bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnosis of Head and Neck Precancerous Lesions in an Animal Model Using Fluorescence Spectroscopy
Authors: Dhingra Jagdish K. , Zhang Xia , McMillan Kathleen , Kabani Sadru , Manoharan Ramasamy , Itzkan Irving , Feld Michael S. , Shapshay Stanley M. 
Published: November 2003

AbstractLaser‐induced fluorescence (LIF) of tissues depends on their biochemical and histomorphologic characteristics. LIF spectroscopic properties of 9,10‐dimethyl‐1,2‐benzanthracene (DMBA)‐induced precancerous and early cancerous lesions in a hamster buccal pouch mucosa model were studied. Fluorescence spectra from neoplastic lesions showed a characteristic fluorescence peak in the red region of the visible spectrum centered between 630 and 640 nm when excited with 410‐nm light. Using this as a diagnostic criterion, 45 of 49 lesions studied were correctly diagnosed, including early dysplastic lesions. Follow‐up study of four dysplastic lesions over 2 weeks revealed an increase in red fluorescence intensity. The findings of these experiments suggest that LIF spectroscopy may be a valuable noninvasive technique not only for early diagnosis of head and neck cancer, but also to probe a possible biochemical surrogate biomarker in the follow‐up of suspected lesions.
Relative Accuracy of Fine‐Needle Aspiration and Frozen Section in the Diagnosis of Well‐Differentiated Thyroid Cancer
Authors: Mulcahy Maureen M. , Cohen James I. , Anderson Peter E. , Ditamasso John , Schmidt Waldemar 
Published: November 2003

AbstractThe need for and extent of thyroid surgery for a thyroid nodule is usually primarily based on fine‐needle aspiration (FNA) and frozen section diagnosis. The relative role of these modalities in 66 patients who had undergone FNA and subsequent thyroidectomy with frozen section was investigated. Cases that demonstrated discordance between FNA and frozen section (n = 22; 33%) were identified, and all slides were re‐reviewed by a cytopathologist using current established cytologic criteria. A change in diagnosis was made in 13 cases with an increase in accuracy of FNA from 71% to 88%. The accuracy of frozen section (92%) did not change appreciably with re‐review (94%). The accuracy of FNA and frozen section combined was found to be 98%. The rate of discordance decreased from 33% to 13% with re‐review. When strict histologic and cytologic criteria are applied, FNA and frozen section are accurate and complementary methods that help in determining the operative management of thyroid masses. However, when FNA yields a diagnosis of “follicular neoplasm,” frozen section is unlikely to change this diagnosis.
Lipoperoxidation As a Measure of Free Radical Injury in Otitis Media
Authors: Haddad Joseph 
Published: November 2003

AbstractFree radical damage, as evidenced by lipoperoxidation, has previously been demonstrated to contribute to the inflammatory changes associated with acute otitis media. The present study was undertaken to evaluate whether lipoperoxidation continues to be present for a period of time after middle ear infection. Eighty‐two 300‐ to 400‐g guinea pigs were injected with Streptococcus pneumoniae in the left ear and sterile saline in the right ear as a control. Animals were examined and sacrificed on day 5, 10, 20, or 30; middle ear mucosa was harvested and assayed for lipid hydroperoxide content. A statistically significant increase in lipoperoxidation was seen at each time point studied, compared with controls. Lipoperoxidation was highest at days 5 and 10; a significant decrease was seen at days 20 and 30. Histologic sections of middle ear mucosa of two animals per group were prepared and evaluated for inflammation. These results demonstrate that lipoperoxidation may contribute to middle ear inflammation for a significant period of time after acute infection; the findings are discussed in light of other work on the role of free radicals in otitis media.
Hearing Results With the Dornhoffer Ossicular Replacement Prostheses
Authors: Dornhoffer John L. 
Published: November 2003

