bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spatial Distribution of Tumor Vaccine Improves Efficacy
Authors: Couch Marion , Saunders John K. , O'Malley Bert W. , Pardoll Drew , Jaffee Elizabeth 
Published: November 2003

AbstractObjectives Genetically engineered tumor cells were used as a vaccine in a murine model to compare tumor formation after inoculating multiple sites versus a single site. The effect of vaccinating draining lymph node basins was evaluated.Study Design Mice were vaccinated in either the floor of the mouth, the draining nodes of the front legs, the hind leg, or a combination of sites. Seven days later, the mice were challenged with parental tumor cells in the floor of the mouth and followed for tumor growth.Methods A retroviral vector was used to transduce the granulocyte‐macrophage colony‐stimulating factor (GM‐CSF) gene into SCCFVII/SF tumor cells, which were then irradiated to prevent replication in vivo. Syngeneic C3H/HeJ mice were vaccinated with 1 × 106 cells in various sites, then challenged with 1 × 105 parental cells after 7 days.Results Animals vaccinated in multiple sites had better protection from later tumor challenge than those receiving single vaccinations. Of the animals receiving vaccination at multiple sites, those vaccinated in the site of tumor challenge (floor of the mouth) had more protection than those not vaccinated at the site.Conclusions Mice vaccinated at multiple draining lymph node sites were better primed against tumor challenge than mice receiving single inoculations. Vaccination strategies that included the challenge site (floor of the mouth) and the nodes near this site were optimal.
Herpes Simplex Virus and Meniere's Disease
Authors: Vrabec Jeffrey T. 
Published: November 2003

AbstractObjective/Hypothesis This study was designed to investigate the hypothesis that Meniere's disease is associated with herpes simplex virus (HSV) reactivation in the vestibular ganglion.Study Design Case control study.Methods Vestibular ganglia were obtained from archival surgical pathology specimens from patients undergoing vestibular neurectomy for vertigo caused by Meniere's disease. All patients met criteria for classification as definite Meniere's disease according to American Academy of Otolaryngology/Head and Neck Surgery (AAO‐HNS) criteria. Control specimens were obtained from willed body donors. Sections from each ganglion were studied for prevalence of viral DNA using a nested polymerase chain reaction designed to amplify the HSV DNA polymerase gene. Quantitative analysis determined the number of viral copies per standard unit of ganglionic DNA.Results HSV DNA was more prevalent in paraffin embedded ganglia from patients with Meniere's disease (100%) than in fresh‐frozen control ganglia (81%) (P = .02). Fixation and paraffin embedding substantially reduced recovery of HSV virus in selected control specimens. Quantitative analysis found no correlation between viral copy number in control ganglia processed frozen versus formalin fixed and paraffin embedded.Conclusions HSV is more commonly isolated from vestibular ganglia of patients with Meniere's disease than the general population. The routine histologic preparation of formalin fixation and paraffin embedding significantly altered the quantity of virus detected though not in a predictable manner. The study provides supportive evidence for a viral etiology in Meniere's disease.
Therapeutic Selective Neck Dissection: A 25‐Year Review
Authors: Muzaffar Kamil 
Published: November 2003

AbstractObjectives/Hypothesis The aim of the study was to show the efficacy of selective neck dissection in combination with postoperative radiation therapy in controlling squamous cell carcinoma metastatic to the cervical lymph nodes. The study compared the incidence of recurrences and overall disease‐free survival between comparable cohorts undergoing a selective neck dissection and classic radical or modified neck dissection.Study Design Retrospective, 25‐year review was made of data from a tertiary care academic facility comprising both private patients and veterans.Methods Inclusion criteria studied patients with untreated head and neck cancer who had squamous carcinoma metastatic to cervical lymph nodes on histological examination and were treated with a selective (n = 61), modified (n = 54), or radical neck dissection (n = 61). The three groups were compared with respect to regional control and overall cancer‐free survival. All patients remained cancer free at the primary site, received postoperative radiation therapy, and had a minimum follow‐up of 2 years. The median follow‐up was 4.3 years.Results Control of recurrent carcinoma in the neck, as well as the incidence of overall cancer‐free survival, was comparable in the three cohorts with no significant statistical difference. Eight of 176 sides of the necks (4.5%) showed evidence of recurrence (2 of 61 [3.3%] in the selective neck dissection group and 6 of 115 [5.2%] in the radical and modified neck dissection group. Disease‐free 2‐year survival was 80% in the selective neck dissection group and 64% in the radical and modified neck dissection group.Conclusion Selective neck dissection, when used in combination with postoperative radiation therapy, is an efficacious way to manage metastatic squamous cell carcinoma to the neck.
Evaluation of Parathyroid Hormone as a Functional Biological Marker of Rat Laryngeal Transplant Rejection
Authors: Nelson Marc , Dan Olivia , Strome Marshall 
Published: November 2003

