bluuebunny/crossref_metadata_2025_split huggingface dataset:
Argon Laser Irradiation to the Semicircular Canal
Authors: Sugio Yuichiro , Nomura Yasuya , Oki Seido 
Published: November 2003

AbstractIn order to elucidate the effects of argon laser irradiation on the lateral semicircular canal of the guinea pig, the vestibular labyrinth was histologically studied after irradiation, using the conventional celloidin method. Irrigation of the external meatus with ice water was used to evaluate the function of the semicircular canal by recording caloricnystagmus. When irradiation was performed, a laser probe was approximated to the lateral canal, 0.5 to 1 mm away from the surface of the canal. Each time, power applied was 1.0 W on the dial of the laser machine. The duration of irradiation was 0.5 s. The lateral canal was irradiated one to 15 times. Twenty‐five to 87 days after irradiation, the temporal bones were fixed in Heidenhein‐Susa solution, removed, and subjected to celloidin processing. The irradiated bony wall of the lateral canal demonstrated charring. Lucent areas were observed around and under the charred area. The semicircular duct showed shrinkage with disappearance of the trabecular mesh. New bone formation was observed along the endosteum of the irradiated area. The lateral canal was completely occluded by ossification with or without fibrosis when sufficient energy was applied. The anterior and posterior canals were normal. Caloric tests using 5 mL of ice water for 5 s failed to elicit nystagmus on the irradiated side.
Platelet Aggregation in Head and Neck Tumors in China
Authors: Huang Guang‐Wu , Nong Hui‐Tu , Yu Qi‐Song , Kinjoh Kiyohiko , Nakamura Mariko , Kosugi Tadayoshi 
Published: November 2003

AbstractWe measured the maximum aggregation rate (MAR) of platelets in 770 patients with malignant head and neck tumors, 55 patients with benign tumors of the head and neck, and 164 healthy people as a control group. The results were as follows:1. the mean MAR value of patients with malignant tumors was significantly higher than the control group mean value; 2. prior to treatment, the mean MAR value increased with advancing tumor stage;3. both MAR values of relapsed or metastasized patients and of nonsurvivors in stage III and IV increased significantly compared with survivors or patients recovering from malignant tumors. The results of the present study suggest that MAR values of patients with malignant tumors of the head and neck may serve as indicators in evaluating therapeutic procedures and prognosis.
Molecular Temporal Bone Pathology: I. Historical Foundation
Authors: Wackym Phillip A. 
Published: November 2003

AbstractThe application of molecular biology techniques to temporal bone research is resulting in rapid changes in our understanding of the fundamental mechanisms of auditory, facial nerve, and vestibular function. The use of the polymerase chain reaction, cDNA libraries, and in situ hybridization histochemistry, the determination of genetic defects, and the manipulation of transgenic animals are the molecular biology tools that are available to approach these research problems. Knowledge of the molecular pathology that results in the otologic and neuro‐otologic dysfunction many of our patients experience is currently in its infancy. A review of the historical foundation of temporal bone pathology and the evolution of the application of cell and molecular biology methods to archival celloidin‐embedded human temporal bone material is presented.
Congenital Cholesteatomas in the Tympanic Membrane
Authors: Weber Peter C. , Adkins Warren Y. 
Published: November 2003

AbstractThe etiology of congenital middle ear (ME) cholesteatomas is unclear. One etiologic possibility of ME cholesteatoma may be progression of a congenital tympanic membrane (TM) cholesteatoma. We recently have encountered three cases of congenital tympanic membrane cholesteatoma. Each child, ages 1, 3, and 14 years, presented with cholesteatoma of the tympanic membrane extending into the middle ear. These children have not had previous otologic surgery including myringotomy, nor had they had repeated middle ear infections, perforation, or trauma. Neither the 3‐year‐old nor 14‐year‐old child complained of hearing loss. Audiograms demonstrated only a mild conductive loss. Each child underwent excision with tympanoplasty. Although the middle ear component of the cholesteatoma was always more extensive than the pearl seen, the point of attachment was the TM and not the middle ear. This demonstrates one possible source for congenital cholesteatomas.
Interleukin‐8 Concentration Predicts the Neutrophil Count in Middle Ear Effusion
Authors: Nassif Paul S. , Simpson Steven Q. , Izzo Angelo A. , Nicklaus Pamela J. 
Published: November 2003