AbstractThe “ideal” prosthesis for ossicular reconstruction should, from a surgical standpoint, require easy manipulation, reduce surgeries to partial or total variants, and be constructed of stable, biocompatible material. From an acoustic standpoint, a prosthesis should weigh 10 to 40 mg, provide proper tension between the tympanic membrane (TM) and stapes, form less than a 30‐degree angle with the TM, and accommodate the malleus. Work was conducted with Smith & Nephew Richards, Inc. (Memphis, TN), to develop a partial ossicular replacement prosthesis (PORP) and a total ossicular replacement prosthesis (TORP) that combined the majority of these features. This retrospective study used a computerized otologic database to identify patients implanted with a Dornhoffer HAPEX PORP or TORP from June 1995 to March 1997. The surgical procedures utilizing these prostheses were primary cholesteatoma and revision surgery of previously performed modified or radical mastoidectomies complicated by poor hearing or chronically draining cavities. Preoperative and postoperative air and bone conduction four‐frequency (500, 1000, 2000, and 3000 Hz) puretone averages (PTAs) were used to calculate the PTA air‐bone gaps (ABGs). Results in 52 cases (follow‐up, 1 year) showed a statistically significant improvement in hearing (P < 0.05) for each group. Excellent hearing results (≤10 dB PTA‐ABG) were seen in 69% of PORP cases and in 35% of TORP cases, and good results (11 to 20 dB PTA‐ABG) were seen in 31% and 50% of PORP and TORP cases, respectively. Designing an ossicular replacement prosthesis with both surgical and acoustic factors in mind has led to encouraging short‐term hearing results.
Optimization of Speech Processor Fitting Strategies for Chinese‐Speaking Cochlear Implantees
Authors: Sun John C. , Skinner Margaret W. , Liu S. Y. , Wang Frances N.M. , Huang T. S. , Lin Tai 
Published: November 2003

AbstractObjectives: To compare speech recognition performance in Chinese‐speaking cochlear implant patients with a speech processor program selected by the clinical audiologist in Taiwan and with a new speech processor program based on the Washington University clinical procedure developed by Skinner et al.Study Design: Six adult Chinese‐speaking patients implanted with the Nucleus cochlear implant system participated in this study.Methods: A fitting procedure developed in 1995 by Skinner et al. at Washington University School of Medicine was used to create a new speech processor program to optimize each patient's hearing in everyday life. Speech tests (vowels, consonants, tones, and words), sound‐field thresholds, and a self‐report questionnaire were used to evaluate each patient's performance with his or her previous speech processor program and a new one.Results: Four of the six patients had significant changes from the previous to the new speech processor program. These changes were associated with improvement in score on at least one speech test, more sensitive sound field thresholds, and reported improvement in some everyday listening situations on the questionnaire.Conclusions: These results suggest that use of this procedure with adult cochlear implantees may improve benefit in everyday life. Analysis of the speech test stimuli and patients' responses provides a basis for modification or creation of new Mandarin Chinese speech tests for preoperative and postoperative evaluation of adult cochlear implant patients.
Blood Distribution in the Facial Nerve in Temporal Bones Acquired From Cases With Subarachnoid Hemorrhage
Authors: Kishimoto Seiji , Saito Haruo 
Published: November 2003

AbstractThe objectives of this study, conducted in eight temporal bones from five autopsied cases of subarachnoid hemorrhage, were to delineate the communication between the cerebrospinal fluid space and each space of the epineurium, perineurium, and area surrounding the nerve fibers in the facial nerve and to identify the site of hypertonic diuretic solution infusion most likely to decrease the facial nerve swelling at the initial stage of facial palsy. In all eight specimens, blood cells had directly entered into each space from the labyrinthine segment of the facial nerve. The subarachnoid space extended to the first genu of the nerve. The genu, which is the site of the initial lesion in Bell's palsy, is concluded to be the most effective site of intracanal decompression of the facial nerve with hypertonic diuretic solution.
Mitochondrial DNA Deletion Is a Predisposing Cause for Sensorineural Hearing Loss
Authors: Ueda Narihisa , Oshima Takeshi , Ikeda Katsuhisa , Abe Koji , Aoki Masashi , Takasaka Tomonori 
Published: November 2003

AbstractComposed of a postmitotic stable tissue, the inner ear is a target organ for mitochondrial DNA (mtDNA) mutation. To determine whether mtDNA mutation is a predisposing factor in patients with sensorineural hearing loss (SNHL), the authors assessed the mtDNA4977 deletion from 60 patients with SNHL and 47 normal control subjects. All cases had no past history of ototoxic or noise exposure, middle ear disease, or other known etiological factors for SNHL. DNA specimens extracted from peripheral blood leukocytes were used for detection of mtDNA4977 deletion by polymerase chain reaction. Patients with SNHL had a significantly higher rate of the mtDNA4977 deletion than did controls (75% vs. 30%, P < 0.0001). The detection rate of mtDNA4977 deletion was significantly increased with the deterioration of the hearing threshold. Aging did not influence the detection rate of mtDNA4977 deletion in either the control or SNHL group. The authors have described high detection rates of the mtDNA4977 deletion in patients with idiopathic bilateral SNHL and propose that at least some of the advanced SNHL cases should be categorized as mitochondrial oxidative phosphorylation diseases. This inference would offer novel possibilities for treatment and prevention of SNHL including presbycusis.
Pseudoepitheliomatous Hyperplasia Versus Squamous Cell Carcinoma of the External Auditory Canal
Authors: Gacek Mark R. , Gacek Richard R. , Gantz Bruce , McKenna Michael , Goodman Max 
Published: November 2003

