bluuebunny/crossref_metadata_2025_split huggingface dataset:
In Vivo Diagnosis of Persistent and Recurrent Nasopharyngeal Carcinoma by Contact Endoscopy
Authors: Pak Martin Wai , To Ka Fai , Leung Sing Fai , van Hasselt Charles Andrew 
Published: November 2003

AbstractObjective To evaluate the potential use of contact endoscopy for the diagnosis of persistent and recurrent nasopharyngeal carcinoma in postirradiated patients.Study Design Prospective study to examine 64 consecutive patients who have been irradiated for nasopharyngeal carcinoma in a clinic setting using contact rhinoscopes (Karl Storz, Tuttlingen, Germany [7215 AA, 0°, and 7215 BA, 30°; 23 cm long. 4 mm in diameter]).Methods The superficial cells of the posterior walls of the nasopharynx were stained with 1% methylene blue and examined with contact rhinoscopes with the patient under local anesthesia at high magnifications (×60 and ×150). Biopsy of the areas under examination was performed. The contact endoscopic images were analyzed and correlated with the corresponding histological sections of the biopsy tissues.Results Contact endoscopy was performed in 64 patients (54 men; mean age, 42 y) with the use of local anesthesia. Four patterns of contact endoscopic findings were identified: squamous metaplasia (43 cases), postirradiation atypia (10), granulation tissue (6), and malignancy (5). In the last group, the nasopharynx appeared normal in two patients (40%). The findings of contact endoscopy correlated well with the histological findings (kappa reliability coefficient = 0.847;P <.001; diagnostic accuracy, 92.1%). For prediction of persistent and recurrent disease, the sensitivity and specificity of endoscopic findings were both 100%.Conclusion Contact endoscopy is an accurate, reliable office‐based procedure that allows for in vivo and in situ diagnosis of persistent and recurrent nasopharyngeal carcinoma in postirradiated patients.
Myringotomy Delays the Tympanic Membrane Recovery in Acute Otitis Media: A Study in the Rat Model
Authors: Spratley Jorge , Hellström Sten , Eriksson Per‐Olof , Pais‐Clemente Manuel 
Published: November 2003

AbstractBackground/Hypothesis Acute otitis media is a major cause of visits to pediatric health care providers. Myringotomy in uncomplicated acute otitis media is debatable today. The study addressed this problem through the otomicroscopic and histopathological observations of the events occurring in the tympanic membrane during the first week after myringotomy.Study Design Randomized study in an experimental animal model.Methods Under anesthesia, the left middle ear of 36 Sprague‐Dawley rats was inoculated with Streptococcus pneumoniae type 3. Forty‐eight hours later, at day 0, four animals were immediately killed and the remaining animals were randomly assigned into a myringotomy group (n = 16, myringotomy on the left ear) and a non‐myringotomy group (n = 16, otomicroscopy without myringotomy). Otomicroscopy and killings were performed in series of four animals from each group at days 1, 2, 4, and 7 after myringotomy. Tympanic membranes were collected after fixation and processed for light and electron microscopy.Results All inoculated ears showed a manifest acute otitis media at day 0. An intense infiltration by inflammatory cells and edema distorted severely the tympanic membrane structure. These findings decreased the following days. However, inflammation as evaluated by the thickness and the cytoarchitecture of the tympanic membrane layers, recovered significantly faster in the membranes in the non‐myringotomy group. At day 7, all tympanic membranes in the myringotomy group were closed by a hypertrophic keratinizing epithelium and a remodeling connective tissue layer, whereas the animals in the non‐myringotomy group had a residual edema in the lamina propria.Conclusions The present infectious model induced an intense inflammatory reaction within the entire structure of the tympanic membrane. Myringotomy provoked a delayed recovery from the inflammatory process within the tympanic membrane. Therefore, if applicable to human conditions, the use of myringotomy in the management of acute otitis media should be restricted to selected cases of acute otitis media.
The Diagnostic Utility of an Electronic Nose: Rhinologic Applications
Authors: Thaler Erica R. 
Published: November 2003