AbstractInterleukin‐8 (IL‐8), a potent neutrophilic chemoattractant and inflammatory cytokine, is present in middle ear effusions (MEEs) of children with otitis media and is thought to be responsible for the accumulation of neutrophils in MEEs. We hypothesized that IL‐8 concentration predicts the total number and proportion of neutrophils in MEEs. IL‐8 concentration and total and differential cell counts were measured in MEEs of children undergoing tympanostomy tube placement for otitis media. IL‐8 was present in 80 (98%) of 82 effusions. The mean ± SEM value for IL‐8 was 7342 ± 847 pg/mL. The mean ± SEM count and percentage of neutrophils were 1.34 × 106 ± 3.44 × 105 and 70.6 ± 3.1%, respectively. IL‐8 concentrations correlated positively with the total number(r = +0.30; P = 0.02) and percentage of neutrophils(r= +0.32; P = 0.01) in the effusion. Additionally, purulent effusions had greater IL‐8 concentrations (P = 0.003) and greater neutrophil count (P = 0.03) than mucoid or serous effusions. We conclude that IL‐8 is consistently present in MEEs of children and IL‐8 concentration predicts the total number and proportion of neutrophils. Furthermore, IL‐8 concentration and the total number of neutrophils correlate positively with the type of effusion. These results support the hypothesis that IL‐8 recruits neutrophils to the middle ear in MEEs.
An Optimal Choice: Home Intravenous Hydration After Tonsillectomy
Authors: Blakeslee Don B. , Jafek Bruce W. , Birney Janice L. 
Published: November 2003

AbstractMost tonsillectomies are performed as outpatient procedures in an ambulatory care facility. The postoperative period can be protracted, which can cause dehydration and readmission to the hospital. Timely intervention with home intravenous (IV) hydration can help prevent this complication. A prospective clinical trial was designed to evaluate the benefit of home IV therapy after tonsillectomy. One hundred consecutive patients underwent tonsillectomy. Fifty returned home without home IV hydration and another 50 returned home with home IV hydration. Clinical data were collected by the homecare nurse during the postoperative period. Comparison between these two groups showed that the patients with home IV hydration had less morbidity. Daily assessment of the patient by telephone is the best screening method to determine the need for IV hydration for the posttonsil‐lectomy patient.
Rethinking the Use of Auditory Brainstem Response in Acoustic Neuroma Screening
Authors: Zappia John J. , O'Connor Cathleen A. , Wiet Richard J. , Dinces Elizabeth A. 
Published: November 2003

AbstractThe ability of magnetic resonance imaging (MRI) to detect very small acoustic tumors has triggered many to rethink the use of auditory brainstem response (ABR) in the screening of acoustic tumors. To assess ABR accuracy, we conducted a retrospective study of 388 surgically treated patients. Of these patients, 111 had complete databases including both preoperative MRIs and ABRs. The ABR was abnormal by wave V interaural latency difference in 106 (95%) of the cases. Although our overall sensitivity was 95%, sensitivity varied according to tumor size. ABR was abnormal or absent for all tumors (100%) larger than 2 cm in diameter, for 98% of tumors 1.1 to 2 cm in diameter, and for only 89% of tumors less than or equal to 1 cm in diameter. Ramifications of this in the decision‐making process are presented. Criteria for cut‐off values are also discussed.
Ethical Issues Raised by Managed Care
Authors: Gonsoulin Thomas P. 
Published: November 2003

AbstractHealth care costs have risen steadily for many years as a result of an inflationary reimbursement system, technologic advances, an aging population, and increasing patient expectations. The growth of managed care organizations (MCOs) has accelerated rapidly in recent years as an attempt to control costs. Because MCOs are involved with medicine, a moral enterprise, they enter the ethical arena. In this report several of the ethical issues raised by the attempted union of potentially conflicting systems are explored. The discussion focuses on four sets of relationships: physician‐patient, physician‐physician, patient‐MCO and medicine‐MCO as systems. Some remedies for dealing with the conflicts raised are offered.
Wound Complications Associated With Brachytherapy for Primary or Salvage Treatment of Head and Neck Cancer
Authors: Righi Paul D. , Weisberger Edward C. , Krakovits Paul R. , Timmerman Robert D. , Wynne Michael K. , Shidnia Homayoon 
Published: November 2003

