bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sleep‐Disordered Breathing: Radiofrequency Thermal Ablation Is a Promising New Treatment Possibility
Authors: Bäck Leif , Palomäki Maarit , Piilonen Anneli , Ylikoski Jukka 
Published: November 2003

AbstractObjectives The aim of this study was to assess the efficacy and morbidity of radiofrequency thermal ablation of the soft palate in subjects with sleep‐disordered breathing.Study Design Prospective, nonrandomized study. Outpatient treatment and an extended follow‐up time of 12 months.Methods Twenty‐one healthy men who were 18 to 60 years of age (median age, 44 y) with sleep‐disordered breathing were enrolled to the study. All the patients had habitual snoring for at least 1 year that was associated with excessive daytime sleepiness interfering with social or professional activities. Radiofrequency energy was delivered to the soft palate in two treatment sessions separated by 1 week at 460 ± 1 kHz with an energy delivery of 600 and 300 J. Snoring Score, Epworth Sleepiness Scale, and cephalometric analysis were measured preoperatively and postoperatively. Certain inflammatory laboratory parameters and visual analogue scale scores of symptoms were measured related to the procedure.Results The changes in Snoring Score and Epworth Sleepiness Scale scores were statistically significant. The change in the length of the soft palate was statistically significant, whereas the change in palatal width was not. There were no notable changes in the laboratory parameters. The symptom visual analogue scores were low and transient, resolving within days.Conclusions The radiofrequency thermal ablation of the soft palate in patients with sleep‐disordered breathing seems to be effective. It is safe and associated with only a low morbidity. The promising results must be confirmed in a placebo‐controlled study with a larger sample size and a long‐term follow‐up.
Unilateral Palate Paralysis in Patients With Nasopharyngeal Carcinoma: Imaging and Clinical Correlations
Authors: Su Chih‐Ying , Lui Chun‐Chung 
Published: November 2003

AbstractObjective Neck masses, hearing impairment, and blood‐tinged nasal discharges are three major clinical manifestations of nasopharyngeal carcinoma (NPC). Because of the relationship between the anatomic structures of the fossa of Rosenmüller and the levator veli palatini muscle, NPC arising in the fossa can invade the levator muscle, limiting movement or causing paralysis of the ipsilateral soft palate. It is well known that NPC originates commonly from the fossa of Rosenmüller. We therefore hypothesize that the clinical signs of unilateral palate paralysis in patients with NPC must be far more common than usually realized. This issue is, as yet, not fully addressed in the literature.Study Design A prospective study of all patients with newly diagnosed NPC.Methods Two hundred sixty‐four patients with newly diagnosed NPC were studied. Clinical records included the details of their clinical presentations and the results of physical and neurological examinations. The degree of elevation of the soft palate during phonation was carefully evaluated. Magnetic resonance imaging (MRI) of the head and neck region with a particular emphasis on the levator veli palatini muscles was then performed. The degree of paralysis of the palate was correlated with the degree of invasion of the levator muscles by the tumor, as seen with imaging. The incidence of paralysis of the palate in the patients with NPC was also determined.Results At the time of diagnosis, ipsilateral paralysis of the palate was observed in 137 (52%) of the 264 patients with NPC. The results of imaging indicated that 62% (163 of 264) of the patients had radiological evidence of tumor invasion of the levator muscle. The degree of paralysis of the palate corresponded well to the extent of tumor invasion of the levator muscle. Paralysis of the palate was not evident in 26 patients with early perimuscular infiltration of the levator muscle.Conclusion This study revealed that ipsilateral invasion of the levator veli palatini muscle by NPC is common and typically presents with signs of unilateral palate paralysis. This subtle sign is relatively common in patients with NPC. Consequently, we think palate function should be routinely tested when diagnosing NPC, particularly when the patient has unilateral aural symptoms or a neck lump.
Histopathological Changes of Chorda Tympani in Chronic Otitis Media
Authors: Gedikli Orhan , Doğru Harun , Aydin Gülsen , Tüz Mustafa , Uygur Kemal , Sari Aliye 
Published: November 2003

