bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of Long‐Term Nasal Continuous Positive Airway Pressure Therapy on Morphology, Function, and Mucociliary Clearance of Nasal Epithelium in Patients With Obstructive Sleep Apnea Syndrome
Authors: Bossi Roberto , Piatti Gioia , Roma Elisabetta , Ambrosetti Umberto 
Published: July 2004

AbstractObjectives/Hypothesis:The objective was to investigate the possible modification of nasal mucosa function and mucociliary clearance in a group of patients with severe obstructive sleep apnea syndrome receiving mechanical ventilation with long‐term nasal continuous positive airway pressure (n‐CPAP), without nasal diseases.Study Design:The study design was experimental. Eight (six male and two female) nonsmoker patients were selected on the basis of two sleep questionnaires, were identified as needing n‐CPAP therapy, and showed normal values of mucociliary transport time, ciliary beat frequency, and anterior rhinomanometry.Methods:After a full polysomnographic examination, the authors recorded respiratory disturbance index (RDI), apnea/hypopnea index, nadir arterial oxygen saturation, and sleep stage. Every patient underwent pulmonary function test; arterial blood gas analysis; chest radiography; electrocardiography; ear, nose, and throat evaluation with rhinoscopy; anterior rhinomanometry; a saccharine test to measure the mucociliary transport time; and a brushing of nasal epithelium for study of ciliary beat frequency. All patients underwent polysomnographic examination in basal condition with overnight n‐CPAP (without humidifier) and repeated this examination after 1 and 6 months with Auto CPAP (Autoset Res Care, Sidney, Australia) to titrate n‐CPAP pressure and measure the new respiratory disturbance index.Results:The mean basal respiratory disturbance index (number of respiratory events during sleep per hour of recording time) was 53.7 ± 21.5 events/h; after 6 months of n‐CPAP therapy (mean value, 7.5 ± 0.7 cm H2O) the respiratory disturbance index was 5.7 ± 3.76 events/h. Values for nasal resistance, mucociliary transport time, and ciliary beat frequency were normal before and after the ventilatory treatment.Conclusion:In the study group of patients with severe obstructive sleep apnea syndrome, the nocturnal use of n‐CPAP without humidifier did not modify the function and mucociliary clearance of nasal epithelium.
Nontuberculous Mycobacteria‐Induced Parotid Lymphadenitis Successfully Limited With Clarithromycin and Rifabutin
Authors: Shah Maulik B. , Haddad Joseph 
Published: July 2004

AbstractObjectives/Hypothesis: Nontuberculous mycobacterial adenitis of the parotid gland is often difficult to diagnose. The rarity of these infections in the parotid region and the lack of specific guidelines pose a treatment challenge to the clinician. Three cases of nontuberculous mycobacterial adenitis are presented, with clinical response to antibiotics before surgery.Study Design: Retrospective chart review was made of children up to 18 years of age presenting with a parotid mass diagnosed as nontuberculous mycobacterial infection.Methods: Three patients (age range, 15 to 30 mo) with nontuberculous mycobacteria‐induced parotid lymphadenitis were treated with a combination antibiotic regimen of clarithromycin and rifabutin or with clarithromycin alone.Results: All three patients responded clinically to the antibiotic treatment as evidenced by a smaller mass size and resolution of the overlying discoloration. Subsequent parotidectomy or biopsy appeared to be easier to perform because of decreased inflammation and edema and a more readily dissectible facial nerve.Conclusion: Children with nontuberculous mycobacteria‐induced parotid lymphadenitis should be started on a trial of antibiotic treatment before surgery. Although surgery remains the definitive treatment modality, a larger study of preoperative antibiotic use against nontuberculous mycobacterial adenitis of the parotid in children is necessary.
Can Maximum Phonation Time Predict Voice Outcome after Thyroplasty Type I?
Authors: Lundy Donna S. , Casiano Roy R. , Xue Jun W. 
Published: July 2004

