bluuebunny/crossref_metadata_2025_split huggingface dataset:
Supracricoid Laryngectomy with CHEP: Functional Results and Outcome
Authors: Lima Roberto A. , Freitas Emilson Q. , Kligerman Jacob , Dias Fernando L. , Barbosa Mauro M. , Sa Geraldo M. , Santos Izabella C. , Farias Terence 
Published: February 2003

OBJECTIVESTo assess whether supracricoid laryngectomy with cricohiodoepiglottopexy could successfully reach the cure and preserve the voice in glottic laryngeal cancer, we studied 27 patients with T2/T3 squamous cell carcinoma of the larynx treated in our institution with cricohiodoepiglottopexy.STUDY DESIGNA retrospective analysis has been carried out between 1995 through 1997. We classified 11 patients as T2N0M0 and 16 patients as T3N0M0. Nineteen patients had bilateral selective lateral neck dissection, 3 patients had unilateral lateral neck dissection, and 5 patients had undissected neck. Survival was analyzed under the Kaplan‐Meyer method.RESULTSFive patients had postoperative complications, 2 were treated with a total laryngectomy. The remaining 25 patients kept the normal airway, swallowing, and speech. None of the patients in the neck dissection group had neck metastasis. Two patients had recurrences, 1 with local recurrence was treated with a total laryngectomy and is alive without disease; the other patient had neck recurrence, was treated with radical neck dissection plus radiotherapy, and is dead of the disease. One patient had a second tumor in oropharynx treated with palliative radiotherapy and is dead of the disease. Three years disease‐free survival was 75% for T2 and 79% for T3.CONCLUSIONSThis technique is useful in the treatment of selected cases of T3/T2 glottic cancer regarding the extent of disease. The incidence of complications in need of a complete laryngectomy does not compromise the functionality of this technique. The survival is comparable to patients who submitted to total laryngectomy and near‐total laryngectomy, regarding the extent of the lesion.
Extrathyroid Spread in Papillary Carcinoma of the Thyroid: Clinicopathological and Prognostic Study
Authors: Ortiz S. , Rodríguez J. M. , Soria T. , Pérez‐Flores D. , Piñero A. , Moreno J. , Parrilla P. 
Published: February 2003

INTRODUCTIONThe extrathyroid spread (ETS) is one of the risk factors that influence mortality and recurrence in patients with papillary carcinoma of the thyroid (PCT). The aim of this study is to analyze the clinical and histologic features and follow‐up of a series of patients with ETS undergoing surgery for PCT and to identify patients with a greater risk of presenting with ETS.MATERIAL AND METHODSRetrospective study of a series of 200 patients undergoing surgery for PCT, of whom 47 (23.5%) presented with ETS. The clinical and histologic features and follow‐up of the patients with ETS were compared with those without ETS using the Pearson χ2 test. We used a logistics regression model to perform a multivariant analysis for ETS. The survival and disease‐free interval rates were calculated using the Kaplan‐Meier method.RESULTSETS is most associated with patients over 50 years of age, with tumors over 4 cm that are not encapsulated, with lymph node metastasis, and with certain PCT histologic subtypes after the multivariant analysis. The overall rate of recurrence and mortality in patients with ETS was much higher than in patients without ETS.CONCLUSIONSPCT patients with ETS have a greater risk of tumor‐related recurrence and mortality than patients without ETS. There are patients with certain clinical and histologic features who have a greater risk of presenting with ETS.
A Tongue Suspension Suture for Obstructive Sleep Apnea and Snorers
Authors: Woodson B. Tucker 
Published: February 2003

