bluuebunny/crossref_metadata_2025_split huggingface dataset:
Natural Course of Serum‐Specific Immunoglobulin E and Immunoglobulin G4 for a Span of Eight Years in Untreated Patients With Perennial Allergic Rhinitis
Authors: Ohashi Yoshihiro , Nakai Yoshiaki , Ohno Yoshiharu , Okamoto Hideki , Kakinoki Yasushi , Masamoto Tateo , Tanaka Ayaki , Hayashi Motoyo 
Published: November 2003

AbstractDuring the past two decades, considerable attention has been devoted to the clinical role of serum‐specific IgE and IgG4 following immunotherapy. To definitely discuss the clinical role of serum‐specific IgG4, we should know the natural course of serum‐specific IgG4 in the untreated patient with allergic rhinitis. To our knowledge, however, no such kind of study can be found in the literature. Our present study focused on the long‐term follow‐up of serum‐specific IgE and IgG4 in patients who were not treated with immunotherapy for perennial allergic rhinitis. They were scheduled to take no medication for their perennial nasal symptoms for 8 years. Serum‐specific IgE and IgG4 in untreated patients with perennial allergic rhinitis never significantly change during the observation period. These data will be of great value for studies in serologic changes following active treatment for atopic diseases. Additionally, our study suggests that a reduction in serum‐specific IgE and an increase in serum‐specific IgG4 following immunotherapy are not the result of an immunotherapy‐independent and age‐related phenomenon but the result of active immunologic modulation by immunotherapy.
Detection of Epstein‐Barr Virus in Nasopharyngeal Carcinoma by In Situ Hybridization and Polymerase Chain Reaction
Authors: Murono Shigeyuki , Yoshizaki Tomokazu , Tanaka Saichiro , Takeshita Hajime , Park Chang‐Soo , Furukawa Mitsuru 
Published: November 2003

AbstractThe association of Epstein‐Barr virus (EBV) with nasopharyngeal carcinoma (NPC) has been shown by various methods. The purpose of this study is to identify the most useful method to detect EBV in NPC. Both polymerase chain reaction (PCR) for EBV‐DNA and in situ hybridization for EBV‐encoded small RNAs(EBERs) were examined in formalin‐fixed, paraffin‐embedded NPC specimens. In situ hybridization was performed in 56 cases, and PCR for EBV‐DNA was performed in 42 cases. EBV‐DNA was detected in 0 of 3 keratinizing squamous cell carcinomas(KSCC), 22 of 24 nonkeratinizing carcinomas (NKC), all 13 undifferentiated carcinomas (UNPC), and 0 of 2 adenocarcinomas (AC). EBERs were detected in 0 of 5 KSCC, 30 of 32 NKC, 16 of 17 UNPC, and 0 of 2 AC. Among them, EBERs was detected in 35 of 42 cases in which PCR was also performed, 0 of 3 KSCC, 22 of 24 NKC, all 13 UNPC, and 0 of 2 AC, respectively. Both results were consistent in 40 of 42 cases. We conclude that both PCR and in situ hybridization are useful to detect EBV in NPC. In situ hybridization has a particular advantage because it can demonstrate the localization of EBV in neoplastic cells. In addition, close association of NKC and UNPC but not KSCC and AC with EBV is suggested.
In Situ Lifetime, Causes for Replacement, and Complications of the ProvoxTMVoice Prosthesis
Authors: Laccourreye Ollivier , Ménard Madeleine , Crevier‐Buchman Lise , Couloigner Vincent , Brasnu Daniel 
Published: November 2003

AbstractOne hundred ProvoxTMvoice prostheses consecutively inserted in 37 patients and replaced only when phonation was impaired or complications noted were analyzed for in situ lifetime, causes for replacement, and complications. The mean in situ lifetime was 311 days. Actuarial analysis(Kaplan‐Meier method) of the in situ lifetime revealed that 65.9%, 23.7%, and 16.4% of the voice prosthesis were still in situ by the 6th, 12th, and 18th postinsertion month. Cause for replacement was salivary leakage through the prosthesis valve, salivary leakage around the prosthesis, deterioration of the prosthesis, and excessive crusting resulting in increased airflow resistance in 33%, 27%, 24%, and 16% of cases, respectively. Complications included granulation tissue formation, cervical cellulitis, necrosis of the tracheoesophageal puncture, tracheostomal stenosis, and swallowing impairment in six, two, one, three, and one patient, respectively.
Analysis of Voice Changes After Thyroplasty Using Linear Predictive Coding
Authors: Plant Randall L. , Hillel Allen D. , Waugh Patricia F. 
Published: November 2003

