bluuebunny/crossref_metadata_2025_split huggingface dataset:
Inner Ear Extension of Vestibular Schwannomas
Authors: Falcioni Maurizio , Taibah Abdelkader , Trapani Di Giuseppe , Khrais Tarek , Sanna Mario 
Published: November 2003

AbstractObjective Inner ear extension of vestibular schwannomas (VSs) is a rare finding but has important clinical implications. This report reviews the treatment options and presents the experience of the Gruppo Otologico, Piacenza, Italy, in this field.Study Design Case report and literature review.Methods Five cases of VSs with inner ear extension were surgically removed. In all of them, the cochlea was partially or completely invaded by the lesion.Results In 4 cases, the inner ear extension was preoperatively identified on magnetic resonance imaging, and the surgical removal was planned through a transotic approach. In the last case, the cochlear invasion was not detected preoperatively, and the lesion was removed during a second surgery performed to seal a cerebrospinal fluid fistula.Conclusions VSs with inner ear extension should be distinguished from pure intralabyrinthine schwannomas because of differences in clinical significance. Cochlear involvement is more frequent than vestibular involvement and is often accompanied by a dead ear. Dead ear caused by small VSs should alert the surgeon to the possibility of a cochlear extension. The presence of an intracochlear involvement requires the adoption of an approach that allows control of the cochlear turns, and we found the transotic approach to be the most suitable. Undetected cochlear extensions that are left in place may grow with time.
Familial Auditory Neuropathy
Authors: Wang Qiuju , Gu Rui , Han Dongyi , Yang Weiyan 
Published: November 2003

AbstractObjectives/Hypothesis Auditory neuropathy is a sensorineural hearing disorder characterized by absent or abnormal auditory brainstem responses and normal cochlear outer hair cell function as measured by otoacoustic emission recordings. Many risk factors are thought to be involved in its etiology and pathophysiology. Four Chinese pedigrees with familial auditory neuropathy were presented to demonstrate involvement of genetic factors in the etiology of auditory neuropathy.Study Design Probands of the above‐mentioned pedigrees, who had been diagnosed with auditory neuropathy, were evaluated and followed in the Department of Otolaryngology‐Head and Neck Surgery, China People Liberation Army General Hospital (Beijing, China). Their family members were studied, and the pedigree maps established.Methods History of illness, physical examination, pure‐tone audiometry, acoustic reflex, auditory brainstem responses, and transient evoked and distortion‐product otoacoustic emissions were obtained from members of these families. Some subjects received vestibular caloric testing, computed tomography scan of the temporal bone, and electrocardiography to exclude other possible neuropathic disorders.Results In most affected patients, hearing loss of various degrees and speech discrimination difficulties started at 10 to 16 years of age. Their audiological evaluation showed absence of acoustic reflex and auditory brainstem responses. As expected in auditory neuropathy, these patients exhibited near‐normal cochlear outer hair cell function as shown in distortion product otoacoustic emission recordings. Pure‐tone audiometry revealed hearing loss ranging from mild to profound in these patients. Different inheritance patterns were observed in the four families. In Pedigree I, 7 male patients were identified among 43 family members, exhibiting an X‐linked recessive pattern. Affected brothers were found in Pedigrees II and III, whereas in pedigree IV, two sisters were affected. All the patients were otherwise normal without evidence of peripheral neuropathy at the time of writing.Conclusion Patients with characteristics of nonsyndromic hereditary auditory neuropathy were identified in one large and three smaller Chinese families. Pedigree analysis suggested an X‐linked, recessive hereditary pattern in one pedigree and autosomal recessive inheritances in the other three pedigrees. The phenotypes in the study were typical of auditory neuropathy; they were transmitted in different inheritance patterns, indicating clinical and genetic heterogeneity of this disorder. The observed inheritance and clinical audiological findings are different from those previously described for nonsyndromic low‐frequency sensorineural hearing loss. This information should facilitate future molecular linkage analyses and positional cloning for the relative genes contributing to auditory neuropathy.
Objective vestibular tests as outcome measures in head injury patients
Authors: Gottshall Kim , Drake Angela , Gray Nicola , McDonald Eric , Hoffer Michael E. 
Published: November 2003

