bluuebunny/crossref_metadata_2025_split huggingface dataset:
Functional Study of GJB2 in Hereditary Hearing Loss
Authors: Choung Yun Hoon , Moon Sung‐Kyun , Park Hong‐Joon 
Published: November 2003

AbstractObjectives/Hypothesis The gene GJB2 of the gap junction protein connexin 26 (Cx26) was found to be the main causative gene of autosomal recessive nonsyndromic hearing loss (DFNB1). Although 35delG has been known as the major mutation in Western countries, 235delC was reported to be a specific form of mutation in Asian populations. The objective of the study was to identify how 235delC and E114G changes found in the Korean population affected the function of GJB2 using molecular biological techniques.Methods Genes containing 235delC and E114G were cloned into the pcDNA3 vector, and HeLa cells were transfected with the recombinant DNA samples by the liposome complex method. The expression and subcellular localization of Cx26 were determined, using antibodies against amino acid sequences in the intracellular loop (IL) and N‐terminal (NT) portions of Cx26. To analyze functions of the GJB2 as a gap junction channel, we examined Lucifer yellow dye transfer between cells with a scrape‐loaded technique. Wild‐type GJB2 (WT) with normal hearing was used as a positive control, and mock transfected cells were used as a negative control.Results Immunocytochemical analysis showed that cells transfected with E114G and WT gave characteristic punctate patterns of reaction in the cell membrane with both antibodies. However, 235delC cells were not stained with anti‐IL antibody but stained slightly just around the nucleus only with anti‐NT antibody. In a functional study of GJB2, transfer of Lucifer yellow into contiguous cells was detected in both WT and E114G, but no transfer activity was observed in 235delC.Conclusions The 235delC mutation showed a loss of targeting activity to the cell membrane and severe deterioration of gap junction activity. For the E114G, we did not find any difference from WT transfected cells.
Otogenic Sigmoid Sinus Thrombosis: What Is the Role of Anticoagulation?
Authors: Bradley Dewayne T. , Hashisaki George T. , Mason John C. 
Published: November 2003

AbstractObjectives The treatment of otogenic sigmoid sinus thrombosis with surgery and antibiotics is well established. However, the role of anticoagulation remains unstudied. The study reviews the signs, symptoms, radiological evaluation, surgical treatment, and medical management of patients with otogenic sigmoid sinus thrombosis treated with or without anticoagulation.Study Design Retrospective review of nine patients from 1995 to 2001 with sigmoid sinus thrombosis.Methods Patients were identified by a review of all medical and radiological records. Signs, symptoms, diagnostic studies, treatments, and outcomes were recorded. In addition, telephone follow‐up was performed.Results Nine patients were identified over a 6‐year period from 1995 to 2001. Patients had a mean follow‐up time of 9 months (range, 1–24 mo). Of the nine patients identified, eight patients (89%) had tympanostomy tube placement, six patients (67%) had canal wall intact mastoidectomy, and one patient (11%) had canal wall down mastoidectomy. Needle aspiration of the sinus was performed in four of nine patients (44%), and incision of the sinus in two of nine (22%). Treatment with broad‐spectrum antibiotics occurred in all patients with a mean duration of 12 days (range, 2–22 d) intravenously and 7 days (range, 0–21 d) orally. Sixty‐seven percent of patients (six of nine) were anticoagulated: Five patients received low‐molecular‐weight heparin, and one patient received heparin‐coumadin. No mortality occurred in either the anticoagulated or non‐anticoagulated group. One anticoagulated patient did have persistent headaches and otorrhea.Conclusions Surgery and antibiotic therapy are the cornerstones of the management of otogenic sigmoid sinus thrombosis. However, the role of anticoagulation remains unclear. Because complications of embolization and persistent sepsis are low in otogenic sigmoid sinus thrombosis patients treated with or without anticoagulation, withholding anticoagulation in selected patients is reasonable. Serial imaging to monitor for thrombus progression is advisable.
Cavernous Hemangioma of the External Ear Canal
Authors: Reeck Jay B. , Yen Thomas L. , Szmit Andrew , Cheung Steven W. 
Published: November 2003

