma formation and a resulting shockwave effect. This laser technology has the ability to generate a powerful stress wave sufficient to disrupt biofilm without any ill effect to the underlying host structure.
Sinonasal Outcomes After Endoscopic Sinus Surgery in Asthmatic Patients With Nasal Polyps: A Difference Between Aspirin‐Tolerant and Aspirin‐Induced Asthma?
Authors: Awad Osama G. , Lee John H. , Fasano Mary Beth , Graham Scott M. 
Published: February 2009

AbstractObjectives/Hypothesis: Aspirin‐sensitivity, asthma, and nasal polyposis (NP) comprise the clinical entity of Samter's triad. The aim of this study is to report the sinonasal outcomes of endoscopic sinus surgery (ESS) in treating NP in asthmatic patients, comparing aspirin‐induced asthmatic (AIA) patients with aspirin‐tolerant asthmatics (ATA).Study Design: Retrospective chart review.Methods: The records of 66 patients with NP and asthma were retrospectively reviewed. Forty‐one AIA patients were compared with 25 ATA patients. For each patient, a Lund‐Mackay computed tomography (CT) score of the preoperative scans and the available postoperative CT scans in a period of 18 months were calculated and used as primary endpoint. Sinonasal improvement assessed by patients and reported with a symptoms scale was used as the secondary endpoint for the comparison immediately before surgery and 6 months and 12 months following ESS.Results: Preoperative CT scores in AIA patients compared with ATA patients were significantly higher 19 (standard deviation, 4.82) vs. 14 (standard deviation, 6.8), respectively (P = .006). This difference was sustained for the available postoperative CT scans (P < .0001). During the period of 18 months follow‐up, 63.4% of AIA patients vs. 96% of ATA patients had CT improvement with a statistically significant difference between the two groups (P = .003). At 6 months following ESS, 63.4% of AIA patients vs. 56% of ATA patients had symptomatic improvement. At 12 months, 68.3% of AIA patients vs. 60% of ATA patients had symptomatic improvement, with no significant difference between the two groups.Conclusion: AIA patients had more extensive sinonasal disease than ATA patients. Both groups showed statistically significant improvement in sinonasal outcomes after ESS. The difference between the two groups was statistically significant for patients' CT improvement with worse CT scores being seen in AIA patients.
Protective Effect of Immunosuppression on Granulation Tissue Formation in Metallic Airway Stents
Authors: Shlomi Dekel , Peled Nir , Shitrit David , Bendayan Daniele , Amital Anat , Kramer Mordechai R. 
Published: February 2009

AbstractObjectives/Hypothesis: The use of self‐expanding metallic airway stents has been extended in recent years in inoperable patients with malignant and benign airway diseases. The risk of granulation tissue formation in the stent is a major concern. The objective of the present study was to determine whether immunosuppression modulates granulation tissue formation in airway stents, as seen in coronary stents.Study Design: The study included 19 patients with benign airway obstructions and 11 recipients of lung transplants with anastomotic obstructions who were receiving immunosuppression therapy.Methods: The degree of in‐stent granulation tissue formation was evaluated (score range, 0–3) every 3 months for 2 years.Results: Granulation tissue formation was significantly lower in the transplant recipients than in the nontransplant patients at 3 months (score 0.7 vs. 1.6, P = .031), 15 months (score 0 vs. 1.1, P = .026), and 18 months (score 0 vs. 1.8, P = .020). During the 2 years of follow‐up, the transplant recipients underwent significantly fewer laser resections and brachytherapy treatments for in‐stent granulation.Conclusions: The immunosuppression given to lung transplant recipients may have an inhibitory effect on granulation tissue formation in metallic airway stents. Further studies are needed to evaluate the effect of systemic therapy or coated stents with drugs such as sirolimus.
Nonverbal Cognitive Abilities and Auditory Performance in Children Fitted With Auditory Brainstem Implants: Preliminary Report
Authors: Colletti Liliana , Zoccante Leonardo 
Published: February 2009

