bluuebunny/crossref_metadata_2025_split huggingface dataset:
Which comes first? psychogenic dizziness versus otogenic anxiety
Authors: Staab Jeffrey P. , Ruckenstein Michael J. 
Published: November 2003

AbstractObjective: To investigate the hypotheses that physical neurotologic conditions may trigger anxiety disorders (otogenic pattern of illness), that psychiatric disorders may produce dizziness (psychogenic pattern), and that risk factors for these syndromes may be identified. Study Design: Retrospective review of all patients (N = 132) treated at a tertiary care balance center from 1998 to 2002 for psychogenic dizziness with or without physical neurotologic illnesses. Methods: All patients underwent comprehensive neurotologic and psychiatric evaluations with attention to the longitudinal course of symptoms and risk factors for psychopathology. Patients were grouped according to the condition first causing dizziness. Risk factors were compared across groups. Results: Three equally prevalent patterns of illness were found: anxiety disorders as the sole cause of dizziness (33% of cases), neurotologic conditions exacerbating preexisting psychiatric disorders (34%), and neurotologic conditions triggering new anxiety or depressive disorders (33%). Panic disorder and agoraphobia were significantly more prevalent than less severe phobias in the first two groups, whereas the opposite pattern existed in the third group (P < .0001). More patients in the first two groups had risk factors for anxiety disorders (P < .05). Depression was not a primary cause of dizziness in any patient. Vestibular neuronitis, benign paroxysmal positional vertigo, and migraine were the most common neurotologic conditions. Conclusions: These data support the hypothesis that physical neurotologic conditions may trigger psychopathology as often as primary anxiety disorders cause dizziness. A third pattern appears to be equally common wherein physical neurotologic conditions exacerbate preexisting psychiatric illnesses. Individuals at risk for anxiety disorders may be more likely to have primary psychopathology.
Combining acoustic and electrical hearing
Authors: Gantz Bruce J. , Turner Christopher W. 
Published: November 2003

AbstractObjectives/Hypothesis: The concept of combining electrical stimulation for high‐frequency sound with acoustic hearing for low‐frequency information was tested. In addition, whether residual hearing can be preserved when an electrode is placed into the inner ear up to 10 mm and whether place of electrical stimulation influences speech perception were tested. Study Design: A single‐subject clinical trial design was employed. Methods: Six postlingual adults with severe high‐frequency hearing impairment were recruited to participate in the study. A new six‐channel cochlear implant was designed for the clinical trial. The intracochlear electrodes were either 6 or 10 mm in length based on a Nucleus CI‐24 multichannel implant. Monosyllabic word understanding and consonant identification testing in a recorded sound‐only condition were used to assess changes in speech perception. Follow‐up was greater than 12 months. Results: Acoustic hearing was preserved in all six subjects (n = 3,6‐mm electrodes; n = 3,10‐mm electrodes). Preoperative monosyllabic word and sentence scores were unchanged in all subjects following implantation. A 30% to 40% improvement in consonant recognition occurred with the 10‐mm electrode. The subjects with 10‐mm electrodes were able to understand 83% to 90% of the monosyllabic words using the implant plus binaural hearing aids. Scores were more than doubled when compared with preoperative scores with hearing aids only. Conclusion: The human ear has the capability to integrate both acoustic and high‐frequency electrically processed speech information. Placement of a short, 10‐mm electrode does not appear to damage residual low‐frequency inner ear hair cell function, interfere with the micro mechanics of normal cochlear vibration, or decrease residual speech perception. The improvement in speech recognition was due primarily to the increased perception of higher‐frequency consonantal speech cues, and this improvement took several months to become apparent. Such a device can provide a substantial benefit in speech understanding to individuals with severe high‐frequency hearing loss, while still maintaining the benefits of the residual lower‐frequency acoustic hearing. The position of the electrode and the place of frequency information within the cochlea were shown to be important factors in the success of such a device.
Protease inhibitors α1‐antitrypsin and ilomastat are not ototoxic in the chinchilla
Authors: Antonelli Patrick J. , Schultz Gregory S. , Sundin David J. , Pemberton Philip A. , Barr Philip J. 
Published: November 2003

