bluuebunny/crossref_metadata_2025_split huggingface dataset:
HLA‐DRB1, ‐DQA1, and ‐DQB1 Genotypes in Patients With Nasal Polyposis
Authors: Molnar‐Gabor Etelka , Endreffy Emöke , Rozsasi Ajnacska 
Published: November 2003

AbstractObjectives/Hypothesis Genetic etiology is suspected in the development of nasal polyposis on the basis of familial aggregation. This study investigated whether there is an association between HLA‐DRB1, ‐DQA1, and ‐DQB1 alleles and developing nasal polyposis.Study Design Data from 50 polypectomized patients were compared with data from 50 healthy randomly selected controls. Polyp score, possible asthma, aspirin sensitivity, and ASA triad were also recorded.Methods Genotyping of HLA‐DRB1 alleles was carried out with the Dynal RELI SSO HLA‐DRB, a direct DNA probe test that utilizes a polymerase chain reaction (PCR) and nucleic acid hybridization for the differentiation of 70 HLA‐DRB alleles and 9 supertypes. For DQA1* genotyping PCR‐RFLP (restriction fragment length polymorphism) was used, differentiating eight alleles. The DQB1* typing was carried out using a INNO‐LiPA DQB PCR‐reverse hybridization kit, allowing the discrimination of 30 alleles.Results People carrying the HLA‐DR7‐DQA1*0201, and ‐DQB1*0202 haplotype were found to have a two to three times higher odds ratios (ORs) for developing the disease, compared with controls. Patients with ASA triad carried the above‐mentioned DR7 allele with the linked alleles significantly more often (P < .001). Subjects carrying HLA‐DR5 allele and the linked alleles had lower odds ratio values.Conclusion These results underline that allergy is not conditional for the formation of nasal polyps as thought before. Nasal polyposis associated with asthma and aspirin sensitivity is probably a unique form of nasal polyps. The authors plan further investigations in this field.
Characterization of an Experimentally Induced Inner Ear Immune Response
Authors: Ma Chun‐lei , Billings Peter , Harris Jeffrey P. , Keithley Elizabeth M. 
Published: November 2003

AbstractObjective To determine the effects of a sterile immune response on the structure and function of the cochlea.Methods An immune response was created in guinea pigs by systemically sensitizing the animals to keyhole limpet hemocyanin and subsequently challenging the inner ear with the protein. Animals were allowed to survive for 1 to 5 weeks, after which the cochlea was evaluated histologically. Hearing was measured by auditory brainstem response before the inner ear challenge, during the survival period, and prior to sacrifice.Results Inflammatory cells infiltrated the cochlea from the circulation. Surface preparations and plastic sections of the organ of Corti 1 and 2 weeks after the initiation of the inflammation demonstrated degeneration of the sensory and supporting cells in cochlear turns containing inflammatory cells. Good preservation of structures was seen in the more apical cochlear turns with little or no inflammatory cells. In cochleas from animals that survived 5 weeks, most of the infiltrated cells were cleared after undergoing apoptosis and the inflammatory matrix in the scala tympani began to calcify. Hearing loss was moderate to severe depending on the amount of inflammation.Conclusion Although in general the immune response serves to protect an organism from infection, these results demonstrate that bystander injury associated with local immune responses in the cochlea, an organ incapable of regeneration, causes permanent cochlear destruction and hearing loss.
Outcomes Research and Obstructive Sleep Apnea
Authors: Piccirillo Jay F. 
Published: November 2003

AbstractSleep disorders in general and obstructive sleep apnea syndrome in particular are prevalent health problems. This report describe the methodology and findings from a prospective multicenter outcomes research study on obstructive sleep apnea syndrome that was conducted by the American Academy of Otolaryngology—Head and Neck Surgery. Other outcome measures available for outcomes research in obstructive sleep apnea syndrome are also summarized.
Outcomes Assessment for Chronic Otitis Media: The Chronic Ear Survey
Authors: Nadol Joseph B. , Staecker Hinrich , Gliklich Richard E. 
Published: November 2003

AbstractAnalysis of outcomes in chronic otitis media has in the past been limited to audiological measurement or physical examination. The Chronic Ear Survey (CES) is an instrument to measure the impact of chronic otitis media and its treatment. The survey provides information regarding total ear‐specific health, as well as subscore information regarding activity restriction, symptoms, and medical resource usage attributable to chronic otitis media. Application of the CES to a prospective, nonrandomized series of 147 patients revealed that patients with chronic otitis media have significantly decreased CES scores compared with unaffected controls and that surgical intervention provides a significant improvement in ear‐specific outcomes.
Prospective, Randomized Outcome Study of Endoscopy Versus Modified Barium Swallow in Patients With Dysphagia
Authors: Aviv Jonathan E. 
Published: November 2003

