bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical application of fluorescence in situ hybridization for chromosome 11q13 analysis in head and neck cancer
Authors: Alavi Sassan , Namazie Ali , Calcaterra Thomas C. , Wang Marilene B. , Srivatsan Eri S. 
Published: November 2003

AbstractObjective: Squamous cell carcinoma of the head and neck (HNSCC) still has one of the lowest 5‐year survival rates. Despite advances in diagnosis, treatment, and research, survival rates have not improved in recent years. This report examines the utility of fluorescence in situ hybridization (FISH) in detecting chromosome 11q13 amplification in HNSCC and in evaluating the correlation between 11q13 amplification and tumor behavior. Study Design: This study used FISH to determine the incidence of 11q13 amplification in 20 HNSCCs and 10 normal controls from the same patients. Tumor touch preparations and paraffin‐embedded tissues from the same patient samples were used for comparative analysis. Both single and dual color FISH was performed. Methods: Repetitive chromosome 11 specific alpha satellite DNA probe and chromosome 11q13 specific probe cyclin D1 were used for the FISH analysis. Results: Experiments revealed amplification of chromosome 11q13 in three fresh touch preparations. FISH on paraffin tissues showed amplification in two additional samples. Intensity of amplification, as high as 20 copies per nucleus, was observed in paraffin preparations, whereas a maximum of only six copies was seen in fresh preparations. Amplification was not detected in any of the normal samples. All five cases with 11q13 amplification had metastases and four of these were from poorly differentiated tumors. In the nonamplified cases, 5 of 15 had metastases and 2 of 15 was poorly differentiated. Conclusions: The present study indicates that FISH is a useful technique for detecting molecular changes such as amplification of chromosome 11q13 in HNSCC. FISH in paraffin preparations allows for accurate measurement of intensity of amplification and makes it possible for the evaluation of a large collection of archival material. The data also suggest that 11q13 amplification is correlated with poorly differentiated tumors and metastasis. Thus FISH has the potential to be a valuable diagnostic/prognostic tool in head and neck cancers. Key Words: Head and neck tumors, FISH, chromosome 11q13.
Rhinosinusitis and atopy in patients infected with HIV
Authors: García‐Rodríguez Javier F. , Corominas Mercè , Fernández‐Viladrich Pedro , Monfort José L. , Dicenta Manuel 
Published: November 2003

AbstractHypothesis: Rhinosinusitis is common during HIV infection; its prevalence is uncertain and could probably be related to clinical features, immunoallergological status, and diagnostic criteria. Methods: Seventy‐four patients hospitalized with HIV infection were prospectively evaluated for the presence of rhinosinusitis based on clinical findings, nasal endoscopy, or paranasal sinus computed tomography (CT). Immune status, nasal smear, features of atopy (based on the prick test), and its contribution to sinusal inflammatory pathology were also evaluated. Results: Most patients were severely immunosuppressed: CD4+ 155 ± 201 cells/mL and 12 ± 11% (mean ± SD). Thirty‐five percent of the patients presented at least two criteria of rhinosinusitis (clinical findings, nasal endoscopy, and CT: 35%; clinical findings and CT: 50%; nasal endoscopy and CT: 15%). CT scan showed multiple sinus involvement, opacification over 25% of the total volume of the maxillary sinus in 50% of patients, and opacification of the sphenoidal sinus in 40% of cases. Atopy was present in 18% of patients, a figure which reflects the expected prevalence in our geographic area. Two independent predictors were associated with a higher probability of rhinosinusitis: bilateral absence of maxillary infundibular patency (odds ratio, 7.5; 95% CI = 2.03–27.9) and low total count (odds ratio, 0.99; 95% CI = 0.99–1.00) or percentage of CD4+ (odds ratio, 0.93; 95% CI = 0.88–1.00). Conclusions: There is a high prevalence of rhinosinusitis in HIV‐infected individuals. This finding is related to a decreased cellular immunity, but it does not appear to be related to IgE‐related immediate hypersensitivity. Nasal endoscopy should be the first‐step diagnostic test. However, when clinical suspicion exists and endoscopy fails to explain symptoms, CT scan is a valuable adjunct to establish this diagnosis. Key Words: rhinosinusitis, HIV, atopy, endoscopy, computed tomography.
Laser management of oral leukoplakias: A follow‐up study of 70 patients
Authors: Schoelch Michael L. , Sekandari Nahid , Regezi Joseph A. , Silverman Sol 
Published: November 2003

