bluuebunny/crossref_metadata_2025_split huggingface dataset:
Limited Hepatic Resection for Hepatocellular Carcinoma in the Caudate Lobe
Authors: Ikegami Toru , Ezaki Takahiro , Ishida Teruyoshi , Aimitsu Shiomi , Fujihara Megumu , Mori Masaki 
Published: July 2004

AbstractThe most appropriate approach to treating hepatocellular carcinoma (HCC) in the caudate lobe has not yet been determined. A series of 197 patients who had undergone curative hepatic resection for HCC were analyzed. Fifteen patients had HCC in the caudate lobe: three in the Spiegel lobe (SP), three in the caudate process (CP), and nine in the paracaval portion (PC). Patients with HCCs in the SP and CP underwent partial hepatectomy. HCCs in the PC were approached in one of three ways: anterior approach and partial hepatectomy of the PC (Ant+PHx‐PC), partial hepatectomy, or left lobectomy. Clinicopathologic variables, including the underlying liver disease, the mean tumor size, and the pathologic characteristics of HCC, did not differ between surgery of the caudate lobe and that of other segments. The overall survival was 88.9% at 3 years and 66.7% at 5 years after resection of HCC in the caudate lobe; the corresponding figures were 86.1% at 3 years and 68.6% at 5 years for the other segments. The recurrence‐free survival rate was 51.9% at 3 years and 34.6% at 5 years for the caudate lobe, and it was 52.1% at 3 years and 32.8% at 5 years for the other segments. Clinicopathologic characteristics of HCCs originating in the caudate lobe were not different from those in the other segments. Limited resection of HCC in the caudate lobe confers a similar prognostic value as in other segments.
Predictors of wound complications after laryngectomy: A study of over 2000 patients
Authors: Schwartz Seth R. , Yueh Bevan , Maynard Charles , Daley Jennifer , Henderson William , Khuri Shukri F. 
Published: July 2004

OBJECTIVESTo identify risk factors for and the rate of wound complications after laryngectomy in a large, prospectively collected national dataset, and to generate a predictive model.STUDY DESIGNWe used the National Surgical Quality Improvement Program (NSQIP) registry created by the Department of Veterans Affairs (VA) to identify patients undergoing total laryngectomy from 1989 to 1999 (n = 2063). We linked these data to inpatient and outpatient VA administrative records to capture data for prior radiation. Over 20 preoperative and intraoperative risk factors were analyzed using bivariate techniques. Those significant at the P < 0.01 level were analyzed with logistic regression and conjunctive consolidation to identify independent predictors of wound complications.RESULTSThe overall wound complication rate was 10.0%. In adjusted analyses, prolonged operative time (> 10 hours, odds ratio = 2.10, 95% confidence interval: 1.32‐3.36), exposure to prior radiation therapy (OR =1.63, 1.07‐2.46), presence of diabetes (OR = 1.78, 1.04‐3.04), preoperative hypoalbumine‐mia (OR =1.90, 1.32‐2.74), anemia (OR =1.59, 1.07‐2.36), and thrombocytosis (OR =1.48, 1.04‐2.10) were independently associated with postoperative wound complications. A prognostic model using three variables—prior radiation therapy, diabetes, and hypoalbuminemia—provided excellent risk stratification into three tiers (6.3%, 13.7%, 21.7%).CONCLUSIONSPreoperative radiation, prolonged operative time, low albumin, and diabetes were independently associated with postoperative wound infections. These results will help to identify patients at risk for wound complications, thus allowing for heightened surveillance and preventive measures where possible.
Preliminary Report Of Endolaryngeal And Endotracheal Laser Surgery Of Juvenile‐Onset Recurrent Respiratory Papillomatosis By Nd:Yag Laser and a New Fiber Guidance Instrument
Authors: Janda Philip , Leunig Andreas , Sroka Ronald , Betz Christian S. , Rasp Gerd 
Published: July 2004

