bluuebunny/crossref_metadata_2025_split huggingface dataset:
Simultaneous Treatment With BDNF and CNTF After Peripheral Nerve Transection and Repair Enhances Rate of Functional Recovery Compared With BDNF Treatment Alone
Authors: Lewin Sheryl L. , Utley David S. , Cheng Elbert T. , Verity A. Neil , Terris David J. 
Published: November 2003

AbstractThe objective was to investigate the effects of brain‐derived neurotropic factor (BDNF) and ciliary neurotropic factor (CNTF) on peripheral nerve regeneration. Thirty Sprague‐Dawley rats underwent left sciatic nerve transection and repair according to three experimental groups: epineurial coaptation (EC), EC with BDNF delivered by an osmotic pump (EC‐BDNF), and EC with BDNF and CNTF delivered similarly (EC‐BDNF/CNTF). Nerve regeneration was assessed using sciatic functional indices, quantitative histomorphology, and molecular analysis for proteins associated with nerve regeneration. Analysis of variance (ANOVA) comparing all groups at each time point demonstrated significant differences between groups on days 20, 30, 40, 50, 60, and 80. A paired, two‐tailed Student's t‐test with the Bonferroni correction for multiple comparisons demonstrated that at 40 days postoperatively, animals in the EC‐BDNF/CNTF group (n = 7) manifested superior functional recovery compared with those in the EC group (n = 9) and those in the EC‐BDNF group (n = 9) (P < 0.001 and P < 0.05, respectively). At 80 days, the animals in both the EC‐BDNF (P < 0.01) and EC‐BDNF/CNTF (P < 0.05) groups demonstrated greater functional recovery compared with those in the EC group, with no significant difference between the two factor groups at the endpoint. Morphometric analysis demonstrated that nerves from animals in the EC‐BDNF/CNTF group had the largest mean axon diameters as compared with those from the EC (proximal: P < 0.001, distal: P < 0.05) and EC‐BDNF(proximal: P < 0.01) groups. No significant differences were seen in nerve cross‐sectional area. In distal nerve segments, Western blot analysis revealed that expression of myelin‐associated glycoprotein was higher than control for the EC group and lower than control for both the EC‐BDNF and EC‐BDNF/CNTF groups. We conclude that BDNF/CNTF combined treatment increases the early rate of functional sciatic nerve regeneration over treatment with BDNF alone, although the degree of maximal recovery was similar at the conclusion of the experiment.
Safety of Direct Laryngoscopy As an Outpatient Procedure
Authors: Armstrong Michael , Mark Lynette J. , Snyder Douglas S. , Parker Stephen D. 
Published: November 2003

AbstractThe safety of outpatient direct laryngoscopy has recently been challenged in the literature. We reviewed the first 589 direct laryngoscopies performed at a new outpatient surgery center. There were nine unplanned admissions to the hospital, including five airway emergencies that developed within the first 30 min after extubation. Three patients required reintubation before leaving the operating room. On postoperative telephone follow‐up, 9% complained of mild to moderate sore throat. There were no major complications after discharge. We conclude that the risk of airway emergencies after direct laryngoscopy is less than 1% in carefully selected patients. The procedure can be safely performed as an outpatient procedure as long as transportation to a hospital is readily available for the few patients in whom complications arise.
Sodium Ipodate (Oragrafin) in the Preoperative Preparation of Graves' Hyperthyroidism
Authors: Tomaski Sharon M. , Mahoney Eileen M. , Burgess Lawrence P.A. , Raines Kristen B. , Bornemann Michael 
Published: November 2003

AbstractFourteen Graves' hyperthyroid patients who had been prepared for surgery with sodium ipodate (SI) 500 mg orally twice daily for 3 days were retrospectively studied. SI was administered in combination with propylthiouracil (10 cases) and beta blockers (all cases), which had been previously initiated. Free serum thyroxine (T4) and total triiodothyronine (T3) concentrations were measured before and after SI therapy on the morning of surgery. SI treatment significantly reduced total T3 concentration from 445.9 to 193.4 ng/dL (P < 0.0001) and free T4 concentration from 3.874 to 2.800 ng/dL (P = 0.0003). Preoperatively, only one patient had persistent tachycardia, and intraoperatively this same patient required beta blockers. Blood loss was unremarkable or reduced (average blood loss, 121 mL). On clinical examination glands were firm with normal or somewhat decreased vascularity. On histologic study all glands demonstrated changes consistent with treated Graves' disease. Preoperative treatment with SI appears to be a safe and efficacious method of preparing hyperthyroid patients for surgery.
Endoscopic Sinus Surgery Complications in Residency
Authors: Gross Rick D. , Sheridan Mark F. , Burgess Lawrence P. 
Published: November 2003