AbstractHypothesis: Dynamic visual acuity testing (DVAT) and the Dizziness Handicap Index (DHI) can be used as reliable outcome measures in patients after head injury. Background: Balance disorders are a significant disability after mild traumatic brain injury (TBI). Assessing when individuals can perform activities of daily living, return to work, and begin to play sports can be difficult to determine. Objective outcome measures that correlate with successful life skills can be useful in managing these patients. Methods: Fifty‐three active duty individuals who suffered mild TBI underwent weekly DVAT testing and were administered a weekly DHI. Results in this group were compared with 46 control subjects who had not experienced TBI. In addition, weekly scores were compared with the patient's functional level, time to return to work, and time to perform all job related activities. Results: Individuals with TBI showed an overall increase of 42% in DVAT function over the first 4 weeks of testing, whereas controls showed an 8% increase. Concurrently, individuals with TBI averaged a 18‐point improvement in DHI function, whereas control subjects showed no significant change in this score. Improvement in DVAT and DHI function correlated closely at the 1‐week time point. Improvement in the patient's cognitive function, ability to return to activities of daily living, and ability to return to work gradually improved continuously. Conclusion: DVAT and the DHI can be used as reliable outcome measures in evaluating the progress of patients with balance disorders associated with TBI. These measures allow providers to make more reliable recommendations regarding such activities as returning to work.
Multilevel temperature‐controlled radiofrequency therapy of soft palate, base of tongue, and tonsils in adults with obstructive sleep apnea
Authors: Fischer Yvonne , Khan Martin , Mann Wolf J. 
Published: November 2003

AbstractObjectives/Hypothesis: The concept of two‐level pharyngeal collapse in patients with obstructive sleep apnea is too simplified. Aggressive multilevel surgeries addressing several airway segments, including skeletal surgery, demonstrate improved success rates. Study Design: The study aimed to evaluate the safety and efficacy of multilevel radiofrequency application to soft palate, tonsils, and base of tongue in 16 white patients (mean age, 56.9 ± 11.1 y; mean body mass index, 27.3 ± 2.6 kg/m2) with obstructive sleep apnea. There was one dropout. Therapeutic effects after one treatment session were assessed 20.6 ± 12.6 weeks postoperatively. Treatment outcome measurements were based on Epworth Sleepiness Scale, Likert scales, and polysomnography. Methods: Every patient received 16 treatment sites with a total dose of 9750 J radiofrequency energy into soft palate, base of tongue, and tonsils. Success was defined as respiratory disturbance index equal to or less than 20 or at least 50% improvement if baseline respiratory disturbance index was less than 20. Statistical analysis was determined with the Spearman rank test. Results: Mean score on Epworth Sleepiness Scale decreased from 11.1 to 8.2 (P = .0001). Of the patients, 53.3% reported improvement of their daytime sleepiness. Snoring was assessed with 10‐point Lickert scale, and score decreased from 7.5 to 4.9 (P = .08). Mean respiratory disturbance index decreased from 32.6 δ 17.4 to 22.0 δ 15.0 (P = .003). By our definition of success, 5 of 15 patients (33%) have been treated successfully surgically and 4 of 15 (27%) had remarkable improvement after one treatment session; 1 patient (6.6%) demonstrated deterioration. There were two adverse effects, one superficial ulceration of the soft palate and one unilateral tonsillar abscess formation, with an overall complication rate of 13.3% for our patients and 0.41% for all treatment sites (n = 240). Conclusion: Moderate to severe obstructive sleep apnea usually requires multilevel pharyngeal surgery. Radiofrequency offers the potential of altering the upper airway on different sites.
Hemicricoidectomy as the primary diagnosis and treatment for cricoid chondrosarcomas
Authors: Cohen Jacob T. , Postma Gregory N. , Gupta Sumeer , Koufman James A. 
Published: November 2003

