bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of Transoral Intraluminal Wallstents for Tracheal Stenosis or Tracheomalacia
Authors: Casiano Roy R. , Numa William A. , Jacobo Nurko Y. 
Published: November 2003

AbstractObjectives The efficacy and safety of intraluminal Wallstent Endoprosthesis (Boston Scientific/Medi‐Tech, Quincy, MA) placement to restore airway patency in patients with tracheal stenosis or tracheomalacia are unknown.Study Design Retrospective review in setting of tertiary, referral, and academic center.Methods A retrospective review of 13 consecutive patients over a 2‐year period who underwent transoral resection of tracheal stenosis and immediate transoral Wallstent placement. One patient had tracheomalacia. All of the patients were considered at high risk for transcervical surgery or had failed prior traditional open procedures.Results The average patient age was 54.2 years, with nine male and four female patients. All had Cotton/Myer stenoses (grades II to IV) with moderate to severe degrees of inspiratory stridor. Four patients were tracheotomy dependent. The length of stenosis varied from 1 to 4 cm. One patient had a 10‐cm segment of tracheomalacia. At the time of writing, none of the patients has had a problem with significant migration or extrusion and most of the patients have incorporated the stent well without any short‐term obstructive granulation tissue. After a mean follow‐up of 15 months (range, 4–24 mo). 10 of the 12 patients with stenosis (83%) have remained free of any inspiratory noise during breathing. The one patient with tracheomalacia also has remained free of symptoms.Conclusions Transoral Wallstents appear to be safe and may be a reasonable alternative in the restoration of airway patency in select patients with tracheal stenosis or tracheomalacia.
More Aggressive Behavior of Squamous Cell Carcinoma of the Anterior Tongue in Young Women
Authors: Vargas Hannah , Pitman Karen T. , Johnson Jonas T. , Galati Lisa T. 
Published: November 2003

AbstractObjective To review the combined experience from two large medical centers in treating young female patients with anterior tongue cancer to determine the clinical course of this unique subset of patients.Study Design Retrospective study.Methods Seventeen female patients less than 40 years of age (group A) and 17 older patients, both male and female, greater than 40 years of age (group B) who had treatment for invasive squamous cell carcinoma of the anterior tongue were studied. The charts were reviewed for the clinical staging, treatment, and outcome of each patient. The disease‐free survival and recurrence rates were compared between the two cohorts.Results The mean disease stage between the groups was II. The survival analysis showed a significant difference between the two groups in recurrences (group A = 65%, group B = 41%;P = .02). Further, of the patients who had recurrence, the young women did so significantly earlier in their disease course than the older patients (group A = 14 mo, group B = 40 mo;P < .05). Although the survival differences did not reach statistical significance (P = .15), the power of the study was low (power = 0.26) resulting in a high‐level type II error.Conclusion These data suggest that young women with squamous cell carcinoma of the anterior tongue have significantly higher rates of recurrent disease and the interval to recurrence is significantly shorter than in older patients. Further investigation is warranted until a statistically significant cohort is accrued; until that time, these patients warrant an aggressive initial treatment and close surveillance for recurrence.
External Beam Radiation Followed by Planned Neck Dissection and Brachytherapy for Base of Tongue Squamous Cell Carcinoma
Authors: Kaylie David M. , Stevens Kenneth R. , Kang Mathew Y. , Cohen James I. , Wax Mark K. , Andersen Peter E. 
Published: November 2003

AbstractBackground Surgical resection of tongue base cancer can leave the patient with significant functional deficits. Other therapies, such as external beam radiation followed by neck dissection and radiation implants, have shown equal tumor control with good functional outcome.Methods Between March 1991 and July 1999, 12 patients at Oregon Health Sciences University, the Portland Veterans Administration Medical Center and West Virginia University School of Medicine Hospital were treated with external beam radiation followed by neck dissection and Ir192 implants. Two patients had T1 disease, two had T2, five patients had T3 tumors, and three had T4 tumors. Six had N2a necks, three had N2b necks, and three had N2c. Follow‐up ranged from 13 months to 8 years.Results After external beam radiation, five patients had complete response and seven had partial response in the neck without complications. One patient underwent a unilateral radical neck dissection, eight had unilateral selective neck dissections involving levels I to IV, and three had dissections involving levels I to III. One of the five patients who had a complete clinical response in the neck had pathologically positive nodes. One patient had a pulmonary embolus that was treated and had no permanent sequelae. There were three complications from brachytherapy. Two patients had soft tissue necrosis at the primary site and one patient had radionecrosis of the mandible. All healed without further therapy. One patient had persistent disease and underwent a partial glossectomy but died of local disease. Distant metastasis developed in two patients. All others show no evidence of disease and are able to eat a normal diet by mouth.Conclusion This combination of therapies should be considered when treating tongue base cancer.
Glutathione S‐Transferase π in Squamous Cell Carcinoma of the Head and Neck
Authors: Bentz Brandon G. , Kenneth Haines G. , Radosevich James A. 
Published: November 2003

