bluuebunny/crossref_metadata_2025_split huggingface dataset:
Enhancement of Ad‐p53 Therapy with Docetaxel in Head and Neck Cancer
Authors: Yoo George H. , Piechocki Marie P. , Oliver Jeffery , Lonardo Fulvio , Zumstein Lou , Lin Ho‐Sheng , Kim Harold , Shibuya Terry Y. , Shehadeh Nasfat , Ensley John F. 
Published: October 2004

AbstractObjective: The objective of this project was to determine the mechanisms in which docetaxel enhances Ad‐p53 tumor suppressive effects in head and neck cancer.Background: In advanced head and neck squamous cell carcinoma (HNSCC), the 5‐year survival rate is less than 40%. Because patients with advanced HNSCC have a high rate of local‐regional failure (40‐60%) with existing treatment modalities, aggressive local therapy approaches need to be developed. Previous data show that docetaxel or Ad‐p53 alone have significant anti‐tumor activity in HNSCC. Before testing whether a combination approach (Ad‐p53 and docetaxel) could be developed in clinical trials, preclinical experiments were performed.Methods: The p53 gene was overexpressed in 2 head and neck squamous carcinoma (HNSCC) cell lines, HN30 and HN12, and a murine Balb/c mucoepidermoid carcinoma (BMEC) cell line. Docetaxel's enhancement of adenoviral transduction (bGAL expression), coxsakie‐adenovirus receptor (CAR) expression, and Ad‐p53 induction of apoptosis (Annexin V expression) were measured. The modulation of regulators in the cell cycle, apoptosis and signal transduction pathways were measured using Western blot.Results: Docetaxel increased adenoviral transduction, which was dependent on the dose of docetaxel and levels of Ad‐bGAL. The enhanced viral transduction was due in part to the upregulation of the CAR protein. Pretreatment with docetaxel enhanced Ad‐p53‐induced apoptosis through increased expression of exogenous p53. Together, the combination of docetaxel and Ad‐p53 altered expression of key regulators in the cell cycle, apoptosis and signal transduction pathways with an increase in the expression of p53, bax, cleaved PARP, cleaved caspase‐3 and phosphorylation of c‐Jun at position at 63Ser. Cyclin A and B1 expression were down regulated by docetaxel and Ad‐p53. When comparing the docetaxel‐resistant to sensitive cell lines, the altered expression of p27 and skp1 by docetaxel and Ad‐p53 were dissimilar between these cell lines.Conclusions: Docetaxel enhanced Ad‐p53 transduction and increased expression of exogenous p53 gene transfer, apoptosis, and antitumor mechanisms. These results support a clinical combination of docetaxel with p53 gene therapy in patients with head and neck cancer.
Intratympanic Injections of Dexamethasone for Long‐Term Control of Vertigo
Authors: Barrs David M. 
Published: October 2004

AbstractObjective: To examine whether intratympanic injection of dexamethasone is effective in long‐term control of vertigo for patients with Ménière disease whose dietary and diuretic therapy has proved unsuccessful.Study Design: Retrospective chart review performed at Carolina Ear and Hearing Clinic, Raleigh, North Carolina.Methods: Thirty‐four patients with intractable Ménière disease were given intratympanic injections of corticosteroids using dexamethasone 10 mg/mL for 4 weeks. The control of vertigo was documented in the 2‐year period after completion of the course of injections. All patients were continued on a diet and a diuretic during the study period.Results: Only 24% (8 of 34) of patients had control of vertigo with a single course of injections. Three patients had control of vertigo for 12 months and responded to a repeat series of injections with good control. Five patients who had recurrent vertigo at 6 months or earlier responded to repeat injections, for a total of 16 patients (47%) whose vertigo was controlled with a single course or multiple courses of intratympanic injections of corticosteroids.Conclusions: Approximately one‐half of patients (47%) with intractable Ménière disease achieved control of vertigo with one or more courses of intratympanic injections of corticosteroids. A single course of treatment alone can be expected to produce long‐term control of vertigo in only one‐fourth (24%) of patients. This study indicates that intratympanic injections of corticosteroids should not be expected to give long‐term control of vertigo in patients with Ménière disease. Multiple courses of intratympanic injections of corticosteroids, in conjunction with other treatments, are necessary in most patients with Ménière disease who have intractable vertigo.
Endoscopic Management of Hypopharyngeal Stenosis after Organ Sparing Therapy for Head and Neck Cancer
Authors: Sullivan Christopher A. , Jaklitsch Michael T. , Haddad Robert , Goguen Laura A. , Gagne Adele , Wirth Lori J. , Posner Marshall R. , Tishler Roy B. , Norris Charles M. 
Published: October 2004