AbstractUniversity of California, Department of Stomatology, School of Dentistry, San Francisco, California.Objectives/Hypothesis: To assess the efficacy of laser therapy for the management of premalignant oral lesions. Study Design: The study group consisted of seventy consecutive laser‐treated patients with oral leukoplakia. The microscopic diagnosis included idiopathic focal keratosis, dysplasias of all grades, and verrucous hyperplasia (proliferative verrucous leukoplakia). Thirty‐nine patients had some degree of microscopic dysplasia and six demonstrated high‐risk proliferative verrucous leukoplakia. The clinical appearances of the lesions were white (homogeneous leukoplakia) in 48, red and white (erythroleukoplakia) in 8, and verrucous in 14. There were 38 men and 32 women in this group. The average age was 63 years (range, 31–90 y). Methods: Lasers employed were the CO2 and Nd:YAG lasers, and standard laser safety protocols were used. Results: There was no postoperative infection, hemorrhage, or paresthesia. Two patients developed pyogenic granulomas in their surgical sites. Fifty‐five of 70 patients were followed for more than 6 months; follow‐up averaged 32 months (range 6–178 mo). Twenty‐nine patients had complete control of their lesions; 19 patients had small recurrences removed with subsequent laser surgeries, leading to control; 2 patients had complete recurrences; and 5 patients developed squamous cell carcinoma at the lesion site. Verrucous lesions had an especially high rate of recurrence (83%), with 9 of 12 ultimately controlled with subsequent surgeries. Conclusions: Laser surgery of oral leukoplakia is an effective tool in a complete management strategy that includes careful clinical follow‐up, patient education to eliminate risk factors and report suspicious lesions, and biopsy of suspicious lesions when appropriate. However, recurrence and progression to cancer remain a risk. Key Words: oral cancer, laser, CO2, Nd:YAG, leukoplakia.
Osteosarcoma of the head and neck: A review of the johns hopkins experience
Authors: Ha Patrick K. , Eisele David W. , Frassica Frank J. , Zahurak Marianna L. , McCarthy Edward F. 
Published: November 2003

AbstractObjective: To determine factors including treatment modalities which influence survival in patients with osteosarcoma of the head and neck.Study Design: Retrospective clinicopathologic study of 27 patients with osteosarcoma of the head and neck.Methods: The clinical charts and pathology slides were reviewed on 27 patients who had osteosarcoma of the head and neck between 1946 and 1998. The following variables were examined for their effect on survival: age of diagnosis, site of tumor, presentation, race, sex, prior radiation exposure, retinoblastoma history, margin status, and method of treatment.Results: The average age at the time of diagnosis of the patients was 37.6 years (range, 7–82 y). The sex distribution was similar with 14 male and 13 female patients. Eight of 27 patients had osteosarcoma of the mandible, 9 of 27 had osteosarcoma of the maxilla and paranasal sinuses, and in 10 of 27 patients osteosarcoma occurred elsewhere, including the temporal bones, occipital bones, and orbit. The overall 2‐year survival was 66% with a 5‐year survival rate of 55%.Conclusions: Positive surgical margins and a high tumor grade were found to have a statistically deleterious effect on overall survival. There was no detectable effect on survival of age, race, sex, prior radiation exposure, tumor site, and tumor cell type. It was not possible to differentiate between the different adjuvant treatment modalities because of the small numbers in the study.Key Words: Bone, malignancy, osteogenic sarcoma, radiation therapy, surgery.
Anti‐Endothelial Autoantibodies in Patients With Sudden Hearing Loss
Authors: Ottaviani Fabrizio , Cadoni Gabriella , Marinelli Luca , Fetoni Anna Rita , De Santis Antonella , Romito Anna , Vulpiani Paola , Manna Raffaele 
Published: November 2003