AbstractObjective To document the occurrence of a cavernous hemangioma of the external ear canal and to review the relevant literature.Study Design Case report and literature review.Methods Review of a patient chart, imaging studies, operative report, and histologic findings.Results A cavernous hemangioma of the external ear canal not involving the tympanic membrane was surgically excised without complication. This is the third documented cavernous hemangioma of the external ear canal without tympanic membrane involvement in the English literature. Computed tomography scan is invaluable to narrow the differential diagnosis. Complete removal is curative.Conclusions Cavernous hemangioma of the external ear canal with or without tympanic membrane involvement is a rare otologic entity amenable to surgical treatment. Temporal bone computed tomography scan imaging is an important preoperative diagnostic tool.
Modulation of Murine Allergic Rhinosinusitis by CpG Oligodeoxynucleotides
Authors: Hussain Iftikhar , Jain Vipul V. , Kitagaki Kunihiko , Businga Thomas R. , O'shaughnessy Patrick , Kline Joel N. 
Published: November 2003

AbstractBackground Allergic rhinosinusitis is characterized by eosinophilic inflammation of the upper airway, which is induced by TH‐2 cytokines. CpG oligodeoxynucleotides (ODN) are known to induce TH‐1 and to suppress TH‐2 cytokines in a variety of settings, including murine models of asthma.Objective To examine the effect of CpG ODN in a murine model of upper airway allergic inflammation and to correlate with reduction of its manifestations of sneezing and nasal scratching.Methods BALB/c mice were sensitized using Ovalbumin (Ova) intraperitoneally and challenged with aerosolized Ova. CpG ODN were administered at the time of Ova sensitization. Outcomes measured included nasal symptoms, submucosal eosinophilia in the areas lined by respiratory or olfactory epithelium, and bone marrow eosinophilia. To delineate the mechanism of CpG ODN‐induced suppression of eosinophilic inflammation, in vitro experiments were carried out to examine the effect of stimulation with Ova on splenocytes obtained from mice that were treated with CpG or control ODN (or no ODN) in vivo. Supernatant was collected after 72 hours of incubation and cytokines were measured by enzyme linked immunosorbent assay.Results CpG ODN administered at the time of Ova sensitization effectively abrogated nasal symptoms and eosinophilic upper airway inflammation compared with mice treated with control ODN or with no ODN. Cytokine data revealed that Ova sensitization suppressed IFN‐γ and induced IL‐4 and IL‐5 compared with non‐sensitized mice. CpG ODN treatment reversed these effects.Conclusion CpG ODN prevents the development of TH‐2‐mediated eosinophilic inflammation and symptoms in a murine model of allergic rhinosinusitis.
The Role of Acid and Alkaline Reflux in Laryngeal Squamous Cell Carcinoma
Authors: Galli J. , Cammarota G. , Calò L. , Agostino S. , D'Ugo D. , Cianci R. , Almadori G. 
Published: November 2003

AbstractHypothesis At present, main factors considered responsible for the onset of squamous cell carcinoma are tobacco smoking, alcohol abuse, and exposure to viral and toxic agents. In last years, great interest has been focused on gastroesophageal reflux as independent carcinogenic factor and co‐carcinogen in association with smoking and alcohol assumption.Study Design Initially, the aim of this study was to objectively evaluate the presence of distal and proximal esophageal reflux with multielectrode pH measurement in patients with cancer of the larynx and/or hypopharynx (group A). However, in the course of the study, pharyngolaryngeal cancer was also observed in 4 patients with achlorhydria; therefore, the hypothesis that alkaline reflux might be involved in the onset of laryngeal cancer was tested (group B).Methods Twenty‐one consecutive patients with laryngeal or hypopharyngolaryngeal squamous cell carcinoma (group A) entered the study. Twenty‐one patients without laryngo‐pharyngeal diseases were used as control subjects. A validated questionnaire of the clinical history was completed by all patients who underwent 24‐hour pH monitoring. Group B included 40 consecutive gastrectomized patients (28 males and 12 females) in whom biliary or alkaline reflux was directly consequent to Billroth I or Billroth II operation. The control group was composed of 40 non‐gastrectomized dyspeptic patients. The clinical history was controlled and obtained; EDGS and ENT examination with videolaryngoscopy was performed in all patients.Results In group A, pH measurement showed pathological reflux in 80.9% (17 of 21) of patients with no typical symptoms in 63.7% of them. The difference was significant with respect to the control group. In group B, 6 of 40 (15%) had preneoplastic lesions or a history of laryngeal tumor. The difference was significant with respect to the control group. A total of 7.5% of group B patients had previously undergone CO2 laser cordectomy for laryngeal squamous cell carcinoma and 7.5% had leukoplakia. We found a significantly higher incidence (<.05) of neoplastic and preneoplastic disease of the larynx in patients undergoing Billroth II and total gastrectomy than in those undergoing Billroth I and Roux‐en‐Y resection. We also found a significant increase (<.01) in ENT lesions in the group of patients who had undergone gastrectomy more than 20 years previously.Conclusions In agreement with literature reports, results obtained in group A confirmed that gastroesophageal reflux is often present in patients with neoplastic lesions of the pharynx and larynx. Furthermore, gastric resection is indicated for the first time as an additional risk factor or cofactor of precancerosis and squamous cell carcinoma of the pharynx or larynx. Further studies are necessary to establish the cause and effect relationship between biliary reflux and pharyngo‐laryngeal tumors.
Microvascular Free Tissue Transfer in Reconstructing Skull Base Defects: Lessons Learned
Authors: Teknos Theodoros N. , Smith Jonathan C. , Day Terry A. , Netterville James L. , Burkey Brian B. 
Published: November 2003