AbstractObjectives/Hypothesis Short‐term immunosuppressive protocols in a preclinical rat model that have led to prolonged survival of the graft in preliminary trials were investigated. Rat allografts, by their heterotopic nature, do not allow direct examination or functional interpretation. The primary objective of the study was to identify a reliable functional biological marker allowing monitoring of graft status. A secondary goal was to use this marker to indicate onset of rejection.Study Design The authors elected to study rat parathyroid hormone as a functional marker of laryngotracheal complex rejection. Theoretically, a pulsed immunosuppressive regimen that is administered when parathyroid hormone levels begin to fall could prevent rejection.Methods Eleven Lewis recipient rats underwent parathyroidectomy one week before laryngeal transplantation. Parathyroid hormone levels were obtained on various days following transplantation, then analyzed with an intact rat parathyroid hormone assay. Animals were killed on different days to allow for comparison of parathyroid hormone levels with histopathological signs of rejection.Results All animals had undetectable levels of parathyroid hormone before transplantation. By 24 hours after transplantation, parathyroid hormone levels were within normal range. At 72 hours, the parathyroid hormone levels dropped precipitously. Rejection of parathyroid glands paralleled the early histological changes of rejection seen in the other anatomical areas of interest in the laryngotracheal graft.Conclusion The study represents the first time a hematological marker has been identified that has predictive value for rejection of transplanted rat larynges. As such, it not only enables a 3‐month experimental window with reasonable numbers of animals, but also opens the door for novel sequencing of immunosuppressive modalities.
Outcome analysis of endoscopic sinus surgery in patients with nasal polyps and asthma
Authors: Batra Pete S. , Kern Robert C. , Tripathi Anju , Conley David B. , Ditto A. M. , Haines G. K. , Yarnold Paul R. , Grammar Leslie 
Published: November 2003

AbstractObjective: To investigate the efficacy of endoscopic sinus surgery (ESS) in the management of chronic sinusitis and asthma in patients with nasal polyps and steroid‐dependent asthma. Study Design: Retrospective chart review. Methods: The study included 17 patients who underwent ESS with nasal polyps, steroid‐dependent asthma with or without aspirin sensitivity and a minimum of 1 year postoperative follow‐up. Nine patients were ASA sensitive, and eight patients were ASA tolerant. Chronic sinusitis and asthma were evaluated using subjective (patient complaints) and objective (computed tomography scans, pulmonary function tests, steroid doses) criteria. Preoperative data were compared with data obtained 12 to 18 months postESS. Tissue samples were graded for degree of inflammation and edema. Results: Thirteen of the 17 (76.5%) patients reported improved clinical symptoms postESS. The postoperative Lund‐Mackay scores were statistically lower for the 17 patients (P < .0001). The group experienced improvement in postoperative forced expiratory volume at 1 second (FEV1) (P < .014). Twelve of 17 (70.6%) experienced reduction in systemic steroid usage (P < .048). The ASA sensitive patients did not have a statistical improvement in postoperative FEV1 (P > .08) and sinonasal symptoms (P > .16) compared with the ASA tolerant group. Polyp tissue from the ASA sensitive patients demonstrated more edema and more inflammation on average than ASA tolerant polyps, but the results were not statistically significant. Conclusion: ESS demonstrates a beneficial effect on the sinonasal and asthma symptomatology in patients with nasal polyps and asthma using objective measures. Subset of aspirin‐tolerant patients have statistically better outcome for sinonasal symptoms and pulmonary function testing than aspirin‐sensitive patients.
Tutorials in clinical research: VII. Understanding comparative statistics (contrast)—part B: Application of T‐test, Mann‐Whitney U, and Chi‐Square
Authors: Neely J. Gail , Hartman James M. , Forsen James W. , Wallace Mark S. 
Published: November 2003

