bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anti–Heat Shock Protein 70 Antibodies in Meniere's Disease
Authors: Rauch Steven D. , Zurakowski David , Bloch Donald B. , Bloch Kurt J. 
Published: November 2003

AbstractObjectives To determine the prevalence of anti–heat shock protein 70 (anti‐HSP70) antibodies in patients with Meniere's disease and healthy subjects and to probe the relationship between antibody status and clinical features of Meniere's disease.Study Design Prospective cohort study of consecutive consenting patients with Meniere's disease.Methods Serum samples were obtained prospectively from 134 patients with Meniere's disease and 124 blood donors. Serial samples were taken at 3‐month intervals in 38 of 134 patients with Meniere's disease. Demographic data and clinical characterization of vestibular and auditory status were acquired with each sample. Serum was assayed for anti‐HSP70 antibodies by Western blot using bovine renal extract, recombinant bovine HSP70, and recombinant human HSP70 antigens.Results Immunoreactivity against bovine renal extract HSP70 was found in 38% of patients with Meniere's disease, compared with 25% of blood donors (P < .04). Reactivity with recombinant antigens was not significantly different between patients with Meniere's disease and healthy control subjects. Patients with Meniere's disease who reacted with all three antigens were more likely to have simultaneously active hearing and balance symptoms (P = .03). Neither univariate nor multivariate statistical analysis established any other association between serological findings and clinical features of Meniere's disease. Tests performed on serial samples of patients with Meniere's disease also showed no association of positive or negative test results with changes in clinical course.Conclusions Because of the high prevalence of anti‐HSP70 antibodies in healthy subjects and the very limited association of anti‐HSP70 antibody status with clinical features or course of Meniere's disease, we conclude that, at present, the detection of anti‐HSP70 antibodies by Western blotting offers little clinically useful information in Meniere's disease.
Does Tongue Size Differ Between Patients With and Without Sleep‐Disordered Breathing?
Authors: Do Katherine L. , Ferreyra Henry , Healy John F. , Davidson Terence M. 
Published: November 2003

AbstractObjectives/HypothesisTo determine whether there is a difference in the tongue size of patients with and without sleep‐disordered breathing (SDB) and to evaluate whether tongue volume correlates with body mass index (BMI), neck circumference, age, Epworth Sleepiness Scale score, or apnea‐hypopnea index (AHI).Study DesignNineteen patients (9 with SDB; 10 without SDB) were enrolled in this prospective study.MethodsAll patients completed a sleep questionnaire including the Epworth Sleepiness Scale and underwent a physical examination, portable sleep study, and magnetic resonance imaging (MRI) study. An examiner masked to the patients' disease status measured tongue volume from the MRI films.ResultsThere was a trend for patients with SDB to have a larger tongue volume than patients without SDB (P= .065). Tongue volume only positively correlated with BMI (P= .005) and neck circumference (P= .013), but there was no correlation with age (P= .23) or AHI (P= .40).ConclusionsThere is a statistical trend for patients with SDB to have larger tongue size compared with non‐SDB patients, but tongue size is independent of AHI and correlates significantly with BMI and neck circumference. We interpret these findings to suggest that variations in tongue size alone cannot account for disease severity and may simply reflect the larger body habitus often seen in patients with SDB.
A Clinicopathological Study of Sinonasal Neuroendocrine Carcinoma and Sinonasal Undifferentiated Carcinoma
Authors: Smith Shane R. , Som Peter , Fahmy Adham , Lawson William , Sacks Steve , Brandwein Margaret 
Published: November 2003

