bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of parathyroid autotransplantation for preservation of parathyroid function after total thyroidectomy
Authors: El‐Sharaky Magdy I. , Kahalil Mohamed R. , Sharaky Ola , Sakr Mahmoud F. , Fadaly Geylan A. , El‐Hammadi Habashi A. , Moussa Mohamed M. 
Published: September 2003

AbstractBackground.Hypoparathyroidism with permanent hypocalcemia is a well‐recognized complication after thyroid surgery.Aim.This study was conducted to assess the role of immediate parathyroid autotransplantation in the preservation of parathyroid function after total thyroidectomy.Patients and Methods.Twenty‐eight patients had autotransplantation of parathyroid glands resected or devascularized during total thyroidectomy. Data were collected prospectively regarding demographics, indication for surgery, operative procedure, pathologic diagnosis, number of glands transplanted, and subsequent course. Thyroid nodules were evaluated by ultrasonography, radionuclide scanning, and/or fine‐needle aspiration cytology. All patients had serum ionized calcium, phosphorus, and intact parathyroid hormone (PTH) levels measured preoperatively and monitored regularly postoperatively for a period of 14 weeks and again at 6 months after operation. Patients were categorized into three groups according to the number of glands transplanted: one (group 1, n = 6), two (group 2, n = 14), or three glands (group 3, n = 8). In three other volunteers, one parathyroid gland was transplanted in the brachioradialis and subjected to electron microscopy 1, 2, and 4 weeks after transplantation.Results.Total thyroidectomy was performed for malignant disease in 16 patients (57.1%) and for benign disease in 12 (42.9%) patients. All patients reverted to asymptomatic normocalcemia without the need for any medications within 4 to 14 weeks. Normal levels of serum markers were regained slower when one gland was transplanted compared with two or three glands (P < .01). Electron microscopic examination showed evidence of ischemic degeneration in the transplanted tissues 1 week postoperatively. Regeneration started by the second week and coincided with normalization of PTH levels. Optimum resting and nearly normal status of parathyroid tissue was achieved by the fourth week.Conclusions.This study showed that active PTH production coincides with regeneration of parathyroid cells and that autotransplantation of at least two resected or devascularized glands during total thyroidectomy nearly eliminates permanent postoperative hypoparathyroidism, thus improving the safety of total thyroidectomy performed for malignant or benign disease. © 2003 Wiley Periodicals, Inc. Head and Neck 25: 799–807, 2003
Comorbid condition as a prognostic factor for complications in major surgery of the oral cavity and oropharynx with microvascular soft tissue reconstruction
Authors: Borggreven Pepijn A. , Kuik Dirk J. , Quak Jasper J. , de Bree Remco , Snow Gordon B. , Leemans C. René 
Published: September 2003

AbstractBackground.Identification of factors, especially comorbidity, that affect the incidence and severity of complications in head and neck cancer patients.Methods.One hundred patients with an oral/oropharynx carcinoma undergoing composite resection and microvascular soft tissue transfer were analyzed. Patient data and tumor and treatment factors were recorded. Comorbidity was graded by an Adult Comorbidity Evaluation 27 (ACE‐27) test. Postoperative complications were scored according to their severity.Results.Comorbidity score ACE‐27 grade 2 or higher was present in 47% of patients, whereas 33% had a clinically important complication develop. A comorbidity score of ACE‐27 grade ≥2 was a strong predictor for complications (p < .001). There were no other predictors for postoperative complications.Conclusions.Comorbidity is of great importance for prediction of postoperative complications in head and neck cancer patients, especially an ACE‐27 grade ≥2. It may be concluded from these results that prevention of complications should focus on comorbidities. © 2003 Wiley Periodicals, Inc. Head and Neck 25: 808–815, 2003
Papillary thyroid cancer: High inter‐(simple sequence repeat) genomic instability in a typically indolent cancer
Authors: Wiseman Sam M. , Loree Thom R. , Rigual Nestor R. , Hicks Wesley L. , Winston Janet S. , Swede Helen , Bartos Jeremy D. , Anderson Garth R. , Stoler Daniel L. 
Published: September 2003