AbstractObjectives/Hypothesis: The objective was to present a new approach for the diagnosis and treatment of chondrosarcoma involving the cricoid cartilage. The technique involved an extramucosal resection of the ipsilateral half of the involved cricoid cartilage, providing enough tissue to be sent for pathological study, and resulted in good laryngeal function without jeopardizing patients' long‐term survival. Study Design: Retrospective study. Methods: A retrospective study of eight patients who underwent hemicricoidectomy for cricoid chondrosarcoma was performed at the Center for Voice Disorders, Wake Forest University (Winston‐Salem, NC). One patient was a woman and seven were men. The mean age at diagnosis was 64 years (age range, 53‐72 y). Results: All patients had a low‐grade tumor. Primary treatment included hemicricoidectomy in all cases. In six (75%) of the patients, tracheotomy was required at the initial surgery. The mean time for decannulation was 3.2 months (range, 5 d‐1 y). In four cases a second procedure was required because of recurrence. The second procedure included two total laryngectomies and two endoscopic carbon dioxide laser excisions. The mean follow‐up time was 3 years (range, 2 mo‐10 y). At the time of writing, six patients were alive without recurrence, one patient was alive with disease; and one patient had died of unrelated causes. Conclusion: The authors recommended unilateral hemicricoidectomy as the diagnosis and treatment of choice. This procedure allows sufficient tissue for histological study and provides good long‐term breathing and phonatory function without compromising long‐term survival. This procedure is appropriate for patients with 1) mobility of one vocal fold, 2) dysphonia or aphonia, and 3) an adequate subglottic airway.
Covalent linking of proteins and cytokines to suture: Enhancing the immune response of head and neck cancer patients
Authors: Shibuya Terry Y. , Kim Sanghun , Nguyen Kevin , Parikh Parag , Wadhwa Ashish , Brockardt Chad , Do Johnny 
Published: November 2003

AbstractBackground: The immune system of advanced stage head and neck cancer patients is frequently suppressed. Poor immune function has been correlated with poor clinical outcome. Immunotherapeutic strategies have been previously attempted in an effort to enhance immune function and improve survival. Previous studies have shown surgical suture can be transformed into an immune stimulant capable of activating the T lymphocytes of cancer patients. The development of a process for covalently linking proteins and cytokines to suture could have enormous potential for the in vivo manipulation of the immune system. Hypothesis: We hypothesize proteins and cytokines can be covalently linked to surgical suture while preserving their functional properties. Study Design: Prospective study testing normal donor and head and neck squamous cell carcinoma (HNSCC) patient lymphocytes. Method: Polyester suture was acid hydrolyzed followed by reacting with 1‐ethyl‐3(‐3‐dimethylamino propyl carbodiimide) (EDAC) to create a suture‐EDAC intermediate. Next, selected proteins (horseradish peroxidase [HRP] or bovine serum albumin [BSA]) or cytokines (interleukin [IL]‐2 or interferon [IFN]‐γ) were reacted with the suture‐EDAC intermediate to test the covalent linkage of the selected protein or cytokine to suture. Functional activity of the linked proteins was measured spectrophotometrically. The linking of cytokines to suture was tested by stimulating normal donor peripheral blood lymphocytes (PBL) or HNSCC patients' lymphocytes. The functional activity was confirmed by proliferation, enzyme linked immuno‐adsorbent assay (ELISA), and phenotype expression of T cells. Results: The conditions for optimally linking a protein to polyester suture were defined using HRP as a model protein. HRP retained its enzymatic activity. The optimal conditions for linking IL‐2 or IFN‐γ were defined. The covalently linked cytokines retained their immune enhancing properties for stimulating PBL and lymph node lymphocytes (LNL) from HNSCC patients to proliferate, generate a TH1 immunologic profile of cytokines (IL‐2, IL‐12, IFN‐γ), and stimulate T lymphocytes. Conclusion: This is the first report to demonstrate that cytokines can be covalently linked to surgical sutures and retain their immune‐stimulating properties. Proteins linked to suture also retained their enzymatic activity. The clinical implications of functionally active cytokines or proteins linked to surgical suture may be very significant in the future for manipulating the immune system in vivo or enhancing wound healing.
The H+/K+‐ATPase (proton) pump is expressed in human laryngeal submucosal glands
Authors: Altaian Kenneth W. , Kenneth Haines G. , Hammer Neal D. , Radosevich James A. 
Published: November 2003