OBJECTIVEA tongue suture is postulated to prevent tongue base collapse in obstructive sleep apnea (OSA) and snoring. This procedure uses a permanent tongue base suture to support the pharynx and lessen collapse. This study evaluates 2‐month results in 28 OSA and snoring patients.STUDY DESIGN AND SETTINGSForty‐three patients have been enrolled in a multi‐institutional prospective open enrollment study using the “Repose” bone screw system. Subjects were evaluated using polysomnography measures of general health (SF‐36), snoring, and sleep (Epworth Sleepiness Scale and Functional Outcomes of Sleep) performed before and again 2 months after treatment.RESULTSIn 14 OSA patients (Apnea + Hypopnea (AHI) > 15) and 14 snorers (AHI <15), no change was noted in sleep architecture or lowest oxygen saturation. AHI decreased in OSA (35.4 + 13.7 to 24.5 + 14.5, P < 0.00), but not in snorers. AHI decreased in the lateral (16.5 + 16.5 to 3.8 + 6.4, P < 0.01) but not the supine position. Epworth Sleepiness Scale, Functional Outcomes of Sleep, and snoring scales improved. Snoring decreased but remained bothersome to the bed partner.CONCLUSIONSA tongue suspension suture partially reduces the respiratory severity of OSA. Small changes are noted in symptoms of sleepiness, snoring, and functional outcomes. Demonstration of efficacy of the technique and device will require further controlled trials.
Meta‐Analysis of Tympanostomy Tube Sequelae
Authors: Kay David J. , Nelson Magalie , Rosenfeld Richard M. 
Published: February 2003

OBJECTIVETo estimate the incidence of tympanostomy tube sequelae based on systematic review of published case series and randomized studies.DATA SOURCESEnglish‐language MEDLINE search from 1966 through April 1999 with manual reference search of proceedings, articles, reports, and guidelines.STUDY SELECTIONCohort studies with otitis media as the primary indication for tube placement.DATA EXTRACTIONTwo reviewers independently extracted data from 134 articles.DATA SYNTHESISTransient otorrhea occurred in 16% of patients in the postoperative period and later in 26%; recurrent otorrhea occurred in 7.4% of patients and chronic otorrhea in 3.8%. Sequelae of indwelling tubes included obstruction (7% of ears), granulation tissue (5%), premature extrusion (3.9%), and medial displacement (0.5%). Sequelae after tube extrusion included tympanosclerosis (32%), focal atrophy (25%), retraction pocket (3.1%), cholesteatoma (0.7%), and perforation (2.2% with short‐term tubes, 16.6% with long‐term tubes). Meta‐analysis showed that long‐term tubes increased the relative risk of perforation by 3.5 (95% CI, 1.5 to 7.1) and cholesteatoma by 2.6 (95% CI, 1.5 to 4.4). Similarly, intubation increased the relative risk of tympanosclerosis by 3.5 (95% CI, 2.6 to 4.9) and focal atrophy by 1.7 (95% CI, 1.1 to 2.7) over nonintubated control ears (baseline tympanosclerosis and atrophy rates of 10% and 14%, respectively).CONCLUSIONSSequelae of tympanostomy tubes are common but are generally transient (otorrhea) or cosmetic (tympanosclerosis, focal atrophy). Nonetheless, the high incidence suggests a need for ongoing otologic surveillance of all patients with indwelling tubes and for a reasonable time period after tube extrusion. Long‐term tubes should be used on a selective and individualized basis.
A New Laser Treatment for Vocal Cord Papilloma—585‐nm Pulsed Dye
Authors: Valdez Tulio A. , Mcmillan Kathleen , Shapshay Stanley M. 
Published: February 2003

OBJECTIVESMicrovascular targeting with the 585‐nm pulsed dye laser (PDL) may provide a new form of therapy to control symptoms caused by recurrent respiratory papillomatosis (RRP).METHODSTen patients with RRP underwent 13 procedures under general anesthesia with the 585‐nm PDL. A micromanipulator (11 procedures) and a flexible nasolaryngoscope (2 procedures) were used to deliver the laser pulses. Patients were followed postoperatively according to protocol.RESULTSClinical examination revealed regression of papillomas in all patients. Seven patients had complete regression after PDL surgery, and 2 patients had partial response to treatment. One patient was lost to follow‐up. No complications were present during this prospective nonrandomized pilot study.CONCLUSIONPatients treated with PDL experienced regression of their papillomas. PDL may provide patients with RRP with an alternative treatment without the risks associated with CO2 laser surgery. This procedure also has potential to be delivered on an outpatient basis with flexible fiberoptic laryngoscopes.
Potent Effector Function of Tumor‐Sensitized L‐Selectinlow T Cells against Subcutaneous Tumors Requires LFA‐1 co‐Stimulation
Authors: Seeley Brook M. , Barthel Steve W. , To Wyatt C. , Kjaergaard JØrgen , Plautz Gregory E. 
Published: February 2003

