bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Animal Model for External Ear Canal Inflammation
Authors: Wright Charles G. , Pawlowski Karen S. , Roland Peter S. , Meyerhoff William L. 
Published: November 2003

AbstractObjective To develop an animal model for testing efficacy of anti‐inflammatory drugs designed to treat external ear canal (EAC) disease.Methods Histological and morphometric methods were used to characterize EAC inflammation produced by topical application of tetradecanoylphorbol acetate (TPA) in mice. The effects of both single and repeated TPA applications were studied. A treatment trial was performed to evaluate the effects of a ciprofloxacin/hydrocortisone suspension on TPA‐induced EAC inflammation. In 10 animals, two bilateral applications of TPA were made, spaced 24 hours apart. Immediately after the second TPA application, otic suspension was applied unilaterally four times over a 48‐hour period. The contralateral EACs were left untreated to provide TPA‐only controls.Results Twenty‐four hours after a single TPA application, EAC skin showed polymorphonuclear (PMN) leukocyte infiltration, vascular dilation, and thickening of the dermis and epidermis. Dermal and epidermal thickening were more pronounced after two TPA applications and PMN leukocyte infiltration remained high 48 hours after a second TPA placement. After treatment with the otic suspension, PMN leukocyte counts were reduced by an average of 76% relative to EACs that received TPA only. There was also statistically significant reduction of dermal swelling and a trend toward reduced epidermal thickness. Vascular dilation was clearly reduced as well. EACs that received four applications of the suspension alone showed no adverse effects compared with those that received saline.Conclusion TPA‐induced inflammation of the mouse EAC provides a suitable model for testing the therapeutic efficacy of anti‐inflammatory agents being considered for clinical use.
Reducing Post‐tonsillectomy Pain With Cryoanalgesia: A Randomized Controlled Trial
Authors: Robinson Simon R. , Purdie Gordon L. 
Published: November 2003

AbstractObjective/Hypothesis To evaluate the use of cryoanalgesia in reducing post‐tonsillectomy pain.Study Design A prospective, randomized double‐blind study of 59 consecutive patients (age range, 8–40 y) undergoing tonsillectomy for recurrent tonsillitis.Methods All patients underwent bipolar tonsillectomy. At the completion of the tonsillectomy patients were randomly assigned to a control or a cryotherapy group. The cryotherapy patients had both their tonsillar fossa “supercooled” to between −20°C and −32°C for 1 minute. Patients recorded their pain using a visual analogue scale over the next 10 days. Patients were also monitored for postoperative complications, time until resumption of a normal diet, time back to work or school, and analgesic consumption.Results The two groups were similar for age and sex. There was a 28.3% reduction in mean pain scores over the 10 days in the cryotherapy compared to the control group. This difference did not significantly depend on the day after operation or time of the day. Cryotherapy patients also returned to work or school, on average, 4 days earlier than controls. There was no significant difference in postoperative complications between the two groups.Conclusion Cryotherapy is a new technique that significantly reduces post‐tonsillectomy pain without evidence of causing additional complications.
Postsurgical Prevertebral Abscess of the Cervical Spine
Authors: Talmi Yoav P. , Knoller Nachshon , Dolev Mark , Wolf Michael , Simansky David A. , Keller Nathan , Hadani Moshe , Ohry Abraham , Kronenberg Jona 
Published: November 2003

AbstractObjectives Prevertebral abscess formation is an uncommon occurrence following cervical spine fusion surgery. Abscesses may present early or in a delayed fashion and require surgical drainage and long‐term antibiotic treatment. The issues of osteomyelitis and the need for plate removal remain unresolved.Study Design A case series of six tetraplegic patients admitted for rehabilitation to the Chaim Sheba Medical Center (Tel Hashomer, Israel) is presented.Methods Five patients were trauma patients; one patient underwent repeated procedures and irradiation for tumor of the cervical spine. All patients developed prevertebral abscesses after a mean period of 30 days from their fusion surgery. Computed tomography scan was used in all patients to establish the diagnosis and define the extent of the infective process. All patients underwent one or more drainage procedures. The plate was removed in two patients at 1 and 4 months.Results Infection completely resolved in four patient and was refractory in one patient with malignant tumor, and a chronic small fistula remained in one case. Staphylococcus aureus was the main infective organism, but mixed infections were the rule. Even for a protracted course of infection, no significant osteomyelitis was encountered.Conclusions Abscess formation after instrumentation of the neck may be more common than formerly recognized. Despite the prolonged course of disease and treatment, osteomyelitis is not a major concern. There is no automatic indication for plate removal to control infection, although plating may be safely removed after 10 to 12 weeks if the neck is explored and the cervical spine is stable. A high index of suspicion is warranted, and early recognition and diagnosis, prompt surgical drainage under general anesthesia, and long‐term antibiotic treatment are key for eradication of the infective process. Prophylactic antibiotics may be of value. Meticulous antisepsis and surgical technique should be maintained to reduce the incidence of these severe complications.
The Larynx During Exercise
Authors: Naito Akira , Niimi Seiji 
Published: November 2003