AbstractObjectives/Hypothesis Oxidative/reductive (redox) DNA damage from radical species such as nitric oxide (NO·) are increasingly being implicated in the development of cancer. Moreover, redox‐protective cellular mechanisms, such as glutathione S‐transferase, may determine cellular susceptibility to this redox‐mediated damage.Methods Formalin‐fixed, paraffin‐embedded tissue samples of 11 normal oral mucosa, 15 reactive/dysplastic lesions, and 131 head and neck squamous cell carcinomas (HNSCCs) were immunohistochemically stained using a polyclonal antibody against glutathione S‐transferase π (GST‐π). Slides were reviewed in a blinded fashion by the study pathologist (g.k.h.) and intensity was graded, noting the pattern of immunostaining. These staining characteristics were compared with those obtained using monoclonal antibodies against endothelial constitutive nitric oxide synthase (ecNOS) and nitrotyrosine, a marker of NO·'s pathological nitrosylation of proteins on serial sections of the same tissue. Patient charts were reviewed and clinical data collected.Results The expression of GST‐π was significantly increased in reactive/dysplastic and HNSCC samples compared with normal squamous mucosa (P < .001 for both). Furthermore, among the carcinomas the expression of GST‐π was significantly increased in higher‐grade lesions (P < .02). The expression of GST‐π correlated highly with the expression of ecNOS and nitrotyrosine (P < .0001 for both).Conclusions These findings demonstrate that GST‐π is upregulated in conjunction with the NO·‐generating ecNOS isoform and implicate GST‐π in protecting HNSCC from the cytotoxic effects of high concentrations of NO· found in the tumor bed.
Therapeutic Efficacy of Th1 and Th2 L‐selectin− CD4+ Tumor‐Reactive T Cells
Authors: To Wyatt C. , Seeley Brook M. , Barthel Steven W. , Shu Suyu 
Published: November 2003

AbstractObjective To evaluate the cytokine secretion profile and therapeutic efficacy of Th1 CD4+ L‐selectin− tumor‐draining lymph node lymphocytes in the treatment of murine pulmonary metastases.Study Design Prospective, murine in vivo and in vitro study.Methods B6 mice were injected bilaterally subcutaneously with MCA 205 sarcoma cells to initiate tumor growth. Eleven days later, tumor‐draining inguinal lymph nodes were harvested. Single‐cell suspensions were prepared and fractionated using magnetically activated cell sorting. Sorted CD4+ L‐selectin− lymphocytes were activated with anti‐CD3 monoclonal antibody for 48 hours either alone to give a Th1 phenotype, or in the presence of interleukin (IL)‐4 and anti‐interferon‐γ (α‐IFN‐γ) monoclonal antibody to elicit a Th2 phenotype. Activated cells were then expanded for 3 days in IL‐2. Resulting cells were used to treat 3‐day pulmonary metastases. Enzyme‐linked immunosorbent assay and intracellular fluorescent‐activated cell‐sorter (FACS) scanning were used to evaluate the cytokine secretion profiles of these cells.Results Activated and expanded L‐selectin− CD4+ T cells demonstrated a Th1 cytokine profile and excellent antitumor efficacy. In contrast, L‐selectin− CD4+ lymphocytes activated in the presence of IL‐4 and α‐IFN‐γ monoclonal antibody demonstrated a Th2‐like profile and significantly (P < .05) poorer antitumor efficacy.Conclusions The cytokine environment during the activation of tumor‐draining lymph nodes can influence the therapeutic efficacy of activated L‐selectin−, CD4+ T cells. Cell mediated, Th1‐dependent immunity appears to play an important role in mediating tumor regression. Culture conditions promoting Th2 cells resulted in T cells associated with diminished antitumor efficacy.
Sensorineural and Conductive Hearing Loss Associated With Lateral Semicircular Canal Malformation
Authors: Johnson Jacob , K. Lalwani Anil 
Published: November 2003