OBJECTIVESRecurrent respiratory papillomatosis (RRP) caused by human papilloma virus (type 6 and 11) is the most common benign neoplasm of the larynx in children. Despite being a benign disease, treatment is very difficult and is characterized by frequent recurrence, spread throughout the respiratory tract, and malignant degeneration. Besides surgical resection and the established CO2 laser treatment, laser surgery by fiber‐guided Nd:YAG laser light promises to be a bloodless and effective treatment procedure. To improve this new method, a novel fiber guidance instrument has been developed to aid in endolaryneal laser surgery of RRP.STUDY DESIGN AND SETTINGThe method described uses a specially designed instrument for fiber guidance that is equipped with a bendable distal tip to move the fiber end precisely. Moreover, the instrument includes an additional channel for the suction of smoke and pyrolysis products. Up to now, 5 patients (aged 4 to 8 years) with RRP were treated by Nd:YAG laser light (λ = 1064 nm; power, 10W; irradiance, 3.5 kW/cm2, continuous wave) with a prototype version of the new instrument and were followed up for 12 months each. RESULTS: Because of the adequate length and the bendable distal tip with a range of −5° up to 45° to the optical axis of the fiber and less than 10% light loss at maximal deflection, RRP can be treated by Nd:YAG laser light easily and precisely. The continuous suctioning ensured an optimum view of the operating field and a minimal load of potential infectious laser plume and toxic pyrolysis products for the patient as well as for the physician. The laser treatment of RRP with the new fiber guidance instrument was only minimally traumatic. During 1‐year follow‐up visits, all Nd:YAG laser light‐treated patients, showed a regression of the disease.CONCLUSIONSThe new fiber guidance instrument enables a precise and easy treatment of the RRP with fiber‐guided laser systems (eg, Nd:YAG‐, diode‐, and KTP‐lasers) and an effective removal of infectious laser plume as well as toxic pyrolysis products. A follow‐up period of 1 year revealed that Nd:YAG laser surgery seems to prevent a rapid recurrence of juvenile respiratory papillomatosis in the treated patients.
Significance of Asymptomatic Tonsil Asymmetry
Authors: Cinar Fikret 
Published: July 2004

OBJECTIVEAsymmetry of tonsils that arouses suspicion for malignancy is one of the indications for tonsillectomy. The purpose of this study was to evaluate the incidence of occult malignancy in patients with asymptomatic unilateral tonsillar enlargement.STUDY DESIGN AND SETTINGA prospective controlled trial was carried out in two institutions, Beyoglu Research and Training Hospital and Karaelmas University Hospital, during a 6‐year period. Of patients selected for tonsillectomy, patients with unilateral tonsillar enlargement were identified and were included in this study. Patients who had risk factors that were significant for malignancy were excluded. After excision, two tonsil specimens were measured before sending for histology. Matched controls with symmetric tonsils underwent the same procedures. Preoperative diagnosis of tonsil asymmetry with the postoperative histologic diagnosis were correlated for the incidence of malignancy.RESULTSOf the 792 patients undergoing tonsillectomy, 53 patients (6.69%) with asymmetry of tonsils and who had no other risk factors for malignancy underwent tonsillectomy. The size difference of the tonsils ranged from 0 to 19 mm. In the control group of 51 patients with symmetric tonsils, the size difference ranged from 0 to 8 mm. The analysis showed statistically significant difference in the degree of asymmetry between the two groups (P <. 001). Most of the specimens contained reactive lymphoid hyperplasia in both groups (58.49% and 54.9%, respectively). No malignancies or unusual pathological findings were encountered on histologic examination in either group.CONCLUSION AND SIGNIFICANCETonsil asymmetry may only be apparent in patients with an otherwise normal physical examination, secondary to benign hyperplasia or anatomical factors. Therefore, the presence of tonsil asymmetry without factors such as suspicious appearance, significant systemic signs and symptoms, progressive enlargement of the tonsil, concomitant neck adenopathies, and history of malignancy or immunocompromise, may not indicate malignancy, as a sole clinical feature.
Postoperative Infection in Cochlear Implant Patients
Authors: Cunningham Calhoun D , Slattery William H. , Luxford William M. 
Published: July 2004

OBJECTIVERecently, the association of meningitis with cochlear implants has raised concern over the safety of these devices. We examined the incidence of all postoperative infections in patients undergoing cochlear implant surgery.STUDY DESIGN AND SETTINGSA retrospective chart review of all patients undergoing cochlear implants at a private tertiary referral center from 1993 to 2002 was performed. Cochlear implant surgeries in 462 adults and 271 children were reviewed. Patients with evidence of a postoperative infection or infectious complication related to cochlear implantation were identified, and data on patient characteristics, surgery, and treatment outcome were obtained.RESULTSThe overall incidence of postoperative infection in our cochlear implant series was 4.1%. Major infectious complications occurred in 3.0% of cases, and the majority of infections required surgical intervention. A history of chronic ear disease may increase the risk of infectious complications. There were no cases of meningitis.CONCLUSIONSCochlear implants remain a safe procedure with a low complication rate. The majority of infections can be managed without removing the implant device. Advances in surgical technique and flap design have decreased the occurrence of wound‐related complications. However, identification of risk factors for infection and optimization of treatment regimens will further reduce the complications associated with postoperative infection.
C‐Myc And Bcl‐2 Expression In Supraglottic Squamous Cell Carcinoma of the Larynx
Authors: Ozdek Ali , Sarac Sarp , Akyol M. Umut , Sungur Arzu , Yilmaz Taner 
Published: July 2004