AbstractObjective measurement of vocal quality is difficult in patients with severe voice disorders. Improved success has been reported using a modeling technique known as linear predictive coding. This technique uses an inverse filter to estimate a glottic excitation signal. The pitch amplitude is defined as the height of the first peak of the autocorrelation of the glottic excitation signal. In this study linear predictive coding was used to analyze voice disorders in patients with vocal fold immobility. Voice recordings were made in 16 patients undergoing vocal fold medialization and 10 patients who had no surgical procedure between measurements. The voice quality was rated by three speech pathologists. Five acoustic parameters were calculated from the samples. The best agreement with the listeners' perceptual analysis was achieved using the pitch amplitude. Both pitch amplitude and the perceptual ratings of voice quality improved in patients undergoing vocal fold medialization. Therefore the linear model of speech production and inverse filtering are useful in measuring vocal quality in patients with vocal fold immobility.
Utility of Preoperative Radionuclide Scanning for Primary Hyperparathyroidism
Authors: Sinha Christopher K. , Hamaker Ronda , Hamaker Ronald C. , Freeman Stephen B. , Borrowdale Richard W. , Huntley Tod C. 
Published: November 2003

AbstractThis study retrospectively reviews 60 cases of primary hyperparathyroidism, 21 of whom underwent technetium 99 sestamibi scanning and 10 of whom underwent thallium 201/technetium 99 pertechnetate scanning preoperatively. The sestamibi and thallium scans demonstrated an 89.5% and a 62.5% sensitivity rate for adenoma, respectively. Neither scan demonstrated hyperplastic glands well. Although the scans localized adenomatous glands to the correct side well, the ability to localize them more discretely was 68.4% and 62.5%, respectively. In cases of solitary adenoma the effect of an accurate preoperative scan on operative time for bilateral exploration was not significant, whereas the experience of the attending surgeon was significant. Also, the cost of the scans at our institution was greater than the cost of the time saved in performing even unilateral neck exploration. Thus preoperative radionuclide scanning is not cost‐effective for the initial exploration of patients with primary hyperparathyroidism and is insufficiently sensitive to make routine unilateral neck exploration for adenoma consistently effective.
Positional Vertigo and Ageotropic Bidirectional Nystagmus
Authors: Casani Augusto , Giovanni Vannucci , Bruno Fattori , Luigi Ghilardi Pier 
Published: November 2003

AbstractA strong paroxysmal positional horizontal nystagmus accompanied by symptoms similar to those of paroxysmal positional vertigo (PPV) can be observed in a small fraction of patients who have positional vertigo. This nystagmus may be a lateral canal variant of PPV. We evaluated nine patients who had episodes of prolonged, intense positional vertigo provoked by lateral movements of the head while in the supine position. The nystagmus appeared as horizontal and was directed toward the uppermost ear (ageotropic) when the head was rotated to either side (bidirectional). The duration of nystagmus lasted more than 1 minute in all the cases, although it presented a progressive decrease in the velocity of the slow component. The clinical and electronystagmographic features of this syndrome lead us to propose a different form of horizontal canal PPV associated with a paroxysmal positional ageotropic and bidirectional nystagmus, probably caused by a “heavy cupula” as a result of deposits of extraneous bodies (otolithic?) or by a cupula denser than the endolymph.
Mutation of p53 in Squamous Cell Cancer of the Head and Neck: Relationship to Tumor Cell Proliferation
Authors: Wood Nancy B. , Kotelnikov Valery , Caldarelli David D. , Hutchinson James , Panje William R. , Hegde Poornima , Leurgans Sue , LaFollette Suzanne , Taylor Samuel G. , Preisler Harvey D. , Coon John S. 
Published: November 2003

AbstractRapid proliferation of squamous cell carcinomas of the head and neck (SCCHN) during therapy may contribute to treatment failure. We have investigated the presence of p53 abnormalities in patients with SCCHN as a correlate of proliferation rate and other pathologic and clinical variables. p53 Mutation, as determined by polymerase chain reaction and single‐strand conformation polymorphism analysis of microdissected frozen sections of tumor biopsies, was significantly associated with a high labeling index, as determined by in vivo infusion of IUdR and BrdU (P = 0.017). p53 Protein expression was detected by immunohistochemistry with two different antibodies, followed by quantitative image analysis. Many cases exhibited strong p53 protein expression in the absence of mutations within the conserved region of the gene, and expression was not related to proliferation. The presence of p53 mutations was related to tumor differentiation in this group of patients.
Suprastomal Granulation Tissue and Pediatric Tracheotomy Decannulation
Authors: Merritt Robert M. , Bent John P. , Smith Richard J. H. 
Published: November 2003

