bluuebunny/crossref_metadata_2025_split huggingface dataset:
‘Eosinophilic Fungal Rhinosinusitis’: A Common Disorder in Europe?
Authors: Braun Hannes , Buzina Walter , Freudenschuss Kurt , Beham Alfred , Stammberger Heinz 
Published: November 2003

AbstractObjectives/Hypothesis The traditional criteria for the diagnosis of allergic fungal sinusitis include chronic rhinosinusitis, “allergic mucin” (mucus containing clusters of eosinophils), and detection of fungi by means of histological examination or culture. In 1999, a group of Mayo Clinic researchers, with a novel method of mucus collection and fungal culturing technique, were able to find fungi in 96% of patients with chronic rhinosinusitis. Immunoglobulin E–mediated hypersensitivity to fungal allergens was not evident in the majority of their patients. Because the presence of eosinophils in the allergic mucin, not a type I hypersensitivity, is probably the common denominator in the pathophysiology of allergic fungal sinusitis, the Mayo Clinic group proposed a change in terminology from allergic fungal sinusitis to eosinophilic fungal rhinosinusitis. Using new techniques of culturing fungi from nasal secretion, as well as preservation and histological examination of mucus, we investigated the incidence of “eosinophilic fungal rhinosinusitis” in our patient population.Study Design Methods In an open prospective study nasal mucus from patients with chronic rhinosinusitis as well as from healthy volunteers was cultured for fungi. In patients, who underwent functional endoscopic sinus surgery, nasal mucus was investigated histologically to detect fungi and eosinophils within the mucus.Results Fungal cultures were positive in 84 of 92 patients with chronic rhinosinusitis (91.3%). In all, 290 positive cultures grew 33 different genera, with 3.2 species per patient, on average. Fungal cultures from a control group of healthy volunteers yielded positive results in 21 of 23 (91.3%). Histologically, fungal elements were found in 28 of 37 patients (75.5%) and eosinophilic mucin in 35 of 37 patients (94.6%). Neither fungi nor eosinophils were present in 2 of 37 patients (5.4%).Conclusions Our data show that the postulated criteria of allergic fungal sinusitis are present in the majority of patients with chronic rhinosinusitis. Either those criteria will be found to be invalid and need to be changed or, indeed, “eosinophilic fungal rhinosinusitis” exists in the majority of patients with chronic rhinosinusitis. Based on our results, fungi and eosinophilic mucin appear to be a standard component of nasal mucus in patients with chronic rhinosinusitis.
Aggressiveness and Quantification of Epithelial Proliferation of Middle Ear Cholesteatoma by MIB1
Authors: Mallet Y. , Nouwen J. , Lecomte‐Houcke M. , Desaulty A. 
Published: November 2003

AbstractObjective To assess an easy method that predicts cholesteatoma aggressiveness.Study Design An experimental prospective study.Methods Monoclonal antibody MIB1 was used to determine epithelium proliferation in 91 cholesteatomatous ears. Clinical and surgical parameters were compared with proliferation activity to determine pathological and clinical correlation.Results Statistical correlations were established between hyperproliferation of the cholesteatoma and severe bone erosion (leading to major cholesteatoma complications) and between hyperproliferation and middle ear inflammation (associated with more surgical difficulties and a higher risk of recurrence). A high proliferation index was also found in children's cholesteatoma, which is known to have more aggressive behavior.Conclusion Immunohistochemical use of the MIB1 antibody is a simple technique that can help to determine the aggressiveness of a cholesteatoma.
Recurrent Laryngeal Nerve Monitoring in Thyroid and Parathyroid Surgery: The University of Michigan Experience
Authors: Marcus Benjamin , Edwards Bruce , Yoo Sirius , Byrne Anne , Gupta Anurag , Kandrevas Janet , Bradford Carol , Chepeha Douglas B. , Teknos Theodoros N. 
Published: November 2003