AbstractObjective Lateral semicircular canal (LSCC) malformation is one of the most common radiological inner ear malformations. Traditionally, inner ear malformations are thought to be associated with sensorineural hearing loss (SNHL). Recent experience with patients with LSCC malformation suggested that LSCC malformation may be associated with both SNHL and conductive hearing loss (CHL). The auditory phenotype associated with LSCC malformation is not well delineated. The objective of this study is to define the nature of the hearing loss associated with LSCC malformation.Study Design Retrospective reviewMethods Retrospective review of clinical records, audiological evaluation, and imaging studies.Results Two patients with unilateral and 13 patients with bilateral LSCC malformation were identified. LSCC malformation was associated with CHL in 14% (4 ears), SNHL in 71% (20 ears), normal hearing in 11% (3 ears) and CHL due to atresia in one ear. Hearing loss varied from mild to profound but did not correlate with the severity of LSCC malformation. In bilateral malformation, the hearing loss was asymmetric in half of the cases. Malformation of the posterior limb of the LSCC was always associated with a large vestibular aqueduct. An absent or rudimentary LSCC was invariably associated with a cochlear abnormality.Conclusions LSCC malformation, like other inner ear malformations such as large vestibular aqueduct and X‐linked mixed deafness with perilymph gusher, can be associated with CHL, SNHL, or normal hearing. Children with unexplained conductive hearing loss often undergo exploratory surgery to improve hearing. Given that inner ear malformations may be associated with a pure CHL, it is critical that children undergo computed tomography scan of the temporal bone prior to undergoing exploratory surgery.
Obstructive Sleep Apnea Syndrome: A Comparison Between Far‐East Asian and White Men
Authors: Li Kasey K. , Kushida Clete , Powell Nelson B. , Riley Robert W. , Guilleminault Christian 
Published: November 2003

AbstractObjectives To investigate the possible differences between Far‐East Asian men and white men in obstructive sleep apnea syndrome (OSAS).Study Design Prospective nonrandomized controlled study.Methods This study compared consecutive Far‐East Asian men with OSAS (n = 50) with two selected groups of White men with OSAS (n = 50 in each group). One group of white men was controlled for age, respiratory disturbance index (RDI), and minimum oxygenation saturation (LSAT). Another group was controlled for age and body mass index (BMI). Cephalometric analysis was performed on all subjects.Results The majority of the Far‐East Asian men were found to be nonobese (mean BMI, 26.7 ± 3.8) but had severe OSAS (mean RDI, 55.1 ± 35.1). When controlled for age, RDI, and LSAT, the white men were substantially more obese (mean BMI, 29.7 ± 5.8, P = .0055). When controlled for age and BMI, the white men had less severe illness (RDI, 34.1 ± 17.9, P = .0001). Although the posterior airway space and the distance from the mandibular plane to hyoid bone were less abnormal in the Far‐East Asian men, the cranial base dimensions were significantly decreased.Conclusions The majority of the Far‐East Asian men in this study were found to be nonobese, despite the presence of severe OSAS. When compared with white men, Far‐East Asian men were less obese but had greater severity of OSAS. There may be differences in obesity and craniofacial anatomy as risk factors in these two groups.
Factors in the Pathogenesis of Tumors of the Sphenoid and Maxillary Sinuses: A Comparative Study
Authors: Reino Anthony J. 
Published: November 2003

