bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endoscopic Approach to Orbital Blowout Fracture Repair
Authors: Strong E. Bradley , Kim Kenneth K. , Diaz Rodney C. 
Published: October 2004

OBJECTIVESTransconjunctival and subciliary approaches to orbital floor blowout fractures (OBF) have known risks of postoperative eyelid malposition. This study evaluates the endoscopic transmaxillary repair of OBFs in a cadaveric model and clinical setting.METHODSSixteen cadaveric and 10 clinical OBFs were repaired endoscopically. A Caldwell‐Luc approach and modified sinus surgery instrumentation were used to repair each fracture. Variations in fracture pattern, instrumentation, and surgical technique were evaluated.RESULTSEndoscopic repair was achieved in all 16 cadaveric orbits and in 9 of 10 patients. Fracture patterns were classified as either medial or lateral to the infraorbital nerve. Average clinical operating time was 1:38. Of 9 postoperative CT scans, 5 were rated as excellent, 3 as good, and 1 as poor.CONCLUSIONSThe endoscopic transmaxillary approach is a safe, viable technique for OBF repair. It offers improved visualization, anatomic fracture repair, no risk of postoperative eyelid complications, and good clinical results. EBM rating: C.
Contemporary Staging and Prognosis for Primary Tracheal Malignancies: A Population‐Based Analysis
Authors: Bhattacharyya Neil 
Published: October 2004

OBJECTIVEDetermine staging characteristics and survival outcomes for primary malignancies of the trachea.DESIGNCross‐sectional analysis of national cancer database.METHODSCases of primary tracheal malignancy were extracted from the Surveillance, Epidemiology, and End Results database for the time period 1988‐2000. T‐stage, N‐stage, and overall stage of presentation were determined. Mean, median, and 5‐year survival statistics were computed using Kaplan‐Meier survival analysis for each tumor histology and for the overall cohort according to stage.RESULTSNinety‐two cases with adequate histologic information were identified. Mean age at presentation was 59.3 years with an equal sex distribution. Squamous cell carcinoma was the most common tumor type (41 cases) followed by adenoid cystic carcinoma (19 cases). Forty‐nine cases (53%) presented with stage 3 or stage 4 disease. Squamous cell carcinoma exhibited poorer survival (mean survival, 44.0 month, 5‐year survival, 34%) than adenoid cystic carcinoma (mean survival, 115 month, 5‐year survival, 78%). Five‐year unadjusted survival rates according to overall stage were 52.8%, 70.0%, 75.0%, 15.1%, respectively.CONCLUSIONSPrimary tracheal malignancies often present with advanced stage. Patients with squamous cell carcinoma of the trachea have poorer prognoses when compared with adenoid cystic carcinoma and other tumor types. Staging tracheal cancer with a TNM‐based system helps predict survival. EBM rating: C.
A New Immune‐Competent Animal Model of Mucosally Derived Squamous Cell Carcinoma
Authors: Djalilian Hamid R. , Lessan Khashayar , Grami Vahid , Pambuccian E. , Spellman Stephen R. , Low Walter C. , Hall Walter A. , Ondrey Frank G. 
Published: October 2004

OBJECTIVESTo develop an immune‐competent animal model for mucosally derived squamous cell carcinoma (SCCA).STUDY DESIGNFifteen Fischer 344 rats were inoculated with 1, 2, 5, 10, or 20 × 106 FAT7 cells in their flanks. The animals were observed for tumor growth and metastasis.RESULTSAll animals developed tumors that grew exponentially. Pulmonary metastases developed in all animals and 13% developed lymph node metastases.CONCLUSIONThe FAT7 flank tumor in Fischer 344 rats is a new animal model that closely resembles the behavior of human mucosal head and neck cancer.SIGNIFICANCEThe existence of an immune‐competent, mucosally derived, and reliable animal model of SCCA that somewhat resembles human head and neck SCCA gives the opportunity to perform immune‐modulating experiments on head and neck cancer in these animals. EBM rating: B‐3.
Intracranial Blood Flow Velocities and Co2 Reactivity in Diagnosing Migraine‐Related Dizziness
Authors: Le Thong T. , Burch Christina M. , Sargent Eric W. 
Published: October 2004