AbstractObjectives To develop a system capable of observing the larynx during various body movements and to investigate the relation between upper limb movements and laryngeal closure, often referred as “airtrapping.”Study Design An endoscope capable of observing the larynx during various body movements was developed and the laryngeal state was monitored during these movements in three subjects. The output of 12 subjects' forearms was recorded with and without laryngeal closure.Results The larynx was observable even during extreme exercises such as horizontal bar exercises and vault exercises. Laryngeal closure was almost always seen during the beginning of maximum effort of the upper limbs. During constant effort, the state of the larynx varied. When the output of the upper limbs was compared with and without laryngeal closure, there was an average of 20% power loss.Conclusions This study suggests four possible uses for this system. 1) The system could be useful to evaluate laryngeal disorders during exercise such as exercise‐induced laryngomalacia. 2) The results could be used to improve the pushing exercise, a voice therapy technique. 3) The status of patients with incomplete laryngeal closure in connection with the upper limbs could be evaluated more thoroughly. 4) The technique and equipment could be used to observe the larynges during normal vocal processes that require body movement.
Efficacy of Botulinum Toxin A for Treatment of Upper Esophageal Sphincter Dysfunction
Authors: Alberty Jürgen , Oelerich Michael , Ludwig Karl , Hartmann Sabine , Stoll Wolfgang 
Published: November 2003

AbstractObjectives To investigate the efficacy of botulinum toxin A (BTA)–induced chemodenervation of the upper esophageal sphincter (UES) in patients with dysphagia and UES dysfunction.Study Design Prospective clinical trial in 10 selected patients with pure UES dysfunction.Methods In each patient 30 units of BTA were injected into the UES under brief general anesthesia. Videofluoroscopic swallowing study (VSS) was done and a clinical symptom score was determined before and after treatment.Results On VSS relative opening of the UES improved in all patients (mean ± SD: 47 ± 14% before versus 71 ± 24% after treatment;P < .01). Hypopharyngeal retention or laryngeal penetration of barium was significantly reduced in four of seven patients. Clinical symptom scores improved in all patients. One patient was free of symptoms, mild dysphagia persisted in six patients, and moderate dysphagia persisted in three patients.Conclusions Our results support the use of BTA in selected patients with pure UES dysfunction. Its efficacy is limited by the possibility of a persistent structural stenosis of the UES and the risk of BTA diffusion into the larynx or hypopharynx.
New Guidelines for Endoscopic Localization of the Anterior Ethmoidal Artery: A Cadaveric Study
Authors: Lee Wai Chung , Ming Ku Peter Ka , van Hasselt Charles Andrew 
Published: November 2003

AbstractObjectives To determine objective data to improve the methods of identification of the anterior ethmoidal artery during endoscopic dissection.Study Design Cadaveric dissection of adult human heads.Methods A 0°, 4‐mm rigid endoscope was used to guide uncinectomy and frontoethmoidectomy. The location of the anterior ethmoidal artery was first determined visually and then confirmed by passing a needle through the anterior ethmoidal foramen from the orbit into the nose in all cases. The distances were endoscopically measured using a simple ruler between two nasal landmarks and the anterior ethmoidal artery.Results Fifty‐six nasal fossae in 28 cadavers were dissected endoscopically. The median distance between the artery and the “axilla” formed by the anterior attachment of the middle turbinate to the lateral nasal wall was 20 mm (range, 17–25 mm), irrespective of the side. The measurement differed by less than 2 mm between the sides in the same individual. The median distance between the artery and the “axilla” formed by the medial and lateral crura of the lower lateral cartilage (superomedial edge of the nostril) was 62 mm (range, 55–75 mm) for both sides. The artery was found to be in direct alignment with the two “axillae” formed by the middle turbinate and the nostril edge.Conclusions The distance between the ethmoidal artery and the axilla of the middle turbinate showed the least intraindividual and interindividual variations. The tip of the endoscope (or the ruler) points directly at the anterior ethmoidal artery in the fovea ethmoidalis when its edge is aligned with the two nasal landmarks. These simple guidelines can aid the identification of the artery in endoscopic frontoethmoidectomy.
Clinical Study and Literature Review of Nasal Irrigation
Authors: Tomooka Lance T. , Murphy Claire , Davidson Terence M. 
Published: November 2003