AbstractBrachytherapy can be employed in the primary or salvage treatment of head and neck cancer. The advantage of brachytherapy is the stereotactic limitation of radiation exposure to noninvolved tissues. Wound complications associated with brachytherapy have been discussed only sporadically in the literature. This retrospective study examines 28 patients, 20 for initial treatment and eight for salvage, with varying site and stage head and neck cancer treated with brachytherapy in addition to external beam radiation therapy and/or surgery. The overall complication rate was 50% (14/28), with infection and minor flap breakdown being the most common problems. Tumor site in the primary treatment group was the only significant factor in wound complications. In the salvage group complications were minor and primarily related to flap coverage of brachytherapy catheters.
Trends and Perspectives in Minimally Invasive Surgery in Otorhinolaryngology‐Head and Neck Surgery
Authors: Plinkert Peter , Löwenheim Hubert 
Published: November 2003

AbstractThe roots of minimally invasive surgery (MIS) in otolaryngology‐head and neck surgery (ORL‐HNS) can be traced to the 1950s. Today, endonasal sinus surgery and endolaryngeal surgery already fulfill the principles of MIS. To widen its spectrum of indications, however, MIS must be able to offer three advantages that conventional macrosurgery and microsurgery already have: free maneuverability for the instrument, sensory feedback, and three‐dimensional imaging. Every anatomical region (e.g., paranasal sinuses, upper aerodigestive tract, cerebellopontine angle) requires specific surgical instrumentation. Here, the authors present recently developed steerable instruments that allow two additional degrees of freedom not attainable with conventional instruments. These instruments may permit access to problem zones(e.g., laterally extending frontal and ethmoidal sinus recesses) in the near future. For better control of the instrument and the operative procedure, tactile feedback can be achieved with appropriate microsensor systems. Three‐dimensional vision can be realized by three‐dimensional video‐endoscopes and sequential image processing.
Frey's Syndrome After Parotidectomy: A Retrospective and Prospective Analysis
Authors: Linder Thomas E. , Huber Alex , Schmid Stephan 
Published: November 2003

AbstractGustatory sweating is a well‐known sequela after parotid surgery. In a retrospective and prospective study of patients undergoing parotid surgery, the onset, time course, extent, and treatment modalities of Frey's syndrome were analyzed. Twenty‐two percent of the patients evaluated by questionnaires and 43% of the patients followed prospectively within 1 year were found to be symptomatic. Although the Minor starch‐iodine test was positive in 38% of patients at 3 months, none of these patients experienced symptoms. Up to 12 months after surgery the rate of patients who tested positive increased to 96% and the total area of sweating expanded to a mean value of 18 cm2. Whereas most of the patients are not markedly disturbed, few patients (5% to 10%) suffer from severe gustatory sweating. These patients present a therapeutic challenge.
Effects of Aspergillus fumigatus and Alternaria alternata on Human Ciliated Epithelium in Vitro
Authors: Cody D. Thane , McCaffrey Thomas V. , Roberts Glen , Kern Eugene B. 
Published: November 2003

AbstractFungi represent the etiologic agent in a large number of patients with chronic sinusitis. Despite this, no study has examined the effects of fungi on ciliated epithelium. This study evaluates the effects of cultures and filtrates of
Aspergillus fumigatus
and
Alternaria alternata
on ciliary beat frequency (CBF) in vitro. CBF was recorded after exposure to either a control or experimental solution. A statistical comparison of control and experimental values was performed to determine significance at
P
< 0.05. A statistically significant inhibition of CBF in cultures and filtrates of
A fumigatus
and
A alternata
was demonstrated. We conclude that a soluble metabolite produced by clinical isolates of both
A fumigatus
and
A alternata
causes inhibition of CBF and may represent one virulence factor involved in the development of fungal sinusitis.
Expression of Adhesion Molecules in Nonallergic Chronic Sinusitis
Authors: Shimomura Akira , Ikeda Katsuhisa , Suzuki Hideaki , Nakabayashi Seiichiro , Oshima Takeshi , Furukawa Masayuki , Takasaka Tomonori , Ando Noriaki , Ohtani Haruo , Nagura Hiroshi 
Published: November 2003