AbstractObjective: This tutorial on comparative statistics has been written in two complementary segments. The first paper (part A) focused on explaining the general concepts of the null hypothesis and statistical significance. This second article (part B) addresses the application of three specific statistical tests. These two articles should be read sequentially and the first article should be available for reference while one reads the second. Study Design: Tutorial. Methods: The authors met weekly for 10 months to discuss clinical research articles and the applied statistics. The difficulty was not the material but the effort to make it easy to read and as short as possible. Results: The article discusses the application of three common statistical indexes of contrast, χ2, Mann‐Whitney U, and Student t‐test and other concepts, such as sample size, degrees of freedom, errors, power, and confidence intervals. Conclusions: Statistical tests generate a number known as a statistic (χ2, U, t), which is sometimes called a “critical ratio” because it helps us to make a decision. This number is then associated with a probability, or P value. Sample size is a crucial element in the initial design of a research project and in the subsequent ability of the results to show statistical significance if the difference is clinically important. The example data used in this paper demonstrate the application of the three specific tests and illustrate the effect of sample size on the results.
Tissue engineered muscle implantation for tongue reconstruction: A preliminary report
Authors: Bunaprasert Tanom , Hadlock Tessa , Marler Jennifer , Kobler James , Cowan Douglas , Faquin William , Varvares Mark 
Published: November 2003

AbstractObjectives/Hypothesis: Because current tongue reconstructive methods introduce adynamic, variably sensate tissue into the mouth, the critical functions of the tongue in articulation and deglutition may be compromised. The objective of this work was to introduce a combination of myoblasts and scaffolding material into rat hemiglossectomy defects and to examine the extent of neomuscle formation in the reconstructed area, under the hypothesis that the presence of myoblasts leads to formation of new muscle. Study Design: Randomized, prospective animal study. Methods: Myoblasts were harvested from neonatal Lewis rats, and a growth factor enriched collagen gel was prepared. Syngeneic adult animals received either hemiglossectomy alone or reconstruction with one of four experimental reconstructive preparations: collagen gel alone, collagen gel with suspended myoblasts, the gel‐cell combination in undifferentiated muscle construct form by way of tissue culture for 7 days in a preformed mold, or differentiated constructs, cultured in myoblast fusion medium. After 6 or 16 weeks, animal weight gain was recorded, animals were killed, and the tongues harvested. The tissue was examined histologically, and quality of the muscular regenerate was rated on a scale according to predefined criteria. Results: Animals in all groups gained weight appropriately. In groups receiving hemiglossectomy alone or acellular (gel only) reconstruction, there was significant scarring and lack of neomuscle formation. In groups receiving myoblast transplantation, either by way of gel suspension or in the form of undifferentiated or differentiated constructs, muscle quality was superior to controls. Conclusions: Myoblast transplantation into hemiglossectomy defects appears to lead to new muscle formation and does not inhibit normal weight gain in animals after tongue implantation.
Management of vascular malformations of the mandible and maxilla
Authors: Persky Mark S. , Yoo Helen J. , Berenstein Alejandro 
Published: November 2003

