bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ciliary Activity in Differentiating and Reactivated Human Respiratory Epithelial Cells
Authors: Hard Robert , Besch Stephen R. , Tristram Deborah , Han Jin , Hicks Wesley 
Published: November 2003

AbstractObjective: Experimental studies of mucociliary clearance, especially those involving drug effects, suffer from the difficulty of determining whether drugs act directly on ciliary motility or whether their effects are indirect, acting via changes in cell metabolism, viscous load, or alternative mechanisms. The present study provides a solution to this problem by comparing the motile characteristics of ciliated cells that have differentiated in primary cell culture with those of demembranated cilia reactivated with MgATP. Methods: Human respiratory epithelial cells (REC) were dissociated from trachea, bronchus, nasal polyps, or turbinates and then placed in a dissociated cell culture system. Thirty‐three percent of the dissociated cells contain beating cilia. Following 1 week in culture, the REC dedifferentiated, but then rediffer‐entiated within 96 hours after they were brought to an air interface. Results: The cilia on such cells beat with planar waves consisting of power and recovery strokes. Beat frequencies at 20°C were 15 ± 2.3 Hz. Ciliary beating often was coordinated both within and between cells with a defined antilaeoplectic pattern of coordination. Either fresh or cultured cells could be demembranated with Triton X‐100 and reactivated with MgATP. The activity of these reactivated models was equivalent to those observed in living cells. Conclusion: The authors have demonstrated that ciliary beat frequency of demembranated human respiratory epithelial cells can be modulated by MgATP and can be adjusted to the same level of activity as measured in living cells. This allows them to selectively test whether a drug's effects on mucociliary transport are the result of direct interactions with the ciliary apparatus or are produced through other indirect mechanisms.
Pervasive Developmental Delay in Children Presenting As Possible Hearing Loss
Authors: Ho Philip T. , Keller Jeffrey L. , Berg Abbey L. , Cargan Abba L. , Haddad Joseph 
Published: November 2003

AbstractObjective/Hypothesis: Children who fail to develop adequate language skills and/or appropriate social skills by age 2 years often are referred to the department of otolaryngology for otolaryngologic examination and evaluation of possible hearing deficits. Discovering a gross disparity between hearing function and language ability often uncovers an underlying developmental disorder satisfying criteria for diagnosis on the spectrum of autism and pervasive developmental delay (PDD). The otolaryngologist has a unique opportunity to identify these autistic children and initiate their evaluation and management. Study Design: Retrospective review. Methods: Review of charts of children referred over the past 4 years to the Department of Otolaryngology for possible hearing loss identified 15 children who were later diagnosed with PDD. Results: Fifteen children initially referred for hearing evaluation were subsequently identified with a diagnosis of PDD. Males outnumbered females 4 to 1, with the average age of referral being 2 years. One third of the patients displayed middle ear disease that improved with PE tube placement. One third of the patients showed brainstem conduction dysfunction on auditory brainstem evoked response testing. Conclusions: Children with developmental delays, especially higher functioning ones, may present with a myriad of language and communication deficits that are often mistakenly attributed to hearing loss. Otolaryngologists and audiologists can assist in their early identification and appropriate referral for therapy.
Congenital Absence of the Long Process of the Incus
Authors: Wehrs Roger E. 
Published: November 2003

AbstractObjective/Hypothesis: To review the case reports of three generations of one family, suffering from bilateral conductive hearing loss due to congenital absence of the long process of the incus. Study Design: Review of the literature regarding hereditary congenital absence of the long process of the incus to determine its mode of inheritance such as autosomal dominant or X‐linked. Also document the types and results of surgical repairs performed by previous investigators of this defect and compare them with the present study. Methods: Three female patients of direct lineage. Mother, daughter, and granddaughter, who were personally seen, operated on, and followed up over a period of 26 years. Results: All three female patients presented with similar symptoms and findings of hearing impairment since birth, with no history of ear infections, and with normal appearing tympanic membranes. However, they had severe conductive hearing loss with normal bone conduction and discrimination. Operative findings were identical in all three patients, with the incus ending in a blind stub, and with absence of the capitulum of the stapes. The type of ossicular reconstruction varied with the changing of times and advances in otologic surgery, as well as the prosthetic materials used. All three patients received improvement in their hearing, and this improvement has been maintained over the 26‐year span of the study. Conclusions: Hearing loss due to congenital absence of the incus is uncommon but not rare. Interestingly, no other instance of inherited cases were reported in the literature. In this family the defect appears to be an inherited trait either due to an autosomal dominant mutation or an X‐linked dominant inheritance. This abnormality is amendable to surgery, and any well‐executed technique usually gives good hearing results.
Extent of Lymphadenectomy Achieved by Various Modifications of Neck Dissection: A Pathologic Analysis
Authors: Busaba Nicolas Y. , Fabian Richard L. 
Published: November 2003