AbstractObjectives: The objective of this study was to describe and evaluate the efficacy of an endoscopic technique for the management of postchemoradiation hypopharyngeal stenosis in head and neck cancer patients.Study Design: Retrospective review.Methods: Patients with postchemoradiation hypopharyngeal stenoses were identified from the Dana Farber Cancer Institute head and neck database. Patients who had undergone extirpative surgery and reconstruction were excluded. All patients underwent either anterograde dilatation (AD) by the lead author (C.A.S.) or transgastric retrograde esophagoscopy with anterograde dilatation (TREAD) (C.A.S., M.T.J.). Chemoradiation records, clinic notes, operative reports, and swallowing test data were reviewed. Removal of the gastric feeding tube was considered the endpoint of rehabilitation.Results: Seventeen patients had postcricoid stenoses identified by modified barium swallow. Endoscopy confirmed 15 postcricoid stenoses and 2 proximal esophageal stenoses. Nine (53%) patients had partial stenoses, and eight (47%) had complete stenoses. Eight partial stenosis patients underwent 10 AD procedures and 3 TREAD procedures. Eight complete stenosis patients underwent 9 TREAD procedures and 26 subsequent AD procedures. Fifteen of 16 (93%) patients resumed swallowing after dilatation. Thirteen (81%) patients maintained their weight on an oral diet and had their gastric feeding tubes removed. Complications included hypopharyngeal perforation (13%), abdominal wall infection (6%), stomach wall dehiscence (6%), and chondroradionecrosis of the cricoid cartilage (6%).Conclusions: Postcricoid hypopharyngeal stenosis may be partial or complete after organ sparing chemoradiation for head and neck cancer. Using the TREAD technique, successful rehabilitation of swallowing can be achieved with a low incidence of complications.
Significance of Nasal Polyps in Chronic Rhinosinusitis: Symptoms and Surgical Outcomes
Authors: Deal R Tyson , Kountakis Stilianos E. 
Published: October 2004

AbstractPurpose: To demonstrate the significance of nasal polyps on the symptoms of chronic rhinosinusitis (CRS) and their influence on surgical outcomes.Methods: Retrospective analysis of prospectively collected data comparing two groups of patients diagnosed with CRS with and without nasal polyps that underwent surgical management with a minimum 1‐year follow‐up period. Subjective scoring was performed using the Sino‐Nasal Outcome Test (SNOT‐20) questionnaire. Computed tomography (CT) scans were compared using the Lund‐Mackay scoring system. The two groups were analyzed for the need of revision surgery.Results: Two hundred one patients underwent surgical management of CRS over a 3‐year period. One hundred four were male, 97 were female, and the average age was 49 (range 18–80) years. Polyps were present in 78 patients with CRS, whereas 123 patients did not have polyps. The average CT score was 18 for the polyp group and 9.5 for the patients without polyps (P = .0000). Nonpolyp group SNOT‐20 scores were 26.5 preoperatively with improvement to 5.1 at 6 months and 5.0 at 12 months postoperatively (85% improvement). Polyp group SNOT‐20 preoperative scores averaged 32.2 with improvement to 9.2 at 6 months and 9.1 at 12 months postoperatively (81% improvement, P = .003). Nine patients required revision surgery (4.5%), eight (10%) who had polyps and one (0.8%) who did not (P = .002).Conclusion: The presence of nasal polyps has a significant negative impact on patients with CRS. Patients with nasal polyps have more severe symptoms with less improvement after operative intervention, higher CT scores at presentation, and a significantly higher need for revision surgery.
Prevalence of Helicobacter pylori in Patients with Nasal Polyps: A Preliminary Report
Authors: Koc Can , Arikan Osman Kursat , Atasoy Pnar , Aksoy Altan 
Published: October 2004