AbstractObjectives/Hypothesis: Sudden hearing loss (HL) can be caused by autoimmune disorders localized to the inner ear or secondary to systemic immune diseases. Studies in autoimmune animal strains showing HL have reported changes in the cochlear stria vascularis. The authors investigated the presence of antiendothelial cell antibodies (AECA) to see if immunemediated vasculitis may play a role in human sudden HL. Study Design: A prospective study in patients with sudden HL. Methods: Fifteen consecutive patients (mean age, 32 y) affected by sudden HL and 14 normal subjects were included. Patients with familial deafness and metabolic diseases were excluded. Extensive audiovestibular, imaging, microbiological, immunological, and routine examinations were performed. AECA were detected on rat kidney tissue sections on the sera collected at −20°C. Results: AECA were positive in 8 of 15 patients (53%) (2 of 5 men and 6 of 10 women), thus differing significantly from the normal control population, in which only 2 of 14 tested AECA positive (P = .023). Conclusions: In patients with sudden HL, immune‐mediated vascular damage can have a pathogenetic role and AECA might represent a serological marker of vasculitis.
Is Epistaxis Evidence of End‐Organ Damage in Patients With Hypertension?
Authors: Neto José Faibes Lubianca , Fuchs Flávio Danni , Facco Sandro Rogério , Gus Miguel , Fasolo Leonardo , Mafessoni Rafael , Gleissner Ana Luiza 
Published: November 2003

AbstractObjectives/Hypothesis: To study the association between history of mild to severe epistaxis with different stages of hypertension and with other evidence of target organ damage in a sample of patients attending an outpatient hypertension clinic, controlling for potential confounding factors. Study Design: A survey of adult patients with hypertension. Methods: A consecutive sample of 323 adults with hypertension was studied. The main outcome measures were history of adult epistaxis, high blood pressure, duration of hypertension, nasal abnormalities, and fundoscopic and electrocardiogram abnormalities. Results: Ninety‐four patients (29.1% of the whole sample) reported at least one episode of nosebleed after 18 years of age. Of these, 59 (62.8%) needed medical assistance to control at least one of the episodes. The history of epistaxis was not associated with blood pressure classified according to the World Health Organization/International Society of Hypertension paradigm or classified as severe or not severe. There was a trend of an association between history of epistaxis and duration of hypertension. The history of severe epistaxis (epistaxis that needed medical assistance) was not associated with blood pressure classified as severe or not severe and with duration of hypertension. More patients with left ventricular hypertrophy had a positive history of adult epistaxis. There was no association between history of epistaxis or history of severe epistaxis and fundoscopic abnormalities. Among the abnormalities detected at rhinoscopy, only the presence of enlarged septal vessels was associated with history of epistaxis. The presence of enlarged septal vessels was strongly and independently associated with history of epistaxis in the logistic regression model. Duration of hypertension and left ventricular hypertrophy showed a trend for an association with the history of epistaxis in the adult life. Conclusions: A definite association between blood pressure and history of adult epistaxis in hypertensive patients was not found. The evidence for an association of duration of hypertension and left ventricular hypertrophy with epistaxis suggests that epistaxis might be a consequence of long‐lasting hypertension. The association between the presence of enlarged vessels at rhinoscopy with history of epistaxis in hypertensive patients is a novel observation that needs to be addressed in future observations.
A New Transnasal Approach to Endoscopic Marsupialization of the Nasolabial Cyst
Authors: Su Chih‐Ying , Chien Chih‐Yen , Hwang Chung‐Feng 
Published: November 2003

AbstractObjective: Nasolabial cyst is a mucus‐secreting, nonodontogenic cyst in the nasofacial area. It is usually situated behind the ala nasi, extending backward beneath the nasal floor into the inferior meatus and forward into the labio‐gingival sulcus behind the upper lip. Patients with nasolabial cysts generally undergo surgical removal of the cyst via a transoral sublabial approach. This article reports a simple, less invasive surgical procedure for the treatment of nasolabial cysts. Study Design: A transnasal endoscopic marsupialization method was designed to treat patients with nasolabial cysts. From 1996 through 1998, 16 consecutive patients underwent this new surgical procedure. Methods: With patients under local anesthesia, the roof of the cyst, which was firmly attached to the mucous membrane of the anterior nasal floor, was removed transnasally with a sickle knife and scissors. Under the guidance of a nasoendoscope, the opening of the cyst was widened with bite forceps. Meanwhile, the cut edges of the nasal mucosa and the epithelium lining of the cyst were adequately matched. The nose was then loosely packed. Results: All but 1 of the 15 patients were successfully treated with this technique, and the whole surgical procedure was usually completed within 15 to 20 minutes. Postoperative endoscopic and radiological findings revealed that the cyst was replaced by an air‐containing sinus with a persistent opening at the anterior or anterolateral nasal floor. There has been no evidence of mucus accumulation in the newly created sinus or recurrence of the cyst during a mean follow‐up of 16 months. Conclusions: Transnasal endoscopic marsupialization is a simple and effective surgical procedure for treatment of nasolabial cysts.
Transforming Growth Factor‐α and Rhinitis
Authors: Lam Samuel M. , Zhu De‐Fen , Ahn Jeffrey M. 
Published: November 2003