AbstractEndothelial and epithelial adhesion molecules are important in the recruitment of leukocytes to inflammatory sites. To determine the relationship between recruited leukocytes and adhesion molecules in the paranasal sinus mucosa of nonallergic chronic sinusitis, we surgically obtained mucosa from 16 patients and identified the expression of intercellular adhesion molecules(ICAM‐1), vascular cell adhesion molecule‐1 (VCAM‐1), E‐selectin, and P‐selectin by immunohistochemistry. Neutrophils were significantly dominant in the nasal discharge as compared with eosinophils. The degree of neutrophil infiltration in the paranasal sinus mucosa was prominent in both intraepithelial and subepithelial areas as compared with the lamina propria. In each tissue site, the degree of infiltration of neutrophils was similar to that of eosinophils. These findings suggest that the tissue neutrophils actively and rapidly migrated into the lumen. All the adhesion molecules except VCAM‐1 were expressed in the vascular endothelial cells. On the other hand, the surface epithelial cells showed the expression of only ICAM‐1. The expression of ICAM‐1 on the endothelial cells correlated with the degree of neutrophil infiltration in the mucosa. The eosinophil infiltration was not dependent on any adhesion molecules examined here. It was concluded that ICAM‐1 expression in the mucosa may be involved in neutrophil recruitment and may contribute to the establishment of the inflammatory cell distribution in the paranasal sinus of nonallergic chronic sinusitis.
Incus and Stapes Footplate Simulator
Authors: Mathews Shawn B. , Hetzler Douglas G. , Hilsinger Raymond L. 
Published: November 2003

AbstractProsthesis placement in stapes surgery is difficult to master. Although temporal bone dissection is an important adjunct to operative experience and anatomic knowledge when training residents to perform this procedure, the high cost and scarcity of temporal bones available for teaching purposes limit their convenience as teaching tools. Therefore, to augment training of residents, the authors developed an inexpensive, easily constructed middle ear simulator made from a disposable drinking cup, toothpicks, and a tongue depressor. The device is used with a microscope and ear instruments to manipulate, place, and crimp stapes prostheses. Improved surgical skills can lead to better surgical results, and this middle ear simulator can help to improve otologic surgical skills by giving residents the opportunity to practice techniques necessary to master stapes surgery.
Tumors of the Nasal Columella Treated by Mohs Micrographic Surgery
Authors: Oriba Howard A. , Snow Stephen N. 
Published: November 2003

AbstractPrimary nasal columellar tumors are rare but can exhibit aggressive clinical behavior, often leading to devastating outcomes if these tumors are not completely removed. Eleven patients with nonmelanoma nasal columellar lesions were evaluated. All lesions were excised by obtaining tumor‐free margins with Mohs micrographic surgery. Seven of eight cases with basal cell carcinoma have been tumor free for more than 5 years, the eighth case remains tumor free at 4 years. The primary squamous cell carcinoma lesions treated in this study have fared well; one patient has been tumor free for the past 4.3 years. No local recurrence or distant metastasis has occurred to date for all cases. We conclude that intervention with Mohs micrographic surgery for the treatment of early nasal columellar tumors may lead to improved outcomes.
Analysis of the Mechanical Behavior of the Nijdam Voice Prosthesis
Authors: Verkerke Gijsbertus J. , de Vries Martin P. , Schutte Harm K. , van den Hoogen Frank J.A. , Rakhorst Gerhard 
Published: November 2003

AbstractThe valveless Nijdam prosthesis is a new voice prosthesis for laryngectomized patients using tracheoesophageal speech. An “umbrella‐like hat” covers the esophageal side of the tracheoesophageal fistula and is deformed during speech by air pressure. To decrease pressure loss during speech, a good understanding of the mechanical behavior is essential. In the present study, the Finite Element Method (FEM), used in engineering to analyze the mechanical behavior of complex structures, was applied to analyze eight possible improvements of the Nijdam prosthesis. This study found that, during speech, deformation of hat and soft tissue occur. Distinct differences in the hat's deformation of the eight models also were found. It is concluded that complex structures like the Nijdam prosthesis can be analyzed by FEM. An optimal model was found to decrease pressure loss while stresses in the device remain safe.
The Physiologic Reservoir of Epstein‐Barr Virus Does Not Map to Upper Aerodigestive Tissues
Authors: Liavaag Per Gunnar , Cheung Roy K. , Kerrebijn Jeroen D.F. , Freeman Jeremy L. , Irish Jonathan C. , Dosch Hans‐Michael 
Published: November 2003