AbstractObjective/Hypothesis The thesis explores the applicability of electronic nose technology in medical decision‐making. Specifically, the studies undertaken in the thesis were designed to test the ability of the electronic nose to assist in diagnostic questions encountered in the field of rhinology.Study Design Three separate studies were undertaken. All involved analysis of specimens by the electronic nose, obtained either in vitro or in vivo: known matched sets of cerebrospinal fluid and serum, bacterial samples from known plated specimens, and culture swabs taken from patients suspected of having rhinosinusitis who also had a matched standard bacterial culture taken from the same site. The goal of analysis was to determine whether the electronic nose was able to identify or categorize specimens or groups of specimens.Methods Each specimen was tested using the organic semiconductor‐based Cyranose 320 electronic nose. Data from the 32‐element sensor array were subjected to principal‐component analysis to depict differences in odorant patterns. Distinction of specimens was identified by calculation of Mahalanobis distance.Results The electronic nose was able to distinguish serum from cerebrospinal fluid in pure isolates as well as in isolates collected on small cottonoid pledgets at amounts of 0.2 mL or greater. It was also able to distinguish between control swabs and bacterial samples as well as among bacterial samples collected in vitro. Preliminary work suggests that it may be able to distinguish between presence and absence of bacterial infection in specimens collected on nasal swabs.Conclusions The electronic nose is able to distinguish reliably between cerebrospinal fluid and serum sampled in small amounts, may be able to identify presence and type of bacterial pathogen in vitro, and is able to identify presence or absence of bacteria on nasal swabs. Because this information is available immediately, the electronic nose may be a powerful new technology for diagnostic use, not only for rhinologic purposes but in many other aspects of medicine as well.
Retinoblastoma–Cyclin‐Dependent Kinase Pathway Deregulation in Vestibular Schwannomas
Authors: Lasak John M. , Welling D. Bradley , Akhmametyeva Elena M. , Salloum Mariah , Chang Long‐Sheng 
Published: November 2003

AbstractObjectives The purpose of the study was to identify genes of the retinoblastoma protein (pRb)–cyclin‐dependent kinase (CDK) pathway that are deregulated in vestibular schwannomas when compared with normal vestibular nerve tissues.Study Design Expression profiles in eight vestibular schwannomas (four sporadic tumors, one neurofibromatosis type 2 tumor, and three cystic tumors) and a paired normal vestibular nerve from one of the eight patients were chosen. Genes examined included the retinoblastoma susceptibility gene (Rb‐1); cyclins D1, D2, A, and E; the CDK inhibitors p18, p19, and p27; CDK2 and CDK6; transcription factors E2F‐4, E2F‐5, and DP‐1; and the neurofibromatosis type 2 gene.Methods Total RNA samples were extracted from normal vestibular nerve and vestibular schwannoma tissues and used to generate radiolabeled complementary DNA (cDNA) samples. Labeled cDNA probes were then hybridized to cDNA microarray filters. The hybridization signal was captured and quantified. Differential gene expression profiles between the normal vestibular nerve and vestibular schwannoma were compared. Real‐time polymerase chain reaction and immunohistochemistry were used to further confirm the cDNA microarray data.Results Among genes in the pRb‐CDK pathway, CDK2 was substantially underexpressed in seven of the eight vestibular schwannoma tumors examined. Quantitative RNA expression analysis using real‐time polymerase chain reaction also showed consistent downregulation of CDK2 in the tumors. Anti‐CDK2 antibody stained predominantly in the vestibular nerve and ganglion cells but only weakly in the vestibular schwannoma tissues.Conclusions The pRb‐CDK pathway was altered in all vestibular schwannoma tumors examined, with CDK2 significantly downregulated in seven of the eight tumors. Further investigation into the regulatory mechanisms governing CDK2 expression may lead to a better understanding of vestibular schwannoma tumorigenesis.
Vestibular Evoked Myogenic Potentials in Delayed Endolymphatic Hydrops
Authors: Young Yi‐Ho , Huang Tsung‐Wei , Cheng Po‐Wen 
Published: November 2003