AbstractObjective To demonstrate the effectiveness of microvascular free tissue transfer in reconstructing complex skull base defects.Study Design Retrospective chart review.Methods A retrospective chart review was conducted identifying patients with anterior or lateral skull base defects, or both, who underwent microvascular free flap reconstruction. Appropriate demographic, pathological, and preoperative and postoperative clinical data were collected and analyzed.Results Thirty‐five patients with skull base defects were identified, including 8 women (Mean age, 43.9 y; age range, 28–75 y) and 27 men (mean age, 57.9 y; age range, 19–85 y). Defects were secondary to trauma in two cases, whereas the remaining 33 cases were secondary to ablative procedures for a variety of malignant tumors, of which squamous cell carcinoma was the most common (n = 18). The average defect surface area was 89.3 cm2, and 36 free flaps were used. The most commonly used flap was the rectus myocutaneous (n = 20); however, six different flap types were employed, including three radial forearm fascial flaps. In all, there were seven flap‐related complications and there was one total flap loss. A total of 43 postoperative complications occurred in 23 patients, with the most common complications being grouped as intracranial (n = 10), orbital (n = 9), and cardiac (n = 9). The perioperative mortality rate was 5.7%, and the average hospital stay was 13.5 days (range, 7–37 d).Conclusions The use of microvascular free tissue transfer for reconstruction of complex skull base defects has proven highly successful in the large series presented in the current study. The versatility and reliability of free flaps for such reconstruction are discussed, and helpful hints are given to minimize the complication rate.
Relative Risk of Stroke in Head and Neck Carcinoma Patients Treated With External Cervical Irradiation
Authors: Haynes Jeffrey C. , Machtay Mitchell , Weber Randal S. , Weinstein Gregory S. , Chalian Ara A. , Rosenthal David I. 
Published: November 2003

AbstractObjective To determine the rate of cerebrovascular events (stroke) in patients irradiated to high doses for squamous cell carcinoma of the head and neck.Study Design Retrospective chart review of 413 patients treated from 1987 to 2000 with squamous cell carcinoma of the head and neck was performed to determine the risk of stroke compared with the expected rate.Methods Surgical, radiotherapeutic, radiological, and clinical or office records of 413 patients were analyzed, and data were collected regarding clinical risk factors for stroke, irradiation parameters, and follow‐up on whether or not a stroke event occurred. The actuarial risk of stroke for this population was calculated and compared with expected risk from population‐based data.Results Of the 413 patients, 20 had strokes in follow‐up, occurring between 2 and 146 months after radiotherapy. The 5‐year actuarial rate of stroke was 12%, which corresponded to a relative risk of 2.09 (P = .0007) compared with the population‐based “expected” data. Median radiation therapy dose was 64 Gy; there was no correlation between radiation therapy dose and stroke risk. No correlation was identified between surgery near the carotids and stroke risk.Conclusions An association between high‐dose cervical irradiation for squamous cell carcinoma of the head and neck and stroke is demonstrated. Although the relative risk is approximately doubled, the absolute risk is modest in comparison to the risk of cancer recurrence. Further study of this association and possible interventions is warranted.
Aesthetics and the Hispanic Rhinoplasty
Authors: Leach Joseph 
Published: November 2003