AbstractObjective Aspiration pneumonia is a significant cause of morbidity and mortality in both acute and long‐term care settings. While there are many reasons for patients to develop aspiration pneumonia, there exists a strong association between difficulty swallowing, or dysphagia, and the development of aspiration pneumonia. The modified barium swallow test (MBS) and endoscopic evaluations of swallowing are considered to be the most comprehensive tests used to evaluate and manage patients with dysphagia in an effort to reduce the incidence of pneumonia. The purpose of this study was to provide an initial investigation of whether flexible endoscopic evaluation of swallowing with sensory testing (FEESST) or MBS is superior as the diagnostic test for evaluating and guiding the behavioral and dietary management of outpatients with dysphagia. FEESST combines the standard endoscopic evaluation of swallowing with a technique that determines laryngopharyngeal sensory discrimination thresholds by endoscopically delivering air pulse stimuli to the mucosa innervated by the superior laryngeal nerve.Study Design Randomized, prospective cohort outcome study in a hospital‐based outpatient setting.Methods One hundred twenty‐six outpatients with dysphagia were randomly assigned to either FEESST or MBS as the diagnostic test used to guide dietary and behavioral management (postural changes, small bites and sips, throat clearing). The outcome variables were pneumonia incidence and pneumonia‐free interval. The patients were enrolled for 1 year and followed for 1 year.Results Seventy‐eight MBS examinations were performed in 76 patients with 14 patients (18.4%) developing pneumonia; 61 FEESST examinations were performed in 50 patients with 6 patients (12.0%) developing pneumonia. These differences were not statistically significant (ξ2 = 0.93, P = .33). In the MBS group the median pneumonia‐free interval was 47 days; in the FEESST group the median pneumonia‐free interval was 39 days. Based on Wilcoxon's signed‐rank test, this difference was not statistically significant (z = 0.04, P = .96).Conclusion Whether dysphagic outpatients have their dietary and behavioral management guided by the results of MBS or of FEESST, their outcomes with respect to pneumonia incidence and pneumonia‐free interval are essentially the same.
Effects of Thermal Conducting Media on the Skin Surface During Laser Irradiation
Authors: Ries William Russell , Speyer Matthew T. , Reinisch Lou 
Published: November 2003

AbstractObjectivesTo investigate the effects of thermally conductive, optically transparent media placed on skin during treatment with the flashlamp excited dye laser (FEDL). The use of higher energy densities to treat persistent cutaneous vascular lesions may result in a decrease in the number of treatment sessions. However, increased fluences can cause complications of scarring, hyperpigmentation, infection, skin texture changes, or hypopigmentation. The thermally conductive media should assist in dissipating surface thermal energy and thereby protect the skin from the complications.Study DesignThis was a prospective laboratory study using an animal model. The results were verified in a prospective, pilot, human‐use trial.MethodsThe threshold for acute skin damage and measurements of the thermal transients were made using a rabbit model. The threshold for purpura was noted with and without the use of a sapphire as a thermal conductor. The thermal transients were measured with small thermocouples placed subcutaneously. On a human subject, purpura intensities were photographed and measured using computer morphometrics after treatment with the FEDL and skin surface protection with air, glass, sapphire, and diamond as conductive media.ResultsWith the interposition of the sapphire thermal conductor during the FEDL treatment, excessive temperature increases of the epidermis were prevented during the laser pulse compared with glass and controls. Both sapphire and diamond resulted in decreased purpuric intensities with the applications of equivalent fluences. Wound recovery time for the purpura was decreased by approximately half a day when any of the surface conductors were used.ConclusionsThe decreased transient temperature and decrease in purpura seen with the use of sapphire and diamond protecting the epidermis during treatment with the FEDL should result in fewer untoward effects during treatment of vascular lesions and facilitate their management.
Patterns of Maxillofacial Injuries As a Function of Automobile Restraint Use
Authors: Major M. Scott , MacGregor Allison , Bumpous Jeffrey M. 
Published: November 2003

