bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ki‐67 (MIB1), p53, and Lewis‐X (LeuM1) as Prognostic Factors of Recurrence in T1 and T2 Laryngeal Carcinoma
Authors: Sittel Christian , Eckel Hans E. , Damm Michael , von Pritzbuer Ekkehard , Martin Kvasnicka Hans 
Published: November 2003

AbstractObjectives Recently published data suggest a prognostic value of immunohistochemical proliferation markers for limited laryngeal carcinoma. Previous studies have reported contrasting findings on this issue. In this context, different treatment modalities may be responsible for contradictory findings. To study the relationship between proliferative activity—expressed by the immunohistochemical labeling index of proliferation‐associated markers Ki‐67 (MIB1), Lewis‐X (LeuM1), and proliferating cell nuclear antigen (PCNA) and by p53 status—and treatment failure in a matched‐pair study on recurrent and nonrecurrent T1 and T2 glottic carcinoma having received primary transoral laser surgery.Methods Twenty‐one patients with tumor recurrence were randomly selected and matched with 26 patients with nonrecurrent disease regarding histopathological grading and age. MIB1 staining was used to determine the Ki‐67 labeling inde‐, and LeuM1 staining for detecting the Lewis‐X antigen; immunohistochemistry determined the p53 status and PCNA labeling inde‐.Results The Ki‐67 labeling index was significantly (P = .001) higher in tumors from patients who had treatment failure (mean = 20.02%) than in patients who did not fail treatment (“nonfailures”) (mean = 9.95%). Carcinoma with a Ki‐67 (MIB1) labeling index above the median (15%) of the general study population showed a mean time to relapse of 23 months (n = 21), compared with 50 months for cases (n = 26) below the median (P = .016). PCNA labeling index correlated less impressively with tumor recurrence (mean = 28.59% for treatment failures, mean = 21.75% for nonfailures, P = .022). Positive detection of the Lewis‐X antigen was significantly associated with recurrence (P = .015) and time to relapse (P = .006). Status of p53 was not a significant prognostic factor.Conclusion The Ki‐67 (MIB1) labeling index may be associated with early relapse of limited laryngeal carcinoma treated with transoral laser surgery. Since the prognostic relevance of Ki‐67 seems to be different for radiological and surgical concepts of treatment, Ki‐67 might become useful as criterion of therapy selection. The Lewis‐X antigen, for the first time used on laryngeal carcinoma, seems to be a strong prognostic marker deserving further investigations.
Wedge Turbinectomy: A New Combined Photocoagulative Nd:YAG Laser Technique
Authors: Vagnetti Alessandro , Gobbi Emanuele , Maria Algieri Giuseppe , D'Ambrosio Luciano 
Published: November 2003

AbstractObjectives To demonstrate that Nd:YAG laser photocoagulation using a combination of interstitial and contact approaches in the surgical treatment of inferior turbinate hypertrophy yields improved results in terms of postoperative nasal patency, complications, and relapse.Study Design A group of 121 patients with symptoms of nasal obstruction due to hypertrophied inferior turbinates were treated between January 1994 and December 1997 at the Otolaryngology—Head and Neck Surgery Unit of the Main Military Hospital of Rome using the wedge turbinectomy, a new endonasal laser technique.Methods This is a combined photocoagulative procedure performed under local anesthesia. In the first surgical step we perform interstitial photocoagulation using Nd:YAG laser and in the second step we use a contact approach, making two strips of photocoagulated mucosa running side by side from the tail to the head of turbinate.Results At 1‐year follow‐up, the complication rate in all our patients treated with this laser technique was very low and we achieved a steady improvement in nasal patency in 104 patients (85.9%). The relapse rate was approximately14%, but we observed that 65% of the patients who experienced long‐term failure were affected by allergic rhinitis.Conclusions An accurate preoperative evaluation of the cause of the turbinate hypertrophy is fundamental to achieving better results after laser turbinectomy and reducing the risk of relapse.
Candidate's Thesis: Chronic Sinusitis and Anosmia: Pathologic Changes in the Olfactory Mucosa
Authors: Kern Robert C. 
Published: November 2003