AbstractObjectives/Hypothesis Nasal disease, including chronic rhinosinusitis and allergic rhinitis, is a significant source of morbidity. Nasal irrigation has been used as an adjunctive treatment of sinonasal disease. However, despite an abundance of anecdotal reports, there has been little statistical evidence to support its efficacy. The objective of this study was to determine the efficacy of the use of pulsatile hypertonic saline nasal irrigation in the treatment of sinonasal disease.Study Design A prospective controlled clinical study.Methods Two hundred eleven patients from the University of California, San Diego (San Diego, CA) Nasal Dysfunction Clinic with sinonasal disease (including allergic rhinitis, aging rhinitis, atrophic rhinitis, and postnasal drip) and 20 disease‐free control subjects were enrolled. Patients irrigated their nasal cavities using hypertonic saline delivered by a Water Pik device using a commercially available nasal adapter twice daily for 3 to 6 weeks. Patients rated nasal disease–specific symptoms and completed a self‐administered quality of well‐being questionnaire before intervention and at follow‐up.Results Patients who used nasal irrigation for the treatment of sinonasal disease experienced statistically significant improvements in 23 of the 30 nasal symptoms queried. Improvement was also measured in the global assessment of health status using the Quality of Well‐Being scale.Conclusions Nasal irrigation is effective in improving symptoms and the health status of patients with sinonasal disease.
Evaluating the Role of Magnetic Resonance Imaging Scans in the Surgical Management of Acoustic Neuromas
Authors: Hampton Susanne M. , Adler Julian , Atlas Marcus D. 
Published: November 2003

AbstractObjective To assess the reliability of magnetic resonance imaging (MRI) in predicting the size and position of an acoustic neuroma, with particular reference to the intracanalicular portion.Study Design Prospective study comparing the position of the tumor in the internal auditory canal on fast spin‐echo MRI with the actual position measured intraoperatively.Methods The study was performed in a tertiary referral neurotology center, encompassing both the public and private health care systems. Fifteen consecutive patients admitted for acoustic neuroma removal via the translabyrinthine approach were studied. The main outcome measure was tumor position in the internal auditory canal expressed in millimeters, accurate to the nearest 0.5 mm.Results The fast spin‐echo MRI was accurate within an error of 1 mm in predicting the lateral extent of the tumor in the internal auditory canal.Conclusion Fast spin‐echo MRI can accurately predict the lateral extent of an acoustic neuroma and allow accurate planning of the surgical approach.
Structural Changes and Protein Expression in the Mastoid Bone Adjacent to Cholesteatoma
Authors: Cinamon Udi , Kronenberg Jona , Benayahu Dafna 
Published: November 2003

AbstractObjective Cholesteatoma of the mastoid and middle ear causes erosion of nearby bone. In this study we examined the mastoid bone adjacent to cholesteatoma and compared it with normal mastoid bone. In particular, noncollagenous proteins, which have a special structural and functional role in bone, were addressed.Study Design Nine mastoid specimens with cholesteatoma and four normal specimens obtained at surgery were examined.Methods Histological and immunohistochemical methods were employed to evaluate the nature of structure and noncollagenous protein content changes in the mastoid bone affected by cholesteatoma.Results The bone associated with cholesteatoma had structural changes as a noncontinuous periosteum, empty lacunae, irregular cement lines, and, specifically, the appearance of eosonophilic vesicles at the interface between the bone and cholesteatoma. Immunohistochemistry demonstrated that noncollagenous proteins were apparently absent in the affected mastoid bone. Bone remote from the cholesteatoma seemed normal.Conclusions These findings demonstrate for the first time the changes in the noncollagenous protein content in the mastoid bone affected directly by cholesteatoma. These changes could be a result of a direct influence of cholesteatoma‐derived products on the osteoblast.
Genetic Analysis in the Diagnosis of Familial Paragangliomas
Authors: Petropoulos Anna E. , Luetje Charles M. , Camarata Paul J. , Keith Whittaker C. , Lee Graham , Baysal Bora E. 
Published: November 2003

