bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Genomic Predictor of Oral Squamous Cell Carcinoma
Authors: Whipple Mark E. , Mendez Eduardo , Farwell D Gregory , Agoff S Nicholas , Chen Chu 
Published: July 2004

AbstractObjectives/Hypothesis: The objective was to identify a genomic profile that predicts the likelihood of oral squamous cell carcinoma compared with normal oral mucosa in unknown tissue samples.Study Design: Using a training set of tissue samples that were histologically classified as oral squamous cell carcinoma or normal mucosa, the authors used principal component analysis to develop a genomic predictor for oral squamous cell carcinoma. On a separate test set of unclassified samples, the authors used the predictor to classify the samples, then evaluated the performance of the predictor using histological diagnosis.Methods: The authors used a data set consisting of messenger RNA extracted from 29 oral squamous cell carcinoma and 19 normal oral mucosa tissue samples and hybridized to Affymetrix oligonucleotide microarrays containing probe sets for 7070 genes and expressed sequence tags. The samples were divided into a training set of 15 oral squamous cell carcinoma and 10 normal samples and a test set consisting of the remaining samples. Using principal component analysis on the training set, the authors found a composite gene expression vector (principal component vector), which they used to compute likelihood ratios for oral squamous cell carcinoma on the test set. By calculating the contribution of each gene to the principal component vector, the authors identified genes with the greatest predictive value.Results: Using the likelihood ratio, the authors correctly classified all 23 samples in the test set as either oral squamous cell carcinoma or normal. The authors found that many of the most predictive genes are known to be markers of squamous cell carcinoma or normal mucosa.Conclusion: Principal component analysis can be used with genomic microarray data to correctly predict the presence of oral squamous cell carcinoma in unknown tissue samples.
Effect of Magnetic Resonance Imaging on Internal Magnet Strength in Med‐El Combi 40+ Cochlear Implants
Authors: Wackym P Ashley , Michel Michelle A. , Prost Robert W. , Banks Kristin L. , Runge‐Samuelson Christina L. , Firszt Jill B. 
Published: July 2004

AbstractObjective: Magnetic resonance imaging (MRI) has been contraindicated when cochlear implants containing an internal magnet are in place because of concerns regarding torque, force, demagnetization, artifacts, induced voltages, and heating. The objective was to determine the magnetic field strength of Med‐El Combi 40+ cochlear implant internal magnets after MRI studies.Study Design/Methods: Two fresh cadavers were used to study demagnetization using a repeated measures design and a magnetometer. Pre‐ and postMRI measurement of magnetic field strength was completed. Five sets of sagittal T1‐weighted, axial T1‐weighted, and axial T2‐weighted sequences were performed on a cadaver at 0.2 Tesla in the device‐up and device‐down positions. In the other cadaver, 15 sets of sagittal T1‐weighted, axial T1‐weighted, and axial T2‐weighted sequences were performed on a cadaver at 1.5 Tesla were conducted, 5 each with the head oriented at 80, 90, and 100 degrees rotated around the yaw plane (rotated around the z‐axis). Subsequently, three cochlear implant patients completed 0.2 Tesla MRIs. For these patients, subjective and objective assessment of cochlear implant performance was performed.Setting: Academic medical center.Results: In the cadaver studies, analysis of variance showed no significant difference in the magnetic field strength after the 0.2 or 1.5 Tesla scans. There was no significant difference in the magnetic field strength for the three patients undergoing 0.2 Tesla MRIs and no adverse consequences, including no changes in telemetry, auditory sensations, nonauditory sensations, and sound quality.Conclusions: No significant demagnetization of the internal magnet occurred during repeated 1.5 Tesla MRI scans with the head orientations used in this study. In the cochlear implant patients, no significant demagnetization of the internal magnet occurred after a 0.2 Tesla MRI.
Swallowing‐Related Quality of Life After Head and Neck Cancer Treatment
Authors: Gillespie M Boyd , Brodsky Martin B. , Day Terry A. , Lee Fu‐Shing , Martin‐Harris Bonnie 
Published: July 2004

