bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bacteria Detected by Culture and 16S rRNA Sequencing in Maxillary Sinus Samples From Intensive Care Unit Patients
Authors: Westergren Viveka , Bassiri Mansour , Engstrand Lars 
Published: November 2003

AbstractObjectives/Hypothesis In critically ill patients, the occurrence of artificial ventilation–acquired sinus disease is common. A possible sinus bacterial infection is occult and is combined with diagnostic difficulties. Culture as a method has limited capacity to verify the presence of bacteria and leaves unanswered the question of a possible infective agent because bacteria are difficult to grow when killed or suppressed by current antibiotic therapy. Hitherto unidentified micro‐organisms are also possible in the microenvironments of maxillary sinuses.Study Design Prospective case series.Methods Twenty maxillary sinus samples (17 aspirates and 3 lavages) from nine critically ill patients with possible infectious disease were investigated by broad‐range 16S rRNA polymerase chain reaction followed by sequencing. These results were compared with the previous culture results from gingiva (passage route), maxillary sinus absorption, and mucosa samples.Results The contaminations were rare (2 of 20) and corresponded well to culture results. One previously undiagnosed bacterium was found. Two aspirates were negative on both culture and polymerase chain reaction, whereas the corresponding maxillary sinus mucosal cultures had been positive.Conclusions Applying a low‐contamination maxillary sinuses sampling technique makes 16S rRNA sequencing clinically useful. The polymerase chain reaction and culture results were generally comparable. However, by polymerase chain reaction, bacteria were found that were missed by culturing. Some aspirates were free of bacterial remnants on 16S rRNA polymerase chain reaction, but corresponding mucosal cultures were positive. This could indicate that infection is induced within the tissue. It also indicates that infectious agents introduced into the sinuses may have routes other than the ostium. Further clinical use of 16S rRNA sequencing is required to enlarge our knowledge in applied microbiology and paranasal sinus disease.
Investigating the Nasal Cycle Using Endoscopy, Rhinoresistometry, and Acoustic Rhinometry
Authors: Lang Christian , Grützenmacher Stefan , Mlynski Barbara , Plontke Stefan , Mlynski Gunter 
Published: November 2003

AbstractObjectives Cyclic congestion and decongestion in the two nasal cavities is seen in connection with the respiratory function of the nose. The turbulent behavior of nasal airflow is a prerequisite for adequate contact of inspired air particles with the mucosa. The aim of this study was to gain insight into this turbulent behavior of nasal airflow during the nasal cycle.Methods The nasal cycle in 10 healthy human subjects was investigated using endoscopic imaging, rhinoresistometry, and acoustic rhinometry every 20 minutes over a time period of up to 15 hours. The following parameters were recorded for each nasal cavity: airflow resistance, hydraulic diameter, friction coefficient λ as an indicator for the wall configuration triggering turbulence, transition from laminar to turbulent flow, and the minimal cross‐sectional areas.Results In addition to the known cyclic change of flow resistance and nasal width, a periodic change in the turbulence behavior was observed. In the resting phase, mainly laminar flow was found. During the working phase, the onset of turbulence occurred already at low flow velocities. The increase of turbulence during the working phase is caused by the increase in cross‐sectional area in the anterior cavum due to decongestion of the mucosa of the head of the inferior turbinate and the septal tuberculum.Conclusions Rhinoresistometry and acoustic rhinometry complement each other. The combination of the two methods provides insight into the functional changes during the nasal cycle and into nasal physiology in general. The authors therefore advocate a combination of the two methods for functional evaluation of the nasal airway.
Inflammation and Remodeling of the Sinus Mucosa in Children and Adults With Chronic Sinusitis
Authors: Sobol Steven E. , Fukakusa Moto , Christodoulopoulos Pota , Manoukian John J. , Schloss Melvin D. , Frenkiel Saul , Hamid Qutayba 
Published: November 2003