AbstractObjectives To evaluate histological changes in the olfactory mucosa of patients with chronic rhinosinusitis. These results are analyzed in light of current understanding of the pathophysiology of anosmia secondary to nasal and sinus disease.Study Design Prospective study of olfaction on patients undergoing sinus surgery for the management of chronic rhinosinusitis.Methods Thirty patients, aged 22 to 39 years, underwent olfactory biopsy at the time of surgery with evaluation by a pathologist. Inflammatory changes were graded as mild (normal), moderate, or severe. Clinical olfactory function was evaluated using the University of Pennsylvania Smell Identification Test (UPSIT). The results correlated with the degree of olfactory dysfunction.Results Of the 30 patients 19 had unequivocal olfactory mucosa in the biopsy specimen. Eleven had only respiratory or indeterminate mucosa. Nine patients demonstrated normal olfactory mucosa and normal olfactory function (UPSIT >35). Ten patients demonstrated pathological changes in the olfactory mucosa with an influx of lymphocytes, macrophages, and eosinophils. Of these 10 patients, 7 had olfactory deficits as determined by UPSIT. The remaining three patients had normal olfactory function despite moderate chronic inflammation. These studies indicate that the olfactory mucosa is capable of mounting an inflammatory response similar to that seen in the respiratory mucosa of patients with chronic sinusitis. These data suggest that the olfactory deficits in these patients may be the result of inflammatory changes within the olfactory mucosa in addition to any alteration in airflow to the olfactory cleft.
Acoustic Characteristics of Voice After Severe Traumatic Brain Injury
Authors: McHenry Monica 
Published: November 2003

AbstractObjectives/Hypothesis To describe the acoustic characteristics of voice in individuals with motor speech disorders after traumatic brain injury (TBI).Study Design Prospective study of 100 individuals with TBI based on consecutive referrals for motor speech evaluations.Methods Subjects were audio tape‐recorded while producing sustained vowels and single word and sentence intelligibility tests. Laryngeal airway resistance was estimated, and voice quality was rated perceptually.Results None of the subjects evidenced vocal parameters within normal limits. The most frequently occurring abnormal parameter across subjects was amplitude perturbation, followed by voice turbulence index. Twenty‐three percent of subjects evidenced deviation in all five parameters measured. The perceptual ratings of breathiness were significantly correlated with both the amplitude perturbation quotient and the noise‐to‐harmonics ratio.Conclusions Vocal quality deviation is common in motor speech disorders after TBI and may impact intelligibility.
Application of the Vestibular Disorders Activities of Daily Living Scale
Authors: Cohen Helen S. , Kimball Kay T. , Adams Angela S. 
Published: November 2003

AbstractObjective Existing scales of functional performance are either insufficiently sensitive or omit some important daily life tasks. This paper demonstrates that a new scale of self‐perceived disablement in the vestibularly impaired population—the Vestibular Disorders Activities of Daily Living Scale (VADL)—differentiates between disabled and healthy persons and evaluates the associations of this assessment with other measures of vestibular disorders.Study Design Prospective.Methods Subjects were 1) asymptomatic, healthy adults, 2) patients with benign paroxysmal positional vertigo, 3) patients with chronic vestibulopathy excluding Meniere's disease, postsurgical vertigo, and postconcussion vertigo, and 4) family members. Patient were assessed on the VADL, the Dizziness Handicap Inventory, level of vertigo, and computerized dynamic posturography. Healthy subjects and family members completed the VADL.Results The VADL differentiates healthy persons from patients but does not differentiate between patient groups. Patients perceived themselves as more independent than their spouses perceived them to be. Scores are weakly correlated with vertigo frequency and posturography scores for conditions with unreliable kinesthesia and absent or unreliable vision. The VADL is more responsive to higher levels of impairment than the Dizziness Handicap Inventory.Conclusions This well‐normed, self‐administered scale of self‐perceived disablement is useful for evaluating the functional status of patients with peripheral vestibular disorders. Perceptions of patients and significant others vary, but scores are moderately correlated with some standard measures of vestibular function. As it assesses a different domain of function than do standard diagnostic tests, the VADL will augment these tests during initial evaluation and may be useful for assessing posttreatment change.
Genome‐Wide Screening for Radiation Response Factors in Head and Neck Cancer
Authors: Singh Bhuvanesh , Kim Se‐Heon , Carew John F. , Yu Irene , Shaha Ashok R. , Wolden Suzanne , Boyle Jay , Shah Jatin P. , Rao Pulivarti H. 
Published: November 2003