OBJECTIVESTo evaluate the expression and prognostic significance of c‐myc and bcl‐2 oncogenes in squamous cell carcinoma (SCC) of the supraglottic larynx.STUDY DESIGNA retrospective cohort study of 61 patients who underwent surgery for SCC of the supraglottic larynx. Gender, age, TNM status, operative procedure, recurrences, and disease‐free survival periods were recorded.METHODSHematoxylin and eosin‐stained sections were reexamined for grade, invasion of tumor margins, lymphovascular invasion, lymphocyte infiltration, and perineural invasion. Immunohistochemical detection of c‐myc and bcl‐2 oncogenes was performed using monoclonal antibodies.RESULTS: No correlation was observed between either c‐myc or bcl‐2 and the clinical and histopathologic parameters. Survival analysis revealed no correlation of either c‐myc (P = 0.88) or bcl‐2 (P = 0.85) with the disease‐free survival. c‐myc expression was found to be significantly higher in bcl‐2‐positive patients (P = 0.001).CONCLUSION: Neither c‐myc nor bcl‐2 had shown to be prognostic factor for laryngeal carcinoma in this present study. Correlation between c‐myc and bcl‐2 supports the experimental observations of cooperative action between these two genes in tumorigenesis.
Removal of Fish Bones in the Oropharynx and Hypopharynx Under Video Laryngeal Telescopic Guidance
Authors: Lee Fei‐Peng 
Published: July 2004

OBJECTIVEThe study goal was to present the technique and results of removal of fish bones in the oropharynx and hypopharynx under video laryngeal telescopic guidance.STUDY DESIGN AND SETFrom January 2001 to December 2002, a total of 27 patients with fish bones lodged in the oropharynx and hypopharynx were studied at the ENT Department of Taipei Medical University Hospital.RESULTSAll fish bones were removed smoothly without necessitating further procedures at the time of the initial clinical examination and had an uneventful clinical course.CONCLUSION: Removal of fish bones lodged at the tongue base, vallecula, and hypopharynx under video laryngeal telescopic guidance has the advantages of good illumination, clear visualization, and precise extraction. The technique has also proven to be efficient, safe, well tolerated, and with low morbidity.SIGNIFICANCE: Removal of the fish bones from difficult areas in oropharynx and hypopharynx with this technique can reduce the use of direct laryngoscope under general anesthesia.
Intracordal Injection of Autologous Auricular Cartilage in the Paralyzed Canine Vocal Fold
Authors: Lee Byung‐Joo , Wang Soo‐Geun , Goh Eui‐Kyung , Chon Kyon‐Myong , Lee Chang‐Hun 
Published: July 2004

OBJECTIVEVocal fold augmentation by injectable material under direct visual control is an easy and simple operation. However, when autologous fat or bovine collagen is used, resorption creates a problem. And autologous fascia is debating about absorption now days. This study is to evaluate the histology of minced and injected autologous auricular cartilage and fat graft in the augmentation of unilateral vocal fold paralysis using a canine model.METHODNine dogs were operated. At first, a piece of auricular cartilage was harvested from ear and minced into tiny chips with a scalpel, and a piece of fat tissue was harvested from inguinal area and minced into tiny chips with a scalpel. Cutting off a section of the recurrent nerve paralyzed the right vocal fold. The minced cartilage and fat‐paste (0.2 mL) was injected using a pressure syringe into the paralyzed thyroarytenoid muscle under direct laryngoscopy. Two animals were sacrificed at 3 days, three at 3 weeks, two at 3 months, one at 6 months, and one at 12 months. Each dog underwent laryngectomy and serial coronal sections of paraffin blocks from the posterior part of the vocal fold were made.RESULTSThere was no significant complication perioperatively and during follow‐up. There was acute inflammatory findings in the graft at 3 days and 3 weeks. The injected cartilage remained in the larynx until 12 months.CONCLUSIONThe autologous auricular cartilage graft is well tolerated and may be very effective material for volumetric augmentation on paralyzed vocal cord.
Ototoxic Protection of Sodium Thiosulfate: Daily vs Constant Infusion
Authors: Stocks Rose Mary S. , Gould Herbert J. , Bush Andrew J. , Dudney B. Wayne , Pousson Monique , Thompson Jerome W. 
Published: July 2004