AbstractAlthough numerous decannulation techniques have been reported, often involving costly sleep studies, repetitive laser procedures, and tracheotomy tube “downsizing,” no established standard of care exists. We advocate the following simple, minimally invasive decannulation protocol. After excluding concomitant airway lesions, suprastomal granulation is removed transtomally by an endoscopically guided rongeur. A tracheotomy tube is then fashioned with a fenestration centered in the tracheal lumen. Decannulation occurs if the patient maintains adequate ventilation over a 12‐ to 24‐hour observation period with the fenestrated tracheotomy capped. Over 18 months we prospectively followed 10 consecutive children presenting as potential decannulation candidates. Using the aforementioned technique, nine of 10 patients were successfully decannulated (average follow‐up, 11.5 months). The postoperative capped fenestrated tracheotomy trial provides a realistic assessment of preparedness for decannulation. We recommend this protocol as a rapid, efficient, and cost‐effective means of achieving decannulation.
Efficacy of Tympanomastoid Surgery for Control of Infection in Active Chronic Otitis Media
Authors: Merchant Saumil N. , Wang Pa‐chun , Jang Chul‐Ho , Glynn Robert J. , Rauch Steven D. , McKenna Michael J. , Nadol Joseph B. 
Published: November 2003

AbstractThe efficacy of surgery in controlling infection in 272 tympanomastoidectomy procedures for chronic otitis media (COM) was assessed by means of a four‐point rating scale that incorporated both symptoms and signs, such as the presence or absence of otorrhea and granulation tissue. Of the 272 procedures, 170 were performed for COM with cholesteatoma and 102 were for active COM with granulation tissue but no cholesteatoma. Forty‐seven percent were primary procedures, and 53% were revisions. Minimum follow‐up was 12 months for all cases, with a mean of 30 months. Adequate control of infection occurred in 248 (91%) of the 272 cases. Of the 24 cases (9%) that developed persistent infection, 10 were controlled with a combination of oral and topical antibiotics and/or delayed skin grafting in the office. Thus overall satisfactory control of infection was achieved in 258 of 272 cases (95%). The outcome was influenced by the diagnostic category of COM: COM with cholesteatoma did significantly better than COM with granulation tissue (P= 0.02). The outcome was not influenced by the following variables: primary versus revision surgery, canal wall‐up versus canal wall‐down surgery, and extent of disease. The results suggest that active COM with granulation tissue may be more difficult to control than COM with cholesteatoma.
Stapedectomy in Patients With Small Air‐Bone Gaps
Authors: Lippy William H. , Burkey John M. , Schuring Arnold G. , Rizer Franklin M. 
Published: November 2003

AbstractControversy exists concerning stapedectomy for patients with small air‐bone gaps. The purpose of this study was to examine the results for patients who had a stapedectomy to correct a small (10 dB or less) air‐bone gap. One hundred fifty‐four patients with suspected otosclerosis were explored and a stapedectomy was performed in 136 (88.3%) of these cases. The mean pure‐tone average (PTA) improved 16.7 dB and overclosed the preoperative bone conduction PTA by 8.1 dB. The majority of the stapedectomy patients (89.7%) had a PTA closure greater than or equal to 0 dB. These results showed that stapedectomy can be an effective procedure for eliminating and overclosing even small air‐bone gaps due to otosclerosis.
Soluble Intercellular Adhesion Molecule‐1 Level in Sera Is Elevated in Perennial Allergic Rhinitis
Authors: Ohashi Yoshihiro , Nakai Yoshiaki , Tanaka Ayaki , Kakinoki Yasushi , Ohno Yoshiharu , Masamoto Tateo , Sakamoto Hirokazu , Kato Akifumi , Washio Yushi , Hayashi Motoyo 
Published: November 2003

