bluuebunny/crossref_metadata_2025_split huggingface dataset:
Eosinophilic Cationic Protein as a Marker of Nasal Inflammation in Patients With Cystic Fibrosis
Authors: Weber Alexander , Kiefer Jan , Peters Silke , Schneider Markwart , Bargon Joachim , May Angelika 
Published: November 2003

AbstractObjectives: Evaluation was made of eosinophilic cationic protein (ECP) in nasal secretion for measuring the degree of nasal inflammation and monitoring response to therapy in cystic fibrosis (CF) patients with chronic rhinosinusitis. Symptoms and findings in regard to ECP levels before and after treatment were described.Study Design: Study was prospective, with 21 CF patients aged 4 to 19 years; 20 healthy volunteers served as controls. Collection of nasal secretion by a sponge was performed, and blood samples were obtained for serum. Cystic fibrosis (CF) patients were classified according to nasal symptoms and findings.Methods: ECP was measured by fluoroimmunoassay. Age, sex, nasal symptoms, and endoscopic and histological findings were obtained, and examinations were conducted before and after treatment; recurrences were recorded.Results: In CF patients with chronic nasal inflammation, increased nasal levels of ECP were detected when compared with asymptomatic CF patients or healthy nonatopic subjects. ECP concentrations were strongly related to the extent of nasal disease; patients with nasal polyps had higher levels than those without. Checked at 1 and 4 months after treatment, ECP levels declined with regression of symptoms, and in patients with exacerbation of nasal disease, ECP levels rose.Conclusions: According to our study, there is a relationship between levels of ECP in nasal secretions and the degrees of nasal inflammation. In addition, the measurement of ECP could be useful in monitoring nasal disease in CF patients.
Clinical Significance of Rebound Nystagmus
Authors: Lin Chao‐Yu , Young Yi‐Ho 
Published: November 2003

AbstractObjective/Hypothesis: Magnetic resonance imaging (MRI) examination is performed in cases of rebound nystagmus to elucidate the responsible site for rebound nystagmus.Methods: Patients with vertigo or tinnitus received a battery of audiological and neuro‐otological tests. Those who had rebound nystagmus were rechecked by electronystagmography and examined by MRI.Results: Ten patients had a second‐degree nystagmus evoked by changing direction of fixation, from the lateral to the forward gaze. All patients displayed positive MRI findings in cerebellum or brainstem, including tumor in seven cases and stroke in three cases. Moreover, in seven of eight cases with unilateral lesions, rebound nystagmus was ipsilateral with respect to the side of the lesion.Conclusion: Rebound nystagmus implies a lesion in cerebellum or brainstem for which MRI examination is 100% sensitive. It has a certain lateralizing value, with its direction away from the lesioned side.
Effect of Laser Uvulopalatoplasty on Middle Ear Function
Authors: Marais Joe , Armstrong Michael W.J. 
Published: November 2003

AbstractObjectives: Palatal musculature is known to be responsible for the active opening of the eustachian (auditory) tube. Because laser‐assisted uvulopalatoplasty (LAUP) may involve partial division of these muscles, the effect of this procedure on middle ear pressures (MEPs) and middle ear volumes (MEVs) was investigated.Study Design: A controlled interventional trial with one limb receiving treatment and the other none. Preoperative and postoperative measurements were carried out in both groups.Methods: A control group of 15 normal volunteers and a study group of 22 patients undergoing LAUP all of whom had normal ears and type A tympanograms before the trial were recruited. Repeat tympanometry was carried out after 3 months in both groups. The results of MEP and MEV were recorded for both groups and analyzed by the Mann‐Whitney U test.Results: A trend toward reduced MEP and MEV was noted in the LAUP group, but did not achieve statistical significance. A study with more patients may achieve significance.Conclusions: No significant effects on middle ear pressures or volumes 3 months after LAUP were demonstrated. A much larger study may, however, arrive at a statistically significant result and further work is warranted. Relevant palatal and tubal anatomy is discussed and a brief review of the relevant literature is given.
Antimicrobial Activity of Synthetic Salivary Peptides Against Voice Prosthetic Microorganisms
Authors: Elving G. Jolanda , van der Mei Henny C. , Busscher Henk J. , Amerongen Arie van Nieuw , Veerman Enno C. I. , van Weissenbruch Ranny , Albers Frans W. J. 
Published: November 2003