AbstractObjectives: The aim of the study is to determine the presence of H. pylori in nasal polyps by both immunohistochemical staining with H. pylori antibody of biopsy specimens and enzyme‐linked immunoadsorbent assay (ELISA) of sera.Study Design: A prospective, controlled, clinical trial.Methods: We enrolled 30 patients with nasal polyps and 20 controls with middle concha bullosa undergoing endoscopic sinus surgery (ESS). Blood samples of both the study and control groups were evaluated for anti‐H. pylori specific immunoglobulin (Ig)G antibodies by ELISA. In addition, biopsy specimens of the removed polyps and the mucosal part of middle conchas were examined by the immunohistochemical analysis with H. pylori antibody.Results: In the blood samples, specific IgG antibodies to H. pylori were found in 26 (86.7%) of 30 polyp patients and 17 (85%) of 20 controls. In 6 (20%) of the 30 patients, H. pylori was identified in the nasal polyp tissue, but it was not detected in the mucosal part of the middle concha specimens. No significant statistical difference was observed for H. pylori antibodies by ELISA among the patients with nasal polyps and the control group (Fisher's exact test, P = .59). However, there was a statistical difference between the polyp biopsy specimens and the control biopsy specimens by immunohistochemical staining (Fisher's exact test, P = .037).Conclusions: This study indicates that H. pylori was found in increased prevalence in the nasal polyps. However, further controlled epidemiologic studies would be necessary to confirm our results and clarify the potential underlying pathogenetic mechanisms.
Safety of Minimally Invasive Pituitary Surgery (MIPS) Compared with a Traditional Approach
Authors: White David R. , Sonnenburg Robert E. , Ewend Matthew G. , Senior Brent A. 
Published: October 2004

AbstractIntroduction: Transsphenoidal hypophysectomy is becoming progressively less invasive. Recent endoscopic techniques avoid nasal or intraoral incisions, use of nasal speculums, and nasal packing. Several case series of endoscopic endonasal pituitary surgery have been reported, but relatively little data exists comparing complication rates to more traditional approaches. We compare the complications of our first 50 cases of endoscopic, minimally invasive pituitary surgery (MIPS) to our last 50 sublabial transseptal (SLTS) procedures.Study Design: Retrospective case control study.Methods: Fifty consecutive MIPS procedures and 50 consecutive SLTS procedures were reviewed retrospectively. Complication rates were analyzed and compared.Results: Total complications per patient (P = .005), postoperative epistaxis (P = .031), lip anesthesia (P = .013), and deviated septum (P = .028) occurred more often in the SLTS group. No significant difference was seen in cerebrospinal fluid leak, meningitis, ophthalmoplegia, visual acuity loss, diabetes insipidus, intracranial hemorrhage, or death. In the MIPS group, length of stay (P < .001), use of lumbar drainage (P = .007), and nasal packing (P < .001) were also significantly reduced.Conclusions: Endoscopic endonasal pituitary surgery provides improved complication rates when compared with SLTS approaches. In addition, we note advantages of the MIPS approach, including reduced length of hospital stay and decreased use of lumbar drainage and nasal packing.
Basilar Membrane Displacement Related to Endolymphatic Sac Volume
Authors: Xenellis John E. , Linthicum Fred H. , Webster Paul , Lopez Ricardo 
Published: October 2004

AbstractObjective: To demonstrate that the amount of basilar membrane displacement toward the scala tympani and its attachment to the bony wall of the scala tympani (i.e., interscalar septum) in hydropic temporal bones is related to the intraosseous endolymphatic sac volume.Study Design: A retrospective analysis of temporal bones from individuals with the histopathologic diagnosis of “endolymphatic hydrops.”Methods: Fifty‐two temporal bones, from 38 patients, with the histopathologic findings of “endolymphatic hydrops” were analyzed microscopically. Data were obtained regarding the displacement of the basilar membrane, endolymphatic sac volume, hair cell loss, strial atrophy, ganglion cell loss, and last measured auditory thresholds. The relationships between these variables were examined statistically.Results: Nineteen of the 52 temporal bones (36.5%) with endolymphatic hydrops showed displacement of the basilar membrane toward the scala tympani in the apical and middle segments of the cochlea. A reduced volume of the endolymphatic sac was significantly related to increased severity of basilar membrane deformation (Rho = −.646; P ≤ .001). Multiple regression analysis showed that severity of basilar membrane deformation was the single best predictor of low frequency thresholds while loss of hair cells was the best predictor of pure‐tone average threshold.Conclusions: The displacement of the basilar membrane in the apical and middle segments that may occur with endolymphatic hydrops, to the extent that it impinges on the interscalar septum, is related to a reduction in the intraosseous endolymphatic sac volume.
Sinonasal Sarcoidosis: Review and Report of Fifteen Cases
Authors: Braun Jean Jacques , Gentine André , Pauli Gabrielle 
Published: October 2004

