bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Locally Applied Drugs on the Endolymphatic Sac Potential
Authors: Couloigner Vincent , Loiseau Alain , Sterkers Olivier , Amiel Claude , Ferrary Evelyne 
Published: November 2003

AbstractIn Ménière's disease, an inner ear disorder related to an endolymphatic hydrops, an alteration of the functioning of the endolymphatic sac has been proposed. The endolymphatic sac is assumed to be involved in the secretion/resorption of endolymph. The epithelial transport systems have been indirectly studied by the recording of the endolymphatic sac transepithelial potential (ESP) in control conditions and after the local injection of drugs such as diuretics that have been proposed in the treatment of Ménière's disease. The ESP was recorded, in vivo, in guinea pigs up to 150 minutes after the perisaccular injection of 5 μL of a 150 mmol/L (mM) NaCl solution containing various drugs known to inhibit ionic transport systems. The initial ESP was +8.4 ± 0.3 mV (mean ± SEM, n = 78). The basolateral injection of 5 μL of 150 mM NaCl induced an ESP decrease of 64% ± 6.0% (n = 12), 5 minutes after the end of the injection. Then ESP increased, returning to its initial value at 60 minutes and surpassing it at 120 minutes. Diuretics such as acetazolamide (10−3 mol/L [M]), an inhibitor of carbonic anhydrase, and amiloride (10−4 M), an inhibitor of Na channel or Na/H exchanger, decreased the ESP recovery. At variance, bumetanide (10−6 M, 10−4 M), the Na‐K‐Cl cotransport inhibitor, and chlorothiazide (10−4 M), a Na‐Cl cotransporter inhibitor, failed to alter the ESP as compared with the control group. Ouabain (10−3 M), the Na+,K+‐adenosine triphosphatase (ATPase) inhibitor, prevented the ESP recovery otherwise observed 60 minutes after the NaCl injection. Bafilomycin A1, the inhibitor of the vacuolartype H+‐ATPase, prevented the recovery of the ESP with a log‐dose/effect (10−5 M, 10−6 M, 10−8 M). Disulfonic acid stilbene (DIDS) (10−4 M), an inhibitor of transporters involving HCO3−, also prevented the ESP recovery. These results suggest that the genesis of the ESP was highly dependent on acid‐base transport systems including carbonic anhydrase, a vacuolar‐type H+‐ATPase, and an anionic transport system blocked by DIDS. Further studies are needed to confirm the alteration of the acid‐base balance in this epithelium and its possible involvement in the pathogenesis of Ménière's disease.
Vestibular Disease Unmasked by Hyperventilation
Authors: Bance Manohar L. , O'Driscoll Martin , Patel Nimesh , Ramsden Richard T. 
Published: November 2003

AbstractHyperventilation‐induced dizziness is often thought to be psychogenic, but its effects in the presence of known vestibular disease have not been adequately examined. In this study hyperventilation was tested in two models of vestibular disease. These were, first, patients with profound unilateral vestibular deficit (prior translabyrinthine acoustic neuroma resection [postsurgery group]) and, second, patients with variable unilateral vestibular deficit (unoperated unilateral acoustic neuroma [presurgery group]). Patients were hyperventilated for 90 seconds. Using infrared videonystagmography, 100% of the 32 postsurgery patients and 82% of the 28 presurgery patients developed nystagmus with hyperventilation. Hyperventilation was more sensitive than head shake for eliciting nystagmus in these models. The false‐positive rate for nystagmus in 29 normal volunteers was 3.5% for hyperventilation and 10% for head shake. Our results show that hyperventilation can unmask underlying vestibular disease.
Angiographic Embolization for Epistaxis: A Review of 114 Cases
Authors: Tseng Ewen Y. , Narducci Carl A. , Willing Steven J. , Sillers Michael J. 
Published: November 2003

AbstractAngiography with selective embolization has become an accepted method of treating posterior epistaxis that is not controlled with conservative measures. The authors reviewed 112 cases of patients who had received selective angiographic embolization for refractory epistaxis from January 1990 to December 1995. There were 114 embolizations over this 5‐year period. The immediate success rate was 93%, with long‐term success achieved in 88% of patients. The overall complication rate was 17%, with the long‐term morbidity rate less than 1%. Selective angiographic embolization is a safe and effective method that should be considered in the treatment of refractory epistaxis.
Inlay Tympanoplasty: Cartilage Butterfly Technique
Authors: Eavey Roland D. 
Published: November 2003