AbstractObjectives: Quantify the extent of lymphadenectomy achieved by the various modifications of neck dissection based on microscopic pathologic analysis.Study Design: Retrospective review of neck specimens of patients who underwent neck dissection for head and neck malignancies at our institution over a 5‐year period.Methods: Charts and pathology report findings on patients who underwent neck dissection were reviewed. Patients who received preoperative chemotherapy or radiation therapy to the neck were excluded. The number of lymph nodes documented by pathologic microscopic examination for each specimen was recorded.Results: There were 164 neck specimens on 135 patients (29 patient had simultaneous bilateral neck dissection). Those were divided into four groups based on the non‐lymphatic structures preserved. There were 58 radical neck dissections (radical neck dissections) (group 1), 50 modified radical neck dissections sparing the eleventh cranial nerve (group 2), 15 modified radical neck dissections sparing the eleventh cranial nerve and internal jugular vein (group 3), and 33 modified radical neck dissections sparing the eleventh cranial nerve, internal jugular vein, and sternocleidomastoid muscle (group 4). The remaining 8 had other modifications of radical neck dissection. The mean number of lymph nodes found per specimen was 34 in group 1, 27 in group 2, 31 in group 3, and 22 in group 4. We performed one‐way between‐group analysis of variance (ANOVA). Pair‐wise comparisons of means were carried out subsequent to ANOVA utilizing the Fisher Exact Test. Group 4 was significantly different from all other groups. Additionally, group 2 significantly differed from group 1.Conclusions: The extent of lymphadenectomy achieved by neck dissection decreases as the number of nonlymphatic structures preserved in the neck increases. The impact of this finding on the pathologic staging or prognosis needs further analysis.
In Situ Identification of Normal Visceral Tissues Using Contact Telescopic Microscopy
Authors: Richtsmeier William J. , Huang Patti , Scher Richard L. 
Published: November 2003

AbstractObjectives: To improve the intraoperative anatomic identification of normal tissues during surgery using histologic‐like criteria. Study Design: A contact telescope was used to identify normal visceral tissues in an animal model using pigs and dogs during routine human surgical procedures. Methods: Tissues that could be identified grossly were stained topically with methylene blue and then examined with the contact telescope. The histologic appearance of these tissues with the contact telescope was correlated with routine histologic hematoxylin and eosin stains obtained after such tissues were excised. Results: Normal tissues, such as fat, blood vessels, muscle, and parathyroid tissue, can be identified reliably in animals and humans. The contact telescope appears to be able to differentiate between a variety of visceral tissues in the neck and may become useful for practical differentiation between tissues during surgery.
Multidimensional Assessment of Voice Characteristics After Radiotherapy for Early Glottic Cancer
Authors: Verdonck‐De Leeuw Irma M. , Hilgers Frans J. M. , Keus Ronald B. , Koopmans‐Van Beinum Florien J. , Greven An J. , De Jong Jos M. A. , Vreeburg Gerard , Bartelink Harry 
Published: November 2003

