bluuebunny/crossref_metadata_2025_split huggingface dataset:
Current Status of Neoadjuvant Therapy for Adenocarcinoma of the Distal Esophagus
Authors: Zacherl Johannes , Sendler Andreas , Stein Hubert J. , Ott Katja , Feith Marcus , Jakesz Raimund , Siewert J. Rüdiger , Fink Ulrich 
Published: November 2003

AbstractProspective studies dealing with preoperative therapy in adenocarcinoma of the esophagus alone are rare. The interpretation of the preferential phase II trials and a few phase III trials is complicated, as most studies include adenocarcinoma of the esophagus (i.e., Barrett’s carcinoma), adenocarcinoma of the esophagogastric junction (including cardia carcinoma and subcardia carcinoma), or squamous cell carcinoma. Preoperative chemotherapy, generally well tolerated, cannot decrease the incidence of local failure beyond the level achieved with surgery alone, but it might delay systemic relapse. Preoperative radiotherapy can enhance local control, but it fails to improve overall survival. Neoadjuvant chemoradiation was demonstrated in only one randomized trail to have a survival benefit, but survival in the surgery‐alone group was unusually low. Generally, survival was ameliorated in patients responding to neoadjuvant treatment. However, preoperative chemoradiation was often accompanied by a remarkable increase in postoperative morbidity and mortality. Nonresponding patients have, in this respect, a worse prognosis than responders after resection. The prediction of responding patients to neoadjuvant therapy as well as the early identification of patients who will not respond is of utmost clinical importance. Today, there is no absolute evidence that neoadjuvant treatment for patients with potentially resectable Barrett’s cancer prolongs survival. In patients with locally advanced, presumably not completely resectable adenocarcinoma of the esophagus, preoperative treatment appears to increase the chance for a curative resection and enhance survival in responding patients. Neoadjuvant treatment of adenocarcinoma of the esophagus, as a consequence, is currently not the standard treatment and should be performed only within controlled clinical trials.
Evolution of Neck Dissection for ImprovedFunctional Outcome
Authors: Samant Sandeep , Robbins K. Thomas 
Published: November 2003

AbstractNeck dissection plays a crucial role in the management of
metastatic neck disease. Until recently, radical neck dissection has been the
standard treatment for malignant cervical adenopathy irrespective of the nodal
staging. However, in recent years, there has been a trend toward the
development of more conservative operations, wherein certain nonlymphatic
structures and lymph node groups can be selectively preserved. Radical neck
dissection still remains the surgical standard against which various
modifications must be compared. The need to perform more conservative surgery
comes from the realization that the radical operation is attended by
significant postoperative morbidity, and that some of the structures removed in
the course of this operation can actually be preserved without any compromise
in oncologic safety. The purpose of this article is to discuss the evolution of
conservation surgery in the management of metastatic neck disease, define the
clinical applications of various types of neck dissection, and evaluate the
implications of these conservation approaches on preservation of
function.
Scintigraphic Evaluation of Jejunal Interposition after Distal Esophageal Resection for Early Barrett’s Carcinoma
Authors: Stier Albrecht W. , Feith Marcus , Weigel Christiane , Schwaiger Marcus , Heidecke Claus D. , Stein Hubert J. 
Published: November 2003

AbstractSubtotal esophagectomy still is the major treatment for early Barrett’s carcinoma. The inevitable loss of the gastric reservoir leaves an unresolved functional problem. Distal esophageal resection combined with a short jejunal interposition might be a safe alternative with the advantage of better functional results. In this series, 12 or more months after limited surgery for early Barrett’s carcinoma 8 patients underwent functional investigation by alimentary scintigraphy. The activity of a technetium‐labeled bolus passing through the esophagus and the jejunal interposition into the stomach was consecutively measured. Compared to 11 healthy controls the transit through the tubular esophagus showed no significant delay; transit time, however, increased with a bolus‐induced dilation of the jejunal interposition. The length of the transit time through the jejunal interposition correlated with the length of the jejunal segment. The delay of bolus passage into the stomach did not result in substantial symptoms in jejunal segments shorter than 12 cm. Propulsive activity within the jejunal interposition resulted in a bolus transport into the stomach without any reflux to the esophagus. These data demonstrate good transport function and reflux prevention of short jejunal segments interposed between the esophagus and the stomach.
Effects of trauma‐focused research on recent domestic violence survivors
Authors: Johnson Lesley E. , Benight Charles C. 
Published: November 2003