AbstractFor closure of a nonmarginal tympanic membrane perforation, currently popular techniques utilize either an underlay or an onlay approach. However, both procedures require incising canal skin. A transcanal inlay procedure could provide theoretical advantages of ease, speed, and comfort. Specifically designed cartilage that could facilitate the transcanal approach similar to placement of a solid tube was employed and evaluated. A transcanal cartilage butterfly inlay technique was found to be efficient and effective to close a subgroup of small‐to‐medium‐sized tympanic membrane perforations including cases in which the condition of the tympanic membrane was somewhat hostile. Postoperative patient comfort was an additional benefit.
Neurotrophin 3, Not Brain‐Derived Neurotrophic Factor or Neurotrophin 4, Knockout Mice Have Delay in Vestibular Compensation After Unilateral Labyrinthectomy
Authors: Gacek Richard R. , Khetarpal Umang 
Published: November 2003

AbstractOn the basis that neurotrophins (NTs) affect neuronal synaptic plasticity, are expressed in various cell types of the vestibular system, and exert a trophic influence on statoacoustic neurons, the authors hypothesized a role for NTs in vestibular compensation. To test this hypothesis, they performed unilateral surgical labyrinthectomy in 11 heterozygous (+/−) neurotrophin 3 (NT3) and brain‐derived neurotrophic factor (BDNF) knockout mice and in two neurotrophin 4 (NT4) homozygous (−/−) knockout mice, each with a control (+/+) sibling, for a total of 26 mice. Four BDNF(+/−) and four NT3(+/−) mice with their (+/+) controls each were allowed to recover in a normal lighted room for 3, 7, 14, and 30 days following labyrinthectomy. Two BDNF(+/−) and two NT4(−/−) mice with controls were kept in total darkness for 1‐and 16‐day survival periods. One NT3(+/−) mouse without a control (which died in surgery) was sacrificed after 16 days in darkness. The behavior of all mice was videorecorded to monitor their recovery. Compared with normal (+/+) littermate controls, NT3(+−) mice demonstrated a delay in compensation (8 to 10 days) in light surround, whereas NT4(−/−) mice showed only a minor delay in dark surround. Despite a 40% lower vestibular ganglion cell population in BDNF(+/−) mice compared with (+/+) controls, BDNF(+/−) mice did not reveal a detectable delay in recovery following labyrinthectomy. These findings suggest that a 50% loss of NT3 protein significantly affects vestibular recovery in adult mice. Perhaps variations in achieving vestibular compensation in humans may be partly secondary to genetically different NT3 levels in vestibular pathways.
Role of the External Nasal Dilator in the Management of Nasal Obstruction
Authors: Roithmann Renato , Chapnik Jerry , Cole Philip , Szalai John , Zamel Noe 
Published: November 2003

AbstractThe aim of this study is to evaluate the effect of an external nasal dilator in patients with nasal obstruction secondary to mucosal congestion (n = 33) or to septal deviation in the nasal valve area (n = 28). A group of subjects with healthy nasal cavities was tested also (n = 51). Acoustic rhinometric and rhinomanometric nasal measurements were performed with and without the dilator and before and after topical decongestion of the nasal mucosa. A visual analog scale was employed to evaluate the subjective sensation of nasal obstruction. Objective measurements showed that the external dilator increased the minimum cross‐sectional area and decreased the nasal resistance significantly in all three groups (P < 0.01). The effect was more impressive in patients with septal deviation (P < 0.001). Subjective assessments reflected patency in all subjects except those in the mucosal swelling group (P = 0.06). From this study the authors conclude that the external nasal dilator offers an effective, nonsurgical therapeutic approach in the management of septal deviation that obstructs the nasal valve area. Although patients with nasal obstruction secondary to mucosal congestion showed objective improvement with the nasal dilator, these changes were not accompanied by a sensation of enhanced patency.
Epithelial Cell Proliferation, Apoptosis, and Apoptosis Inhibition in Inverted Papillomas
Authors: Guichard Christophe , Gilain Laurent , Al Samad Issam Abd , Piron Gaëlle , Brugel Lydia , Escudier Estelle , Coste André 
Published: November 2003