AbstractObjective Sinonasal undifferentiated carcinoma (SNUC) and sinonasal neuroendocrine carcinoma (SNEC) are relatively newly recognized, rare entities requiring further clinicopathological analysis to advance our understanding and determine prognostic distinctions between them.Study Design Retrospective chart review.Methods Cases were retrieved from the Copath system. One patient was seen in consultation from an outside institution. Histological and immunohistochemical findings, patient demographics, treatment regimens, and outcomes were analyzed and compared.Results Ten patients (7 men, 3 women) ranging in age from 17 to 58 years (mean age, 44.7 y) were included. Four patients were classified with SNEC, six as having SNUC. The predominant site was the superior nasal cavity or ethmoids (seven cases), followed by the maxilla (four cases). Disease in four patients was clinically staged as N1 (three with SNUC, one with SNEC), and in six patients as N0 (three with SNEC, three with SNUC). Of the nine patients who were treated initially with surgical resection, seven received postoperative radiation therapy alone, one received postoperative radiation and chemotherapy, and one had only limited postoperative chemotherapy. One patient was treated with radiation therapy and chemotherapy alone, without surgical resection. Follow‐up was obtained ranging from 6 to 108 months (mean period, 26.4 mo). Three patients died of disease 10, 14, and 41 months, respectively, after diagnosis. Three patients had persistent disease at 6, 9, and 21 months, respectively, two of them with distant metastases. Four patients were disease free after 6, 18, 31, and 108 months, respectively.Conclusions SNUC and SNEC are both aggressive tumors, usually presenting in middle age as a nasal mass. Both tumors have the capacity to metastasize locally and distantly, and both can result in poor outcomes. This small series precludes a demographic or prognostic distinction between the two groups.
Engineering Autogenous Cartilage in the Shape of a Helix Using an Injectable Hydrogel Scaffold
Authors: Saim Aminuddin B. , Cao Yilin , Weng Yulai , Chang Chia‐Ning , Vacanti Martin A. , Vacanti Charles A. , Eavey Roland D. 
Published: November 2003

AbstractObjective Previous successful efforts to tissue engineer cartilage for an auricle have used an immunocompromised nude mouse xenograft model. Subsequent efforts in an immunocompetent autogenous animal model have been less successful because of an inflammatory response directed against the foreign scaffold polymer used to provide an auricular shape. We studied an alternative polymer material and surgical technique to engineer autogenous cartilage in the shape of a human ear helix using injectable hydrogel scaffolding, Pluronic F‐127 (polyethylene oxide and polypropylene oxide).Subject Yorkshire swine.Material and Methods Fresh autogenous chondrocytes were suspended in a biodegradable, biocompatible co‐polymer hydrogel, Pluronic F‐127, at a concentration of 3 × 107 cells/mL. To support the contour of the implant, a skin fold channel in the shape of the helix of a human ear was created in the skin in three sites on the ventral surface of the animal. The cell‐hydrogel suspension was injected through the skin fold channel. For controls, injections were made into identical channels using either cells alone or the Pluronic F‐127 without cells. After 10 weeks, the specimens were excised and examined both grossly and histologically.Results Grossly, all implants retained a helical‐like shape. Excised specimens possessed flexible characteristics consistent with elastic cartilage. The specimens could be folded and twisted and on release of mechanical pressure would instantly return to the original shape. Histological evaluation of the implants using H&E, Safranin O, trichrome blue, and Verhoeff's stains demonstrated findings consistent with mature elastic cartilage. Control injection of hydrogel alone demonstrated no evidence of cartilage formation and control injection of chondrocytes alone showed evidence only of disassociated elastic cartilage.Conclusion Injection of autologous porcine auricular chondrocytes suspended in a biodegradable, biocompatible hydrogel of Pluronic F‐127 resulted in the formation of cartilage tissue in the approximate size and shape of a human ear helix. This preliminary method extends the concept of auricular tissue engineering from an immunocompromised xenograft animal model to an immunocompetent autologous animal model.
Influenza A Virus Infection of Human Middle Ear Cells In Vitro
Authors: Buchman Craig A. , Fregien Nevis 
Published: November 2003

