bluuebunny/crossref_metadata_2025_split huggingface dataset:
Increased Expression of Interleukin‐9, Interleukin‐9 Receptor, and the Calcium‐Activated Chloride Channel hCLCA1 in the Upper Airways of Patients With Cystic Fibrosis
Authors: Hauber Hans‐Peter , Manoukian John J. , Nguyen Lily H. P. , Sobol Steven E. , Levitt Roy C. , Holroyd Kenneth J. , McElvaney Noel G. , Griffin Siobhan , Hamid Qutayba 
Published: November 2003

AbstractObjectives/Hypothesis Mucus overproduction is commonly found in airway disease in patients with cystic fibrosis. Interleukin‐9 (IL‐9) has been shown to mediate airway hyper‐responsiveness and mucus overproduction. Recently, the calcium‐activated chloride channel hCLCA1 has been described to be upregulated by IL‐9 and has been thought to regulate the expression of soluble gel‐forming mucins. We sought to examine the expression of IL‐9, interleukin‐9 receptor (IL‐9R), and hCLCA1 in the upper airway of patients with cystic fibrosis in comparison to healthy control subjects and to demonstrate the relationship of IL‐9, IL‐9R, and hCLCA1 expression with mucus production.Study Design Prospective design.Methods Biopsy samples from nasal polyps of four patients with cystic fibrosis, nasal mucosa of six patients with cystic fibrosis, sinus mucosa of eight patients with cystic fibrosis, and nasal mucosa of six healthy control subjects were stained with periodic acid‐Schiff (PAS) to identify mucus glycoconjugates. IL‐9, IL‐9R, and hCLCA1 expression was determined by immunocytochemical study.Results We demonstrated significant increases in IL‐9, IL‐9R, and hCLCA1 immunoreactivity in the mucosa of patients with cystic fibrosis compared with that found in control subjects (P <.05). There were no significant differences between the different locations (nasal polyps, nasal mucosa, and sinus mucosa) in the patient group (P >.05). We also observed a significant increase in the number of mucus‐producing cells in biopsy specimens from patients with cystic fibrosis in comparison to control subjects. A positive correlation was found between hCLCA1‐positive cells and IL‐9‐positive cells (correlation coefficient [r] = 0.79, P <.05) or IL‐9R‐positive cells (r = 0.92, P <.05). Moreover, a positive correlation was also present between PAS‐positive (mucus‐producing) cells and hCLCA1‐positive cells (r = 0.64, P <.05) or IL‐9R‐positive cells (r = 0.64, P <.05).Conclusions Increased expression of IL‐9 and IL‐9R, as well as upregulation of hCLCA1, in mucus‐overproducing epithelium of patients with cystic fibrosis supports the hypothesis that IL‐9 contributes to mucus overproduction in cystic fibrosis. Expression of hCLCA1 may also be responsible, in part, for the overproduction of mucus. These preliminary findings suggest that hCLCA1 might be an interesting new therapeutic target to control mucus overproduction in airway disease in patients with cystic fibrosis.
Detection of Epstein‐Barr Virus–Derived Latent Membrane Protein‐1 Gene in Various Head and Neck Cancers: Is It Specific for Nasopharyngeal Carcinoma?
Authors: Tsang Ngan‐Ming , Chang Kai‐Ping , Lin Shinn‐Yn , Hao Sheng‐Po , Tseng Chen‐Kan , Kuo Tseng‐tong , Tsai Ming‐Hsui , Chung Tsao‐Chuen 
Published: November 2003