AbstractObjectives/Hypothesis: To assess voice characteristics of patients following radiotherapy for early glottic cancer through a multidimensional analysis protocol including vocal function and voice quality measures. Methods: Voice analyses were performed for 60 patients treated with radiotherapy (66 Gy/33 fractions, 60 Gy/30 fractions, or 60 Gy/25 fractions) for early T1 glottic cancer and 20 matched control speakers. There was a longitudinal group of 10 patients for whom data were collected before as well as 6 months and 2 years after radiation. Furthermore, data were collected for five separate groups of 10 patients each, before, 6 months after, 2 years after, 3 to 7 years after, and 7 to 10 years after radiation. Vocal function was investigated by means of videolaryngostroboscopy, phonetography, maximum phonation time, and phonation quotient measures. Voice quality was assessed by means of objective acoustical analysis and subjective perceptual ratings by trained raters. Results: Voice characteristics of patients were decreased before radiotherapy, improved after treatment, and became comparable to the voice characteristics of control speakers in at least 55% of the patients. Following radiotherapy, deviant voice quality was mainly negatively affected by increased age and stripping the vocal cord for initial diagnosis. Stroboscopy revealed that next to increasing age and stripping the vocal cord, continued smoking after treatment decreased vocal function following radio‐therapy. Conclusion: Voices of patients diagnosed with early glottic cancer improved but did not normalize fully after radiotherapy. Stripping the vocal cord for initial diagnosis and continued smoking after treatment decreased voice characteristics. A multidimensional analysis protocol including perceptual and acoustical analysis of voice quality and stroboscopic analysis of vocal function is recommended to investigate voice characteristics following treatment for early glottic cancer.
Evidence for Laryngeal Paralysis in Cricoarytenoid Joint Arthritis
Authors: Gacek Richard R. , Gacek Mark R. , Montgomery William W. 
Published: November 2003

AbstractObjective/Hypothesis: To demonstrate denervation atrophy of laryngeal muscles in a case of gout involving the cricoarytenoid joint. Methods: The posterior cricoarytenoid (PCA) and arytenoideus (A) muscles from a 72‐year‐old man with extensive gout were compared with those from a normal adult larynx (age and sex unknown) using stereologic techniques for changes in muscle composition and fiber diameter. Results: The PCA and A muscles in the gout specimen contained changes Indicative of muscle degeneration. In the PCA the volume fraction (VF) of intact muscle was 0.30, of degenerating muscle 0.13, and of fat 0.16. A normal PCA had a VF for intact muscle of 0.64 and 0 for degenerating muscle and fat. Similar changes were seen in the gout A muscle but were not measured. Muscle fiber diameters in the gout PCA (1,024 fibers) showed a significantly higher atrophy and hypertrophy factor than the normal PCA (1,255 fibers). The variability coefficient in the gout PCA (487) was almost double that in the normal PCA (290). Although muscle fiber diameters were not measured in the A muscle in gout, variability in fiber size was seen. Conclusions: The pattern and magnitude of muscle fiber degeneration in the PCA and A muscles from a larynx with gout fixation of the cricoarytenoid joint indicate neural degeneration. Since similar changes were not found in the thyroarytenoid (TA) and lateral cricoarytenoid (LCA), the neuropathy is selective for the posterior branch of the recurrent laryngeal nerve. This neuropathy is likely responsible for vocal cord adduction (stridor) and incomplete closure of the posterior commissure (aspiration) associated with acute cricoarytenoid arthritis. In chronic cricoarytenoid joint arthritis, ankylosis of the joint space maintains the adducted cord position.
Vascular Anomalies Causing Symptomatic Tracheobronchial Compression
Authors: Mclaughlin Robert B. , Wetmore Ralph F. , Tavill Michael A. , Gaynor J. William , Spray Thomas L. 
Published: November 2003

AbstractObjectives/Hypothesis: To review the clinical presentation and diagnostic evaluation of patients with symptomatic congenital vascular anomalies causing tracheobronchial compression and to establish the short‐ and long‐term results of surgical intervention with respect to postoperative complications, persistent symptoms, and ventilator and tracheostomy dependence. Study Design: Retrospective review. Methods: Chart review and telephone follow‐up. Results: Between 1987 and 1996, 35 children underwent surgical intervention to relieve symptomatic tracheobronchial compression resulting from a congenital vascular anomaly. Historically, the onset of symptoms occurs within the first months of life; however, only 12 (34%) of patients were diagnosed by 6 months of age and 13 (37%) were diagnosed at greater than 1 year of age. Excluding anomalous innominate artery, chest radiography or barium swallow was suggestive of a congenital vascular anomaly in 30 (94%) of the patients. Magnetic resonance imaging correctly delineated the anatomy of the vascular anomaly in 29 patients. Bronchoscopy was diagnostic in all three patients with anomalous innominate arteries causing tracheal compression. Postoperative follow‐up was obtained in 32 (91%) of patients; 25 (78%) of these were asymptomatic at the time of their most recent examination. The remaining patients had persistent stridor, recurrent respiratory tract infections, and/or chronic cough. In all three patients who underwent postoperative bronchoscopy for persistent symptoms, tracheomalacia was demonstrated in the region of previous compression. Conclusions: Tracheobronchial compression from congenital vascular anomalies is a rare but treatable cause of respiratory symptoms. Early diagnosis requires a prompt, thorough clinical and radiologic evaluation. Surgery affords excellent long‐term resolution of symptoms.
Isolated Nasalis Muscle Reconstruction in Secondary Unilateral Cleft Lip Nasal Reconstruction
Authors: Bagatain Marijo , Khosh M. Morad , Nishioka Gary , Larrabee Wayne F. 
Published: November 2003

