bluuebunny/crossref_metadata_2025_split huggingface dataset:
“Decadose” Effects of Cisplatin on Squamous Cell Carcinoma of the Upper Aerodigestive Tract. I. Histoculture Experiments
Authors: Robbins K. Thomas , Hoffman Robert M. 
Published: November 2003

AbstractThere is substantial laboratory and clinical evidence that solid tumors rapidly acquire cellular resistance to cisplatin. Experiments with human carcinoma cell lines and clonogenic assays indicate that resistance is usually mild to moderate and can be circumvented with higher concentrations of drug. The purpose of this investigation was to test this hypothesis with a histoculture assay of human upper aerodigestive tract (UADT) carcinomas.Using a sponge‐gel supported histoculture, 43 tumor specimens from patients with squamous cell carcinoma (SCC) of the UADT were grown and exposed to cisplatin. Growth inhibition by the drug, in concentrations equivalent to peak therapeutic doses (1.5 μg/mL) and concentrations 10 and 25 times greater (15 and 37.5 μg/mL), were measured in specimens from patients with previously untreated and recurrent lesions.In vitro, the overall rate of sensitivity of the tumor samples to cisplatin concentrations of 1.5, 15, and 37.5 μg/mL were 22%, 62%, and 83%, respectively. In patients with previously untreated disease, the respective rates were 25.9%, 63.3%, and 79.3%, as compared with 10.0%, 55.6%, and 85.6%, respectively, for patients with recurrent disease. The response difference between cisplatin concentrations of 1.5 and 15 μg/mL was statistically significant. The “decadose” effect of cisplatin on growth inhibition was 2.44‐fold for untreated lesions and 5.56‐fold for recurrent tumors.The results indicate that resistance to standard doses of cisplatin by SCC of the UADT can be substantially overcome with a decadose (standard dose × 10) increase and is more pronounced in tumors from patients with recurrent disease. Progress toward improving survival of patients may be possible by incorporating decadose cisplatin therapy into a multimodality treatment plan.
Brainstem Auditory Evoked Potentials in Patients With Ischemic Heart Disease
Authors: Karamitsos Dimitrios G. , Kounis Nicholas G. , Zavras George M. , Kitrou Michael P. , Goudevenos John A. , Papadaki Paraskevi J. , Koutsojannis Constantinos M. 
Published: November 2003

AbstractThe authors of this study used the method of increased stimulus rate on brainstem auditory evoked potentials (BAEPs) in 30 patients with ischemic heart disease (IHD) and in an equal number of healthy age‐matched control subjects. The BAEPs were recorded using 100‐ to 3000‐Hz alternating polarity clicks at a rate of 22.6 per second. Measurements included the absolute latencies of waves I through V, the interpeak latencies I‐III, III‐V, and I‐V, and the peak amplitudes of peaks I, III, and V.The measured absolute latencies and interpeak latencies were found to be significantly increased, and the peak amplitudes were found to be diminished. The audiometric tests revealed no significant hearing loss in IHD patients. This study is the first to demonstrate prolongation of BAEPs in IHD patients. BAEP recording may become an additional noninvasive tool for detecting IHD patients with impaired microcirculation.
Ambulatory Tonsillectomy and Adenoidectomy
Authors: Gabalski Edward C. , Mattucci Kenneth F. , Setzen Michael , Moleski Patricia 
Published: November 2003

AbstractThe performance of tonsillectomy and adenoidectomy in an ambulatory setting is controversial. However, most current studies show that with adequate criteria for patient selection and careful postoperative observation, these procedures can be safely done as outpatient surgery. This study was undertaken to reassess the safety of outpatient tonsillectomy and adenoidectomy surgery and to reevaluate the current recommendations for postoperative care.A prospective study was undertaken to relate the incidence of significant complications, including hemorrhage, protracted emesis, and fever, to each postoperative hour. The study included 534 pediatric patients (age 14 or less) undergoing tonsillectomy with or without adenoidectomy. All 534 patients were observed for 5 postoperative hours, and 175 of the 534 patients were observed for 6 postoperative hours.To assess complications occurring in the first postoperative week, all attending surgeons involved in this study were asked to anonymously report the occurrence of hemorrhage, protracted emesis, and/or fever from the time of discharge through the seventh postoperative day.In this study, no complications were encountered during the fifth or sixth postoperative hours. These results indicate that it is both safe and appropriate to perform tonsil and adenoid surgery in the ambulatory setting. Furthermore, the current recommendation that patients remain under postoperative recovery room observation for 6 hours appears to be excessive. This observation period may be safely reduced to 4 hours.
Histopathology and CT Analysis of Partially Resected Middle Turbinates
Authors: Biedlingmaier John F. , Whelan Philip , Zoarski Greg , Rothman Michael 
Published: November 2003