AbstractObjectives/Hypothesis: Auditory brainstem implants (ABIs) can provide excellent open set speech recognition in adults without auditory tumors. These favorable results prompted us to extend ABI indications to children with profound hearing loss (HL) who are not candidates for a cochlear implant (CI). This article reports on the auditory performance and cognitive development measured in children with ABIs.Study Design: This study quantifies the development of auditory perceptual and nonverbal cognitive abilities of children with profound HL undergoing ABI. From 2000 to 2006, 17 children aged 14 months to 16 years received an ABI for different tumor and nontumor diseases in our department in Verona, and nine children were operated in other countries. Six of the children had been previously fitted elsewhere with a CI with no auditory results. Fourteen children had multiple associated psychomotor handicaps.Methods: The retrosigmoid approach was used in all children. Intraoperative and postoperative electrically evoked auditory brainstem responses were performed in all children. Perceptual auditory abilities were evaluated with the Evaluation of Auditory Responses to Speech battery and the Category of Auditory Performance test. Cognitive evaluation was performed on 10 children using the Leiter International Performance Scale—Revised test.Results: All children consistently use their devices for 8 h/d at average and have environmental sound awareness and utterance of words and simple sentences. Their category of auditory performance test scores increased significantly with ABI use. Scores on two of the four subtests considered for cognitive evaluation in this study increased significantly (P < .05) during the first year of ABI use. Postimplant cognitive outcomes were positively related to the auditory results.Conclusions: The present investigation clearly indicates that children who are not candidates for CI fitted with ABI obtain significant development of their hearing ability and a significant improvement in some cognitive parameters. The outcomes of the present study suggest that children with cochlear or cochlear nerve abnormalities with associated cognitive deficits should not be excluded from ABI implantation.
Characterization of Laryngeal Muscle Stem Cell Survival and Proliferation
Authors: Walz Patrick C. , Hiatt Kelly K. , Naidu Moumita , Halum Stacey L. 
Published: February 2009

AbstractObjectives/Hypothesis: Laryngeal muscle and skeletal muscle stem cells (MSC) have been shown to differ in physiological basal activity and responsiveness to stimuli. Given these differences, it is the purpose of this investigation to characterize the in vitro proliferation and survival of laryngeal and skeletal MSC to determine whether intrinsic differences exist that may account for differences noted in vivo.Study Design: Basic science experiment utilizing rat MSC.Methods: Cultures of both laryngeal and skeletal MSC were harvested and equal numbers from both groups were expanded under similar conditions, quantifying cellular population to determine proliferation rate for each population. Increased proliferative potential was confirmed using Western blot analysis of extracellular signal‐regulated kinase phosphorylation. As per standard survival assay protocol, cultures were placed in serum‐deprived medium and cell survival was assessed by terminal uridine deoxynucleotidyl transferase‐mediated dUTP nick end labeling assay at 72 hours.Results: Our results demonstrated increased proliferation of laryngeal MSC relative to the skeletal MSC when cultured under similar conditions. Western blot demonstrated increased activation of the proliferation pathway, extracellular signal‐regulated kinase, in the laryngeal group. There was no detectable difference in the MSC survival between the two groups.Conclusions: Compared with skeletal MSC, laryngeal MSC demonstrate increased proliferation and regenerative capacity. This may explain some of the differences in physiological role and responses involved in each cell population's tissue of origin.
TNF‐α Drives Matrix Metalloproteinase‐9 in Squamous Oral Carcinogenesis
Authors: Hohberger Laurie , Wuertz Beverly R. K. , Xie Hongwei , Griffin Tim , Ondrey Frank 
Published: February 2009