AbstractObjective To determine the pattern and severity of maxillofacial injuries sustained in a motor vehicle accident (MVA) resulting from automobile restraint use.Design Retrospective database review of patients injured in a MVA who were admitted to the level I trauma center at the University of Louisville Hospital in Louisville, Kentucky.Methods Demographic data, drug and alcohol impairment screening, and comorbidity data were obtained from database searches of trauma records. Forty‐four patients had an airbag deployed, 34 patients wore seat belts, and 94 patients were unrestrained. All maxillofacial Abbreviated Injury Scale (AIS) ratings were compared among the three groups.Results Twenty‐two of the 44 patients (50%) in the airbag group sustained only facial injuries. Fifteen of them had lacerations; four others had only facial abrasions. Three of the airbag patients had moderate facial injuries (AIS = 2); none required operative management. The airbag group had a mean AIS rating of 1.13, the seat belt group a mean AIS of 1.29, and the unrestrained group a mean AIS of 1.46. Patients using either seat belts (mean age, 40.5 y) or airbags (mean age, 44.9 y) were older than the unrestrained group (mean age, 39.6 y). Drug and/or alcohol impairment was significantly greater in the unrestrained group (mean, 38%) compared with the seat belt group (mean, 26%) and the airbag group (mean 11%).Conclusions Use of airbags is associated with less severe maxillofacial injuries compared with either a seat belt alone or no restraint. There is an inherent risk of minor maxillofacial injuries with airbag usage, but the severity of injury is distinctly reduced.
Increased Expression of Transforming Growth Factor‐β1, Acidic Fibroblast Growth Factor, and Basic Fibroblast Growth Factor in Fetal Versus Adult Fibroblast Cell Lines
Authors: Lee Nina J. , Wang Steven J. , KayDurairaj K. , Srivatsan Eri S. , Wang Marilene B. 
Published: November 2003

AbstractObjectives Fetal wound healing occurs without scar tissue formation. Differences in growth factor expression between fetal and adult fibroblasts have been explored. Recently we used RNA expression studies to demonstrate that transforming growth factor (TGF)‐β1, acidic fibroblast growth factor (α‐FGF), and basic fibroblast growth factor (β‐FGF) could be detected in both fetal and adult fibroblast cell lines. In addition, adult fibroblasts showed greater relative expression of these growth factors than fetal fibroblasts. The aim of this study was to identify the level of protein expression in fetal and adult fibroblasts.Study Design/Methods Fetal and adult fibroblasts were grown in culture using standard and serum‐free media. After protein extraction, Western blot studies were performed to detect the presence and amount of TGFβ‐1, α‐FGF, and β‐FGF growth factor proteins. β‐Tubulin was used as a control.Results TGFβ‐1, α‐FGF, and β‐FGF proteins were detected in fetal and adult fibroblasts grown in standard and serum‐free media. The fetal fibroblasts showed higher levels of all three growth factor proteins compared with the adult fibroblasts.Conclusions Western blot studies suggest higher levels of TGFβ‐1, α‐FGF, and β‐FGF expression in fetal fibroblasts. It is clear that significant differences exist in the expression/production of these growth factors and it seems likely that further study of these differences will help elucidate the unique healing capabilities of fetal fibroblasts.
Supracricoid Partial Laryngectomy With Cricohyoidoepiglottopexy and Cricohyoidopexy for Glottic and Supraglottic Carcinomas
Authors: Bron Luc , Brossard Edgar , Monnier Philippe , Pasche Philippe 
Published: November 2003