AbstractObjectives: To determine the role of treatment modality in swallowing outcome after head and neck cancer treatment and to identify potential risk factors for posttreatment dysphagia.Study Design: Cross‐sectional survey of patients with no evidence of disease 12 months or more after the treatment of a stage III or IV squamous cell carcinoma of the oropharynx, larynx, or hypopharynx.Methods: Potential subjects were stratified by tumor site and tumor T‐stage to achieve a balanced comparison between chemoradiation (n = 18) and surgery/radiation (n = 22) groups. Outcome measures included a dysphagia risk factor survey, the MD Anderson Dysphagia Inventory (MDADI), and the Short‐Form 36 (SF‐36).Results: Patients who received chemoradiation for oropharyngeal primaries demonstrated significantly better scores on the emotional (P = .03) and functional (P = .02) subscales of the MDADI than did patients who underwent surgery followed by radiation. There were no significant differences between chemoradiation and surgery/radiation groups for laryngeal and hypopharyngeal primaries. Additional risk factors for posttreatment dysphagia include prolonged (>2 weeks) nothing by mouth (NPO) status (P = .002) and low SF‐36 Mental Health Subscale score (P = .002).Conclusion: The study suggests that chemoradiation may provide superior swallowing outcome to surgery/radiation in patients with oropharyngeal primary. Patients with depressed mental health and prolonged feeding tubes may be at higher risk of long‐term dysphagia.
Prospective Evaluation of Endoscopic Approaches to the Thyroid Compartment
Authors: Terris David J. , Haus Brian M. , Nettar Kartik , Ciecko Shawn , Gourin Christine G. 
Published: July 2004

AbstractObjective: To compare a number of endoscopic approaches to the thyroid compartment.Design: Prospective, nonrandomized, experimental investigation in a porcine model.Methods: We performed a consecutive series of 13 endoscopic thyroidectomies using 5 distinct approaches. The procedures differed by the direction of the approach, incision placement, and use of facilitative maneuvers. The parameters assessed included procedure duration, estimated blood loss, heart rate, blood pressure, temperature, oxygen saturation, and arterial blood gas levels. The thyroid specimens were weighed and examined histologically.Results: Four of the endoscopic approaches were successfully used for resection of the thyroid (12 of 13 animals). The mean operative times were as follows: superior approach (n = 4), 47 ± 14.6 minutes; lateral axillary approach (n = 4), 67 ± 11.8 minutes; and superficial axillary (n = 3), 67.7 ± 22.3 minutes. The one axillary approach took 84 minutes. The precordial approach (n = 1) lasted 47 minutes and then required open conversion. The overall median estimated blood loss was 0 (range 0–100) mL. The mean change in blood pressure and pH from the beginning to the end of the procedure was −0.5 ± 24.1 mm Hg and 0.16 ± 0.07, respectively. The thyroid glands weighed 4.3 ± 0.9 g and had normal glandular architecture with no evidence of significant tissue trauma or thermal injury. There were no cases of pneumothorax, subcutaneous emphysema, or air embolism.Conclusion: A number of approaches to the thyroid compartment are conceivable. The superior approach proved to be the fastest and easiest, whereas the lateral axillary and superficial axillary were the best approaches from a cosmetic and clinical standpoint.
Pathology of the Olfactory Epithelium: Smoking and Ethanol Exposure
Authors: Vent J , Robinson A M. , Gentry‐Nielsen M J. , Conley D B. , Hallworth R , Leopold D A. , Kern R C. 
Published: July 2004