AbstractObjectives/Hypothesis The sinus mucosal inflammatory response in adult patients with chronic sinusitis is well documented in the literature. In contrast, little is known about the pathogenesis of this condition in children. The objective of the study was to compare the inflammatory cell profile and the extent of tissue remodeling in the sinus mucosa of children and adults with chronic sinusitis.Study Design Prospective design.Methods Children (n = 7) and adult patients (n = 7) with chronic sinusitis undergoing functional endoscopic sinus surgery were recruited for the study. Patients with no evidence of sinus disease (n = 6) were used as control subjects. Using immunohistochemical analysis, sinus mucosal specimens were assessed for the presence of T lymphocytes, eosinophils, basophils, mast cells, and neutrophils. The extent of submucosal collagen deposition was evaluated in histological sections using van Gieson stain.Results The number of T lymphocytes, eosinophils, and basophils and the amount of subepithelial collagen deposition are significantly higher in the mucosa of both adults and children with chronic sinusitis compared with normal control subjects (P <.01). The number of mast cells is significantly higher in the mucosa of children with chronic sinusitis compared with normal control subjects (P <.01). The number of eosinophils and neutrophils and the amount of subepithelial collagen deposition are significantly greater in adults compared with children with chronic sinusitis (P <.01).Conclusions The sinus mucosal inflammatory profile is similar in adults and children with chronic sinusitis. However, the degree of tissue eosinophilia and remodeling is significantly greater in adult sinus specimens when compared with those of children with chronic sinusitis.
Postoperative Magnetic Resonance Imaging Findings After Transtemporal and Translabyrinthine Vestibular Schwannoma Resection
Authors: Brors Dominik , Schäfers Maria , Bodmer Daniel , Draf Wolfgang , Kahle Gabriele , Schick Bernhard 
Published: November 2003

AbstractObjectives/Hypothesis Magnetic resonance imaging (MRI) has become the investigation of choice to follow up patients after vestibular schwannoma resection.Study Design Retrospective.Methods Postoperative MRI findings of 70 patients after vestibular schwannoma resection through a transtemporal (n = 48) and a translabyrinthine (n = 22) approach were reviewed. Time‐dependent changes in intensity, size, and shape of enhancement in the internal auditory canal before and after contrast administration, postoperative temporal lobe gliosis, and changes of fat grafts were evaluated.Results After vestibular schwannoma resection, all patients showed signal enhancements in the internal auditory canal ranging from a faint to high signal intensity in the first postoperative MRI, 3 to 6 months after surgery. In the next MRI at 12 to 24 months after surgery, 30 patients (43%) showed a decreased signal, 35 patients (50%) a stable enhancement, and 5 patients (7%) an increased enhancement in the internal auditory canal depicted as an intense nodular or mass‐like pattern. In patients with decreased or stable enhancement, a residual tumor could be excluded in the following MRI scans, whereas in all patients with increased enhancements after 12 to 24 months, signal enhancement further increased and residual tumors were detected. Different degrees of temporal lobe gliosis were found in 15 of 48 cases (31%) after transtemporal tumor removal. Enhancement of fat grafts used in 22 cases decreased to different degrees in 14 cases (64%).Conclusions Differentiation of residual tumor from scar tissue in the internal auditory canal after vestibular schwannoma resection requires close, long‐term follow‐up. Nodular and progressive enhancements in the internal auditory canal indicate residual tumor. Linear enhancement in the internal auditory canal has been found to be a common finding after vestibular schwannoma resection not associated with residual tumor.
Single Cell Analysis of Adenoid CD5+ B Cells and Their Protective Contributions to Nasopharyngeal Immunity
Authors: Arita Miori , Kodama Satoru , Suzuki Masashi , Mogi Goro 
Published: November 2003