AbstractSoluble intercellular adhesion molecule‐1 (sICAM‐1) in sera was measured in some allergic disorders, but serum sICAM‐1 levels in perennial allergic rhinitis remain to be determined. Our study was aimed at elucidating whether the serum sICAM‐1 levels in patients with perennial allergic rhinitis are different from those in nonatopic healthy volunteers and whether immunotherapy can modulate sICAM‐1 levels. Serum sICAM‐1 was determined in 20 nonallergic volunteers and 137 patients with perennial allergic rhinitis by a sandwich enzyme‐linked immunosorbent assay. Our study demonstrated that the level of sICAM‐1 in untreated patients is significantly elevated, as compared with nonatopic subjects. Immunotherapy could decrease sICAM‐1 in perennial allergic rhinitis, but this suppressive effect became apparent only after many years of immunotherapy. In patients on immunotherapy, a close correlation was observed between sICAM‐1 and nasal symptom scores. To take these lines of evidence together, a decrease in sICAM‐1 might be related to the working mechanism of immunotherapy, and serum sICAM‐1 could be used to monitor the effect of immunotherapy.
Nasal and Sinus Polyposis in Children
Authors: Triglia Jean‐Michel , Nicollas Richard 
Published: November 2003

AbstractNasal and sinus polyposis in the pediatric population is uncommon and its etiology is unclear. In this 11‐year retrospective study, the authors describe the etiologic features and evaluate the effectiveness of endoscopic sinus surgery in 46 children. Patients were divided into three groups according to whether nasal and sinus polyposis was isolated (n = 14), or associated with either asthma (n = 5) or cystic fibrosis (n = 27). An allergy was present in 10% of patients with isolated polyposis, 80% of patients with polyposis associated with asthma, and 22% of patients with polyposis associated with cystic fibrosis. The indications for surgery were disabling symptoms, especially chronic nasal obstruction, rhinorrhea, and mouth breathing, and failure to respond to medical treatment. No surgical complications were encountered. Most patients reported improvement in quality of life with reduction of nasal obstruction in 83% of cases and rhinorrhea in 61%. Minor asymptomatic recurrence (i.e., a few micropolyps localized on the roof of the ethmoid cavity) was observed in 24% of the cases in this series, and major recurrence with the same functional symptoms as before surgery in 12%. However, recurrences were higher in patients with cystic fibrosis, because minor recurrence with no clinical manifestation was observed in 32% of these cases and major recurrence in 16%. Endoscopic sinus surgery must be decided in collaboration with the pediatric and pulmonary physicians, and must be performed skillfully. With a mean follow‐up of 3.7 years, results in this series are encouraging.
Resource Utilization and Patient Morbidity in Head and Neck Reconstruction
Authors: Brown Matthew R. , McCulloch Timothy M. , Funk Gerry F. , Graham Scott M. , Hoffman Henry T. 
Published: November 2003

AbstractMany papers have addressed the technical aspects of free tissue transfer in head and neck cancer patients. However, there has not been a critical assessment of the impact of free tissue transfer on resource utilization and patient morbidity compared with pedicle flap reconstructions. Two cohorts of patients derived from 245 consecutive reconstructions were tightly matched by age, site, stage, and histology, yielding 44 patient pairs differing in method of reconstruction. Patients undergoing free flap reconstruction spent more time in the operating room than those reconstructed with pedicled flaps (993 min vs. 777 min, P < 0.0001). The group with free flap reconstruction spent fewer days in the surgical intensive care unit and hospital (2 days vs. 2.5 days; 18.5 days vs. 22.6 days). This difference is attributed to the paucity of postoperative complications in the group with free flap reconstruction (fistula formation 4.5% vs. 21%, P < 0.04). These data indicate that the continued use of sophisticated reconstructive techniques in head and neck cancer patients is economically sound as assessed by patient morbidity and resource utilization.
Necrotizing Fasciitis of the Face
Authors: Shindo Maisie L. , Nalbone Vincent P. , Dougherty William R. 
Published: November 2003

AbstractNecrotizing fasciitis (NF) is a rapidly progressive soft tissue infection with high morbidity and mortality rates. Its occurrence in the head and neck region is uncommon, the majority of reported cases being limited to involvement of the neck, usually from infections of dental or pharyngeal origin. Involvement of the face from NF is rare; only 35 such cases have been reported in the literature since 1960. It is not only associated with a high mortality but can also result in severe disfigurement of the face, posing challenging reconstructive problems. Successful management of facial NF requires early diagnosis, prompt institution of broad spectrum antibiotics, aggressive surgical debridement to control the infection, and reconstruction of the resultant soft tissue defects. This report describes four additional cases of facial necrotizing fasciitis. One of the four patients died as a result of sepsis and multi‐organ system failure. Two of the three surviving patients had significant facial disfigurement. A comprehensive review of the facial NF cases reported in the literature is also provided. Based on our experience with facial NF and the results of all previous case reports, the clinical manifestations, pathogenesis, and management of this disease are discussed.
Gas Exchange Function Through the Mastoid Mucosa in Ears After Surgery
Authors: Takahashi Haruo , Honjo Iwao , Naito Yasushi , Miura Makoto , Tanabe Makito , Hasebe Seishi , Toda Hiroshi 
Published: November 2003