AbstractThis study investigated the impact of trauma‐focused research on domestic violence survivors. At the end of a survey assessing psychological distress, abuse severity, coping self‐efficacy (CSE), and cognitions, questionnaire items were utilized to assess participants' levels of gain, unexpected upset, and regret of participation. Participants were 55 women who had recently experienced abuse by a partner. Forty‐five percent reported positive gain from participation, 25% reported they were more upset than anticipated, and a minority of women (6%) expressed regret for participation. Results indicated that women who were more upset than expected scored significantly higher on depression, PTSD, and number of lifetime traumas, and significantly lower on CSE. Implications for enhancement of consent form documents and debriefing procedures are addressed.
Predictors of nonpathological dissociation in Northern Ireland: The affects of trauma and exposure to political violence
Authors: Dorahy Martin J. , Lewis Christopher Alan , Millar Robert G. , Gee Travis L. 
Published: November 2003

AbstractRecent work has identified an empirical distinction between pathological and nonpathological dissociation. This study examined the correlates of nonpathological dissociation in a Northern Irish sample. The Dissociative Experiences Scale, the Traumatic Experiences Checklist, the Guilt Inventory, and the General Health Questionnaire, as well as two open‐ended questions assessing exposure to political violence were completed by 119 participants. Nonpathological dissociation was predicted by age, perceived impact of traumatic events, and adherence to moral standards. Moreover, dissociation was found to be significantly higher in those exposed directly to political violence and those experiencing childhood emotional abuse. Results are consistent with previous theoretical and empirical work and it is proposed that nonpathological dissociation is related to traumatic experience in Northern Ireland.
Laser‐Assisted Uvulopalatoplasty for Obstructive Sleep Apnea
Authors: Mickelson Samuel A. 
Published: November 2003

AbstractLaser‐assisted uvulopalatoplasty (LAUP) can reduce snoring by sequentially removing excessive vibratory tissue of the velopharynx. The procedure can be performed under local anesthesia in an office setting. Since the appearance of the soft palate is similar after both LAUP and uvulopalatopharyngoplasty, LAUP may also be efficacious in the management of obstructive sleep apnea syndrome (OSAS).LAUP was performed in 34 consecutive prospectively evaluated patients with OSAS. Of the 34 patients, 28 (82%) were male; the mean age was 53 years, and the mean body mass index was 31.1. In the study population of 13 patients who completed preoperative and postoperative sleep studies, the apnea index decreased from 19.4 to 4.2 (P=.006), the respiratory disturbance index (RDI) decreased from 31.2 to 15.7 (P=.092), and mean lowest oxyhemoglobin saturation increased from 82.3% to 85.0% (P=.581). The RDI fell to 10 or lower in 38.5.% of patients and was reduced by at least 50% in 53.8% of the study group. Snoring was significantly reduced in 92.3% of patients (P<.001). These early results suggest that LAUP may be efficacious in the management of OSAS.
Outcome of Pyriform Sinus Cancer
Authors: Marks Steven C. , Lolachi Christopher M. , Shamsa Falah , Robinson Kevin , Aref Amr , Jacobs John R. 
Published: November 2003

AbstractPyriform sinus cancer remains one of the most lethal of human diseases. Regardless of approach attempted significant enhancement of survival has not been realized. In this study a retrospective single institutional review of all patients diagnosed with pyriform sinus cancer during the 1980s was conducted. The results in 93 patients show an overall determinant 5‐year survival of 14.3%. Of patients undergoing surgery, median determinant survival was 37 months and 5‐year survival was 34.6%. In resectable patients treated with radiation with or without chemotherapy, median determinant survival was 13 months with 5‐year survival of 7.1% (P<.01). Surgical salvage was attempted in 8 patients without success.In conclusion, due to the apparent survival advantage for surgical patients, the low rate of surgical salvage, and the relatively low rate of organ preservation in prospective trials, pyriform sinus cancer is a poor site for organ preservation. Surgery followed by radiation therapy should remain the standard of care for pyriform sinus cancer.
Choanal Atresia
Authors: Brown Orval E. , Pownell Patrick , Manning Scott C. 
Published: November 2003