AbstractObjectives: Proteases of both the serine and the metalloprotease families have been shown to play a role in the pathogenesis of otitis media. Inhibitors of proteases from each of these families have been shown to beneficially impact disease progression in a number of related chronic inflammatory conditions. The purpose of this study was to assess the safety of protease inhibitors when instilled into the middle ear, with a view to their potential use in the treatment of human otitis media. Study Design: Prospective, randomized, controlled trial in the chinchilla model. Methods: After completing baseline auditory testing and bilateral transpalatal obstruction of the Eustachian tube, chinchillas received weekly transbullar injections of protease inhibitor (α1‐antitrypsin, ilomastat, or both), vehicle, or saline. After 1 month, hearing was tested and the animals were sacrificed. Temporal bone histopathologic examination was performed. Results: All treatment groups demonstrated a statistically insignificant average loss in long‐term hearing (0 dB) for all measures using clicks and tones (P > .15 for all conditions). All treatment groups were statistically insignificantly different from one another (P = .5625). Histopathologic examination revealed no significant inner ear changes. Conclusions: Protease inhibitors that are currently under study in animal models and humans for the treatment of inflammatory diseases that are related to imbalances between protease and protease inhibitor have no significant toxic effect on the inner ear of chinchillas. These findings support the safety of further clinical trials using these inhibitors to treat middle ear inflammation.
Nasopharyngeal flora and drug susceptibility in children with macrolide therapy
Authors: Iino Yukiko , Sasaki Yukako , Miyazawa Tesuo , Kodera Kazuoki 
Published: November 2003

AbstractObjectives/Hypothesis: Low‐dose, long‐term administration of macrolides (macrolide therapy) has been used as an effective treatment for chronic respiratory tract diseases. The authors reported on the nasopharyngeal flora in children treated with macrolide therapy. Study Design: Prospective study. Methods: Nasopharyngeal cultures were obtained from 73 children with chronic rhinosinusitis and/or otitis media with effusion at the end of the low‐dose administration of clarithromycin (macrolide group). As control subjects, 98 children with chronic rhinosinusitis and/or otitis media with effusion who were not given macrolides were also included in the study. The culture results were evaluated with respect to antimicrobial susceptibility patterns, risk factors for carriage of erythromycin‐resistant Streptococcus pneumoniae, and the clinical efficacy of the therapy. Results: The macrolide therapy did not have a significant effect on the incidence or the susceptibility patterns of potential pathogens except for Moraxella catarrhalis. Most of children in the macrolide group possessed a normal flora compared with the control children. The risk factors for carriage of erythromycin‐resistant S pneumoniae were male gender in the macrolide group and age under 6 years and use of antimicrobial drugs other than macrolides in the control group. The clinical efficacy of the therapy was independent of carriage of erythromycin‐resistant S pneumoniae. Conclusion: Macrolide therapy has little effect on carriage of drug‐resistant pathogens, and the efficacy of the therapy depends on the anti‐inflammatory effect of the drugs, which is independent of their antimicrobial effect.
Local production of aspergillus fumigatus specific Immunoglobulin E in nasal polyps
Authors: Weschta M. , Rimek D. , Formanek M. , Polzehl D. , Riechelmann H. 
Published: November 2003

AbstractAspergillus spp. play a significant role in the etiology of immunoglobulin (Ig)E mediated allergic fungal sinusitis (AFS). It is unclear whether Aspergillus spp. are also involved in nasal polyps without the characteristic clinical features of AFS. Objectives: The frequency of Background: Aspergillus spp. and Aspergillus‐specific IgE in nasal lavages and serum of patients with severe nasal polyps (n = 33) without clinical features of AFS should be investigated. Study Design: Prospective study. Methods: An aliquot of nasal lavage fluid was treated with dithiothreitol and examined for Aspergillus fumigatus by culture and an Aspergillus‐specific polymerase chain reaction (PCR) assay. An additional aliquot of nasal fluid and serum of the same patient were tested for specific IgE (Unicap, Pharmacia, Freiburg, Germany) to recombinant Aspergillus fumigatus allergen (rAspf) 1 to 6. Results: All patients had negative skin prick tests for Aspergillus fumigatus. Four of 33 (12%) lavage samples were positive for Aspergillus spp. by PCR. In one of these samples, rAspf‐specific IgE was detected but none in the serum. Nasal lavage and serum samples of the remaining 29 patients were negative for rAspf‐specific IgE. Conclusions: Aspergillus spp. detection is rare in patients with severe nasal polyps without characteristic clinical features of AFS. Specific IgE in nasal secretions may be elevated in patients with negative skin prick tests and serum IgE. In these cases, immunologic mechanisms similar to AFS may be involved. Fungal etiology has been proposed to underlie severe nasal polyps in general. However, Aspergillus spp. seem not to play a significant role.
Intratympanic steroids: Do they acutely improve hearing in cases of cochlear hydrops?
Authors: Hillman Todd M. , Arriaga Moises A. , Chen Douglas A. 
Published: November 2003