AbstractObjective The object of the study was to determine the incidence of the presence of Epstein‐Barr virus–derived latent membrane protein‐1 (LMP‐1) gene in various head and neck cancers by polymerase chain reaction method.Study Design Prospective study.Methods During a 5‐year period, polymerase chain reaction was used to investigate the presence of LMP‐1 gene in various head and neck cancers from different locations and histopathological types, noncancerous nasopharyngeal biopsy samples, and tonsillectomy specimens from patients with chronic hypertrophic tonsillitis.Results Of 202 patients enrolled in the study, 53 were diagnosed by pathological study with oropharyngeal carcinoma, 45 with nasopharyngeal carcinoma, 26 with oral cavity carcinoma, 26 with laryngohypopharyngeal carcinoma, 31 with nasopharyngeal lymphoid hyperplasia, and 21 with tonsils with lymphoid hyperplasia. After the application of polymerase chain reaction, the LMP‐1 gene was not detected in any sample from oral cavity carcinoma, laryngohypopharyngeal carcinoma, or nasopharyngeal lymphoid hyperplasia or from tonsillectomy specimens but was detected in only one case of tonsillar carcinoma. On the contrary, the LMP‐1 gene was detected in 43 (95.6%) of 45 samples from patients with nasopharyngeal carcinoma. The statistical analysis shows a significant association (P <.001) between the presence of LMP‐1 gene and tumor localization in the nasopharynx.Conclusions The study shows that the presence of LMP‐1 gene detected by polymerase chain reaction in the tumor cell is only significantly associated with tumor located in the nasopharynx, implying that Epstein‐Barr virus plays a trifling role in the tumorigenesis of carcinomas arising from other head and neck locations. The polymerase chain reaction method that was used is a potential tool for screening nasopharyngeal carcinoma.
Primary and Metastatic Cancer of the Parotid: Comparison of Clinical Behavior in 232 Cases
Authors: Bron Luc P. , Traynor Sean J. , McNeil Edward B. , O'Brien Christopher J. 
Published: November 2003

AbstractObjectives/Hypothesis Parotid malignancy may develop as a primary cancer of salivary tissue or by metastatic involvement of parotid lymph nodes. The aim of the study was to compare the clinical behavior of primary and metastatic parotid cancers by analyzing patterns of treatment failure and clinical outcomes.Study Design Retrospective review of clinical and pathologic data prospectively accessioned onto a computerized database.Methods A prospectively documented series of 232 parotidectomies carried out for treatment of cancer from 1988 to 1999 was reviewed. There were 177 male and 55 female patients with a median age of 65 years (age range, 17–97 y). Median follow‐up time was 4 years. Pathological groups included 54 patients with primary parotid cancer, 101 with metastatic cutaneous squamous cell carcinoma, 69 with metastatic melanoma, and 8 with other metastatic cancers.Results Neck nodes were clinically positive in 12 patients with primary cancer, 24 patients with squamous cell carcinoma, 16 with melanoma, and 2 with other metastatic malignancies. Conservative parotidectomy, preserving the main trunk of the facial nerve, was performed in 185 patients, and 47 patients had a radical parotidectomy sacrificing the facial nerve. There were 54 therapeutic and 110 elective neck dissections. Adjuvant radiotherapy was given to 39 patients with primary cancer, 86 with squamous cell carcinoma, 50 with melanoma, and 8 in the other metastatic group (78% of the patients in the series). Local control rates at 5 years in the four groups were 86%, 75%, 94%, and 100%, respectively (P <.01). Survival rates at 5 years were 77%, 65%, 46%, and 56%, respectively (P <.01).Conclusions The pattern of parotid malignancy is unique in Australia because of the high incidence of skin cancer, which can metastasize to the parotid gland. Metastatic cutaneous malignancy predominates. The pattern of failure and outcome varied depending on histological findings. Local failure occurred most often in metastatic squamous cell carcinoma, whereas patients with melanoma had the highest incidence of distant spread.
A Randomized Controlled Trial of Early Oral Feeding in Laryngectomized Patients
Authors: Seven Huseyin , Calis Asli Batur , Turgut Suat 
Published: November 2003

AbstractObjective To evaluate the safety and efficacy of early oral feeding by comparing it with feeding through primary tracheoesophageal puncture after total laryngectomy with primary pharyngeal closure.Study Design A prospective, randomized, controlled study.Methods Patients who underwent total laryngectomy with primary pharyngeal closure and who were candidates for primary voice restoration (an in whose cases primary tracheoesophageal puncture [TEP] was created) were included. After total laryngectomy, patients were randomly assigned to either the oral group (study group) or the TEP group (control group). Patients in the oral group were fed orally with a clear liquid diet on the first postoperative day, then advanced to a regular diet, whereas patients in the TEP group were fed through tracheoesophageal puncture and received nothing orally until the seventh postoperative day; then they were fed orally if fistula had not occurred. Standard criteria for discharge were used for all the patients.Results During a 3‐year period, 67 patients were enrolled in the trial, and complete data were available for 65 patients (32 patients in the oral group, 33 patients in the TEP group). The two groups were similar for factors reported to influence the rate of pharyngocutaneous fistula. In three (9%) patients in the TEP group, fistula occurred on the 5th, 7th, and 14th postoperative days, respectively. Two (6.2%) fistulas occurred in the oral group on the sixth and eighth postoperative days, respectively. In patients without fistula, the mean length of hospital stay was 7.6 days (range, 4–19 d [SD = 3.1 d]) for the oral group and 8.2 days (range, 7–18 d [SD = 2.6 d) for the TEP group. There was no significant difference between two groups for either the incidence of fistula or the length of hospital stay.Conclusions Initiation of oral feeding on the first postoperative day in patients undergoing total laryngectomy with primary pharyngeal closure is a safe clinical practice. However, it does not shorten the length of hospital stay for these patients.
Use of WuScope for Exchange of Endotracheal Tube in a Patient With Difficult Airway
Authors: Sprung Juraj , Wright Laurie C. , Dilger John 
Published: November 2003