AbstractOtolaryngology has seen a rapid proliferation of functional endoscopic sinus surgery, and there is variability in the teaching of the procedure, in part because of the seriousness of the complications. A retrospective review of 106 consecutive cases was conducted at a teaching program to evaluate complications. Complication rates were combined and compared with the reported complication rates of other teaching programs and practicing otolaryngologists. The complication rate in our program was 13.9%; all were minor complications. This compared favorably with the rates of other programs (6% to 29%). The combined complication rate for residency training programs (16.6%) was significantly greater than the nonresident complication rate (10.5%). When divided into major and minor complications, the resident minor complication rate (15.9%) was significantly greater than the nonresident rate (8%), yet the major complication rates were significantly less for the resident group (0.7%) than for the nonresident group (2.5%). In addition, complications were significantly greater when procedures were performed under general anesthesia as compared with local anesthesia, and estimated blood loss was significantly greater under general anesthesia.
Tumor‐Associated Glycoprotein (TAG‐72) in Chronic Submandibular Sialadenitis and Normal Minor Salivary Glands Defined by Monoclonal Antibody B72.3
Authors: Epivatianos Apostolos , Poulopoulos Athanasios , Kayavis Ioannis , Papanayotou Panayotis 
Published: November 2003

AbstractFormalin‐fixed, paraffin‐embedded samples of three normal minor salivary glands, 10 chronic submandibular sialadenitis, and three normal submandibular glands were studied immunohistochemically using the monoclonal antibody (Mab) B72.3 in order to have a better understanding of the distribution of tumor‐associated glycoprotein (TAG‐72). Diffuse expression of TAG‐72 was observed in the mucous cells of normal minor salivary glands, and in the ducts with goblet cell metaplasia and/or hyperplasia of chronic submandibular sialadenitis (eight of 10). Focal expression of TAG‐72 was seen in the acinar mucous cells of normal submandibular gland (three of three), and in the mucous cells of normal or atrophic acini of chronic submandibular sialadenitis (eight of 10). These results should be considered in the cytologic diagnosis of the mucoepidermoid carcinoma using the Mab B72.3 as a diagnostic aid, as well as in future studies for the radiation immunolocalization and immunotherapy of submandibular gland tumors.
Molecular Temporal Bone Pathology: II. Ramsay Hunt Syndrome (Herpes Zoster Oticus)
Authors: Wackym Phillip A. 
Published: November 2003

AbstractIn 1907 J. Ramsay Hunt suggested that herpes zoster oticus resulted from a geniculate ganglionitis; however, many contemporary authors believe that this disorder represents a neuritis or polycranial neuropathy. Herpes varicella‐zoster viral (VZV) DNA was identified, using the polymerase chain reaction, in archival celloidin‐embedded temporal bone sections from two patients who clinically had Ramsay Hunt syndrome (herpes zoster oticus). The presence of VZV was confirmed by sequencing the PCR products. These experiments demonstrated that VZV genomic DNA was present in the geniculate ganglion of the side with facial paralysis and cutaneous recrudescence in both patients and in the clinically unaffected side in patient 1. In addition, patient 2 had a sudden hearing loss and was found to have VZV genomic DNA in sections from the affected side containing the spiral ganglion, Scarpa's ganglion, organ of Corti, and macula of the saccule. No VZV genomic DNA was identified in temporal bone sections from five patients with Bell's palsy and ten patients without evidence of otologic disease. In this study, the histopathology of these two cases yielded complementary information regarding the role of VZV in herpes zoster oticus. These data suggest that in patients with Ramsay Hunt syndrome, latent VZV is located in the geniculate ganglia and may be present in the auditory and vestibular primary afferent ganglia in some patients.
Familial Occurrence of Unilateral Vestibular Schwannoma
Authors: Bikhazi Nadim B. , Slattery William H. , Lalwani Anil K. , Jackler Robert K. , Bikhazi Paul H. , Brackmann Derald E. 
Published: November 2003