AbstractObjective: To study the acute effects on hearing of intratympanic dexamethasone in patients with cochlear hydrops. Study Design: Retrospective review. Methods: Patients who met established criteria for the diagnosis of Ménière's disease or had a history of fluctuating hearing loss and met hearing loss criteria for Ménière's disease, indicating cochlear hydrops, underwent a series of one to three intratympanic injections of dexamethasone in the affected ear. Follow‐up audiograms were obtained 1 week after each injection and, in many patients, several months after injection. Results: Fifty patients met inclusion criteria and were studied. Using the American Academy of Otolaryngology‐Head and Neck Surgery reporting guidelines, hearing improved acutely in 20 of the 50 patients (40%), was worse in 2 (4%), and did not change in 28 (56%). For those who improved, the average decrease in threshold was 14.2 dB. Whether the patient had typical Ménière's disease or cochlear hydrops did not affect the response to therapy. There were no significant complications from the injections. Conclusions: Intratympanic administration of dexamethasone may acutely affect sensorineural hearing loss associated with endolymphatic hydrops. A prospective, controlled study is required.
Electromechanical reshaping of septal cartilage
Authors: Ho Ki‐Hong Kevin , Valdes Sergio H. Diaz , Protsenko Dmitriy E. , Aguilar Guillermo , Wong Brian J. F. 
Published: November 2003

AbstractObjectives: This study describes the process of tissue electroforming and how shape changes in cartilage can be produced by the application of direct current (DC). The dependence of shape change on voltage and application time is explored. Study Design: Basic investigation using ex vivo porcine septal cartilage grafts and electromechanical cartilage deformation focused on development of a new surgical technique. Methods: Uniform flat porcine nasal septal cartilage specimens were mechanically deformed between two semicircular aluminum electrodes. DC current was applied to establish charge separation and electrical streaming potential. Voltage (0–3.5 V) and application time (0–5 minutes) were varied. Shape change was measured, and shape retention was calculated using analytic representation. The effect of the direction of applied current on shape change was evaluated by switching the polarities of electrodes and using parameters of 0 to 5.5 V and 5 minutes. Temperature during reshaping was monitored with a thermocouple, and surface features were evaluated using light microscopy. Results: Reshaped specimen demonstrated mechanical stability similar to native cartilage tissue. Shape retention strongly correlated with increasing voltage and application time. Only a small current (<0.1 A) through the tissue was measured. Temperature change was less than 2°C during electroforming, suggesting that electroforming likely results from some nonthermal mechanisms. Surface features indicated that electrodeposition may occur depending on electrode material and magnitude of the applied voltage. Conclusions: These findings demonstrate that cartilage can be reshaped through the process we have described as “electroforming” by generating intrinsic differences in charge separation with negligible heat production.
Opium and risk of laryngeal cancer
Authors: Mousavi Mohammad Reza Ahamadi , Damghani Mohammad Ali , Haghdoust Ali Akbar , Khamesipour Ali 
Published: November 2003

