bluuebunny/crossref_metadata_2025_split huggingface dataset:
The failing flap in facial plastic and reconstructive surgery: Role of the medicinal leech
Authors: Utley David S. , Koch R. James , Goode Richard L. 
Published: November 2003

AbstractObjective: To review the use of the medicinal leech, Hirudo medicinalis, in salvaging the failing, venous‐congested flap. A protocol for the use of leeches is presented. Four illustrative cases of failing flaps (pectoralis major, midline forehead, and temporalis) are presented. Study Design: Literature review comprised of MEDLINE search 1965 to present. Retrospective review of four cases involving the management of the failing, venous‐congested flap. Methods: A retrospective review of four cases of failing, venous‐congested flaps was performed. Results: The authors' experience, as well as the data from the reviewed medical literature, demonstrates the importance of early intervention in order to salvage the failing, venous‐congested flap. Leeches are an immediate and efficacious treatment option. Conclusions: 1. Review of the literature indicates that the survival of the compromised, venous‐congested flap is improved by early intervention with the medicinal leech. H medicinalis injects salivary components that inhibit both platelet aggregation and the coagulation cascade. The flap is decongested initially as the leech extracts blood and is further decongested as the bite wound oozes after the leech detaches. 2. When a flap begins to fail, salvage of that flap demands early recognition of reversible processes, such as venous congestion. The surgeon must be familiar with the use of leeches and should consider their use early, since flaps demonstrate significantly decreased survival after 3 hours if venous congestion is not relieved. In the four cases presented, a standardized protocol facilitated early leech use and provided for the psychological preparation of the patient, availability of leeches, and an antibiotic prophylaxis regimen. 3. The complications associated with leech use can be minimized with antibiotic therapy, wound care, and hematocrit monitoring. 4. The use of the medicinal leech for salvage of the venous‐congested flap is a safe, efficacious, economical, and well‐tolerated intervention.
A longitudinal, functional study of peripheral nerve recovery in the mouse
Authors: Yao Mike , Inserra Michelle M. , Duh Michael J. , Terris David J. 
Published: November 2003

AbstractObjectives: To verify the validity of the recently described sciatic functional index for mice to monitor neuronal functional recovery over time using a blinded, randomized, and controlled evaluation. Study Design: Surgery was performed on the left sciatic nerves of 62 C57/BL mice after randomly assigning them to one of four surgical groups: sham surgery, sciatic nerve crush, nerve transection without repair, and nerve transection followed by epineurial suture repair. Sciatic functional indices were measured before surgery and then after surgery at 10‐day intervals for 90 days, using a previously described formula. Results: Sham surgery did not affect nerve function when compared with preoperative values (P > .24). Crush surgery produced a reversible nerve injury that fully recovered after 20 days. Nerve transection without repair resulted in complete functional disability without recovery of function during the 90‐day follow‐up interval. When transected nerves were repaired, complete functional disability was noted at day 10, with subsequent functional recovery to 26% of function at day 30. This level of recovery persisted until the 60th postoperative day when muscle contractures resulted in progressive worsening of the index. There were statistically significant differences between the sciatic functional indices of each of the groups (P < .05). Conclusions: The previously described sciatic functional index for mice is an accurate indicator of the level of sciatic neuronal function during recovery. This index represents a method of evaluating neuronal function that may provide a better reflection of the recovery parameters that are important in clinical situations. The sciatic functional index will allow for study of sciatic nerve functional recovery in genetically engineered transgenic mice.
Doxycycline sclerosis of benign lymphoepithelial cysts in patients infected with HIV
Authors: Lustig Lawrence R. , Lee Kelvin C. , Murr Andrew , Deschler Daniel , Kingdom Todd 
Published: November 2003

AbstractBenign lymphoepithelial cysts (BLCs) are a widely recognized cause of parotid gland swelling in HIV‐infected patients. Although they are neither invasive nor associated with malignant degeneration, BLCs can become large and disfiguring. Multiple modalities have been used to control these cysts, but no ideal treatment has been identified. The current study examines the efficacy of doxycycline as a BLC sclerosant in eight patients, and nine BLCs (bilateral BLC in one patient). Follow‐up ranged from 12 to 17 months in all cases. Doxycycline sclerosis controlled further cyst growth in 100% of cases with no serious complications. The BLCs became negligible or unnoticeable in two patients, and in six patients (seven BLCs) the cyst became fibrosed and showed no evidence of further growth over the follow‐up period. Although further studies are needed to determine the long‐term efficacy of this treatment modality, doxycycline sclerosis appears to offer a simple, safe, cost‐effective, office‐based therapeutic option for the treatment of BLCs in patients infected with HIV.
First results of clinical application of videokymography
Authors: Schutte Harm K. , Švec Jan G. , Šram František 
Published: November 2003

