bluuebunny/crossref_metadata_2025_split huggingface dataset:
L‐N‐Acetyl‐Cysteine Protection Against Cisplatin‐Induced Auditory Neuronal and Hair Cell Toxicity
Authors: Feghali Joseph G. , Liu Wei , Van De Water Thomas R. 
Published: November 2003

AbstractObjectives The aim of this study is to determine the efficacy of L‐N‐acetyl‐cysteine (L‐NAC) as a protectant for inner ear auditory sensory cells against the toxic effects of cisplatin.Study Design Prospective laboratory study of the otoprotective effect of L‐NAC on auditory neurons and hair cells in vitro.Methods The study has two arms. The first arm evaluated the neuroprotective effect of L‐NAC on early postpartum auditory ganglion cell cultures. Two culture media were used. The two media differed in that one of them was enhanced by the addition of neurotrophins (neurotrophin type 3 and brain‐derived neurotrophic factor) and a growth factor (transforming growth factor‐β1). Then the survival of cisplatin‐treated auditory neurons was studied before and after pretreatment with protective levels of L‐NAC. The second arm of the study evaluated the effect of L‐NAC on cisplatin damage initiated to auditory hair cells. Early‐postpartum organ of Corti explants were grown in culture. Their rate of survival was studied after exposure to toxic levels of cisplatin. Then, survival of cisplatin‐damaged hair cells was studied after they were pretreated with L‐NAC.Results Pretreatment of cultures with L‐NAC protected both auditory neurons and hair cells from the effects of exposure to toxic levels of cisplatin. This observed otoprotective effect was dose dependent.Conclusions Our in vitro studies have demonstrated that L‐NAC protected both auditory neurons and hair cells from the toxic effects of cisplatin. Because it protects both of these inner ear structures, L‐NAC may be potentially useful in protecting hearing, in general, from cisplatin‐induced damage. In addition, L‐NAC has low systemic and mucosal toxicity. It also has a low molecular weight that may allow it to readily cross the round window membrane. All these characteristics make it potentially suitable for transtympanic application for the prevention of the ototoxicity of cisplatin in vivo.
Potassium Recycling Pathways in the Human Cochlea
Authors: Weber Peter C. , Cunningham Calhoun D. , Schulte Bradley A. 
Published: November 2003

AbstractObjectives/Hypothesis Potential pathways for recycling potassium (K+) used in the maintenance of inner ear electrochemical gradients have been elucidated in animal models. However, little is known about K+ transport in the human cochlea. This study was designed to characterize putative K+ recycling pathways in the human ear and to determine whether observations from animal models can be extrapolated to humans.Study Design A prospective laboratory study using an immunohistochemical approach to analyze the distribution of key ion transport mediators in the human cochlea.Methods Human temporal bones were fixed in situ within 1 to 6 hours of death and subsequently harvested at autopsy. Decalcification was accomplished with the aid of microwaving. Immunohistochemical staining was then performed to define the presence and cell type‐specific distribution of Na,K‐ATPase, sodium–potassium–chloride cotransporter (NKCC), and carbonic anhydrase (CA) in the inner ear.Results Staining patterns visualized in the human cochlea closely paralleled those seen in other species. Anti‐Na,K‐ATPase stained strongly the basolateral plasma membrane of strial marginal cells and nerve endings underlying hair cells. This antibody also localized Na,K‐ATPase to type II, type IV, and type V fibrocytes in the spiral ligament and in limbal fibrocytes. NKCC was present in the basolateral membrane of strial marginal cells as well as in type II, type V, and limbal fibrocytes. Immunoreactive carbonic anhydrase was present in type I and type III fibrocytes and in epithelial cells lining Reissner's membrane and the spiral prominence.Conclusions The distribution of several major ion transport proteins in the human cochlea is similar but not identical to that described in various rodent models. These results support the presence of a complex system for recycling and regulating K+ homeostasis in the human cochlea, similar to that described in other mammalian species.
Improving the Otolaryngology Consultation Service in a Teaching Hospital
Authors: Carr Michele M. 
Published: November 2003

