bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analysis of the Human Neurofibromatosis Type 2 Gene Promoter and its Expression
Authors: Welling D. Bradley , Akhmametyeva Elena M. , Daniels Robert L. , Lasak John M. , Zhu Lingyun , Miles‐Markley Beth A. , Chang Long‐Sheng 
Published: February 2003

OBJECTIVEIt is hypothesized that transcriptional regulation plays an important role for neurofibromatosis type 2 (NF2) expression in Schwann cells and other cell types. The objective of this study is the isolation and characterization of the transcriptional regulatory elements of the NF2 gene.STUDY DESIGN AND SETTINGA bacterial artificial chromosome library and a partial genomic DNA library were used to isolate the human NF2 gene; NF2 promoter‐luciferase constructs were generated, and promoter activities were assayed. This study was carried out in a molecular biology laboratory.RESULTSA bacterial artificial chromosome clone with an approximately 100‐kilobase insert containing nearly the entire human NF2 gene has been isolated. An additional 5’ NF2 sequence has also been cloned. Transient transfection experiments demonstrate strong promoter activity from the NF2 5’ flanking DNA.CONCLUSIONSThe NF2 gene is approximately 100 kilobases long. Both positive and negative regulatory elements are present in NF2 5’ flanking regions.SIGNIFICANCEBetter understanding of the NF2 gene and its regulation will improve molecular diagnostics and ultimately treatment of patients with NF2.
Reconstruction of Tracheal Defects with Dehydrated Human Costal Cartilage: An Experimental Study in Rats
Authors: Dal Teoman , Demirhan Beyhan 
Published: February 2003

Reconstruction of tracheal defects continues to be a difficult problem in head and neck surgery. In this study, to evaluate the outcomes of tracheal reconstruction with a nonautogenous material, we used solvent‐dehydrated human costal cartilage in 3 different forms: graft, neovascularized graft, and prefabricated free flap. Thirty‐five Sprague‐Dawley rats were distributed into 3 groups with 10 animals in groups 1,10 in group 2, and 15 in group 3. Surgically created tracheal defects were repaired with a free cartilage graft in group 1, and a piece of cartilage was neovascularized for 3 weeks in the inguinal region and then used as a fibrovascular tissue‐coated cartilage graft in group 2. In group 3, the neovascularized cartilage was transferred to the defect as a prefabricated free flap based on a vascular pedicle containing femoral vessels. Four weeks later, the tracheal reconstruction specimens were evaluated with light microscopy to determine cartilage survival, infection, and epithelial regrowth. The most favorable outcomes were obtained in group 3, where the material was used as a prefabricated neovascularized free flap.
Computed Tomography Stage, Allergy Testing, and Quality of Life in Patients with Sinusitis
Authors: Krouse John H. 
Published: February 2003

BACKGROUNDChronic rhinosinusitis is a common disease associated with significant morbidity. CT has been a poor predictor of the extent of symptoms among these patients. Allergic rhinitis is frequently associated with chronic rhinosinusitis. This study examines CT stage, allergic sensitivity, and sinus‐related symptoms.METHODSForty‐eight patients with chronic rhinosinusitis underwent CT scanning and skin end‐point titration (SET). They also completed the Rhinosinusitis Disability Index (RSDI), a measure of sinus‐related disability.RESULTSNo association was noted between CT stage and severity of sinus‐related symptoms. There was a significant correlation between CT stage and SET mean end point and between SET mean end point and RSDI physical scale score, as well as between significance on the RSDI emotional scale score and overall score.CONCLUSIONThe degree of allergic disease is a better indicator of symptom severity and impairment in quality of life among patients with chronic rhinosinusitis than CT stage. Careful evaluation and treatment of allergic disease is critical in the treatment of chronic rhinosinusitis.
Numerical Densities of Myonuclei and Satellite Cells in Muscle Fiber Types in the Aging Human Thyroarytenoid Muscle: An Immunohistochemical and Stereological Study Using Confocal Laser Scanning Microscopy
Authors: Malmgren Leslie T. , Fisher Patricia J. , Jones Christine E. , Bookman Linda M. , Uno Toshiyuki 
Published: February 2003