AbstractObjective To investigate whether histopathological changes of chorda tympani might exist in patients with chronic otitis media without facial paralysis.Study Design The study was designed as a prospective trial.Methods Twenty of 107 patients with chronic otitis media, in whom the chorda tympani were injured inadvertently during middle ear surgery, were enrolled into the study. The cases were divided into two groups based on the activity of chronic infection at the time of surgery. Twelve cases with suppurative disease were included in group I, and 8 cases with dry ear in group II.Results Histopathological examinations of the specimens revealed findings such as thickening of perineural and epineural connective tissue, vacuolar degeneration of Schwann cells, and proliferation of fibroblasts in endoneurium. Disorganization of the axons of some nerve fibers was also determined.Conclusion Based on the histopathological changes of chorda tympani in chronic middle ear disease, it is postulated that chronic otitis media may give rise to functional loss of the nerve.
Delayed, Reversible Hearing Loss Caused by Difluoromethylornithine (DFMO)
Authors: Doyle Karen Jo 
Published: November 2003

AbstractObjectives/Hypothesis Difluoromethylornithine (DFMO) is an anticancer experimental drug that is ototoxic. The objectives of these three experiments were to: 1) determine a dose and dosing schedule of DFMO that produces significant hearing loss (HL) in newborn gerbils; 2) compare the HL level for control and newborn gerbils receiving daily subcutaneous injections of DFMO; and 3) to determine if DFMO‐related HL is significantly reversible following discontinuation of DFMO treatment.Study Design Prospective, non‐randomized experimental design with placebo controls.Methods Click‐evoked auditory brainstem response (ABR) testing was performed for 21‐day‐old Mongolian gerbils following daily subcutaneous injections of DFMO or saline. Three experiments were carried out using different injection schedules and doses of DFMO. In experiment 3, animals were retested at 42 days of age following a 3‐week recovery from DFMO.Results Animals administered an 18‐day regimen of DFMO at 1 g/kg per day (from day 3 to day 20) had click thresholds of 25 to 65 dB nHL, whereas animals receiving daily injections of saline had thresholds of 5 to 20 dB nHL. Animals retested after 3 weeks of recovery from DFMO treatment had thresholds ranging from 5 to 20 dB nHL. Differences were statistically significant.Conclusions DFMO causes mild to moderate HL in neonatal gerbils that recovers after discontinuation of the drug.
Inhibition of Motor Nerve Regeneration in a Rabbit Facial Nerve Model
Authors: Yian Christopher H. , Paniello Randal C. , Gershon Spector J. 
Published: November 2003

AbstractObjectives/Hypothesis We hypothesized that intramuscular injection of vincristine into the upper lip selectively prevents reinnervation of the target muscle (quadratus labii superioris) after facial nerve transection.Study Design Prospective controlled experiment.Methods Transection injuries with primary neurorrhaphy were performed just proximal to the buccal and zygomatic branches of both facial nerves in 20 rabbits. The left (experimental) quadratus labii superioris muscle was injected with 200 μg vincristine 72 hours after injury; the right (control) side was injected with saline. Functional, electrophysiological and histological studies were performed 6 weeks after surgery.Results After 6 weeks, the control side had a mean axon count (distal buccal branch) of 1160, conduction velocity of 50.4 m/s, reduction of compound action potential amplitude of 44%, and functional index of 1.67 units. The experimental side had a mean axon count of 265, conduction velocity of 16.5 m/s, reduction of compound action potential amplitude of 88%, and a functional index of 0.176 units. All parameters were significantly reduced by vincristine blockade (P <.05). The zygomatic division (not exposed to vincristine) displayed a trend toward increased axon counts, but this was not statistically significant (P = .131).Conclusions These results demonstrate that reinnervation of a selected muscle can be prevented by injection of vincristine. Enhanced reinnervation of adjacent muscle groups may also occur. Thus, nerve blockade by vincristine may be useful for the prevention of synkinesis.
Inverted Papilloma: A Review of 53 Cases
Authors: Thorp M. A. , Oyarzabal‐Amigo M. F. , du Plessis J. H. , Sellars S. L. 
Published: November 2003