AbstractObjective To examine the type and quality of consultations requested from the otolaryngology service at a tertiary care hospital.Study Design Retrospective.Method Review of written documentation of consultations over a 6‐month period.Results One hundred eleven requests were received, and 107 written reports were made. Twenty services made requests. Thirty‐two percent of requests had a legible requester or contact listed. Sixty‐seven percent of requests stated why the patient was in hospital, and 85% stated the otolaryngological complaint. Thirty‐two percent of requests made accurate reference to the otolaryngological history, and 6% recorded an ENT examination that was accurate. Seven percent of patients were intubated, and 16% had a tracheostomy prior to evaluation. Forty‐eight percent of patients required flexible nasopharyngolaryngoscopy. Sixteen percent of patients required rhinoscopy, and 16% required tracheotomy. Twelve percent of patients needed audiograms, and small numbers of patients required biopsy, debridement of ears, ventilation tube insertion, nasal packing, or radiological studies. Reports were made by senior residents, and evidence that the case was discussed with or seen by an attending surgeon was present in 43% of reports. A diagnosis was stated in 85% of reports, and in 3% the diagnosis appeared to be inaccurate as compared with the history and physical examination recorded. A follow‐up plan was stated in 70% of reports.Conclusions There is a need to educate physicians about collegial communication regarding patients. This information can direct curriculum needed to prepare otolaryngology residents to provide a consultative service in a teaching hospital. This method of determining “true learning needs” can be used in other situations to improve resident training.
Free Tissue Reconstruction of the Hypopharynx After Organ Preservation Therapy: Analysis of Wound Complications
Authors: Teknos Theodoros N. , Myers Larry L. , Bradford Carol R. , Chepeha Douglas B. 
Published: November 2003

AbstractPurpose Previous series have demonstrated a 77% rate of major wound complications in salvage surgery of the larynx following organ preservation protocols. The purpose of this study is to determine the incidence of wound complications in these patients when microvascular free tissue transfers are used for reconstruction of the hypopharynx.Design Retrospective case series.Setting Academic tertiary care center.Patients and Method We reviewed the medical records of 42 patients with stage III and IV laryngeal squamous cell carcinoma treated with an organ‐sparing protocol consisting of induction chemotherapy followed by definitive radiation therapy. Ten of these patients who required surgical salvage were reconstructed using radial forearm free tissue or lateral arm transfer and constitute the study group.Main Outcome Measures Wound complications.Results Wound complications occurred in 2 patients (20%) undergoing free flap reconstruction of the hypopharynx after organ preservation protocols, which was significantly lower (P = .003) than previous reports using other forms of closure and/or reconstruction. One patient in this study group had a small pharyngocutaneous fistula that resolved with conservative therapy after 1 week. The other patient had a larger pharyngocutaneous fistula that resolved over 3 weeks. The mean interval from completion of the chemoradiation regimen to surgery was 21.3 months (range, 2–60 mo). The average free tissue flap size was 94.3 cm2 (range, 45–165 cm2). Average harvest and ischemia times were 59 minutes (range, 41–87 min) and 187.7 minutes (range, 120–240 min), respectively. All flaps survived, and one patient had a minor donor site wound dehiscence. The average hospital stay was 7.8 days. There were no mortalities in this series.Conclusions Our results suggest that free tissue transfer reconstruction of the hypopharynx is the preferred method of reconstruction following combined chemotherapy and radiation therapy protocols. Surgical complications are significantly reduced and hospital stays are minimized.
Comparison of Wound Healing Using the CO2 Laser at 10.6 μm and 9.55 μm
Authors: Converse George M. , Ries William Russell , Reinisch Lou 
Published: November 2003

