bluuebunny/crossref_metadata_2025_split huggingface dataset:
P53 and Ki‐67 as Outcome Predictors for Advanced Squamous Cell Cancers of the Head and Neck Treated With Chemoradiotherapy
Authors: Lavertu Pierre , Adelstein David J. , Myles Jonathan , Secic Michelle 
Published: November 2003

AbstractHypothesis P53 and Ki‐67 status will predict response to treatment, organ preservation, and survival in patients with advanced squamous cell cancers of the head and neck treated with chemoradiotherapy (CRT).Study Design Retrospective analysis of p53 and Ki‐67 status from the CRT arm of a randomized, controlled trial (n = 50) and from patients receiving the same treatment but not enrolled in the trial (n = 55).Methods P53 and Ki‐67 status were established from archived tissue samples using immunohistochemical (IHC) staining. Tumors were positive for p53 (p53+) when more than 2% of cells stained for p53 and were positive for Ki‐67 (Ki‐67+) when any cell stained for Ki‐67. End points were tumor response, tumor recurrence, survival status, and organ preservation at last follow‐up, and time to events. Predictive models were calculated for each outcome.Results Neither marker predicted tumor response to treatment. P53+ status was associated with tumor recurrence (P = .003) and locoregional recurrence (P = .003). Adjusting for time to event, p53+ status was significantly related to a lower recurrence‐free survival (P = .004), lower disease‐specific survival (P = .04), lower overall survival with primary site preservation (P = .03), and lower disease‐specific survival with primary site preservation (P = .003). Multivariate analysis revealed that p53+ status was significantly related to a lower recurrence‐free survival (P = .01, risk ratio [RR] = 3.65) and lower disease‐specific survival with organ preservation (P = .02, RR = 3.41). Ki‐67+ status was not related to any variables. However, multivariate analysis revealed that Ki‐67+ was significantly related to a lower overall survival (P = .05, RR = 2.03). The combination of both markers negative (p53‐/Ki‐67‐) was associated with a lower incidence of tumor recurrence (P = .02), lower locoregional recurrence (P = .01), and fewer second primary lesions (P = .04). Adjusting for time to event, p53‐/Ki‐67‐ status was significantly related to a higher recurrence‐free survival (P = .02), higher disease‐specific survival with primary site preservation (P = .02), and higher overall survival with primary site preservation (P = .02). Multivariate analysis revealed that p53‐/Ki‐67‐ status was significantly related to a higher overall survival with site preservation (P = .01, RR = 2.78).Conclusions P53 and Ki‐67 status appear to be related to the various survival end points considered in this study. However, this relation does not seem to be sufficient to warrant treatment modifications. Closer follow‐up may be justified in both p53+ and Ki67+ patients to detect recurrence or a second primary at an earlier stage, possibly improving survival.
Remote Delivery of rAAV‐GFP to the Rat Brainstem Through the Recurrent Laryngeal Nerve
Authors: Rubin Adam D. , Hogikyan Norman D. , Sullivan Kelli , Boulis Nicholas , Feldman Eva L. 
Published: November 2003

AbstractObjective To demonstrate that a recombinant adeno‐associated viral vector (rAAV) carrying the gene for green fluorescent protein (GFP) could be delivered to the rat brainstem by remote injection into the recurrent laryngeal nerve.Study Design/Methods rAAV‐GFP is a serotype 2 adeno‐associated vector containing the cDNA of GFP and woodchuck hepatitis virus posttranscriptional regulatory element (WPRE) under the control of the CAG promoter (obtained from Matthew During, PhD, Thomas Jefferson Medical College). Five microliters or 10 μL of 1.4 × 109 particles/μL of rAAV‐GFP were injected into the right recurrent laryngeal nerve of adult Sprague‐Dawley rats. Rats were killed and perfused at 3 (n = 3) and 11 weeks (n = 3). Brainstems were removed and cryosectioned. Fluorescent in‐situ hybridization (FISH) was performed on cryosections from animals killed at 3 weeks using a cDNA probe for woodchuck polyribosomal enzyme within the rAAV vector. In a third group (n = 2), Fluoro‐Gold (Fluorochrome, Inc., Denver, CO) was injected into the right thyroarytenoid muscle for comparison of neuronal uptake distribution. These rats were killed and perfused at 3 weeks.Results The presence of GFP was noted in neurons throughout the medulla of all rat brainstems after unilateral rAAV‐GFP injection at both 3 and 11 weeks. In contrast to the Fluoro‐Gold, GFP was noted bilaterally and outside of the nucleus ambiguus. FISH confirmed the presence of virus within neurons expressing GFP at 3 weeks.Conclusions Remote delivery of rAAV‐GFP to the rat brainstem is possible through injection into the recurrent laryngeal nerve. This has important therapeutic implications for the future treatment of recurrent laryngeal nerve injury and neurodegenerative diseases.
Long‐Term Follow‐up Results of Electrogustometry and Subjective Taste Disorder After Middle Ear Surgery
Authors: Saito Takehisa , Manabe Yasuhiro , Shibamori Yoshiyuki , Yamagishi Takahiro , Igawa Hideki , Tokuriki Masaharu , Fukuoka Yoko , Noda Ichiro , Ohtsubo Toshio , Saito Hitoshi 
Published: November 2003