OBJECTIVEMigraine‐related dizziness can present with or without headache, often making diagnosis difficult. Flow velocity and CO2 reactivity testing using transcranial Doppler (TCD) measurement of intracranial blood flow has been described as abnormal in patients with classic or common migraine. This study sought to determine the utility, if any, of this noninvasive technique in the diagnosis of migraine‐related dizziness.STUDY DESIGN AND SETTINGA prospective, controlled study in academic neurotology and neurology practices was conducted. Nine patients with migraine‐related dizziness and 10 patients with no history of migraine or dizziness were tested with transcranial Doppler ultrasound in a blinded fashion.RESULTSNo statistically significant differences in intracranial blood flow velocities or in cerebrovascular reactivity to hypocapnia were found between patients and controls.CONCLUSIONSAssessment of intracranial blood flow velocity and CO2 reactivity using TCD does not help in the diagnosis of migraine‐related dizziness.SIGNIFICANCEA reliable objective test for the diagnosis of migraine‐related dizziness remains elusive, and the diagnosis of this patient group continues to be suboptimal.
Modulation of Th1 and Th2 Cytokine Profiles and Their Association with Advanced Head and Neck Squamous Cell Carcinoma
Authors: Sparano Anthony , Lathers Deanne M. R. , Achille Nicholas , Petruzzelli Guy J. , Young M. Rita I. 
Published: October 2004

OBJECTIVEPlasma cytokine concentrations from patients with head and neck squamous cell carcinoma (HNSCC) were measured to determine whether the potential modulation of host Th1 vs Th2 immune responses are associated with advanced clinical disease.STUDY DESIGN AND SETTINGThe concentrations of IL‐4, IL‐6, IL‐10, and IL‐12 were measured in the plasma of 58 patients with histologically proven HNSCC. These data were examined with respect to the histologic size (T‐stage) of the primary tumor, and presence of nodal metastasis.RESULTSThe concentrations of IL‐12 were greater from patients without nodal metastasis, and with T1/T2‐stage tumors. IL‐10 levels were greater from patients with nodal metastasis, and with T3/T4‐stage tumors. The concentrations of IL‐6 were greater from patients with T3/T4‐stage tumors.CONCLUSIONSUsing parameters of primary tumor size and presence of nodal metastasis, patients with advanced HNSCC have significantly less plasma IL‐12 levels, and greater plasma IL‐10 and IL‐6 levels.SIGNIFICANCEPatients with advanced HNSCC have a potentially diminished Th1 immune response, and a stronger potential Th2 immune response when compared to that of patients with less advanced disease. EBM rating: D‐5.
The Effects of Superoxide Dismutase in Gerbils with Bacterial Meningitis
Authors: Ge Norman N. , Brodie Shauna A. , Tinling Steven P. , Brodie Hilary A. 
Published: October 2004