AbstractObjectives/Hypothesis Intraoperative monitoring of the recurrent laryngeal nerve (RLN) is finding increasing acceptance during thyroidectomy. Recently, a laryngeal surface electrode was introduced to enable another form of noninvasive monitoring of the RLN. The present report examines the University of Michigan experience with RLN monitoring using the postcricoid surface electrode.Study Design All patients undergoing partial or total thyroidectomy or parathyroidectomy from January 1999 to July 2001 were considered candidates for the study. Audiologists trained in intraoperative electrophysiological techniques performed all of the monitoring.Methods Data collected on each patient included 1) stimulation threshold for a laryngeal compound muscle action potential on initial RLN identification, 2) stimulation threshold of the laryngeal compound muscle action potential on completion of the procedure, and 3) flexible fiberoptic evaluation of the larynx at the initial postoperative visit and at the 3‐month follow‐up visit. The average duration of follow‐up was 9.8 months with a range of 3 to 60 monthsResults The average minimum current required for stimulation on first identification of all nerves was 0.57 mA (±0.48 mA). After completion of the procedure a mean threshold level of 0.42 mA (±0.55 mA) was obtained during direct RLN stimulation. Post‐dissection stimulation of the RLN on the side of tumor dissection was 0.92 mA (±0.65 mA) compared with a stimulation threshold of 0.76 mA (±0.57 mA) for the nontumor side.Conclusions Electromyographic monitoring of the RLN using a postcricoid surface electrode provides a safe, simple, and effective method for intraoperative monitoring during thyroid or parathyroid surgery. Further, evoked electromyography confirms RLN integrity at the conclusion of surgery.
Effects of Uvulopalatopharyngoplasty on Collapsibility of the Retropalatal Airway in Patients With Obstructive Sleep Apnea
Authors: Isono Shiroh , Shimada Akiko , Tanaka Atsuko , Ishikawa Teruhiko , Nishino Takashi , Konno Akiyoshi 
Published: November 2003

AbstractObjectives/Hypothesis Uvulopalatopharyngoplasty improves sleep‐disordered breathing, particularly in patients with sleep‐disordered breathing with abnormally high collapsible airway exclusively at the retropalatal airway, as was previously reported. The present study examined the direct and long‐term effects of uvulopalatopharyngoplasty on retropalatal airway collapsibility.Study Design Prospective longitudinal study of 18 patients with abnormally high collapsible airway exclusively at the retropalatal airway.Methods Closing pressure of the retropalatal airway was estimated by endoscopically obtaining static pressure/area relationship of the passive pharynx in completely paralyzed and anesthetized patients with sleep‐disordered breathing (n = 18) before and 3 months after uvulopalatopharyngoplasty. The measurements were repeated 1 year after uvulopalatopharyngoplasty in eight of these patients.Results Uvulopalatopharyngoplasty decreased retropalatal airway closing pressure by 3.5 cm H2O; furthermore, a direct correlation between the severity of sleep‐disordered breathing (as determined by nocturnal oximetry) and retropalatal airway closing pressure was revealed. Uvulopalatopharyngoplasty failures revealed retropalatal airway closing pressure greater than atmospheric pressure. Reduced retropalatal airway collapsibility was maintained up to 1 year after uvulopalatopharyngoplasty. Two patients developed marked stenosis of the retropalatal airway with aggravation of sleep‐disordered breathing after initial improvement of sleep‐disordered breathing and retropalatal airway collapsibility.Conclusions Uvulopalatopharyngoplasty decreases the retropalatal airway collapsibility. The effect is maintained for at least 1 year after uvulopalatopharyngoplasty, whereas a few patients develop retropalatal airway stenosis leading to recurrence of sleep‐disordered breathing.
Local Administration of Nitric Oxide Donor Significantly Impacts Microvascular Thrombosis
Authors: Chiang Scott , Azizzadeh Babak , Buga Georgette , Ignarro Lou , Calcaterra Thomas , Blackwell Keith 
Published: November 2003