OBJECTIVEAnimal tumor models have demonstrated that adoptive transfer of tumor‐draining lymph node (TDLN) T lymphocytes can cure established tumors in many anatomic sites. However, subcutaneous tumors are relatively refractory and have required maximally tolerated doses of cells. The goals of this study were to determine whether a subset of TDLN T lymphocytes varying in expression of the cell adhesion molecule L‐selectin (CD62L) had augmented therapeutic efficacy and to determine the co‐stimulatory requirements for trafficking and anti‐tumor effector function.STUDY DESIGNTDLNs were recovered from mice bearing progressive MCA 205 fibrosarcomas, and the T lymphocytes were segregated into CD62Llow and CD62Lhigh subsets and activated ex vivo with anti‐CD3 mAb and IL‐2. Mice bearing established subcutaneous MCA 205 tumors were treated with activated T cell subsets and in some experiments with additional mAb against cell adhesion molecules.RESULTSAdoptive transfer of as few as 5 × 106 activated cells cured mice bearing 3‐day subcutaneous MCA 205 tumors initiated with 6 × 106 cells, and the tumors demonstrated a dense infiltrate of CD62Llow cells. In marked contrast, adoptive transfer of 10 times as many T cells derived from the reciprocal CD62Lhigh compartment had no effect on tumor growth. The effector function of the CD62Llow T cells was clearly dependent on co‐stimulation through the cell adhesion molecule LFA‐1, because anti‐LFA‐1 mAb completely abrogated the antitumor reactivity of the transferred cells against subcutaneous tumors and inhibited tumor infiltration. In contrast, blockade of ICAM‐1, VLA‐4, or VCAM‐1 had no inhibitory effect on the anti‐tumor function.CONCLUSIONThese studies demonstrate the high therapeutic activity of the CD62Llow subset of tumor‐draining LN T cells against subcutaneous tumors, a relatively refractory site, and confirm the essential role of LFA‐1 for effector T cell function.SIGNIFICANCEIdentification of the phenotype and requirements for effector function of T lymphocytes sensitized to tumor antigens has implications for clinical trials of adoptive immunotherapy for head and neck carcinoma using a similar approach.
A Prospective Observational Study of 5‐, 7‐, and 10‐day Antibiotic Treatment for Acute Otitis Media
Authors: Pichichero Michael E. , Marsocci Steven M. , Murphy Marie Lynd , Hoeger William , Francis Anne B. , Green John L. 
Published: February 2003

OBJECTIVETo compare 5‐, 7‐ and 10‐day duration of antibiotic therapy for acute otitis media (AOM) in children.STUDY DESIGN AND SETTINGProspective nonrandomized 1‐year evaluation of 3 treatment durations for AOM in a private pediatric setting. Outcomes assessed at 14 ± 4 days after start of therapy with clinical response categorized as cure, improvement, or failure.RESULTSA total of 2172 children were studied; 46.4% were ≤2‐years‐old. Antibiotics used were amoxicillin (61.9% of patients), trimethoprim/sulfamethoxazole (11.7%), cephalosporins (14.2%), amoxicillin/clavulanate (5.2%), and macrolides/azalides (4.8%). No overall difference in outcome was observed comparing the 5‐day (n = 707), 7‐day (n = 423), or 10‐day (n = 1042) treatments, including children ≤2‐years‐old. However, in the subset who had an episode of AOM in the preceding month, outcome differed; 5‐day treatment was followed by more frequent failure than 10‐day treatment (P < 0.001). In logistic regression analysis, variables identified as contributing to a cure were: >2‐years‐old (P < 0.0001), no AOM in the preceding month (P = 0.07), or preceding 12 months (P = 0.03).CONCLUSIONSOur study supports the transition from 10 to 5 days for standard AOM antibiotic treatment duration in most patients. A 10‐day regimen may be superior in children who have experienced an episode of AOM within the preceding month, a known risk factor for resistant bacterial infection in the otitis‐prone patient.
A Novel CD44 v3 Isoform is Involved in Head and Neck Squamous Cell Carcinoma Progression
Authors: Franzmann Elizabeth J. , Weed Donald T. , Civantos Francisco J. , Goodwin W. Jarrard , Bourguignon Lilly Y.W. 
Published: February 2003