AbstractFour case reports are presented to demonstrate the clinical and histopathologic similarity of pseudoepitheliomatous hyperplasia (PH) to squamous cell carcinoma (SCC) in the external auditory canal (EAC). In all four cases the original report of SCC on a biopsy specimen of an EAC lesion was corrected on review to PH. In one patient conservative management resulted in resolution of the EAC lesion. A second patient underwent radiation therapy and partial temporal bone resection with no SCC found in the surgical specimen. A third patient's ear canal had healed with conservative treatment and repeated biopsy revealed no malignancy. After a 6‐year symptom‐free interval, she developed invasive SCC with bone involvement that required surgery and radiation treatment. A fourth patient underwent a sleeve resection of the skin of the EAC that proved to be PH, and no evidence of SCC was found. A thoughtful clinical history, careful physical examination, response to conservative treatment, and close communication with the pathologist should be exercised in the evaluation of EAC lesions.
Immunohistochemical Analysis of Proliferating Cells in a Sterile Labyrinthitis Animal Model
Authors: Chen Mien‐Chi , Harris Jeffrey P. , Keithley Elizabeth M. 
Published: November 2003

AbstractInflammatory reactions within the cochlea lead to the formation of fibrotic tissue and bone. To determine which cells are involved in the proliferation of the inflammatory response within the cochlea, sterile labyrinthitis was created by inoculating keyhole limpet hemocyanin (KLH) into the scala tympani of systemically sensitized animals. Cellular proliferation was assessed immunohistochemically using the monoclonal antibody Ki‐67. Proliferating cells were identified among inflammatory cells and fibroblasts within the matrix, as well as in endosteal cells lining the scala tympani. Inflammatory and potential osteoprogenitor cells were labeled as late as 6 weeks after inoculation, suggesting the absence of a strong immunosuppressive mechanism. Endosteal cells may proliferate and secrete the extracellular matrix used by the inflammatory cells to move within the cochlear scalae. They may also participate in the ossification of the inflammatory matrix.
Quantitative Cytology of Nasal Secretions With Perennial Allergic Rhinitis in Children: Comparison of Noninfected and Infected Conditions
Authors: Shinogi Jun , Majima Yuichi , Takeuchi Kazuhiko , Harada Teruhiko , Sakakura Yasuo 
Published: November 2003

AbstractThis study was performed to quantify the number of inflammatory cells in nasal secretions from pediatric patients with perennial allergic rhinitis under noninfected and infected conditions. Nasal secretions were obtained from seven children under both noninfected and infected conditions with perennial allergic rhinitis to house dust mites, and secondary quantitative cytology was performed on the secretions. The number of neutrophils under infected condition was significantly higher than that under noninfected condition (P < .05), whereas the number of eosinophils in infected condition was significantly lower than that in noninfected condition (P < .05). The ratio of eosinophil count to neutrophil count was more than 0.1 in noninfected condition. The ratio was significantly decreased in infected condition (P < .02). These results suggest that the distribution of inflammatory cells in the nasal mucus of children with allergic rhinitis would be modified under infected condition.
Malignant Transformation of Recurrent Respiratory Papillomatosis Associated With Integrated Human Papillomavirus Type 11 DNA and Mutation of p53
Authors: Rady Peter L. , Schnadig Vicki J. , Weiss Raymond L. , Hughes Thomas K. , Tyring Stephen K. 
Published: November 2003