AbstractObjectives/Hypothesis: Vascular malformations involving the mandible and maxilla are uncommon, and no uniform treatment of these lesions has been defined. The purpose of the study was to evaluate the effectiveness of treating vascular malformations with a multidisciplinary approach and emphasis on endo‐vascular therapy. Study Design: Retrospective chart review of patients. Methods: The treatment of 31 patients (13 male and 18 female patients) with mandibular and/or maxillary vascular malformations presenting between 1979 to 2001 was reviewed. Results: Thirteen patients (42%) presented with mandibular vascular malformations, and an equal number of patients had maxillary vascular malformations. Five patients had involvement of both the mandible and maxilla. Twenty‐six patients (84%) had adjacent soft tissue extension, whereas five patients had a vascular malformation isolated either to the mandible (four cases) or maxilla (one case). Twenty‐six cases consisted of arterial vascular malformations, and five patients had venous and capillary types. Twenty‐five patients (81%) were treated with embolization only, whereas six patients (19%) underwent combined embolization and surgical resection. “Cure” was defined as the complete eradication of disease or permanent resolution of symptoms with complete devascularization by embolization. The cure rates were 70% for mandibular malformations and 46% for maxillary lesions. None of the combined maxillary/mandibular lesions were cured, but all achieved improvement or stabilization of symptoms. The follow‐up range was 1 to 22 years with an average follow‐up of 6.7 years. Conclusion: The location and extent of vascular malformations dictate the treatment and resulting success. Endovascular therapy alone can effectively “cure” most mandibular and maxillary vascular malformations with limited soft tissue involvement. Extensive vascular malformations can be stabilized with control of symptoms, but eradication of the vascular malformation is unlikely even with combined surgery and embolization.
Identification of previously “undetectable” abnormalities of the bony labyrinth with computed tomography measurement
Authors: Purcell Derk D. , Fischbein Nancy , Lalwani Anil K. 
Published: November 2003

AbstractBackground: In patients with congenital sensorineural hearing loss (SNHL), a computed tomography (CT) scan of the temporal bone identifies inner ear malformations in approximately 25%, whereas the inner ear is grossly normal to visual inspection in the remaining 75% of the patients. In the latter group, the hearing loss is often attributed to radiologically undetectable abnormalities of the membranous labyrinth. However, subtle bony malformations may be missed because visual inspection alone is insensitive for detection. Objective: To test the hypothesis that there are subtle bony abnormalities of the inner ear in patients with SNHL who are radiologically deemed to have normal otic bone, using standardized measurements of the inner ear. Study Design: Retrospective review. Methods: Measurements of the cochlea, vestibule, and semicircular canals (SCCs) were made on axial and coronal temporal bone CT scans on 15 patients with normal hearing and 15 patients with congenital SNHL and grossly normal temporal bone CT scans. Student's t‐test was performed to compare the measurements of the two groups. Results: All studies from the SNHL group were deemed normal by visual inspection and standardized measurements (±2 SD from normal). Surprisingly, there were significant differences in the measurements of the cochlea and of the SCCs between patients with and without SHNL (P < .05). Conclusions: As a group, patients with SNHL and a “normal CT scan” have significant differences in the dimensions of the inner ear. This suggests that these patients have disturbed morphogenesis of both membranous and bony labyrinth. This novel observation has important implications for understanding the etiology of SNHL.
Quality of life after different treatment modalities for carcinoma of the oropharynx
Authors: Tschudi Dominique , Stoeckli Sandro , Schmid Stephan 
Published: November 2003

AbstractObjectives: To assess the long‐term posttreatment quality of life of patients with carcinoma of the oropharynx treated with different treatment modalities. Study Design: Retrospective chart review and patient response to EORTC quality of life core questionnaire QLQ‐C30 and EORTC quality of life core head and neck cancer module QLQ‐H&N35 questionnaires. Methods: Two hundred and seventeen patients with carcinoma of the oropharynx were treated with curative intent between 1990 and 1998. In January 2001, a total of 111 disease‐free survivors were identified and included in this study. The questionnaires were completed by 99 patients (89% completion rate). Results: Of 99 patients, 31 patients were treated with surgery alone, 19 with radiation therapy alone and 49 with surgery followed by postoperative irradiation. Median follow‐up for the entire study group was 71 months. Physical, role, emotional, cognitive and social functioning reflected in the functional scale scores of the global EORTC QLQ‐C30 were generally good and showed no significant differences for the different treatment modalities. Comparison of the head and neck specific EORTC QLQ‐H&N35 scores revealed significantly less troubles with swallowing (P = 0.006), social eating (P = 0.007) and social contact (P = 0.008), dry mouth (P <0.0001), sticky saliva (P = 0.0001) and mouth opening (P = 0.001) in non‐irradiated patients versus those treated with any either primary or postoperative radiation therapy. Patients undergoing surgery (with and without postoperative irradiation) had less pain (P = 0.04), less problems with social eating (P = 0.009) and less restricted mouth opening (P = 0.03) than the nonsurgically treated patients. Conclusions: Quality of life after curative treatment of oropharyngeal carcinoma is generally good. Differences regarding quality of life between the different treatment modalities manifest themselves in the head and neck specific EORTC QLQ‐H&N35 module, not in the global core questionnaire EORTC QLQ‐C30.
Endoscopie posterior cricoid split and rib grafting in 10 children
Authors: Inglis Andrew F. , Perkins Jonathan A. , Manning Scott C. , Mouzakes Jason 
Published: November 2003

