bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tumor Necrosis Factor‐α, an Initiator, and Etanercept, an Inhibitor of Cochlear Inflammation
Authors: Satoh Hitoshi , Firestein Gary S. , Billings Peter B. , Harris Jeffrey P. , Keithley Elizabeth M. 
Published: November 2003

AbstractObjectives/Hypothesis The inner ear rapidly mounts an immune response that can lead to cochlear degeneration and permanent hearing loss. Identification of proinflammatory cytokine expression during the initiation of the response should lead to rational therapeutic strategies that block the response, reducing damaging sequelae.Study Design A cochlear immune response to keyhole limpet hemocyanin (KLH) injected into the inner ear or subarachnoid space of sensitized animals was created. Etanercept was administered to a group of animals to blunt the immune response.Methods Cochleae were immunoassayed for expression of interleukin‐1β, tumor necrosis factor‐α, and interleukin‐6 and evaluated for the amount of cochlear‐infiltrated cells.Results Tumor necrosis factor‐α and interleukin‐1β were expressed by infiltrated cells shortly after KLH injection. Tumor necrosis factor‐α was expressed whether the antigen was introduced with or without surgical trauma. Interleukin‐1β was also expressed by the cochlear fibrocytes during the immune response and in surgical control animals, but not after intrathecal injection of antigen. Interleukin‐6 expression was minimal during the response. Based on this observation, animals were treated with systemic injection of Etanercept, which reduced cochlear infiltrating cell number and cochlear fibrosis.Conclusion Interleukin‐1β expression is a general cochlear response to trauma, whereas tumor necrosis factor‐α expression in the infiltrated immunocompetent cells is the cytokine that induces amplification of the response that leads to cochlear disease.
In Vivo Characteristics of HPV‐Immortalized and Carcinogen Transformed Oral Keratinocytes
Authors: Yoo George H. , Piechocki Marie P. , Lonardo Fulvio , Meng Hong , Kewson Danny , Shibuya Terry Y. , Kim Harold , Stachler Robert , Ensley John F. 
Published: November 2003

AbstractPurpose To characterize in vivo features of HPV‐immortalized and carcinogen transformed oral keratinocytes.Methods The growth and squamous differentiation of IHGK (immortalized human gingival keratinocyte with HPV), IHGKN [4‐(methylnitrosamino)‐1‐(3‐pyridyl)‐1‐butanone, (NNK)]‐carcinogen transformed keratinocytes, and two head and neck squamous cell carcinoma (HNSCC) cell lines, HN30 and HN12, were tested by injecting these cells into SCID mice. The growth, histological features, and expression of PCNA, Involucrin, and high molecular weight keratin of the tumors formed were compared among these cell lines.Results All cell lines formed a palpable lesion at 2 weeks; however, only HN30 continued to grow. IHGK and IHGKN cells formed palpable nodules within 2 weeks with no further growth after 4 to 5 weeks, and no regression of the nodule was noted at 12 weeks. HN12 cells did not form tumor nodules unless these cells were co‐injected with immortalized fibroblasts. Both IHGK and IHGKN cells formed a well‐circumscribed epithelial lesion with islands of differentiated squamous cells bound by a myxoid matrix. Nests of basal‐horny squamous cells centrally differentiated into anucleate squamous cells. IHGK and IHGKN nodules had more squamous differentiation than HN12 and HN30 and further differentiated over time. IHGK and IHGKN cells expressed differentiation (involucrin and high molecular weight keratin) and proliferation (PCNA) markers that suggest that IHGK and IHGKN behave as well‐differentiated squamous lesions when compared with malignant HN12 and HN30 nodules. IHGK and IHGKN cells showed an initial growth phase followed by terminal differentiation, and then a phase characterized by regression and host inflammatory stage.Conclusions The growth, histology, and expression of differentiation and proliferation markers of IHGK and IHGKN lesions into SCID mice demonstrate that these cells are endowed with a limited malignant potential. Our in vivo model with these intermediate cell lines can provide a short‐term analysis for studying the biology of HNSCC progression and the activity of chemoprevention agents.
The Influence of Radiotherapy on the Lifetime of Silicone Rubber Voice Prostheses in Laryngectomized Patients
Authors: Elving G. Jolanda , van Weissenbruch Ranny , Busscher Henk J. , van der Mei Henny C. , Albers Frans W. J. 
Published: November 2003