AbstractObjectives/Hypothesis: The study was performed to investigate the possible association between opium dependency and laryngeal cancer. Study Design: A hospital‐based, group‐matched, case‐control study was presented. Methods: Ninety‐eight patients with laryngeal cancer and 312 age‐ and gender‐matched control subjects were selected at the otorhinolaryngology ward of a referral university‐affiliated hospital. Data on cigarette smoking and alcohol and opium dependency were collected before surgery through semi‐structured interview. Results: The crude odds ratios of laryngeal cancer were 15.07 (95% confidence interval [CI], 6.92–32.8 [P < .0001]) for cigarette smoking, 21.55 (95% CI, 10.54–44 [P < .0001]) for opium dependency, and 1.84 (95% CI, 1.008–3.38 [P < .048]) for male gender. Because of strong associations, a logistic regression model was prepared; the odds ratio for gender in the final model was 0.87 (95% CI, 0.39–1.92 [P = .11]). According to the results, it seemed that gender was not an independent risk factor for laryngeal cancer. Also, the adjusted odds ratios for smoking (5.21) (95% CI, 2.33–11.67 [P < .002]) and opium dependency (10.74) (95% CI, 5.76–20.02 [P < .002]) were lower than the crude odds ratios, but both ratios were significant. The mean patient ages were 55.1 years (SD = 12.05 y) in opium‐dependent patients and 65.6 years (SD = 12.8 y) in opium‐nondependent patients (P = .01). Conclusion: The results of the study suggest that opium dependency is not only an independent possible risk factor for laryngeal cancer but also significantly increases the likelihood of developing of the disease at a younger age.
Expression of focal adhesion kinase and phosphorylated focal adhesion kinase in squamous cell carcinoma of the larynx
Authors: Aronsohn Michael S. , Brown Heather M. , Hauptman Garrett , Kornberg Lori J. 
Published: November 2003

AbstractObjectives: Focal adhesion kinase (FAK) is overexpressed in a variety of human cancers including those derived from the oral cavity. The purpose of this work is to determine the expression patterns of FAK and its activated form, FAK pY397, in squamous cell carcinoma of the larynx and to correlate FAK expression with tumor differentiation and clinical parameters. Study Design: A retrospective study using archival tissue. Methods: Thirty‐five paraffin embedded tissue specimens of laryngeal carcinoma were obtained from the Department of Pathology at the University of Florida College of Medicine. Immunohistochemical staining of the specimens for FAK and activated phospho‐FAK (FAK pY397) was performed. Intensity of staining, distribution of staining, and percentage of cells stained was determined by one pathologist. Results: There was a statistically significant correlation between FAK staining intensity and tumor differentiation. Poorly differentiated tumors stained more intensely than moderately differentiated tumors (P < .001). There was no correlation between FAK pY397 staining and differentiation (P = .163). However, FAK pY397 staining was unexpectedly found in the nuclei of many specimens. FAK was present in the basal layer of cells within nontransformed squamous mucosa derived from tonsillectomy specimens and in blood vessels. A small amount of FAK pY397 was also localized to blood vessels in nontransformed squamous mucosa. Conclusion: FAK and phospho‐FAK are overexpressed in squamous cell carcinoma of the larynx. FAK expression correlates with differentiation. Future investigations will examine the potential of FAK and FAK pY397 expression both as a prognostic indicator and a point of therapeutic inhibition.
Expression of intercellular adhesion molecule (ICAM)‐1 in adenoid cystic carcinoma of the head and neck
Authors: Shirai Akiko , Furukawa Mitsuru , Yoshizaki Tomokazu 
Published: November 2003