AbstractObjectives/Hypothesis The wound healing characteristics of incisions made with the short pulsed CO2 laser tuned to 9.55 μm versus the traditional 10.6 μm were investigated. Previous studies have shown that at 9.55 μm, collagen is targeted more selectively than at 10.6 μm, which results in decreased acute thermal injury patterns. This study investigates the difference in wound healing over time between lasers and compares laser incisions with cold knife techniques .Study Design Randomized controlled trial using a porcine model.Methods Tissue from 10.6‐μm and 9.55‐μm incisions of 10 piglets was evaluated with histological analysis and tensiometry at 3, 7, 14, and 21 days postoperatively. A Bonferroni‐Dunn corrected analysis of variance analysis at a 95% significance level was used to compare the effect of wavelength.Results The results demonstrate that although knife incisions are consistently stronger than laser incisions, the 9.55‐μm CO2 laser incisions are no stronger than incisions made with the conventional 10.6‐μm laser. Furthermore, histological analysis shows no difference in lateral thermal damage between lasers at 3, 7, 14, and 21 days postoperatively. The progression of collagen formation and inflammation does not differ over time.Conclusion This study of wound healing using a porcine model demonstrates that the 9.55‐μm CO2 laser does not demonstrate an improvement in wound healing over the traditional 10.6‐μm CO2 laser. These results may be secondary to the common explosive vaporization mechanism produced by both lasers in the infrared spectrum.
Rhino‐Frontal Sinuseptotomy (RFS): A Combined Intra–Extra Nasal Approach for the Surgical Treatment of Severely Diseased Frontal Sinuses
Authors: Stennert Eberhard 
Published: November 2003

AbstractObjectives Frontal sinus surgery is a challenge to those involved in the treatment of recurrent frontal sinusitis. The purpose of this report is to describe the technique and to present the results of a combined endoscopic and external approach to the frontal sinus (rhino‐frontal sinuseptotomy [RFS]).Material RFS was performed in 45 patients by the author; 41 of these patients had a follow‐up over 12 months and were included in this series. Indications for RFS were severe chronic frontal sinusitis (n = 23), mucoceles (n = 12), in two cases each with osteoma, inverting papilloma, and malignant tumors of the frontal sinus, respectively. The surgical technique is started with an external approach according to Jansen‐Ritter and includes the resection of the interfrontal septum, partial resection of the nasal septum, bilateral subtotal resection of the middle turbinates, bilateral endoscopic ethmoidectomy, and resection of the frontal sinus floor. The nasofrontal communication is epithelialized with free mucosal grafts and fixed with fibrin clue.Results After a mean follow‐up of 62 months, 40 patients (98%) had a widely patent epithelialized nasofrontal communication. Ninety‐one percent of the patients with chronic frontal sinusitis or mucoceles noted complete relief of their frontal discomfort within 1 week after RFS. No patient required revision surgery of the nasofrontal outflow tract after RFS. Only one severe complication was recognized (cerebrospinal fluid leakage).Conclusion The results reported here with the RFS technique are superior to those reported on external procedures and endoscopic drill‐out procedures. The key to successful management is the creation of a large nasofrontal communication, and direct epithelialization with free mucosal grafts obtained from the septum and turbinates.
Use of Dexamethasone on the Prophylaxis of Nausea and Vomiting After Tympanomastoid Surgery
Authors: Liu Yun‐Hou , Li Min‐Jia , Wang Pa‐Chun , Ho Shung‐Tai , Chang Ching‐Fong , Ho Chiu‐Ming , Wang Jhi‐Joung 
Published: November 2003

AbstractObjective The aim of this study was to evaluate the prophylactic effect of dexamethasone on postoperative nausea and vomiting (PONV) in patients undergoing tympanomastoid surgery.Study Design Eighty patients (n = 40 in each of two groups) undergoing tympanomastoid surgery under general anesthesia were enrolled in this randomized, double‐blind, placebo‐controlled study.Methods After tracheal intubation, group 1 received 10 mg dexamethasone intravenously, whereas group 2 received saline intravenously. Several parameters concerning with the occurrence of PONV were evaluated.Results We found that dexamethasone reduced the total incidence of nausea and vomiting by 45%, with a 95% confidence interval of 26% to 64% (P <.001). Furthermore, dexamethasone reduced the incidence of vomiting episodes >4 times and the incidence of patients requiring rescue antiemetics (P <.05).Conclusion Dexamethasone at a dosage of 10 mg administered intravenously is effective in preventing PONV in patients undergoing tympanomastoid surgery.
Motility‐Related Proteins as Markers for Head and Neck Squamous Cell Cancer
Authors: Abraham Manoj T. , Kuriakose M. Abraham , Sacks Peter G. , Yee Herman , Chiriboga Luis , Bearer Elaine L. , Delacure Mark D. 
Published: November 2003