AbstractThirty‐eight partial middle turbinate resections from 20 patients undergoing endoscopic sinus surgery were evaluated by histopathology of mucosa and bone and by computed tomography (CT) appearance prior to resection. Histopathologic analysis revealed not only mucosal inflammation but also chronic osteitis of the bone in all patients with sinus disease. The preoperative CT was accurate in predicting turbinate osteitis when the scans displayed advanced grades III and IV disease. These findings suggest that in advanced disease, conservative partial middle turbinate resections may be necessary to remove chronically infected bone from the osteomeatal complex. Because it is unsafe to remove all of the middle turbinate, consideration should also be given to long‐term antibiotic therapy to treat the osteitis found in advanced disease.
Characterization of Postoperative Edema Following Laser‐Assisted Uvulopalatoplasty Using MRI and Polysomnography
Authors: Terris David J. , Clerk Alex A. , Norbash Alexander M. , Troell Robert J. 
Published: November 2003

AbstractLaser‐assisted uvulopalatoplasty (LAUP) has been introduced as an alternative to uvulopalatopharyngoplasty for the treatment of snoring. Despite limited study, the use of this procedure has been expanded to include patients with obstructive sleep apnea syndrome. Although the potential cost‐savings of performing sleep apnea surgery on an outpatient basis are self‐evident, concern exists regarding the safety of this practice.In an effort to characterize the risk of performing LAUP on an outpatient basis, eight patients with mild or no sleep apnea were identified and intensively studied before and after the first stage of LAUP to cure snoring. Assessment included preoperative magnetic resonance imaging (MRI) scans, polysomnography, and videoendoscopy. Each of these diagnostic studies was then repeated between 48 and 72 hours after LAUP. Complete polysomnographic data were available for seven of the eight patients.The mean (±SD) preoperative respiratory disturbance index (RDI) was 11.3 ± 10.9, and the mean oxygen saturation nadir (LSAT) was 87.7 ± 6.2% (n = 7). The mean airway cross‐sectional area at the palate (by MRI) was 49.8 ± 22.8 mm2 (n = 8). After LAUP, the mean RDI nearly doubled to 21.7 ± 9.9 (P>.1). The apnea index increased fourfold from 3.3 ± 3.5 to 14.8 ± 10.9 (P<.03). The mean LSAT remained stable at 87.4 ± 4.1% (P>.5). The cross‐sectional area of the airway decreased to a mean of 47.9 ± 22.4 mm2 (P>.5).These data suggest that LAUP may temporarily worsen obstructive sleep apnea. Although the clinical significance of this degree of worsening is uncertain, it would be prudent to consider perioperative use of nasal continuous positive airway pressure in patients with more than mild obstructive sleep apnea who undergo ambulatory LAUP.
Aggressive Papillary Tumors of the Temporal Bone
Authors: Levin Roger J. , Feghali Joseph G. , Morganstern Nora , Llena Josefina , Bradley Margaret K. 
Published: November 2003

AbstractAggressive papillary tumors of the temporal bone are neoplasms that are locally invasive and destructive. Previously classified on histologic study as middle ear adenomas or adenocarcinomas, observational evidence suggested that they arose from endolymphatic sac.To evaluate this hypothesis, we established a tissue culture from cells derived from such a papillary tumor and compared immunohistochemical stains of the original tumor with stains on endolymphatic epithelium. Similarities in expression of neuroectodermal antigens were observed. Similar staining antigens in cells derived from tumor and the endolymphatic sac provide evidence that epithelium from endolymphatic sac is the site of origin for these aggressive neoplasms.In tissue culture the cells remain contact inhibited and dependent on serum or growth factors with survival beyond the expected senescence at 30 to 50 generations. Therefore the cell culture technique provides a model for study of the disruption of growth control and invasive properties of this tumor.
Metastatic Cutaneous Squamous Cell Carcinoma of the Head and Neck Region
Authors: Tavin Ellis , Persky Mark 
Published: November 2003