AbstractObjectives/Hypothesis: Adenoid cystic carcinoma of the head and neck (ACCHN) is characterized by late recurrence and frequent distant metastasis. Tumor attack by cytotoxic T lymphocytes and macrophages is mediated by the interaction of leukocyte function‐associated antigen (LFA)‐1 on lymphocytes with intercellular adhesion molecule (ICAM)‐1 on the tumor surface. Thus, the reduced expression of ICAM‐1 on tumor cells could contribute to their escape from host immune surveillance. To investigate the relationship between the clinical features of ACCHN and host immune surveillance, the expression of ICAM‐1 and infiltration of T/natural killer (NK) cells and macrophages were immunohistochemically examined. Study Design: Retrospective analysis of immunohistochemical tumor characteristics and clinical outcome. Methods: Immunohistochemical study of ICAM‐1, T/NK cells, and macrophages was performed on paraffin sections of 42 patients with ACCHN. The expression of T/NK cells and macrophages was represented by T‐cell‐restricted antigen (TIA)‐1 and CD68 expression, respectively. The expression of these molecules and clinical features were analyzed. Results: Of 42 ACCHN cases, 15,9, and 15 patients were classified as ICAM‐1 high, TIA‐1 high, and CD68 high, respectively. The TIA‐1 expression scores in ICAM‐1‐low patients were significantly lower than those in ICAM‐1‐high patients (1.3 ± 3.7 vs. 8.3 ± 12.7, P = .0031). The CD68 expression scores in ICAM‐1‐low patients were also significantly lower than those in ICAM‐1‐high patients (9.6 ± 9.G vs. 21.1 ± 17.6, P = .0047). Moreover, ICAM‐1‐high patients had a significantly better disease‐free survival rate (P = .043). Conclusions: Reduced expression of ICAM‐1 may promote immune evasion and metastasis, resulting in poor prognosis in ACCHN.
Modified endoscopic lothrop as a salvage for the failed osteoplastic flap with obliteration
Authors: Wormald Peter John , Ananda Arjuna , Nair Salil 
Published: November 2003

AbstractObjective: To evaluate the effectiveness of the modified endoscopic Lothrop (MEL) procedure for the management of failed osteoplastic flap (OPF) with obliteration of the frontal sinuses. Setting: Adelaide University Academic Hospital Complex. Study Type: Prospective case study of 16 patients presenting with symptoms after OPF with obliteration of the frontal sinuses. Materials and Methods: Sixteen patients presented with symptoms of frontal sinus pain after having previously undergone OPF and fat obliteration of the frontal sinuses. All patients underwent computed tomography scanning; 13 underwent magnetic resonance imaging scanning, and 6 underwent a bone scan with technetium to exclude frontal osteitis. All patients underwent exploration of the frontal sinuses by way of the MEL procedure. Results: Fifteen patients were found to have a frontal sinus mucocele, whereas one patient had no mucocele with only new bone and fibrous tissue found at the MEL procedure. Twelve of the 16 patients with mucoceles had resolution of their frontal headaches, with 15 having a patent and healthy communication between the mucocele and the nasal cavity. The one patient without a mucocele continues to have frontal pain. One patient underwent a successful MEL procedure but had persistent symptoms until a supraorbital ethmoid mucocele was removed at a revision procedure. Two other patients continued to have frontal headaches and pain despite a healthy ostium into the frontal sinus mucocele. Conclusions: MEL is a viable alternative to revision OPF for symptomatic patients who are shown to have a mucocele of the frontal sinuses.
Retronasal olfactory function in nasal polyposis
Authors: Landis Basile N. , Giger Roland , Ricchetti Alma , Leuchter Igor , Hugentobler Marianne , Hummel Thomas , Lacroix Jean‐Silvain 
Published: November 2003

AbstractObjective: To investigate the question of whether there is a difference in retronasal olfactory function between patients suffering from chronic rhinosinusitis with nasal polyposis (NP) and healthy controls. This question was based on the clinical observation that many of these patients present with smell loss without complaining about loss of the appreciation of foods. Study Design: Open prospective study comparing symptomatic patients with healthy controls. Methods: A total of 56 healthy volunteers and 42 NP patients were tested for orthonasal and retronasal odor identification. All subjects received detailed nasal endoscopy; NP was staged according to the Malm classification. Patients rated their olfactory function on visual analogue scales. Orthonasal testing was performed using the “Sniffin' Sticks” test kit. Retronasal testing was evaluated with odorized powders applied to the oral cavity. In both tests, subjects were asked to identify 10 items using a forced choice paradigm. Results: Overall, odor identification was better in controls compared with NP patients (P < .001). Although controls exhibited no difference between orthonasal and retronasal smelling (P = .26), in NP patients, olfactory function was significantly better when odors were applied through the retronasal route (P < .001). Ratings of general olfactory abilities correlated with retronasal and orthonasal olfactory function in NP patients (P < .001) but not in healthy controls (P = .34) Conclusion: Better retronasal than orthonasal olfactory function seems to be associated with the presence of mechanical obstruction in the anterior portion of the olfactory cleft. In turn, these data indicate that olfactory loss in NP seems to be caused by regional mechanical or inflammatory factors.