AbstractObjectives/Hypothesis Current aesthetic standards for rhinoplasty have been formulated for an Anglo‐American population. Nevertheless, these standards vary, and it is doubtful that these norms are universally applicable to Anglo populations, much less Hispanic ones.Study Design A retrospective study was carried out to determine how the Western norms apply to rhinoplasty populations of Anglo and Hispanic background. The effectiveness of rhinoplasty techniques used in Hispanic rhinoplasty were assessed.Methods The open approach was used frequently to augment the nasal skeleton in this population with thick skin. Techniques were primarily aimed at achieving symmetry, straightening the dorsum, and improving projection, since these Hispanic patients were less interested in tip definition or alar base narrowing.Results Hispanics were significantly more likely to have dorsal humps, saddle deformities, dependent alae, retracted columellae, and poor tip projection. The nasolabial (columellar‐labial) angle method of assessing tip rotation was not accurate in the Hispanic population. Tip definition was better in Anglos, and skin thickness and base width were greater among Hispanics. Rhinoplasty can be effective in achieving aesthetic norms: As a group, the Hispanic profile was brought into greater conformity with the aesthetic norms than their Anglo counterparts who did not have surgery.Conclusions Thick nasal skin does not adapt well to a small osteocartilaginous framework, and it is better to augment and strengthen the skeleton with cartilage grafts. Even among Anglos, the Western artistic canons are merely guidelines. Good communication with the patient is more important than adhering to aesthetic norms.
The Clinical Value of Image Cytometry DNA Analysis in Distinguishing Branchial Cleft Cysts From Cystic Metastases of Head and Neck Cancer
Authors: Nordemar Sushma , Högmo Anders , Lindholm Johan , Tani Edneia , Sjöström Björn , Auer Gert , Munck‐Wikland Eva 
Published: November 2003

AbstractObjectives/Hypothesis A branchial cleft cyst presents as a lump in the neck that, generally, is easily cured by surgical excision. The preoperative diagnosis is based on clinical examination and, especially in the Scandinavian countries, fine‐needle aspiration cytology. However, at times, the histopathological analysis of the excised cyst reveals a cystic metastasis of squamous cell carcinoma of the head and neck. If adequate diagnosis could be obtained preoperatively, patients would most likely fare better. The study was performed to investigate whether the diagnostic accuracy for these lesions could be improved preoperatively by image cytometry DNA analysis of the fine‐needle aspiration cytology specimen.Study Design Image cytometry DNA analysis was performed on the preoperative fine‐needle aspiration cytology specimen and the surgical specimens from 51 patients with solitary cysts in the lateral region of the neck. Thirty‐six patients were selected because there was a discrepancy between findings on fine‐needle aspiration cytology and the final histopathological diagnosis or an uncertain cytological diagnosis. There were 25 metastatic squamous cell carcinomas and 3 thyroid cancers, there was 1 lymphoma and 1 sialoadenitis, and there were 21 branchial cleft cysts.Methods The cytodiagnostic Giemsa‐stained slides were destained in Methanol and then stained with Schiff's reagent. The paraffin‐embedded material from excised cysts were cut and deparaffinized and then stained with Schiff's reagent. Ahrens image analysis was used for DNA analysis and lymphocytes were used as control cells. DNA valves exceeding 5c was regarded as aneuploid.Results Image cytometry DNA analysis of the preoperative cytological specimen was possible in 41 of 51 patients. We found that in 53% of the cases with cystic metastasis, image cytometry DNA analysis, when possible, revealed aneuploidy, thus indicating malignancy. DNA analysis showed diploidy in all benign cases.Conclusions Aneuploidy is highly specific for malignancy. Image cytometry DNA analysis increases the diagnostic sensitivity for malignant cystic metastasis and therefore is a valuable supplement to conventional cytological study for these lesions.
A Lack of Association Between p53 Mutations and Recurrent Nasopharyngeal Carcinomas Refractory to Radiotherapy
Authors: Chang Kai‐Ping , Hao Sheng‐Po , Lin Shinn‐Yn , Tsao Kuo‐Chien , Kuo Tseng‐tong , Tsai Ming‐Hsui , Tseng Chen‐Kan , Tsang Ngan‐Ming 
Published: November 2003