OBJECTIVEThis study determines the role of changes in numerical densities of myonuclei and satellite cells in age‐related remodeling of the thyroarytenoid muscle (TA).DESIGNChanges in numerical densities (NV) and ratios (NN) of myonuclei and satellite cells were estimated for the entire TA by use of stereological techniques.RESULTSThere was no age‐related change or difference between fiber types for NV myonucleus, fiber' but Nv myonucleus, fiber increased with decreasing fiber diameter. There was a trend toward a decrease in Nv satellite cell, fiber and a decrease in NN satellite cell, myonucleus. Nv satellite cell, fiber was higher for type 1 than for type 2 fibers, and type 1 satellite cells increased disproportionately with increasing total satellite cell numerical density.CONCLUSIONDecreased satellite cell proliferation may contribute to age‐related fiber loss and atrophy in the TA.SIGNIFICANCETherapeutic techniques based on activation of satellite cells may block age‐related fiber loss and atrophy in the TA.
Prevalence of Reflux in 113 Consecutive Patients with Laryngeal and Voice Disorders
Authors: Koufman James A. , Amin Milan R. , Panetti Marguerite 
Published: February 2003

OBJECTIVESThe goal was to estimate the prevalence of laryngopharyngeal reflux (LPR) in patients with laryngeal and voice disorders.STUDY DESIGN AND SETTINGThis was a prospective study of 113 unselected, new patients with laryngeal and voice disorders. Patients completed an extensive medical history form including a reflux symptom profile. A comprehensive otolaryngologic examination was performed with photographic transnasal fiberoptic laryngoscopy. Patients with both symptoms and findings of LPR (78/133, 69%) underwent ambulatory 24‐hour double‐probe pH monitoring.RESULTSSeventy‐three percent (57/78) of patients undergoing pH testing had abnormal studies. Thus 50% (57/113) of the entire the study population had pH‐documented reflux. Of the diagnostic sub‐groups studied, the highest incidence of reflux was found in patients with vocal cord neoplastic lesions (88%) and patients with muscle tension dysphonias (70%). LPR was infrequently found in patients with neuromuscular disorders.CONCLUSIONLPR occurs in at least 50% of all patients at our center with laryngeal and voice disorders at presentation.
Outcomes and Quality of Life in Conductive Hearing Loss
Authors: Stewart Michael G. , Coker Newton J. , Jenkins Herman A. , Manolidis Spiros , Bautista Marilyn H. 
Published: February 2003

OBJECTIVEThe goal was to measure quality of life (QOL) and hearing‐specific functional status before and after treatment of conductive hearing loss (CHL).STUDY DESIGN AND SETTINGA prospective, longitudinal, outcomes‐based study was performed at an academic medical center.RESULTSMean baseline QOL scores in CHL patients were comparable with those of the general population. Audiometric studies indicated significant improvements in hearing threshold in all treated patients. There was no significant improvement in mean global QOL scores after treatment of CHL, although there was little room for improvement over baseline. The hearing‐specific instrument did demonstrate significant improvements in emotional and social/situational hearing status after treatment. Patients treated with hearing aids had poorer baseline QOL and hearing status than patients treated with surgery and tended to show declines in QOL and only partial improvement in hearing‐specific functional status after treatment.CONCLUSIONSTreatment of CHL resulted in improvements in hearing‐specific functional status, although changes were difficult to detect with a global QOL instrument.
Carcinoma of the Buccal Mucosa
Authors: Chhetri Dinesh K. , Rawnsley Jeffrey D. , Calcaterra Thomas C. 
Published: February 2003

OBJECTIVEThe goal was to analyze the outcome of surgical therapy for buccal carcinoma.STUDY DESIGNA retrospective chart review was done.SETTINGThe study took place in a major tertiary‐care hospital.RESULTSTwenty‐seven patients received first‐time surgical therapy for buccal carcinoma. Treatment was surgery alone in 15 and surgery followed by radiation therapy in 6 patients. Six additional patients received surgical salvage for radiation therapy failure. Composite resection of the tumor was performed in 16 patients (59%). Five‐year observed actuarial survival rates were 100%, 45%, 67%, and 78%, and locoregional recurrence rates were 0%, 27%, 44%, and 0% for stages I to IV, respectively. The 5‐year actuarial survival rates were 80% after surgery and 82% after surgery and postoperative radiation therapy. Patients who underwent surgical salvage after radiation therapy failure had a 1‐year survival rate of 0%.CONCLUSIONAggressive surgical treatment of buccal carcinoma may result in better survival rates.SIGNIFICANCEThe article analyzes buccal carcinoma in regards to the patterns of presentation, treatments rendered, and patterns of failure.
Ultrasound‐guided fine‐needle aspiration and thyroid disease
Authors: Newkirk Kenneth A. , Ringel Matthew D. , Jelinek James , Mark Alexander , Wartofsky Leonard , Deeb Ziad E. , Sessions Roy B. , Burman Kenneth D. 
Published: February 2003