AbstractBackground: Thyroplasty type I, as introduced by Isshiki and colleagues almost 30 years ago, has become the gold standard of improving glottal incompetence caused by unilateral vocal fold paralysis. Intraoperative assessment of the adequacy of glottal closure is subjective and based on the perceptual judgment of vocal quality and degree of improvement in glottal gap size.Objective/Hypotheses: The primary purpose of this study was to investigate whether the intraoperative measurement of maximum phonation time (MPT) is an adequate predictor of voice outcome after thyroplasty type I. To assess this possibility, it was necessary to evaluate the effect of body posture (seated vs. supine) and anesthesia (none vs. light sedation) on the measure of MPT.Study Design: A prospective study of 20 individuals with unilateral vocal fold paralysis was undertaken.Methods: Subjects were assessed at three time points: pre‐, intra‐, and postoperatively across parameters of breathiness rating, glottal gap size, glottal flow rate, and MPT.Results: Results indicated that MPT was significantly lower in the supine versus seated position. In addition, light sedation resulted in a trend toward lower MPT that was not statistically significant. Finally, the intraoperative measurement of MPT, although lower than a 1‐month postoperative measurement, was significantly predictive of the outcome.Conclusions: The intraoperative measure of MPT appears to be an adequate predictor of the postoperative outcome.
Retrosigmoid Versus Middle Fossa Surgery for Small Vestibular Schwannomas
Authors: Mangham Charles A. 
Published: July 2004

AbstractObjectives/Hypothesis: The objective was to determine the effect of approach, middle fossa versus retrosigmoid, on the hearing and facial nerve outcome of surgery for small vestibular schwannomas.Study Design: The study had two parts, a case study of patient data entered into a prospectively designed database at the author's institution, and a meta‐analysis of similar published data.Methods: There were 73 of the author's private practice patients who met the inclusion criteria of intracanalicular vestibular schwannoma and total tumor removal by a retrosigmoid approach. American Academy of Otolaryngology—Head and Neck Surgery standardized hearing and facial nerve classifications of these patients and similar data from 11 other institutions were used to compare results of the two surgical approaches.Results: Median facial nerve results for all institutions were significantly better with the retrosigmoid approach (grade I: 95% for retrosigmoid and 81% for middle fossa). Median hearing results trended toward better outcome with the middle fossa approach (same preoperative hearing class: 48% for middle fossa and 39% for retrosigmoid). Individual institution had an equal or greater effect on outcome than the choice of surgical approach.Conclusion: Surgical team accounted for more variability in hearing and facial nerve outcome than did approach. Retrosigmoid approach yielded significantly better facial nerve outcome. The trend toward better hearing outcome with the middle fossa approach may never achieve statistical significance across institutions because of high variability among surgical teams and small numbers of teams reporting results.
Advantages of Cochlear Implantation in Prelingual Deaf Children before 2 Years of Age when Compared with Later Implantation
Authors: Manrique Manuel , Cervera‐Paz Francisco Javier , Huarte Alicia , Molina Maite 
Published: July 2004

AbstractObjectives: To compare the auditory abilities and speech performance of children with a profound prelingual bilateral hearing‐impairment when subjected to a cochlear implant (CI) before or after 2 years of age. To analyze the complications that arose during, or as a result of, the implantation process in these groups.Design: Prospective cohort single‐subject, repeated‐measures study of children with profound bilateral hearing impairment subjected to CI.Setting: Tertiary referral center with a program of pediatric CI from 1991.Patients: This study analyzed 130 children subjected to multichannel CI for profound prelingual bilateral hearing‐impairment in two age groups: 0 to 2 (n = 36) and 2 to 6 years of age (n = 94).Interventions: The children were evaluated before, and each year after, the intervention (for up to 5 years) with both closed‐set and open‐set auditory and speech perception tests. Their speech ability was evaluated according to the Peabody Picture Vocabulary and Reynell general oral expression scales.Results: Auditory and speech perception tests improved significantly in all children after CI, regardless of the follow‐up time. The infant's performance was better the earlier the implant was performed. Speech tests showed that the development of children treated before 2 years of age was similar to normal children, and no additional complications were observed when compared with CI in older children.Conclusions: When performed before 2 years of age, CI offers a quicker and better improvement of performance without augmenting the complications associated with such an intervention.
Transnasal Endoscopic Repair of Cerebrospinal Fluid Rhinorrhea and Skull Base Defect: Ten‐Year Experience
Authors: Lee Ta‐Jen , Huang Chi‐Che , Chuang Chi‐Cheng , Huang Shiang‐Fu 
Published: July 2004