AbstractHypothesis Increased cell motility is a hallmark of cancer cells. Proteins involved in cell motility may be used as molecular markers to characterize the malignant potential of tumors.Methods Molecular biology and immunohistochemistry techniques were used to investigate the expression of a selected panel of motility‐related proteins (Rho A, Rac 2, Cdc42, PI(3)K, 2E4, and Arp2) in normal, premalignant, and squamous cell cancer cell lines of human head and neck origin. To assess the clinical potential of these proteins as molecular markers for cancer, immunohistochemistry was performed on paraffin‐fixed head and neck cancer specimens (n = 15).Results All six motility‐associated proteins were overexpressed in the premalignant and squamous cell cancer cell lines relative to normal keratinocytes. Immunohistochemistry with Rho A and Rac 2 showed increased staining in areas of cancer but not in normal tissue.Conclusion Proteins involved in cell motility can be used as markers for head and neck squamous cell carcinoma. The head and neck cell lines used in this study may be used as a model to further investigate cell motility. Molecular markers of motility could have a significant impact on the diagnosis and staging of cancers originating from differentiated non‐motile cells.
Quality of Life After Treatment for Advanced Laryngeal and Hypopharyngeal Cancer
Authors: Major M. Scott , Bumpous Jeffrey M. , Flynn Michael B. , Schill Kathleen 
Published: November 2003

AbstractObjectives To compare health‐related quality of life measures after treatment for advanced (stages III and IV) laryngeal and hypopharyngeal cancers.Study Design Retrospective chart review and patient response to Health Status Questionnaire‐12 (HSQ‐12).Methods Our study included 54 patients identified from the Tumor Registry of the University of Louisville Brown Cancer Center who were diagnosed and treated between 1995 and 2000. Demographics, tumor data, and treatment information were obtained from the Tumor Registry database. Questionnaires were mailed to all patients and included telephone follow‐up. Comparative data and responses were analyzed for the 24 patients who responded to the survey.Results Fifteen patients were treated with chemotherapy and radiation therapy (CRT). Six patients underwent surgery with postoperative radiation therapy (SRT). The remaining three patients were treated with radiation therapy but were not used in this analysis. The average follow‐up was 35 months after treatment. The CRT and SRT groups were statistically similar regarding age, sex, duration of follow‐up, tumor grade, and tumor stage. Laryngeal primary tumors were more common in the SRT group than in the CRT group (P = .005). Eight domains were assessed by the HSQ‐12: physical functioning, role‐physical, bodily pain, health perception, energy/fatigue, social functioning, role‐mental, and mental health. No statistical differences were found between the CRT and SRT groups, except for role limitations attributable to physical health (P = .007).Conclusions These results indicate that only one of eight domains differs significantly between treatment groups when using the HSQ‐12. Two‐year survival end‐point analysis of global health assessment may represent a simplified and meaningful way to compare treatment modalities in patients with advanced‐stage head and neck cancer.
A Prospective Study of Quality of Life in Head and Neck Cancer Patients. Part II: Longitudinal Data
Authors: Bjordal Kristin , Ahlner‐Elmqvist Marianne , Hammerlid Eva , Boysen Morten , Evensen Jan F. , Biörklund Anders , Jannert Magnus , Westin Thomas , Kaasa Stein 
Published: November 2003