AbstractObjectives: Sinonasal sarcoidosis remains a poorly understood and uncommon chronic granulomatous disease of unclear origin. We have attempted to characterize the main clinical and radiologic criteria for diagnosis and to discuss the treatment.Methods: A retrospective study of 15 cases of chronic, symptomatic, and biopsy‐proven sinonasal sarcoidosis and a review of the literature are realized.Results: Among the 15 patients, there were 8 women and 7 men with a mean age of 44 years. The most frequent presentation was a chronic, often crusty, rarely destructive inflammatory rhinosinusitis with nodules on the septum and/or the turbinates. Pulmonary sarcoidosis was associated in 12 cases. Involvement of the nasopharynx, the pharyngolarynx, the skin, the lachrymal and salivary glands, and the liver was associated in some cases. Levels of angiotensin‐converting enzyme were elevated in 10 cases and normal in 3 cases. Gallium scan performed in three cases was positive. Radiologic studies showed nodules on the septum and/or the turbinates in 14 cases, complete or subtotal opacification of the sinuses and/or the nasal cavities in 13 cases, and nasopharyngeal or pharyngolaryngeal lesions in 4 cases. Treatment with corticosteroids, methotrexate, azathioprine, and surgery appear globally disappointing in view of the side effects and the relapses during a long follow‐up (3–15 yr; mean, 6 yr).Conclusion: On the basis of this study, we propose the following diagnostic criteria: 1) histopathologic confirmation of noncaseating granuloma; 2) chronic rhinosinusitis poorly responsive to conventional treatment and radiologic evidence of rhinosinusitis, often with nodules on the septum and/or the turbinates; 3) elevated level of angiotensin‐converting enzyme; 4) positive gallium scan (if performed); 5) frequent evidence of systemic, especially pulmonary, sarcoidosis; 6) no evidence of other granulomatous diseases, such as Wegener granulomatosis.
Evaluation of Donor Site Function and Morbidity of the Fasciocutaneous Radial Forearm Flap
Authors: de Bree Remco , Hartley Chris , Smeele Ludwig E. , Kuik Dirk J. , Quak Jasper J. , Leemans C René 
Published: October 2004

AbstractObjective: To assess the results of the use of the free radial forearm flap in terms of objective morbidity and subjective patient response.Study Design: The donor sites were examined from 37 patients who underwent reconstruction with a free fasciocutaneous radial forearm flap in the head and neck after ablative tumor surgery.Methods: Patients were asked to fill in a written questionnaire. The following additional tests were performed: resting skin temperature of digits I and V, temperature after submersion in iced water, grip and pinch tests, and goniometry.Results: Resting skin temperature was slightly decreased for donor hands 0.69°C (P < .001) and 0.31°C (P = .048) for digits I and V, respectively, but recovery after submersion in iced water showed no differences. The strength tests and goniometry revealed no statistically significant findings between donor and control sides. On the questionnaire, 9 patients (24%) reported slightly impaired function, 14 (38%) could not wear their watch or bracelet, 17 (46%) reported numbness, 5 (14%) reported soreness, 5 (14%) reported itching, 6 (16%) reported cold intolerance, 5 (14%) reported bad cosmetic appearance, and 9 (24%) expressed the opinion that they were insufficiently counseled.Conclusion: There is a negligible objective morbidity of a free radial forearm flap harvest procedure, but a number of patients have subjective complaints when asked. Elaborate presurgical counseling can probably reduce these complaints.
Neurologic Diagnosis and Treatment in Patients with Computed Tomography and Nasal Endoscopy Negative Facial Pain
Authors: Paulson Eric P. , Graham Scott M. 
Published: October 2004

AbstractObjective: To determine the helpfulness of specialist neurology referral for patients with facial pain, a normal sinus computed tomography (CT) scan, and normal nasal endoscopy findings.Study Design: Prospective identification of patients and analysis of data approved by the Institutional Review Board.Methods: The data of 104 consecutive patients presenting with facial pain, a normal sinus CT scan, and normal nasal endoscopy findings were reviewed. The patients presented to a single rhinologist in a tertiary care institution. All patients were referred for specialist neurologic evaluation and potential treatment. Further information was obtained from a patient survey.Results: Of the 104 patients, 81 were women and 23 were men. The average age was 46 years (range, 22–85). Fifty‐six had clear CT scans, 48 had minimal change, and all had negative endoscopies. Twenty‐nine had previous unsuccessful sinus surgery. The average follow‐up period was 10.5 months. Forty of 75 patients seeing a neurologist were seen on multiple occasions. Four percent of patients seen by a neurologist had an unsuspected serious intracranial diagnosis. The most common diagnoses were migraine (37%), rebound headache (17%), chronic daily headache (17%), and obstructive sleep apnea (16%). Overall, 58% improved on medical therapy; 60% of those with a clear CT scan improved, and 53% of those with minimal change on CT scan improved (P = .749).Conclusions: Facial pain remains a difficult symptom to diagnose and treat in rhinologic practice. Patients often undergo surgery without help. Most patients with facial pain, a normal sinus CT scan, and normal endoscopy findings benefit from neurologic consultation. Serious intracranial pathologic conditions can be excluded and diagnosis‐specific pharmacogenetic therapy instituted with improvement in more than 50%.
Tissue Microarray Analysis Reveals Prognostic Significance of COX‐2 Expression for Local Relapse in T1–2N0 Larynx Cancer Treated with Primary Radiation Therapy
Authors: Cho Edward I. , Kowalski Diane P. , Sasaki Clarence T. , Haffty Bruce G. 
Published: October 2004