AbstractObjectives/Hypothesis: Diagnosis and treatment of gastroesophageal and laryngopharyngeal reflux disease has significantly increased over recent years. The larynx is highly sensitive to the effects of LPRD and is similarly responsive to proton pump inhibitor pharmacotherapy. The hypothesis of the study was that proton pump activity exists in the human larynx and plays a functional role in normal and/or pathological laryngeal tissue. Study Design: Pathological investigation. Methods: Two fresh human cadaveric larynges (one male and one female larynx) were obtained as part of an exempt protocol from the Human Subjects Committee and were formalin fixed and paraffin embedded. Banked human stomach tissue was also obtained for use as comparative positive and negative control specimens. Sections were immunostained with monoclonal antibodies reactive with both alpha and beta subunits of the H+/K+‐ATPase (proton) pump. Specimens were reviewed for staining pattern and intensity. Results: Stomach parietal cells (known to produce gastric acid) exhibited strongly positive staining for both the alpha and beta subunits of the proton pump. There was no staining in stomach cells that were not morphologically consistent with the parietal cell. In the human larynx there were strong focal and identical staining patterns in the serous cells and ducts of the minor seromucinous glands by both alpha and beta monoclonals to the proton pump. There was variable staining in the laryngeal epithelium that was thought to be consistent with artifact staining resulting from tissue processing. Conclusion: The H+/K+‐ATPase (proton) pump is present in serous cells and ducts of submucosal glands in the human larynx. Proton pump inhibitor pharmacotherapy may have a site of action in seromucinous glands of the human larynx, with possible relevance for patients treated for chronic laryngitis with or without laryngopharyngeal reflux disease.
fMLP causes degranulation followed by regranulation in rat nasal glands
Authors: Kim Seon‐Tae , Nakanaga Takashi , Ueki Iris , Nadel Jay A. 
Published: November 2003

AbstractObjective: To determine the mechanism of mucus production by nasal glands. Study Design: Because neutrophilic inflammation is associated with mucus hypersecretion in disease states, here we examine the role of neutrophil recruitment in mucous cell degranulation and regranulation in rat nasal glands. Methods: N:‐formyl‐methionyl‐leucyl‐phenylalanine (fMLP) was aerosolized intranasally in rats (n = 5), and its effects on degranulation and regranulation of submucosal glands were evaluated by Alcian blue/periodic acid‐Schiff (AB/PAS) staining and by immunolocalization of neutrophils and epidermal growth factor receptor (EGF‐R). Results: In control subjects, glands were filled with mucin. After fMLP inhalation, degranulation, 31.7 ± 0.8% (P < .01), was maximal at 2 to 4 hours. By 24 to 48 hours after fMLP inhalation, degranulation had decreased to 10.3 ± 0.6% (P < .05), indicating that regranulation of mucous glycoconjugates was occurring. After fMLP inhalation, neutrophils around submucosal glands increased within 0.5 hours from 1.4 ± 0.1 to 9.5 ± 0.3 per 0.0032 mm2 (P < .05). In control subjects, EGF‐R protein was expressed near acinar ducts, 16.4 ± 0.7% of gland area, and increased to 30.9 ± 0.9% (P < .05) 24 to 48 hours after fMLP inhalation. Nasal pretreatment with a selective EGF‐R tyrosine kinase inhibitor (BIBX1522, 15 mg/kg bid) prevented regranulation at 24 hours after fMLP inhalation (degranulation 27.8 ± 0.3%, P < .05, compared to 24 hours after fMLP alone), indicating that inhibition of EGF‐R activation had prevented regranulation after fMLP inhalation. Conclusions: Degranulation of rat nasal glands by fMLP is followed by regranulation; regranulation depends on a neutrophil‐associated EGF‐R cascade.
The effect of hydrogen peroxide applied to the middle ear on inner ear function
Authors: Perez Ronen , Freeman Sharon , Cohen David , Sichel Jean‐Yves , Sohmer Haim 
Published: November 2003