AbstractObjectives.The object of this study is to measure genomic instability in papillary thyroid cancer and correlate these measurements with known clinical prognosticators such as patient age, tumor size, histologic subtype, and three commonly used thyroid risk assessment indices. A secondary objective of this study was to use the measurements of genomic instability to estimate the number of mutational events present in the papillary thyroid cancer genome.Methods.Inter‐simple sequence repeat polymerase chain reaction (ISSR‐PCR) is a rapid and reproducible technique for quantitation of genomic instability, or the degree of genome alteration, in solid tumors. This includes quantitation of amplifications, deletions, translocations, and insertions. Twenty‐eight papillary carcinomas were evaluated by ISSR‐PCR.Results.Evaluation of 28 papillary carcinomas by ISSR‐PCR demonstrated a wide range of genomic instability. Of the panel of clinicopathologic factors examined, only patient age was significantly associated with genomic instability. The mean genomic instability index value was greatest in the youngest age group, which was significantly different from the median value measured in the oldest age group (3.7, 2.5, respectively, p = .05). The mean value in the intermediate age group fell between the younger and older groups (3.1). By use of ISSR‐PCR, we have calculated 15,000 individual genomic events as having occurred in each papillary tumor cell.Conclusions.Despite its generally indolent biologic behavior, papillary thyroid cancer exhibits a high degree of genomic instability comparable to that seen in colorectal cancer. These results suggest that elevated genomic instability, as measured by ISSR‐PCR, may not be sufficient to enable thyroid tumor progression to less indolent disease and that this process is severely constrained by some additional essential factor such as the differentiated state of the tissue or the need to bring into play an additional form of genomic destabilization. © 2003 Wiley Periodicals, Inc. Head and Neck 25: 825–832, 2003
Who merits a neck dissection after definitive chemoradiotherapy for N2–N3 squamous cell head and neck cancer?
Authors: McHam Scott A. , Adelstein David J. , Rybicki Lisa A. , Lavertu Pierre , Esclamado Ramon M. , Wood Benjamin G. , Strome Marshall , Carroll Marjorie A. 
Published: September 2003

AbstractBackground.The role of neck dissection (ND) after definitive chemoradiotherapy for squamous cell head and neck cancer is incompletely defined. We retrospectively reviewed 109 patients with N2–N3 disease treated with chemoradiotherapy to identify predictors of a clinical complete response in the neck (CCR‐neck), pathologic complete response after ND (PCR‐neck), and regional failure.Method.All patients were given 4‐day continuous infusions of 5‐fluorouracil (1000 mg/m2/d) and cisplatin (20 mg/m2/d) during the first and fourth weeks of either once daily (n = 68) or twice daily (n = 41) radiation therapy. ND was considered for all patients after completion of chemoradiotherapy and was performed in 32 of the 65 patients achieving a CCR‐neck after chemoradiotherapy and in all 44 patients with residual clinical evidence of neck disease. CCR‐neck, PCR‐neck, and regional failure were then correlated with potential predictors, including T, N, largest lymph node size (<3 cm, ≥3 cm), primary tumor site, and radiation fractionation schedule.Results.Achievement of a CCR‐neck was predicted by N, N2 vs N3 (53 of 80 vs 12 of 29, p = .019) and by largest lymph node size, <3 cm vs ≥3 cm (19 of 25 vs 46 of 84, p = .06). Achievement of a PCR‐neck could not be predicted by any clinical parameter. Regional failure occurred both in patients undergoing ND and those not dissected (5 of 76 vs 4 of 33, p = .33) and proved more likely only in the ND patients with residual positive pathology compared with those achieving a PCR‐neck (5 of 25 vs 0 of 51, p < .001). Primary site was not a useful predictor of CCR‐neck, PCR‐neck, or regional failure. Most importantly, CCR‐neck (vs <CCR‐neck) did not predict either a PCR‐neck (24 of 32 vs 27 of 44, p = .21) or regional failure (5 of 65 vs 4 of 44, p = .80).Conclusions.After chemoradiotherapy, clinical parameters do not identify those patients with residual neck node disease or those at risk for regional failure, suggesting that ND be considered for all N2–N3 patients. © 2003 Wiley Periodicals, Inc. Head and Neck 25: 791–798, 2003
Videofiberoptic examination of the pharyngoesophageal segment and esophagus in patients after total laryngectomy
Authors: Chu Pen‐Yuan , Guo Yuan‐Ching , Tai Shyh‐Kuan , Hwang Jui‐Ling , Tsai Tung‐Lung , Chang Shyue‐Yih 
Published: September 2003