AbstractObjectives: To investigate whether synthetic salivary antimicrobial peptides have an inhibitory effect on the growth of bacteria and yeasts isolated from used silicone rubber voice prostheses.Methods: The antimicrobial activities of six synthetic salivary peptides (histatin 5, dhvar1, dhvar4, dhvar5, lactoferrin b 17–30 [LFb 17–30], and cystatin S1–15) at concentrations of 2 and 4 mg/mL were determined against different oropharyngeal yeast (four) and bacterial (eight) strains and against a “total microflora” isolated from explanted voice prostheses using agar diffusion tests. The spectrum of susceptible microorganisms was determined qualitatively.Results: Histatin 5 and cystatin S1–15 did not show any antimicrobial activity against the microorganisms involved in this study. Dhvar1 was active against some of the oropharyngeal microorganisms tested, including the yeast strains, but not against Rothia dentocariosa, Staphylococcus aureus, Escherichia coli, and the total microflora. Dhvar4 was active against all microorganisms tested, including the total microflora. Dhvar5 lacked activity against E coli and the total microflora. LFb 17–30 did not inhibit the growth of any of the yeast strains involved and showed only minor activity against some of the bacterial strains. LFb 17–30 slightly inhibited the growth of the total microflora from an explanted prosthesis.Conclusions: The synthetic salivary peptide dhvar4 has a broad antimicrobial activity against all microorganisms that are commonly isolated from explanted voice prostheses, including yeasts. Therewith, it may represent a useful drug, as an alternative for antibiotics and antimycotics employed in various ways to prolong the lifetime of voice prostheses in laryngectomees.
Role of the Specialty Society in Outcomes Assessment: The Development of COGENT
Authors: Monsell Edwin M. , Holzer Susan Sedory 
Published: November 2003

AbstractThe Cooperative Outcomes Group for ENT (COG*ENT), a clinical outcomes project of the American Academy of Otolaryngology—Head and Neck Surgery Foundation, was established to assess clinical outcomes of otolaryngological care of patients with two diseases, otitis media and rhinosinusitis. COG*ENT has produced an assessment tool with many potential applications. The development and early experience of the Foundation with this project are described, emphasizing the factors the authors believe are important for success.
A Transgenic Insertional Inner Ear Mutation on Mouse Chromosome 1
Authors: Friedman Rick A. , Adir Yardit , Crenshaw E. Bryan , Ryan Allen F. , Rosenfeld Michael G. 
Published: November 2003

AbstractObjectives/HypothesisTo clone and characterize the integration site of an insertional inner ear mutation, produced in one of fourteen transgenic mouse lines. The insertion of the transgene led to a mutation in a gene(s) necessary for normal development of the vestibular labyrinth.Study DesignMolecular genetic analysis of a transgene integration site.MethodsMolecular cloning, Southern and northern blotting, DNA sequencing and genetic database searching were the methods employed.ResultsThe integration of the transgene resulted in a dominantly inherited waltzing phenotype and in degeneration of the pars superior. During development, inner ear fluid homeostasis was disrupted. The integration consisted of the insertion of a single copy of the transgene. Flanking DNA was cloned, and mapping indicated that the genomic DNA on either side of the transgene was not contiguous in the wild‐type mouse. Localization of unique markers from the two flanks indicated that both were in the proximal region of mouse chromosome 1. However, in the wild‐type mouse the markers were separated by 6.3 cM, indicating a sizable rearrangement. Analysis of the mutant DNA indicated that the entire region between the markers was neither deleted nor simply inverted.ConclusionsThese results are consistent with a complex rearrangement, including at least four breakpoints and spanning at least 6.3 cM, resulting from the integration of the transgene. This genomic rearrangement disrupted the function of one or more genes critical to the maintenance of fluid homeostasis during development and the normal morphogenesis of the pars superior.
A Clinicopathological Study of 15 Patients With Neuroglial Heterotopias and Encephaloceles of the Middle Ear and Mastoid Region
Authors: Gyure Kymberly A. , Thompson Lester D.R. , Morrison Alan L. 
Published: November 2003