AbstractObjective To assess the surgical management of patients with inverted nasal papilloma over a 14‐year period.Study Design Retrospective study.Setting Tertiary health care center.Results Fifty‐three patients (38 males, 15 females) with an average age of 49.8 years were treated. Overall recurrence rate was 28% and a malignant association of 9% was shown. Recurrence rates varied from 27% in patients with more extensive disease involvement treated by lateral rhinotomy and medial maxillectomy, to 30% in patients with less extensive disease treated conservatively. Of the 5 patients with associated malignancy, 3 (6% of all patients) are likely to have undergone malignant transformation.Conclusion Aggressive initial management remains the therapeutic aim in this condition.
In Vivo Diagnosis of Nasopharyngeal Carcinoma Using Contact Rhinoscopy
Authors: Pak Martin Wai , To Ka Fai , Leung Sing Fai , van Hasselt Charles Andrew 
Published: November 2003

AbstractObjectives To evaluate the potential use of contact endoscopy for the diagnosis of nasopharyngeal carcinoma (NPC).Study Design Prospective study to examine the nasopharynx of 30 patients with nasopharyngeal carcinoma and 18 subjects with normal nasopharynx in a clinic setting using contact rhinoscopes (Karl Storz, Tuttlingen, Germany, 7215 AA, 00 and 7215 BA, 300; 23 cm long; 4 mm in diameter).Methods The superficial cells of the normal nasopharynx and the nasopharyngeal tumors were stained with 1% methylene blue and examined with contact rhinoscopes at high magnifications (×60 and ×150). The areas under examination were then biopsied. The contact endoscopic images were compared with the corresponding hematoxylin and eosin‐stained histologic sections of the biopsied tissues.Results Sixty‐six procedures were performed in 48 patients. The images of normal pseudostratified ciliated epithelium and squamous epithelium were readily recognized by contact endoscopy in all subjects with normal nasopharynx (10 men and 8 women; mean age, 51.9 y). Twenty‐six of 30 patients with NPC (86.6%; 18 men and 8 women; mean age, 50.6 y) were successfully examined by contact endoscopy under local anesthesia. In these 26 patients, two patterns of malignant cells were identified with contact endoscopy. The patterns of contact endoscopic images corresponded well with the histologic findings.Conclusion Contact endoscopy is an accurate and reliable office‐based procedure, which allows for in‐vivo diagnosis of nasopharyngeal carcinoma.
Expression of p16, nm23‐H1, E‐cadherin, and CD44 Gene Products and Their Significance in Nasopharyngeal Carcinoma
Authors: Huang Guang‐Wu , Mo Wu‐Ning , Kuang Guo‐Qian , Nong Hui‐Tu , Wei Ming‐Yi , Sunagawa Masanori , Kosugi Tadayoshi 
Published: November 2003

AbstractObjective The present study was aimed to determine whether p16/MTS1, nm23‐H1, E‐cadherin, and CD44 proteins were expressed in nasopharyngeal carcinoma (NPC) and whether those expressions were pathologically significant in the progress of NPC.Method We examined non‐cancerous nasopharyngeal mucosa (20 cases) and NPC (80 cases) using immunohistochemistry with six different types of monoclonal antibodies against p16, nm23‐H1, E‐cadherin, CD44H, CD44v3, and CD44v6 proteins.Results The results showed that 1) the rates of positive p16 protein expression and of preserved E‐cadherin protein expression in NPC were significantly lower than those in non‐cancerous tissue (P <.01); 2) no significant difference in the rate of positive expression of nm23‐H1, CD44H, CD44v3, and CD44v6 proteins were observed between non‐cancerous nasopharyngeal mucosa and NPC; 3) no significant difference in the expression of those proteins were found by respective correlation analyses of sex, stage, and size of primary tumor in NPC; and 4) no significant difference in the rates of positive expression of CD44H, CD44v3, and CD44v6 proteins were observed in NPC between with and without lymph node metastasis, indicating that those gene products did not correlate with lymph node metastasis in NPC. However, there were inverse correlations between the expression of p16, nm23‐H1, or E‐cadherin protein and lymph node metastasis (P <.05), indicating that the expression of p16, nm23‐H1, and E‐cadherin gene were related to the carcinogenesis and tumor progression of NPC.Conclusion Detecting the expressions of those gene products may provide clinically valuable information for therapeutic strategy and for predicting the prognosis of patients with NPC.
The Effect of Vagal Nerve Stimulation on Voice
Authors: Charous Steven J. , Kempster Gail , Manders Ernest , Ristanovic Ruzica 
Published: November 2003