AbstractBackground.Posttreatment follow‐up in patients with squamous cell carcinoma of the head and neck is critical because of the high risk of recurrence or a new primary tumor. However, in patients who have undergone total laryngectomy, evaluation of the pharyngoesophageal segment (PES) and esophagus is difficult.Methods.Sixty patients who had undergone total laryngectomy received a videofiberoptic examination of the PES and esophagus at the OPD office during follow‐up.Results.Satisfactory examination was achieved in 56 (93%) of the patients. Each procedure was completed within 15 minutes. Although only 11 (18%) of the patients were symptomatic at follow‐up, 19 patients (34%) had significant findings, including one local recurrence and two secondary esophageal cancers. Patients were asymptomatic in all three cases.Conclusions.Videofiberoptic examination is a simple, effective, and relatively noninvasive method that can be performed in the OPD office to evaluate the PES and esophagus in patients after total laryngectomy. © 2003 Wiley Periodicals, Inc. Head Neck 25: 858–863, 2003
Applicability of lymphoscintigraphy with sentinel node biopsy to eccrine carcinoma of the head and neck
Authors: Chang Amy S. , Busam Klaus , Kraus Dennis H. 
Published: September 2003

AbstractBackground.Eccrine carcinoma of the head and neck has the propensity to metastasize both to regional and distant sites. When associated with nodal metastasis, there is a high incidence of distant spread of disease, ultimately being associated with the death of the patient. Management of the patient with clinically negative nodes remains controversial. Although elective nodal dissection has been performed, the impact of this intervention remains indeterminate. This case series serves as a feasibility study for use of the technique of lymphoscintigraphy with sentinel node biopsy for eccrine carcinoma arising in the head and neck.Methods.Two patients with eccrine carcinoma underwent sentinel node biopsy by way of the standard, three‐part technique using lymphoscintigraphy, 1% isosulfan blue dye, and intraoperative use of the gamma probe.Results.In each of these cases, the lymphoscintigram successfully identified sentinel lymph nodes. Intraoperative findings were significant for confirmation of sentinel nodes with the presence of blue dye in the lymph node. In one case, frozen section identified a positive sentinel lymph node, and the patient underwent definitive nodal dissection and postoperative radiotherapy. In the second case, immunohistochemistry as part of final pathology identified a single microscopic foci of metastatic eccrine carcinoma, for which the patient elected to receive definitive radiation therapy.Conclusions.This report documents the efficacy of lymphoscintigraphy with sentinel lymph node biopsy in identifying microscopic metastasis eccrine carcinoma in primary lesions arising in the head and neck. © 2003 Wiley Periodicals, Inc. Head and Neck 25: 879–882, 2003
Quality of life in patients with oropharynx carcinomas: Assessment after accelerated radiotherapy with or without chemotherapy versus radical surgery and postoperative radiotherapy
Authors: Allal Abdelkarim S. , Nicoucar Kevin , Mach Nicolas , Dulguerov Pavel 
Published: September 2003

AbstractBackground.In oropharyngeal carcinomas, it is assumed that the effectiveness of the different treatment approaches is roughly equivalent, whereas the functional outcome after radical radiotherapy (RT) is superior to that associated with primary surgery. The aim of this study is to assess quality of life (QoL) outcomes of patients after two treatment strategies: radical surgery with postoperative RT and accelerated concomitant boost RT with or without chemotherapy.Methods.Sixty patients who were disease free at least 1 year after treatment of oropharynx carcinoma were studied. Forty had been treated with radical RT (median tumor dose, 69.9 Gy in 5.5 weeks), and 20 had been treated with primary surgery and postoperative monofractionated RT (median dose, 60.2 Gy). Seven of the former patients received chemotherapy concomitantly with, and one before, RT. Functional outcome was assessed by the subjective Performance Status Scale for Head and Neck cancer (PSSHN) and the general QoL by the European Organization for Research and Treatment of Cancer Core QoL questionnaire (EORTC QLQ‐C30). The unpaired t test was used to assess for significant differences between means.Results.By use of the PSSHN module, scores were generally higher in the RT group, with a significant difference in the speech subscale (p = .005), a trend for a significant difference for the eating in public subscale (p = .08), and an insignificant difference for the normalcy of diet subscale (p = .25). When analyzed by tumor stage, no significant differences were observed for T1–2 tumors, whereas for patients with T3–4 tumors highly significant differences favoring the RT group became evident for all three subscales. Although no significant differences were observed using the EORTC QLQ C‐30 functional scales, patients treated with primary surgery reported significantly more dyspnea (28 vs 12, p = .04) and appetite loss (30 vs 13, p = .05). In patients with T3–4 tumors, trends toward better scores favoring the RT group were observed for physical, role, emotional, and social functions, as well as a significantly better score for pain symptoms.Conclusions.Although for early stages no clear advantage in QoL outcome was noted for the RT group compared with the surgery group, for advanced‐stage disease an advantage favoring radical RT seemed apparent. For those patients, if an equivalency between the two treatment strategies could be assumed regarding oncologic results, then nonsurgical treatment should be considered the preferred option. © 2003 Wiley Periodicals, Inc. Head and Neck 25: 833–840, 2003
The prevalence and significance of clinically unsuspected neoplasms in cervical lymph nodes
Authors: Ansari‐Lari M. Ali , Westra William H. 
Published: September 2003