AbstractObjective/Hypothesis Vestibular evoked myogenic potential (VEMP) has become an established test to explore the sacculo‐collic reflex. The study aims to investigate the VEMPs in cases of delayed endolymphatic hydrops because greatly dilated saccule was observed in histopathological specimens of delayed endolymphatic hydrops.Study Design Prospective study.Methods Twenty patients with delayed endolymphatic hydrops were subjected to pure‐tone audiometry, caloric testing, and VEMP test. Delayed VEMP was defined as the latency of peak I exceeding 22.6 milliseconds or of peak II exceeding 33.1 milliseconds. Interaural amplitude difference over the sum of amplitudes of both ears was measured, and when the ratio exceeded 0.36, it was identified as augmented VEMP or depressed VEMP depending on whether the amplitude of the lesioned side was greater or less than the opposite side.Results The VEMP test revealed that 9 patients (45%) were normal, 6 (30%) exhibited absent VEMPs, and 5 (25%) displayed abnormal VEMPs, including delayed VEMPs in 2, depressed VEMPs in 2, and augmented VEMPs in 1. The caloric test indicated that 9 (47%) of the 19 ears exhibited normal caloric response, whereas 10 ears displayed abnormal caloric responses including canal paresis in 8 and absent caloric response in 2. Six ears had preserved both the caloric response and the VEMPs, whereas no ear demonstrated both absent caloric response and absent VEMPs.Conclusions The residual caloric as well as saccular functions after ear insult may determine whether delayed endolymphatic hydrops will occur. These findings suggest that patients with sudden deafness or juvenile unilateral total deafness should undergo caloric testing and VEMP test to predict the occurrence of delayed endolymphatic hydrops in the future.
Tympanometric Findings in Patients With Enlarged Vestibular Aqueducts
Authors: Sato Eisuke , Nakashima Tsutomu , Lilly David J. , Fausti Stephen A. , Ueda Hiromi , Misawa Hayato , Uchida Yasue , Furuhashi Atsushi , Asahi Kiyomitsu , Naganawa Shinji 
Published: November 2003

AbstractObjectives The purpose of this study was to study systematically some relationships between the resonance frequency of the middle‐ear transmission system and the volume of the endolymphatic duct and sac in patients with an enlarged vestibular aqueduct (EVA).Study Design Prospective study.Methods Thirteen patients (24 ears) with EVA, 17 subjects (29 ears) with normal hearing, and 17 patients (21 ears) with sensorineural hearing loss without EVA served as experimental subjects. Standard pure‐tone audiometry, standard clinical tympanometry (using a 226‐Hz probe tone), and multifrequency tympanometry were performed on each ear. Magnetic resonance imaging was used to determine the area of the cochlear modiolus and the volume of the endolymphatic duct and sac.Results The audiometric configurations for most patients sloped downward from the low to the high frequencies. A significant air‐bone gap was computed at each of these test frequencies. Multifrequency tympanometry yielded resonance frequencies for the patients with EVA that was significantly lower than those measured for the control subjects. In general, for patients with EVA, the resonance frequency of the middle ear system decreased as the volume of the endolymphatic duct and sac increased. This inverse relation was significant (correlation coefficient = −0.483, P = .0157). However, there was no correlation between resonance frequency and the degree of cochlea modiolar deficiency.Conclusions Clinically, our findings suggest that EVA probably should be included in the differential diagnosis for a patient who presents with a moderate to severe mixed hearing loss, a normal tympanogram at 226 Hz, and a resonance frequency that is abnormally low.
Cytokine Profiles in a Rat Model of Otitis Media With Effusion Caused by Eustachian Tube Obstruction With and Without Streptococcus pneumoniae Infection
Authors: Hebda Patricia A. , Piltcher Otavio B. , Swarts J. Douglas , Alper Cuneyt M. , Zeevi Adriana , Doyle William J. 
Published: November 2003