AbstractHypothesis
Human‐derived normal middle ear mucosal cells can be harvested and cultured and will support influenza A virus (INF A) infection.Study Design
Protocols for the collection and in vitro culture of middle ear mucosal cells were developed and used to investigate the effects of INF A infection as it relates to the pathogenesis of otitis media.Materials and Methods
Middle ear mucosa was harvested during surgeries that opened the normal middle ear. Middle ear mucosal cells were plated and grown in collagen‐coated dishes. Cells were characterized before and after INF A exposure using phase‐contrast and immunofluorescence microscopy as well as reverse transcriptase‐polymerase chain reaction (RT‐PCR) for cytokeratin 18 gene expression and INF A.Results
Primary cultures of human middle ear epithelial cells were established. Prolonged growth of middle ear cells yielded a second cell type that failed to stain for cytokeratin on immunofluorescence but continued to produce positive RT‐PCR results on cytokeratin 18 analysis. After INF A exposure, cytological changes and immunofluorescence staining showed cellular infection. RT‐PCR analysis using INF A–specific primers showed positive results for up to 72 hours after viral exposure.Conclusions
Primary cultures of human middle ear mucosal cells have been established. Two distinctly different cell culture systems have been developed: 1) middle ear epithelial cells and 2) either dedifferentiated epithelial cells or fibroblasts. Exposure of both cell types to INF A demonstrates that each can support cellular infection and viral replication. These models should be useful for studies of the pathogenesis of virus‐mediated otitis media.
Accuracy, Utility, and Cost of Frozen Section Margins in Head and Neck Cancer Surgery
Authors: DiNardo Laurence J. , Lin James , Karageorge Lampros S. , Powers Celeste N. 
Published: November 2003

AbstractObjectives Intraoperative frozen section analysis of surgical margins is widely used in head and neck cancer surgery. This study evaluates frozen section accuracy relative to permanent controls and final margins from the entire specimen, the rate at which frozen sections impact intraoperative management, and the resultant cost.Study Design Retrospective.Methods From 1997 to 1999 the frozen section results, permanent controls, and final tumor margins from 80 consecutive patients undergoing 420 intraoperative frozen section margins for head and neck malignancy were reviewed.Results A 98.3% accuracy rate (sensitivity, 88.8%; specificity, 98.9%) was found compared with permanent sections of the same tissue. However, 40% (8 of 20) of patients with positive final margins on the resection specimen, and 100% (15 of 15) with close (<5 mm) margins were not detected by frozen section analysis. The overall accuracy of frozen section in the evaluation of close or positive final margins was 71.3% (sensitivity, 34.3%; specificity, 100%). In addition, 5% (4 of 80) of patients potentially benefited from intraoperative frozen section by virtue of immediate margin revision. The estimated cost of intraoperative frozen section averaged as much as $3123 per patient, with a cost‐benefit ratio of 20:1.Conclusions Intraoperative frozen section margins are accurate, but they are costly and cannot reliably eradicate positive final margins. Patients with early‐stage lesions and those undergoing re‐resection for recurrence or salvage surgery after radiation failure derived the greatest potential benefit from frozen section margins.
Laryngotracheal Reconstruction and the Hidden Airway Lesion
Authors: Rutter Michael J. , Thompson Link Dana , Liu James H. , Cotton Robin T. 
Published: November 2003

AbstractObjective Single‐stage laryngotracheal reconstruction (SSLTR) is an increasingly common technique to achieve decannulation of patients with laryngotracheal stenosis. In a proportion of cases airway distress on extubation may be attributed to a dynamic second airway lesion not diagnosed before surgery. Our aim is to describe our recent experience with these frustrating patients.Methods Between July 1997 and July 1999 we prospectively followed patients who underwent SSLTR and experienced difficulty after extubation owing to an unsuspected second airway lesion.Results During this 24‐month period we performed 80 SSLTRs. In six surgeries performed on five patients, a second airway lesion complicated extubation. In five patients the second lesion was not diagnosed before surgery because there was significant airway stenosis and tracheotomy. The sixth patient was transferred to our care intubated. In all cases the airway surgery for the dominant lesion was technically successful, but revealed a second dynamic lesion. There were three cases of tracheomalacia, two cases of laryngomalacia, and one case of arytenoid prolapse. All patients required intervention. Tracheotomy was required in four patients.Conclusions Failure to achieve extubation after SSLTR may be caused by a dynamic second airway lesion that was previously disguised by a more dominant airway lesion. Surgical repair of the dominant lesion will allow manifestation of the dynamic lesion due to the Bernoulli effect. The combination of a tracheotomy and a dominant airway lesion limits airflow and potentially disguises the situation.
Assessment of Real‐Time Clinical Facial Function During Vestibular Schwannoma Resection
Authors: Axon Patrick R. , Ramsden Richard T. 
Published: November 2003