AbstractBackground.Histopathologic scrutiny of surgical pathology specimens can uncover unexpected but important pathologic processes that might not (yet) be clinically apparent. We suspect that cervical lymph nodes removed from patients with known cancers of the head and neck might occasionally harbor clinically unsuspected neoplasms.Methods.We reviewed the pathology reports of all patients who had undergone cervical lymph node dissections at our institution between 1984 and 2001 to determine the prevalence of occult metastatic thyroid cancer and other clinically unsuspected tumors. The medical records were reviewed to obtain follow‐up information when histologic examination disclosed some significant finding that was unsuspected on clinical grounds.Results.Of the 1337 patients who underwent cervical lymphadenectomy during the 17‐year period, 27 (2.0%) had at least one lymph node harboring an unanticipated finding that raised the concern of a clinically unsuspected neoplasm. Sixteen (1.2%) of these patients had conclusive histologic evidence of an unexpected neoplasm, including 6 patients (0.4%) with malignant lymphomas (low‐grade B cell, n = 5; high‐grade B cell, n = 1) and 10 patients (0.7%) with metastatic papillary thyroid carcinomas. An additional 11 patients (0.8%) had lymph nodes harboring “benign” thyroid inclusions or psammoma bodies. Four of these 11 patients underwent thyroidectomy, but thyroid cancer was not detected in the ipsilateral thyroid. Only one patient died as a consequence of the incidentally discovered neoplasm.Conclusions.To the degree that our study population is reflective of the adult population at large, at least 1% of adults harbor malignant neoplasms in their cervical lymph nodes. Although this statistic seems alarmingly high, most of these neoplasms are indolent and do not undergo unrelenting progression to clinically overt malignancies. © 2003 Wiley Periodicals, Inc. Head and Neck 25: 841–847, 2003
Prognostic significance of tumor angiogenesis, Ki 67, p53 oncoprotein, epidermal growth factor receptor and HER2 receptor protein expression in undifferentiated nasopharyngeal carcinoma—a prospective study
Authors: Ma Brigette B. Y. , Poon Terence C. W. , To K. F. , Zee Benny , Mo Frankie K. F. , Chan Charles M. L. , Ho Stephen , Teo Peter M. L. , Johnson Phillip J. , Chan Anthony T. C. 
Published: September 2003

AbstractBackground.This study prospectively examines the prognostic role of p53 oncoprotein (p53), Ki67‐antigen (Ki67), tumor angiogenesis (MVD), epidermal growth factor receptor (EGFR), and HER2 receptor protein (HER2) expression in Chinese with undifferentiated nasopharyngeal carcinoma (NPC).Methods.Seventy‐eight Chinese were recruited from October 1995 to July 1997 at the Prince of Wales Hospital, Hong Kong. Pretreatment immunohistochemical preparations of the primary tumor were made, and clinical data were collected prospectively until October 30, 2000. The markers were correlated with overall survival (OS), disease‐free survival (DFS), time to progression (TTP), and UICC stage.Results.On univariate analysis, EGFR expression correlated with poorer OS (p = .0001), DFS (p = .01), shorter TTP (p = .0001), and advanced T stage (p = .036). Strong EGFR expression, when compared with weak or moderate, was associated with poorer OS (p = .04) and shorter TTP in a subgroup of patients with UICC stage III–IV disease. HER2 expression was associated with advanced UICC stage (p = .006). The presence of p53 expression correlated with poorer DFS (p = .01) and a trend toward shorter TTP (p = .06). No correlation was found with Ki67‐antigen or MVD. On multivariate analysis, only EGFR expression was significantly linked to shorter OS and TTP.Conclusions.EGFR expression in undifferentiated NPC is associated with a poor clinical outcome. A prognostic role of p53 and HER2 expression is suggestive but not consistently defined in this study. The relatively high prevalence of positive staining for EGFR supports the use of molecular targeted therapy in this disease. © 2003 Wiley Periodicals, Inc. Head and Neck 25: 864–872, 2003
Control rooms' design in industrial facilities
Authors: Meshkati Najmedin 
Published: September 2003