AbstractObjectives: Stroboscopy is based on the assumption that the vibration of the vocal folds is stable and regular. Irregular vibrations, which are common in voice pathology, cannot easily be studied and described in a reliable way. Videokymography overcomes most of these drawbacks. Design: The use of the recently invented videokymography for studying vocal fold vibrations in patients is introduced. Method: Videokymography, using a modified CCD‐video camera, works in two modes: standard and high speed. In standard mode the vocal folds are displayed on a video monitor in the usual way, providing 50 images per second (or 60 in the National Television Standards Committee (NTSC) system). This is used for routine laryngoscopic and stroboscopic examination of the larynx. In high‐speed mode (nearly 8000 images per second) only one line from the whole image is selected and displayed on the x‐axis of the monitor; the y‐axis represents the time dimension. Results: All kinds of vocal fold vibrations, including those leading to pathological rough, breathy, hoarse, or diplophonic voice productions can be observed. Videokymography visualizes small left‐right asymmetries, open quotient differences along the glottis, lateral propagation of mucosal waves, and movements of the upper margin and, sometimes in the closing phase, the lower margin of the vocal folds. Conclusion: Videokymography is advantageous for a more accurate diagnosis of voice disorders. Videokymography provides a simple way to study irregular vibrations of the vocal folds. Information is directly available for further processing and allows a first‐time quantification of vibrations registered.
Differentiation and cathepsin D expression in human oral tumors
Authors: Brysk Miriam M. , Lei Gang , Adler‐Storthz Karen , Chen Zhuo , Horikoshi Toshio , Brysk Henry , Tyring Stephen K. , Arany Istvan 
Published: November 2003

AbstractObjectives/Hypothesis: This study aimed to ascertain whether cathepsin D expression could be related to the stage of differentiation of oral tumors. Study Design: Human oral biopsies of 10 squamous cell carcinomas and of the corresponding perilesional normal tissues were used. The tumors had all been clinically graded as advanced stage but nonmetastatic; five were classified histopathologically as poorly differentiated. Methods: The gene expression of cathepsin D and keratin K13 in the biopsies was measured by reverse transcription polymerase chain reaction. Ratios of tumor‐to‐control readings helped compensate for sample variability. Results: Keratin K13, as a suprabasal cell marker, tended to confirm the histological grading of the tumors (but was not otherwise useful in distinguishing tumors from normal tissue). Substantial overexpression of cathepsin D was found in the poorly differentiated tumors. Conclusions: Cathepsin D overexpression is considered a prognostic indicator of metastasis. In this sample, it was also associated with dedifferentiation. Cathepsin D might serve as a valuable gauge in clinical exploration of the connection between dedifferentiation and metastasis.
Molecular temporal bone pathology: IV. Analysis of DNA template length using mitochondrial PCR primers
Authors: Wackym Phillip A. , Kerner Marc M. , Grody Wayne W. 
Published: November 2003

AbstractThe focus of this study was to identify, via molecular biology techniques, the length of the DNA templates present in individual archival celloidin‐embedded human temporal bone sections. Earlier studies have suggested that the maximum template length present in these tissues is on the order of 471 base pair (bp). Polymerase chain reaction (PCR) amplification of 92 bp, 121 bp, 471 bp, and 609 bp regions of mitochondrial DNA (mtDNA), extracted from single archival celloidin‐embedded human temporal bone sections, was used to assess the length of the template DNA extracted. These data are crucial to determine the limits of applying PCR technology to amplify specific genomic DNA targets located within the human inner ear. The results described should be of value to those investigators extracting DNA from archival individual human temporal bone sections for polymerase chain reaction assays of specific genetic alterations or infectious agents associated with temporal bone pathologies.
Palliative laser therapy for recurrent head and neck cancer: A phase II clinical study
Authors: Paiva Marcos B. , Blackwell Keith E. , Saxton Romaine E. , Calcaterra Thomas C. , Ward Paul H. , Soudant Jac , Castro Dan J. 
Published: November 2003