AbstractObjective Cytokine expression was studied in a rat model of otitis media with effusion.Methods The left eustachian tube was obstructed (eustachian tube obstruction [ETO]) in 84 rats. Forty‐two ears were challenged with Streptococcus pneumoniae, and those rats were treated from day 2 to day 7 with ampicillin. Twelve rats (6 per group) were killed on days 1, 2, 7, 21, 35, 56, and 112; mucosa was harvested and assayed for interleukin‐1β (IL‐1β), tumor necrosis factor‐α (TNF‐α), interleukin‐6 (IL‐6), interleukin‐10 (IL‐10), interferon‐γ (IFN‐γ), transforming growth factor‐β (TGF‐β), monocyte chemoattractant protein‐1 (MCP‐1), and interleukin‐8 (IL‐8) gene expression, and effusion was assayed for IL‐1β, TNF‐α, IL‐6, IL‐10, and macrophage inflammatory protein‐2 (MIP‐2) protein.Results Most cytokines were detectable in the effusion from infected ears with ETO on days 1 and 2 only. MIP‐2 exhibited a biphasic response. Only effusion MIP‐2 was consistently detected in uninfected ears with ETO. Three patterns of mucosal cytokine messenger RNA (mRNA) upregulation were observed: isolated early (IL‐1β, IL‐8), isolated late (TNF‐α, IFN‐γ), and biphasic (MCP‐1, IL‐6, TGF‐β) responses. Early cytokine mRNA upregulations were observed only in the infected ears with ETO, whereas late upregulations were observed in both groups.Conclusions Early expression of the assayed cytokines occurred only in ears with active infection. For both groups, a late upregulation of cytokine message but not protein was documented. The profile of cytokine expression during otitis media episodes may be useful in defining etiology, disease stage, and prognosis.
High‐Resolution Magnetic Resonance Imaging of Human Cochlea
Authors: Silver Robert D. , Djalilian Hamid R. , Levine Samuel C. , Rimell Frank L. 
Published: November 2003

AbstractObjectives High‐resolution MRI (MRI) of human inner ear structures provides several advantages over other imaging modalities. High‐resolution visualization of inner ear ultrastructure in a noninvasive manner may provide important information about inner ear disease that is not obtainable in other ways. The study was performed to demonstrate the capabilities of MRI at high resolution on the human cochlea, vestibular structures, and facial nerve. Comparative analyses of MRI anatomy with that seen on histological dissection were made. The aim of the study was to define the anatomy of human cadaveric cochlea using a 9.4‐Tesla magnetic resonance scanner, currently the most powerful magnetic resonance magnet available.Study Design Experimental pilot study of cadaveric human cochleae.Methods Serial scanning using a 9.4‐Tesla magnetic resonance imager on normal preserved and fresh cadaveric inner ears was performed in different planes.Results The images revealed detailed anatomy of the modiolus, utricle, saccule, semicircular canals, and facial nerve. Specifically, identifiable structures within the cochlea included the osseous spiral lamina, Reissner's membrane, membranous spiral lamina, spiral ligament, and others.Conclusions Data established through the acquisition of images from cadaver cochlea, facial nerve, and vestibular complex provide a foundation for developing steps for testing temporal bones and, eventually, patients with Meniere's disease and other inner ear disease. The present ongoing project will provide information on baseline images of the inner ear using high‐resolution MRI.
Reduction of Diplopia Following Endoscopic Orbital Decompression: The Orbital Sling Technique
Authors: Metson Ralph , Samaha Mark 
Published: November 2003

AbstractObjective Although endoscopic orbital decompression has become the surgical treatment of choice for patients with proptosis from Graves disease, postoperative diplopia requiring corrective eye muscle surgery can occur in up to 63% of patients. The purpose of the study was to evaluate a new technique intended to reduce the incidence of diplopia following endoscopic orbital decompression.Study Design Case‐control.Methods Endoscopic orbital decompression was performed on 58 orbits in 37 patients with proptosis from Graves disease. The orbital sling technique, which makes use of a horizontal strip of periorbital fascia to prevent prolapse of the medial rectus muscle, was used on 20 orbits in 13 patients. Conventional endoscopic decompression was performed in 24 control subjects. The mean duration of follow‐up was 3.3 ± 1.3 years (range, 1.7–5.1 y).Results The incidence of new‐onset or worsened diplopia following endoscopic decompression was significantly lower for the orbital sling group compared with control subjects (0% vs. 29.2%, respectively [P = .038]). No patients in the orbital sling group developed new‐onset diplopia following surgery. Of the eight patients with pre‐existing diplopia from the orbitopathy, double vision improved in four patients (50%) and was unchanged in the remaining four patients (50%). The mean reduction in proptosis was comparable for the orbital sling and control groups (5.1 ± 1.1 mm vs. 5.0 ± 1.9 mm, respectively [P = .98]).Conclusions The preservation of a fascial sling overlying the medial rectus muscle during endoscopic orbital decompression appears to reduce the incidence of postoperative diplopia, while still allowing for a satisfactory reduction in proptosis. This modification of the standard decompression technique should be considered for the treatment of patients with proptosis.
The Fate of Mastoid Obliteration Tissue: A Histopathological Study
Authors: Linthicum Fred H. 
Published: November 2003