OBJECTIVESCD44 comprises a family of isoforms involved in tumorigenesis. Here we investigate the role of CD44 isoforms in head and neck squamous cell carcinoma (HNSCC) progression.MATERIALS AND METHODSHNSCC specimens underwent reverse transcriptase‐polymerase chain reaction (RT‐PCR) followed by Southern blot analysis. After surface biotinylation, FaDu (hypopharyngeal HNSCC) and CD44v3‐transfected COS‐7 cells were CD44 antibody‐precipitated and compared by Western blot analysis. FaDu cells underwent double immunofluorescence staining and growth assays.RESULTSSouthern blot analysis suggested differential CD44v3 isoform expression in tumor and normal tissue. Cloning and sequencing revealed 2 novel CD44v isoforms. Western blot analysis suggested CD44v3 expression in COS‐7 transfectants and FaDu. Double immunofluorescence staining revealed colocalization of CD44v3 and actin in FaDu projections. Anti‐CD44v3 antibody decreased FaDu growth.CONCLUSIONHNSCC tissue and FaDu appear to express CD44v3 isoforms. These isoforms may promote tumorigenesis.CLINICAL SIGNIFICANCECD44v3 isoforms may be effective tumor markers and targets for HNSCC therapy.
Accuracy of Terminology and Methodology in Economic Analyses in Otolaryngology
Authors: Kezirian Eric J. , Yueh Bevan 
Published: February 2003

OBJECTIVEEconomic studies increasingly guide health care resource allocation decisions. Because rigorous adherence to accepted definitions and research techniques is critical to ensure accuracy, we evaluated the terminology and methods of otolaryngology economic analyses.STUDY DESIGNA total of 71 articles published from 1990 to 1999 in 6 peer‐reviewed otolaryngology journals with terms such as “cost‐effective” in their title or representing economic analyses were reviewed for terminology and use of established methodology guidelines.RESULTSOver half (35 of 66) of terms such as “cost‐effective” were used incorrectly, and 60% of articles (39 of 64) confused “charge” and “cost” data. Eleven percent (7 of 64) of papers specified the perspective of their analysis. About half (17 of 30) reported a summary measure such as a cost‐effectiveness ratio. Only one third (23 of 63) performed sensitivity analyses.CONCLUSIONAdherence to accepted definitions and research methods is inconsistent, although we did note moderate improvements in making the distinction between costs and charges, defining of study perspective, and performing sensitivity analysis.SIGNIFICANCEGreater attention to both terminology and methodology can enhance the quality of economic analyses and ultimately improve certain resource allocation decisions.
Long‐Term Histologic Effects of Inferior Turbinate Laser Surgery
Authors: Wexler David B. , Berger Gilead , Derowe Ari , Ophir Dov 
Published: February 2003