AbstractObjectives: Laser therapy is becoming a more precise, minimally invasive alternative for tumor ablation. Recent reports confirm successful palliation of pain and functional disabilities in patients with advanced deep carcinoma of the head and neck using interstitial laser phototherapy (ILT). Study Design, Patients, and Methods: The current study describes an ongoing Phase II trial of neodymium/yttrium‐aluminum‐garnet (Nd:YAG) laser therapy for palliation of advanced head and neck cancer. A total of 40 advanced cancer patients have been entered into this protocol (25 men and 15 women). Results: Nineteen of these patients had no evidence of recurrence after ILT with an average follow‐up of 11 months (range, 2 to 24 mo). Currently, 19 of these patients are alive, 14 with tumor remission and six with persistent disease. A total of 79 tumor sites received ILT with 43 (54.5%) completely ablated. Stratified by tumor site, ILT led to a complete response in 21 of 24 in the oral cavity, eight of 28 neck tumors, four of 10 in skin, and 10 of 17 in other sites. The procedure was well tolerated in most cases and was repeated at intervals in patients with residual disease or recurrences for a total of 118 laser treatments (average, 2.95 treatments per patient). Conclusions: The results suggest that ILT can be performed safely and repeated as needed, and may be less costly than conventional surgery for head and neck cancer. However, additional follow‐up is needed to obtain convincing evidence of long‐term therapeutic benefits.
Dose‐related tissue effects of the CO2 and noncontact Nd:YAG lasers in the canine glottis
Authors: Sullivan Christopher A. , Rader Anne , Abdul‐Karim Fadi W. , Abbass Hassan , Mohr Rose M. 
Published: November 2003

AbstractObjectives: The CO2 laser is the standard for control of recurrent respiratory papillomatosis because of its predictable action on laryngeal tissue. The noncontact neodymium:yttrium aluminum garnet (Nd:YAG) 1064‐nm laser is generally not used in the larynx owing to the lack of data on its tissue effects, and its potential lack of safety in the larynx. Combined Nd:YAG and CO2 laser treatments have been used safely in the tracheobronchial tree to eradicate recurrent respiratory papillomas. The objectives of this study were to describe and evaluate a method for applying the noncontact Nd:YAG laser to the larynx, to compare the tissue effects of the Nd:YAG, CO2, and combined Nd:YAG and CO2 lasers in the canine larynx, and to extrapolate canine tissue data to the human. Methods: The CO2, Nd:YAG, and combined Nd:YAG/CO2 lasers were applied to the glottis in four mongrel dogs. Laryngectomy was performed and the tissue was examined histologically. The nature and degree of tissue injury were analyzed relative to laser type and energy data. Results: In the canine larynx, the CO2 laser vaporized the surface epithelium and caused varying degrees of edema and necrosis of the lamina propria. The Nd:YAG laser did not cause ulceration but did show a greater degree of thermal damage to the lamina propria. Combined Nd:YAG/CO2 applications resulted in separation of the perimysial fibers from the muscle fibers of the vocalis muscle. Conclusion: These findings suggest that the noncontact Nd:YAG laser can be applied in a controlled fashion to the canine larynx at appropriate power densities. Anatomical differences between human and canine larynges are considered. Extrapolation to humans is proposed. Key Words: Laser, larynx, tissue effects, papillomatosis.
An objective analysis of the impact of lateral rhinotomy and medial maxillectomy on nasal airway function
Authors: Lueg Edgar A. , Irish Jonathon C. , Roth Yehuda , Brown Dale H. , Witterick Ian J. , Chapnik Jerry S. , Gullane Patrick J. 
Published: November 2003