AbstractThe human Epstein‐Barr herpesvirus (EBV) has distinct oncogenic potential, but with over 90% of the adult world population infected, malignancy is a rare outcome of carrier status. However, EBV's association with over half of Hodgkin's and non‐Hodgkin's lymphomas as well as several solid tumors, notably nasopharyngeal carcinoma, makes EBV‐linked malignancies one of the largest single cancer entities. EBV is a B‐lymphotropic virus, well controlled by surveillant T cells in immunocompetent hosts. To determine the presence and site of principal virus reservoirs is a likely prerequisite for understanding the etiology of EBV‐associated tumors. Its near 100% association with nasopharyngeal carcinoma led to postulates that the upper aerodigestive tract tissue may be common sites of persistent latent or low‐grade replicating infection. Using a protocol designed to avoid viral crosscontamination, the authors employed polymerase chain reaction to detect genomic EBV DNA sequences in 231 biopsies from different mucosal sites in the upper aerodigestive tract, as well as from salivary gland tissue and neck nodes in individuals not suspected to have EBV‐related malignancy. Only two samples, one from oral cavity mucosa and one from parotid gland tissue, were positive for EBV. The observation that oropharyngeal tissue is not the principal EBV reservoir has mechanistic implications for the development of EBV‐positive tumors in that locale.
Nitric Oxide Synthase in the Innervation of the Human Nasal Mucosa: Correlation With Neuropeptides and Tyrosine Hydroxylase
Authors: Tasman Abel‐Jan , Bogatzki Beate , Heppt Werner , Hauser‐Kronberger Cornelia , Fischer Axel 
Published: November 2003

AbstractNitric oxide (NO) is a powerful mediator in the central and peripheral nervous system. In the present study the authors have examined the human nasal mucosa innervation for the presence of the neuronal isoform of the NO‐generating enzyme, NO‐synthase (NOS), and its correlation with other neuronal mediators and markers by means of double‐labeling immunohistochemistry. NOS‐immunoreactive nerve fibers were observed to be numerously present around glands and venous sinusoids and, less frequently, around small arteries and veins. Few fibers were seen in the lamina propria. NOS appeared to be frequently colocalized in nerve fibers with vasoactive intestinal peptide and, occasionally, with substance P and tyrosine hydroxylase, a marker for catecholamine biosynthesis. These findings suggest that neurally released NO is an important regulatory mediator of glandular secretion and blood flow in the nasal mucosa.
A Surgical Technique to Prevent Tracheostomal Stenosis After Laryngectomy
Authors: Vlantis Alex C. , Marres Henri A.M. , van den Hoogen Frank J.A. 
Published: November 2003

AbstractTracheostomal stenosis after total laryngectomy is a frequently occurring nuisance to both the patient and the surgeon. Although many causes may contribute to the development of tracheostomal stenosis, operative technique seems to play a major role. The authors describe and explain their method of stomal construction. Over a 10‐year period they have used the described method on 260 patients undergoing a total laryngectomy, with an incidence of tracheostomal stenosis of 6%.
Intelligibility and Perceptual Ratings After Treatment for Laryngeal Cancer: Laryngectomy Versus Radiotherapy
Authors: Finizia Caterina , Lindström Jörgen , Dotevall Hans 
Published: November 2003

AbstractIn Sweden the most common treatment for T3‐T4 laryngeal carcinoma is radical radiotherapy (with surgery for salvage), because the voice is thus preserved. A Swedish study showed that surgery yielded a significantly better 5‐year survival and locoregional control at 3 years in T4 laryngeal carcinoma than radical radiotherapy. With these results in mind, we wanted to compare the different modes of treatment (surgery with a tracheoesophageal [TE] fistula and radical radiotherapy) with respect to the patients' speech proficiency. Twenty‐eight subjects (with 14 patients in each treatment group) were judged by inexperienced and experienced listeners according to intelligibility by transcription and three perceptual ratings. From the perceptual ratings of speech intelligibility, voice quality, and speech acceptability we conclude that there is a significant difference, the irradiated speakers being rated higher than the tracheoesophageal speakers. It is also clear that most of the TE and irradiated laryngeal speaking patients are comparable to normal laryngeal speakers in intelligibility by transcription. Experienced and inexperienced listeners are able to rate TE and irradiated laryngeal speech reliably and similarly according to intelligibility by transcription. The inexperienced listeners rated the TE speakers significantly higher than did the experienced listeners.