BACKGROUNDInflammatory products, such as oxygen radicals generated during the course of bacterial meningitis, can damage nerve endings, hair cells, and/or supporting cells in the cochlea. Superoxide dismutase (SOD), an O2‐scavenger, has been shown to play an important role in the protection against radical toxicity in various animal experiments.OBJECTIVETo study the antioxidant effects of SOD on the inflammatory response of gerbils with bacterial meningitis.STUDY DESIGNMeningitis was induced in three groups of 10 gerbils by intrathecal (IT) injection of Streptococcus pneumoniae into the cisterna magna. Group 1 received IT SOD, group 2 received intramuscular (IM) SOD, and group 3, the control group, received IM normal saline. Histologic data and auditory brainstem responses (ABR) were obtained from each gerbil.RESULTSFibrosis and/or neo‐ossification were near absent in the IT SOD group and significantly less fibrosis occurred in the IM group (IT vs. IM: P = 0.010; IT vs. control group: P = 0.001). The amount of surviving spiral ganglion cells correlated inversely with the extent of fibrosis (r = −0.753, P < 0.00001).CONCLUSIONSIT injection of SOD significantly reduced cochlear fibrosis and neo‐ossification, reduced the spiral ganglion cell loss, and decreased damage of the cochlear components following bacterial meningitis.
Allergic Fungal Sinusitis: Can We Predict the Recurrence?
Authors: Sohail Masroor Alam , Al Khabori Mazin Jawad , Hyder Jamil , Verma Ashok 
Published: October 2004

OBJECTIVEThe goal of the present study was to find out if recurrence can be predicted in cases of allergic fungal sinusitis. We also studied the influence of postoperative corticosteroid therapy on recurrence following surgery.STUDY DESIGN AND SETTINGThis study was conducted at the ENT Department of Al Nahdha Hospital, which is a tertiary referral and teaching hospital in Muscat, Sultanate of Oman. The study is a retrospective analysis of 32 cases of allergic fungal sinusitis. Age, sex, extent of disease, and preoperative serum IgE levels were compared in patients who had recurrence with those who did not. We also studied the incidence, onset, and severity of recurrence in patients who received systemic corticosteroid as postoperative therapy and compared these values to those who received nasal corticosteroid spray only.RESULTSNo statistically significant difference was noted in the parameters of age, sex, extent of disease, and preoperative serum IgE levels when these values were compared in the group of patients who had recurrence (8 patients) with the group of patients who did not (32 patients). No statistically significant difference was found in the incidence of recurrence in patients in whom systemic corticosteroids were used postoperatively (17 patients) compared with patients who used nasal corticosteroid spray only (15 patients). However, when the patient had a recurrence, when it occurred it was earlier and more severe in patients who used nasal corticosteroid spray only (4 patients).CONCLUSIONSAt the present time, it is not possible to predict recurrence using parameters of age, sex, extent of disease, and serum IgE levels. Larger number of patients preferably in a prospective multicenter meta study are required to address this issue. Though use of systemic corticosteroid does not decrease the incidence of recurrence, it may delay the onset of recurrence and decrease the severity of recurrence.
Electrocautery versus Cold Knife Technique Adenotonsillectomy: A Cost Analysis
Authors: O‐lee T. J. , Rowe Mark 
Published: October 2004

OBJECTIVEMuch has been written about the merits of various techniques of adenotonsillectomy. Proponents of each technique tout many virtues over one another. However, cost remains one variable that has not been thoroughly addressed. In this study, we compared the surgery time, anesthesia time, bleeding, and cost between 2 well‐established techniques. Electrocautery tonsillectomy/adenoid ablation was compared against traditional cold knife dissection with adenoid curette.STUDY DESIGN AND SETTINGA retrospective chart review of 275 patients in a large tertiary teaching hospital.RESULTSThe electrocautery group had overall savings of 8, 8, and 9 minutes in surgery, anesthesia, and operating room times, respectively. In terms of cost, the variable cost of the electrocautery group was 19% less than the cold knife dissection group.CONCLUSION/SIGNIFICANCEThis study demonstrated that cautery ablation of adenoids, when employed as part of adenotonsillectomy, enables the surgical team to save significant amount of time, and substantial cost for patients. EBM rating: B‐3.
CO2 Laser Stapedotomy with the “One‐Shot” Technique— Clinical Results
Authors: Jovanovic S. , Schönfeld U. , Scherer H. 
Published: October 2004