AbstractObjective: The lateral rhinotomy and medial maxillectomy procedure, while known to interrupt nasal valve supports, has not previously been reported to adversely affect nasal airway function. The purpose of this study was to utilize state‐of‐the‐art techniques to objectively analyze the impact of this procedure on nasal airway function. Design: The study design was retrospective and subject controlled. Methods: The study population was derived from an academic, tertiary‐referral, otolaryngology—head and neck surgery department with an estimated catchment population of 4 million people. Subjects included 21 consecutive, long‐term postoperative patients who had undergone lateral rhinotomy and medial maxillectomy for inverted papilloma. Objective measures included vestibular cephalometric measurements, airflow rhinomanometry, and acoustic rhinometry. Results: Statistically significant results reveal that although lateral rhinotomy and medial maxillectomy are associated with alar collapse, both overall nasal airflow and valve areas are increased. Conclusion: Lateral rhinotomy and medial maxillectomy does not adversely affect nasal airway function. This appears to be the result of concomitant resection of the functionally dominant inferior turbinate. This suggests that lateral rhinotomy performed in conjunction with operations not requiring inferior turbinectomy, such as anterior craniofacial resection, may adversely affect nasal airway function. Key Words: Lateral rhinotomy, medial maxillectomy, nasal airway function, airflow, rhinomanometry, acoustic rhinometry.
Direct bonded orthodontic brackets for maxillomandibular fixation
Authors: Utley David S. , Utley Jack D. , Koch R. James , Goode Richard L. 
Published: November 2003

AbstractObjectives/Hypothesis: Mandibular fracture treatment often includes arch bar maxillomandibular fixation (MMF), either alone or in combination with open reduction/internal fixation (ORIF) techniques. The glove perforation rate associated with arch bar placement, the incidence of blood‐borne pathogen positivity in facial fracture patients, and the injurious effects of arch bars on dental enamel and gingiva have prompted the development of safer alternatives to arch bar MMF. This study evaluates the efficacy, ease of use, and safety profile of one such alternative: orthodontic direct bonded bracket fixation (MMF/DBB). Study Design: Prospective study of consecutive mandible fracture patients treated with MMF/DBB. Methods: Thirty‐two patients with mandibular fractures were evaluated from January 1994 to July 1997. Fourteen were appropriate for treatment with MMF/DBB (12 men and two woman; mean age, 24.6 ± 7.2 y; range, 16–42 y). Fracture sites included symphysis, angle, condylar neck, coronoid, and body. Nine patients underwent MMF/DBB alone; five underwent MMF/DBB with subsequent ORIF. Results: No infection, malocclusion, malunion/nonunion, or enamel/ gingiva injury occurred. Mean follow‐up was 6 months (range, 1–12 mo). Oral hygiene with MMF/DBB was superior to historical controls using arch bars. Conclusions: MMF/DBB can serve as the single treatment method with satisfactory results in patients with favorable, less complicated mandible fractures, although with increased experience, we have treated several more complex cases with MMF/DBB alone. In cases necessitating ORIF, MMF/DBB can be performed preoperatively to align fracture segments and reestablish occlusion. This facilitates placement of osteosynthesis plates and reduces ORIF operative time. MMF/DBB is an economical, safe technique that minimizes blood‐borne‐pathogen risk to the operative team, eliminates periodontal injury, facilitates postoperative dental hygiene, and is painless to apply and remove.
Three‐dimensional xenograft model of dysplastic human laryngeal mucosa
Authors: Shores Carol G. , Yarbrough Wendell G. 
Published: November 2003

AbstractObjective: Development of new therapeutic interventions in head and neck squamous cell carcinoma (HNSCC) will be facilitated by a model system that incorporates the ease of manipulation found in current tissue culture systems while retaining the three dimensional architecture that defines these malignancies. Study Design: Original scientific investigation. Methods: We describe a modification of a normal respiratory mucosa model system which recreates premalignant mucosal histology. Grossly normal appearing human mucosa is harvested from laryngectomy specimens, the mucosal epithelium selectively removed by protease treatment and placed in conventional tissue culture. After 7 days, the cells are seeded into denuded rat tracheas, which are in turn implanted in flank pockets of athymic nu/nu mice. The tracheas are incubated for three weeks, removed and the mucosa examined histologically. Results: As originally described, normal pseudostratified squamous epithelium can be re‐established in this system.10 Using human dysplastic mucosa as a starting material, mucosal histologies of respiratory dysplasia, squamous metaplasia, squamous dysplasia and squamous carcinoma in situ can be established. Conclusion: This system will provide a paradigm for future therapeutic interventions to modify the progression of squamous metaplasia to dysplasia, carcinoma in situ and invasive squamous cell carcinoma. Key Words: Head and neck squamous cell carcinoma, xenograft model, dysplasia.
Predicting vocal outcome by means of a vocal endurance test: A 5‐year follow‐up study in female teachers
Authors: De Bodt Marc S. , Wuyts Floris L. , Van De Heyning Paul H. , Lambrechts Leen , Abeele Dirk Vanden 
Published: November 2003