AbstractObjectives/Hypothesis Heterotopic masses of neuroglial tissue involving non‐midline structures, specifically, the middle ear region, are exceptional. The pathogenesis of these lesions and, in particular, their relation to encephaloceles, is uncertain.Study Design and Methods H&E‐stained sections from 15 lesions diagnosed as neuroglial heterotopias or encephaloceles involving the middle ear region were reviewed. Radiographic or operative evidence of a central nervous system (CNS) relation and clinical factors possibly related to pathogenesis were analyzed.Results All 15 lesions (from six men and nine women; mean age, 49 y; range, 16–67 y), regardless of their relation to the CNS, were composed of varying proportions of neurons and glia with associated chronic inflammatory cells and reactive gliosis. No significant ependymal or choroid plexus component was present. Operative findings revealed that two lesions had definite CNS connections and two were unrelated to the CNS; this relation could not be determined in the remaining cases. Seven of 10 patients for whom clinical information was available had a history of chronic otitis media or mastoiditis or both; four of these seven patients also had a history of previous trauma or surgery. Three patients, including both patients whose lesions had no demonstrable CNS attachment, had no predisposing factors.Conclusions Most neuroglial heterotopias of the middle ear are probably acquired encephaloceles. These lesions occur in older patients than do their midline counterparts. Determination of the relation of these lesions to adjacent CNS structures must be done radiographically or using operative findings, because histology alone cannot be reliably used to render an accurate diagnosis.
Reliability of the Muller Maneuver and Its Association With Sleep‐Disordered Breathing
Authors: Terris David J. , Hanasono Matthew M. , Liu Yung C. 
Published: November 2003

AbstractObjectives/Hypothesis Use of the Muller maneuver (MM) in the evaluation of patients with obstructive sleep apnea is controversial. One criticism of this test is that it is somewhat subjective. Our objective is to explore the reliability of this technique and its association with sleep‐disordered breathing.Study Design Prospective study performed in an academic tertiary care center.Methods An analysis of MM scores from 180 consecutive patients obtained independently by two examiners was completed. These scores were compared with each other and with the apnea‐hypopnea index (AHI) obtained from polysomnographic studies.Results Collapse of the soft palate (PAL), lateral pharyngeal wall (LPW), and base of the tongue (BOT) was rated on a five‐point scale (0–4). The mean scores determined by the faculty examiner were 2.47, 2.06, and 1.58, respectively; the mean scores determined by the resident examiner were 2.34, 2.25, and 1.48, respectively. The scores of the two examiners correlated to within ±1 unit 83.9% of the time at the PAL, 91.1% at the LPW, and 85.0% at the BOT. The degree of correlation was not influenced by year of training of the resident. When the AHI was converted to a four‐point scale based on severity, the score correlated within ±1 of the average MM score 72.1% of the time.Conclusions Despite the subjective nature of the MM, the five‐point scale can be used by independent examiners to achieve an evaluation of the upper airway that is reproducible. The preoperative severity of sleep‐disordered breathing based on the AHI is moderately correlated with the MM score.
Quantitative Impact of Pediatric Sinus Surgery on Facial Growth
Authors: Senior Brent , Wirtschafter Ari , Mai Charlie , Becker Cristy , Belenky Walter 
Published: November 2003

AbstractObjective/Hypothesis To quantitatively evaluate the long‐term impact of sinus surgery on paranasal sinus development in the pediatric patient.Study Design Longitudinal review of eight pediatric patients treated with unilateral sinus surgery for periorbital or orbital cellulitis with an average follow‐up of 6.9 years. Control subjects consisted of two groups, 9 normal adult patients with no computed tomographic evidence of sinusitis and 10 adult patients with scans consistent with sinusitis and a history of sinus‐related symptoms extending to childhood.Methods Application of computed tomography (CT) volumetrics, a technique allowing for precise calculation of volumes using thinly cut CT images, to the study and control groups.Results Paired Student t test analyses of side‐to‐side volume comparisons in the normal patients, patients with sinusitis, and patients who had surgery revealed no statistically significant differences. Comparisons between the orbital volumes of patients who did and did not have surgery revealed a statistically significant increase in orbital volume in patients who had surgery.Conclusions Only minimal changes in facial volume measurements have been found, confirming clinical impressions that sinus surgery in children is safe and without significant cosmetic sequelae.
Eustachian Tube Endoscopy in Patients With Chronic Ear Disease
Authors: Linstrom Christopher J. , Silverman Carol A. , Rosen Arie , Meiteles Lawrence Z. 
Published: November 2003