AbstractObjectives To establish a relationship between voice prosthetic lifetime in laryngectomized patients and the irradiation dose applied to the neck node levels (field of the neck) in which the major salivary glands are partially included. Furthermore, a possible relationship between voice prosthetic lifetime and the irradiation dose applied to the primary tumor site was studied.Study Design A retrospective analysis was performed on 101 patients after laryngectomy.Methods The records of 101 patients who underwent total laryngectomy between January 1993 and November 1999 at the Department of Otorhinolaryngology, University Hospital Groningen, The Netherlands, were analyzed. The following parameters were obtained: age, sex, radiotherapy, radiation fields, irradiation dose per field, tumor site, TNM classification, and valve insertion.Results Irradiation to extensive neck fields, including the submandibular glands, did not influence the voice prosthetic lifetime after laryngectomy. However, primary tumor doses exceeding 60 Gray significantly shortened the mean voice prosthetic lifetime per patient.Conclusions This study identified an association between radiation on the primary tumor site with a dose equal to or more than 60 Gray and limited lifetimes of voice prostheses.
Optimizing Treatment of Nasal Fractures
Authors: Staffel J. Gregory 
Published: November 2003

AbstractObjectives/Hypothesis A graduated protocol involving closed reduction, septoplasty, osteotomies, upper lateral cartilage release, anterior perpendicular plate fracture, and camouflaging cartilage grafts yields a higher percentage of straight noses in cases of acute fracture than treatment with closed reduction alone.Study Design Retrospective chart and literature review followed by a prospective, non‐randomized sequential trial.Methods Closed reduction was performed on 26 cases of acute nasal fracture and the results were compared with a subsequent series of 79 cases treated using a more complete protocol.Results The cases treated with the more complete protocol yielded straighter noses. The difference was statistically significant using Wilcoxon rank sum analysis at the P = .028 level.Conclusions Treatment of the acutely fractured nose involving an individually tailored protocol of closed reduction, septoplasty, osteotomies, release of the upper lateral cartilages, fracture of the anterior extension of the perpendicular plate of the ethmoid, and camouflaging cartilage grafts yields straighter noses than treatment by closed reduction alone.
Biophysics of Cochlear Implant/MRI Interactions Emphasizing Bone Biomechanical Properties
Authors: Sonnenburg Robert E. , Wackym Phillip A. , Yoganandan Narayan , Firszt Jill B. , Prost Robert W. , Pintar Frank A. 
Published: November 2003

AbstractObjective/Hypothesis The forces exerted during a 1.5‐Tesla MRI evaluation on the internal magnet of a cochlear implant (CI) raise concern about the safety for CI recipients. This study determines the magnitude of force required to fracture the floor of a CI receiver bed.Method Recessed CI beds were drilled to maximum uniform thinness into formalin‐fixed and fresh–frozen human calvaria specimens. A Med‐El stainless steel CI template mounted to the piston of an electrohydraulic testing device was used to fracture the floor of the implant beds. Force and displacement were measured as a function of time using a digital data acquisition system.Results Mean force to first failure, displacement to first failure, and minimum thickness, respectively, were: group 1 (formalin‐fixed, 0.3–0.4‐mm thick [n = 22]), 34.08 N (8.21–59.64 N, standard deviation [SD] 15.41 N), 1.09 mm (0.40–2.16 mm, SD 0.51 mm), 0.36 mm (0.3–0.4 mm, SD 0.05 mm); group 2 (formalin‐fixed, 0.5–0.9 mm thick [n = 21]), 52.82 N (20.28–135.53 N, SD 25.29 N), 1.08 mm (0.50–2.28 mm, SD 0.47 mm), 0.58 mm (0.5–0.9 mm, SD 0.12 mm); group 3 (fresh–frozen [n = 9]), 134.13 N (86.44–190.70 N, SD 34.92 N), 1.96 mm (1.47–2.46 mm, SD 0.35 mm), 0.42 mm (0.3–0.6 mm, SD 0.11 mm).Conclusions The mean magnitude of force required to fracture the floor of a CI bed is significantly greater than those that are generated when a Med‐El Combi 40+, CII Bionic Ear CI, or Nucleus Contour CI is placed into a 1.5‐Tesla MRI unit.
Acoustic Properties of Different Cartilage Reconstruction Techniques of the Tympanic Membrane
Authors: Mürbe Dirk , Zahnert Thomas , Bornitz Matthias , Hüttenbrink Karl‐Bernd 
Published: November 2003