AbstractObjectives/Hypothesis:Many reports have advocated the feasibility of using an endoscope for the treatment of cerebrospinal fluid (CSF) rhinorrhea and skull base defect, and diversified endoscopic techniques and repairing materials have recently been proposed. This study determined the effectiveness of endoscopic repair of CSF leaks and interpreted the indications of the lumbar drain.Study Design:Retrospective follow‐up.Methods:A total of 39 patients with CSF rhinorrhea (20 traumatic, 13 iatrogenic, and 6 spontaneous) were treated in one institution over a 10‐year period. An underlay procedure was used to make eight (20.5%) repairs by way of a turbinate composite graft (4 patients), turbinate mucosa graft (3 patients), or the Dura Substitute (Preclude) (1 patient). A free turbinate graft with the applied fibrin glue was used to repair the defect by way of an overlay procedure in 23 (59.0%) lesions. Abdominal fat was used to repair the other eight (20.5%) lesions.Results:Defects in the cribriform plate and anterior ethmoid sinus comprised the majority (61.5%) of all lesions. The successful rates for overlay, underlay, and fat obliteration procedures were 91.3% (21/23), 87.5% (7/8), and 100% (8/8), respectively. There were no statistical difference between underlay and overlay techniques (P= .792, Student's t test). Lumbar drainage was performed in 18 of 39 (46.2%) cases. Most patients required nasal packing (89.7%) and prophylactic parenteral antibiotics (97.4%). CSF rhinorrhea was resolved during the first attempt in 36 of 39 (92.3%) patients. All leaks were successfully repaired after a second attempt. No major complications were encountered.Conclusion:The endoscopic approach is safe and effective for the treatment of CSF rhinorrhea, even in the cases not successfully treated by previous neurosurgical approaches. Lumbar drain was suggested for defects in the frontal and sphenoid sinus and defects associated with meningocele or encephalocele. Complete exposure of the defect, appropriate selection of a fitting graft, as well as accurate placement and stabilization of the graft are critical to the success of repair.
Treatment of a Proximal Accessory Nerve Injury with Nerve Transfer
Authors: Novak Christine B. , Mackinnon Susan E. 
Published: July 2004

AbstractObjective and Hypothesis: This study presents a case report of a patient who sustained an iatrogenic proximal accessory nerve injury that was treated with a medial pectoral to accessory nerve transfer.Study Design: Case study.Materials and Methods: Chart of one patient who was treated with a medial pectoral to accessory nerve transfer was reviewed.Results: Five months after excision of a branchial cyst that resulted in a very proximal injury to the accessory nerve, this patient underwent a medial pectoral to accessory nerve transfer. At final follow‐up, 3 years after surgery, the patient had full abduction overhead with some residual shoulder/scapular discomfort and mild scapular winging.Conclusion: The medial pectoral to accessory nerve transfer provides a viable surgical option with good reinnervation of the trapezius muscle in patients with a proximal accessory nerve injury where standard nerve repair or graft techniques are not feasible.
Impact of Anterior Commissure Involvement on Local Control of Early Glottic Carcinoma Treated by Laser Microresection
Authors: Steiner Wolfgang , Ambrosch Petra , Rödel Ralph M.W. , Kron Martina 
Published: July 2004

AbstractObjectives: To analyze the impact of anterior commissure involvement on local control, survival, and laryngeal preservation in patients with early glottic cancer (pT1a–pT2a) treated with unimodality laser microsurgical resection.Study Design: Retrospective review of 263 patients with early glottic cancer treated between 1986 and 1996.Methods: Data on local control and overall survival rates were analyzed and calculated by the Kaplan‐Meier method; the larynx preservation rates were given absolutely.Results: Among 158 patients presenting with T1a glottic cancer, the anterior commissure was involved in 28 cases; the 5‐year local control rate was 84%, and the larynx preservation rate was 93%. In the 130 cases without anterior commissure involvement, the 5‐year local control rate was 90.0% and the corresponding larynx preservation rate 99%. In the T1b category consisting of 30 patients, anterior commissure involvement was observed in 16 patients; the 5‐year local control rate was 73%, and the larynx preservation rate was 88%. In the 14 cases without anterior commissure involvement, the 5‐year local control rate was 92% and the corresponding larynx preservation rate 100%. Seventy‐five patients had T2a glottic carcinomas, with normal vocal cord movement. The anterior commissure was involved in 45 cases; the 5‐year local control rate was 79%, and the larynx preservation rate was 93%. In the 30 cases without anterior commissure involvement, the 5‐year local control rate was 74.0% and the corresponding larynx preservation rate 97%.Conclusions: This study shows the effectiveness of laser microsurgery for early glottic carcinoma regardless of anterior commissure involvement at presentation. This method can be performed as an outpatient procedure, even when conducting reresections.
Medicolegal Analysis of Injury During Endoscopic Sinus Surgery
Authors: Lynn‐Macrae Alastair G. , Lynn‐Macrae Rebecca A. , Emani Janaki , Kern Robert C. , Conley David B. 
Published: July 2004