AbstractObjectives: Transforming growth factor‐α (TGF‐α) has been implicated in diverse physiologic and pathophysiologic functions including immunological, inflammatory, and neoplastic processes. TGF‐α has been localized in the hyperproliferative, inflammatory environment of chronic otitis media, cholesteatoma, and asthmatic airways. TGF‐β1, which must be present with TGF‐α to transform fibroblasts, has been found in rhinitic mucosa and in asthma in prior studies. The authors sought to identify whether TGF‐α also played a role in the inflammatory cascade and fibrosis of rhinitis. Study Design: A nonrandomized, prospective study was carried out in which samples of inferior turbinate and nasal polyps from rhinitic and nonrhinitic patients were subjected to immunohistochemistry and Western blotting to determine the presence of TGF‐α. Methods: Twenty‐seven subjects undergoing surgery for rhinitis, obstructive sleep apnea, nasal fracture, and rhinoplasty were recruited for this study, the latter three groups acting as controls. Immunohistochemical and Western blotting techniques were employed to identify the presence of TGF‐α in inferior‐turbinate and nasal‐polyp samples of rhinitic subjects. Results: Immunohistochemistry demonstrated the selective staining of TGF‐α in the basement membrane and extracellular matrix, including lymphatic, vascular, and glandular structures, in most turbinate samples and the absence of staining in corresponding controls. Further, TGF‐α was isolated to a discrete 30‐kD band in both inferior turbinate and polyp tissues by Western blotting without staining in the corresponding controls. Conclusions: These results suggest that TGF‐α may play a role in the inflammatory derangement of rhinitis.
Use of Endoscopically Placed Expandable Nitinol Tracheal Stents in the Treatment of Tracheal Stenosis
Authors: Ducic Yadranko , Khalafi Reza S. 
Published: November 2003

AbstractObjective: To evaluate the potential utility of a new endoscopically placed expandable tracheal stent in the treatment of benign symptomatic stenoses of the cervical trachea. Study Design: Pilot study utilizing a prospectively followed case series. Methods: An initial group of six patients undergoing stent placement was examined with rigid and flexible endoscopy under anesthesia immediately following stent placement and at postoperative 6 to 8 weeks. Subsequently each patient was followed clinically for a minimum of 6 months. Results: All stents were well tolerated with no observed complications. Immediate reversal of symptomatic airway obstruction without the need for adjunctive tracheotomy was noted in every patient. At 6 weeks, endoscopic confirmation of complete intraluminal mucosalization without formation of any granulation tissue or scar bands within the stented areas was noted in each case. Conclusions: This preliminary pilot study supports the use of nitinol expandable tracheal stents as an alternative in the treatment of benign symptomatic tracheal stenoses.
Deterioration of Olfaction and Gustation As a Consequence of Total Laryngectomy
Authors: Van Dam Frits S.A.M. , Hilgers Frans J.M. , Emsbroek Geta , Touw Frederieke I. , Van As Corina J. , De Jong Nynke 
Published: November 2003

AbstractIntrodution: After total laryngectomy the absence of a nasal airflow results in a decrease in olfaction and perception of flavors. Materials and Methods: Odor perception was assessed in 63 laryngectomized patients with two different olfactory tests. The methods used by patients to smell were observed during olfactory testing. Patients' judgment about their olfaction and gustation was assessed by means of a structured questionnaire, semistructured interview, and self‐rating. Results: Based on the results of the olfactory tests, patients were categorized as “smellers” and “nonsmellers.” Approximately one third of the patients were able to smell the odorous substances used in the olfactory tests. The smellers more often used a variety of methods to smell than the nonsmellers (P > .002); in most patients the method consisted of active use of facial muscles. Patients appeared well able to judge their own odor perception. Compared with the smellers, the nonsmellers judged their odor perception as worse (P > .003) and reported a more severe decrease in gustation after the operation (P > .033). The results of this study in laryngectomized patients confirm the interrelation between olfaction and gustation: the nonsmellers reported a poorer gustation and a more severe decrease in gustation and appetite than both the smellers and a reference group of elderly persons (P > .05). Patients who reported a deterioration of olfaction and gustation tended to experience negative consequences such as the inability to smell smoke, leaking gas, or agreeable odors. Conclusion: Olfaction and odor‐related flavor sensation are seriously deteriorated after total laryngectomy.
Effects of Activated Macrophages and Fibroblast Growth Factor on Random Skin Flap Survival in Swine
Authors: Bach Kevin K. , Cupp Craig , Brewster Douglass , Wester Derin , Keefe Michael 
Published: November 2003