AbstractObjectives/Hypothesis: Reconstruction of the nasalis muscle in the unilateral cleft lip nasal deformity improves surgical results. Study Design: A retrospective analysis of a series of 112 consecutive procedures. Methods: Chart review and analysis of standardized preoperative and postoperative clinical photographs. Results: Patients treated with this technique had improved contour of the alar base compared with historical controls. Conclusion: Nasalis muscle reconstruction should be considered in the repair of the moderate to severe unilateral cleft nose deformity.
Hearing Loss With a Mitochondrial Gene Mutation Is Highly Prevalent in Japan
Authors: Oshima Takeshi , Ueda Narihisa , Ikeda Katsuhisa , Abe Koji , Takasaka Tomonori 
Published: November 2003

AbstractObjectives/Hypothesis: Mutations in the mitochondrial genome may predispose people to sensorineural hearing loss. An adenine to guanine point mutation in the tRNALeu(UUR) gene at nucleotide 3,243 is one of the deaf‐related mutations. This mutation is reported to be associated with 0.9% of diabetes mellitus patients. However, the prevalence of this mutation in hearing‐impaired patients still remains unknown. The aim of this study was to determine the prevalence of this mutation among bilaterally sensorineural hearing‐impaired patients in Japan. Study Design: Retrospective survey of 100 patients with bilateral sensorineural hearing loss without any evident causes. Methods: Mitochondrial DNA fragments from the patients were amplified by polymerase chain reaction, followed by a restriction enzyme fragment length polymorphism method. Results: Three patients with this mutation were identified. Their clinical profiles were different from the category which had been considered as hearing loss caused by this mitochondrial gene mutation. Conclusions: The mutation is associated with approximately 3% of bilateral sensorineural hearing loss cases of unknown origin and is possibly distributed widely in sensorineural hearing‐impaired patients in Japan.
Effects of medialization laryngoplasty on airway resistance: A pilot study
Authors: O'Grady Kevin F. , Irish Jonathan C. , Doyle D. John , Gullane Patrick , Butany Jagdish 
Published: November 2003

AbstractObjective: To investigate the effects of medialization laryngoplasty on laryngeal airway resistance at various clinically relevant flow rates. Study Design: This study was conducted using a total of 13 laboratory experiments. Two of the experiments were used to validate the cadaveric model employed. Eleven experiments were used to quantify airway resistance relative to increasing medialization laryngoplasty stent size. Methods: With autopsy consent the authors obtained 13 consecutive and anatomically complete larynges for experimentation. A thyrotomy window measuring 8 × 6 mm was made on the left side of the thyroid cartilage. A #4 laryngeal mask was secured to the pharyngeal airway with sutures. Eleven experiments were conducted at the same flow rates using increasingly larger stents from 1 mm to 11 mm in size. Using the Bernoulli equation, the pressure measured at the proximal end of the laryngeal mask is representative of the pressure drop across the airway. The experimental model was validated in two experiments using flow rates between 5 and 50 L/min and stents measured at 5, 10, 15, and 20 mm. Results: Average results from the 11 experiments indicate that at increasing levels of medialization, from 0 to 11 mm, there is essentially the same pressure drop across the larynx at a given flow rate. Conclusion: At physiologic airflow rates in a cadaveric model, medialization laryngoplasty implants of 11 mm or less seem to have no obvious effect on airway resistance.
Phonation threshold pressure measurements during phonation by airflow interruption
Authors: Jiang Jack , O'Mara Timothy , Conley David , Hanson David 
Published: November 2003