AbstractObjective To describe a method for the exchange of a defective endotracheal tube using the WuScope in patients with difficult airways who cannot tolerate interrupted ventilation.Study Design Case report.Methods Detailed description of proposed modality for the endotracheal tube exchange.Results Exchanging a defective endotracheal tube in patients with a “difficult airway” and compromised oxygenation can be a challenging task. Performing fiberoptic visualization with the WuScope and using a “double intubation” technique may be an acceptable method for endotracheal tube exchange in some clinical situations.Conclusion By using our technique the exchange of an endotracheal tube in a patient with a difficult airway may be achieved without interrupting the ventilation.
Transoral Laser Microresection for Cancer of the Larynx Involving the Anterior Commissure
Authors: Pearson Bruce W. , Salassa John R. 
Published: November 2003

AbstractObjective To share the authors' experience of transoral laser microresection in the treatment of squamous cell carcinoma of the anterior commissure of the larynx.Study Design Retrospective review of 39 patients with squamous carcinoma involving the anterior commissure of the larynx, all managed with transoral laser microresection between September 1996 and December 2001. Twenty‐three patients had pT1 or pT2 cancers. Sixteen patients had pT3 or pT4 disease, two with N2b neck metastases. Twenty patients had cancers exhibiting spread to the subglottis. Twenty‐five patients had received prior treatment(s).Methods Specific data points entered into a portable database were retrospectively verified against the patient's electronic medical record. Sorting and analysis were completed in a desktop spreadsheet. We evaluated tumor recurrence, cause of death, tracheostomy, hospital length of stay, and voice quality.Results None of the 17 patients with early cancers (pT1 or pT2a) had local recurrence, and none received postoperative radiotherapy. Five of the 22 patients with intermediate or advanced disease (pT2b/pT3 or pT4 cancer) required second treatments for persistent or recurrent disease. Of these, two had small residual foci amenable to second‐stage resection by laser. One patient developed a prelaryngeal soft tissue recurrence and retained his larynx after wide local excision and radiotherapy. Two patients (both previously irradiated) developed delayed recurrences requiring total laryngectomy. Four retreated patients remained alive without disease. One patient died of other causes. Voice remained no worse after transoral laser microresection in 19 patients. It was one level worse (on a scale of 0 to 5) for 16 patients. Eleven patients received temporary tracheotomies, some for airway, some for exposure. Twelve patients left the hospital on a same‐day basis. The average hospital stay was 3.3 days.Conclusion Transoral laser microsurgery is one of the options to be considered for the treatment of squamous cell cancer involving the anterior commissure of the larynx.
Delayed‐Onset Facial Paralysis After Vestibular Neurectomy
Authors: Vrabec Jeffrey T. , Coker Newton J. , Jenkins Herman A. 
Published: November 2003

AbstractObjectives/Hypothesis Delayed‐onset facial paralysis (beginning more than 3 d after the procedure) has been described as a complication of many different types of otological procedures. The incidence of this problem in vestibular neurectomy and the relationship to surgical approach are detailed in the study.Study Design Retrospective case review.Methods In the setting of a tertiary referral center, vestibular neurectomy was performed in 70 individuals with disabling vertigo unresponsive to medical therapy who elected vestibular neurectomy. The main outcome measure was incidence of delayed onset facial paralysis.Results Delayed‐onset facial paralysis was significantly more common after the middle fossa (18%) and translabyrinthine (11%) approaches compared with the retrosigmoid approach (0%)Conclusions Surgical approach influences the incidence of delayed‐onset facial paralysis. Measures to prevent this complication such as prophylactic antiviral medication or labyrinthine segment decompression may be considered in middle fossa and translabyrinthine operations.
Unbiased Stereologic Type I and Type II Hair Cell Counts in Human Utricular Macula
Authors: Gopen Quinton , Lopez Ivan , Ishiyama Gail , Baloh Robert W. , Ishiyama Akira 
Published: November 2003