AbstractVestibular schwannoma (VS) may present clinically in one of two forms: sporadic unilateral or hereditary bilateral. Almost all cases of familial transmission have been associated with the diagnosis of neurofibromatosis type II (NF‐2). In this report, we describe nine families (18 individuals) presenting with unilateral VS without evidence of NF‐2. In four of the nine families, the affected individuals were of parent‐offspring relationship, in three families they were cousin‐cousin, and in the remaining two families, they were sibling‐sibling and aunt‐nephew. No other members of the families were diagnosed with NF‐2. There was no evidence for gender predilection or genomic imprinting among affected individuals. This study suggests that familial occurrence of unilateral VS may be genetically inherited as it occurs more commonly than would be estimated by chance alone. Future genetic studies will elucidate whether occurrence of unilateral VS in these families represents a variable expression of NF‐2, chance occurrence of unilateral VS in families, or a new genetic disorder.
Practical Use of Total and Partial Ossicular Replacement Prostheses in Ossiculoplasty
Authors: Slater Patrick W. , Rizer Franklin M. , Schuring Arnold G. , Lippy William H. 
Published: November 2003

AbstractThe use of porous polyethylene total and partial ossicular replacement prostheses (TOPs and POPs) for ossicular reconstruction in middle ear surgery was retrospectively reviewed at the Warren Otologic Group, a tertiary referral center for otologic problems. Extrusion rates, lower than those previously reported, and improvement in hearing results were found in 250 cases. Follow‐up ranged from 6 months to 8 years. This paper details the optimal placement and relationships of the prosthesis, the interposed tragal cartilage, and the drum. Modifications to the prosthesis have increased stability and ease of reconstruction. The hearing results of both TOP and POP reconstruction, and comparison with the literature, will be presented. With TOPs, the air‐bone gap was closed to within 20 dB in 67% of cases. With POPs, similar results were obtained in 81% of cases.
Preoperative Evaluation of Patients With Primary Hyperparathyroidism: Role of High‐Resolution Ultrasound
Authors: Koslin D. Bradley , Adams Jeffery , Andersen Peter , Everts Edwin , Cohen James 
Published: November 2003

AbstractUnilateral parathyroid exploration with adenoma removal and identification of a normal parathyroid gland is an accepted surgical approach for the treatment of patients with primary hyperparathyroidism. This study prospectively evaluated the ability of high‐resolution sonography to localize adenomas preoperatively and the effect of this localization on operative time and cost in 37 previously untreated patients undergoing surgical treatment for primary hyperparathyroidism. The sensitivity and positive predictive value of the sonographic examination were 84% and 90%, respectively. A true positive sonographic examination decreased surgical time by an average of 40 minutes and reduced operative charges by $564, including the cost of the test ($156). In experienced hands high‐resolution sonography can be a cost‐effective means of localizing parathyroid adenomas where unilateral exploration is considered an accepted surgical approach.
Adenoid Cystic Carcinoma of the Salivary Glands: A Review of 10 Years
Authors: Sur Ranjan K. , Donde Bernard , Levin Victor , Pacella Juan , Kotzen Jeff , Cooper Kum , Hale Martin 
Published: November 2003

AbstractA retrospective analysis was performed of 50 patients with adenoid cystic carcinoma who were seen in the Department of Radiation Oncology, University of Witwatersrand, Johannesburg, South Africa, in the past 10 years. There were 25 men and 25 women with a mean age of 52 years (age range, 21 to 88 years). Five patients had metastatic disease, and 17 had neural invasion. Thirty‐four patients had surgery (11, complete; 23, microscopic residual). Sixteen patients had radiotherapy as initial management. The disease‐free survival was 26%, overall survival was 29%, and local control was 30% at 10 years. Most recurrences occurred in the first 3 years. Nine patients had metastasis following treatment. The mean survival after metastasis was 15 months. Seven prognostic variables were analyzed using the log‐rank test. There was no impact of age, site, type of salivary gland (major vs. minor), tumor stage, node positivity, or neural invasion on disease‐free survival, overall survival, or local control. Extent of surgical resection (complete vs. microscopic residual) had a significant impact on disease‐free survival and local control (P < 0.05) but no impact on overall survival (P > 0.05) because of the slow‐growing nature of these tumors. Similarly, patients who had microscopic residual after surgery and were treated with radiotherapy did better than those who had biopsy and radiotherapy, although this was not significant statistically (P > 0.05). Thus, whenever possible, every attempt must be made to remove all microscopic tumor by surgery. Addition of postoperative radiotherapy with high‐energy photons did not improve the locoregional control or survival in our series. There is a place for neutrons in the treatment of adenoid cystic carcinomas in advanced cases of inoperable or recurrent tumors, as a review of literature shows.
Management of Nasopharyngeal and Oropharyngeal Stenosis in Children
Authors: McLaughlin Kevin E. , Jacobs Ian N. , Wendell Todd N. , Gussack Gerald S. , Carlson Grant 
Published: November 2003