AbstractIntroduction Radiation therapy is an integral part of the treatment of head and neck cancer. Factors predicting radiation response are ill defined. The aim of this study was to identify genetic aberrations associated with radiation response in cell lines derived from head and neck squamous cell carcinomas (HNSCC) using comparative genomic hybridization (CGH) for genome‐wide screening.Methods Five cell lines derived from HNSCC were subjected to a single course of radiation (400 cGy) in parallel with a similarly handled, untreated control. Cellular response to radiation was determined on posttreatment days 1, 2, 3, 4, and 5 using a cell viability assay (MTT assay). Radiation response was defined as 35% or greater decrease in cell survival relative to control. Tumor doubling time was determined by cell counts performed at day 0 and 1 for each cell line. All experiments were done in quadruplicate. CGH analysis was performed by differentially labeling DNA from tumor and normal tissue with fluorescent agents. The labeled DNAs were simultaneously hybridized to normal metaphase chromosomes. Image analysis for fluorescence intensity along the entire length of each metaphase chromosome allowed generation of a color ratio, which was used to detect copy number changes.Results Radioresistance was identified in two of five cell lines. The tumor doubling time was not a predictor of radiation response. CGH identified a complex pattern of aberrations, with gain of 3q common to all cell lines. The number of genetic aberration was higher in radiation‐sensitive cell lines than in radiation‐resistant ones. No recurrent aberrations were unique to the radiation‐resistant cell lines. Recurrent gains at 7p and 17q and losses at 5q, 7q, and 18q were unique to the radiation‐sensitive cell lines.Conclusions The number of aberrations identified by CGH analysis may be a predictor of radiation response. A large study of primary tumors is warranted to confirm this association and identify specific genetic aberrations associated with radiation response.
Efficacy of Computed Tomographic Image–Guided Endoscopic Sinus Surgery in Residency Training Programs
Authors: Casiano Roy R. , Numa William A. 
Published: November 2003

AbstractObjective To determine the efficacy of computed tomographic image‐guided endoscopic surgery in the hands of inexperienced surgeons.Study Design Four second‐year otolaryngology residents, with no prior experience performing ethmoidectomies, performed endoscopic sinus surgery (ESS) on formalin‐fixed human cadaveric specimens with and without the aid of computer‐assisted surgery (CAS).Methods Each resident was asked to identify critical sinus, orbital, and skull base structures while performing a total ethmoidectomy and multiple sinusotomies. Their surgical accuracy (percentage of correctly identified structures), total operative time, and incidence of major complications were recorded for each side. A total of 16 sides were evaluated (8 with and 8 without CAS). Statistical significance between groups was determined by means of Pearson's χ2 analysis.Results Statistical analysis showed a significant difference (P = .001) in the mean accuracy of identifying critical anatomical landmarks between the CAS (97%) and non‐CAS (76.8%) groups. Although not statistically significant, operative time appeared to be longer in the group using CAS (average of 67 vs. 80 min). Three major intracranial complications were documented only in the group not using CAS.Conclusions Although, unquestionably, a thorough knowledge of the anatomy remains essential for performing ESS, CAS improves surgical accuracy and reduces the risk of major intracranial or intraorbital complications for residents. In additional, our data suggest that this technology may enhance surgical efficiency and improve the learning curve by reducing operative time (below one's normal baseline) while maintaining a greater than 90% accuracy in identifying critical anatomical landmarks.
Arytenoid Adduction Combined With Gore‐Tex Medialization Thyroplasty
Authors: McCulloch Timothy M. , Hoffman Henry T. , Andrews Brian T. , Karnell Michael P. 
Published: November 2003