OBJECTIVECompare the effect of a daily dose of sodium thiosulfate (STS) to continuous infusion of STS on Hartley albino guinea pig (HAGP) on cisplatin (CP)‐induced sensorineural hearing loss.STUDY DESIGNProspective randomized pilot study comparing a single daily dose of STS to a constant controlled infusion of STS given the middle ear space (MES) with an ototoxic regimen of CP. The hearing thresholds will be obtained by auditory brainstem response (ABR) 1 week before and after treatment. Treatment effects on responses at 2, 8, and 16 kHz signals will be investigated by an analysis of variance with one between subjects' condition and two within subjects' conditions.SETTINGBasic science laboratory.RESULTSSTS protection resulted in significantly less hearing loss post‐treatment for the protected ears. Guinea pigs with continuous infusion of STS demonstrated less loss in the protected ear than those who received the single daily dose. As expected, hearing loss at 2 kHz was less than that at 8 and 16 kHz.CONCLUSIONA continuous infusion of STS directly to the MES is better than a single daily dose of STS to the MES in reducing the ototoxicity of CP.SIGNIFICANCEAny targeted protection, whether by continuous infusion or daily dose, is better than no protection against the sensorineural hearing loss of CP.
Adenotonsillectomy for Obstructive Sleep Apnea in Obese Children
Authors: Mitchell Ron B. , Kelly James 
Published: July 2004

OBJECTIVETo study changes in sleep behavior and quality of life in obese children after adenotonsillectomy for obstructive sleep apnea.STUDY DESIGN AND SETTINGProspective study at the University of New Mexico Children's Hospital.METHODSChildren who met inclusion criteria and had a respiratory distress index (RDI) greater than 5 were enrolled in the study and underwent adenotonsillectomy. All children underwent preoperative and postoperative full‐night polysomnography. Age‐ and gender‐specific percentile BMI was recorded at the time of polysomnography. Caregivers were asked to complete an OSA‐18 quality of life survey prior to polysomnography and a second survey within 6 months of surgery. Scores from preoperative and postoperative polysomnography and OSA‐18 surveys were compared using the paired Student's t test.RESULTSThe study population included 30 children. Twenty‐six children (86%) were male. The mean age of the children at the time of inclusion in the study was 9.3 years; range, 3.0 to 17.2. The mean preoperative BMI was 28.6 (range, 19.2 to 47.1) and the mean postoperative BMI was 27.9 (range, 17.8 to 27.9). A 2‐tailed paired t test showed that this difference is not statistically significant (P = 0.06). The mean preoperative RDI was 30.0 and the mean postoperative RDI was 11.6 (P < 0.001). The preoperative mean total OSA‐18 score was 78.2 and the postoperative mean total score was 39.8 (P < 0.001).CONCLUSIONObese children with OSA who undergo adenotonsillectomy show a marked improvement in RDI and in quality of life with no change in BMI. However, in the majority of children, OSA does not resolve.
Pediatric Suprastomal Granuloma: Management and Treatment
Authors: Gupta Akash , Cotton Robin T. , Rutter Michael J. 
Published: July 2004

OBJECTIVESuprastomal granulomas (SSG) are a common complication of pediatric tracheotomy. Occasionally excision is indicated for obstructive granulomas. We report on our experience on the management of SSG requiring excision.STUDY DESIGN AND SETTINGA retrospective chart review of 68 patients who underwent SSG excision at a tertiary referral pediatric hospital between July 1997 and November 2002. The medical charts were reviewed for excision techniques and outcomes.RESULTSA total of 106 excisions of SSG were performed on 68 patients. Of the patients, 25 (36.8%) required multiple excisions. Removal techniques included sphenoid punch (34.9%), optical forceps (34.0%), open excision (22.6%), electrocautery (4.7%), and hook and eversion (3.8%).CONCLUSIONThe majority of SSG do not require removal. If excision is indicated, we recommend using optical forceps for soft and friable lesions and the sphenoid punch for fibrous and firm granulomas. For granulomas that have a broad base, are very large, or where endoscopic instrumentation is not possible, we recommend open excision.
Fusaric acid: A novel agent and mechanism to treat HNSCC
Authors: Stack Brendan C. , Hansen J. Paul , Ruda James M. , Jaglowski Jeff , Shvidler Joseph , Hollenbeak Christopher S. 
Published: July 2004