AbstractObjectives/Hypothesis: The objective was to assess the effect of hydrogen peroxide applied to the middle ear on cochlear and vestibular function. Study Design: Prospective animal study. Methods: Sand rats underwent a right‐side total labyrinthectomy, and a polyethylene tube was inserted into the left‐side middle ear. Following baseline recordings of vestibular evoked potentials in response to linear acceleration stimuli and auditory brainstem response, each experimental animal received five daily applications of hydrogen peroxide into the left‐side middle ear. Two control groups received saline and gentamicin, respectively. Subsequently, recordings were repeated and compared with baseline measurements. Results: Saline administration affected neither vestibular evoked potentials nor auditory brainstem response. In contrast, both responses could not be recorded following gentamicin application. After hydrogen peroxide administration, auditory brainstem response could not be recorded in 25% (3 of 12) of the animals, whereas in the remaining nine animals the average auditory brainstem response threshold was significantly elevated by 55 dB (P = .000002). Linear vestibular evoked potentials could not be recorded in 42% (5 of 12) of the animals. Conclusion: It appears that topical hydrogen peroxide adversely affects both cochlear and vestibular function of the sand rat. The study demonstrated the effect of a reactive oxygen species on inner ear function and may be useful in the study of mechanisms responsible for this damage and its protection. Clinically, although an animal model was used in the present study, caution should be exercised when large amounts of hydrogen peroxide are applied to a dry, perforated ear.
Water and urea interactions with the native and unfolded forms of a β‐barrel protein
Authors: Modig Kristofer , Kurian Elizabeth , Prendergast Franklyn G. , Halle Bertil 
Published: November 2003

AbstractA fundamental understanding of protein stability and the mechanism of denaturant action must ultimately rest on detailed knowledge about the structure, solvation, and energetics of the denatured state. Here, we use 17O and 2H magnetic relaxation dispersion (MRD) to study urea‐induced denaturation of intestinal fatty acid‐binding protein (I‐FABP). MRD is among the few methods that can provide molecular‐level information about protein solvation in native as well as denatured states, and it is used here to simultaneously monitor the interactions of urea and water with the unfolding protein. Whereas CD shows an apparently two‐state transition, MRD reveals a more complex process involving at least two intermediates. At least one water molecule binds persistently (with residence time >10 nsec) to the protein even in 7.5 M urea, where the large internal binding cavity is disrupted and CD indicates a fully denatured protein. This may be the water molecule buried near the small hydrophobic folding core at the D–E turn in the native protein. The MRD data also provide insights about transient (residence time <1 nsec) interactions of urea and water with the native and denatured protein. In the denatured state, both water and urea rotation is much more retarded than for a fully solvated polypeptide. The MRD results support a picture of the denatured state where solvent penetrates relatively compact clusters of polypeptide segments.
Boltzmann‐type distribution of side‐chain conformation in proteins
Authors: Butterfoss Glenn L. , Hermans Jan 
Published: November 2003

AbstractWe analyze packing imperfections in globular proteins as reflected in deviations of torsion angles from the equilibrium values for the isolated side chains. The distribution of conformations of methionine and lysine residues in a database of high‐resolution structures is compared with energies of model compounds calculated with high‐level quantum‐mechanics. The distribution of the C–C and C–S torsion angles (χ3) correlates well with the Boltzmann factor of the torsion energy, exp(−βE) of the model compounds C2H5—C2H5 and C2H5—S—CH3. An exponential relation was again found between the relative occurrence of g+, g− and t conformations for Cα—Cβ bonds in long side chains and the energy differences of rotamers of α‐amino n‐butyric acid, when dependence on backbone conformation was taken into account. The distribution of all 27 rotamers of methionine was correlated with the energy differences between the model's rotamers, corrected for clashes with nearby residues, the correlation being good for a set with backbone in the β‐conformation, but less clear for backbone α‐conformation. In all correlations, the value of the coefficient β corresponds to a temperature of circa 300 K. These results can be interpreted with a model that considers the structure of a folded protein as resulting from packing imperfectly complementary parts, with a requirement of an overall low energy. Compromises are required to optimize the fit of nonbonded contacts with surrounding groups, and side chains assume conformations away from the energy minimum. An exponential distribution is a most probable distribution, and this can be established easily under conditions other than thermal equilibrium.