AbstractObjectives/Hypothesis The use of cartilage in reconstruction of the tympanic membrane has been established especially in cases such as tubal dysfunction and adhesive processes. Cartilage offers the advantage of higher mechanical stability compared with membranous transplants but may alter the acoustic transfer characteristics of the graft. Apart from material properties, it can be assumed that, also, the microsurgical reconstruction technique might influence the sound transmission properties of the reconstructed tympanic membrane. The purpose of the study was to investigate the acoustic transfer characteristics of different cartilage transplants being typically used in different reconstruction techniques of the tympanic membrane.Methods Cartilage plates of different thicknesses (1.0, 0.7, 0.5, and 0.3 mm), cartilage palisades, and cartilage island transplants of varying size were investigated by means of an ear canal–tympanic membrane model. In contrast to former single‐point measurements, sound‐induced vibrational amplitudes of the entire transplant were measured by scanning laser Doppler vibrometry (measuring points, n = 133) (PSV‐200, Polytec, Waldbronn, Germany). Frequency response functions (displacement vs. sound pressure) of all measured points were determined in the frequency range of 200 Hz to 4 kHz for the different transplants.Results Cutting thick cartilage transplants into thin plates or palisades decreased the first resonance frequency and increased its amplitude, reflecting improved sound transmission properties of the transplant. From an acoustical point of view, the 0.5‐mm cartilage plate seems preferable compared with the palisade technique. Cartilage island techniques showed vibration characteristics superior to plate or palisade techniques.Conclusions Apart from material characteristics, the sound transmission properties of the reconstructed tympanic membrane are strongly influenced by the reconstruction technique. The choice of the surgical technique should consider requirements based on mechanical stability and acoustic transfer characteristics of the transplant.
Submandibular and Intracranial Hydatid Cyst in an Adolescent
Authors: Guney Onder , Ozturk Kayhan , Kocaogullar Yalcn , Eser Olcay , Acar Osman 
Published: November 2003

AbstractObjectives An unusual case of hydatid disease is reported. Review of the pertinent literature did not reveal any hydatid disease located simultaneously in both the intracranial and submandibular glands. This is the first case with hydatid disease occurring in both locations at the same time.Study Design The case of an 18‐year‐old is presented; the symptoms, findings, methods of diagnosis, and our approach for treatment are discussed; and the literature is reviewed.Results The intracranial lesion was completely excised by left‐sided frontoparietal craniotomy, and the mass in the right side of the submandibular gland was removed through a submandibular approach at the same session. The intact cyst was completely excised. Histological examination of both lesions confirmed the diagnosis of hydatid cyst by Echinococcus granulosus. Postoperative recovery was uneventful, and the patient was discharged on the seventh day.Conclusions Hydatid cyst should be suspected during the evaluation of cervical masses, particularly in endemic regions. Hydatid disease infestations are best treated with complete excision of the intact cyst.
Intraoperative Parathyroid Hormone Levels in Thyroid and Parathyroid Surgery
Authors: Warren Frank M. , Andersen Peter E. , Wax Mark K. , Cohen James I. 
Published: November 2003

AbstractObjective To determine the utility of intraoperative parathyroid hormone measurement in predicting postoperative hypocalcemia after thyroid and parathyroid surgeries that places total parathyroid function at risk.Study Design Retrospective case review.Methods The case records of 23 patients undergoing total or completion thyroidectomy and 30 patients undergoing parathyroid exploration were reviewed. All patients had intraoperative parathyroid hormone levels measured. Samples were taken before dissection and 10 minutes after the resection was completed. Serial ionized calcium levels were measured in the postoperative period. Percentages of reduction in PTH levels from preoperative to postresection levels were calculated. Percentages of reduction in PTH level and the absolute value of the intraoperative PTH values were compared with postoperative ionized calcium levels.Results In the 23 patients who underwent thyroid surgery, the average preoperative and postoperative PTH values were 50 pg/mL (range, 17–87 pg/mL) and 34 pg/mL (range, 4–93 pg/mL), respectively. The average decrease in PTH was 39% (range, 39%–90%). The incidence of hypocalcemia was significantly higher in patients with intraoperative PTH levels less than 15 pg/mL relative to patients with PTH levels greater than 15 pg/mL in this setting (P = .006). In the 30 patients who underwent parathyroid exploration, average preoperative and postoperative PTH levels were 291 pg/mL (range, 65–1675 pg/mL) and 113.8 pg/mL (range, 6.5–1263 pg/mL) respectively. The intraoperative PTH level did not correlate with postoperative calcium levels in the parathyroid group. Percentages of decrease in PTH levels greater than 60% was statistically associated with surgical cure in this population.Conclusions The study demonstrates that intraoperative PTH levels greater than 15 pg/mL after total or completion thyroidectomy indicate a low risk of postoperative hypocalcemia and that these patients may be candidates for outpatient surgery. In the parathyroid group, intraoperative PTH levels do not correlate well with postoperative calcium levels.
Obstructive Congenital Epulis: Prenatal Diagnosis and Perinatal Management
Authors: Kumar Pankaj , Kim Harold Hyon Soo , Zahtz Gerald D. , Valderrama Elsa , Steele Andrew M. 
Published: November 2003