AbstractObjectives/Hypothesis A paucity of research exists on trans–eustachian tube endoscopy to evaluate the status of the eustachian tube. Fuller examination of the role of the eustachian tube in chronic ear disease is needed, particularly because the eustachian tube has been implicated in the chronicity and pathogenesis of chronic ear disease. Therefore the purpose of this study was to evaluate the eustachian tube, based on observations from trans–eustachian tube endoscopy.Study Design Twenty‐two adult patients with chronic ear disease gave informed consent to participate in a prospective, trans–eustachian tube endoscopic investigation.Methods Flexible, fiberoptic, nonarticulating (outside diameter of 0.5 mm) and articulating (outside diameter of 1.0 mm) endoscopes (coherent fused bundle of 3,000 pixels) were employed. The eustachian tube endoscopy was performed under general endotracheal anesthesia as the initial part of a larger, otological surgical procedure for chronic ear disease. The endoscope was passed from the middle ear (transtympanic approach) to the nasopharynx.Results The 0.5‐mm endoscope passed entirely through the eustachian tube from the tympanic orifice into the pharyngeal orifice in 16% of the cases. Stenotic blockage occurred at the infundibulum in 37%, isthmus in 42%, and fossa of Rosenmüller in 5% of cases. The eustachian tube mucosa was abnormal in 64% of cases. The risk for abnormal eustachian tube mucosa was four times greater for persons with long‐standing disease (≥20 y) than for persons without long‐standing disease (<20 y). The mean therapeutic efficiency of ossicular reconstruction was higher for the subgroup with normal than for the subgroup with abnormal eustachian tube mucosa.Conclusions The findings of trans–eustachian tube endoscopy provide objective evidence concerning eustachian tube status in persons with chronic ear disease and have implications for the timing of surgical intervention (ossicular reconstruction).
Analysis of Local Cytokine Gene Expression in Patients With Allergic Rhinitis Treated With CO2 Laser Surgery
Authors: Takeno Sachio , Osada Rika , Furukido Kyosuke , Yajin Koji 
Published: November 2003

AbstractObjectives/Hypothesis Laser surgery of the inferior turbinates has become a popular surgical treatment for patients with allergic rhinitis, particularly for those who have persistent nasal obstruction and do not respond well to pharmacological therapy. The aim of this study was to investigate the effects of the laser surgery on local cytokine gene expression at the mucosal surface in relation to the improvement of nasal symptoms.Study Design A prospective analysis of 25 patients with allergic rhinitis caused by the house dust mite who underwent laser surgery twice with a 1‐month interval on an outpatient basis. Fifteen healthy volunteers served as normal control subjects.Methods Improvement of the nasal symptoms was evaluated on a graded scale. Nasal mucosal cells were obtained by brushing from the inferior turbinate at each visit. The expression of messenger RNA (mRNA) encoding granulocyte‐macrophage colony‐stimulating factor (GM‐CSF), interleukin (IL)‐6, IL‐8, RANTES (regulated on activation, normal T‐cell expressed and secreted), and eotaxin was semiquantitatively analyzed by reverse transcription–polymerase chain reaction (RT‐PCR).Results Two months after treatment, the nasal symptom scores significantly decreased from baseline. The decrease was most apparent in nasal obstruction. RT‐PCR analysis revealed that a significant decrease in IL‐8 and RANTES expression (P < .001 and P = .012, respectively) was observed after successive laser treatment, and the reduction in these cytokines was significantly correlated. On the other hand, mRNA expression of GM‐CSF, IL‐6, and eotaxin remained unchanged.Conclusions This study provided evidence that the expression of local inflammatory cytokines can be attenuated in part by CO2 laser treatment, which may be closely related to the clinical effectiveness of this procedure.
Management of Acute Pulmonary Hemorrhage in Children
Authors: Sidman James D. , Wheeler William B. , Cabalka Allison K. , Soumekh Benhoor , Brown Carl A. , Wright Gregory B. 
Published: November 2003