OBJECTIVEIn this study we sought to define the histologic changes produced by laser treatment of inferior turbinates.STUDY DESIGNEight inferior turbinates with prior laser treatment (mean, 26.8 months) were analyzed by light microscopy after turbinectomy for relief of refractory nasal obstruction. Histologic findings were compared with those of a group of 8 hypertrophic inferior turbinates that had no previous laser surgery.RESULTSLaser‐treated areas of the inferior turbinates demonstrated a histologically bland appearance, with marked diminution of seromucinous glands and relative preponderance of connective tissue matrix. Prominence of venous sinusoids was also significantly reduced in the laser‐treated areas. Surface epithelium including goblet cells was reconstituted over the areas of laser application.CONCLUSIONClinical laser surgery of the inferior turbinate produces striking long‐term histologic changes.SIGNIFICANCEThe data suggest a differential response of turbinate histologic components to application of laser energy, with the glandular component being particularly sensitive. Further correlative study is needed to clarify the clinical significance of laser‐induced histologic changes in inferior turbinates.
Association of 8p23 Deletions with Poor Survival in Head and Neck Cancer
Authors: Bockmühl Ulrike , Ishwad Chandramohan S. , Ferrell Robert E. , Gollin Susanne M. 
Published: February 2003

OBJECTIVEAllelic loss at 8p23 occurs frequently in head and neck squamous cell carcinoma. The objective of this study was to determine the prognostic importance of 8p23 loss.STUDY DESIGN AND SETTINGSWe tested 51 primary tumors and 19 lymph node metastases for loss of heterozygosity with 7 microsatellite polymorphisms at 8p23 and correlated the results with disease‐free interval and disease‐specific survival.RESULTSThe Kaplan‐Meier analysis demonstrated statistically significant association of 8p23 allelic loss with both shorter disease‐free interval and disease‐specific survival. For the pN stage, the log‐rank test indicated significance in correlation with the disease‐free interval, whereas the pT stage showed a significant correlation with disease‐specific survival. Multivariate analysis identified loss of heterozygosity at 8p23 as independent prognostic marker for disease‐free interval.CONCLUSIONOur data suggest that 8p23 allelic loss is associated with poor prognosis in head and neck squamous cell carcinoma and could be useful refining diagnosis of these tumors.
Kawasaki Disease Presenting as Cervical Lymphadenitis or Deep Neck Infection
Authors: Kao Hsiu‐Tsun , Huang Yhu‐Chering , Lin Tzou‐Yien 
Published: February 2003

OBJECTIVETo describe a group of patients with Kawasaki disease who had cervical lymphadenopathy as their dominant initial presentations.MATERIALS AND METHODSWe retrospectively reviewed the medical records of 14 children who were admitted to Chang‐Gung Children's Hospital between May 1996 and July 1998 with the initial impression of cervical lymphadenitis, cellulitis, and/or deep neck infection but for which a diagnosis of Kawasaki disease was established later.RESULTSFive (35.7%) patients were less than 5 months of age, and 8 (57.1%) patients were more than 53 months of age. The mean duration for establishing a diagnosis of Kawasaki disease from the onset of illness was 8.2 (6 to 20) days. Initially, empiric antibiotics were prescribed in each case with unsatisfactory response. Intravenous immune gamma globulin (2 g/kg) was administered in 13 patients. Three (21.4%) patients developed coronary artery lesions.CONCLUSIONIf a child less than 6 months or more than 4 years of age has a fever and an enlarged cervical lymph node and is unresponsive to empiric antibiotics, Kawasaki disease should be considered.
Short‐Lasting Drop Attacks in Meniere's Disease
Authors: Kentala E. , Havia M. , Pyykkö I. 
Published: February 2003

OBJECTIVESTo study the vertigo attacks known as Tumarkin attacks or drop attacks (DA). DA are characterized by sudden loss of balance with or without falls but with preserved consciousness, and they are supposedly triggered by changes in the otolith function of Meniere's disease (MD).STUDY DESIGN AND SETTINGData from 243 consecutive MD patients were collected into a database of an otoneurologic expert system.RESULTSDA was experienced by 72% (n = 173) of the patients with MD. It correlated with visually provoked vertigo. Gait difficulties, tinnitus, and anxiety were more common in the DA group. Long lasting vertigo attacks were more frequently provoked in the DA subjects by physical strain (58% vs 14%), head movements or changes in head position (71% vs 48%), pressure changes (54% vs 12%), or rapid movements in visual surroundings (65% vs 35%) than in the non‐DA subjects.CONCLUSIONDA are common in MD patients. The abrupt occurrence of DA make them poorly tolerated.SIGNIFICANCEDA are more common in advanced MD.
Ventral Approach to the Rat Middle Ear for Otologic Research
Authors: Pinilla Mayte , Ramírez‐Camacho Rafael , Jorge Eduardo , Trinidad Almudena , Vergara José 
Published: February 2003