AbstractObjective To describe the technique of combined Gore‐Tex medialization thyroplasty with arytenoid adduction and to determine the long‐term vocal outcome of patients treated for unilateral vocal cord paralysis with this procedure.Study Design A retrospective chart review and patient reevaluation for patients treated at The University of Iowa Hospitals and Clinics between May 1995 and June 1999.Methods The review addressed patient demographics, perioperative and long‐term complications, and voice outcomes. Details of the surgical technique are provided within the manuscript.Results Seventy‐two Gore‐Tex medialization procedures were completed. Arytenoid adduction was included in 22 of these procedures. This subset of patients was compared with the patients treated with Gore‐Tex alone. No major postoperative complications occurred in either group. Preoperative and postoperative voice and videostroboscopy data were available for 19 arytenoid adduction patients and 25 Gore‐Tex alone patients. On a seven‐point scale (6 [severely abnormal] → 0 [normal voice]), the average patient rating of voice dysfunction improved from 4.2 to 1.6 (arytenoid adduction) and 4.5 to 2.8 (Gore‐Tex alone). Maximum phonation time improved from 6.9 seconds to 16.7 seconds in the arytenoid adduction group. Subjective voice assessment employing the four‐point GRBAS scale (3 [severely abnormal] → 0 [normal]) identified average improvement from an overall grade of 2.1 to 0.8 arytenoid adduction and 2.2 to 1.5 in the Gore‐Tex alone group. Improvement was identified in the vocal quality of breathiness from 1.9 to 0.2 (arytenoid adduction) and 1.9 to 0.9 (Gore‐Tex alone).Conclusions The combined technique of Gore‐Tex medialization thyroplasty and arytenoid adduction provide functional results that appear to exceed the improvement attained with medialization alone.
Quantitative Analysis of Eotaxin and RANTES Messenger RNA in Nasal Polyps: Association of Tissue and Nasal Eosinophils
Authors: Shin Seung‐Heon , Park Jae‐Yul , Jeon Chang‐Ho , Choi Jin‐Kyo , Lee Sang‐Heon 
Published: November 2003

AbstractObjectives/Hypothesis Nasal polyps develop in the ethmoidal and middle turbinate area, often in relation to inflammatory conditions. Their exact etiology and pathogenesis are still under debate. Histologically, the polyps are infiltrated by a number of inflammatory cells, with eosinophil predominating in most specimens. This finding suggests that the nasal polyp is an inflammatory growth that is controlled by the local environment. The chemokines eotaxin and RANTES (r egulated on a ctivation n ormal T cell e xpressed and s ecreted) have been postulated to be involved in the recruitment and activation of eosinophils to certain inflamed tissues. The purpose of this study was to investigate eotaxin and RANTES mRNA expression in nasal polyps and its effect on tissue and nasal eosinophils.Methods Nasal polyps (917 allergic and 30 nonallergic cases) were obtained from endoscopic sinus surgery, and 15 normal inferior turbinates also were taken. Immunohistochemical staining for eosinophils and quantitative reverse transcriptase–polymerase chain reaction (RT‐PCR) tests for eotaxin and RANTES mRNA expression were performed, and the concentration of nasal eosinophil cationic protein (ECP) was measured.Results The amounts of eotaxin mRNA in the allergic nasal polyps were 11.4 times higher and the levels in the nonallergic polyps were 6.4 times higher than in the normal inferior turbinate. However, the RANTES mRNA expression did not show any differences among the three groups. Tissue eosinophilia and nasal ECP levels were significantly correlated with eotaxin mRNA level but not with RANTES mRNA expression.Conclusion Nasal polyp eosinophilic infiltration and activation correlate mainly with increased eotaxin gene expression rather than with RANTES expression.
Variability of Eustachian Tube Function: Comparison of Ears With Retraction Disease and Normal Middle Ears
Authors: Bunne Marie , Falk Bernt , Magnuson Bengt , Hellström Sten 
Published: November 2003

AbstractObjective To explore the short‐term and long‐term variability of tubal opening and closing in ears with advanced retractions and in healthy ears.Study Design/Methods Twenty ears with retraction type middle ear disease (R‐MED) and 20 normal ears underwent direct recording of the middle ear pressure during repeated forced openings, equalization of +100 daPa and −100 daPa by swallowing, Valsalva inflation, and forceful sniffing. Tests were performed twice (separated by 30 min) on each of 2 days separated by 3 to 4 months.Results There was considerable intraindividual variability of the forced opening pressure and the closing pressure in both groups, within as well as between sessions and test days. Although the variability was 1.5 to 2 times higher in ears with retraction than in the normal group, mean Po and Pc did not differ between the groups. Compared with normal ears, ears with retraction changed more frequently from a positive to negative test response, or vice versa, when re‐tested after 30 minutes. Rates of positive response in the equalization and Valsalva tests were significantly lower in diseased ears compared with normal ears.Conclusions Eustachian tube opening and closing functions vary more in ears with retraction disease than in normal ears, which is consistent with the variable clinical course of R‐MED and implies that single tubal function tests have little prognostic value on the individual level.
Safety of Neck Rotation for Ear Surgery in Children With Down Syndrome
Authors: Wendell Todd N. , Holt Philip J. , Thomas Allen A. 
Published: November 2003