BACKGROUND:Fine‐needle aspiration represents a critical diagnostic test in determining proper management of thyroid disease and the use of ultrasound‐guided fine‐needle aspiration (USGFNA) has increased over the years.METHODS:A retrospective chart review of patients undergoing USGFNA. Two hundred fifteen patients underwent 234 procedures with 362 nodules aspirated within a 2 ½‐year period.RESULTS:The mean ages of women and men were 51.9 and 57.8, respectively. The average size of nodules was 2.1 cm. A difficult to assess gland or nodule was the most common indication for USGF‐NA (33%). The sensitivity was 88.2%, specificity was 80.0%, the PPV was 65.2%, the negative predictive value was 94.1%, and the accuracy was 82.5%. The cancer yield, inadequacy, and complication rates were 44%, 10.5%, and 8.5%, respectively.CONCLUSIONS:USGFNA aspiration is a safe and effective diagnostic modality in the management of thyroid disease, especially for nodules that are difficult to palpate.
Botulinum toxin type A (BOTOX) for treatment of migraine headaches: An open‐label study
Authors: Binder William J. , Brin Mitchell F. , Blitzer Andrew , Schoenrock Larry D. , Pogoda Janice M. 
Published: February 2003

OBJECTIVE:The object of this clinical experience was to evaluate the correlation between pericranial botulinum toxin type A (BOTOX, Allergan Corp, Irvine, CA) administration and alleviation of migraine headache symptoms.STUDY DESIGN AND SETTING:A nonrandomized, open‐label study was performed at 4 different test sites. The subjects consisted of 106 patients, predominantly female, who either (1) initially sought BOTOX treatment for hyperfunctional facial lines or other dystonias with concomitant headache disorders, or (2) were candidates for BOTOX treatment specifically for headaches. Headaches were classified as true migraine, possible migraine, or nonmi‐graine, based on baseline headache characteristics and International Headache Society criteria. BOTOX was injected into the glabellar, temporal, frontal, and/or suboccipital regions of the head and neck. Main outcome measures were determined by severity and duration of response. The degrees of response were classified as: (1) complete (symptom elimination), (2) partial (≥50% reduction in headache frequency or severity), and (3) no response [neither (1) nor (2)]. Duration of response was measured in months for the prophylactic group.RESULTS:Among 77 true migraine subjects treated prophylactically, 51% (95% confidence interval, 39% to 62%) reported complete response with a mean (SD) response duration of 4.1 (2.6) months; 38% reported partial response with a mean (SD) response duration of 2.7 (1.2) months. Overall improvement was independent of baseline headache characteristics. Seventy percent (95% confidence interval, 35% to 93%) of 10 true migraine patients treated acutely reported complete response with improvement 1 to 2 hours after treatment. No adverse effects were reported.CONCLUSIONS:BOTOX was found to be a safe and effective therapy for both acute and prophylactic treatment of migraine headaches. Further research is needed to explore and develop the complete potential for the neuroinhibitory effects of botulinum toxin.
Lymphatic malformation: Predictive factors for recurrence
Authors: Fliegelman Lawrence J. , Friedland David , Brandwein Margaret , Rothschild Michael 
Published: February 2003

OBJECTIVE:Although lymphatic malformations are often found to be well circumscribed when surgery is undertaken in early childhood, complete surgical excision can be difficult when the lesion is infiltrative. This study retrospectively evaluates these patients in an attempt to identify prognostic factors that may predict recurrence.STUDY DESIGN AND SETTING:A retrospective chart review was conducted covering the years 1991 to 1998. Seventeen patients were identified having undergone 32 surgical resections of tumors described as lymphatic malformations. Data abstracted from the charts included the site of the lesion, surgical and histologic assessment of encapsulation, and status at follow‐up examination.RESULTS:Six of 17 patients developed a recurrence after surgery. Correlation between recurrence and histologic or operative impressions of encapsulation was significant by χ2 analysis (P < 0.01).CONCLUSION:On the basis of the findings of this case series, lymphatic malformations that are found to be nonencapsulated and infiltrative by intraoperative or histologic assessment are more likely to recur.
Bone‐screw mandible fixation: An intraoperative alternative to arch bars
Authors: Vartanian A. John , Alvi Aijaz 
Published: February 2003