AbstractObjectives CD5+ B cells are phenotypically and functionally distinct from the conventional (CD5−) B cells, and the function of CD5+ B cells in the upper respiratory tract remains unknown. A previous study showed that immunoglobulin A–producing cells in the adenoid play a protective role in the nasopharynx. In the present study, the contribution of adenoid CD5+ B cells to nasopharyngeal immunity at the single cell level was investigated.Study Design In vitro laboratory study.Methods Mononuclear cells were isolated from adenoids of children aged 1 to 12 years, and the frequency of CD5+ B cells was determined by flow cytometry. The numbers of cells producing immunoglobulin M, immunoglobulin G, and immunoglobulin A in sorted adenoid CD5+ B cells were determined by enzyme‐linked immunospot assay. Further, to characterize adenoid CD5+ B cells, the expression of various surface molecules was analyzed by flow cytometry.Results The results showed that adenoids of young children contain a relatively large number of CD5+ B cells, which have a greater capacity for antibody production than do CD5− B cells. CD5+ B cells also differed from CD5− B cells in the expression of interleukin receptors Il‐4R, IL‐5R, and IL‐10R as well as CD27, B7‐1, B7‐2, Fas, and Bcl‐2.Conclusions These findings suggest that adenoid CD5+ B cells contribute to protective immunity by forming a first line of defense in the upper respiratory tract of young children and that they are probably regulated in a manner that differs from that of CD5− B cells.
Comparison of the Effects of Radiofrequency Tissue Ablation, CO2 Laser Ablation, and Partial Turbinectomy Applications on Nasal Mucociliary Functions
Authors: Şapçi Tarik , Şahin Betül , Karavus Ahmet , Akbulut Uğur Günter 
Published: November 2003

AbstractObjectives One of the major causes of chronic nasal airway obstruction is disease of the inferior turbinate. However, there is no agreement on how to deal with this problem. Comparison was made of the nasal functions after treatment by radiofrequency tissue ablation, laser ablation, and partial turbinectomy using subjective symptom scores and objective tests.Study Design Prospective, randomized clinical trial.Methods The study was conducted on three groups of 45 adult volunteer patients with symptoms and signs of nasal obstruction and stuffiness related to enlarged turbinates. In group A, laser ablation was applied to the inferior turbinate on one side and partial turbinectomy to the inferior turbinate on the other side. In group B, radiofrequency tissue ablation was applied to the inferior turbinate on one side and partial turbinectomy to the inferior turbinate on the other side. In group C, patients who were not treated by any surgical techniques were the control subjects. Clinical examinations, visual analogue scales, rhinomanometry, and isotopic study of nasal mucociliary transport time were used to assess treatment outcomes.Results At 12 weeks after surgery, the nasal mucociliary transport time results were compared in the same patients. The average time was 25.60 minutes on the side where laser ablation was applied and 11.40 minutes on the side where partial turbinectomy (PT) was applied. In the patients on whom radiofrequency tissue ablation and partial turbinectomy were applied, the average nasal mucociliary transport time was 10.33 minutes on the radiofrequency tissue ablation side, whereas it was 11.33 minutes on the partial turbinectomy side. Rhinomanometric measurements demonstrated a significant decrease in nasal resistances at 12 weeks in both sides in groups A and B.Conclusions In the study it was demonstrated that radiofrequency tissue ablation to the turbinate is effective in improving nasal obstruction objectively and in preserving nasal mucociliary function. Laser ablation of the turbinate is effective in improving the nasal obstruction; however, it disturbs the mucociliary function significantly. With the partial turbinectomy technique, results obtained were similar to the results with the radiofrequency tissue ablation technique.
Vocal Cord Palsy Resulting From Spontaneous Carotid Dissection
Authors: Wessels Tiemo , Sparing R. , Neuschaefer‐Rube C. , Klötzsch C. 
Published: November 2003