AbstractObjectives/HypothesisTo explain the processes that lead to the development of tumors in the maxillary and sphenoid sinuses.Study DesignA 32‐year review of the world's literature on neoplasms of these two sinuses and a randomized case‐controlled study comparing the normal mucosal architecture of the maxillary to the sphenoid sinus.MethodsAnalysis of a 32‐year world literature review reporting series of cases of maxillary and sphenoid sinus tumors. Tumors were classified by histological type and separated into subgroups if an individual incidence rate was reported. Histomorphometry of normal maxillary and sphenoid sinus mucosa was performed in 14 randomly selected patients (10 sphenoid and 4 maxillary specimens). Specimens were fixed in 10% formalin, embedded in paraffin, and stained with periodic acid–Schiff (PAS) and hematoxylin. Histomorphometric analysis was performed with a Zeiss Axioscope light microscope (Carl Zeiss Inc., Thornwood, NY) mounted with a Hamamatsu (Hamamatsu Photonics, Tokyo, Japan) color‐chilled 3 charge coupled device digital camera. The images were captured on a 17‐inch Sony (Sony Corp., Tokyo, Japan) multiscan monitor and analyzed with a Samba 4000 Image Analysis Program (Samba Corp., Los Angeles, CA). Five random areas were selected from strips of epithelium removed from each sinus, and goblet and basal cell measurements were made at magnifications ×100 and ×400.ResultsThe literature review revealed that the number and variety of tumors in the maxillary sinus are much greater than those in the sphenoid. The incidence of metastatic lesions to each sinus is approximately equal. No recognized pattern of spread from any particular organ system could be determined. On histomorphometric study there were no statistically significant differences between the sinuses in the concentration of goblet cells, basal cells, or seromucinous glands.ConclusionsFactors involved in the pathogenesis of tumors of the maxillary and sphenoid sinuses include differences in nasal physiology, embryology, morphology, and topography. There are no significant histological differences in the epithelium and submucous glands between the two sinuses to explain the dissimilar formation of neoplasms.
Centrosome Hyperamplification in Head and Neck Squamous Cell Carcinoma: A Potential Phenotypic Marker of Tumor Aggressiveness
Authors: Mark Gustafson L. , Gleich Lyon L. , Fukasawa Kenji , Chadwell Jon , Ann Miller Mary , Stambrook Peter J. , Gluckman Jack L. 
Published: November 2003

AbstractObjectives/Hypothesis There is currently no single histological or genotypic marker that reliably predicts the biological behavior of head and neck squamous cell carcinoma (HNSCC). While multiple genetic mutations have been investigated, no single genotypic alteration has consistently correlated with tumor aggressiveness. Phenotypic markers may prove more predictive, because they can represent many different genetic alterations. We investigated the frequency of centrosome hyperamplification in HNSCC and examined its usefulness as a marker for tumor recurrence.Study Design Analysis of archived paraffin blocks using immunohistochemistry.Methods Eighteen patients who underwent resection of oral cavity squamous cell carcinoma were reviewed. Ten patients had cancers that recurred locally within 1 year of resection, and 8 patients were tumor free at 5 years. The amount of centrosome hyperamplification in the cancer specimens and all surgical margins was graded as follows: 0, none; 1+, rare hyperamplification; 2+, greater than 10% of cells per high‐powered field; and 3+, greater than 20% of cells per high‐powered field.Results Centrosome hyperamplification was found in 17 of 18 tumors (94%). Grade 2+ or 3+ hyperamplification was found more in cancers that recurred (9 of 10) than in those that did not (3 of 8) and was more prevalent in the histologically normal margins of patients with recurrence (8 of 10) than in those without recurrent cancer (3 of 8).Conclusions Our results demonstrate the e‐tremely frequent occurrence of centrosome hyperamplification in HNSCC. Centrosome hyperamplification is a phenotypic marker for HNSCC and can reflect multiple genotypic changes. Its presence in histologically normal margins suggests that it may be useful for analysis of primary tumors and tumor margins.
Intranasal Surfactant Aerosol Therapy for Otitis Media With Effusion
Authors: Venkatayan Natarajan , Troublefield Yolanda L. , Connelly Patricia E. , Mautone Alan J. , Chandrasekhar Sujana S. 
Published: November 2003

AbstractObjective To determine the effect of surfactant alone and with other medications delivered intranasally as a metered dose inhaler (MDI) aerosol on the resolution of e‐perimentally induced otitis media with effusion (OME).Background Eustachian tube dysfunction is a primary factor in the pathogenesis of OME. Intranasal surfactant via MDI has been shown in this laboratory to reduce passive opening pressure of the eustachian tube in normal gerbils and mice.Study Design OME was developed in 35 gerbils by transtympanic injection of 10 μg lipopolysaccharide from Klebsiella pneumoniae. Pretreatment otomicroscopy and tympanometry were performed to exclude pre‐existing middle ear disease, and postinfection evaluations were performed on alternate days for a period of 30 days. Five animals received no treatment (control group); four were treated with propellant only (placebo); seven received surfactant alone; eight received surfactant and betamethasone; and six received surfactant with phenylephrine. All medications were sprayed intranasally as an aerosolized MDI and administered daily from postinfection day 2 onward.Results OME resolved after 16.0 ± 0.44 days (mean ± SD) in controls. There was no difference seen in the placebo or the surfactant with phenylephrine groups. Treatment with surfactant yielded resolution in 10.57 ± 0.37 days; this was reduced to 8.57 ± 0.37 days with surfactant plus betamethasone. These differences are statistically significant. There was no recurrence of OME in any group.Conclusion This study demonstrates that using an aerosolized MDI surfactant with and without betamethasone decreases the duration of OME in this in vivo gerbil model.
Expression Patterns of p27Kip1 and Ki‐67 in Cholesteatoma Epithelium
Authors: Won Chae Sung , Joon Song Jae , Kyu Suh Han , Hyun Jung Hak , Ho Lim Hyun , Jae Hwang Soon 
Published: November 2003