AbstractObjectives To demonstrate the histopathological fate of tissues used for mastoid obliteration over a period of 30 years.Study Design Retrospective histopathological analysis of archival temporal bone microscopic sections.Methods From the database of the laboratory, the 17 temporal bones from subjects who had undergone mastoid obliteration procedures were identified. The microscopic appearance of the obliteration tissue was described, and microphotographs made of significant findings.Results Fat and bone chips, or paté, retained their bulk in the obliterated space, whereas subcutaneous tissue and muscle lost bulk but seemed to promote healing. Some substances, such as bone wax, used for hemostasis and buried under obliteration tissue, were found to produce a subclinical inflammatory reaction, but other materials, such as Surgicel and Gelfoam, did not.Conclusions Fat and bone chips, or paté, used as mastoid obliteration tissue, retained their bulk and identity, whereas subcutaneous tissue and muscle did not.
Submucosal Bipolar Radiofrequency Thermal Ablation of Inferior Turbinates: A Long‐Term Follow‐up With Subjective and Objective Assessment
Authors: Bäck Leif J.J. , Hytönen Maija L. , Malmberg Henrik O. , Ylikoski Jukka S. 
Published: November 2003

AbstractObjective To assess the efficacy and morbidity of bipolar radiofrequency thermal ablation of the inferior turbinates in patients with nasal obstruction caused by turbinate hypertrophy.Study Design Prospective, nonrandomized study and outpatient treatment.Methods Twenty patients (age range, 23–77 y; median age, 52 y) enrolled in the study. There was one dropout. All the patients had nasal blockage despite medical treatment. Bipolar radiofrequency thermal ablation was delivered to inferior turbinates at 100 kHz with a voltage root mean square value of 168 to 182. The preoperative and postoperative nasal functions were investigated by immediate and long‐term visual analogue scale (VAS) scores of symptom parameters, olfactory thresholds, saccharine transit time, rhinomanometry, and acoustic rhinometry. The follow‐up was conducted at 1 week and 3, 6, and 12 months.Results The VAS scores of subjective complaints (nasal discharge, itching, sneezing, crusting) decreased, and the VAS scores of evaluation of the effectiveness (frequency of nasal obstruction, degree of nasal obstruction, and patient satisfaction) increased statistically significantly in the 12‐month follow‐up without relapses. There were no adverse effects on nasal epithelial clearance time and olfactory functions. In rhinomanometry the changes in total nasal resistance and response to the vasoconstrictor agent were not statistically significant. In acoustic rhinometry the change in the sum of both nasal cavity volumes from nostril to 5 cm was statistically significant 6 and 12 months after the treatments. The difference between the preoperative and postoperative vasoconstrictive effect was not statistically significant.Conclusion The bipolar radiofrequency thermal ablation of inferior turbinates is a promising alternative, which should be considered when planning inferior turbinate interventions.
Nasal Nitric Oxide in Children: A Novel Measurement Technique and Normal Values
Authors: Daya Hamid , Qian Wei , McClean Pat , Haight James , Zamel Noel , Papsin Blake C. , Forte Vito 
Published: November 2003

AbstractObjectives To develop and standardize a technique for measuring nasal nitric oxide (NO) output in children and to determine normal values in this population.Study Design Prospective study evaluating a new technique for measuring nasal nitric oxide in a cohort of normal patients and a cohort of patients with nasal disease.Methods Nasal NO was measured using an aspiration technique, aspirating room air through the nasal cavities by means of a Teflon nozzle placed in one nasal vestibule while maintaining velopharyngeal closure using a party “blow‐out” toyResults Nasal NO measurements were performed in 45 children (mean age, 11.0 y; age range, 3.2–17.6 y) There were 20 girls and 25 boys. All children were able to perform the maneuvers necessary for measurement of nasal NO output. Among the subgroup of normal healthy children (30), there was considerable variation in NO output between subjects, with a mean NO output of 481 nL/min and an SD of 283 nL/min.Conclusions Nasal NO can be readily measured in children using the presented technique. There is considerable variability in the values for nasal NO output in normal children.