bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Positron Emission Tomography on the Initial Staging and Therapy in Locoregional Advanced Squamous Cell Carcinoma of the Head and Neck
Authors: Schmid Daniel T. , Stoeckli Sandro J. , Bandhauer Florian , Huguenin Pia , Schmid Stephan , von Schulthess Gustav K. , Goerres Gerhard W. 
Published: November 2003

AbstractObjective To evaluate the impact of 18F‐fluoro‐deoxy‐glucose positron emission tomography after standard diagnostic workup in patients with advanced head and neck squamous cell carcinoma on staging and radiation treatment planning.Study Design Prospective controlled study.Methods Forty‐eight patients (42 men and 6 women; mean age, 61 y; age range, 35–85 y) with histologically confirmed, advanced‐stage (any T, N≥N2 or T≥T3, any N) mucosal head and neck squamous cell carcinoma underwent positron emission tomography. The routine workup consisting of physical examination, panendoscopy, chest x‐ray film, and contrast‐enhanced high‐resolution helical computed tomography scan (HRCT) was used for comparison. End points were the extent of lymph node disease, distant metastases, and second primary tumors.Results In 41 of 48 patients (85%) the lymph node findings between HRCT and positron emission tomography were concordant. In three patients positron emission tomography led to an upstaging of the tumor in its N category, and in four patients positron emission tomography underestimated lymph node involvement. Positron emission tomography revealed more difficulties in delineating lymph node metastases adjacent to the primary tumor than did HRCT, but was superior for the detection of distant and contralateral lymph node metastases. Positron emission tomography suggested distant metastatic lesions in 6 of 48 patients (13%). Cytological workup confirmed distant metastases in two (4%) and second primary tumors in another two patients (4%). Positron emission tomography results were false‐positive in two (4%) patients because of inflammatory changes.Conclusions Whole‐body PET is able to assess lymph node involvement, distant metastases, and second primaries in a single study. Even after a routine clinical staging, positron emission tomography leads to a change of treatment in approximately 8% of patients.
Endoscopic Staple Diverticulostomy for Zenker's Diverticulum: Review of Literature and Experience in 159 Consecutive Cases
Authors: Chang Christopher Y. , Payyapilli Rose J. , Scher Richard L. 
Published: November 2003

AbstractObjectives/Hypothesis Several reports since the early 1990s have advocated a minimally invasive technique, endoscopic staple diverticulostomy (ESD), to treat Zenker's diverticulum. However, long‐term results and comparisons with the reported experience with external or other endoscopic approaches have been lacking in the literature. We present follow‐up on our experience with ESD since 1995 and compare it with the results obtained by other endoscopic or external techniques for treatment of Zenker's diverticulum.Study Design Retrospective review of 159 consecutive ESD procedures performed on 150 unique patients with Zenker's diverticulum between March 1995 and August 2002. Telephone interviews of patients were conducted to assess long‐term treatment outcome. Review of the literature was performed by Ovid MEDLINE search for all reports on the surgical treatment of Zenker's diverticulum in the English language between January 1990 and August 2002.Methods Data were retrospectively reviewed and information was tabulated for age, sex, size of diverticulum, symptoms, duration of symptoms, operative time, length of hospital stay, time before oral intake, complications, and relief of symptoms at first postoperative visit. Follow‐up interviews of patients were conducted to assess current status of symptoms and, if any symptoms returned, how many months after the procedure they recurred. All case series in the literature in the English language since 1990 that were found in the Ovid MEDLINE database and referenced from identified articles were also tabulated for the same information.Results At the time of initial follow‐up after ESD, 98% of patients reported complete or improved symptoms. Average hospital stay was 0.76 days, with a diet started on postoperative day 0.25. There was a 2.0% significant complication rate without mortality. Further follow‐up (average, 32.2 mo) identified a recurrence rate of 11.8%. On review of the literature, patients who underwent ESD had shorter perioperative courses, quicker return to diet, and lower complication and mortality rates compared with external procedures. ESD had comparable operative times and mortality rates, but fewer complications and more rapid convalescent times compared with other endoscopic procedures. Recurrence rates were found to be variable.Conclusions Overall, ESD is an outpatient procedure with few complications. The technique has a faster operative and convalescence period with fewer complication rates compared with other endoscopic or external transcervical approaches. The results in the present study and those reported in the English language literature advocate that ESD be the initial preferred treatment for Zenker's diverticulum.
Fibronectin and Adhesion Molecules on Canine Scarred Vocal Folds
Authors: Hirano Shigeru , Bless Diane M. , Rousseau Bernard , Welham Nathan , Scheidt Troy , Ford Charles N. 
Published: November 2003