AbstractObjectives The present study compares the long‐term follow‐up results of electrogustometry with patient reports of taste dysfunction after middle ear surgery.Study Design Retrospective review of 371 patients who underwent middle ear surgery.Methods Patients were divided into the following groups depending on the degree of manipulation or surgical damage to the chorda tympani nerves: the no‐touch group (group 1 [n = 109]); the touch group (group 2 [n = 149]); and the severed nerve group (group 3 [n = 113]). Electrogustometry was periodically performed over the course of several years.Results The incidences of postoperative subjective taste disorder in groups 1, 2, and 3 were 2.8%, 25.5%, and 38.9%, respectively. Although the subjective taste disorder usually recovered within 1 to 2 years after surgery in all groups, it persisted for more than 2 years in 2.7% of the touch group and 5.3% of the severed nerve group. Concerning postoperative electrogustometric results, in the no‐touch group, 8.3% of patients showed threshold elevation on electrogustometry, but the elevated thresholds completely recovered in all cases. In the touch group, 45% of patients exhibited elevated electrogustometric thresholds on their first postoperative test, including 32.9% who subsequently had complete electrogustometric recovery, 10.1% who subsequently had incomplete recovery, and 2% who failed to recover during the follow‐up period. In the severed nerve group, none of the patients was responsive to the electrical stimulus on the first postoperative test, including 8.8% of patients who subsequently exhibited complete electrogustometric recovery, 32.7% who later had incomplete electrogustometric recovery, and 58.4% who never recovered any electrogustometric responsiveness. Nerve repair in the severed nerve group produced better recovery, as measured electrically.Conclusions The incidence of postoperative subjective taste disorder was low, although inconsistent with the high incidence of threshold elevation on electrogustometry, especially in the severed nerve group. Preservation or repair of the chorda tympani nerve is recommended in order to maintain or recover gustatory function.
Determination of Ototoxicity of Common Otic Drops Using Isolated Cochlear Outer Hair Cells
Authors: Jinn Tae Hoon , Kim Paul D. , Russell Paul T. , Church Christopher A. , John Earnest O. , Jung Timothy T. K. 
Published: November 2003

AbstractObjectives Otic drops are commonly used not only for otitis externa, but also for otorrhea in the presence of tympanostomy tubes or tympanic membrane perforations. Many studies have demonstrated the ototoxicity of common otic preparations such as Cortisporin® otic drops (Monarch Pharmaceuticals, Bristol, TN). The purpose of this study was to assess the relative ototoxicity of common otic preparations by direct exposure to isolated cochlear outer hair cells (OHCs).Methods OHCs from adult chinchilla cochlea were exposed to standard bathing solution (control), acetic acid, Acetasol HC® (Alpharma USPD Inc., Baltimore, MD), Gentacidin® (CIBA Vision Ophthalmics, Atlanta, GA), and Tobradex® (Alcon, Fort Worth, TX). The cells were observed using an inverted microscope, and the images were recorded in digital still‐frame and video, and analyzed on the Image Pro‐Plus 3.0 program (Media Cybernetics, Silver Spring, MD).Results and Conclusions As measured by time to cell death and change in morphology of OHCs, acetic acid with or without hydrocortisone was most toxic to OHCs. Cortisporin was more cytotoxic than gentamicin and Tobradex.
Enhancement of Delta Aminolevulinic Acid–Photodynamic Therapy In Vivo by Decreasing Tumor pH With Glucose and Amiloride
Authors: Piot Benoît , Rousset Nathalie , Lenz Peter , Eléouet Sabine , Carré Jérome , Vonarx Véronique , Bourré Ludovic , Patrice Thierry 
Published: November 2003