AbstractObjective The object of this study was to determine the incidence of p53 mutation in recurrent nasopharyngeal carcinoma refractory to radiotherapy.Study Design Prospective study.Methods There were 31 patients enrolled in this study between 1995 and 1998. All patients had received radiotherapy but none of them had undergone chemotherapy or local salvage surgery previously.Results The p53 status of each tumor was analyzed by polymerase chain reaction and by sequencing of exons 5 to 8 (codons 126–306). Five (16.1%) of 31 patients had mutations in the p53 gene, of which 2 were non‐sense mutations, 2 were transition mutations, and 1 was a frameshift deletion mutation. The majority of the p53 mutations were found in exon 5. There is no significant difference in the incidence of p53 mutation compared with that of the previous reports for the primary disease. Based on the clinicopathologic data, there was no specific difference found between these 5 patients and the others.Conclusions This study shows that p53 mutation is an infrequent event and may have no essential role in recurrent nasopharyngeal carcinomas.
Stapedectomy Versus Stapedotomy: Comparison of Results With Long‐Term Follow‐up
Authors: House Howard P. , Hansen Marlan R. , Dakhail Abdul Aziz A. Al , House John W. 
Published: November 2003

AbstractObjective/Hypothesis To compare the effectiveness and long‐term stability of hearing results between stapedectomy and small fenestra stapedotomy in patients with conductive hearing loss due to otosclerosis.Study Design Retrospective review of prospectively collected audiometric data.Methods The hearing results and complication rates of 209 ears with long‐term follow‐up that underwent either stapedectomy or stapedotomy by the senior author (h.p.h.) between 1961 and 1989 were compared. Forty‐two patients underwent stapedectomy in one ear and stapedotomy in the opposite ear, permitting a paired case review of the results in these patients. The techniques were compared with respect to initial and late hearing results and change of the results over time.Results Patients undergoing stapedectomy and stapedotomy were followed for an average of 11.5 and 6.0 years, respectively. There were no statistically significant differences in initial or late postoperative pure‐tone average (PTA), PTA air–bone gap, speech discrimination scores, or incidence of sensorineural hearing loss between the two groups. Ears treated by stapedotomy showed statistically better initial and late postoperative 4‐kHz air‐conduction threshold and initial 4‐kHz air–bone gap, but the gap difference was not significant with late follow‐up. There was no significant difference in the percentage of patients with air–bone gap closure within 10 dB for any frequency other than 4 kHz at the initial postoperative test. Importantly, the successful outcomes in both groups were stable over long‐term follow‐up. Results were the same when comparing the two procedures in patients having undergone both.Conclusion These results show that, in the hands of an experienced surgeon, either technique provides satisfactory and stable long‐term results.
A New Ventilation Tube for Long‐Term Middle Ear Ventilation
Authors: Bonvin P. , Hansen B. Bakke , Hentzer E. 
Published: November 2003

AbstractObjectives The treatment of secretory otitis media often requires repeated tubulation of the tympanic membrane as the standard ventilation tubes are extruded before the disease of the middle ear has remitted. The T‐tube and its modification have been developed to remain longer in situ, often requiring surgical removal. The rates of subsequent persisting tympanic membrane perforations and granulations around the tube have been unacceptably high. In the search for a long‐term ventilation tube with fewer complications, the Duravent tube (Smith and Nephew) has been developed. The aim of the study was to estimate duration in situ and observe complications in using the Duravent tube compared with standard tubes and T‐ tubes.Study Design Retrospective study.Methods In all, 51 patients have been treated with the Duravent tube over a 2‐year period. In all, 72 Duravent tubes have been inserted. All patients were subsequently invited for a follow‐up examination at a median time of 28 months (range, 11–43 mo) after the tube insertion and were followed up for 5 years.Results The duration in situ was optimal with a median duration of 17 months. The Duravent tube was extruded spontaneously in all but four cases in which surgical removal was necessary. The rate of persisting perforations of the tympanic membrane was low (4.2%) compared with 24% after the use of the T‐tube. Likewise, the usual complications connected with long‐term ventilation tubes were less frequent (14% compared with 35% when using the T‐tube).Conclusions In the present study, the Duravent tube has proved superior to other known long‐term ventilation tubes. The problem of granulations, otorrhoea, and tube occlusion was significantly less than reported in other studies using the T‐tube.