OBJECTIVES:Bone‐screw mandible fixation (BSMF) is evaluated as an alternative to intraoperative arch‐bar maxillomandibular fixation before plating of mandibular fractures. BSMF is achieved by wire ligation of opposing bone‐screws placed in the maxilla and mandible.METHODS:A retrospective evaluation of 23 patients with 40 mandibular fractures who underwent man‐dibular fracture repairs. BSMF was used instead of arch bars to ensure proper dental occlusion. All fractures were then plated, after which BSMF was removed before termination of anesthesia.RESULTS:Normal occlusion was observed in 21 patients (91.3%), Class II malocclusion was noted in 1 patient (4.3%), and 1 patient was edentulous. No complications related to the use of BSMF were observed.CONCLUSION:BSMF can serve as a viable alternative to arch‐bar maxillomandibular fixation for obtaining temporary intraoperative occlusion. BSMF produces acceptable malocclusion rates and offers the advantages of decreased intraoperative time, lower risk for percutaneous and mucosal wire punctures, and ease of use.
Submucosal Radiosurgical Uvulopalatoplasty for the Treatment of Snoring: Is the Monitoring of Tissue Impedance and Temperature Necessary?
Authors: Taliaferro Cort 
Published: February 2003

OBJECTIVETo determine the safety and efficacy of submucosal radiofrequency uvulopalatoplasty. This procedure uses fixed, predetermined parameters of application without the concomitant monitoring of tissue impedance and temperature in the submucosal radiofrequency induced ablation and volumetric reduction of the soft palate as a treatment of chronic socially disruptive snoring.DESIGNThis nonrandomized prospective study used preoperative and postoperative questionnaires and visual analogue scales to evaluate snoring and postoperative pain.SETTINGTreatments were performed on an outpatient basis in a community‐based clinic.PATIENTSNineteen patients sought treatment for chronic socially disruptive snoring, without complaints of excessive daytime somnolence, who met the predetermined criteria of a respiratory distress index of less than 20.INTERVENTIONRadiofrequency energy (3.8 MHZ) was applied to the submucosal tissues of the soft palate through a specially designed needle electrode with a predetermined wattage and treatment time. The number of treatments ranged from 1 to 6 (mean, 3.1). Resolution of snoring or diminution of snoring, to the point where it was no longer bothersome to the patients' bedmate, was considered the successful endpoint of the treatments.RESULTSSixteen patients were successfully treated and satisfied with the results. Three patients had only mild or moderate improvement in snoring despite multiple treatments. Postoperative pain was rated as mild (≤3 on the visual analogue scale) in 86% of treatments. In 8 (14%) of 58 treatments,mucosal injury was inadvertently sustained, but all healed without complications.CONCLUSIONSubmucosal radiofrequency uvulopalatoplasty, using the described technique, appears to be a safe, effective, and well‐tolerated treatment for chronic socially disruptive snoring. These initial results indicate that the concomitant monitoring of tissue impedance and tissue temperature during radiofrequency ablation and volumetric reduction of the soft palate is not necessary and adds significantly to the cost of the procedure. (Otolaryngol Head Neck Surg 2001;124:46‐50)
Neck‐Dissection Surgical Specimens Treated by Lymph Node Revealing Solution
Authors: Koren Rumelia , Shvero Jacob , Yaniv Eitan , Veltman Vladimir , Konichezky Miriam , Groushko Ilia , Sadov Rima , Feinmesser Raphael , Gal Rivka 
Published: February 2003

The detection of metastatic lymph nodes in cancer patients is essential for determining the cancer stage, and thus, the therapeutic modalities. However, very small lymph nodes can easily be missed during routine examination. We described a “Lymph Node Revealing Solution” (LNRS) that helps to detect tiny lymph nodes in neck dissection specimens. Twenty‐one consecutive specimens of neck‐dissection were investigated. The entire surgical specimen, fixed at first in formalin, was searched for lymph nodes by the traditional method. These were excised and sent for processing. The remaining tissue was immersed for 24 hours in LNRS. The lymph nodes stood out as white chalky nodules on the background of the yellow fat. They were then excised, and examined. A total of 227 lymph nodes were detected by the traditional method; 38 (17%) were positive for metastasis. Using the LNRS method, an additional 72 nodes were identified, among them 8 (11%) were positive for metastases and 2 cases were upstaged. LNRS is an inexpensive and easy method of detecting tiny lymph nodes; it enhances significantly the yield of normal and metastatic nodes of neck‐dissection specimens and helps to establish a more accurate staging. (Otolaryngol Head Neck Surg 2001; 124:72‐5)
Organ Preservation by Transoral Laser Microsurgery in Piriform Sinus Carcinoma
Authors: Steiner W. , Ambrosch Petra , Hess C. F. , Kron Martina 
Published: February 2003