AbstractCutaneous squamous cell carcinoma has a relatively low metastatic rate (0.5% to 16%), but patients with the disease should always be evaluated for possible regional nodal involvement. We reviewed the records of 37 patients with metastatic disease among the 388 patients with head and neck cutaneous squamous cell carcinoma who were treated at New York University Medical Center between 1961 and 1992. In this group of patients the most common primary site was the cheek or preauricular region and the most common metastatic site was the level I neck lymph nodes. Seven patients (18%) had metastases at initial presentation. Among the remaining patients the average time to the development of metastases was 19 months. Nineteen patients (51%) had recurrence at the primary site before metastasis; 11 (30%) developed metastases with control of the primary tumor. Analysis of the records of 31 patients treated for cure revealed that 13 were treated by surgery, 2 by radiation therapy, and 16 by a combination of surgery and radiation therapy. During the mean follow‐up period of 49 months, 11 (35%) of these 31 patients died of their disease. Recurrence of the primary tumor appeared to increase the risk for nodal and distant metastases.
In Vitro and In Vivo Determination of the Thermal Effect of Middle Ear Endoscopy
Authors: Bottrill Ian , Perrault Donald F. , Poe Dennis 
Published: November 2003

AbstractDuring middle ear endoscopy, patients frequently experience vertigo. We theorized that this effect is secondary to heat produced by the scope. We evaluated two Hopkins rods and two fiberoptic scopes to assess the temperature elevation at the lateral semicircular canal (LSCC) of temporal bones and in a live canine model. These results were compared to the results of a standard 44° C water caloric.We demonstrated in both models that the temperature rise at the LSCC increased relative to the scope diameter and that the Hopkins rods produced the same or greater heating effect than a warm caloric. Direct exposure of the thermocouple to the light produced a greater temperature elevation.We conclude that endoscopes produce sufficient heat to induce caloric stimulation of the LSCC. Care should be exercised to prevent the possibility of thermal injury.
Quantitative Analysis of Interleukin‐1‐Alpha Gene Expression in Middle Ear Cholesteatoma
Authors: Bujía J. , Kim C. , Boyle D. , Hammer C. , Firestein G. , Kastenbauer E. 
Published: November 2003

AbstractRegardless of its origin, cholesteatoma is characterized by the presence of a keratinizing epithelium with an hyperproliferative behavior leading to a very important bone resorption. Previous studies have demonstrated overexpression of interleukin‐1 (IL‐1) protein in middle ear cholesteatoma by immunohistochemistry and enzyme‐linked immunosorbent assay, suggesting a significant role for IL‐1‐alpha.In this study, the presence of IL‐1‐alpha messenger ribonucleic acid (mRNA) was quantified by in situ hybridization on frozen sections (n=10) and by computer‐assisted image analysis. Human skin obtained from the external ear canal (n=10) was used as the control. A higher percentage of cells hybridized for the antisense probes IL‐1‐alpha mRNA was found in cholesteatoma epithelium. Furthermore, keratinocytes of the suprabasal cell layers were also found to contain specific hybridizations. Some cells in cholesteatoma stroma also contained IL‐1‐alpha mRNA transcripts. The results of this study confirm the central role of IL‐1‐alpha in the epithelium hyperproliferation and bone resorption observed in middle ear cholesteatoma.
Cervical Thymic Cyst: Case Reports and Review of the Literature
Authors: Nguyen Quoc , deTar Michael , Wells Winfield , Crockett Dennis 
Published: November 2003

AbstractDue to its rarity, cervical thymic cyst is seldom included in the differential diagnosis of a neck mass. Approximately 80 cases have been reported thus far, and most of these cases have occurred asymptomatically in children and adults. Only 5 cases have involved patients younger than 1 year of age.The authors report four new patients with thymic cyst in the neck. Two of the patients were newborns in whom the cyst caused airway obstruction and dysphagia. All four patients underwent successful resection of the lesions, with complete resolution of symptoms.The embryology, histopathology, and differential diagnosis of cervical thymic cysts are also reviewed. The authors recommend that despite its infrequent occurrence, cervical thymic cyst should be considered in the evaluation of neck masses in children.
Extranodal Rosai‐Dorfman Disease of the Head and Neck
Authors: Goodnight James W. , Wang Marilene B. , Sercarz Joel A. , Fu Yao S. 
Published: November 2003