AbstractThe anatomic classification of choanal atresia is commonly quoted as 90% bony and 10% membranous. This incidence is from a review by Fraser in 1910 of 115 cases, “many of which were insufficiently described.” We have reviewed 47 computed tomography scans of choanal atresia from the literature and 16 from our clinical experience, and classified the anatomy as bony, mixed bony‐membranous, or pure membranous. Our results reveal a combined incidence of 18 (29%) pure bony, 45 (71%) mixed bony‐membranous, and no pure membranous atresia. We propose a new classification of choanal atresia to include bony, mixed, and membranous to accurately reflect the anatomic abnormalities. Our series of 11 patients under‐going transnasal microsurgical repair, a critical review of the literature, and the implications of the anatomic classification on the choice of surgical procedure are presented.
Holmium
Authors: Metson Ralph 
Published: November 2003

AbstractAlthough surgical lasers were introduced to the field of otolaryngology more than 20 years ago, their use in rhinologic surgery has remained relatively limited. With the development of the holmium:yttrium‐aluminum‐garnet (YAG) laser, a device is now available that offers those features necessary for effective sinus surgery: precise bone ablation, efficient soft tissue coagulation, and fiberoptic transmission. This solid‐state laser of 2.1‐μm wavelength can be coupled with endoscopic instrumentation for the surgical treatment of sinus disease.This study was conducted to determine the clinical efficacy of the holmium:YAG laser for endoscopic sinus surgery. A microscopic analysis of laser‐treated sinus tissue was also performed in an attempt to determine the histologic basis of the observed clinical findings.In a prospective, randomized, controlled, single‐blinded study, 32 consecutive patients underwent endoscopic sinus surgery using the holmium:YAG laser on one side of the nose and conventional endoscopic instrumentation on the other side. Patients rated symptoms for each side of the nose at 1 week, 1 month, 3 months, 6 months, and 2 years after surgery. Healing parameters were similarly rated by the surgeon. Until the study was completed, patients were not told which side of the nose had been treated with laser surgery.No intraoperative complications occurred. The mean intraoperative blood loss was 24.6 mL less on the laser‐treated side of the nose than on the conventionally treated side (P<.001). At 1 week after surgery, there was increased mucosal edema on the laser‐treated side (P<.01). Crust formation was greater on the conventionally treated side at 1 week and was greater on the laser‐treated side at 1 month (P<.01). Improvements in symptoms of pain, congestion, and drainage were equivalent for both treatment modalities (P<.001).Microscopic analysis demonstrated the ability of the holmium:YAG laser to remove tissue in relatively thin layers with ablation depths of 260±8.2 μm, 286±9.4 μm, and 341±20.4 μm per pulse at energy levels of 0.5, 1.0, and 1.5 J, respectively. A zone of thermal necrosis extending up to 1 mm beyond the site of laser impact was thought to correlate with the increased postoperative edema observed on the laser‐treated side.Endoscopic sinus surgery with the holmium:YAG laser is as effective as nonlaser techniques in relieving the symptoms of chronic sinusitis. Laser surgery offers improved intraoperative hemostasis, but it causes increased postoperative tissue edema. The holmium:YAG laser provides the surgeon with an additional tool for the performance of safe, effective sinus surgery.
Inhibition of Head and Neck Tumor Cell Growth With Arachidonic Acid Metabolism Inhibition
Authors: Ondrey Frank G. , Juhn Steven K. , Adams George L. 
Published: November 2003

AbstractHead and neck tumors are known to synthesize arachidonic acid metabolites. The authors have postulated that these substances may confer growth advantage to cancer cells, and by interfering with arachidonic acid metabolism squamous cancer growth may be altered. The tongue derived squamous carcinoma cell line, SCC‐25, was treated with three leukotriene synthesis inhibitors and indomethacin. A dose‐dependent decrease in DNA synthesis occurred with leukotriene inhibition, but not prostaglandin inhibition. All leukotriene synthesis inhibitors produced a dramatic and immediate effect (>70% inhibition by 4 hours) without cytotoxicity (>90% trypan blue exclusion). Cell populations at 96 hours were decreased when compared to control populations. In conclusion, leukotrienes or other lipoxygenase products may play a role as growth factors for squamous cell carcinoma, and arachidonic acid inhibition may be a novel target for chemotherapeutic intervention.
Comparison of Labyrinthectomy and Vestibular Neurectomy in the Control of Vertigo
Authors: Gacek Richard R. , Gacek Mark R. 
Published: November 2003