AbstractObjective To examine the expressions of fibronectin and other adhesion molecules on the scarred vocal folds in a short‐ and long‐term animal model.Study Design Animal model.Methods Six beagles' vocal folds were stripped unilaterally and left untreated. After wounding the vocal folds were harvested from three dogs at 2 months and three dogs at 6 months. The untouched vocal fold was used as a control, and the stripped vocal fold as scarred. Subsequently, the expressions of fibronectin, cadherin, syndecan‐1 and syndecan‐4 on both vocal folds were examined by immunohistochemical and image analysis.Results Compared with the control vocal folds, fibronectin significantly increased in the superficial layer of the lamina propria on the scarred vocal folds at both 2 and 6 months. Co‐deposition of collagen was observed only at 6 months. Syndecan‐4 was significantly overexpressed at the basal layer cells of the epithelium at both 2 and 6 months. No significant expression of either cadherin or syndecan‐1 was detected.Conclusions Scar characteristics at 2 and 6 months are not identical, suggesting that a 2‐month period may not be a sufficient to study vocal fold scarring. Adhesion molecules are important in reorganization of extracellular matrix during wound healing because of their binding and adhesion characteristics. The results indicate that fibronectin might be important in providing a scaffold for the deposition of other proteins such as collagen, and the binding characteristics might affect the stiffness of the scarred vocal fold. Prolonged expression of syndecan‐4 may reflect the role of focal adhesion during the assembly of scar structure. Ultimately, better understanding of the histological features of the scarred vocal fold might lead to new approaches to treatment.
Immunohistochemical Characterization of the Epidermoid Formation in the Middle Ear
Authors: Liang Jianning , Michaels Leslie , Wright Anthony 
Published: November 2003

AbstractObjective To study the incidence, size, and origin of epidermoid formations after accurately characterizing them by cytokeratin immunohistochemical analysis.Study Design A strategy of screening sections for possible epidermoid formations in the entire eardrum area in paraffin‐embedded, serially sectioned developing temporal bones was used. Unstained adjacent sections were subjected to immunohistochemical staining, to provide accurately identified epidermoid formations for a study of their appearance and size in relation to age.Methods The immunohistochemical expression patterns for epidermoid cytokeratins of several antibodies at different gestational ages were determined. Then, epithelial structures suspected as epidermoid formations were characterized as epidermoid with age‐appropriate antibodies in 36 paraffin‐embedded temporal bones from 19 cases with an age range of 6 gestational weeks to 15 months postpartum using a novel method of antigen retrieval by heating sections in a 70°C water bath.Results Each of 22 temporal bones ranging in age from 16 weeks gestation to 8 months postpartum contained one or more, often numerous, epidermoid formations. Sizes of epidermoid formations increased significantly with increasing age. The formations were found anywhere in the annular lateral wall region of middle ear, but the majority were in the anterosuperior region. A further study of the interface between annular external canal epidermis and middle ear epithelium in a larger group suggested that epidermoid formations arise at approximately 16 gestational weeks from the external canal epidermis.Conclusion The findings indicate that epidermoid tissue in the middle ear normally originates from external canal epidermis at approximately the 16th gestational week and grows before disappearing.
Hereditary Paraganglioma Due to the SDHD M1I Mutation in a Second Chinese Family: A Founder Effect?
Authors: Lee Soo‐Chin , Chionh Siok‐Bee , Chong Siew‐Meng , Taschner Peter E. M. 
Published: November 2003