OBJECTIVEA new class of carboxylic acids has tumoricidal activity for head and neck squamous cell cancer (HNSCC). Fusaric acid (FA) can chelate divalent cations, especially zinc, and inactivate zinc finger proteins involved in DNA repair and protein synthesis.METHODS2 squamous carcinoma lines were utilized for in vitro and in vivo portions of this study. Cell counting and flow cytometry were used to analyze cells in culture in treatment and control groups over 96 hours. HNSCC subcutaneous implants were created in treatment and control groups of BALB‐c nude mice (N = 30).RESULTSIn vitro studies demonstrated significant changes in cell numbers and cell cycle. In vivo studies of daily intralesional therapy for 1 month also showed reduced onset of growth and overall growth compared to controls.CONCLUSIONFA appears to have a tumoristatic/tumoricidal effect on HNSCC. Further nude mice studies are needed to optimize dosing and administration regimens for FA in anticipation of clinical trials.
Endoscopic treatment of laryngeal and tracheal stenosis—has mitomycin C improved the outcome?
Authors: Perepelitsyn Ilya , Shapshay Stanley M. 
Published: July 2004

OBJECTIVEThe management of laryngeal and tracheal stenosis remains a challenging problem despite advances in endoscopic surgical techniques. Scar formation and restenosis is the main cause of failure, and this study assesses the efficacy of two adjuvant treatments: endoscopic steroid injection and topical mitomycin C application.STUDY DESIGN AND SETTINGThis is a retrospective cohort study comparing the efficacy of 3 endoscopic techniques: (1) carbon dioxide (CO2) laser incisions with bronchoscopic dilatation, (2) CO2 laser with dilatation followed by steroid injection into the stenotic area, and (3) CO2 laser with dilatation followed by topical application of mitomycin C. Included in the statistical analysis were 47 procedures performed by the senior investigator in a tertiary medical center between 1994 and 2001 based on their success or failure.RESULTSThe percentages of successful outcomes in the study groups were 15%, 18.2%, and 75% with the CO2 laser, CO2 laser with steroid injection, and CO2 laser with mitomycin C, respectively. Statistical comparisons reveal that the differences in outcomes were statistically significant (P < 0.05) between the mitomycin group and each of the other two treatment groups, whereas there was no statistically significant difference between the laser only and laser with steroid groups. There were no complications noted with the use of adjuvant medications.CONCLUSIONThese patient group results indicate a statistically significant increase, from <20% to 75%, in the success rate of endoscopic treatment of acquired upper airway stenosis when topical mitomycin C is added to the treatment regimen. No benefit has been demonstrated for using intraoperative local steroid injections as an adjunct to laser treatment.CLINICAL SIGNIFICANCEMitomycin C appears to be an effective and safe adjuvant treatment in the endoscopic management of laryngeal and tracheal stenosis.
Effect of symptoms on executive function in bipolar illness
Authors: DIXON T. , KRAVARITI E. , FRITH C. , MURRAY R. M. , McGUIRE P. K. 
Published: July 2004

Background. The relationship between cognitive function and symptomatology in bipolar disorder is unclear. This study assessed executive function during the manic, depressed and remitted stages of bipolar I disorder.Method. Tasks assessing phonological and semantic verbal fluency, the Hayling Sentence Completion Test, the Stroop Neuropsychological Screening Test and the Cognitive Estimates Test were administered to manic (n=15), depressed (n=15), and remitted (n=15) bipolar I patients, and to healthy controls (n=30). Multiple regression analyses and analyses of covariance were used to identify potential determinants of executive dysfunction in the three bipolar groups.Results. Executive function deficits were particularly associated with the manic state. In general, manic patients performed less accurately than the remitted and depressed groups, and their performance deficit was related to the severity of positive thought disorder. The depressed and remitted bipolar groups showed a less widespread pattern of impairment. Deficits in response initiation, strategic thinking and inhibitory control were evident in all the bipolar groups.Conclusions. Executive function deficits in bipolar I disorder are most evident during mania, and are particularly associated with formal thought disorder. However, deficits in response initiation, strategic thinking and inhibitory control may be more related to the underlying disorder than a particular symptom profile.