AbstractObjective The objective of the study was to obtain unbiased estimates of the total number of type I and type II hair cells in human utricular macula from individuals with documented normal vestibular function.Study Design Application of unbiased stereology using microdissected human temporal bone specimens was conducted in an observational study.Methods Postmortem temporal bones were obtained from 10 normal patients (age range, 42–96 y; mean age, 82 y). The utricular maculae were microdissected, embedded in plastic, and cut into serial 2‐μm sections. Unbiased estimates of the total number of type I and type II hair cells were obtained using the physical fractionator technique of stereology.Results The average total number of hair cells was 27,508 (CV = 11%) consisting of 17,326 (coefficient of variation [CV] = 11%) type I hair cells and 10,182 (CV = 13%) type II hair cells. The ratio of type I to type II hair cells was 1.70:1. In the age range of the study, there was no statistically significant correlation between hair cell counts and age.Conclusions Morphometric studies of the human utricular sensory epithelium can be accomplished using unbiased stereology on microdissected specimens. There was no effect of age on total hair cell counts or on the ratio of type I to type II hair cells in the age range of the study. Further studies on younger subjects are needed to establish the effect of age. The results from the present study are closely aligned with prior studies that estimated total hair cell counts using surface mount preparations. The current data represent the first total type I and type II hair cell counts in human utricular neuroepithelium.
The Normal Inferior Turbinate: Histomorphometric Analysis and Clinical Implications
Authors: Berger Gilead , Balum‐Azim Marwa , Ophir Dov 
Published: November 2003

AbstractObjective To study the histological and morphometric features of the normal inferior turbinate.Study Design A prospective, nonrandomized study.Methods Sixteen specimens were removed at autopsy and during septoplasty operations, stained with H&E, and investigated microscopically. The soft tissue and bony elements were measured. Morphometric analysis included measurements of the relative proportions of the soft tissue constituents.Results The medial mucosal layer is thicker than the bone and the lateral mucosa; the difference between the mucosal layers is statistically significant. The inferior turbinate is almost exclusively covered with a pseudostratified ciliated columnar epithelium that houses more goblet cells on its lateral side. It has a well‐defined basement membrane zone that is significantly thicker on the medial side. The main bulk of the inferior turbinate is the lamina propria that is built of loose connective tissue and superficially harbors an inflammatory cell infiltrate. The area fraction of glands in the lateral mucosa significantly exceeds that of the medial and inferior mucosal layers, whereas that of venous sinusoids varies significantly, with the greatest difference inferiorly. Decreased proportion of glands and an increase in venous sinusoids are associated with advanced age. The cancellous central bony layer is made of interwoven trabeculae and houses the major arterial supply of the turbinate. After the major arteries exit the bone, they lie in the deepest portions of the medial and lateral mucosal layers but are missing from the inferior layer.Conclusion In‐depth histomorphometric analysis can assist in developing new function‐preserving approaches to turbinate surgery.
Expression of the Extra Domain B of Fibronectin, a Marker of Angiogenesis, in Head and Neck Tumors
Authors: Birchler Manfred T. , Milisavlijevic Dusan , Pfaltz Madeleine , Neri Dario , Odermatt Bernhard , Schmid Stefan , Stoeckli Sandro J. 
Published: November 2003

AbstractObjectives/Hypothesis The extra domain B (ED‐B) of fibronectin, a naturally occurring marker of tissue remodeling and angiogenesis, is expressed in the majority of aggressive solid human tumors, whereas it is not detectable in normal vessels and tissues.Study Design In view of the diagnostic and therapeutic clinical applications of the L19 antibody, which is specific for the ED‐B domain of fibronectin, a prospective immunohistochemical analysis of different head and neck tumors was performed.Methods In all, 82 head and neck tissue biopsy specimens were immunohistochemically analyzed using the L19 antibody. They consisted of 53 different malignant tumors, 8 benign tumors, 10 nontumoral lesions, and 11 normal control tissues.Results A strong positive staining with the L19 antibody could be observed in 87% of the investigated malignant tumors, in only 38% of the benign tumors, and in 20% of the nontumoral lesions (P <.0001). The extra domain B was completely absent in the normal control tissue samples.Conclusions The results show that ED‐B is abundantly expressed around the neovasculature and in the stroma of the majority of malignant tumors of the head and neck but is undetectable in normal tissues. The ED‐B domain of fibronectin is a good‐quality tumor‐stroma–associated antigen that warrants clinical trials with antibody‐based pharmaceuticals, including immunoscintigraphic investigations and radioimmunoguided surgery with the radiolabeled L19 antibody.
Tracheal Autotransplantation as a New and Reliable Technique for the Functional Treatment of Advanced Laryngeal Cancer
Authors: Delaere Pierre R. , Hermans Robert 
Published: November 2003