AbstractObjectives/Hypothesis Hereditary paraganglioma is a rare condition that is inherited in an autosomal‐dominant fashion. Four distinct loci have been associated with hereditary paraganglioma, including the SDHD, SDHC, and SDHB genes and a locus at 11q13. The SDHD, SDHC, and SDHB genes code for subunits of succinate dehydrogenase, which forms part of the mitochondrial respiratory chain. SDHD mutations are widely distributed along the gene with no apparent hot spots, although a founder effect has been described in the Dutch population.Methods Following a prior report of the SDHD M1I mutation in an Australian Chinese family, a second Chinese family with the same mutation is reported. The proband developed bilateral head and neck paragangliomas at age 34 years and a functioning adrenal pheochromocytoma and two extra‐adrenal abdominal paragangliomas 7 years later. His brother had unilateral head and neck paraganglioma at age 39 years. Given the multicentricity of the proband's tumor and the familial clustering of paragangliomas, a clinical diagnosis of hereditary paraganglioma was made, and the proband was tested for a mutation in the SDHD gene.Results The proband was found to be heterozygous for the SDHD MII mutation that removes the start codon, and his brother subsequently tested positive for the same mutation. The family is not related to the Australian Chinese family.Conclusion The finding suggests the possibility of a founder effect in the Chinese population and warrants further investigation.
Bile Acid Induces Cyclo‐Oxygenase‐2 Expression in Cultured Human Pharyngeal Cells: A Possible Mechanism of Carcinogenesis in the Upper Aerodigestive Tract by Laryngopharyngeal Reflux
Authors: Sung Myung‐Whun , Roh Jong‐Lyel , Park Bum Jung , Park Seok Woo , Kwon Tack‐Kyun , Lee Sang Joon , Kim Kwang Hyun 
Published: November 2003

AbstractObjectives/Hypothesis Laryngopharyngeal reflux is a common event in patients with head and neck cancer. Bile acid is known to be related to tumor formation in the esophagus through the overexpression of cyclo‐oxygenase‐2 (COX‐2), an enzyme that produces prostanoids. To better understand the mechanism of the laryngopharyngeal reflux–cancer connection, we examined COX‐2 expression by bile acid in cultured human pharyngeal mucosa cells.Methods COX‐2 expression induction by various combinations of chenodeoxycholate and acidity was observed by Western blotting and reverse transcriptase–polymerase chain reaction. COX‐2 promoter activity was also measured by luciferase promoter assay.Results Chenodeoxycholate, one of the bile acid components, was found to induce COX‐2 expression in human pharyngeal cells. Moreover, the induction of COX‐2 by chenodeoxycholate was enhanced by acidity in a dose‐dependent manner, and the promoter activity of COX‐2 was increased by chenodeoxycholate in SNU‐1041, a human laryngeal cancer cell line, whereas the transcription of COX‐2 was inhibited by actinomycin‐D.Conclusion Bile salts or acidic conditions, or both, can induce COX‐2 expression in normal pharyngeal mucosa, which implies that laryngopharyngeal reflux has a role in the tumorigenesis of the upper aerodigestive tract.
Noise in Magnetic Resonance Imaging: No Risk for Sensorineural Function But Increased Amplitude Variability of Otoacoustic Emissions
Authors: Wagner Wolfgang , Staud Irene , Frank Gerhard , Dammann Florian , Plontke Stefan , Plinkert Peter K. 
Published: November 2003

AbstractObjectives Objectives were to perform exact measurements of the noise exposure in a magnetic resonance imager and to investigate the effects of magnetic resonance imaging (MRI) noise on hearing sensitivity, which are still controversial, in a large number of patients.Study Design Prospective trial.Methods Acoustic noise during seven different MRI sequences was measured using a custom‐made microphone containing no ferromagnetic parts. In 244 ears of 126 patients, pure‐tone audiometry was performed once before and once after MRI noise, and distortion product otoacoustic emissions were measured once before and three times after MRI.Results The sound pressure level (SPL) at the patient's ear (with consideration of the sound‐damping effect of the head support) ranged from 79.5 to 86.5 dB (A), depending on the MRI sequence, with brief sound pressure peaks up to 120 dB SPL. No significant incidence of temporary threshold shift and no reduction of mean distortion product otoacoustic emission amplitude were apparent. However, a significant increase in distortion product otoacoustic emission amplitude variability after noise exposure with equal distribution of increased and decreased amplitudes was observed. This variability showed a maximum at 15 minutes after noise, as demonstrated by continuous measurements.Conclusions First, MRI noise does not impose a risk to hearing function under the measurement condition of a sound‐damping head support or ear protectors. Second, a subtle effect is demonstrated by increased distortion product otoacoustic emission amplitude variability. Third, the increased otoacoustic emission amplitude variability is an audiometric parameter that is extremely sensitive to effects of acoustic stimulation, indicating more discrete changes in cochlear activity than pure‐tone audiometry or otoacoustic emission amplitude reduction. A shift of the operation point (OP) of the outer hair cell (OHC) between basilar membrane and tectorial membrane is suggested as underlying cause.
Preliminary Results With the Use of AlloDerm in Chronic Otitis Media
Authors: Fayad Jose N. , Baino Tony , Parisier Simon C. 
Published: November 2003