AbstractA technological system's overall performance, which is an aggregate of its safety, reliability, and efficiency indicators, is a function of its control room operators' performance. Operators' performance is also strongly determined and moderated by the design of the control room. Moreover, today's complex industrial facilities require operators to continually adapt to new and unforeseen changes in technological system and environmental demands. There is no clear‐cut distinction between system design and operation since the operator will have to match system properties to changing demands and operating conditions. Thus, this continuous process needs a cohesive and integrated framework for information gathering from the interfaces, analysis according to operators' task demand, and decision making within the organizational and regulatory contexts of the technological system. Therefore, there is a need to approach human factors in a more global and systematic manner, which includes integration of display systems design, task demands, and with operators' information processing behavior. © 2003 Wiley Periodicals, Inc. Hum Factors Man 13: 269–277, 2003.
Errors in technological systems
Authors: Duffey R.B. , Saull J.W. 
Published: September 2003

AbstractMassive data and experience exist on the rates and causes of errors and accidents in modern industrial and technological society. We have examined the available human record, and have shown the existence of learning curves, and that there is an attainable and discernible minimum or asymptotic lower bound for error rates. The major common contributor is human error, including in the operation, design, manufacturing, procedures, training, maintenance, management, and safety methodologies adopted for technological systems.To analyze error and accident rates in many diverse industries and activities, we used a combined empirical and theoretical approach. We examine the national and international reported error, incident and fatal accident rates for multiple modern technologies, including shipping losses, industrial injuries, automobile fatalities, aircraft events and fatal crashes, chemical industry accidents, train derailments and accidents, medical errors, nuclear events, and mining accidents. We selected national and worldwide data sets for time spans of up to ∼200 years, covering many millions of errors in diverse technologies. We developed and adopted a new approach using the accumulated experience; thus, we show that all the data follow universal learning curves.The vast amounts of data collected and analyzed exhibit trends consistent with the existence of a minimum error rate, and follow failure rate theory. There are potential and key practical impacts for the management of technological systems, the regulatory practices for complex technological processes, the assignment of liability and blame, the assessment of risk, and for the reporting and prediction of errors and accident rates. The results are of fundamental importance to society as we adopt, manage, and use modern technology. © 2003 Wiley Periodicals, Inc. Hum Factors Man 13: 279–291, 2003.
Specific empirical free energy function for automated docking of carbohydrates to proteins
Authors: Laederach Alain , Reilly Peter J. 
Published: September 2003

AbstractWe present an automated docking protocol specifically optimized to predict the structure and affinity of a protein–carbohydrate complex. A scoring function was developed based on a training set of 30 protein–carbohydrate complexes of known structure and affinity. Combinations of several models for hydrogen bonding, torsional entropy loss, and solvation were tested for their ability to fit the training set data, and the best model was used with AutoDock. The electrostatic empirical coefficient is larger than in a previously obtained model using a training set comprised of various types of protein–ligand complexes, indicating that electrostatic interactions play a more important role in determining the affinity between a carbohydrate and a protein. The differences in the relative weighting of the empirical coefficients in the model yields predicted free energies for the training set with a standard error of 1.403 kcal/mol. The new scoring function was tested on 17 Aspergillus niger glucoamylase inhibitors for which binding energies had been determined experimentally. Free energies of complex formation were predicted with a residual standard error of 1.101 kcal/mol. The new scoring function therefore provides a robust method for predicting free energies of formation and optimal conformations of carbohydrate–protein complexes. © 2003 Wiley Periodicals, Inc. J Comput Chem 24: 1748–1757, 2003