AbstractObjective Seek information about spinal cord safety for children with Down syndrome positioned for ear surgery.Study Design Prospective consecutive patients, each serving as his or her own control.Methods Somatosensory evoked potentials were recorded from 17 children who were undergoing elective otolaryngological surgery. None of the patients had neurological symptoms or physical examination findings suggesting cervical spinal cord embarrassment. Specifically, muscle tone was normal or mildly reduced globally, consistent with Down syndrome, and deep tendon reflexes were normal and not appreciably different in the upper and lower extremities. On plain lateral radiographs obtained in the neutral, flexed, and extended positions, the patients' cervical spines were normal.Results When the anesthetized children had their necks placed in either right or left 60° rotation, no significant change in somatosensory latency or amplitude was found. With more than 99.999% certainty, neurologically intact children with Down syndrome with normal plain cervical spine radiographs were not exposed to extra risks by 60° neck rotation during surgery.Conclusion Patients with Down syndrome who are neurologically intact and who have normal lateral neck radiographs do not appear at great risk with neck rotation.
Fluorescent In Situ Hybridization Evaluation of p53 Gene Deletions at a Tumor Interface of Lingual Carcinoma
Authors: Hartig Gregory , Zhang Jianhua , Marta Voytovich G. , Newton Michael , Chen Alice , Collins Savita P. , Wu Shi‐Qi 
Published: November 2003

AbstractObjective/Hypothesis To evaluate the ability of fluorescent in situ hybridization (FISH) to detect malignant cells missed by standard histological assessment at an interface between malignant and normal tissue in lingual squamous cell carcinoma (SCC) and to correlate findings of FISH assessment with patients' clinical stages.Study Design Retrospective assessment of archival tissue from 31 patients with lingual SCC treated at University of Wisconsin Hospital and Clinics in Madison.Methods An assay combining standard histological and FISH techniques was used to assess a tumor interface tissue section and allow identification of each tumor's ploidy characteristics and p53 gene deletions and the presence or absence of malignant cells within tissue viewed as “normal” on histological review.Results Forty‐five percent of tumors (14 of 31) demonstrated ploidy changes and 84% (26 of 31) showed p53 deletions. Of these 26 tumors with p53 deletions, 14 were found to have “microfoci” with p53 deletions within tissue that appeared normal on histological e‐amination. These microfoci were found in 75% of late‐stage tumors and in only 35% of early‐stage tumors.Conclusions FISH allowed identification of malignant cells in tissue viewed as normal on standard histological assessment, and this finding occurred more frequently in late‐stage tumors.
A Prospective Population‐Based Study of Cutaneous Malignant Melanoma of the Head and Neck
Authors: Gillgren Peter , Månsson‐Brahme Eva , Frisell Jan , Johansson Hemming , Larsson Olle , Ringborg Ulrik 
Published: November 2003

AbstractObjectives/HypothesisFor cutaneous malignant melanoma (CMM) of the head and neck, neither prognostic factors in population‐based groups, nor outcome with respect to surgical resection margins is clear. Therefore, we analyzed data in a regional registry to align treatment results for CMM of the head and neck with prognosis and survival times.Study DesignPatient material collected prospectively for an 18‐year period in a Swedish cancer registry underwent statistical analyses to establish the most reliable prognostic factors and the influence of surgical treatment on the survival of patients with CMM of the head and neck.MethodsData originated from the CMM database of the Stockholm‐Gotland area of Sweden. Tumor thickness or invasiveness (Breslow or Clark's levels), extent of surgical margin, sex, histogenetic type, anatomic site, and ulceration were compared statistically for 469 patients.ResultsMale patients with head and neck CMM had a 68% 10‐year survival rate; the 10‐year survival rate for female patients was 87%. The corresponding figures for CMM at other sites were 83% and 90%, respectively. Tumor thickness (or Clark level of invasion) was the only statistically significant prognostic factor in a multivariate analysis (P< .001). The surgical resection margin seemed to be of no importance to outcome.ConclusionsLong‐term survival after treatment for CMM of the head and neck is better than reported in most earlier publications, presumably because our evaluation used population‐based materials, an important factor in accurate reporting of this kind. Tumor thickness is the main prognostic factor in estimating outcome.