AbstractObjectives/Hypothesis AlloDerm, an acellular dermal graft, has been used successfully as a material for soft tissue implantation. The authors report their experience with the use of AlloDerm in the reconstruction of the tympanic membrane.Study Design Case review study.Methods Charts were reviewed for all patients who underwent tympanoplasty with and without mastoidectomy between June 1999 and June 2002 in whom AlloDerm was used as a grafting material. There were 24 patients, 17 with simple perforations (8 revisions) and 7 with chronic otitis media with cholesteatoma (6 revisions). Success was defined as closure of the tympanic membrane perforation.Results Closure of the perforation using AlloDerm was achieved in 87.5% of the patients (ie, in all but three patients). Another patient developed serous otitis media and required a myringotomy tube in the postoperative period.Conclusions The success rate for AlloDerm in tympanoplasty was similar to that of temporalis fascia in the authors' experience. AlloDerm can provide a suitable grafting material when fascia is not available or when the size of the defect precludes the use of fascia.
Incidence, Etiology, and Management of Cerebrospinal Fluid Leaks Following Trans‐Sphenoidal Surgery
Authors: Shiley Samuel G. , Limonadi Farhad , Delashaw Johnny B. , Barnwell Stanley L. , Andersen Peter E. , Hwang Peter H. , Wax Mark K. 
Published: November 2003

AbstractObjectives/Hypothesis The incidence of cerebrospinal fluid (CSF) leak following trans‐sphenoidal surgery ranges from 0.5% to 15.0%. Factors predicting which patients are likely to develop postoperative leaks and optimal management of these patients are poorly defined. The objective was to determine 1) the incidence of CSF leak following trans‐sphenoidal surgery; 2) demographic or intraoperative factors associated with postoperative leaks; 3) techniques and efficacy of postoperative leak management at Oregon Health and Science University, (Portland, OR).Study Design Retrospective chart review.Methods Two hundred thirty‐five trans‐sphenoidal surgeries were performed on 216 patients between 1994 and 2001. Follow‐up data were available for 217 operations (92.3%) performed on 202 patients (93.5%).Results Postoperative CSF leaks occurred in 6.0% (13 of 217) of patients. Leaks were more common in the setting of revision surgery versus primary surgery (14.6% vs. 4.0%, P = .0096), nonadenomatous disease versus pituitary adenoma (15.8% vs. 5.1%, P = .059), or if an intraoperative leak occurred (12.7% vs. 2.7%, P = .004). However, on multivariate analysis, only the presence of intraoperative leak (P = .008) and nonadenomatous disease (P = .047) were found to be independently associated with postoperative CSF leak. Size of adenoma was not associated with occurrence of postoperative CSF leak (6.4% for microadenoma vs. 4.2% for macroadenoma) on both univariate and multivariate analysis. There were 13 postoperative CSF leaks: 2 resolved with lumbar drainage and 11 required operative management (three required multiple procedures). Of the three patients who required multiple operations, two had hospital courses complicated by meningitis and postinfectious hydrocephalus and ultimately required ventriculoperitoneal shunts. Endoscopic re‐exploration was successful in 87.5% (7 of 8) of cases.Conclusions Cerebrospinal fluid leaks following trans‐sphenoidal surgery occurred in 6.0% of cases. Nonadenomatous disease and presence of an intraoperative leak were independent predictors of a postoperative leak. Endoscopic re‐exploration combined with packing was an effective technique in managing uncomplicated postoperative leaks. In the setting of meningitis and postinfectious hydrocephalus, more invasive techniques such as ventriculoperitoneal shunt may be necessary.
The Impact of Malignant Disease on Facial Nerve Function After Parotidectomy
Authors: Ellingson Todd W. , Cohen James I. , Andersen Peter 
Published: November 2003