AbstractObjective Vagal nerve stimulation therapy through implanted vagal nerve stimulators is an accepted therapy for refractory seizure disorders. One significant side effect of vagal nerve stimulation is voice change. This study evaluates the impact that these voice changes have on patients' lives, and the physiological effects that vagal nerve stimulation has on the larynx.Methods Patients were selected from the pool of patients at Rush‐Presbyterian‐St. Luke's Medical Center who underwent implantation of vagal nerve stimulator devices. Three methods were used to evaluate the impact the devices had on patients and on their vocal cords. First, a questionnaire was sent to the patients to ascertain the degree of vocal and social impairment that occurs as a result of the implant. Second, videostroboscopy was used to analyze the effect that vagal nerve stimulation had on the larynx. Third, computerized voice analysis objectively analyzed the patients' voices both during and in between vagal nerve stimulations.Results Although patients noted significant voice changes during stimulation of the implant, the impairment is well tolerated and less debilitating than the underlying seizure disorder. Hyperstimulation of the affected vocal cord was observed during vagal stimulation with paramedian positioning, vocal fold tensing, and loss of mucosal wave. Increase in jitter and shimmer was consistent.Conclusion Vagal nerve implantation devices create significant but well‐tolerated vocal side effects. Investigation of these devices increases our understanding of laryngeal physiology and may give insight into future laryngeal pacing. Preimplantation laryngeal examination should be performed routinely to rule out laryngeal pathology that could lead to significant complications.
A Computer‐Assisted Anatomical Study of the Nasofrontal Region
Authors: Landsberg Roee , Friedman Michael 
Published: November 2003

AbstractObjectives/Hypothesis Objectives were as follows: 1) to define the variations of the uncinate process' superior attachment, 2) to study the diameter of the frontal sinus ostium, 3) to study the prevalence of the agger nasi cells, and 4) to evaluate the side‐to‐side variability of these structures.Study Design A retrospective clinical study at a tertiary care center.Methods One hundred forty‐four consecutive computed tomography scans were studied with image‐guided surgery software (InstaTrak, Visualization Technology, Inc., Wilmington, MA) that provides continuous coronal, sagittal, and axial sections. We reported the superior attachment sites of the uncinate process, the diameter of the frontal sinus ostium, and prevalence of the agger nasi cells.Results The uncinate process' main superior attachment into the surrounding structures was found to have the following distribution: 52% to the lamina papyracea, 18.5% to the posteromedial wall of the agger nasi cell, 17.5% to the lamina papyracea and the junction of the middle turbinate with the cribriform plate, 7% to the junction of the middle turbinate with the cribriform plate, 3.6% to the ethmoid roof, and 1.4% to the middle turbinate. The frontal ostium anterior–posterior diameter (mean ± SD) was 7.22 ± 2.78 mm and its transverse diameter (mean ± SD) was 8.92 ± 2.95 mm. Agger nasi cells were found in 78% of the scans.Conclusions The frontal sinus opens into the middle meatus medial to the uncinate process in 88% of the patients and lateral to the uncinate process in 12% of the patients. The naturally wide dimensions of the frontal ostium help to explain why postoperative patency can be achieved merely by exposing the ostium without the need to enlarge it. The frontal ostium dimensions in one side may differ considerably from the contralateral side. An agger nasi cell or a terminal recess, or both, are found in most cases. Image‐guided surgery software is a helpful new tool for anatomical studies and for preoperative evaluation.
Tumor Deposition of Laminin‐5 and the Relationship With Perineural Invasion
Authors: Anderson Timothy D. , Feldman Michael , Weber Randal S. , Ziober Amy F. , Ziober Barry L. 
Published: November 2003