AbstractRecurrent respiratory papillomatosis (RRP), usually confined to the nasopharynx, trachea, and larynx, occasionally can progress to extensive bronchopulmonary disease. Most cases of bronchopulmonary and laryngeal papillomatosis are cytologically benign and do not undergo malignant transformation; however, squamous cell carcinoma (SCC) can arise in RRP in the absence of known risk factors such as radiation and smoking. In this study, the authors investigated molecular genetic alterations occurring in a case of metastasizing SCC that arose in long‐standing bronchopulmonary papillomatosis. Genomic DNA from tracheal papillomata, tracheobronchial papillomata, SCC of the lung, and a lymph node metastasis was extracted. The physical state of the human papillomavirus type 11 (HPV‐11) DNA was investigated by two‐dimensional gel electrophoresis. Molecular genetic alterations of the host genome were studied by direct sequencing of polymerase chain reaction‐amplified gene fragments and restriction fragment length polymorphism (RFLP) analysis. Episomal and integrated forms of HPV‐11 sequences were detected in histologically benign tumors, but only the integrated form of the viral DNA could be found in malignant tissue samples. Molecular genetic studies revealed that an allelic loss of the interferon‐β gene (IFNβ‐1) and an endogenous type of mutation of the p53 antioncogene were found only in the malignant lesions. Mutations were not observed in the ras, neu, or multiple tumor suppressor (MTS1/p16) genes in any specimens. The authors' data indicated that the p53 genetic mutation was associated with integration of HPV‐11 in histologically malignant lesions. This association may promote a progressive genetic instability that can lead to the development and clonal expansion of malignant lesions in RRP.
Contemporary Presentation and Management of a Spectrum of Mastoid Abscesses
Authors: Spiegel Jeffrey H. , Lustig Lawrence R. , Lee Kelvin C. , Murr Andrew H. , Schindler Robert A. 
Published: November 2003

AbstractBackground: The incidence of complications resulting from suppurative otitis media has significantly decreased since the introduction of antibiotics. At the start of the 20th century 50% of all cases of otitis media developed a coalescent mastoiditis. By 1959, the incidence had fallen to 0.4%. Recent studies suggest a current incidence of only 0.24%. Additionally, during the time of Friedrich Bezold (1824‐1908), 20% of patients with mastoiditis developed subperiosteal abscess. Interestingly, this has incidence increased; today nearly 50% of patients diagnosed with coalescent mastoiditis have subperiosteal abscess.Objective: To review the contemporary presentation, diagnosis, and management of a spectrum of mastoid abscesses.Design: Retrospective case series.Setting: Hospitals associated with the Department of Otolaryngology/Head and Neck Surgery at the University of California, San Francisco.Patients: Three patients with mastoid abscesses are reported. One patient displayed “classic” Bezold's abscess, with pus escaping the mastoid near the incisura digastrica and tracking along the digastric and sternocleidomastoid muscles into the neck. The second and third patients exhibited temporoparietal swelling secondary to mastoid abscess eroding the root of the zygomatic process, a complication noted by Bezold in 1908 as occurring “in only very rare cases.”Results and Conclusions: Since only one third of patients show pathologic tympanic membrane changes, and since complaints of otalgia, fever, and tenderness are inconstant, subperiosteal mastoid abscess is frequently a delayed diagnosis. The clinical presentation, pathogenesis, and routes of abscess spread are presented with photographic and radiographic illustration. Medical and surgical management is reviewed, and methods for accurate diagnosis are emphasized.
Subglottic Injury, Gastric Juice, Corticosteroids, and Peptide Growth Factors in a Porcine Model
Authors: Yellon Robert F. , Szeremeta Wasyl , Grandis Jennifer R. , Diguisseppe Patricia , Dickman Paul S. 
Published: November 2003

AbstractObjectives:To study the effects of mucosal injury, gastric juice, and corticosteroids and to determine the presence of peptide growth factors in the subglottic mucosa in a porcine model.Study Design:Prospective cohort animal study.Methods:In this model of subglottic injury, five groups (n = 5 each) of piglets were used. Injury was induced by electroeautery (acute), electrocautery plus repeated saline application (chronic), electrocautery plus repeated gastric juice application (chronic plus gastric juice), or repeated gastric juice application (gastric). Control piglets had normal saline applied repeatedly.Results:Histopathologic findings for the gastric juice group included basal cell hyperplasia (80%), squamous metaplasia (80%), and mucosal ulceration (40%). Control piglets showed squamous metaplasia (80%) but no basilar hyperplasia or ulceration. Immunohistochemistry detected peptide growth factors and epidermal growth factor receptor (EGFR) in all groups. Decreased staining was most frequent in the acute injury group. Quantitative reverse transcriptase polymerase chain reaction (RT‐PCR) documented lower expression of EGFR in the gastric juice group (P= .01).Conclusions:These findings suggest that peptide growth factors and EGFR are part of normal subglottic mucosal turnover. Noxious stimuli decrease production of these factors. Gastric juice had adverse effects documented by histopathology and molecular techniques.
Objective Measures of Laryngeal Function After Reinnervation of the Anterior and Posterior Recurrent Laryngeal Nerve Branches
Authors: Peterson K. Linnea , Andrews Robert , Manek Akshay , Ye Ming , Sercarz Joel A. 
Published: November 2003