AbstractObjectives/Hypothesis Studies of immediate postoperative facial nerve function following parotidectomy focus on benign disease. The purpose of the study was to compare facial nerve function with regard to benign or malignant disease in patients undergoing superficial parotidectomy.Study Design Retrospective cohort study of consecutive patients undergoing parotidectomy between 1995 to 2002.Methods House‐Brackmann (HB) grade was recorded or assigned at the first postoperative visit. For patients with HB grade of III or greater, final resolution of facial nerve function was recorded. A χ2 analysis for independence was conducted between patients with HB grade of II or less and those with HB grade of III or greater and final pathological finding (benign vs. malignant disease). Mean and median times to resolution were determined for patients with HB grade of III or greater. Times to resolution for benign and malignant disease for those with HB grade of III or greater were compared (Kaplan‐Meier method).Results Sixty‐seven patients with benign disease and 52 with malignant disease were included. Ninety‐four percent of patients with benign disease had HB grade of II or less at first postoperative visit (mean period, 11.6 d) compared with 76.9% of patients with malignant disease (mean period, 12.4 d). A χ2 analysis found this difference significant (χ2 = 7.36, P = .0067). Time to resolution for HB grade of III or greater was 253.8 days (±168.2 d) with median time of 229.5 days for benign disease and 182.4 days (±134.6 d) with median time of 138 days for malignant disease. Kaplan‐Meier comparison found no significant differences in time to final resolution (P = .83). Three patients in the group with malignant disease had unresolved dysfunction (one patient for >2 y).Conclusions Patients with benign disease have a greater chance of having HB grade of II or less immediately following surgery; however, whether the disease is benign or malignant, long‐term final facial nerve function is the same.
Tacrolimus and Mycophenolate Mofetil Provide Effective Immunosuppression in Rat Laryngeal Transplantation
Authors: Nelson Marc , Fritz Michael , Dan Olivia , Worley Sarah , Strome Marshall 
Published: November 2003

AbstractObjectives/Hypothesis Tacrolimus is efficacious in several transplantation settings. Some studies have demonstrated improved results using combination therapy with mycophenolate mofetil. Our primary objective was to evaluate the efficacy and optimal dosing of tacrolimus in preventing rejection, using an established rat model of laryngeal transplantation. Further, the ability of mycophenolate to allow lower dosing of tacrolimus while achieving equivalent immunosuppression was investigated.Study Design A dosage efficacy study with 10 experimental arms was conducted.Methods Dosage groups were 0.1, 0.2, 0.3, and 0.6 mg/kg tacrolimus alone and 0.1 mg/kg tacrolimus combined with 15 mg/kg mycophenolate mofetil, 0.1 mg/kg tacrolimus combined with 30 mg/kg mycophenolate mofetil, 0.1 mg/kg tacrolimus combined with 40 mg/kg mycophenolate mofetil, 0.2 mg/kg tacrolimus combined with 15 mg/kg mycophenolate mofetil, 0.2 mg/kg tacrolimus combined with 30 mg/kg mycophenolate mofetil (30 d only), and 0.2 mg/kg tacrolimus combined with 40 mg/kg mycophenolate mofetil. Each group contained 8 to 10 rats. Grafts were harvested for histopathological analysis on day 15 or 30 after transplantation. Histopathological appearance of the graft was blindly graded according to an established scale. Dosage groups were compared on rejection score using Wilcoxon's rank sum test and the Jonckheere‐Terpstra test for trend.Results There was a significant association between increasing dose of tacrolimus and decreasing rejection score at both 15 and 30 days (P <.001). In the groups treated with 0.1 mg/kg T, an increasing dose of mycophenolate was associated with lower rejection scores at both 15 and 30 days (P = .001). In the group treated with 0.2 mg/kg T, there was no evidence that the addition of mycophenolate resulted in lower rejection at 15 days. However, at 30 days, combination therapy with increasing doses of mycophenolate was associated with decreasing rejection score (P = .002).Conclusions Tacrolimus is an effective immunosuppressive agent for laryngeal transplantation. Mycophenolate mofetil allows lower doses of tacrolimus to be used while preserving graft viability in the early post‐transplantation period.