OBJECTIVETo further optimize the surgical technique with the CO2 laser in stapes surgery a scanner system was used to obtain a footplate perforation of 0.5 to 0.6 mm with only 1 laser application (“one‐shot” stapedotomy).STUDY DESIGN188 patients with otosclerosis were submitted to a primary CO2 laser stapedotomy with the SurgiTouch® scanner. This study surveys the surgical technique and clinical results.RESULTSAn adequately large perforation diameter could be achieved with a single shot in 68% of the patients treated with the SurgiTouch® scanner. In 11% of the patients, a second laser application at the same site was necessary. In 21% of the patients, the perforation had to be enlarged by several slightly overlapping laser applications without scanner. The clinical data of this study clearly documents that there is no evidence of laser depending inner ear affections.CONCLUSIONThe CO2 laser combined with modern scanner systems is well suited for application in stapes surgery.
Radiation‐Induced Malignancy of the Head and Neck
Authors: Sale Keith A. , Wallace Derrick I. , Girod Douglas A. , Tsue Terance T. 
Published: October 2004

OBJECTIVEOur goal was to evaluate our experience with radiation‐induced malignancy (RIM), compare that experience to the literature, and review treatment modalities.STUDY DESIGN AND SETTINGThe setting is the University of Kansas Medical Center. A retrospective review was performed to identify patients with RIM. Patients were included if they met the criteria for RIM as delineated in the literature.RESULTSThirteen patients met the criteria for RIM. The mean latency period was 22 years. Sarcomas were the most common type of RIM and the paranasal sinuses were the most common location. Surgical resection was our treatment of choice.CONCLUSIONSOur patient series differs from previous reports in that sarcomas were the predominating RIM and the paranasal sinuses were the most common location. We noted a shorter latency period than has been previously published. Surgical excision is the treatment of choice. EBM rating: C.
The Fluorescence of Thyroid Tissue
Authors: Pitman Michael Jay , Rosenthal Joshua Michael , Savage Howard E. , Yu Goupei , McCormick Steven A. , Katz Alvin , Alfano Robert R. , Schantz Stimson Pryor 
Published: October 2004

OBJECTIVETo investigate the fluorescent characteristics of different thyroid tissues.STUDY DESIGNFresh ex vivo thyroid tissue was surfaced scanned with a fluorescence spectrophotometer. Resultant spectra were evaluated via interpeak ratios.RESULTSInterpeak ratios of all histologies were found to be significantly different from each other (P < 0.001). The diagnostic sensitivity and specificity of fluorescent spectroscopy was 86% and 91% for thyroid nodule capsule, 78% and 59% for papillary thyroid carcinoma, and 82% and 63% for normal thyroid, respectively.CONCLUSIONFluorescent spectroscopy can been used to identify significant differences in the fluorescent characteristics of various thyroid histologies.SIGNIFICANCEThis study is the first investigation of the fluorescence of thyroid tissue. The diagnostic ability of fluorescent spectrometry may allow it to be used as a localization aid for fine needle aspiration, using optical fiber probes. Further investigations may enhance the sensitivity and specificity of fluorescent spectrometry allowing it to replace or compliment fine needle aspiration. EBM rating: B‐3.
Alterations in Eotaxin, Monocyte Chemoattractant Protein‐4, Interleukin‐5, and Interleukin‐13 After Systemic Steroid Treatment for Nasal Polyps
Authors: Woodworth Bradford A. , Joseph Kusumam , Kaplan Allen P. , Schlosser Rodney J. 
Published: October 2004