AbstractObjectives/Hypothesis Delta aminolevulinic acid (ALA)–induced protoporphyrin IX (PpIX) is a fluorescent sensitizer that permits detection and treatment of squamous cell carcinoma of the oral cavity. An exogenously induced decrease in tissue pH was evaluated for its effect in enhancing cellular uptake of ALA and facilitating its transformation into PpIX.Study Design Mice grafted with HT29 colonic cancers had been given glucose and amiloride to modify the pH of tissues. Influence of pH changes has been evaluated on ALA‐induced PPIX fluorescence by optic fiber spectrofluorimetry as well as on tumor growth.Methods Results: The pH in HT 29 tumor decreased from 7.1 to 6.67 (P <.05) after intraperitoneal injection of glucose and amiloride. The PpIX fluorescence ratios in tumor or muscle before, between, and 2 hours after glucose and amiloride injection were not higher than control ratios. Aminolevulinic acid–photodynamic therapy was more efficient on HT 29 tumor–bearing mice when the pH value was decreased with glucose and amiloride, showing a difference in the tumor growth index ratio from the 1st to 14th day of 22% between amiloride‐glucose aminolevulinic acid–photodynamic therapy and aminolevulinic acid–photodynamic therapy alone (P <.05).Conclusions Glucose and amiloride did not change PpIX fluorescence in HT 29 tumor after intraperitoneal injection of aminolevulinic acid but enhanced aminolevulinic acid–photodynamic therapy efficacy. This was probably a result of mechanisms other than an increase in aminolevulinic acid cellular penetration and PpIX production, such as susceptibility to free radical toxicity or alteration of cellular repair enzymes under acidotic conditions. If a decrease of pH induces a more efficient photodynamic therapy as suggested by our results, an easier way to obtain this decrease than glucose and amiloride would be necessary for clinical applications.
Effect of Nasal Surgery on Sleep‐Related Breathing Disorders
Authors: Verse Thomas , Maurer Joachim T. , Pirsig Wolfgang 
Published: November 2003

AbstractObjective/Hypothesis Single cases of patients who have experienced obstructive sleep apnea (OSA) and who recovered completely after nasal surgery have been described in various studies. The purpose of this study was to evaluate the efficacy of only nasal surgery 1) in a group of patients with obstructive sleep apnea and 2) in simple snorers.Study Design A prospective, controlled study with 26 adult patients who underwent nasal surgery as single treatment of their sleep‐related breathing disorders. The cases were evaluated based on the severity level of their preoperative Apnea Hypopnea Index (AHI).Material and Methods Between August 1996 and July 2000, 26 patients who snored and had impaired nasal breathing underwent attended polysomnography in the sleep laboratory as single treatment nasal surgery was performed. Postoperative polysomnographic findings and complications were reviewed.Results Nineteen of 26 patients (73.1%) were diagnosed as having OSA. Seven patients were simple snorers with an AHI below 10. The surgical response rates, defined as greater than or equal to 50% reduction in the postoperative AHI and a postoperative AHI of less than 20, was 15.8% in the apneics. For the whole group, the AHI decreased postoperatively from 31.6 to 28.9. However, daytime sleepiness improved significantly and arousals decreased significantly in both apneics and simple snorers after nasal surgery.Conclusions We conclude that nasal surgery has a limited efficacy in the treatment of adult patients with sleep apnea. Nevertheless, nasal surgery significantly improves sleep quality and daytime sleepiness independent of the severity of obstructive sleep‐related breathing disorders.
Simultaneously Presenting Head and Neck and Lung Cancer: A Diagnostic and Treatment Dilemma
Authors: Kuriakose M. A. , Loree T. R. , Rubenfeld A. , Anderson T. M. , Datta R. V. , Hill H. , Rigual N. R. , Orner J. , Singh A. , Hicks W. L. 
Published: November 2003