AbstractObjectives/Hypothesis Clinical pharmacotherapy has demonstrated a role in preventing microvascular thrombosis in both experimental and clinical settings. Previous studies in the rabbit model have noted an increased rate of thrombosis with intravenous infusion of nitric oxide antagonists. The study assessed the effects of local application of nitric oxide agonists and antagonists on microvascular anastomotic patency rates.Study Design A randomized, prospective analysis.Methods An arterial inversion graft microvascular thrombosis model was used in New Zealand white rabbits. The rabbits were randomly assigned to nitric oxide agonist, antagonist, and control groups. In each rabbit, the common femoral artery was surgically exposed and a 2‐mm arterial inversion graft was harvested. The anastomosis of the graft to the common femoral artery was performed in solutions of either 100 μmol/L spermine NONOate (nitric oxide donor), 100 μmol/L nitro‐L‐arginine‐methyl ester (L‐NAME) (nitric oxide synthase inhibitor), or 0.9% sodium chloride (control) solution. The contralateral common femoral artery also underwent arterial inversion graft testing with the use of the same solution. Arterial patency was assessed 1 hour after anastomosis.Results Sixteen of 22 arterial inversion grafts performed in the spermine NONOate solution remained patent, and 6 of 22 clotted. Eleven of 21 arterial inversion grafts performed in the control solution remained patent, and 10 clotted. Seven of 21 arterial inversion grafts performed in the L‐NAME solution remained patent, and 14 clotted. These results were found to be statistically significant using the χ2 test with a P value of less than .05.Conclusions In the rabbit model, local application of nitric oxide agonists and antagonists can significantly impact anastomotic patency rates. Further studies may demonstrate a role for the clinical use of nitric oxide in microvascular surgery.
Osteoclast Stimulating and Differentiating Factors in Human Cholesteatoma
Authors: Hamzei Michael , Ventriglia Giovanni , Hagnia Mitra , Antonopolous Alexandra , Bernal‐Sprekelsen Manuel , Dazert Stefan , Hildmann Henning , Sudhoff Holger 
Published: November 2003

AbstractObjectives To investigate the expression of osteoclast‐activating and differentiating factors and to study the occurrence of osteoclast precursor cells and osteoclasts in acquired human cholesteatoma tissue.Methods We examined 21 cholesteatoma samples versus 18 normal auditory canal skin specimens for the expression of osteoprotegerin ligand (OPGL), osteoprotegerin (OPG), and macrophage‐colony stimulating factor (M‐CSF) using reverse transcriptase–polymerase chain reaction (RT‐PCR) and immunohistochemistry. Immunohistochemistry and computer‐assisted microscopy using markers CD4, CD11a, CD11b, CD14, CD51, CD68, and TRAP obtained the detection of osteoclast cell lineage.Results An increased expression of the investigated cytokines M‐CSF, OPG, and OPGL was demonstrated by immunohistochemistry and RT‐PCR in cholesteatoma tissue compared with normal external meatal skin. Several CD4‐positive cells exhibited a co‐expression for OPGL within the perimatrix of cholesteatoma. The presence of osteoclast precursor cells was confirmed in all samples of cholesteatoma tissue.Conclusions This study reveals that the number of osteoclast precursor cells is markedly increased in the perimatrix of cholesteatoma tissue. Our results support a concept described for inflammatory arthritis: the inflammation related to cholesteatoma induces bone resorption by release of OPGL from activated T‐cells and triggers osteoclastogenesis. This could be a major target for drugs to inhibit osteoclast formation and bone resorption and may be an adjunct in cholesteatoma management.
Gentamicin‐Induced Hair Cell Death Is Not Dependent on the Apoptosis Receptor Fas
Authors: Bodmer Daniel , Brors Dominik , Pak Kwang , Bodmer Morana , Ryan Allen F. 
Published: November 2003

AbstractObjectives/Hypothesis The hair cells are the most vulnerable elements in the cochlea, and damage to them is the most common cause of sensorineural hearing loss. Understanding the intracellular events that lead to the death of hair cells is a key to developing protective strategies. The Fas death receptor–mediated apoptotic pathway is well studied and plays an important role in the elimination of damaged cells in a number of different cellular systems. We have studied the role of the Fas receptor in aminoglycoside‐mediated toxicity in vitro. We employed the MRL/MpJ‐Fas lpr/lpr mouse, which does not express a functional Fas receptor.Study Design Response of Fas‐deficient hair cells to gentamicin was compared with the response of normal hair cells in vitro.Methods Basal turn organ of Corti explants from p3‐5 mice were maintained in tissue culture and treated with gentamicin for 72 hours. The explants were fixed and were stained with phalloidin, and counting was performed.Results There was no difference in hair cell loss between Fas mutant mice and control MRL/MpJ mice with a functional Fas receptor.Conclusion The gentamicin‐mediated hair cell death is not dependent on a functional Fas receptor.
Tutorials in Clinical Research, Part VIII: Creating a Journal Club
Authors: Forsen James W. , Hartman James M. , Neely J. Gail 
Published: November 2003