AbstractObjectives/Hypothesis Perineural invasion (PNI) is increasingly being recognized as an important indicator of aggressiveness in head and neck squamous cell carcinoma. The mechanisms of PNI are poorly understood. Laminin‐5, an important basement membrane constituent, has been shown to be essential in head and neck squamous cell carcinoma invasion and motility. We hypothesized that tumors exhibiting increased expression of laminin‐5 are more likely to be neurotropic.Study Design Analysis of archived surgical specimens with and without PNI for presence and intensity of laminin‐5 tumor staining.Methods Immunohistochemistry of archived head and neck squamous cell carcinoma specimens with known PNI was performed with anti–laminin‐5 antibodies and appropriate positive and negative control specimens. The staining patterns were characterized as follows: A, few to no tumor cells positive; B, some peripheral cells positive; C, all peripheral cells positive; and D, almost all tumor cells positive. Statistical analysis was by χ2 analysis.Results Forty‐six PNI‐positive and 18 PNI‐negative specimens were analyzed. The staining distribution for the PNI‐positive specimens was as follows: 2% for A, 41% for B, 46% for C, and 11% for D. For tumors without PNI, the distribution was 28% for A, 50% for B, 22% for C, and 0% for D (P = .005). In PNI‐positive tumors, no significant difference in staining was seen between areas with and without PNI.Conclusions We found a significant correlation between laminin‐5 staining and the presence of PNI in head and neck squamous cell carcinoma. Expression of laminin‐5 by tumors is, possibly, an important step in the process of PNI. These preliminary findings support the concept that deposition of basement membrane constituents are required in the multistep process of nerve invasion.
Investigation of Helicobacter pylori Colonization in Adenotonsillectomy Specimens By Means of the CLO Test
Authors: Unver Seref , Kubilay Utku , Sezen Ozan Seymen , Coskuner Temel 
Published: November 2003

AbstractObjectives Investigation of Helicobacter pylori (HP) colonization in adenoid and tonsil tissues by using the CLO (Campylobacter‐like organism) test.Study Design Prospective clinical study. Included in the study were 19 patients aged 4 to 38 who had undergone an adenoidectomy, tonsillectomy, or adenotonsillectomy procedure under local or general anesthesia.Methods Tissue pieces with diameters of 2 mm, which had been obtained from each adenoid and tonsil specimens in the early postoperative stage, were placed in kits specially prepared for HP (CLO test). Color changes were noted after 20 minutes and after periods of 1, 3, and 24 hours.Results Eleven (57.89%) of the 19 patients included in the study were shown to be HP positive, and 8 (42.11%) were negative, regardless of the type of specimen.Conclusion It was shown that there was a high rate of HP colonization in tonsil and adenoid tissues.
Cyclooxygenase‐2 Expression in Human Thyroid Carcinoma and Hashimoto's Thyroiditis
Authors: Cornetta Anthony J. , Russell John P. , Cunnane Mary , Keane William M. , Rothstein Jay L. 
Published: November 2003

AbstractObjectives Cyclooxygenases (COX) are enzymes that catalyze the conversion of arachidonic acid to prostaglandins. COX‐2, unlike the constitutively expressed COX‐1, is an inducible enzyme upregulated during cell proliferation and inflammation. More recently, COX‐2 has been implicated in the development of numerous types of epithelial cancers. In addition, COX‐2 is highly expressed in several inflammatory diseases. Because of its dual role in inflammation and cancer, we were interested in determining if COX‐2 plays a role in the development of human thyroid carcinoma and Hashimoto's thyroiditis, an autoimmune condition frequently associated with thyroid malignancy.Materials and Methods Twenty paraffin‐embedded human tissue specimens, including normal, inflammatory, and neoplastic thyroid sections, were analyzed by immunohistochemical staining for expression of human COX‐2. In addition, COX‐2 protein expression was verified by Western blot in two specimens.Results Immunohistochemical staining confirmed the presence of COX‐2 in thyroid epithelial neoplasms, including papillary and follicular carcinomas. Moreover, COX‐2 expression was observed in patients with Hashimoto's thyroiditis. COX‐2 expression, however, was not observed in normal thyroid tissue, multinodular goiter, or anaplastic carcinoma.Conclusions We have shown that cyclooxygenase‐2 is expressed in thyroid carcinoma and thyroid epithelium from patients with Hashimoto's thyroiditis but not in normal thyroid. The expression of COX‐2 in both of these thyroid pathologies may provide a basis for the relationship between carcinogenesis and autoimmunity.