AbstractObjectives/Hypothesis: It is well known that invasion is a seminal event in the progression of oral and other head and neck carcinoma sites. We have previously demonstrated tumor necrosis factor (TNF)‐α and its dependent cytokines are upregulated in saliva during oral carcinogenesis. TNF‐dependent events stimulate nuclear factor (NF)‐κB and many NF‐κB‐dependent genes are associated with cancer progression.Materials and Methods: In the present study, we examined NF‐κB stimulation of matrix metalloproteinase (MMP)‐9 in a precancerous keratinocyte cell line that models leukoplakia (Rhek cells). We stimulated Rhek cells with both TNF‐α and phorbol myristate acetate, known stimulants of NF‐κB. We then assayed MMP‐9 transcription and secretion by luciferase reporter genes, quantitative real‐time polymerase chain reaction, and fluorometric enzyme‐linked immunosorbent serologic assay.Results: We discovered that the MMP‐9 promoter was significantly stimulated by phorbol myristate acetate and TNF‐α on luciferase reporter gene assays. Further, we uncovered that functional MMP‐9 promoter activation was accompanied by significant increases in MMP‐9 gene expression, as judged by quantitative real‐time polymerase chain reaction<!—AQ1: Per style, genes are set italic while proteins are roman. Please underline genes.—>. Functional activation of the MMP‐9 protein was stimulated by TNF‐α and PMA on a fluorescent enzyme‐linked immunosorbent serologic assay. Finally, we searched our salivary proteomic database for increases in MMP‐9 and discovered it was the third most significant protein in salivas of oral cavity cancer patients over normal controls.Conclusions: We conclude the milieu cytokine, TNF‐α, has the capacity to provide stimulation of events related to early invasion of oral cavity cancer, as judged by its ability to stimulate MMP‐9.
To POP or Not: Ossiculoplasty in Congenital Aural Atresia Surgery
Authors: Dobratz Eric J. , Rastogi Akhil , Jahrsdoerfer Robert A. , Kesser Bradley W. 
Published: February 2009

AbstractObjectives/Hypothesis: To examine indications for ossiculoplasty (OP) in aural atresia surgery and to compare audiometric results and surgical revision rates between patients undergoing OP and those undergoing intact native chain reconstruction (INCR).Study Design: Retrospective chart review.Methods: Charts of patients undergoing surgery for congenital aural atresia were reviewed for demographic data, preoperative Jahrsdoerfer score, ossicular chain status, and audiometric data. Patients undergoing OP were compared with an equal number of age and Jahrsdoerfer grade‐matched patients who had an INCR. The preoperative and postoperative average air‐bone gap (ABG), speech reception thresholds (SRT), and rates of revision surgery were compared between the two groups.Results: Nineteen patients (20 ears) underwent OP during aural atresia repair and were compared with 20 matched patients who had INCR. Mean age, Jahrsdoerfer score, preoperative ABG, and SRT were similar for both groups. Mean postoperative audiometric follow‐up was 33.1 months for the OP group and 20.4 months for the INC group (P = .24). Mean postoperative ABG was 33.8 dB HL for OP and 23.8 dB HL for INCR (P < .05). Mean improvement in ABG was 16.8 dB HL for OP and 29.9 dB HL for INCR (P < .001). Mean improvement in SRT was 24.6 dB HL for OP and 34.8 dB HL for INCR (P < .05). Nine ears (45%) in the OP group and four ears (20%) in the INCR group underwent revision surgery (P = .09).Conclusions: Patients reconstructed with their own intact native chain during aural atresia surgery have better audiometric outcomes than those undergoing OP and are less likely to undergo revision surgery.
The Utility of Second‐Look Operation After Laser Microresection of Glottic Carcinoma Involving the Anterior Commissure
Authors: Roh Jong‐Lyel , Kim Dong‐Hyun , Park Chan Il 
Published: February 2009

AbstractObjectives/Hypothesis: Transoral laser microsurgery for the treatment of glottic carcinoma with anterior commissure (A‐com) involvement is associated with a high rate of recurrence. We prospectively evaluated the outcomes of laser microsurgery and the efficacy of second‐look operation in these patients.Study Design: Prospective evaluation.Methods: Twenty‐seven patients with glottic carcinomas involving the A‐com underwent transoral laser microresection. Twenty‐five patients underwent second‐look operations 3 months after laser surgery.Results: After transoral laser microresection, all patients achieved microscopic clear resection margins. Local recurrence was found in 7 of 27 patients (25.9%). Regional recurrence was found in two patients. Patients with recurrences underwent laser re‐resection or neck dissection; four received radiotherapy, two lost their larynxes, and three died of disease. At second‐look operation, early local recurrence was found in two patients, and anterior glottic webs and granulomas causing dysphonia were treated in 8 and 11 patients, respectively.Conclusions: Laser microsurgery is an effective treatment modality in early glottic cancer with A‐com involvement but is still associated with a high rate of recurrence. Second‐look operation may help detect early local recurrence and treat postoperative airway or voice problems.
Follow‐up of Cochlear Implant Use in Patients Who Developed Bacterial Meningitis Following Cochlear Implantation
Authors: Mancini Patrizia , D'Elia Chiara , Bosco Ersilia , Seta Elio De , Panebianco Valeria , Vergari Valeria , Filipo Roberto 
Published: February 2009