AbstractInverted papillomas (IPs) are rare benign tumors of nasal epithelium with high recurrence rates and malignant transformation potential. Their etiology is still uncertain, and the mechanism of their growth has not yet been fully described. The purpose of this study was to detect, quantify, and compare cell proliferation, apoptosis, and apoptosis inhibition in hyperplastic epithelium from IPs and in inflammatory nasal polyps (NPs). IP samples were obtained after surgical removal of tumor in 13 patients, and NPs were sampled during endoscopic ethmoidectomy in 10 patients with nasal polyposis. Cell proliferation and apoptosis inhibition, respectively, were assessed by immunohistochemical identification of the proliferating cell nuclear antigen (PCNA) and the oncoprotein Bcl‐2. Apoptosis was evaluated by analyzing the DNA fragmentation. Cell proliferation and apoptosis were significantly higher in IPs than in NPs (P = .0002 and P = .043, respectively), while apoptosis inhibition was significantly lower in IPs than in NPs (P = .001). Concerning IPs, cell proliferation was significantly higher than apoptosis (P = .0029) and apoptosis inhibition (P = .0015). The increase in epithelial cell proliferation seemed to be greater in IPs with dysplasia than in IPs without dysplasia. Increased epithelial cell proliferation, but not apoptosis and apoptosis inhibition, seems to be involved in the development of IP.
Oral Leukoplakias Show Numerical Chromosomal Aberrations Detected by Fluorescence in Situ Hybridization
Authors: Lenz Christian F. , Pfuhl Andreas , Finckh Martin , Weidauer Hagen , Bosch X. 
Published: November 2003

AbstractTo examine at which stage in the multistep process of head and neck tumorigenesis numerical chromosomal alterations can be detected by fluorescence in situ hybridization (FISH), biopsies and cell smear preparations of clinically healthy oral tissue, premalignant lesions (leukoplakias), and tumors were analyzed by FISH using chromosome‐specific centromeric probes. Aberrations found in tumor biopsies and in tumor cell smears consisted of trisomy of chromosomes 1, 7, 10, and 17 and monosomy of chromosomes 1, 7, 9, 10, and 17. In five of eight dysplastic oral leukoplakia biopsies, aberrations were seen consisting of trisomy of chromosome 1, 7, and 17, and monosomy of chromosome 9. No aberrations were found in biopsies of hyperplastic lesions (n = 8), or in oral cell smears of persons at risk. Because numerical chromosomal aberrations seem to be highly specific for malignant cells, FISH may help to identify leukoplakias that have a high risk of malignant conversion.
Medical treatment of headache after suboccipital acoustic tumor removal
Authors: Hanson Matthew B. , Glasscock Michael E. , Brandes Jan Lewis , Jackson C. Gary 
Published: November 2003

AbstractObjectives: Suboccipital craniotomy is a frequently used surgical approach for removal of cerebellopontine angle (CPA) tumors. A frequently cited consequence, however, is the high incidence of postoperative headaches. Much has been written regarding prevention of these headaches, but little has been written of their treatment. The authors review their extensive experience in suboccipital tumor removal and the medical management of postoperative headache, highlighting the recent use of a regimen of divalproex sodium and verapamil. Study Design: Retrospective chart review. Methods: The charts of a consecutive series of patients having suboccipital craniotomies for CPA tumors were reviewed. Presence, duration, and severity of headache were noted. Medical treatments and their effectiveness were also noted. Results: Between 1980 and 1997, 228 patients underwent suboccipital craniotomy for removal of CPA tumors. Of these patients, 124 (54.4%) complained of headache. For 62 (27.2%) the headaches persisted for more than a year after surgery. Twenty‐nine patients (12.7%) received no relief from any medication. Ten of these patients received a regimen of divalproex sodium and verapamil, with all patients obtaining significant relief. Conclusion: Headache is a significant problem with the suboccipital approach for acoustic tumor removal. The majority of patients that complain of headache can be adequately treated with nonsteroidal anti‐inflammatory drugs (NSAIDs). If pain is unrelieved by NSAIDs, treatment becomes problematic. The authors' early experience with divalproex sodium/verapamil is encouraging and deserves further investigation as a treatment for these refractory cases.
Pharyngeal acid reflux events in patients with vocal cord nodules
Authors: Kuhn Joan , Toohill Robert J. , Ulualp Seckin O. , Kulpa Judith , Hofmann Candy , Arndorfer Ronald , Shaker Reza 
Published: November 2003