AbstractObjective To describe a multidisciplinary approach for delivery room management of congenital epulis.Study Design Case reports.Methods Reporting of two cases of congenital epulis and review of the literature.Results Antepartum ultrasonography demonstrated massive intraoral masses in two fetuses whereby concerns regarding the patency of the airway at birth necessitated development of a multidisciplinary team of maternal–fetal medicine, neonatal–perinatal medicine, anesthesiology, and otolaryngology. Surgical excision was performed before delivery in one infant and after complete delivery in the other without a need for endotracheal intubation and general anesthesia. Feeding was started early, and both infants were discharged after brief hospital stays. Pathological findings were consistent with congenital epulis. Differential diagnosis and options for surgical intervention are discussed, including ex utero intrapartum treatment.Conclusions A multidisciplinary approach to antenatally identified congenital intraoral masses facilitates care at birth. Surgical treatment in this milieu may be simple and complete at the time of delivery.
Wegener's Granulomatosis of the Orbit: A Clinicopathological Study of 15 Patients
Authors: Fechner Frank P. , Faquin William C. , Pilch Ben Z. 
Published: November 2003

AbstractObjectives Wegener's granulomatosis is a granulomatous and necrotizing vasculitis that classically involves the respiratory and renal systems. The goal of the study was to define clinical and pathological characteristics in a subgroup of patients with the changes of Wegener's granulomatosis involving the orbit.Study Design Retrospective study.Methods A database search identified 15 patients with the histological changes of Wegener's granulomatosis of the orbit presenting over a 23‐year period. A review of the histological specimens, radiological studies, and patient charts was performed. Additional follow‐up data were obtained through patient interviews.Results Of 15 patients (median age, 54 y) with Wegener's granulomatosis of the orbit identified, the disease was limited to the orbit in 12 patients; 3 patients had additional sinonasal involvement. All patients underwent various surgical procedures followed by medical treatment (cyclophosphamide and prednisone). Specimens showed characteristic histopathological features of Wegener's granulomatosis. Follow‐up data were available for 12 patients with a median period of 5 years. In the group with only orbital involvement, none of the patients developed systemic progression of Wegener's granulomatosis. Only one patient had multiple local recurrences and later developed contralateral orbital Wegener's granulomatosis.Conclusions Wegener's granulomatosis limited to the orbit is a localized form of the disease without systemic progression. Diagnostic surgical procedures followed by aggressive medical treatment results in good outcome, although local recurrence may occur.
The Role of Bone in Chronic Rhinosinusitis
Authors: Khalid Ayesha N. , Hunt Jennifer , Perloff Joel R. , Kennedy David W. 
Published: November 2003

AbstractObjectives To evaluate and confirm the histological inflammatory changes that occur in bone and in the overlying mucosa in experimentally induced chronic rhinosinusitis and to evaluate differences in the inflammatory patterns that may occur with different organisms.Study Design Histological study of induced maxillary rhinosinusitis in 29 New Zealand White rabbits (15 with Pseudomonas aeruginosa, 14 with Staphylococcus aureus) 7 to 9 weeks after infection.Methods Following maxillary sinus ostial infection, unilateral chronic bacterial rhinosinusitis was induced in 29 New Zealand White Rabbits, using Pseudomonas aeruginosa (n = 15) and Staphylococcus aureus (n = 14). The pathogenic organism was confirmed by culture, and the rabbits were sacrificed at predetermined time intervals (7, 8, and 9 wk) from the time of infection. Following harvest, en bloc sinus sections were mounted, stained, and analyzed. Specific attention was given to identifying histological changes in paranasal sinus bones on both sides.Results All animals (29 of 29) demonstrated histological evidence of operative occlusion on the side of the original inoculum, and all were culture‐positive for the inoculated organism at death. Histological evidence of chronic rhinosinusitis in the inoculated sinus was demonstrated in 86% of animals (25 of 29). Evidence of chronic osteomyelitis in the noninfected side was seen in 15 of 29 animals (52%) overall, or 9 of 15 animals (60%) infected with pseudomonas and 6 of 14 (43%) animals infected with staphylococcus organisms.Conclusions The study provides further evidence that bacterial rhinosinusitis can involve bone at a distance from the site of primary infection, thereby suggesting that infectious agents may spread through bony structures in the pathogenesis of chronic rhinosinusitis.
Synovial Cell Sarcoma: Diagnosis, Treatment, and Outcomes
Authors: Kartha Swapna S. , Bumpous Jeffrey M. 
Published: November 2003