AbstractObjectives/Hypothesis
Synchronous tumors are defined as malignancies presenting within 6 months of the index tumors. A significant subset of patients present at initial evaluation with malignant tumors of both the head and neck (head and neck squamous cell carcinoma) and the lung, which are termed simultaneous primaries. The management and treatment outcomes in this cohort of patients have not been clearly defined and are the subject of the present review.Study Design Retrospective chart review of previously untreated patients.Methods From January 1974 to December 1997, a total of 2964 patients were treated for mucosal squamous cell carcinoma of the head and neck. Forty‐two patients fulfilled the criteria for synchronous head and neck and lung malignancy. Of these, 27 patients had simultaneous tumors of the head and neck and the lung. This cohort of patients (n = 27) was stratified into three treatment groups. Patients in group A (n = 10) had resectable head and neck and lung primaries treated with curative intent. Group B (n = 8) was composed of patients who could have been treated with curative intent but declined and were given only palliative therapy. Patients in group C (n = 9) were candidates for only palliative treatment.Results The estimated 5‐year disease‐specific survival in group A was 47%, whereas patients in group B had a 5‐year disease‐specific survival of only 13% (P = .05). There were no survivors beyond 1 year in group C. The presence of mediastinal adenopathy in patients in group A portended poor clinical outcome. There was an estimated 5‐year disease‐specific survival of 51% in patients with no preoperative evidence of mediastinal adenopathy (n = 7), whereas 67% of patients with radiological evidence of mediastinal adenopathy died (two of three patients).Conclusion The presence of simultaneous head and neck squamous cell carcinoma and pulmonary malignancies should not be a deterrent to aggressive surgical therapy because a potentially satisfactory outcome can be expected in these patients.
Compositional Difference in Middle Ear Effusion: Mucous Versus Serous
Authors: Chung Myung‐Hyun , Choi Jae Young , Lee Won‐Sang , Kim Hee‐Nam , Yoon Joo‐Heon 
Published: November 2003

AbstractObjectives Serous otitis media is usually responsive to medical treatment, whereas mucoid otitis media is not. The present study was undertaken to elucidate the compositional difference between serous and mucoid effusion and to investigate whether MUC5AC acts as a major mucin in the middle ear mucosa with mucoid otitis media.Study Design This study involved a chemical analysis of middle ear effusion and immunostaining of the middle ear mucosa.Methods Middle ear effusion samples were collected from 27 patients with mucoid otitis media and 18 patients with serous otitis media. The levels of mucin, lysozyme, secretory immunoglobulin A, and interleukin‐8 were measured by dot blotting or enzyme‐linked immunosorbent assay. Periodic acid–Schiff and immunohistochemical staining with monoclonal anti‐MUC5AC antibody were performed on the serial sections of middle ear mucosa with mucoid otitis media.Results Mucoid effusions contained higher levels of mucin, lysozyme, secretory immunoglobulin A, and interleukin‐8 than did serous effusions. Immunohistological study revealed that MUC5AC mucin was expressed in only a small portion of the goblet cells of middle ear mucosa with mucoid otitis media.Conclusions The study suggests that both serous secretions and mucin might make the middle ear effusion more viscous and that mucins other than MUC5AC might have a major role in the viscosity of middle ear effusion. Further study is necessary to identify the major mucins in the middle ear effusion of otitis media with effusion.
Videofluoroscopic Upper Esophageal Sphincter Function in Elderly Dysphagic Patients
Authors: Kendall Katherine A. , Leonard Rebecca J. 
Published: November 2003

AbstractObjectives/Hypothesis The intent of the study was to identify and characterize abnormalities of the timing and extent of upper esophageal sphincter (UES) opening in an elderly population complaining of dysphagia.Study Design A retrospective review of dynamic swallow studies performed on patients greater than 65 years of age without an obvious medical or surgical cause for their dysphagia.Methods Measures of UES opening timing and extent in the patient population were compared with those from 60 young, normal control subjects and 23 elderly control subjects. The relationship of UES function and other swallowing abnormalities was also evaluated.Results No decrease in the size of UES opening was identified in the patient population. The coordination of UES opening relative to the position of the bolus in the pharynx was normal. UES opening was prolonged and was correlated with poor pharyngeal clearing suggestive of weak pharyngeal constriction.Conclusion No primary abnormality of UES function was identified in this elderly dysphagic patient population.
A New Paramedian Approach to Arytenoid Adduction and Strap Muscle Transposition for Vocal Fold Medialization
Authors: Su Chih‐Ying , Lui Chun‐Chung , Lin Hsin‐Ching , Chiu Jeng‐Fen , Cheng Chu‐An 
Published: November 2003