OBJECTIVETo determine alterations in Th2 chemokines eotaxin and monocyte chemoattractant protein‐4 (MCP‐4), and cytokines interleukin‐5 (IL‐5) and interleukin‐13 (IL‐13), in nasal polyps (NP) after steroid treatment.STUDY DESIGNCytokine/chemokine levels were measured in NP before and after steroid therapy and compared to control sinus mucosa.RESULTSTwenty‐one patients (control = 7, NP = 14) were enrolled. Eotaxin and MCP‐4 were significantly higher than control tissue (P = 0.004 and 0.003). All four mediators decreased after steroid treatment (P < 0.03). IL‐5 and IL‐13 in untreated polyps were not significantly different from controls. Patients showed clinical improvement according to SNOT‐20 scores (average presteroid score 19, post‐steroid score 13) and endoscopic grading (1.75 each side presteroid, 1.13 poststeroid).CONCLUSIONSSteroids significantly decreased all cytokine/chemokine levels, but the impact on Th2 chemokines was of a much greater magnitude.SIGNIFICANCENovel approaches to block inflammatory mediators, particularly Th2 chemokines, may lead to better control of nasal polyposis in the future.
Continuous Laryngeal Nerve Integrity Monitoring During Thyroidectomy: Does it Reduce Risk of Injury?
Authors: Robertson Matt L. , Steward David L. , Gluckman Jack L. , Welge Jeff 
Published: October 2004

OBJECTIVETo determine if continuous laryngeal nerve integrity monitoring (NIM) during thyroidectomy is associated with a decreased risk of postoperative recurrent laryngeal nerve (RLN) injury.STUDY DESIGN AND SETTINGRetrospective cohort study of 165 patients who underwent thyroidectomy at a resident teaching institution between 1999 and 2002. The control group had 120 nerves at risk (NAR) whereas the NIM group consisted of 116 NAR. Primary outcome measures included postoperative RLN paralysis, paresis, and total injury rates.RESULTSRLN paralysis occurred in 2.54% NAR in the control group and 0.86% in the NIM group (relative risk (RR) = 0.34, 95% confidence interval (CI95) = 0.04‐3.27, P = 0.62). Temporary RLN paresis occurred in 4.24% NAR in the control group and 3.45% in the NIM group (RR = 0.9, CI95 = 0.23‐3.55, P = 0.89). Total RLN injury occurred in 6.78% NAR in the control group and 4.31% in the NIM group (RR = 0.66, CI95 = 0.21‐2.09, P = 0.48). When compared to all other NAR, advanced T‐stage malignancy was associated with a significantly increased risk of RLN paresis (T4 RR = 9.0, CI95 = 2.56‐31.67, P = 0.0006; T3+T4 RR = 7.5, CI95 = 2.17‐25.86, P = 0.0001) but not paralysis. NIM did not significantly reduce the risk of RLN paresis in the advanced T‐stage subset (T3+T4 RR = 0.36, CI95 = 0.04‐3.0, P = 0.59).CONCLUSIONThere were no statistically significant differences in RLN paralysis, paresis, or total injury rates between control and NIM groups, even in subsets with advanced T‐stage and increased baseline risk. Advanced T‐stage is a significant predictor of RLN paresis in this cohort.
Primary Hyperparathyroidism in Young Adults
Authors: Joshua Benzion , Feinmesser Raphael , Ulanovski David , Gilat Hanna , Sulkes Jaqueline , Eshed Varda , Shpitzer Thomas 
Published: October 2004

OBJECTIVEThe purpose of this study was to compare the incidence of multiglandular disease and rate of treatment failure between younger and older patients with primary hyperparathyroidism.STUDY DESIGN AND SETTINGThe medical charts of patients who underwent surgery for primary hyperparathyroidism at our tertiary‐care institution between 1995 and 2001 were reviewed.RESULTSThree hundred nineteen patients were identified, of whom 33 were aged 40 years or less. There were no statistically significant differences between the younger and older groups in the incidence of multiglandular disease (9.1% for both, P = 1.00) or in the treatment failure rate (12.1% and 8%, respectively, P = 0.43). Sonography was significantly more sensitive than technetium Tc‐sestamibi in the younger group (96% vs 57%, P < 0.05). Parathyroid hormone level and gland weight were significantly higher in the older group (P = 0.004).CONCLUSIONOur results suggest that the same treatment strategy should be applied to all patients with primary hyperparathyroidism. Ultrasound appears to be the localization procedure of choice in younger patients.
Semiparametric method for estimating paleodemographic profiles from age indicator data
Authors: Müller Hans‐Georg , Love Brad , Hoppa Robert D. 
Published: October 2004