AbstractObjective: To report our experience with endoscopic posterior cricoid split and rib graft insertion (EPCS/RG) in children with posterior glottic (PGS) and subglottic stenosis (SGS). Design: Retrospective analysis of case series, with 1 to 2 year follow‐up. Setting: Tertiary‐care pediatric referral center. Patients: Ten consecutive patients undergoing EPCS/RG. Intervention: EPCS/RG is a new procedure that expands the posterior glottic opening by dividing the posterior cricoid lamina endoscopically with a laser and inserting a rib cartilage graft through the laryngoscope. Main Outcome Measures: Laryngeal function and hospital stay. Results: Successful decannulation in two of two patients with PGS and one of five patients with PGS and SGS without further surgery. Of the four not initially decannulated, two were decannulated with adjunctive procedures, and the other two can now tolerate tracheostomy capping for extended periods of time. We achieved improvement in exercise tolerance in three nontracheotomy‐dependent patients. For those with established tracheotomies, median hospital stay was 3 days and intensive care unit care was unnecessary. There were no major complications or deterioration of voice or feeding. Conclusions: EPCS/RG appears to be safe and effective in the management of PGS in selected pediatric patients. This minimally invasive procedure has advantages over traditional open approaches and destructive endoscopic techniques (cordotomy and arytenoidectomy). The role of EPCS/RG alone in the face of severe grades of SGS appears to be limited.
Coblation tonsillectomy versus dissection tonsillectomy: Postoperative hemorrhage
Authors: Belloso Antonio , Chidambaram A. , Morar P. , Timms M. S. 
Published: November 2003

AbstractObjectives/Hypothesis: Coblation tonsillectomy is a recently introduced surgical technique. To measure its benefits against traditional tonsillectomy techniques, it is necessary to compare their complication rates. The study aims to identify differences in reactionary and secondary hemorrhage proportions, comparing coblation with dissection tonsillectomy. Study Design: Prospective observational cohort study. Methods: Hates of reactionary and delayed postoperative hemorrhage were measured, comparing 844 coblation tonsillectomies with a control group of 743 tonsillectomies performed by blunt dissection with bipolar diathermy hemostasis. Results: The secondary hemorrhage rate with coblation‐assisted tonsillectomy was 2.25% compared with 6.19% in the control group (P < .05). The rate of secondary hemorrhage in children following coblation tonsillectomy was 0.95% compared with 4.77% in the control group (P < .05). The difference was also significant (P < .05) in the adult population (4.40% vs. 8.81%, respectively). No difference was found in the reactionary hemorrhage proportions. Conclusion: In the study, coblation tonsillectomy was associated with a lesser incidence of delayed hemorrhage, more significantly in the pediatric population. The new technique using tissue coblation for tonsil dissection offers significant advantages in the postoperative period compared with dissection tonsillectomy with bipolar diathermy hemostasis. Coblation is associated with less postoperative pain and early return to daily activities. Also, there are fewer secondary infections of the tonsil bed and significantly lower rates of secondary hemorrhage with coblation. These results and the disposable nature of the coblation equipment promote coblation tonsillectomy as the authors' preferred dissection method.