AbstractObjective: Gastroesophageal reflux has been implicated in the pathogenesis of vocal cord nodules. However, a cause‐and‐effect relationship has not been established. Because documentation of pharyngeal acid reflux events makes this correlation more plausible, the aim of the present study was to determine the frequency of pharyngeal acid reflux events in patients with vocal cord nodules. Methods: Eleven patients with vocal cord nodules (mean age, 42 ± 6 years) and eleven healthy volunteers (mean age, 45 ± 6 years) were studied. Patients underwent barium esophagram and ambulatory 24‐hour simultaneous three‐site pharyngo‐esophageal pH monitoring. Controls only had ambulatory 24‐hour simultaneous three‐site pH monitoring. In the ambulatory pH monitoring studies, pH was recorded from the manometrically determined sites of pharynx (2 cm above upper esophageal sphincter), proximal esophagus (10 cm distal to pharyngeal site), and distal esophagus (5 cm above the lower esophageal sphincter). Pharyngeal acid reflux event was deemed acceptable if all three sites recorded a decrease in pH below 4 which was not related to meal or drinking. Results: Pharyngeal acid reflux events occurred in seven of 11 patients with vocal cord nodules (1–4 episodes) and two of 11 controls (1–2 episodes) (P < .05). In both groups all pharyngeal acid reflux events occurred in upright position and were not associated with belching or coughing. Barium studies documented hiatal hernia in two patients and gastroesophageal reflux in five of 11 patients. However, none of the esophageal reflux events reached the pharynx on barium esophagram. Conclusions: Prevalence of pharyngeal acid reflux events is significantly higher in patients with vocal cord nodules compared with normal controls and suggests a contributory role for gastroesophagopharyngeal acid reflux in the pathogenesis of some vocal cord nodules.
Presentation, course, and outcome of head and neck skin cancer in african americans: A case‐control study
Authors: Singh Bhuvanesh , Bhaya Mahesh , Shaha Ashok , Har‐El Gady , Lucente Frank E. 
Published: November 2003

AbstractBackground: Several reports have shown that the presentation, course, and outcome of skin cancer is altered in African Americans. Subset data from these studies suggest that the course of head and neck skin cancer may be different from that occurring in other sites. However, very few studies have specifically investigated skin cancer involving the head and neck region in African‐American patients. Methods: Retrospective case‐control study including 215 patients with skin cancer (squamous cell carcinoma [SCC], basal cell carcinoma [BCC], malignant melanoma, and adnexal tumors) presenting to a tertiary care institution over a 9.5‐year period. Cases were defined as African Americans with skin cancer, and the control group included white and Latin‐American patients with skin cancer. Results: Skin cancer occurred in the head and neck region in 135 cases (62%). However, head and neck involvement was less common in African‐American patients (44%) than the control group (76%; P < .001). The anatomic distribution of head and neck skin lesions was similar between the groups, with nasal and scalp skin most often involved. In the head and neck region, the ratio of BCC to SCC (4:1) was similar among all groups. In contrast, in non–sun‐exposed regions, the ratio was 1:8.5 for African‐American patients compared with 1:1 for the control group (P < .001). The overall distribution of malignant melanoma was not influenced by sun exposure in either groups. The study groups were similar in gender distribution, primary treatment modality, rates of positive margins, and development of second skin cancers. Although African Americans presented with more advanced lesions (P < .001), their disease‐free interval was similar to the control group. Only the margin status was a significant predictor of disease‐free survival by multivariate analysis, with a relative risk of 1.68 (95% CI: 1.58–18.24) Conclusions: Head and neck skin cancer is similar with regard to presentation and distribution in patients of all skin types. Moreover, in contrast to previous reports, the course of head and neck skin cancer may be less aggressive in African Americans, if appropriate treatment is provided. This report suggests that differences in skin cancer in African Americans reported in the literature reflect cancer occurring in non–sun‐exposed regions.
A comparison of image guidance systems for sinus surgery
Authors: Metson Ralph , Gliklich Richard E. , Cosenza Mathew 
Published: November 2003