AbstractObjectives To describe a technique for quantifying residual facial function after vestibular schwannoma surgery. The intraoperative electrophysiological results are correlated with immediate postoperative clinical facial function to assess technique validity.Study Design Prospective blinded study.Methods Thirty‐two patients undergoing translabyrinthine resection of vestibular schwannoma were included. Compound muscle action potential (CMAP) amplitude was calculated to suprama‐imal stimulation of the facial nerve, proximal to vestibular schwannoma compression, at the brain stem. The procedure was repeated after tumor removal. Comparison of the two CMAP amplitudes enabled estimation of change in facial function during surgery. The data were correlated with intracranial tumor diameter and immediate postoperative clinical facial function.Results CMAP amplitude recorded after tumor resection correlated with immediate postoperative clinical facial function (0.879, P < .01). Correlation was improved when residual facial function was calculated (0.944, P < .01). In contrast, preoperative tumor size had relatively poor correlation with immediate postoperative facial function (0.688, P < .01).Conclusions Comparison of electrophysiological data before and after tumor removal reduces intersubject variability resulting from intersubject variation in facial muscle morphology. Residual facial function closely correlates with immediate postoperative clinical facial function, assessed using the House‐Brackmann grading system. From the data presented, the technique can inform the surgeon of current clinical facial function at any point during the dissection process.
Changing Trends in Clinical Manifestations of Laryngeal Tuberculosis
Authors: Shin Jung‐Eun , Yuhl Nam Soon , Joo Yoo Seung , Yoon Kim Sang 
Published: November 2003

AbstractObjectives/Hypothesis Despite the dramatic decrease in the incidence of laryngeal tuberculosis, the disease has gained new interest as a result of claims that it has changed its clinical patterns. The aim of this study is to evaluate the changing trends in clinical manifestations of laryngeal tuberculosis.Study Design Retrospective clinical analysis.Methods Clinical analysis of 22 patients with pathologically confirmed laryngeal tuberculosis was carried out retrospectively.Results Patients' ages ranged from 22 to 75 years. The male‐to‐female ratio was 2.14 to 1. The most frequent chief complaint was hoarseness. The true vocal cord and the false vocal cord were commonly involved, and 11 patients showed single lesions. Among 22 patients, only 7 had active pulmonary tuberculosis, and 9 were proven to have normal lung status. The patients with active pulmonary tuberculosis showed more ulcerative and multiple lesions. The patients with normal lung status showed nonspecific, polypoid, and single lesions. All patients responded satisfactorily to antituberculous medication.Conclusions The clinical manifestations of laryngeal tuberculosis have changed and seem to be different from those of classic reports. It can even occur without pulmonary tuberculosis, and the characteristics of lesions seem to be more nonspecific. It might be important to consider tuberculosis in the differential diagnosis of nonspecific laryngeal disease.
Dimensions of the Cricoid Cartilage and the Trachea
Authors: Randestad Åke , Lindholm Carl‐Eric , Fabian Peter 
Published: November 2003