AbstractObjective: The purpose of this analysis is to determine whether a significant correlation exists between cyclooxygenase‐2 (COX‐2) expression and local relapse in a large cohort of patients with T1 to 2N0 laryngeal cancer treated with primary radiation therapy.Methods and Materials: Clinical and molecular analyses were conducted on 123 patients with biopsy‐proven T1 to 2N0 laryngeal cancer. Clinical prognostic factors included pretreatment hemoglobin, age, sex, race, T stage, tumor subsite, beam energy, biologically equivalent dose, therapy duration, and treatment date. Molecular prognostic factors included COX‐2, p53, and Ki‐67 expression. Expression levels were determined by immunohistochemistry on paraffin‐embedded tissues arrayed on tissue microarrays. Multivariate analysis was done with the Cox proportional hazards model.Results: Thirty‐two patients have locally relapsed, for an actuarial 5‐year local relapse‐free rate of 70.4%. On multivariate analysis, positive COX‐2 expression predicted local relapse after radiation therapy. The relative risk (RR) for local relapse with COX‐2 positivity was 2.57 (95% CI, 1.21–5.47; P = .01). Other prognostic factors for local relapse included negative Ki‐67 expression (RR = 5.72; 95% CI, 2.04–16.1; P < .001), T2 stage (RR = 2.98; 95% CI, 1.39–6.38; P = .005), and therapy duration greater than 43 days (RR = 6.04; 95% CI, 1.37–26.7; P = .02).Conclusions: Positive COX‐2 expression predicts for local relapse in T1 to 2N0 larynx cancer in a multivariate model. This relationship may have potential therapeutic implications regarding the use of COX‐2 inhibitors during radiation therapy for optimal outcome.
Safe and Reliable Sound Threshold Measures with Direct Vibration of the Ossicular Chain
Authors: Maassen Marcus M. , Rodriguez Jorge Jesus , Herberhold Stephan , Vonthein Reinhard , Zimmermann Rainer , Baumann Ingo , Brosch Sibylle , Mauz Paul S. , Pfister Markus , Zalaman Ilse M. , Löwenheim Hubert , Zenner Hans P. 
Published: October 2004

AbstractObjectives: The aim of the study was to evaluate the safety and feasibility of piezoelectric malleus vibration audiometer (MVA), which presents micromechanical vibrations to the umbo membranae tympani.Study Design: Phase I study performed in a tertiary referral center (University Hospital).Methods: The coupling rod of the MVA was moved slowly through the outer ear canal toward the eardrum with a micromanipulator. Coupling was completed when the rod tip touched the umbo membranae tympani. Basic audiologic measures of sound threshold obtained with direct stimulation of the malleus are presented. We used MANOVA (multivariate repeated measures ANOVA) to investigate the repeatability of MVA thresholds from one day to the other and when decoupling and retracting the coupling rod 2 mm off the umbo. We also selected the MANOVA to test for unwanted bone‐conduction threshold shifts after MVA application. We assessed normality of the data by quantile‐quantile plots of the residuals.Results: Twenty‐eight male and 10 female subjects with normal hearing, 22.2 to 34.6 years old (median age, 27.2 yr) underwent an examination. Thirty‐six subjects underwent MVA, because 2 of the 38 subjects who volunteered for the study have not undergone the procedure due to the external auditory canal anatomy preventing application of the MVA. The results show that it is possible to safely and reliably measure thresholds of direct vibration of the ossicular chain. Using pure tone audiograms, no pure tone bone‐ and/or air‐conduction threshold shifts occurred after the procedure. None of the subjects reported any other ear‐related symptoms such as vertigo, tinnitus, or dizziness. Geometric mean vibratory displacements at threshold ranged from 0.55 nm at 250 Hz to 0.03 nm at 6 kHz. MANOVA demonstrated a repeatability of MVA thresholds.Conclusion: Malleus vibration audiometry will not allow exact linkage of actual implantable hearing aid. But the present study demonstrates that MVA can provide an audiometric tool for assessing ossicular function and integrity prior to implantation of an electronic hearing amplifier.