AbstractThis paper addresses the problem of estimating an age‐at‐death distribution or paleodemographic profile from osteological data. It is demonstrated that the classical two‐stage procedure whereby one first constructs estimates of age‐at‐death of individual skeletons and then uses these age estimates to obtain a paleodemographic profile is not a correct approach. This is a consequence of Bayes' theorem. Instead, we demonstrate a valid approach that proceeds from the opposite starting point: given skeletal age‐at‐death, one first estimates the probability of assigning the skeleton into a specific osteological age‐indicator stage. We show that this leads to a statistically valid method for obtaining a paleodemographic profile, and moreover, that valid individual age estimation itself requires a demographic profile and therefore is done subsequent to its construction. Individual age estimation thus becomes the last rather than the first step in the estimation procedure.A central concept of our statistical approach is that of a weight function. A weight function is associated with each osteological age‐indicator stage or category, and provides the probability that a specific age indicator stage is observed, given age‐at‐death of the individual. We recommend that weight functions be estimated nonparametrically from a reference data set. In their entirety, the weight functions characterize the relevant stochastic properties of a chosen age indicator. For actual estimation of the paleodemographic profile, a parametric age distribution in the target sample is assumed. The maximum likelihood method is used to identify the unknown parameters of this distribution. As some components are estimated nonparametrically, one then has a semiparametric model. We show how to obtain valid estimates of individual age‐at‐death, confidence regions, and goodness‐of‐fit tests. The methods are illustrated with both real and simulated data. Am J Phys Anthropol 117:1–14, 2002. © 2002 Wiley‐Liss, Inc.
Finger length and distal finger extent patterns in humans
Authors: Peters Michael , Mackenzie Kevin , Bryden Pam 
Published: October 2004

AbstractThe fingers in the adult human hand differ in length and in distal extent. The literature agrees that in the clear majority of males, the distal extent of the ring finger tends to be relatively greater (using the middle finger as standard) than the index finger. However, the results for females vary considerably, with some studies reporting that females show a similar pattern to that of males, while others suggest that the prevalence of a longer index finger is relatively or absolutely more common in females. We provide a review of the literature, and a set of data for both finger length and distal fingertip extent of the finger for a contemporary cohort of young adult females and males (n = 502). Finger length measures favor the ring finger of both sexes, with smaller between‐finger differences for females than for males. However, while the distal fingertip extent favors the ring finger of both hands in males, in females the left hand shows no significant differences, and the right hand shows a small index finger advantage. Thus, the sexual dimorphism in finger measures is more strongly expressed in the distal extent of fingertips than in the length of fingers. The sex differences in distal fingertip extent derive from the index finger only, with a lesser distal extent of the index finger, relative to the middle finger, in males than in females. Am J Phys Anthropol 117:209–217, 2002. © 2002 Wiley‐Liss, Inc.
Mechanical and thermal properties of poly(ethylene terephthalate) fibers crosslinked with disulfonyl azides
Authors: Baker D. A. , East G. C. , Mukhopadhyay S. K. 
Published: October 2004

AbstractA novel method for the crosslinking of poly(ethylene terephthalate) fibers is described using 1,6‐hexanedisulfonyl azide, 1,3‐benzenedisulfonyl azide, and 2,6‐naphthalenedisulfonyl azide. The azides are diffused into poly(ethylene terephthalate) fibers (Dacron) from perchloroethylene solution, and the fibers are heat treated to bring about decomposition of the sulfonyl azide and give rise to crosslinking. A study is made of the mechanical and thermal properties of the resultant fibers, which are changed considerably in comparison to the untreated fiber. © 2002 Wiley Periodicals, Inc. J Appl Polym Sci 83: 1517–1527, 2002