AbstractObjective: To examine the effect of application of activated autologous macrophages and basic fibro‐blast growth factor (FGF) on random skin flap survival in swine. Design: A randomized nonblinded controlled trial. According to a standard design, six dorsally based, random‐pattern skin flaps were raised in each of 12 Yorkshire pigs. Methods: Twenty‐five milliliters of blood is harvested from each animal 20 to 24 hours prior to flap creation. Monocytes are isolated, placed in culture medium, and then activated by the addition of platelet‐derived growth factor (PDGF) and tissue growth factor beta (TGF‐β). Following an 18‐hour incubation period, the monocytes are decanted and quantified, and their viability confirmed. These cells are then infused into the wound bed of the treatment flaps immediately following flap creation, and FGF is added prior to flap closure. The position of treatment and control flaps is systematically varied with regard to anterior‐to‐posterior and side‐to‐side flap positions within each animal. The area of superficial flap necrosis is evaluated on postoperative day 7, digitally scanned, and analyzed using graphics software. Control flaps are elevated similarly, but receive no placebo treatment. Results: Two‐way analysis of variance (ANOVA) demonstrated nonsignificant differences between pig side and anterior, middle, and posterior flap positions within treatment and control flap groups. Using side and position pooled data, a one‐way ANOVA showed no statistically significant differences between treatment and control flaps. Conclusions: The cellular and biochemical events following creation of a surgical wound are complex and incompletely understood. Our attempt to augment the natural role of the macrophage in wound healing by employing cytokines to activate these cells and to accelerate their arrival by implanting them into the wound bed failed to enhance flap survival. Further study is warranted to ascertain the details of wound healing, particularly with respect to cytokine concentrations and the timing of their roles, if we are to find a clinically applicable means of enhancing flap survival.
Corticosteroid Pharmacokinetics in the Inner Ear Fluids: An Animal Study Followed by Clinical Application
Authors: Parnes Lorne S. , Sun Ai‐Hua , Freeman David J. 
Published: November 2003

AbstractObjective: Autoimmune disease (e.g., Cogan syndrome) and other inflammatory inner ear diseases may ravage the labyrinth if not treated aggressively with antiinflammatory medication. Corticosteroids are the mainstay of treatment, yet, partly because of the existence of the blood—labyrinthine barrier, the ideal drug, dose, and route of administration are currently unknown. Study Design: In the present study, we established cochlear fluid pharmacokinetic profiles of hydro‐cortisone, methylprednisolone, and dexamethasone in the guinea pig following oral, intravenous, and topical (intratympanic) administration. High‐performance liquid chromatography was used to determine the drug concentrations, and comparisons were made with simultaneous pharmacokinetic profiles from blood and cerebrospinal fluid. Results: Our findings demonstrated a much higher penetration of all three drugs into the cochlear fluids following topical application as compared with systemic administration, with methylprednisolone showing the best profile. Discussion: The results suggested that intratympanic administration of corticosteroids might be more efficacious while avoiding high blood levels and therefore the deleterious side effects of systemic use. Clinical Application: Thirty‐seven patients with various inner ear disorders causing sensorineural hearing loss were subsequently treated using intratympanic corticosteroids, 20 with dexamethasone, and 17 with methlyprednisolone. Patients with immune‐mediated hearing losses showed the best results, with notable improvement also seen in several cases of a “sudden deafness.” No benefit was seen in patients with cochlear hydrops or those with sudden deterioration of a preexisting hearing loss. Three patients developed a transient otitis media related to the treatments, easily controlled with antibiotics. There were no cases of treatment‐induced hearing loss and no permanent tympanic membrane perforations. Conclusions: Overall, injection of intratympanic corticosteroids for the treatment of hearing loss in inner ear disorders appears to be both safe and highly effective for certain disorders. The concept of this technique is supported by animal experimental data. The findings from the present study warrant further clinical application and experimental investigation.