AbstractObjective To develop a prosthesis‐free medialization laryngoplasty for the treatment of glottal incompetence.Study Design Twenty‐two consecutive patients with glottal incompetence underwent vocal fold medialization using a new paramedian approach to arytenoid adduction and/or strap muscle transposition.Methods Under local anesthesia, the thyroid lamina on the involved side was parasagittally separated 5 mm off the midline. The inner perichondrium was carefully freed from the overlying thyroid cartilage. After dividing the thyrohyoid and cricothyroid membranes, the lamina was retracted laterally, the inner perichondrium was opened, and the lateral cricoarytenoid muscle identified. Tracing the muscle fibers posterosuperiorly, the muscular process of the arytenoid was identified. A 2‐0 or 3‐0 Prolene suture was placed through the muscular process and tied to the cricoid cartilage at the origin of the lateral cricoarytenoid muscle. A bipedicled strap muscle flap was then transposed into the space between the lamina and the inner perichondrium and the thyroid cartilages sutured back into place. Pre‐ and postoperative voice evaluations measured mean fundamental frequency, jitter, shimmer, noise‐to‐harmonic ratio, and maximal phonation time, as well as assessments of voice quality.Results Vocal improvement was obtained in 95% (21 of 22) of patients. There was a significant improvement (P <.05) in all parameters except shimmer. No major complications were noted in any patient, except for dyspnea in one patient resulting from arytenoid overrotation.Conclusion The results suggest that a paramedian approach to arytenoid adduction combined with strap muscle transposition is a safe and effective method for treating glottal incompetence, particularly in patients with unilateral paralytic dysphonia.
Glut3 Expression in Biopsy Specimens of Laryngeal Carcinoma Is Associated With Poor Survival
Authors: Baer Susan , Casaubon Luis , Schwartz Mary R. , Marcogliese Andrea , Younes Mamoun 
Published: November 2003

AbstractObjectives/Hypothesis The aim of the study was to determine the clinical significance of the expression of Glut1 and Glut3 proteins in biopsy specimens of squamous cell carcinoma (SCC) of the larynx.Study Design A retrospective study.Methods Using immunohistochemistry, we immunostained sections of formalin‐fixed, paraffin‐embedded tissues from 48 biopsies of invasive SCC of the larynx for Glut1 and Glut3. The percentages of positive cells were recorded, then correlated with overall patient survival using the Kaplan‐Meier method and the Breslow‐Gehan‐Wilcoxon test for statistical significance.Results All cases were positive for Glut1, and Glut1 expression was not associated with survival difference at any cut‐off value. Eighteen (38%) of the cases were Glut3‐negative and 30 (62%) were Glut3‐positive. Glut3‐positive cases were associated with poorer survival than Glut3‐negative cases (P = .0336). No significant difference was found between Glut3‐negative and Glut3‐positive groups in respect to sex, tumor site (glottic vs. supraglottic), nodal or distant metastasis, or treatment modality. However, there were significantly more poorly differentiated tumors in the Glut3‐positive group than in the Glut3‐negative group (27% vs. 0%, respectively;P = .0182, Fisher's Exact Test). After poorly differentiated tumors were excluded from the survival analysis, Glut3 immunoreactivity remained a significant marker of poor prognosis (P = .0385).Conclusion Immunohistochemical detection of Glut3 in biopsy specimens of SCC of the larynx is a marker of poorer prognosis.
Growth Factors and Their Receptors in the Middle Ear Mucosa During Otitis Media
Authors: Palacios Sean D. , Pak Kwang , Rivkin Alexander Z. , Bennett Thecla , Ryan Allen F. 
Published: November 2003

AbstractObjective The hyperplastic response of the middle ear mucosa during bacterial otitis media is thought to be mediated by the actions of growth factors and their respective receptors. The purpose of the study was to explore the expression of growth factors known to stimulate epithelial cells in other systems, as well as their receptors, in the middle ear mucosa during otitis media.Study Design Expression of mRNA growth factors and receptors was measured over time after inoculation of the rat middle ear with bacteria.Methods The middle ears of 12 male Sprague‐Dawley rats were injected with 105/mL Haemophilus influenzae strain 3655 (nontypeable, biotype II). Three rats were killed at 6, 24, 48, and 72 hours. Three untreated rats were also killed to serve as negative controls. The middle ear mucosa samples were surgically removed and homogenized. Reverse transcription‐polymerase chain reaction was performed on each sample with primers for rat epidermal growth factor, epidermal growth factor receptor (ErbB), heparin binding epidermal‐like growth factor, hepatocyte growth factor, hepatocyte growth factor receptor, keratinocyte growth factor, betacellulin, amphiregulin, and neuregulin‐α.Results Hepatocyte growth factor and epidermal growth factor receptor primers demonstrated polymerase chain reaction products of the expected size that were not displayed in the normal middle ear mucosa. Keratinocyte growth factor and hepatocyte growth factor receptor demonstrated polymerase chain reaction products at all time points tested. Betacellulin and neuregulin‐α products were present at all time points except 72 hours after infection.Conclusions The results of the study support a role for growth factors in the middle ear mucosa during otitis media. These bioactive ingredients contribute to mucosal hyperplasia.