AbstractPrevious research indicates that separate reinnervation of the anterior and posterior branches of the recurrent laryngeal nerve (RLN) can provide purposeful motion of the larynx, even after transplantation. This canine study was undertaken to better determine the results of RLN reinnervation after nerve transection distal to its bifurcation. This approximates ideal conditions for transplantation, because potential rejection and nerve branch mismatch are eliminated. Eight months after nerve repair, video, electromyographic, mechanical, and histologic data were collected on four canines. Results show return of appropriate motion without synkinesis, including purposeful abduction on endotracheal tube occlusion. Abductory function was weaker on the reinnervated side, but adduction was equal or stronger on the reinnervated vocal cord. These results indicate that this method of RLN reinnervation produces consistent, strong physiologic motion in the denervated larynx.
Posterior Laryngeal Clefts: Preliminary Report of a New Surgical Procedure Using Tibial Periosteum As an Interposition Graft
Authors: Garabedian Eréa‐Noël , Ducroz Vincent , Roger Gilles , Denoyelle Françoise 
Published: November 2003

AbstractObjective: To present the preliminary results of a new surgical procedure for posterior laryngeal cleft repair.Design: Retrospective study in an academic tertiary care center.Method: The study included three male patients (age at surgery, 2, 13, and 14 mo). One presented with severe aspiration and cyanotic attacks, the two others with aspiration and recurrent chest infections. The types of laryngeal clefts included complete cleft of the cricoid with varying degrees of tracheal involvement but not further than the first six tracheal rings. Associated malformations included one VATER syndrome, one esophageal atresia, and one tracheoesophageal fistula. Surgery was performed under general anesthesia with nasotracheaI intubation. A vertical anterior laryngofissure was performed. The mucosal margins of the clefts were incised and then repaired in two layers with polyglactin sutures. The original feature of this procedure was the interposition of a small piece of tibial periosteum between the two layers. This fascia graft is known to be strong and resistant in cleft palate surgery.Main Outcome Measure: Clinical and endoscopic follow‐up was used for evaluation of results.Results: The three patients had successful laryngeal repair at a mean follow‐up of 6 months (range, 4‐14 mo).Conclusion: The anterior laryngofissure provides a good surgical access to the cleft. The interposition of tibial periosteum allows durability of the cleft repair. A longer follow‐up is needed to confirm these preliminary results. A computed tomography scan study and a study on the rabbit are planned in order to evaluate the outcome of these periosteal grafts.
A 585‐nanometer pulsed dye laser treatment of laryngeal papillomas: Preliminary report
Authors: Mcmillan Kathleen , Shapshay Stanley M. , McGilligan J. Anthony , Wang Zhi , Rebeiz Elie E. 
Published: November 2003

AbstractObjectives/Hypothesis: Standard management of recurrent respiratory papillomatosis (RRP) currently consists of CO2 laser microsurgical ablation of papillomas. Because of the recurrent nature of this viral disease, patients are often faced with significant cumulative risk of soft tissue complications. As a minimally traumatic alternative to management of RRP, we have investigated the use of the 585‐nm pulsed dye laser (PDL) to cause regression of papillomas by selective eradication of the tumor microvasculature. Study Design: Nonrandomized prospective pilot study. Methods: Patients with laryngeal papillomas were treated with the PDL at fluences of 6 J/cm2 (double pulses per irradiated site), 8 J/cm2 (single pulses), and 10 J/cm2 (single pulses), at noncritical areas within the larynx, using a specially designed micromanipulator. Lesions on the true cords were treated with the CO2 laser, using standard methodology. Results: Clinical examination of three patients treated to date showed that PDL treatment appeared to produce complete regression of papillomas. Unlike the sites of lesions treated by the CO2 laser, the epithelial surface at the PDL treatment sites was preserved intact. Conclusions: These preliminary results suggest the PDL may eradicate respiratory papillomas with minimal damage to normal laryngeal tissue. Further analysis of the ongoing study is required to demonstrate potential benefits of the technique.