AbstractObjectives The cell cycle must be involved in cell proliferation of the epithelium of middle ear cholesteatoma. Cyclins and cyclin‐dependent kinase (CDK) complexes have important regulatory roles during cell cycle progression. Cyclin‐CDK complexes are in turn regulated by the cyclin‐dependent kinase inhibitors (CDKIs), which generally inhibit cell cycle progression. One of the important CDKI members is p27Kip1. The goal of this study is to evaluate the expression of p27Kip1 and Ki‐67, a proliferation marker, in cholesteatoma and in the skin of the external ear canal.Methods The expressions of p27Kip1 and Ki‐67 in cholesteatoma epithelium (n = 20) and ear canal epithelium (n = 7) were investigated by an immunohistochemical technique.Results In cholesteatoma epithelium specimens, the expression of p27Kip1 was observed from the parabasal layer to the granular layer, but not in the basal layer. Ki‐67 was expressed dominantly in the basal and parabasal cell layers. Their expressions tend to be increased compared with their expressions in the normal ear canal skin. The expression pattern of the proliferation marker Ki‐67 in the epithelial layers of two groups was inversely related to the expression of p27Kip1.Conclusions In cholesteatoma, the expressions of CDKI and Ki‐67 were both increased in this study. The ability to inhibit proliferative activity was also increased in the cholesteatoma epithelium. The expression pattern of the proliferation marker Ki‐67 in the epithelial layers was inversely related to the expression of p27Kip1. Not only is the proliferation activity increased, but also the ability to inhibit hyperproliferation is increased in the cholesteatoma epidermis. Despite increased proliferative activity in the cholesteatoma epidermis, epithelial cells still retain the capability to prevent cell cycle arrest by means of p27Kip1.
Aldosterone (Mineralocorticoid) Equivalent to Prednisolone (Glucocorticoid) in Reversing Hearing Loss in MRL/MpJ‐Faslpr Autoimmune Mice
Authors: Trune Dennis R. , Beth Kempton J. , Kessi Monica 
Published: November 2003

AbstractHypothesis Although the glucocorticoid prednisone is the standard therapy for autoimmune sensorineural hearing loss, what this hormone does in the ear to restore hearing is not known. MRL/MpJ‐Faslpr autoimmune mice consistently have shown only stria vascularis disease, implying that abnormal ion balances in the endolymph underlie cochlear dysfunction. Previously we have shown that hearing loss in these mice is reversed with prednisolone treatment. This, coupled with the complete lack of cochlear inflammation, suggests that the restoration of hearing with prednisolone is due to its sodium transport function and not to its anti‐inflammatory or immune suppression effects. Therefore the hypothesis of this study was that the mineralocorticoid aldosterone, which only increases sodium transport, would be as effective as prednisolone in reversing autoimmune hearing loss.Study Design MRL/MpJ‐Faslpr autoimmune mice were treated with either prednisolone or aldosterone to compare steroid effects on auditory brainstem response (ABR) thresholds and stria morphology.Methods After baseline ABR audiometry, autoimmune mice were given prednisolone (5 mg/kg per day), aldosterone (15 μg/kg per day), or water in their drinking bottles. After 2 months of treatment the ABR thresholds were remeasured, and ears collected for histological examination.Results The untreated controls showed continued elevation of ABR thresholds and edematous stria. However, thresholds in most steroid mice were improved or unchanged and their stria morphology improved, particularly with aldosterone treatment.Conclusions Restoration of hearing with steroid treatment is due to increased sodium transport to re‐establish cochlear ionic balances. Aldosterone therapy may offer advantages over prednisone for long‐term management of not only autoimmune hearing loss, but also other forms of nonimmune‐related deafness for which steroids are currently prescribed.