AbstractObjectives/Hypothesis: The present study is a long‐term follow‐up of speech perception outcomes and cochlear implant use in three cases of meningitis that occurred after cochlear implantation.Study Design: Case series study.Methods: Study was performed on three children implanted with different models of Clarion® devices, two of them with positioner. Recognition and comprehension were assessed via the Italian adaptation of GASP (TAP) test, and phonetically balanced bi‐syllabic words in open‐set. High resolution computed tomography scan acquisition was performed to obtain axial coronal and oblique multiplanar reconstructions of the cochlea.Results: Two patients were affected by enlarged cochlear acqueduct and Mondini malformation the first carrying positioner. One patient had a normal cochlea, and the positioner could have been the main cause of bacterial spread. As a consequence of meningitis the child with normal cochlea and the other with enlarged vestibular acqueduct developed cochlear ossification, increased M‐level and worsening of hearing outcomes. The child with Mondini malformation developed facial nerve stimulation. Contralateral implantation was performed in the first two patients.Conclusion: Bacterial meningitis occurring after cochlear implantation may induce cochlear ossification, facial nerve stimulation, and permanent or temporary loss of implant use. Planned follow‐up with high resolution computed tomography and evaluation of M‐levels could be useful prognostic tools in the management of these patients.
Cervical Tuberculosis: A Decision Tree for Protecting Healthcare Workers
Authors: Roberts Daniel S. , Dowdall Jayme R. , Winter Leslie , Sulis Carol A. , Grillone Gregory A. , Grundfast Kenneth M. 
Published: February 2009

AbstractObjectives/Hypothesis: The clinical presentation of cervical tuberculosis (TB) is a unique challenge to the otolaryngologist. To minimize the risk of nosocomial transmission, otolaryngologists must suspect the diagnosis and be familiar with recommendations for TB prevention.Study Design: Scientific review.Methods: We review current literature and recent changes in TB prevention strategies including the Centers for Disease Control and Prevention “Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health‐Care Settings, 2005.”Results: Nosocomial transmission may occur from either unrecognized pulmonary disease or from aerosolization of tubercle bacilli during diagnostic procedures. History of prior TB infection, residence in a country where TB is endemic, close contact with a TB patient, or positive tuberculin skin test should raise suspicion of cervical TB. Physical examination findings may include painless, unilateral cervical lymphadenopathy. Children and human immunodeficiency virus infected patients present unique challenges, as these groups may have atypical presentations. When cervical TB is suspected, the provider should always screen for pulmonary and laryngeal disease. Fine needle aspiration with polymerase chain reaction or culture may accurately identify cervical TB. In rare cases, excisional biopsy may be required.Conclusions: To facilitate interpretation and rapid diagnosis while minimizing risk to health care providers, we provide a decision tree based on new federal guidelines and the clinical experience of a team of infectious disease specialists and otolaryngologists.
The Role of Computed Tomography for Localization of Parathyroid Adenomas
Authors: Zald Philip B. , Hamilton Bronwyn E. , Larsen Michael L. , Cohen James I. 
Published: February 2009

AbstractObjective/Hypothesis: The purpose of this study was to evaluate the use of computed tomography (CT) for localization of parathyroid adenomas (PA) when first‐line imaging is indeterminate.Study Design: Retrospective case series.Methods: A search of operating room and radiology records identified 223 surgical explorations for primary hyperparathyroidism. Adenoma locations on CT, ultrasound, and nuclear scintigraphy were correlated with an independent review of operative records.Results: The presence of adenoma in the correct side and quadrant of the neck was predicted by CT in 89% and 77% of studies, respectively. When first‐line studies were indeterminate, the positive predictive value of CT for localization of PA to the correct side and quadrant of the neck was 87% and 69%, respectively.Conclusions: When first‐line localization studies are indeterminate in patients with primary hyperparathyroidism, CT is a valuable, rapid, and widely available imaging modality that can be used to localize PA.