AbstractObjectives/Hypothesis Tracheal autotransplantation allows for reconstruction of extended hemilaryngectomy defects (including half of the cricoid cartilage) after resection of laryngeal or hypopharyngeal cancer. A series of 38 patients underwent the operation. The technique involved a two‐stage procedure (stage 1, tracheal revascularization; stage 2, hemilaryngectomy and tracheal autotransplantation) because the trachea requires at least 2 weeks for revascularization. The objective was to improve the oncological reliability of the procedure by performing a one‐stage tumor resection.Study Design Five patients who underwent a one‐stage tumor resection are presented. They had T2 (n = 3) to T3 (n = 2) N0 laryngeal tumors.Methods Neck dissection, tumor resection, and tracheal revascularization were all performed during the first operation. The radial forearm fascia flap was designed with a distal fascial paddle and a proximal skin paddle. A 4‐cm segment of cervical trachea was wrapped with the fascial paddle for revascularization, and the skin paddle was used for temporary closure of the extended hemilaryngectomy defect. The definitive reconstruction consisted of tracheal autotransplantation and was performed 4 months after the first procedure. Medical records were reviewed to determine time to oral intake, time to decannulation, length of hospital stay, and postoperative complications.Results After the first operation the skin paddle of the radial forearm flap succeeded in a restoration of the sphincteric function. The mean time to oral intake for solids was 9.0 days (SD = 2.6 d) and the mean length of hospital stay was 11.2 days (SD = 2.2 d). All patients were able to speak with the tracheal cannula in place. All laryngeal functions were restored after the second operation. The mean time to oral intake for solids was 8.2 days (SD = 5.2 d). The mean time to oral intake for liquids was 16.6 days (SD = 6.3 d), and the mean length of hospital stay was 9.6 days (SD = 2.3 d). The mean time to closure of the tracheostomy and removal of the gastric tube was 27.0 days (SD = 5.8 d).Conclusion Tracheal autotransplantation allows for a functional treatment of advanced laryngeal cancers and is compatible with a one‐stage tumor resection.
Hypothermia During Head and Neck Surgery
Authors: Agrawal Nishant , Sewell Duane A. , Griswold Michael E. , Frank Steven M. , Hessel: Todd W. , Eisele David W. 
Published: November 2003

AbstractObjective To determine the predictors and incidence of hypothermia in patients undergoing head and neck surgery.Study Design Retrospective analysis.Methods Patients were either not warmed (n = 43) or actively warmed with forced‐air warming (n = 25). Clinical variables that were assessed as predictors of core body temperature included age, body mass, duration of procedure, estimated blood loss, amount of intravenous fluids administered, and the use of forced‐air warming. The incidence of severe intraoperative hypothermia and potential hypothermia‐related complications was also examined.Results The study demonstrated that advanced age is a risk factor for hypothermia and decreased body mass is associated with lower final body temperatures in the groups of patients that was not warmed. After adjusting for differences in the ages and weights between the two groups, the mean core body temperature was found to be 0.4°C lower in the patients who were not warmed. Severe intraoperative hypothermia occurred in 5 of 38 patients (11.6%) who were not warmed and 2 of 23 patients (8.0%) who were warmed. The complications associated with hypothermia included delayed time to extubation, the development of neck seromas, and flap dehiscence.Conclusions Patients undergoing head and neck surgery are at risk for the development of intraoperative hypothermia and require careful temperature monitoring. Elderly patients and patients with low body mass are more prone to develop low intraoperative core body temperatures. Active warming with forced‐air warmers should be considered for patients at risk for intraoperative hypothermia and for patients who develop hypothermia intraoperatively, to avoid hypothermia‐related complications.