AbstractObjective/Hypothesis: Most methods to measure phonation threshold pressure (PTP) are clinically impractical because they are invasive. This report concerns an airflow interruption system developed to allow noninvasive estimation of (PTP) at different levels of vocal intensity. An estimation of PTP was made for normal subjects with normal larynges and no voice complaints and for individuals who had dysphonia associated with vocal polyps to compare the estimated minimal pressure across the glottis that was required to sustain phonation in the two conditions. Study Design: This was a methodological study designed to measure an unanticipated PTP from a subject. Methods: Subjects sustained a constant tone and the airflow was directed into a section of pipe with an airtight mask over the mouth and nose. The airflow, intramask pressure, and intensity of the acoustic output were recorded. A PTP was predicted from a difference between an estimate of the subglottal pressure and the vocal tract pressure at the point that phonation ceased after interruption of airflow. Eleven control subjects and 13 patients with vocal fold polyps were studied. In each population there were eight men and five women. The individuals in the group with vocal fold polyps averaged 39 years of age, and the control subject group averaged 49 years of age. Normal subjects produced a steady vowel /a/ at 75, 80, and 85 dB. Patients with polyps were unable to sustain phonation at these levels but were able to produce phonation at 65, 70, and 75 dB. The validity of the system was tested using a laryngeal model and in a patient with a normal larynx and voice who had a tracheotomy (placed for sleep apnea syndrome) which allowed direct measurement of subglottal pressure. Results: The measured mean PTP levels (with standard deviation [SD]) for the control subjects were 2.38 (1.273), 2.67 (1.879), and 2.98 (2.23) cm H2O at 75, 80, and 85 dB, respectively. The measured mean PTP levels (with SD) for the patients with polyps were 4.79 (2.67), 5.85 (2.34), and 7.37 (3.26) cm H2O at 75, 80, and 85 dB, respectively. The differences in mean PTP between groups at 75, 80, and 85 dB were significant at P = .013, P = .017, and P = .010, respectively. Conclusions: The estimations of PTP for patients with vocal fold polyps were significantly higher than for the control subjects at three phonation levels.
Effect of pharyngeal stimulation on the motor function of the esophagus and its sphincters
Authors: Bardan Eytan , Saeian Kia , Xie Pengyan , Ren Junlong , Kern Mark , Dua Kulwinder , Shaker Reza 
Published: November 2003

AbstractObjectives/Hypothesis: Sensory impulses from the pharynx induce contraction of the upper esophageal sphincter CUES), relaxation of the lower esophageal sphincter (LES), and inhibition of peristalsis. To determine 1) the magnitude of UES contractile response to threshold volume of fluid that induces LES relaxation and 2) the effect of rapid pharyngeal air stimulation on LES resting pressure and its concurrent influence on the UES and progression of esophageal peristalsis. Methods: Eleven healthy volunteers (age, 31 ± 2 y) were studied by concurrent UES, esophageal‐body, and LES manometry. Results: At a threshold volume of 0.3 ± 0.05 mL, injections of water into the pharynx directed posteriorly, resulted in complete LES relaxation. Duration of these relaxations averaged 19 ± 1 seconds. In 10 of 11 subjects, these relaxations were accompanied by a simultaneous increase in UES resting tone that averaged 142% ± 27% above preinjection values. Pharyngeal stimulation by rapid air injection resulted in complete LES relaxation in ft of the 11 subjects (threshold volume, 14 ± 6 mL). Five of 8 developed a concurrent mild increase in resting UES pressure (17% ± 6% above preinjection values) (P < .05). Pharyngeal water injection inhibited the progression of the peristaltic pressure wave at all tested sites and in all subjects, but pharyngeal air injection in only 2 of the 11 studied subjects. Conclusions: The inhibitory effect of pharyngeal water injection on LES resting pressure is accompanied by a substantial contractile effect on the UES. Although stimulation of the pharynx by rapid air injection may induce LES relaxation, its inhibitory effect on esophageal peristalsis and stimulatory effect on UES pressure are negligible compared with that of water injection.