AbstractNasopharyngeal stenosis and oropharyngeal stenosis are rare and challenging problems in the pediatric population. The most common etiology is currently the surgical trauma associated with ade‐notonsillectomy. Stenosis can vary from a thin band to a complete obstructing cicatrix. Presenting symptoms range from mild hyponasal speech to severe airway obstruction. We present a series of eight children with varying degrees of stenosis and associated symptoms. Choice of treatment varied with the severity of disease. In our series, successful interventions included triamcinolone acetonide injection, lysis of adhesions, rotational and advancement mucosal flaps, and jejunal free flap. Preoperative evaluation and individualized surgical repair are essential for successful treatment.
Interinterpreter Variability in Determining the SP/AP Ratio in Clinical Electrocochleography
Authors: Roland Peter S. , Roth Lisa 
Published: November 2003

AbstractCalculating the SP/AP ratio in electrocochleography requires the interpreting audiologist to unequivocally identify the peak of the SP wave form. If different points are selected, different SP/AP ratios will result. To investigate this effect, 50 electrocochleographic tracings were sent to 10 different audiologists (500 tracings). Twenty of the wave forms sent to each audiologist were identified as “easy,” 10 as “somewhat difficult,” 10 as “very difficult,” and 10 as “no response.” The ranges and standard deviations of the resulting SP/AP ratios were quite high. Analysis of variance showed statistically significant differences in the very difficult and no response group. There is significant interinterpreter difference among SP/AP ratios calculated from the same tracing. This variability affects clinical patient management and investigational projects.
Ansa Cervicalis Nerve: Review of the Topographic Anatomy and Morphology
Authors: Chhetri Dinesh K. , Berke Gerald S. 
Published: November 2003

AbstractIn recent years, there has been a proliferation of techniques utilizing the ansa cervicalis nerve to reinnervate the paralyzed larynx. The anatomic course and morphology of the ansa cervicalis are complicated by the variable course and location along the great vessels of the neck, as well as the significant differences observed in the arrangement of its contributing roots and regional branching patterns. Herein, we review the surgical anatomic course of ansa cervicalis and its innervation of the muscles of the neck, and develop specific recommendations with respect to the use of this nerve in laryngeal reinnervation.
Do Systemic Corticosteroids Effectively Treat Obstructive Sleep Apnea Secondary to Adenotonsillar Hypertrophy?
Authors: Al‐Ghamdi Saleh A. , Manoukian John J. , Morielli Angela , Oudjhane Kamaldine , Ducharme Francine M. , Brouillette Robert T. 
Published: November 2003

AbstractTo determine if pediatric obstructive sleep apnea syndrome (OSAS) caused by adenotonsillar hypertrophy (ATH) could be treated by a short course of systemic corticosteroids, we conducted an openlabel pilot study in which standardized assessments of symptomatology, OSAS severity, and adenotonsillar size were performed before and after a 5‐day course of oral prednisone, 1.1 ± 0.1(± SE) mg/kg per day. Outcome measures included symptom severity, adenotonsillar size, and polysomnographic measures of OSAS. Selection criteria included age from 1 to 12 years, ATH, symptomatology suggesting OSAS, an apnea/hypopnea index (AHI) ≥ 3/hour, and intent to perform adenotonsillectomy. Only one of nine children showed enough improvement to avoid adenotonsillectomy. Symptomatology did not improve after corticosteroid treatment but did after removal of tonsils and adenoids. Polysomnographic indices of OSAS severity did not improve after corticosteroid treatment. After corticosteroids, tonsillar size decreased in only two patients, adenoidal size was only marginally reduced, and the size of the nasopharyngeal airway was not significantly increased. These results suggest that a short course of prednisone is ineffective in treating pediatric OSAS caused by ATH.
Clinical Applications of Otoacoustic Emissions in Sudden Hearing Loss
Authors: Schweinfurth John M. , Cacace Anthony T. , Parnes Steven M. 
Published: November 2003