AbstractObjectives To evaluate the health‐related quality of life (HRQL) of patients with head and neck cancer during and after treatment with radiotherapy, surgery, and chemotherapy.Study Design Prospective, descriptive study.Methods All new patients in four institutions in Norway and Sweden were asked to participate. Health‐related quality of life was assessed at baseline and at 1, 2, 3, 6, and 12 months after start of treatment by means of the European Organization for Research and Treatment of Cancer (EORTC) Core Quality of Life Questionnaire and the EORTC head and neck cancer–specific questionnaire. Baseline results are described elsewhere; longitudinal results are presented in the current article. Three hundred fifty‐seven patients with cancer in the oral cavity, pharynx, larynx, nose, sinuses, and salivary glands and neck node metastases from unknown primaries filled in the questionnaires at baseline.Results Seventy‐eight percent of the patients who were alive after 12 months filled in all questionnaires (218/280). The general trend was that HRQL deteriorated significantly during treatment, followed by a slow recovery until the 12‐month follow‐up with few exceptions (senses, dry mouth, and sexuality). Patients who later died reported worse HRQL at each assessment point compared with patients who filled in all six questionnaires, whereas those who dropped out of the study for other reasons were quite similar to patients who filled in all questionnaires. The patients with pharyngeal cancer in general reported worse HRQL compared with the other groups and did not reach pretreatment values in several domains. Stage was also an important factor for HRQL in patients with head and neck cancer.Conclusion Detailed knowledge about the differences between groups and changes over time may aid us in the communication with patients and in the design of intervention studies focusing on improvement of the support and rehabilitation of patients with head and neck cancer.
All‐trans‐retinoic Acid Enhances the Effect of Adenovirus‐Mediated Wild‐Type p53 Gene Transfer in Head and Neck Squamous Cell Carcinoma
Authors: Nakashima Torahiko , Sun Shi‐Yong , Lotan Reuben , Fujiwara Toshiyoshi , Yasumatsu Ryuji , Komiyama Sohtaro , Clayman Gary L. 
Published: November 2003

AbstractObjectives Adenovirus‐mediated p53 (AdCMVp53) gene therapy for cancer is currently undergoing phase III clinical trials. One problematic aspect of this therapy is that the current protocols result in low transduction of the therapeutic virus in vivo. To search new modalities that can enhance the effect of AdCMVp53 gene therapy, we focused on retinoids.Methods To study the effect of ATRA in combination with AdCMVp53 gene therapy, we pretreated head and neck squamous cell carcinoma (HNSCC) cells for 72 hours with a low‐dose All‐trans‐retinoic acid (ATRA) (10−7 M‐10−8 M) which will not affect the in vitro cell growth, and then infected the cells with low MOI (30MOI) AdCMVp53. In vitro cell proliferation assays, cell cycle assays were performed. Expression of p53 and p53‐related gene products, BAX and p21, were examined.Results The combined treatment with ATRA and Ad‐p53 suppressed cell growth and induced apoptosis significantly more than AdCMVp53 treatment alone (P <.05). p53 expression significantly increased more after the combined treatment than after either treatment alone, at both the transcription and protein levels. In addition, increased expression of p21 and BAX, which are downstream gene products of p53, was observed in the combination. ATRA also enhanced the expression of green fluorescent protein (GFP) transduced by an adenovirus‐cytomegalovirus (CMV)‐GFP vector suggesting ATRA enhances adenovirus‐CMV‐promoted vectors through transcription.Conclusions Our results indicate that ATRA enhances AdCMVp53 expression through transcriptional mechanisms and can synergistically induce apoptosis in HNSCC cells. ATRA has a potential to enhance the effect of adenovirus‐mediated p53 gene therapy for HNSCC.
Pediatric Autoimmune Neuropsychiatric Disorders and Streptococcal Infections: Role of Otolaryngologist
Authors: Orvidas Laura J. , Slattery Marcia J. 
Published: November 2003

AbstractObjective To increase awareness and understanding of the putative role of streptococcal infection in the development of neuropsychiatric disorders in children and to discuss therapeutic options in this group of patients.Methods Case illustration and literature review.Results Two siblings, one with obsessive‐compulsive disorder (OCD) and one with a tic disorder, had tonsillectomy for recurrent streptococcal pharyngitis. At the latest follow‐up visit (11 mo postoperatively), both patients exhibited significant improvement in their psychiatric illnesses. We discuss these cases as well as the diagnosis, pathophysiology, and treatment of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS).Conclusion PANDAS is an active area of research investigating the relationship between streptococcal infections and the development of obsessive‐compulsive disorder or tic disorders (or both) in children. The etiopathogenesis of PANDAS is thought to reflect autoimmune mechanisms and involvement of the basal ganglia of susceptible hosts. Because otolaryngologists evaluate a large portion of pediatric patients with recurrent streptococcal pharyngitis, it is important to be aware of this association and to manage these patients appropriately.