AbstractObjectives:To survey the causes, characteristics, and outcomes of malpractice litigation resulting from injuries sustained during endoscopic sinus surgery (ESS).Study Design:A retrospective analysis of United States state and federal civil litigation involving injuries resulting from ESS.Methods:Sources were state and federal court decisions and jury verdict reports accessed through a computerized legal database. The 41 cases were decided or settled between 1990 and 2003. The cases and reports were analyzed for pertinent data regarding plaintiffs, defendants, allegations of wrongdoing, resulting injury, expert witnesses, and resulting verdict or settlement. Correlation between severity of injury and case outcome was analyzed.Results:All suits reviewed involved ESS. Many cases included multiple causes of action, or types of malpractice, including negligent technique, 31 (76%); lack of informed consent, 15 (37%); and wrongful death, 2 (5%). The defendant‐physician specialty was overwhelmingly otolaryngology, 40 (98%). The most common presenting complaint, or indication for surgery, was chronic sinusitis, 30 (73%). The injuries caused by surgery were frequently multiple, including cerebrospinal fluid (CSF) leak, 10 (24%); brain damage, 6 (15%); diplopia, 7 (17%); and death, 2 (5%). The majority of cases reviewed (83%) resulted in a verdict rather than settlement. The result of the verdict or settlement was 17 (41%) in favor of the plaintiff, 23 (56%) in favor of the defendant, and 1 (2%) unknown. The average award was $751,275, with a median of $410,239 and a range of $61,000 to $2,870,000.Conclusions:This is the first study to review malpractice litigation resulting from injuries sustained during ESS and shows a hitherto unexpected pattern between severity of injury and case outcome.
MUC4 and ErbB2 Expression in Squamous Cell Carcinoma of the Upper Aerodigestive Tract: Correlation With Clinical Outcomes
Authors: Weed Donald T. , Gomez‐Fernandez Carmen , Yasin Mohammed , Hamilton‐Nelson Kara , Rodriguez Michael , Zhang Jin , Carraway Kermit L. 
Published: July 2004

AbstractObjectives/Hypothesis: Expression of the membrane mucin MUC4 has been associated with a variety of malignancies, including squamous cell carcinoma of the upper aerodigestive tract. MUC4 modulates cell signaling pathways as an intramembrane ligand of ErbB2. The hypotheses of the study were that MUC4 expression would correlate with ErbB2 expression and that MUC4 expression would correlate with clinical outcomes in squamous cell carcinoma of the upper aerodigestive tract.Study Design: Retrospective chart review was combined with immunohistochemical analysis of paraffin‐embedded tumor specimens from patients treated with initial definitive surgical resection at an academic tertiary care medical center.Methods: MUC4 and ErbB2 receptor expression was localized by immunohistochemical studies using archival formalin‐fixed and paraffin‐embedded tissue. A limited number of fresh‐frozen tissues were further analyzed by Western blot. Clinical outcomes and histopathological parameters were determined by retrospective chart review and correlated with immunohistochemical findings.Results: One hundred fifty‐four patients were analyzed with a median follow‐up of 12 months among 54 patients who died and 49 months among 100 surviving patients. Membrane expression of MUC4 and ErbB2 was seen in 12% and 13% of tumors, respectively. MUC4 expression was not correlated with pathological grade. A significant correlation was found between MUC4 expression and ErbB2 expression. Multivariate survival analyses revealed that patients whose tumors exhibited MUC4 membrane expression had statistically significant improvement in survival and longer time to recurrence compared with patients whose tumors did not express MUC4 as defined by immunohistochemical staining patterns. No correlations between ErbB2 expression and survival or recurrence were observed.Conclusion: Patients with tumors that retain MUC4 expression exhibit improved survival and decreased recurrence in squamous cell carcinoma of the upper aerodigestive tract. Correlations between MUC4 expression patterns and ErbB2 expression are also observed, suggesting that MUC4‐ErbB2 mediated cell signaling pathways may provide insights into this clinical result.
Higher IL‐10 levels are associated with less effective clearance of Plasmodium falciparum parasites
Authors: Hugosson E. , Montgomery S. M. , Premji Z. , Troye‐Blomberg M. , Björkman A. 
Published: July 2004