AbstractSudden hearing loss (SHL) is a controversial topic for which no definitive practical guidelines exist. Studies employing vasodilators, plasma expanders, anticoagulants, and carbogen inhalations have shown
no
improvement over the rate of spontaneous recovery. At present, there is insufficient evidence to support medical treatment for SHL, except steroid therapy in selected patients. Distortion product otoacoustic emissions (DPOAEs) are sensitive to cochlear disorders and are absent in ischemic injury to the cochlea, but can persist in cochlear neuritis. In a prospective study of 10 patients who presented to Albany Medical Center from 1995 to 1996, three patients with intact DPOAEs at presentation had an average improvement of 33 dB in the pure‐tone average (PTA) of 0.5, 1.0, and 2.0 kHz with steroid therapy, whereas five of seven patients with absent DPOAEs had no improvement in hearing despite steroid therapy in six patients. The presence of DPOAEs may be a useful prognostic factor that positively correlates with recovery from SHL.
Laryngofissure and Cordectomy for Glottic Carcinoma Limited to the Mid Third of the Mobile True Vocal Cord
Authors: Muscatello Luca , Laccourreye Ollivier , Biacabe Bernard , Hans Stéphane , Ménard Madeleine , Brasnu Daniel 
Published: November 2003

AbstractThe objective of this study was to analyze the long‐term results of laryngofissure with cordectomy for invasive glottic squamous cell carcinoma limited to the mid third of the mobile true vocal cord. The authors conducted a retrospective review of the medical charts and operative files of 33 patients with invasive glottic carcinoma limited to the mid third of the mobile true vocal cord managed with laryngofissure and cordectomy. A 10‐year follow‐up was achieved in 30 patients (90.9%). Kaplan‐Meier actuarial analysis of survival, local control, nodal recurrence, distant metastasis, and second primary metachronous tumor was performed. The 5‐year actuarial survival, local control, nodal recurrence, and distant metastasis estimates were 97%, 100%, 0%, and 0%, respectively. Tracheotomy was never performed. The overall laryngeal preservation rate was 100%. The 5‐ and 10‐year actuarial metachronous second primary tumor estimates were 3% and 11.5%, respectively. The authors' experience suggested that laryngofissure and cordectomy should still be considered a valuable oncologic option for the management of invasive glottic carcinoma limited to the mid third of the mobile true vocal cord.
Quantitative Study of Nasal Secretory Cells in Normal Subjects and Patients With Chronic Sinusitis
Authors: Majima Yuichi , Masuda Sawako , Sakakura Yasuo 
Published: November 2003

AbstractThe contribution of nasal secretory cells to mucus hypersecretion in chronic sinusitis was investigated. The mucosae of the inferior turbinate were obtained from 18 normal control subjects and 65 patients with chronic sinusitis. Histochemical quantitation showed that there was no significant difference in the number of goblet cells between normal controls and chronic sinusitis. On the other hand, the number of submucosal acinar cells in chronic sinusitis was significantly higher than that in normal controls (
P
< 0.01). The area occupied by the acini in lamina propria was also increased in chronic sinusitis (
P
< 0.01). There was no significant difference in the distribution of the intra‐acinar glycoproteins between normal control subjects and patients with chronic sinusitis. Results suggest that hyperplasia and hypertrophy of nasal acinar cells may have an important role in mucus hypersecretion in chronic sinusitis.
An Accurate, Cost‐Effective Approach for Diagnosing Retrocochlear Lesions Utilizing the T2‐Weighted, Fast‐Spin Echo Magnetic Resonance Imaging Scan
Authors: Linker Seth P. , Ruckenstein Michael J. , Acker James , Gardner Gale 
Published: November 2003

AbstractRecent data indicate that the auditory brainstem response (ABR) fails to identify a significant number of retrocochlear lesions. Although the magnetic resonance imaging (MRI) scan with paramagnetic enhancement is highly accurate at detecting these lesions, it is time consuming and expensive. We report on our prospective evaluation of a cohort of 155 patients who underwent T2‐weighted, fastspin echo MRI scans designed to screen for retrocochlear lesions. This imaging technique is rapidly performed and provides superb visualization of the relevant anatomic structures at a global cost of $475. Four tumors were identified with this technique. Cost analysis indicates that supplanting ABR with this limited MRI may well represent a cost‐effective approach for evaluating patients with suspected retrocochlear lesions.