AbstractObjective: To investigate the effects of tobacco smoke on the olfactory epithelium. Cigarette smoking has been associated with hyposmia; however, the pathophysiology is poorly understood. The sense of smell is mediated by olfactory sensory neurons (OSNs) exposed to the nasal airway, rendering them vulnerable to environmental injury and death. As a consequence, a baseline level of apoptotic OSN death has been demonstrated even in the absence of obvious disease. Dead OSNs are replaced by the mitosis and maturation of progenitors to maintain sufficient numbers of neurons into adult life. Disruption of this balance has been suggested as a common cause for clinical smell loss. This current study will evaluate the effects of tobacco smoke on the olfactory mucosa, with emphasis on changes in the degree of OSN apoptosis.Study Design: A rat model was used to assess the olfactory epithelium after exposure to tobacco smoke.Methods: Rats were exposed to tobacco smoke alone (for 12 weeks), smoke plus dietary ethanol (for the final 5 weeks), or to neither (control). Immunohistochemical analysis of the olfactory epithelium was performed using an antibody to the active form of caspase‐3. Positive staining for this form of the caspase‐3 enzyme indicates a cell undergoing apoptotic proteolysis.Results: Control rats demonstrated a low baseline level of caspase‐3 activity in the olfactory epithelium. In contrast, tobacco smoke exposure triggered a dramatic increase in the degree of OSN apoptosis that affected all stages of the neuronal lineage.Conclusions: These results support the following hypothesis: smell loss in smokers is triggered by increased OSN death, which eventually overwhelms the regenerative capacity of the epithelium.
Skin Testing in Predicting Response to Nasal Provocation with Alternaria
Authors: Krouse John H. , Shah Anand G. , Kerswill Kristy 
Published: July 2004

AbstractObjective: Examine the efficacy of epicutaneous and intradermal testing in predicting response to nasal provocation with Alternaria antigen.Study Design and Setting: Prospective study. Subjects were tested with the Multi‐Test II (MT) epicutaneous testing device. Subjects with negative wheals were then tested with a 1:500 weight:volume intradermal injection of Alternaria. They had baseline assessment of nasal cross‐sectional area (CSA) using acoustic rhinometry and underwent nasal provocation with increasing Alternaria concentrations. CSA was assessed at each concentration. A nasal allergen provocation score (NAP) of nasal symptoms as well as a nasal visual analogue scale (VAS) were also completed with each concentration.Results: Sensitivity and specificity of MT in predicting nasal response to Alternaria were poor at 42% and 44%, respectively. The addition of intradermal testing increased sensitivity only modestly to 58%. hierarchical linear modeling analysis demonstrated that subjects positive to Alternaria on skin testing did not show a significant reduction in nasal CSA on acoustic rhinometry or significant elevations in two nasal symptom scores with direct nasal provocation.Conclusion and Significance: Skin testing with either epicutaneous or intradermal testing may not be an accurate or sufficient technique in the assessment of Alternaria reactivity. These results suggest that mold allergies may involve more complex immune mechanisms than simply an immunoglobulin (Ig)E mediated type I immediate hypersensitivity response alone. An alternate model for mold sensitivity, as well as modifications in testing methods, may be required in the evaluation of mold allergy.
The Resident 80‐Hour Work Week: How Has It Affected Surgical Specialties?
Authors: Chandra Rakesh K. 
Published: July 2004

AbstractObjectives: To identify strategies employed by surgical departments to address recently implemented resident duty hour regulations, and to assess resident and faculty acceptance of these changes.Methods: Attendees to the 2003 Residency Program Coordinator/Administrator Workshop for sub‐specialties (Denver, CO) were surveyed.Results: The study population included 46 respondents spanning 9 surgical sub‐specialties. Forty‐eight percent of programs instituted at least 1 administrative change specifically to comply with duty hour regulations. The most commonly employed strategies were the hiring of nurse practitioners or physician assistants (30%) and the use of Internet‐based software to track resident duty hours (30%). Other changes included giving call responsibilities to residents on research rotations (19%), institution of home‐call (13%), and assignment of a night‐float resident (11%). Perceptions of program coordinators indicated that junior residents and junior faculty accepted changes better than did senior residents and senior faculty (P=.025).Conclusion: The resident 80‐hour work week is a major health care policy change that has required academic sub‐specialty departments to make significant alterations in their administrative structure. Further study is necessary to determine how these changes affect both quality of training and patient care in the short and long term.
Nasopharyngeal Actinomycosis: A Rare Cause of Nasal Airway Obstruction
Authors: Daamen Nicole , Johnson Jonas T. 
Published: July 2004