OBJECTIVETo describe a simple approach to the rat middle ear because there are few clear descriptions of this technique with minimal morbidity and mortality.STUDY DESIGN AND SETTINGSix male Long‐Evans rats were used in this study. We designed a cervical approach to the middle ear with the purpose of creating an experimental model of ossiculoplasty that permits the postoperative survival of the animal.RESULTSIt was possible in all cases to visualize the majority of structures of the tympanic cavity: promontory, round window, stapedial artery, stapes, incus, and tympanic membrane. There were no cases of postoperative infection or facial paralysis.CONCLUSIONS AND SIGNIFICANCEThe ventral approach to the rat middle ear is a rapid and simple technique that makes the rat the animal of choice for many otologic investigations.
Diagnostic Accuracy of Fine‐Needle Aspiration and Frozen Section in Nodular Thyroid Disease
Authors: Mandell David L. , Genden Eric M. , Mechanick Jeffrey I. , Bergman Donald A. , Biller Hugh F. , Urken Mark L. 
Published: February 2003

OBJECTIVETo assess the diagnostic accuracy of fine‐needle aspiration (FNA) and frozen section (FS) in nodular thyroid disease.SETTINGTertiary care academic medical center.STUDY DESIGNRetrospective review of 139 consecutive patients undergoing surgery for nodular thyroid disease. FNA and FS sensitivity, specificity, and accuracy were calculated with respect to permanent section histology.RESULTSAmong 63 patients with an FNA interpreted as either benign (n = 38) or malignant (n = 25), FNA was accurate (sensitivity 89%, specificity 97%, accuracy 94%). FS identified only one case of carcinoma missed by FNA. Among 76 patients with a “suspicious” FNA, FS was reasonably accurate (sensitivity 67%, specificity 100%, accuracy 89%), but was deferred in 50% of cases.CONCLUSIONGiven high FNA accuracy, more selective use of FS is suggested.SIGNIFICANCEThe study results will assist with intra‐institutional patient counseling and intraoperative decision‐making with respect to FNA and FS results in patients with nodular thyroid disease.
Practice Patterns versus Practice Guidelines in Pediatric Otitis Media
Authors: Stewart Michael G. , Manolidis Spiros , Wynn Rhoda , Bautista Marilyn 
Published: February 2003

OBJECTIVETo study the practice patterns of physicians and their adherence to an evidence‐based practice guideline (PG) on pediatric otitis media with effusion. We hypothesized that overall knowledge of the recommendations from the guidelines would be less than 75%, and that specialist physicians would have better knowledge of the recommendations than generalist physicians.METHODSWe performed a survey study of 1167 otolaryngologists, pediatricians, and pediatric otolaryngologists. Each physician was sent a 6‐item survey asking about their practice patterns and treatment preferences for young children with otitis media with effusion. We compared responses between different specialties.RESULTSThe overall response rate was 48%. Only 8 (1.4%) of the 558 responding physicians answered all 6 items congruent with the PG. Overall, pediatricians, otolaryngologists, and pediatric otolaryngologists had similar total scores, but different scores on individual items.CONCLUSIONSThese results indicate that the practice patterns of pediatricians, otolaryngologists, and pediatric otolaryngologists differ from the recommendations of an evidence‐based PG. In particular, 2 items covering key treatment recommendations were answered in agreement with the PG by fewer than half of the physicians. It is not clear from this study whether these discrepancies were due to poor dissemination or knowledge concerning the PG, or disagreement with its recommendations.