AbstractObjectives/Hypothesis Vocal cord palsy has a variety of causes, such as malignant tumors of the thyroid, lung, or upper mediastinum, aortic aneurysm, surgery of the thyroid, and infectious diseases.Study Design Case report.Methods A 43‐year‐old biologist had a holocephalic headache and right‐sided neck pain for 1 day. Five days later, he developed paralysis of the right‐side vocal cord. In addition, an angiotensin converting enzyme (ACE) inhibitor was administered because the patient had high systolic and diastolic blood pressures, which were formerly not known to the patient. Five days after admission, a temporary sensorimotor hemiparesis occurred.Results Neurological examination revealed, in addition to the known paralysis of the right‐side vocal cord, right‐side palatoplegia, right‐side hypoglossal nerve palsy, and mild dysphagia. Duplex sonography showed evidence of lumen narrowing of the right‐side internal carotid artery caused by an hypoechogenic mural hematoma. Magnetic resonance imaging (0.5 T, Philips Gyroscan) revealed a circumscribed dissection of the right‐side internal carotid artery from the carotid bifurcation to the petrosal segment. The diffusion‐weighted magnetic resonance imaging scan of the brain also demonstrated multiple embolic ischemic lesions in the right hemisphere.Conclusion Internal carotid artery dissection must be included in the differential diagnosis of lower cranial nerve palsy and should be assessed by duplex ultrasonography and magnetic resonance imaging.
Altered Fractionation and/or Adjuvant Chemotherapy in Definitive Irradiation of Squamous Cell Carcinoma of the Head and Neck
Authors: Mendenhall William M. , Riggs Charles E. , Amdur Robert J. , Hinerman Russell W. , Villaret Douglas B. 
Published: November 2003

AbstractObjective To review the roles of altered fractionation and adjuvant chemotherapy in the treatment of patients with squamous cell carcinomas of the head and neck.Study Design Review of the pertinent literature.Methods The literature pertaining to altered fractionation and/or adjuvant chemotherapy for patients with squamous cell carcinomas of the head and neck was reviewed to define the optimal combination of radiotherapy and adjuvant chemotherapy.Results The efficacy of altered fractionation compared with conventional fractionation depends on the fractionation schedule employed. Some hyperfractionated and accelerated fractionation schedules have resulted in improved locoregional control but no significant improvement in overall survival. In contrast to induction and maintenance chemotherapy, concomitant chemotherapy appears to result in improved locoregional control and survival.Conclusions Altered fractionation and/or concomitant chemotherapy results in improved locoregional control and, in some instances, survival for patients with advanced head and neck cancer. Depending on primary site, the applicability of these aggressive treatment regimens is limited by an enhanced probability of severe complications as tumor volume increases. The optimal combination of these modalities is unclear and will be defined by future prospective trials.
Laser Eustachian Tuboplasty: A Preliminary Report
Authors: Poe Dennis S. , Metson Ralph B. , Kujawski Oskar 
Published: November 2003

AbstractObjectives/Hypothesis Surgical correction of eustachian tube dysfunction remains an elusive challenge. Repeat ventilation tube placement is often inadequate to prevent tympanic membrane and middle ear complications. Endoscopic analyses of eustachian tube dynamics have localized the site of primary pathophysiology to within the cartilaginous tube. The study investigated the feasibility, safety, and efficacy of a new endoluminal eustachian tube operation for the treatment of eustachian tube dysfunction.Study Design Prospective, institutional review board–approved surgical trial in a tertiary‐care medical center.Methods Ten patients with more than 5 consecutive years of intractable otitis media with effusion recurring after two or more tympanostomy tube placements were treated with unilateral laser eustachian tuboplasty. Surgery was performed on an outpatient basis with the use of general anesthesia and combined both transnasal and transoral approaches. A 980‐nm diode or argon laser was used to vaporize an appropriate amount of mucosa and cartilage on the posterior wall of the tubal lumen. Preoperative and postoperative dynamic video eustachian tube function analyses were compared. Outcome measures were presence or absence of middle ear effusion and impedance tympanograms.Results Five patients had at least 12 months of follow‐up, and three of them had absence of any effusion (60%). Two patients had recurrence of their otitis media with effusion and required tympanostomy tubes again. Five patients had at least 6 months of follow‐up, and four of them had absence of any effusion. The remaining patient had recurrence of otitis media with effusion and received a tympanostomy tube again. Overall results for all 10 patients after 6 months were 7 free of effusion (70%). There were no intraoperative complications. Postoperative complications were limited to minimal peritubal adhesions and one intranasal synechia.Conclusions Preliminary results suggest that laser eustachian tuboplasty is safe and efficacious in the treatment of intractable eustachian tube dysfunction. Further study will be necessary to determine whether laser eustachian tuboplasty is a suitable alternative to repeated tympanostomy tube placement in selected patients.
Perioperative Adenotonsillectomy Management in Children: Current Practices
Authors: Kay David J. , Mehta Vishvesh , Goldsmith Ari J. 
Published: November 2003