AbstractObjective Important dimensions of the cricoid cartilage and trachea have been studied. Knowledge of size, variations in size, and configuration of these structures is important when tracheal intubation, stenting, endoscopy, and transplantation are to be performed.Methods In 34 male and 27 female adult human specimens, 1861 measurements of the cricoid cartilage and trachea were performed.Results The smallest dimension was found in the frontal plane. The mean inner diameter of the cricoid in this plane with mucous membrane in situ was in women 11.6 mm (range, 8.9–17.0 mm) and in men 15.0 mm (range, 11.0–21.5 mm). The configuration varied more than expected. For example, the angle between the longitudinal axes of the cricoarytenoid joint facets ranged from 42° to 74° in women and from 37° to 75° in men. The mean distance between these joint facets was 10.3 mm (range, 7.4–13.0 mm) in women and 12.6 mm (range, 8.0–18.2 mm) in men. The cross‐section of the trachea varied much in configuration, the smallest frontal diameter being as little as 9.9 mm in women and 12 mm in men.Conclusions In some women the inner diameter of the cricoid ring does not permit passage of a standard‐size (7 mm, internal diameter [ID]) tracheal tube or a standard‐size rigid endoscope through the larynx without mucosal damage. The small distance between the cricoarytenoid joints in many women and some men is the basis for of the clinical observation that women, especially, receive pressure necroses at the medial sides of the arytenoid cartilages attributable to tracheal intubation with standard tubes. The large difference in almost all sizes and shapes of the cricoid cartilage and trachea makes it impossible to standardize the rigid stents used in these organs. When transplantation to the larynx is planned, this variation of the anatomy must be considered.
Use of Computer‐Aided Surgery for Frontal Sinus Ventilation
Authors: Loehrl Todd A. , Toohill Robert J. , Smith Timothy L. 
Published: November 2003

AbstractObjectives To review our experience and evaluate the utility of computer‐aided surgery for frontal sinus and frontal recess disease.Study Design A retrospective review of 31 consecutive patients undergoing computer‐aided surgery for frontal sinus ventilation.Methods The hospital charts of 31 patients were reviewed. Previous sinonasal procedures, etiology of sinonasal disease, preoperative computed tomography (CT) scan findings, preoperative symptoms, endoscopic and intraoperative findings, type of frontal sinus ventilation procedure, complications, imaging system registration method or accuracy, and postoperative course were noted.Results In all 31 patients the surgery was successfully completed, and no intracranial or orbital complications were encountered during or after surgery. Six patients required additional surgery including revision transnasal endoscopic frontal sinus ventilation or osteoplastic flaps with fat obliteration. In the six cases requiring additional surgery, disease severity, most commonly, aspirin triad disease, predisposed to failure of frontal sinus ventilation.Conclusions Computer‐aided surgery is a useful adjunctive device for safe, efficient identification and surgery of the frontal sinus. However, it is not a replacement for sound surgical technique, anatomical knowledge, and experience. In particular, patients with aspirin triad disease with frontal recess and frontal sinus involvement are highly suited for computer‐aided surgery and thorough removal of disease, although failures occur despite this technique. The long‐term benefit of computer‐aided surgery of the frontal sinus has not yet been demonstrated by this or other studies.
Diagnosis and Management of the Lateralized Tympanic Membrane
Authors: Sperling Neil M. , Kay David 
Published: November 2003

AbstractObjective Lateralization of the tympanic membrane (TM) is associated with significant morbidity. In a series of 14 patients, we make observations to illuminate this condition for the diagnosing and treating physician.Study Design Chart review of 14 consecutively treated patients.Methods We analyzed the presenting signs and symptoms, etiology, audiometric data, and operative findings of patients with a lateralized tympanic membrane (TM).Results The etiology was postsurgical in 13 patients (there were four aural atresia repairs and nine tympanoplasties), with 2 patients having had multiple previous surgeries. Presentation averaged more than 5 years after the latest surgery. Presenting symptoms included hearing loss in 10, tinnitus in 3, vertigo in 3, and otorrhea in 2 patients; 3 patients were nonsymptomatic at the time of presentation. The average air–bone gaps were 39 dB before treatment and 29 dB after treatment. Operative findings included cholesteatoma in six patients. Eight patients healed with the TM in the normal position; one had TM retraction, one had a TM perforation, and three had a recurrent lateralization.Conclusion The lateralized TM is primarily, but not necessarily, a complication of otological surgery. It may be associated with considerable morbidity, including hearing loss and cholesteatoma. Patients may present several years after their surgery, occasionally as an incidental finding. Surgical repair is often necessary for significant underlying disease, but re‐establishment of a normal TM can be challenging.