AbstractObjective: Intraoperative computed tomographic guidance systems are available which utilize either electromagnetic (radiofrequency) or optical (infrared) signals to localize instruments within the surgical field. The objective of this study was to compare the use of these two different image guidance technologies for sinus surgery. Study Design: Prospective cohort study. Methods: The electromagnetic‐based InstaTrak system (n = 24) and the optical‐based Stealth‐Station (n = 49) were compared in a series of 73 consecutive sinus series which utilized image guidance technology. Results: Both the electromagnetic and optical systems provided anatomic localization to within 2 mm during surgery. Intraoperative reregistration was effective in correcting for any anatomic drift. There were no intraoperative complications. Mean operative times were 156.3 ± 8.9 minutes for the electromagnetic and 139.2 ± 17.7 minutes for the optical system (P < .05). The average intraoperative blood loss did not differ significantly between groups (electromagnetic, 190.6 ± 28.7 mL; optical, 172.4 ± 23.0 mL). Each system was noted to have limitations. The presence of metallic objects in the operative field interfered with functioning of the electromagnetic system, whereas the optical system required a clear line of sight to be maintained between the infrared camera and surgical handpiece. Both systems required specialized headsets to be worn by patients during surgery to monitor head position. The electromagnetic system also required these headsets to be worn during the preoperative computed tomography scan. Conclusion: Although these two image guidance systems both proved valuable for anatomic localization during sinus surgery, individual preferences can be based on distinct differences in their design and operation.
Expression of glucocorticoid receptor mRNA and protein in the olfactory mucosa: Physiologic and pathophysiologic implications
Authors: Robinson Alan M. , Kern Robert C. , Foster James D. , Fong Karen J. , Pitovski Dimitri Z. 
Published: November 2003

AbstractObjectives: Define the presence and distribution of glucocorticoid receptors (GRs) within the olfactory mucosa in order to assess potential physiologic and pathophysiologic effects of these hormones on olfaction. Study Design: The olfactory mucosa was harvested from adult male rats and guinea pigs. Kidney tissue was utilized as a known positive control. Methods: The techniques of reverse transcriptase‐polymerase chain reaction (RT‐PCR) and immunocyto‐chemistry were utilized to examine the expression of GR mRNA and protein. To assure the presence of olfactory mucosa in the nasal tissue samples, RT‐PCR was utilized to identify the olfactory marker protein (OMP). Results: The presence of GR mRNA was confirmed in both the olfactory mucosa and kidney. GR‐like immunoreactivity associated with the olfactory epithelium was greatest at the apical surface, a position corresponding to the dendrites, knobs, and cilia of olfactory receptor neurons, as well as the supranuclear region of sustentacular cells. Weaker GR‐like immunoreactivity was associated with the region of the cell bodies of the olfactory receptor neurons. Within the lamina propria, acinar cells of the Bowman's glands and olfactory nerve bundles were intensely immunoreactive. Conclusions: The presence of GR mRNA and protein within the olfactory mucosa is consistent with a functional role for glucocorticoid hormones in the systemic regulation of olfaction. Furthermore, these studies suggest that corticosteroid medications may have direct effects on the cells of the olfactory mucosa in the pathologic state. The potential mechanisms whereby these hormones may act are discussed.
Efficacy of tonsillectomy for recurrent throat infection in adults
Authors: Mui Stanley , Rasgon Barry M. , Hilsinger Raymond L. 
Published: November 2003

AbstractObjective/Hypothesis: Sore throats result in health care visits, use of oral antibiotics, and days off work or school for many patients who do not meet American Academy of Otolaryngology—Head and Neck Surgery (AAO‐HNS) guidelines for tonsillectomy. We sought to determine whether tonsillectomy would benefit this group. Study Design: Retrospective analysis of the medical records of all patients aged 16 years or older who had tonsillectomy at our institution between 1988 and 1993. Methods: Number of clinic visits, number of throat cultures positive for streptococci, and number of prescriptions for oral antibiotics recorded for 147 patients during the 2‐year periods before and after tonsillectomy were tabulated. Statistical comparisons were made using the Student's t test. Mean number of clinic visits and oral antibiotics prescribed for throat infection before tonsillectomy were significantly higher than after tonsillectomy. Results: Patients who had throat cultures positive for streptococci had more preoperative clinic visits and use of oral antibiotics than patients whose throat cultures were not positive for streptococci. When surveyed by telephone, most (>87%) of the respondents reported that they had fewer and less severe sore throats, required fewer days off work or school, and would recommend the procedure. Conclusions: Our results suggest that early tonsillectomy in patients with recurrent throat infection may result in improved patient satisfaction, better health, and improved utilization of medical resources.