AbstractOne hundred twenty‐six patients who were treated with labyrinthectomy (81 patients) or vestibular neurectomy (45) between the years 1979 and 1994 were reviewed. The cause for vertigo in 124 of the 126 patients was Meniere's disease (89 patients), labyrinthitis (15), delayed endolymphatic hydrops (8), vestibular neuritis (7), and failed labyrinthectomy (5). In the remaining 2 patients, a normal labyrinth was sacrificed to fistulize a petrous apex cyst. Both procedures were equally effective in relieving vertigo (labyrinthectomy 98.8%; neurectomy 97.8%), but the length of hospitalization, length of disability before return to work, and cost were twice as great with vestibular neurectomy than with labyrinthectomy. More patients exhibited prolonged ataxia following neurectomy (5 patients) than after labyrinthectomy (2). Vestibular neurectomy was associated with several serious complications: reversible facial paresis (15 patients), meningitis (1), cerebrospinal fluid leak (1), and epidural hematoma (1). Labyrinthectomy was complicated by postoperative hyponatremia in 1 patient. Selective vestibular neurectomy preserved hearing in 32 (82%) of 39 patients. Criteria for recommending either ablation procedure are discussed. The incidence of sequential involvement of the contralateral ear was 1.5%.
Elevated Arginine Vasopressin Levels in Squamous Cell Cancer of the Head and Neck
Authors: Talmi Yoav P. , Wolf Gregory T. , Hoffman Henry T. , Krause Charles J. 
Published: November 2003

AbstractThe reported effectiveness of single tumor markers (TMs) associated with squamous cell cancer of the head and neck ranges from 15% to 71%, with most studies reporting sensitivity no higher than 50%. An increased incidence of the syndrome of inappropriate secretion of antidiuretic hormone or arginine vasopressin (SIADH) in patients with head and neck cancer has been reported. Serum arginine vasopressin (AVP) was studied as a possible TM in these patients. Sixty‐three patients with squamous cell carcinoma of the head and neck determined as potentially curable were prospectively evaluated before treatment and compared to 17 patients with apparent cure of head and neck squamous cell cancer who served as controls. Serum AVP levels were obtained and determined by radioimmunoassay in the preoperative period and 1 week postoperatively in 15 patients. Thirty‐four patients were staged as T4, 26 as T3, and 3 as T2. Twenty‐one (33%) of the 63 patients had no neck involvement. Twenty‐four (38%) of 63 patients had elevated serum AVP levels corrected for serum osmolarity. Of the 15 patients evaluated before and after surgery, 8(53%) had elevated serum AVP levels preoperatively. Of these 8 patients, 3 had reduction in AVP levels and 5 had complete normalization after 1 week. The results obtained for serum AVP do not exceed results of other TMs reported. AVP may also not be as specific as other TMs for cancer of the head and neck. Our group with AVP sampled postoperatively is too small for us to draw conclusions, but reduction of its levels after treatment in all patients may be significant. These preliminary results indicate that further evaluation of AVP during the posttreatment course in a larger number of cases, and perhaps with other TMs as well, is warranted.
Quantification of Videostrobolaryngoscopic Findings‐Measurements of the Normal Glottal Cycle
Authors: Woo Peak 
Published: November 2003

AbstractVideostrobolaryngoscopic (VSL) images of vocal fold behavior in 32 male and 33 female normal speakers were analyzed by computer. Image analysis software enhanced the glottal image, allowing extraction of the glottal area. Frame‐by‐frame analysis produced 20 glottal area values for each glottal cycle. The glottal area waveform (GAW) plots these values. From the GAW, features such as peak glottal area, duration of opening and closing, and rates of vocal fold opening and closing were measured. Acoustic measures of sound pressure level(SPL) and fundamental frequency were used to compare changes in GAW with changes in loudness and pitch.Analysis of the data showed significant differences between the sexes in GAW, peak glottal area, closed period, closing slope, and size and incidence of the posterior glottal gap. Intensity and frequency changes significantly affected GAW. Intensity variations affected the steepness of the closing phase and the duration of the closed period. Frequency changes affected the open period and the relative duration of opening vs. closing.This study provides quantitative measures of the VSL image that supplement and corroborate perceptual observations. These measures provide normative data against which similar measures of dysphonic larynges can be compared.
A Positional Maneuver for Treatment of Horizontal‐Canal Benign Positional Vertigo
Authors: Lempert Thomas , Tiel‐Wilck Klaus 
Published: November 2003