AbstractObjectives/Hypothesis Synovial cell sarcoma is a mesenchymal tumor predominantly of the lower extremities. Three percent of cases arise in the head and neck region. It is thought that head and neck synovial sarcoma has a better prognosis than tumors of the extremities. Our experience has demonstrated aggressive behavior of this neoplasm in the head and neck. This compelled us to compare our experience with other studies.Study Design Retrospective chart review.Methods We obtained the records of patients diagnosed with head and neck synovial sarcoma from the Tumor Registry of the University of Louisville School of Medicine (Louisville, KY) and affiliated hospitals for data compiled between January 1990 and December 2000. Data on patient demographics, clinical findings and symptoms, histological findings, treatment, extent of disease, recurrence, and survival were recorded. The literature was reviewed identifying reports of synovial cell sarcoma.Results Five consecutive patients with synovial cell sarcoma were assessed at our facility. The median patient age was 28.2 years. All of the patients underwent an aggressive primary surgical excision followed by irradiation. All patients received chemotherapy after recurrence. Four of the five patients had local recurrence, and all five of the patients developed distant metastases. Three of the patients have died, and two are alive with evidence of disease. Novel sites are reported including the ethmoid sinus and the parotid gland. This group demonstrated a 40% 5‐year overall survival, which was lower than the 60% 5‐year survival reported in the literature for all sites.Conclusions Synovial cell sarcoma of the head and neck is a disease of young people and carries a poor prognosis. The aggressive nature of the disease may require modification of accepted treatment modalities and sequence.
Lipoic Acid in the Treatment of Smell Dysfunction Following Viral Infection of the Upper Respiratory Tract
Authors: Hummel Thomas , Heilmann Stefan , Hüttenbriuk Karl‐Bernd 
Published: November 2003

AbstractObjectives/Hypothesis The study aimed to investigate the potential therapeutic effects of α‐lipoic acid in olfactory loss following infections of the upper respiratory tract. Possible mechanisms of actions include the release of nerve growth factor and antioxidative effects, both of which may be helpful in the regeneration of olfactory receptor neurons.Study Design Unblinded, prospective clinical trial.Methods A total of 23 patients participated (13 women, 10 men; mean age 57 y, age range 22–79 y; mean duration of olfactory loss, 14 mo; range, 4 to 33 mo); 19 of them were hyposmic and 4 had functional anosmia. Alpha‐lipoic acid was used orally at a dose of 600 mg/day; it was prescribed for an average period of 4.5 months. Olfactory function was assessed using olfactory tests for phenyl ethyl alcohol odor threshold, odor discrimination, and odor identification.Results Seven patients (30%) showed no change in olfactory function. Two patients (9%) exhibited a moderate decrease in olfactory function; in contrast, six patients (26%) showed moderate and eight patients (35%) remarkable increase in olfactory function. Two of the 4 patients with functional anosmia reached hyposmia; 5 of 19 hyposmic patients became normosmic. Overall, this resulted in a significant improvement in olfactory function following treatment (P = .002). At the end of treatment parosmias were less frequent (22%) than at the beginning of therapy (48%). Interestingly, recovery of olfactory function appeared to be more pronounced in younger patients than in patients above the age of 60 years (P = .018).Conclusions The results indicate that α‐lipoic acid may be helpful in patients with olfactory loss after upper respiratory tract infection. However, to judge the true potential of this treatment, the outcome of double‐blind, placebo‐controlled studies in large groups of patients must be awaited, especially when considering the relatively high rate of spontaneous recovery in olfactory loss after upper respiratory tract infection.