AbstractObjective The present report is the eighth in a series of sequential tutorials entitled “Tutorials in Clinical Research.” The objective of the report is to provide the reader with information to create or refine a journal club.Study Design Tutorial.Methods The authors met weekly for 3 months and discussed the features of a journal club that would be of interest to otolaryngologists. A Medline search provided a number of relevant articles for review.Results The report is organized into the following sections: Introduction, History of Journal Club, Goals of Journal Club, Basic Organization, Factors Associated With Successful Journal Clubs, Design of Journal Club, Selecting Literature, Evaluation of Journal Club, and Summary.Conclusions There is a paucity of information within the otolaryngology literature regarding the journal club and the significant role it can play in physician education. The flexible nature of the journal club gives it the potential to address many educational needs. Its relevance has never been greater.
Translaryngeal Tracheostomy: Experience of 340 Cases
Authors: Sharpe Michael D. , Parnes Lorne S. , Drover John W. , Harris Chris 
Published: November 2003

AbstractObjective To describe the authors' initial experience with a new and innovative dilational translaryngeal tracheostomy bedside technique.Study Design A prospective documentation of 340 patients who received an elective translaryngeal tracheostomy in a multidisciplinary, tertiary care intensive care unit during a 45‐month period.Results All translaryngeal tracheostomy procedures but one were completed successfully; one was aborted because of bleeding from a thyroid vein. Minor perioperative complications occurred in 42% of patients, which caused no adverse effects. The most common complication was arterial desaturation occurring in 17% of patients; this was short‐lived, and the lowest saturation was 79%. Blood loss was minimal (<5 mL) in all but one case, despite an elevated international normalized ratio (INR) and partial thromboplastin time in 42% and 41% of patients, respectively, and a low platelet count in 13% of patients.Conclusions Translaryngeal tracheostomy is a safe and reliable technique and can also be used in patients with unstable cervical spines and bleeding diathesis. It has become the authors' procedure of choice for an elective bedside tracheostomy in the intensive care unit.
Genetically Engineered Tumor Cell Vaccine in a Head and Neck Cancer Model
Authors: Couch Marion , Saunders John K. , O'Malley Bert W. , Pardoll Drew , Jaffee Elizabeth 
Published: November 2003

AbstractObjectives Using a murine model, a novel tumor vaccine for head and neck squamous cell carcinoma expressing the granulocyte‐macrophage colony stimulating factor (GM‐CSF) gene was evaluated for its ability to protect against tumor challenge.Study Design Mice vaccinated in the floor of the mouth with the GM‐CSF tumor cell vaccine were challenged with parental tumor cells, and subsequent tumor development was monitored. Specificity of the antitumor response was demonstrated by vaccinating the mice and then challenging them with an unrelated but syngeneic radiation–induced fibrosarcoma tumor cell line, RIF. Irradiated (only) tumor cells were used as a control to see whether an augmented antitumor response was attributable to possible increased immunogenicity that could theoretically be induced by the irradiation.Methods The GM‐CSF gene was transduced into tumor cells via a retroviral vector. The tumor cells were irradiated to prevent replication in vivo. GM‐CSF concentrations were determined using ELISA, and physiological activity was confirmed using a biological assay with a GM‐CSF–dependent cell line.Results Vaccination with genetically engineered tumor cells significantly protected against subsequent tumor challenge (5% level) when compared to control groups. Mice were not protected when vaccinated and challenged with the unrelated tumor cell line, RIF. Mice vaccinated with irradiated (only) tumor cells were not protected, either.Conclusions Vaccination with genetically engineered tumor cells offers significant protection from later tumor challenge. The response is systemic and tumor specific, not due to an inflammatory response. Irradiation of the tumor cells does not account for the augmented antitumor response. This work supports the continued investigation of the GM‐CSF tumor vaccine for the treatment of head and neck squamous cell carcinoma.
Swallow Function in Patients Before and After Intra‐Arterial Chemoradiation
Authors: Graner Darlene E. , Foote Robert L. , Kasperbauer Jan L. , Stoeckel Ruth E. , Okuno Scott H. , Olsen Kerry D. , Sabri Alain N. , Maragos Nicolas E. , Cha Stephen S. , Sargent Dan J. , Strome Scott E. 
Published: November 2003