AbstractObjectives: Investigate whether vocal problems in future professional activities can be predicted by early laryngeal and phoniatric evaluation and whether a vocal endurance test can contribute to this evaluation. Study Design: Five‐year follow‐up study of 30 female education majors, initially documented with a standard voice assessment and a vocal endurance test. Measurements before and after vocal endurance testing were compared and related to the vocal outcome 5 years after the initial testing. Methods: Voice assessment included perceptual evaluation, airflow measurements, Fo and SPL measurements, voice range profile and laryngeal (stroboscopic) examination. The Standard Tolerance Test, as recommended by the Union of European Phoniatricians, was followed. This data set was completed with a questionnaire concerning the subjects' vocal behavior. This questionnaire was repeated 5 years later. Results: No significant differences were found for ENT scores (laryngostroboscopy) (P = .018). Logistic regression was used to determine a relationship between initial observations and the final outcome. Conclusions: The role of an endurance test as used in this study is negligible for the prediction of vocal outcome. A combination of laryngeal examination, maximum phonation time, and perceptual evaluation, assessed prior to the endurance test, reveals a prediction of the vocal outcome with a specificity of 90% and a sensitivity of 70%. Key Words: Voice, vocal outcome, vocal endurance test.
Bilateral medialization laryngoplasty
Authors: Postma Gregory N. , Blalock P. David , Koufman James A. 
Published: November 2003

AbstractObjectives: To present indications, techniques, and results of bilateral medialization laryngoplasty (BML). Study Design: Retrospective review of 39 consecutive patients who had BML for correction of glottal insufficiency attributable to presbylaryngis (n = 16), bilateral vocal fold paresis (n = 13), unilateral paralysis with contralateral bowing (n = 4), and other miscellaneous neurologic diseases (n = 6). Methods: Complete preoperative and postoperative clinical and acoustical data were analyzed for 74% (29/39) of the subjects. All 39 subjects completed a patient survey to assess their long‐term outcomes. Results: Overall, 90% (35/39) of the patients who had BML experienced significant improvement in voice and swallowing function. Subsequently, 36% (14/39) of the patients underwent adjunctive lipoinjection for closure of small residual glottal gaps (vocal “fine‐tuning”). Of the BML patients (with or without lipoinjection) who had complete preoperative and postoperative voice data, 83% (24/29) had complete glottal closure after surgery, resulting in normal or near‐normal voices. Eighty‐five percent (33/39) of the patients responded that they “would have surgery again.” Of the six patients who said that they would not have surgery again, three had good results and one had progressive neurologic disease. The mean duration of follow‐up was 17 months. Conclusions: BML is an effective rehabilitative surgical treatment for symptomatic vocal fold bowing. In addition, lipoinjection is useful as an adjunct to BML to enhance the voice outcome in selected cases. Laryngoscope, 108:1429–1434, 1998
Preservation of the stapedius tendon in laser stapes surgery
Authors: Silverstein Herbert , Hester T. Oma , Rosenberg Seth I. , Deems Daniel A. 
Published: November 2003

AbstractObjectives/Hypothesis: The stapedius tendon is routinely transected during stapes surgery. The objective of this study was to evaluate the technique of stapedial tendon preservation during stapes surgery and to compare results of these cases with cases where the stapedial tendon was not preserved. Study Design: Retrospective study. Methods: Four groups of patients were evaluated. Two groups had undergone stapes surgery with preservation of the stapedial tendon. One of these groups underwent a laser stapedotomy minus prosthesis (laser STAMP) procedure, while the other group had a prosthesis inserted. The other two groups had undergone laser stapedotomy with one of two different prostheses being used. Audiometric data were obtained and reviewed both preoperatively and at approximately 6 weeks postoperatively. Results: All groups had overall successful results demonstrating that stapedial tendon preservation is technically possible and does not compromise outcomes. Conclusions: Based on the results, it is recommended that the stapedius tendon be preserved whenever possible during laser stapes surgery. Reasons justifying its preservation are discussed. Laryngoscope, 108:1453–1458, 1998