AbstractHorizontal‐canal benign positional vertigo (HC‐BPV) is characterized by brief attacks of intense vertigo that are induced by mainly rolling over in bed. Examination shows a burst of purely horizontal nystagmus beating toward the undermost ear when the head is turned from supine to either lateral position. Two patients with typical HC‐BPV were treated by a new positional procedure that aims to clear particles from the affected canal. The maneuver starts with the patient in the supine position and consists of three 90‐degree head rotations toward the unaffected ear. Both patients had immediate and sustained relief of their attacks. No positional nystagmus could be elicited after the maneuver. The rapid cessation of positional vertigo and nystagmus adds evidence that HC‐BPV is caused by dense particles that move within the canal whenever its orientation toward gravity is changed.
Effect on the Nasal Mucosa of Long‐Term Treatment With Oxymetazoline, Benzalkonium Chloride, and Placebo Nasal Sprays
Authors: Graf Peter , Hallén Hans 
Published: November 2003

AbstractA parallel, randomized, double‐blind study was performed in 30 healthy subjects to investigate the effects on the nasal mucosa of a 1‐month treatment with nasal sprays. Ten subjects received oxymetazoline nasal spray; 10 subjects used a nasal spray containing the preservative benzalkonium chloride, and the others were treated with a placebo nasal spray. The three variables that were studied‐nasal mucosal swelling, symptom scores, and nasal reactivity‐were estimated by histamine challenge before and after 28 days of treatment. Rhinostereometry was used to measure nasal mucosal swelling and nasal reactivity.After 28 days of use, benzalkonium chloride spray alone induced an increase in nasal mucosal swelling. At the end of the month, the score for nasal stuffiness was significantly higher for the group treated with oxymetazoline than for those treated with benzalkonium chloride. Oxymetazoline nasal spray induced a pronounced increase in nasal reactivity, which was significantly greater than that induced in the placebo group. Long‐term use of placebo and benzalkonium chloride nasal sprays also caused an increase in nasal reactivity, but not to the same extent as with the nasal sprays containing oxymetazoline.The authors concluded that long‐term use of oxymetazoline induces a sensation of nasal stuffiness, which may be due to unconscious exaggeration of the degree of nasal stuffiness, induced nasal hyperreactivity, or a combination of both. These factors are probably the main reasons for the prolonged use of nasal decongestive sprays and the development of rhinitis medicamentosa. Benzalkonium chloride induces mucosal swelling, which explains why the presence of this preservative in a decongestant spray aggravates rhinitis medicamentosa.Laryngoscope, 106:605‐609, 1996
Predictive Value of Facial Nerve Electrophysiologic Stimulation Thresholds in Cerebellopontine‐Angle Surgery
Authors: Selesnick Samuel H. , Carew John F. , Victor Jonathan D. , Heise Carl W. , Levine Jennifer 
Published: November 2003

AbstractThe predictive value of intraoperative stimulation thresholds for facial nerve function, using a constant‐current system, was examined in 49 patients undergoing resection of cerebellopontine‐angle tumors. Immediately after surgery, 75% of the 0.1‐mA threshold group, 42% of the 0.2‐mA group, and 18% of the 0.3‐mA or greater group had good (grade I or II) facial nerve function. One year after surgery, 90% of the 0.1‐mA group, 58% of the 0.2‐mA group, and 41% of the 0.3‐mA or greater group had grade I or II function.A statistically significant breakpoint of 0.2 mA was found to predict good postoperative facial function. Delayed facial paralysis occurred in 22% of patients, but the prognosis for these patients was favorable. Both current stimulation threshold and duration are necessary for a meaningful comparison of data between investigators.Laryngoscope, 106:633‐638, 1996