AbstractObjective Acute pulmonary hemorrhage can result from a variety of causes. This report offers a diagnosis and treatment plan for children with acute, life‐threatening pulmonary hemorrhage resulting from a variety of causes.Methods Retrospective review of children with acute pulmonary hemorrhage cared for at a tertiary care children's hospital during from January 1, 1993 to September 1, 1999.Patients Fourteen children were identified with life‐threatening pulmonary hemorrhage during the study period.Interventions Bronchoscopy was the keystone to diagnosis of pulmonary hemorrhage in this series. All of the children underwent multiple procedures to stabilize the airway and control blood loss. These interventions included CO2 laser bronchoscopy, Nd‐YAG laser bronchoscopy, endoscopic balloon occlusion of a lobe or main bronchus, topical airway vasoconstrictors, endoscopic tumor excision, transcatheter embolization of bronchial vessels, and lobectomy.Outcomes Three children died and 11 survived without neurological sequelae.Conclusions Control of acute pulmonary hemorrhage is a difficult problem and often requires multiple procedures. Endoscopic control is usually required for palliation until more definitive therapy can be undertaken.
Overexpression of p53‐Related Proteins Predicts Rapid Growth Rate of Head and Neck Cancer
Authors: Edström Staffan , Cvetkovska Elisabet , Westin Thomas , Young Cecilia 
Published: November 2003

AbstractObjectives/Hypothesis The p53 tumor suppressor gene plays an important role for cell cycle regulation and is the most frequent mutated gene in head and neck cancer. Controversy remains regarding the biological and clinical value of immunohistochemical identification of the proteins accumulated in association with inactivation of the p53 gene and increased tumor growth. Therefore, the objective of the present study was to perform a cell kinetic analysis of cases with untreated squamous cell carcinoma and to compare the result with immunostaining for p53‐related proteins in the tumor cells.Study Design A prospective series of 32 patients presenting with various stages of untreated squamous cell carcinoma of the head and neck were included. Bromodeoxyuridine (BrdU) was injected as a tracer dose before tumor biopsy for cell kinetic analysis, and p53 protein accumulation was detected using two antibodies (DO7 and PAb 1801).Results Antibody DO7 showed the highest and the optimal immunoreactivity. Diploid tumors were found in 27 cases (84%), and the mean potential doubling time (Tpot)was 55 ± 7 hours for these tumors. Positivity of DO7 (>1%) was demonstrated in 85% of the cases. However, a discrimination level exceeding 20% was required to obtain a significant negative relationship (Spearman's rank correlation coefficient test, P ≤.03) between Tpot and DO7 positivity. At that level, 33% of the tumors remained DO7‐positive. The corresponding Tpot was not significantly different from the overall mean. The rates of metastatic disease and survival were not dependent on DO7 immunoreactivity or cancer cell kinetics.Conclusion Accumulation of p53‐related proteins is associated with an unrestrained growth of head and neck cancer.
Detection of Fungi in the Nasal Mucosa Using Polymerase Chain Reaction
Authors: Catten Michael D. , Murr Andrew H. , Goldstein Jayne A. , Mhatre Anand N. , Lalwani Anil K. 
Published: November 2003

AbstractHypothesis Fungi have been increasingly recognized as important pathogens in sinusitis. However, detection of fungus with conventional culture techniques is insensitive and unreliable. Polymerase chain reaction (PCR) is an exquisitely sensitive assay that can detect the DNA of 10 or less fungal elements. The aim of this study was to compare the sensitivity of conventional culture techniques using PCR analysis.Methods Nasal swabs and DNA samples were collected from the nasal cavities of control subjects and patients with chronic sinusitis. Fungal‐specific PCR analysis and standard cultures were performed on every sample. χ2 analysis was used to test for statistical differences between groups.Results PCR analysis detected fungal DNA in 42% and 40% of control subjects and patients with chronic sinusitis while standard cultures were positive in 7% and 0%, respectively. There was no statistically significant difference in the prevalence of fungi in the normal volunteers and patients with chronic rhinosinusitis.Conclusion PCR is significantly more sensitive than nasal swab cultures in detecting the presence of fungi in nasal mucosa. In addition, our study suggests that the presence of fungi alone is insufficient to implicate it as the pathogen in chronic sinusitis.