AbstractObjectivesIn the management of two related patients with multicentric glomus jugulare tumors, given the incidence of 1:30,000 with approximately 20% familial cases, our objective was to review the genetic characteristics and inheritance patterns of these tumors and to determine what molecular genetic screening possibilities exist for the phenotypically normal family members. In addition, our aim was to review the incidence of various multicentric paraganglioma (PGL) tumor location combinations.MethodsMolecular genetic linkage analysis testing was performed on the 2 patients and 14 other unaffected family members. We report the results of this screening and review the literature on the incidence and genetics of paragangliomas.ResultsThe inheritance pattern in the literature demonstrates autosomal dominant transmission with maternal imprinting (inactivation). The proclivity for multicentric origin increases to 26% in familial cases, as reflected in our patients. In addition to the two patients, four unaffected family members demonstrated the presence of the disease haplotype at chromosome band 11q23, which indicates a very high likelihood of developing a paraganglioma, given the highly penetrant nature of the disease.ConclusionsIt is clear that the familial PGL gene locus is situated at chromosome 11q23. The gene itself and its exact degree of penetrance, however, still await identification. Since early detection of paragangliomas reduces the incidence of morbidity and mortality, genotypic analysis as a screening tool in families of affected patients should play a front‐line diagnostic role, leading to more timely and cost‐effective patient management.
Head and Neck Cancer in Cardiothoracic Transplant Recipients
Authors: Pollard Jeffrey D. , Hanasono Matthew M. , Mikulec Anthony A. , Le Quynh T. , Terris David J. 
Published: November 2003

AbstractIntroduction There is an increased incidence of cancer in patients after organ transplantation. We reviewed a large series of cardiothoracic transplant recipients to determine the incidence and natural history of head and neck malignancy.Methods A total of 1069 heart (n = 855), heart/lung (n = 111), and lung (n = 103) transplants were performed at Stanford University from January 1968 to February 1998. Demographic data, risk factors, and disease course were evaluated in patients who developed cancer. The mean length of follow‐up was 8.9 ± 5.2 years.Results One hundred twenty patients (11.2%) developed 547 non‐lymphomatous malignancies. The mean number of malignancies per cancer patient was 4.6. The average time from transplantation to development of cancer was 63.1 months. A total of 50.5% of malignancies presented in the head and neck; 96.4% of these were cutaneous in origin and 3.6% were noncutaneous. Of cutaneous malignancies, 79.3% were squamous cell carcinoma and 15.9% were basal cell carcinoma. Cutaneous malignancies most commonly presented on the scalp, cheek, lip, and neck. Noncutaneous malignancies involved the oral cavity (5), thyroid (4), and parotid (1). Thirteen percent of cutaneous head and neck cancers behaved aggressively, requiring e‐tensive management including radical surgery, radiation, and/or chemotherapy. A total of 34.2% of cancer patients developed metastases and 54.9% of cancer patients died as a direct result of cancer. A total of 68% of cancer patients were smokers and 23.8% had significant alcohol use.Conclusion Transplant recipients have an increased incidence of cancer presenting in the head and neck. Malignancies in transplant patients behave more aggressively than in the general population. Recognition of this aggressive biological behavior and heightened cancer surveillance should result in improved outcomes.
Patterns of Swallowing After Supraglottic Laryngectomy
Authors: Schweinfurth John M. , Silver Steven M. 
Published: November 2003