AbstractGas exchange function through the mastoid mucosa was investigated in ears after surgery using nitrous oxide. Increase in the mastoid pressure was assessed by a micropressure sensor placed in the mastoid cavity during the second‐stage revision operation performed under general anesthesia using 67% nitrous oxide, 33% oxygen, and sevoflurane on 14 ears with chronic adhesive otitis media or cholesteatoma as well as on seven ears without inflammation as controls. All seven control ears showed pressure increase in the mastoid in various degrees. In the 14 postoperative ears, nine of the 10 ears on which the mastoid mucosa had previously been able to be preserved in various degrees showed pressure increase in the mastoid, but none of the remaining four ears, which had previously had mastoidectomy, showed any pressure increase. The presence or absence of the mastoid pressure increase of those ears was also found to be correlated well with the presence or absence of mastoid aeration on computed tomography examined just before the second‐stage operation. These results appear to indicate that, in ears after surgery, recovery of both the gas exchange function and aeration in the mastoid is expected only when the mastoid mucosa can be preserved even partially.
Foramen Thyroideum: A Comparative Study in Embryos, Fetuses, and Adults
Authors: León Xabier , Maranillo Eva , Mirapeix Rosa Maria , Quer Miquel , Sañudo José Ramón 
Published: November 2003

AbstractThe incidence and characteristics of foramen thyroideum (FT) in embryonic and/or fetal larynges have not been established. In the present study, 90 adult larynges and 53 embryonic‐fetal larynges were studied. The incidence of FT during the embryonic‐fetal period (57%) was statistically different from the adult period (31%) (P = 0.005). All the FT found in the adult period contained vessels and/or nerves, while in the embryonic and fetal period only 63% presented neurovascular elements (P < 0.001). The origin of FT in the embryonic period and its persistence during adult life is discussed.
Skin Grafting in Otology
Authors: Harvey Steven A. 
Published: November 2003

AbstractProper healing after surgery of the external auditory canal and open‐cavity mastoid depend on epithelialization of exposed surfaces. This may be retarded by the formation of abundant granulation tissue or cicatrix, which can be dealt with by the use of thin, split‐thickness skin grafts. This technique, which has received little attention in the literature, is described in detail and nine cases treated for various disorders are illustrated. Patient ages ranged from 5 to 80 years and the mean follow‐up was 17.2 years. Results, complications, and caveats for successful grafting are presented.
Ribonucleases May Limit Recovery of Ribonucleic Acids From Archival Human Temporal Bones
Authors: Lee Kenneth H. , McKenna Michael J. , Sewell William F. , Ung Feodor 
Published: November 2003

AbstractMessenger ribonucleic acid (mRNA) for actin was detected in celloidin‐embedded archival human temporal bone sections with reverse transcription polymerase chain reaction (RT‐PCR). Actin mRNA was detected in 10% of sections analyzed. One possible reason for this modest detection incidence is enzymatic degradation of RNA by exogenously introduced ribonucleases (RNases). We have identified steps of the temporal bone processing protocol for archival storage in which exogenous RNases could be introduced to the tissue, and have verified that the bone sections are exposed to these enzymes. We have demonstrated that implementing precautions to minimize exogenous RNase contamination during processing improves recovery of intact RNA. This study indicates that although gene expression analysis of archival human temporal bones may be limited by enzymatic degradation of RNA, simple modification of processing protocol can improve yield of informative data.
Physiologic Effects of an External Nasal Dilator
Authors: Griffin John W. , Hunter Gary , Ferguson Drew , Sillers Michael J. 
Published: November 2003

AbstractAn external nasal dilator (Breathe Right, CNS, Inc., Bloomington, MN) has become popular with athletes. The dilator is an adhesive band with a central elastic strip. When applied across the nasal valve, the device theoretically increases nasal valve area. We used acoustic rhinometry (Hood Laboratories, Pembroke, MA) to measure the cross‐sectional area at the nasal valve with and without the device in 53 athletes. Thirty athletes were exercised on a cycle ergometer with and without the device while measuring physiologic parameters, including oxygen consumption (VO2), heart rate, and respiratory rate. The study was conducted in a randomized, double‐blind, placebo‐controlled manner. At rest, the external nasal dilator was found to significantly increase nasal valve area in all demographic groups measured. The device was also found to significantly decrease submaximal exercise perceived exertion, heart rate, ventilation, and VO2 when compared with placebo.