AbstractObjective To determine the current practices of preoperative evaluation, surgical techniques, and postoperative treatment of pediatric adenotonsillectomy.Study Design Forty‐one‐item survey measuring the frequency of different evaluations, procedures, and treatments performed, including selected case scenarios, with all items scored on a five‐point ordinal scale ranking frequency.Methods The entire membership of the American Society of Pediatric Otolaryngology (ASPO) and active fellows and members of the American Academy of Otolaryngology—Head and Neck Surgery (AAO–HNS) residing in New York state were anonymously surveyed through mail‐in questionnaires.Results History alone was the most frequent modality for diagnosing both adenoid enlargement and obstructive sleep apnea. The most common preoperative laboratory test ordered before an adenotonsillectomy is a complete blood cell count; ASPO members ordered fewer preoperative laboratory tests than AAO–HNS members. Unipolar cautery is the most frequently used tonsillectomy technique, and curettage followed by cautery is the most popular adenoidectomy technique. Steroids are the most common intraoperative medication administered during an adenotonsillectomy, and office visits remain the most frequently used methods of assessing adenotonsillectomy patients postoperatively.Conclusions Although there are statistically significant trends uncovered by the survey, the results reflect a lack of consensus regarding adenotonsillectomy management. Further randomized controlled trials or large‐scale outcomes projects are much needed to evaluate critically the current practices of pediatric adenotonsillectomies. Additional efforts may also be required to use the information from these studies in effecting changes in actual practice patterns, moving us toward a more evidence‐based paradigm of treating pediatric adenotonsillar disease.
Geometrical Deformation of Vocal Fold Tissues Induced by Formalin Fixation
Authors: Kimura Miwako , Tayama Niro , Chan Roger W. 
Published: November 2003

AbstractObjectives/Hypothesis Many existing studies of vocal fold geometry are based on anatomical measurements made on histologically fixed laryngeal tissues using formalin. However, the validity of these geometric data is questionable because of the potentially significant tissue deformation associated with formalin fixation, particularly tissue shrinkage. Previous experiments have shown that valid geometric data may be obtained on vocal fold tissue samples quickly frozen with liquid nitrogen. Based on this finding, the present study attempted to quantify the geometric deformation of formalin‐fixed vocal fold tissues with respect to quick‐frozen tissues.Methods Six freshly harvested canine larynges were quickly frozen with liquid nitrogen and sectioned at the mid‐membranous coronal plane. Each larynx was thawed and divided into halves along the midsagittal plane, one of which was not fixed; the other was fixed with formalin, from which histological tissue sections were also prepared. Measurements of vocal fold geometry were made on digital images of mid‐membranous coronal sections of the tissue samples, based on linear dimensions of vocal fold depth and thickness defined functionally for biomechanical applications.Results Significant shrinkage of the vocal fold (particularly the vocal fold body) and considerable distortion of the vocal fold contour (particularly at the free edge) were observed for the formalin‐fixed samples and the histological sections in comparison with the unfixed samples.Conclusions Results of the present study suggested that significant geometric artifacts are induced by conventional histological fixation of laryngeal tissues using formalin. These artifacts should be carefully considered for interpreting any vocal fold geometric data obtained through formalin fixation.