AbstractObjectivesTo review the patients operated in our department with supracricoid partial laryngectomy with either cricohyoidoepiglottopexy (CHEP) (59 cases) or cricohyoidopexy (CHP) (10 cases) technique, for primary or recurrent glottosupraglottic squamous cell carcinoma and compare the technique with other surgical or conservative approaches for treatment of laryngeal carcinoma.MethodsFrom hospital charts, we retrospectively reviewed 69 patients who had undergone supracricoid partial laryngectomy with the CHEP or CHP technique between 1983 and 1996 for primary or recurrent glottosupraglottic squamous cell carcinoma in our department. Statistical evaluation of oncological and functional results were conducted. Results were compared with other surgical and conservative treatment for glottosupraglottic carcinoma of the larynx that were published previously in the literature.ResultsSixty‐nine patients had CHEP or CHP for glottosupraglottic carcinoma of the larynx. Thirteen percent of the patients received adjuvant radiotherapy. Minimum follow‐up was 2 years or until death. Five‐year actuarial survival (Kaplan‐Meier method) was 68%. Global local control was achieved in 84% of cases. Among previously untreated patients (n = 54), local control rate was 94.5%. After 1 year, 92.7% of patients achieved normal swallowing and respiration. Salvage total laryngectomy had to be performed in four patients (5.7%) for persistent aspiration and in five patients (7.2%), who were previously treated with radiotherapy, for local recurrence. No permanent tracheostomy or gastrostomy was required.ConclusionsOur experience with supracricoid partial laryngectomy with either CHP or CHEP suggests that this technique is a valuable alternative to radiotherapy for T2–T4 glottosupraglottic carcinomas, particularly those with extension and invasion of the anterior commissure. It allows for preservation of a good laryngeal function without altering the long‐term survival, keeping total laryngectomy as a salvage procedure.
Identification of MUC5B Mucin Gene in Human Middle Ear With Chronic Otitis Media
Authors: Kawano Hirokazu , Paparella Michael M. , Ho Samuel B. , Schachern Patricia A. , Morizono Noriko , Le Chap T. , Lin Jizhen 
Published: November 2003

AbstractObjectives To identify the mucin gene and its expressing cells in the middle ear mucosa with chronic otitis media (COM), and to study the correlation between infiltration of inflammatory cells in the submucosa and expression of the mucin gene in the mucosal epithelium with COM.Study Design Middle ear mucosal specimens removed from the inferior promontory area of 19 patients undergoing middle ear surgery for COM were studied.Methods Sections were stained with H&E, Alcian blue‐periodic acid Schiff (AB‐PAS), polyclonal MUC5B antibody, and specific MUC5B riboprobe for histological, histochemical, immunohistochemical, and mucin mRNA analyses.Results H&E staining revealed pseudostratified epithelia in 18 of the middle ear specimens with COM and cuboidal secretory epithelia in one. AB‐PAS staining of epithelia revealed abundant secretory cells and their products (glycoconjugates). In situ hybridization and immunohistochemistry studies demonstrated that the secretory cells of the middle ear mucosa with COM expressed MUC5B mucin mRNA and its product MUC5B mucin.Conclusions The MUC5B mucin gene and its product were identified in the middle ear secretory cells of patients with COM. Its e‐pression was e‐tensive in pseudostratified mucosal epithelia and related to infiltration of inflammatory cells in the submucosa of the middle ear cleft with COM, suggestive that inflammatory cell products are involved in the production of MUC5B.
Hearing Preservation With Labyrinthine Ablation in Otitis Media
Authors: Antonelli Patrick J. , Briggs Russell D. , Gerhardt Kenneth J. 
Published: November 2003

AbstractObjectives Iatrogenic fenestration of the inner ear in the presence of otitis media is commonly associated with permanent hearing loss. Hearing can generally be preserved when the vestibular labyrinth is ablated in a controlled manner in noninflamed ears. The purpose of this study was to examine the feasibility of hearing preservation with violation of the inner ear in the presence of middle ear inflammation.Study Design Prospective and controlled animal model.Methods Otitis media was induced bilaterally in pigmented guinea pigs with transtympanic injection of Streptococcus pneumoniae, nontypeable Haemophilus influenzae, or formalin‐killed nontypeable H influenzae. Two to 4 days after injection, the horizontal canal of one ear was transected and sealed. Hearing was tested before and after labyrinthine ablation.Results Otitis media was induced in all ears. Bacterial cultures were positive in 19 of 20 S pneumoniae–injected ears, and in 10 of 16 nontypeable H influenzae–injected ears. One week after surgery, elevation of click thresholds (> 15 dB) was encountered in none of the fenestrated or unfenestrated S pneumoniae–infected ears, in two of six unfenestrated and three of six fenestrated nontypeable H influenzae–infected ears, and in one of five killed‐nontypeable H influenzae– injected ears both with and without fenestration.Conclusions These data suggest that ablation of a semicircular canal in the presence of middle ear inflammation or infection does not necessarily lead to profound sensorineural hearing loss. Hearing loss associated with iatrogenic violation of the semicircular canals may be more dependent on factors other than the presence of nonspecific middle ear inflammation.
Partial Parotidectomies: Morbidity and Benign Tumor Recurrence Rates in a Series of 94 Cases
Authors: Lee Rea J. 
Published: November 2003