ABSTRACT The implications of high levels of the immune regulatory cytokine IL‐10 in Plasmodium falciparum malaria are unclear. IL‐10 may down‐regulate pro‐inflammatory responses and also exacerbate disease by inhibiting anti‐parasitic immune functions. To study possible inhibiting effects on parasite clearance, IL‐10 plasma levels were determined in 104 Tanzanian children, 1 to 4 years old, with acute uncomplicated P. falciparum malaria, and analysed for association with parasite densities during 3 days of anti‐malarial treatment. Higher baseline IL‐10 plasma levels were associated with statistically significantly higher parasite densities after 24, 48 and 72 h of treatment. These associations could not be explained by differences in initial parasitaemia, temperature, age, sex or type of treatment. Induction of high IL‐10 production might be a direct or indirect mechanism whereby the parasite evades the immune response.
Monoclonal antibodies against a 62 kDa proteinase of Trichomonas vaginalis decrease parasite cytoadherence to epithelial cells and confer protection in mice
Authors: Hernández H. , Sariego I. , Garber G. , Delgado R. , López O. , Sarracent J. 
Published: July 2004

SUMMARYTrichomonas vaginalis infects the epithelium of the genital tract. The mechanism by which it invades the tissue leading to the disease is not thoroughly understood. However, results of several studies seem to agree that parasite adhesion to epithelium cells is the initial step leading to infection in women. T. vaginalis is associated with high levels of proteolytic activity. The role of some of these proteinases in the development of infection has been demonstrated. The current study establishes the role of a 62 kDa excretion–secretion proteinase in parasite cytoadherence. Monoclonal antibodies (MAbs) against this enzyme were tested for their ability to inhibit this process. Three stable hybrid producers of IgG1class MAbs (4D8, 1A8, 3C11) against the 62 kDa proteinase were obtained. Two of them (4D8 and 1A8) showed parasite recognition by immunofluorescence. Parasite cytoadherence to a monolayer of HeLa cells was inhibited by the 4D8, 1A8 and 3C11 antibodies. MAb 4D8 administered 24 h before a challenge with T. vaginalis by the intraperitoneal route was able to protect the majority of mice. Nitric oxide levels in the serum of animals inoculated with MAb 4D8 and challenged with the parasite were significantly different from those recorded in mice treated with an unrelated MAb. These studies show that an appropriate antibody against 62 kDa proteinase can help the host resist a challenge by the intraperitoneal route with T. vaginalis.
Th1 and Th2 immunological profile induced by cysteine proteinase in murine leishmaniasis
Authors: Alves C. R. , Benévolo‐de‐Andrade T. C. , Alves J. L. , Pirmez C. 
Published: July 2004

SUMMARY This study evaluated the immune response to three synthetic peptides (pI, VMVEQVICFD; pII, VGGGLCFE; pIII, PYFLGSIMNTCHYT) from the COOH‐terminal region of Leishmania amazonensis cysteine proteinases, in BALB/c‐ and CBA‐infected mice with this parasite. Only BALB/c mice, previously inoculated with pI, showed a distinct exacerbation of the lesion. Blastogenesis assays were performed with lymph node cells from the group of mice infected with L. amazonensis, but not inoculated with the peptides, and we detected lymphoproliferative responses in BALB/c and CBA mice with a 5·0×and 2·5×stimulation index, respectively. Cell phenotypes were evaluated and in both mouse strains CD8+cells proliferated more extensively than CD4+cells. INF‐γ and nitric oxide were detected only in supernatants obtained from CBA mouse lymph node cell cultures, whereas IL‐4 was detected in supernatant cultures from both strains of mice. Our results indicate a preferential stimulation of CD8+T‐cell subsets by the pI cysteine proteinase peptide and the induction of both Th1 and Th2 phenotypes during L. amazonensis infections in both BALB/c and CBA mice. We suggest that the pI peptide from the COOH‐terminal region of the cysteine proteinase induces immune responses different from those elicited by the whole molecule.
Inhibition of neutrophil recruitment by ES of Nippostrongylus brasiliensis
Authors: Keir P. A. , Brown D. M. , Clouter‐Baker A. , Harcus Y. M. , Proudfoot L. 
Published: July 2004

SUMMARY It has been reported that excretory–secretory (ES) material from the parasitic nematode Nippostrongylus brasiliensis has potential modulatory effects on the host's immune system. We observed that intratracheal instillation of ES from the L3 stage of the parasite reduced neutrophil numbers in LPS‐induced inflammation as assessed by bronchoalveolar lavage.