AbstractRosai‐Dorfman disease is a rare, idiopathic, benign histiocytic proliferation usually seen in younger patients. Massive lymphadenopathy most commonly involves the cervical lymph nodes, with a predominant infiltration of sinusoidal histiocytes. Nearly half of the patients will have extranodal involvement, 75% occurring in sites in the head and neck. Three cases of extranodal Rosai‐Dorfman disease of the head and neck involving the nose, paranasal sinuses, and parotid gland are presented. The clinical presentation, histologic characteristics, radiographic findings, and treatment of the disease are discussed. Because of the scarcity of cases, the clinical and histopathologic features of this disease may be overlooked. Familiarity with its relatively frequent clinical manifestations in the head and neck, as well as with the diagnostic histopathology, should preclude confusion with other disease entities.
Advances in the Development of the Interferometric Otoscope
Authors: Parnes Steven M. , Cacace Anthony T. , Castracane James , Conerty Michelle , Gardner Glendon M. 
Published: November 2003

AbstractPresent measurement techniques for middle ear function have inherent limitations because they are either spatially insensitive (acoustic immittance) or descriptive and qualitative in nature (otoscopy). By integrating advances in electrooptic technology (fiber optics, miniature diode lasers, solid‐state detector arrays) and digital processing, further advances are possible. On the basis of measurements taken with electronic speckle‐pattern interferometry on human temporal bones and models, we demonstrate quantitative static and dynamic vibration/displacement characteristics of the tympanic membrane with high spatial resolution. Our presentation emphasizes advantages of optically based methods and demonstrates computerized signal processing capable of fringe localization, enhancement, and counting. Miniaturization and real‐time digital image processing in the clinical setting is the goal of this research.
The Effects of Keratinocyte Growth Factor on Healing of Tympanic Membrane Perforations
Authors: Clymer Mark A. , Schwaber Mitchell K. , Davidson Jeffrey M. 
Published: November 2003

AbstractTympanic membrane (TM) perforations heal by reepithelialization and fibrous layer proliferation. The rat TM model may be used to study growth factors that promote epithelialization and fibroblast proliferation, such as epidermal growth factor (EGF) and fibroblast growth factor (FGF). The authors previously evaluated the effects of FGF on tympanic membrane perforations and showed an enhanced rate of wound healing with preservation of normal structure and function. The same model was used to test keratinocyte growth factor (KGF, also called FGF‐7). This growth factor has been shown to stimulate the migration and proliferation of keratinocytes. This is the first study investigating KGF in the tympanic membrane perforation model. Our results show that in contrast to FGF and EGF, KGF does not enhance the rate of wound healing, but rather results in a more organized wound repair process.
Prediction of the Clinical Outcome of Acute Frontal Sinusitis With Ventilation Measurement of the Nasofrontal Duct After Trephination: A Long‐Term Follow‐up Study
Authors: Sipilä J. , Suonpää J. , Wide K. , Silvoniemi P. 
Published: November 2003

AbstractAcute frontal sinusitis has become an increasing clinical problem in the region that is served by the hospital represented by the authors of this study. The standard surgical treatment protocol after the failure of conservative therapy has been to perform trephination of the involved frontal sinus. More sophisticated procedures have been used in patients with prolonged or recurrent disease.The authors have developed a simple ventilation test of the nasofrontal duct that can be used to determine which patients require further surgery. In a long‐term follow‐up study of 85 patients, this ventilation test was shown to predict the cases that would heal uneventfully after trephination and the cases that would require further surgery because of an obstructed nasofrontal duct. The findings of this study are of special interest for modern functional endoscopic sinus surgery, the purpose of which is to open up the nasofrontal region.
Malignant Melanoma Metastatic to the Tonsil
Authors: Barlas Aydogan L. , Myers Jeffrey N. , Myers Eugene N. , Kirkwood John 
Published: November 2003

AbstractMetastasis to the oral cavity from melanoma arising in distant sites is very rare. The authors present three cases of melanoma metastatic to the palatine tonsil: two were cutaneous melanomas and one arose from the mucous membrane of the hard palate. Fewer than 30 cases of metastatic melanoma to the palatine tonsil have been reported, and none have been from mucosal melanoma originating from another mucosal primary site in the head and neck. From this perspective, one of the cases in this article is unique.The authors present clinical histories of the three cases of melanoma metastatic to the palatine tonsil. Two patients were still alive a substantial time after treatment. The case presentations indicate that careful examination of the head and neck should be part of the routine follow‐up examination in all melanoma patients.
Wound Healing: Effects of Closing Tension, Zyplast™, and Platelet‐Derived Growth Factor
Authors: Tzikas MAJ Thomas L. , Burgess LTC Lawrence P. A. , Pickett MAJ Bradley P. , Brammer Robert E. , Vossoughi Jafar 
Published: November 2003