AbstractNasopharyngeal actinomycosis is a rare clinical disease. It can occur after nasal trauma or surgical manipulation. It is also reported to occur without prior trauma, making diagnosis difficult. We report a case of nasopharyngeal actinomycosis that presented as nasal airway obstruction causing snoring and mimicking nasopharyngeal carcinoma. To our knowledge, only a few other cases of nasopharyngeal actinomycosis have previously been published, most coming after mucosal trauma. Diagnosis is made by observing the bacteria or its associated sulfur granules in the biopsy specimen. This anaerobic organism is difficult to culture. Treatment consists of wide debridement and prolonged antibiotic therapy, with good prognosis.
Chondroitin Sulfate Hydrogel and Wound Healing in Rabbit Maxillary Sinus Mucosa
Authors: Gilbert M Erik , Kirker Kelly R. , Gray Steven D. , Ward P Daniel , Szakacs Juliana G. , Prestwich Glenn D. , Orlandi Richard R. 
Published: July 2004

AbstractObjectives/Hypothesis: Chondroitin sulfate (CS) is a glycosaminoglycan in the extracellular matrix of all vertebrates. A biocompatible, nonimmunogenic, pliable hydrogel preparation of CS has recently been produced and has shown benefit in wound healing in murine and porcine epidermis. The objective of the current experiment is to compare the wound healing properties of CS hydrogel versus no treatment in wounds of the maxillary sinus mucosa.Study Design: Prospective investigation in an animal model.Methods: A 6 mm wound was created in bilateral maxillary sinuses of 17 New Zealand white rabbits. CS hydrogel (case) and no dressing (control) were randomly assigned to one side each as wound treatment. Wounds were examined ex vivo at 2, 4, 6, 10, and 14 day postinjury intervals. Wound diameter was measured microscopically by a blinded investigator. Representative specimens were examined histologically.Results: The CS disc was partially integrated into the wounds at the 4‐day interval and completely integrated by the 6‐day interval. The average wound diameters for the case versus control side were similar at 2 days (3.75 mm vs. 4.42 mm) but differed significantly at 4 days (2.86 mm. vs. 3.80 mm., P = .035). At 6 days, the wounds could not be discerned on either the case or control sides. However, histologic analysis revealed accelerated healing with the CS treatment. The treated wounds displayed respiratory epithelium as opposed to the squamous epithelium exhibited on the untreated sides.Conclusions: Despite some limitations, the New Zealand white rabbit is an effective model for the study of sinonasal wound healing. CS hydrogel accelerates wound healing in sinonasal mucosa at a 4‐day endpoint. We propose that the CS hydrogel acts as a surrogate extracellular matrix, serving as a repository for cytokines and growth factors produced by the regenerating mucosa. It may also provide a structural framework for fibroblasts and epithelial regeneration. Further study is necessary to establish this relationship.
Is A Plexiform Neurofibroma Pathognomonic of Neurofibromatosis Type I?
Authors: Lin Vincent , Daniel Sam , Forte Vito 
Published: July 2004

AbstractObjectives/Hypothesis: Several prominent textbooks have claimed that a plexiform neurofibroma is pathognomonic for neurofibromatosis type I. This is not in agreement with the National Institutes of Health criteria, which require two signs to be present, one of which can be a plexiform neurofibroma. Is a plexiform neurofibroma pathognomonic for neurofibromatosis type I?Study Design: Retrospective chart review.Methods: Fifty‐one patients with surgically resected plexiform neurofibromas between the years 1991 and 2001 were identified, and their charts reviewed. The presence and absence of any manifestation of neurofibromatosis type I as detailed in the National Institutes of Health criteria were recorded. The pathology database at the Hospital for Sick Children (HSC) was searched retrospectively.Results: Five of the 51 patients had a single solitary plexiform neurofibroma. They were followed at the neurofibromatosis clinic at the HSC with regular detailed examinations and no other stigmata were found.Conclusion: Although plexiform neurofibromas are highly suggestive of neurofibromatosis type I, they are not pathognomonic as claimed.
Cochlear Implantation for Children With GJB2‐Related Deafness
Authors: Cullen Robert D. , Buchman Craig A. , Brown Carolyn J. , Copeland Ben J. , Zdanski Carlton , Pillsbury Harold C. , Shores Carol G. 
Published: July 2004