AbstractObjectives Review the methods available for parotidectomy. Describe the technique of partial parotidectomy assisted by evoked electromyographic nerve location and the expected morbidity and benign and low‐grade cancer tumor recurrence rates from this modified procedure.Study Design From 1983 to 1999 the author performed or assisted in 94 parotidectomies (79 partial), all done by a single specialty group and all using evoked electromyographic nerve location. The cases were surveyed by reviewing all the hospital and office records on these cases and tabulating the type and extent of surgery, pathology, postoperative problems recorded, and long‐term follow‐up.Methods Partial parotidectomy was elected in those cases of benign and low‐grade malignant disease in which adequate tumor removal required a less than complete lobectomy or total parotidectomy. Heavy reliance was placed on proactive nerve location by an evoked electromyographic device with dissecting/stimulating hemostat. A retrospective review focusing on these cases was performed based on the patient charts and their continued documentation by the practice.Results In 79 partial parotidectomies there were no documented facial nerve injuries and one incidence of recurrence of a benign mixed tumor and an acinic cell carcinoma, respectively.Conclusion Partial parotidectomy has the advantages of reduced risk to the facial nerve, reduced operating time, possible outpatient surgery, and no apparent risk of increased recurrence of benign tumors.
Bacteriology of Nontraumatic Maxillary Sinus Mucoceles Versus Chronic Sinusitis
Authors: Busaba Nicolas Y. , Siegel Noah , Salman Salah D. 
Published: November 2003

AbstractObjective To compare the bacteriology of maxillary sinus mucoceles to chronic sinusitis and understand the pathogenesis of nontraumatic maxillary sinus mucoceles (NTMSM).Study Design Retrospective review.Methods Review of intraoperative bacteriology culture results obtained in patients with NTMSM. Patients with history of facial trauma or previous paranasal sinus surgery were not included in the study. The results were compared to intraoperative cultures obtained from patients with chronic sinusitis (CS).Results The study groups consisted of 16 patients with NTMSM (9 male and 7 female patients) and 211 patients with CS (86 male and 125 female patients). Cultures in the NTMSM group were positive in 7 of 16 patients (44%) (four cultures had more than one isolate). There was no growth in cultures of 9 patients (56%). On the other hand, cultures in 176 patients with CS (83%) grew organisms (42 cultures had more than one isolate); there was no growth in 35 of 211 patients (17%) (P = .0007). The cultures grew aerobic bacteria in 7 of 16 (44%) and 160 of 211 (76%) patients of the NTMSM and CS groups, respectively. Anaerobic bacteria were detected in cultures of 2 of 16 patients (12.5%) with NTMSM compared with 13 of 211 patients (6.2%) in the CS group (P = .286). The most common pathogenic aerobe in the NTMSM group was α‐hemolytic Streptococcus, while Staphylococcus aureus was the most common in the CS group.Conclusion The bacteriology of maxillary sinus mucoceles is different from that of CS. The majority of patients with mucoceles have sterile intraoperative cultures. The data do not support infection as the main origin of NTMSM.
High Incidence of Laryngopharyngeal Reflux in Patients With Head and Neck Cancer
Authors: Copper Marcel P. , Smit Conrad F. , Stanojcic Laki D. , Devriese Pieter P. , Schouwenburg Paul F. , Mathus‐Vliegen Lisbeth M.H. 
Published: November 2003

AbstractObjectives Laryngopharyngeal reflux may play a role in the etiology of squamous cell cancer of the head and neck and contribute to complications in head and neck cancer patients after surgery or during radiotherapy.Study Design Prospective study.Methods To investigate the incidence of laryngopharyngeal and gastroesophageal reflux in patients with head and neck cancer, ambulatory 24‐hour double‐probe pH monitoring was performed in 24 untreated patients with laryngeal or pharyngeal squamous cell carcinoma. In addition, 10 patients who had been irradiated in the head and neck area were analyzed for reflux to study the effect of radiotherapy on reflux.Results Only 4 of the 24 head and neck cancer patients (17%) had neither pathological laryngopharyngeal nor gastroesophageal reflux. Esophageal acid exposure was abnormal in five patients and acid exposure at the level of the upper esophageal sphincter was abnormal in four patients. Eleven patients had pathological reflux in both areas. Irradiated patients did not differ from the untreated patients considering the incidence of pathological laryngopharyngeal or gastroesophageal reflux.Conclusions The data obtained in this study indicate that reflux is a common event in head and neck cancer patients.