AbstractPrevious studies have shown that beginning 5 to 7 days from wounding, the tensile strength of wounds closed under tension in rats is significantly higher than the tensile strength of wounds closed without tension. This study evaluated the effects of increased closing tension, zyplast implant (ZI), and human recombinant platelet‐derived growth factor (PDGF) on the tensile strength of wounds. Six groups of 12 rats each were divided into two main subsets: wounds were closed without tension in three groups and with high tension of approximately 100 g in the three other groups. In both no‐tension and high‐tension groups, one subgroup received no intervention (controls), one subgroup received ZI (zyplast controls), and one subgroup received ZI‐PDGF (ZI used as a carrier for PDGF). Healing was evaluated by tensile strength determinations at 5 days.For the controls, wounds closed under tension showed a trend toward higher tensile strength, but statistical significance was not reached. Compared with controls, tensile strength was 45% lower in the wounds with ZI and closure with tension (P = .0063) and 38% lower in the wounds with ZI and closure without tension (P = .007). Treatment with ZI‐PDGF resulted in 69% higher tensile strengths (P = .049) as compared with ZI controls for wounds closed with tension. This study demonstrated the beneficial effect of PDGF in accelerating healing in wounds closed under tension. Although ZI was able to deliver PDGF to the wound, the use of this substance as a carrier is questioned since it was detrimental to healing.
Risk of Transmission of Human Immunodeficiency Virus Infection During Tympano‐ossicular Homograft: An Experimental Study
Authors: Meylan Pascal R.A. , Duscher Alexandre , Mudry Albert , Monnier Philippe 
Published: November 2003

AbstractIt is generally agreed that middle ear reconstructive surgery performed with tympano‐ossicular homografts produces superior functional results compared with prosthetic material, especially with respect to extrusion rate. The use of homografts, though, has been seriously hampered recently by the fear of transmission of human immunodeficiency virus (HIV) infection. In HIV‐infected patients, the virus is primarily found in the cells of the lymphoid and monocytic lineage. The nature of the tissues in the eardrum and ossicles, mostly fibrous tissue and compact bone without marrow, suggests that little virus load should be found in homografts. Indeed, culturing minced homograft tissue from two HIV‐infected donors with acquired immune deficiency syndrome(AIDS) in a sensitive culture system with PHA‐stimulated lymphoblasts produced no virus. Before use, homografts undergo a fixation procedure in 5% formaldehyde and then are kept in a solution containing Cialit as a preservative. The authors therefore examined the capacity of formaldehyde and Cialit to reduce the infectivity of HIV in models of infected tissue as measured in vitro. The reduction of in vitro infectivity due to these treatments was at least 105‐fold and 102‐fold, respectively. Coupled with the low virus burden in tympano‐ossicular tissue, our data suggests that the fixation procedure affords such a reduction in infectivity that the risk of HIV transmission, even from an HIV‐infected donor, is vanishingly low.
SPECT Gallium Scintigraphy in Malignant External Otitis: Initial Staging and Follow‐up. Case Reports
Authors: Stokkel Marcel P.M. , Boot Ina C.N. , van Eck‐Smit Berthe L.F. 
Published: November 2003

AbstractMalignant external otitis (MEO) is a recognized entity characterized by a stubborn Pseudomonas external otitis; it has been most frequently observed in elderly diabetic patients. Early diagnosis is necessary for successful treatment but, despite a widespread inflammatory response, routine plain x‐ray studies and computed tomography (CT) scanning show no abnormalities in its early stage. In this report, the clinical value of gallium 67 (Ga 67) single photon emission CT (SPECT) is studied in three patients suspected of having MEO, and the results are compared with findings on CT scan and laboratory tests. These results confirm that the high sensitivity of Ga 67 SPECT in the initial recognition of MEO provides a more adequate technique than CT scan. Furthermore, Ga 67 scintigraphy appears to be highly accurate for follow‐up evaluation of these patients.