AbstractObjective To understand the anatomical and physiological basis for early recovery of swallowing function after supraglottic laryngectomy.Study Design Retrospective review.Methods The records of nine patients who had undergone supraglottic laryngectomy at the Stratton Veteran's Administration Hospital (Albany, NY) between 1994 and 1998 were reviewed. Videofluoroscopic swallowing studies were obtained on all patients as early as was safely possible and were reviewed by a multidisciplinary team of physicians, nurses, and speech pathologists with regard to anatomical and functional differences between successful and unsuccessful recovery of swallowing function.Results Five of nine patients resumed regular diets including thin liquids within 1 year of surgery; three patients remained dependent on enteral support. Swallowing success was most closely associated with short oropharyngeal transit time and an anterosuperior position of the larynx. Laryngeal positioning, tongue base mobility, and placement and coordination of the bolus for maximum swallowing efficiency can be improved with time and speech therapy.Conclusions Factors that placed patients at significantly higher risk for aspiration included low laryngeal position and delayed oropharyngeal transit time. Tight lingual‐laryngeal closure did not completely prevent aspiration. At the time of the initial surgical procedure it may be important to position the laryngeal remnant as far superior and anterior under the tongue base as possible.
Intratumoral Hypericin and KTP Laser Therapy for Transplanted Squamous Cell Carcinoma
Authors: Chung Phil S. , Rhee Chung K. , Kim Kwang H. , Paek Woo , Chung Juliet , Paiva Marcos B. , Eshraghi Amir A. , Castro Dan J. , Saxton Romaine E. 
Published: November 2003

AbstractObjectives/Hypothesis To test intratumoral photodynamic therapy (IPDT) as a new treatment for squamous cell carcinoma in a preclinical tumor model.Study Design and Methods Human P3 squamous carcinoma cells were transplanted subcutaneously in athymic nude mice and allowed to grow into 300‐ to 500‐mm3 tumors. Hypericin dye at 1 μg/gm of body weight was injected intratumorally (IT) or intravenously (IV). After 4 hours hypericin biodistribution was assessed in ethanol extracts from tissues by fluorescence spectroscopy. IPDT also was tested by KTP laser fiberoptic insertion in tumors 4 hours after IT dye injection compared to KTP532 laser therapy alone (532 nm, 1W, 40–60 J, 0.6‐mm fiber).Results Hypericin concentration in tissues was as follows: (IT vs. IV) for tumors (3660 vs. 135 ng dye/gm tissue), lung (760 vs. 6345), liver (75 vs. 935), blood (65 vs. 480) compared to skin (465 vs. 110) or muscle (335 vs. 80) adjacent to the squamous cell tumors. Four hours after dye injection, the tumor e‐hibited bright orange fluorescence when e‐cited by KTP 532‐nm green laser light. The IPDT‐treated tumors had a 3.32 ± 0.32‐mm radius of cell destruction when H&E‐stained sections were e‐amined compared with 2.5 ± 0.38 mm for the laser only control group (n = 10, P = .003).Conclusions This pilot study indicates laser IPDT with hypericin induces a significant increase in tumor necrosis compared with laser alone and may be useful as a less invasive adjuvant treatment for recurrent or inoperable human squamous cell cancers of the head and neck.
Transforming Growth Factor‐β Type II Receptors and Smad Proteins in Follicular Thyroid Tumors
Authors: West Jeff , Munoz‐Antonia Teresita , G. Johnson Jean , Klotch Douglas , Muro‐Cacho Carlos A. 
Published: November 2003

AbstractObjective Resistance to transforming growth factor (TGF)‐β–mediated cell growth inhibition is a well‐known pathogenic mechanism in epithelial neoplasia. TGF‐β signaling requires normal function of downstream mediators such as TGF‐β receptors (TβRs) and Smad proteins. The goal of this study is to investigate the expression of components of the TGF‐β signaling pathway in follicular tumors of the thyroid.Study Design Twenty follicular thyroid neoplasms were classified as adenomas (11) or minimally invasive follicular carcinomas (9) according to current pathological criteria. Protein expression was evaluated to identify differences between benign and malignant tumors that could be used as an adjunct to histopathological analysis.Methods Paraffin‐embedded tissue sections containing tumor and adjacent nonneoplastic parenchyma were analyzed by immunohistochemistry for the expression of TβR type II (TβR‐II) and Smad2, Smad4, Smad6, and Smad7. Expression of each protein in the tumor was compared with that of the corresponding adjacent nonneoplastic thyroid parenchyma.Results TβR‐II expression was lost in 78% of the carcinomas. In the remaining 22%, TβR‐II was preserved but Smad2 expression was lost. In all conventional adenomas, however, TβR‐II expression was maintained. Furthermore, all tumors with normal expression of all proteins were adenomas.Conclusions Downregulation of TβR‐II is a consistent abnormality in follicular carcinomas and can be used to differentiate minimally invasive carcinomas from adenomas. Also, downregulation of Smad proteins is another mechanism by which carcinomas can become independent from TGF‐β–mediated growth inhibition.