OBJECTIVETo determine the effectiveness of organ‐preserving CO2 laser microsurgery for the treatment of piriform sinus carcinoma.METHODSA retrospective review of 129 previously untreated patients undergoing CO2 laser microsurgery for the treatment of squamous cell carcinomas of the piriform sinus from 1981 to December 1996 was undertaken. The intention was complete tumor removal by preserving functionally important structures of the larynx. Distribution of tumors (Union Internationale Contre le Cancer/American Joint Committee on Cancer, 1992) was 24 cases with pT1, 74 with pT2, 17 with pT3, and 14 with pT4 disease. Node status was positive in 68% of patients. Seventy‐five percent of patients had stage III or IV disease. Forty‐two percent of the patients were treated solely with surgery, and 58% had surgery and postoperative radiotherapy. The median follow‐up interval was 44 months.RESULTSEighty‐seven percent of patients were controlled locally. Neck recurrences occurred in 14.0% of patients, metachronous distant metastases with locoregional control in 6.2%, and second primary tumors in 18.6%. Twenty percent of patients died of TNM‐related deaths. The 5‐year overall Kaplan‐Meier survival rate was 71% for stages I and II and 47% for stages III and IV disease; the 5‐year recurrence‐free survival rates were 95% and 69%, respectively.CONCLUSIONA comparatively low local recurrence rate, a high recurrence‐free survival rate, and the avoidance of laryngectomy favor function‐preserving surgery of piriform sinus carcinomas. (Otolaryngol Head Neck Surg 2001; 124:58‐67.)
Efficacy of Selective Neck Dissection: A Review of 503 Cases of Elective and Therapeutic Treatment of the Neck in Squamous Cell Carcinoma of the Upper Aerodigestive Tract
Authors: Ambrosch Petra , Kron Martina , Pradier O. , Steiner W. 
Published: February 2003

OBJECTIVEThe purpose of this study was to evaluate the efficacy of selective neck dissection (SND) in elective and therapeutic treatment of the neck.METHODSA retrospective review was undertaken of 503 previously untreated patients undergoing 711 SNDs as a part of initial therapy for squamous cell carcinoma of the larynx, oral cavity, oropharynx, and hypopharynx from August 1986 to June 1997 at a single institution. Lymph nodes were pathologically negative in 249 and positive in 254 patients. Postoperative radiotherapy was given to 14.5% of the node‐negative and 62.2% of the node‐positive patients. The median follow‐up interval was 41 months.RESULTSThe 3‐year regional recurrence rates estimated according to Kaplan‐Meier were as follows: pN0, 4.7%; pN1, 4.9%; pN2, 12.1%. A comparison of recurrence rates with respect to the extent of neck disease and postoperative radiotherapy demonstrated a tendency to an improved regional control in irradiated patients with one metastasis and a distinctly improved regional control in patients with multiple metastases or metastases with extracapsular spread.CONCLUSIONThe results achieved with SND compare favorably with the results reported for modified radical neck dissection. The application of SND might be extended to more advanced neck disease.
Lymphoid Cell Infiltration into Epstein‐Barr Virus‐positive Nasopharyngeal Carcinomas
Authors: Shpitzer Tommy , Kerrebijn Jeroen D. F. , Freeman Jeremy L. , Hartwick Warren , Saiki Yuriko , Irish Jonathan C. , Macmillan Christina M. , Dosch Hans‐Michael 
Published: February 2003

OBJECTIVESA pilot study was designed to analyze lymphoid cell infiltration in Epstein‐Barr virus‐positive (EBV+) nasopharyngeal carcinomas (NPCs) and to determine whether this pattern of infiltration is consistent with non‐EBV+ head and neck carcinomas or with solid EBV+ tumors in other locations.STUDY DESIGNWe performed a retrospective analysis of archived NPCs and oral cavity carcinomas.METHODSImmunohistochemical staining of the archive material for various markers (CD3, CD8, UCHL‐1, S‐100, and intercellular adhesion molecule) was performed. Polymerase chain reaction techniques to establish the presence of the EBV genome were used. Cells in different locations were counted under a light microscope by 2 of the authors.RESULTSThe infiltration pattern of NPCs was different from that of oral cavity carcinomas. Stromal infiltration was significantly denser in oral cavity carcinomas. Tumor nest infiltration was more pronounced in NPCs. The pattern of infiltration was comparable with what has been described for other solid EBV+ tumors.CONCLUSIONSThe immune response to NPCs is likely to be strongly influenced by the presence of the EBV genome. The pattern of infiltration is similar to that of other non‐head and neck EBV+ solid tumors and different from that of EBV‐ head and neck carcinomas.