AbstractObjectives/Hypothesis To prospectively evaluate swallow function in patients with advanced head and neck cancer before and after completion of intra‐arterial chemoradiation therapy and planned neck dissection.Study Design Prospective nonrandomized study.Methods Swallow function was evaluated in 11 patients with resectable T4 and selected T3 head and neck cancer before and, on average, 19 weeks after completion of treatment.Results The Performance Status Scale demonstrated worse scores for both eating in public (P = .004) and normalcy of diet (P = .004) after treatment. Patients who underwent neck dissections had significantly worse scores (P = .02) in normalcy of diet. A significant decline was noted in swallowing functional measures at the time of the repeat evaluation (P = .02). Videofluoroscopic swallow studies revealed altered swallow function in 9 of 11 patients before treatment, with aspiration seen in 3 patients. Following treatment, the incidence of aspiration increased to seven patients. Tongue base retraction, reduced laryngeal elevation, and increased laryngeal vestibule penetration of thick liquid were all statistically significantly worse after treatment. The overall score on the quality of life instrument was not significantly changed from before to after treatment.Conclusions The majority of patients demonstrated significantly worse swallow function on all three methods of analysis at 19 weeks after completion of treatment. Continued detailed monitoring of patients' swallow function is critical in determining long‐term effects of intra‐arterial chemoradiation therapy and neck dissection.
Postural Stability of Preoperative Acoustic Neuroma Patients Assessed by Sway Magnetometry: Are They Unsteady?
Authors: Collins Melanie M. , Johnson Ian J. M. , Clifford Elaine , Birchall John P. , O'Donoghue Gerald M. 
Published: November 2003

AbstractObjectiveThe objective was to evaluate the preoperative postural stability of acoustic neuroma patients using sway magnetometry.Study DesignProspective two‐center study.MethodsFifty‐one patients (mean age, 53 years) diagnosed with unilateral acoustic neuroma on magnetic resonance imaging at two tertiary referral centers were studied. Preoperatively, each patient had sway patterns (with eyes open and with eyes closed, and standing on foam) recorded for 120 seconds by sway magnetometry. Path length for 30 seconds was calculated. The Romberg coefficient (path length with eyes open divided by path length with eyes closed) was calculated.ResultsForty‐four percent of patients had abnormal path lengths with eyes open, and 49% with eyes closed. The Romberg coefficients were significantly lower than normal (P<.001; 95% CI, 0.19–0.87). Mean Romberg coefficient was 0.59 (normal value = 0.73), and all patients had a coefficient of less than 1.ConclusionsHalf of preoperative acoustic neuroma patients are unsteady, exhibiting abnormal sway patterns based on path length measurements. The increase in sway path length demonstrable in normal subjects with eyes closed was significantly exaggerated in patients with acoustic neuroma.
Facial Nerve Stimulation at the Internal Auditory Canal: An Animal Model and Experimental Assessment
Authors: Kelley Timothy F. , Leonetti John P. 
Published: November 2003

AbstractObjectives The main objective was to evaluate a canine model as a reliable animal model for the experimental study of the facial nerve at the internal auditory canal. The study also sought to begin testing the limits of facial nerve stimulation regarding electrically induced nerve damage.Study Design Experimental and clinical analysis of facial nerve function after exposure and electrical stimulation in a canine model.Methods Using a posterior fossa approach, the intracranial portion of the facial nerve was exposed from the brainstem to the internal acoustic meatus in 10 mongrel dogs. The nerve was then stimulated with variable frequency and amperage. The subjects were clinically examined for 2 weeks for evidence of facial nerve dysfunction. Both facial nerves were then harvested in each subject and histologically compared using light microscopy.Results The canine model allowed for reliable exposure of the facial nerve at the internal auditory canal in all subjects (n = 10). The results also showed no functional or histopathological deficits in a canine facial nerve electrically stimulated at up to 50 stimulations of 1 mA per stimulation when stimulated at the internal auditory canal.Conclusions The reported canine model is a reliable animal model for the study of the facial nerve at the internal auditory canal. The canine facial nerve can tolerate at least 50 stimulations at 1 mA and still remain functionally and histopathologically normal.