AbstractObjectives/Hypothesis: Mutations in GJB2 are a common cause of congenital sensorineural hearing loss. Many children with these mutations receive cochlear implants for auditory habilitation. The purpose of the study was to compare the speech perception performance of cochlear implant patients with GJB2‐related deafness to patients without GJB2‐related deafness.Study Design: Retrospective case review.Methods: Pediatric cochlear implant recipients who have been tested for GJB2 mutation underwent chart review. All patients received cochlear implantation at a tertiary referral center, followed by outpatient auditory habilitation. Charts were reviewed for cause and duration of deafness, age at time of cochlear implantation, intraoperative and postoperative complications, duration of use, and current age. Results of standard tests of speech perception administered as a part of the patients' auditory habilitation were reviewed.Results: Twenty patients with GJB2 mutations were compared with 27 patients without GJB2 mutations. There was no statistical difference between patients with and without GJB2‐related congenital sensorineural hearing loss with regard to open‐set and closed‐set speech recognition performance at 12, 24, and 36 months after cochlear implantation. Surgical complications were uncommon.Conclusion: Pediatric patients with congenital sensorineural hearing loss without other comorbid conditions (eg, developmental delay, inner ear malformations) perform well when they receive cochlear implantation and auditory habilitation. The presence or absence of GJB2 mutation does not appear to impact speech recognition performance at 12, 24, and 36 months after implantation.
Giant Cell Arteritis: A New Association with Benign Paroxysmal Positional Vertigo
Authors: Amor‐Dorado Juan C. , Llorca Javier , Costa‐Ribas Carmen , Garcia‐Porrua Carlos , Gonzalez‐Gay Miguel A. 
Published: July 2004

AbstractObjective: To assess the incidence and characteristics of both benign paroxysmal positional vertigo (BPPV) and positional nystagmus in a series of patients with giant cell arteritis (GCA).Study Design: Patients diagnosed with GCA between June 1999 and May 2001 at the single hospital for a defined population were examined prospectively.Method: Patients included in this study fulfilled the 1990 American College of Rheumatology classification criteria for GCA. Otologic and oculographic studies were performed. Type, frequency, and outcome of positional oculographic findings was assessed. Patients were required to have been examined within 1 week after the onset of corticosteroid therapy. Data found in GCA patients were compared with those observed in an age, sex, and ethnically matched control population. Further studies in patients and controls were performed 3 and 6 months later.Results: Forty‐four patients and 44 matched controls were included in this study. Nine (20.5%) GCA patients fulfilled diagnostic criteria of BPPV compared with only 1 (2.3%) of the controls (P = .007). In seven of these nine GCA patients, BPPV was related to the posterior and two to the horizontal semicircular canals, respectively. Horizontal nystagmus was found in seven GCA patients who developed nystagmus in the head hanging position test compared with none in the controls (P = .006).Conclusions: The present study shows a higher frequency of BPPV in GCA than in matched controls. Because most clinical manifestations in GCA are caused by ischemic complications, our results suggest an ischemic etiology as responsible for BPPV in these elderly patients. According to these results, GCA may constitute a new association with BPPV.
Histopathological Basis of Hearing Impairment in Wolf‐Hirschhorn Syndrome
Authors: Ulualp Seckin O. , Wright Charles G. , Pawlowski Karen S. , Roland Peter S. 
Published: July 2004

AbstractObjectives/Hypothesis: To perform histological examination of temporal bones acquired from an infant with Wolf‐Hirschhorn syndrome with an emphasis on identifying abnormalities that might be responsible for hearing impairment in this disorder.Study Design: Retrospective case review.Methods: Temporal bones were taken at autopsy from a 10‐month‐old infant with Wolf‐Hirschhorn syndrome. The right‐side temporal bone was studied by microdissection. The middle ear was examined, and the inner ear sensory organs dissected for study by light microscopy. The left‐side temporal bone was embedded in celloidin, and sections were cut for microscopic examination.Results: Chronic otitis media was observed in both ears. Inflammation, effusion, and adhesions were present in the middle ear space. The malleus was malformed, and the chorda tympani nerve was found to pass through the bone of the malleus bilaterally. There was an area of sharply defined outer hair cell loss in the lower basal turn of the right‐side organ of Corti, and defects were noted in the bone of the apical osseous spiral lamina in both cochleae.Conclusion: In addition to the presence of otitis media, the likelihood of congenital abnormalities of the middle and inner ear should be considered in the assessment of patients with Wolf‐Hirschhorn syndrome with hearing impairment.