Publications by authors named "Mike Yao"

34 Publications

Redefining risk of contralateral cervical nodal disease in early stage oropharyngeal cancer in the human papillomavirus era.

Head Neck 2021 Jan 21. Epub 2021 Jan 21.

Department of Radiation Oncology, Mount Sinai Health System, New York, New York, USA.

Background: The optimal extent of surgery and/or radiation to the contralateral lymph node region is unknown in early-stage human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC).

Methods: To investigate the pathologic incidence of and risk factors for contralateral nodal disease (CND) in cT1-T2 HPV-related OPSCC treated with transoral robotic surgery (TORS) and bilateral neck dissection (BND), the records of 120 patients were reviewed.

Results: Eleven patients displayed pathologic contralateral nodal disease (pCND), including 7.1% of tonsil and 10.9% of base of tongue (BOT) cases. Medial hemistructure involvement and cN2 disease were significantly associated with pCND. Zero cN0 patients had pCND, and on multivariate analysis only cN classification remained significantly associated with pCND. Four percent of BOT patients and 2% of tonsil patients with a well-lateralized primary and cN0/N1 neck demonstrated pCND.

Conclusions: HPV-related OPSCC that are cN0-N1 have exceedingly low rates of pCND. Well-lateralized HPV-related BOT primaries with limited clinical nodal disease may be candidates for ipsilateral only treatment.
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http://dx.doi.org/10.1002/hed.26607DOI Listing
January 2021

2-Octyl cyanoacrylate to prevent salivary fistula formation following oral cavity microvascular reconstruction: A prospective trial.

Am J Otolaryngol 2020 Sep - Oct;41(5):102552. Epub 2020 May 28.

Department of Otolaryngology Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, NY, New York, USA.

Background: Salivary fistulas remain a significant problem in patients undergoing major head and neck reconstructive surgery. Surgical sealants have become increasingly used in cutaneous and non-cutaneous wound closure, providing a barrier to fluids/gases and promoting healing. The purpose of this study was to determine the efficacy of a common surgical sealant, 2-Octyl Cyanoacrylate (2-OCA, Dermabond®), in the prevention of salivary fistulas following free flap reconstruction of the oral cavity.

Methods: In this non-randomized, single arm prospective trial, patients undergoing free flap reconstruction of gravity-dependent oral cavity defects were recruited. Application of 2-OCA was performed along flap inset suture lines at the time of surgery. Prospectively collected trial data were propensity score matched to a control cohort to compare outcomes. Data collected include demographics, medical co-morbidities, previous treatments, primary tumor site, and subsites reconstructed. The primary outcome measure was rate of salivary fistula formation. Secondary outcomes were time to development of leak and percentage of patients tolerating oral feeding at one month post-operatively.

Results: In the 46 propensity score matched pairs, eight (17.4%) out of 46 patients in the 2-OCA prospective cohort and seven (15.2%) out of 46 patients in the control cohort developed postoperative salivary fistulas within the one-month study interval (p = 1.00). The average time to postoperative leak in the 2-OCA group was 12.5 days versus 7.1 days in the control cohort (p = 0.10). In the 2-OCA group, 30 (65.2%) patients were tolerating regular diet at one month post-operatively compared to 33 (71.7%) in the control cohort (p = 0.65).

Conclusion: Salivary fistula rates after application of a 2-OCA surgical sealant were not improved compared to a control cohort in this single institutional trial. There are several surgical sealants available, each with varying elasticity and adhesiveness. Future studies are needed to identify surgical sealants that are able to provide sufficient strength and adhesion to seal closures and combat corrosive saliva, but elastic enough to handle motion related tension during swallowing and post-operative movements in the head and neck.
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http://dx.doi.org/10.1016/j.amjoto.2020.102552DOI Listing
November 2020

Lymph Node Ratio in HPV-Associated Oropharyngeal Cancer: Identification of a Prognostic Threshold.

Laryngoscope 2021 01 29;131(1):E184-E189. Epub 2020 Apr 29.

Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A.

Objective: To evaluate the utility of lymph node ratio (LNR) as a prognostic factor for survival and recurrence in surgically treated patients with human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC).

Study Design: Retrospective cohort study.

Methods: In this retrospective cohort study of a tertiary healthcare system in a major metropolitan area, we reviewed 169 consecutive patients with HPV-related OPSCC treated using transoral robotic surgery. Univariable and multivariable Cox proportional hazards regression analysis with stratified models were used to compare LNR with other traditional clinicopathologic risk factors forrecurrence and survival. An LNR cutoff was found using the minimal P approach.

Results: Multivariable Cox regression models showed that each additional percentage increase in LNR corresponded to an adjusted hazard ratio (HR) of 1.04 (confidence interval [CI] 1.02-1.07). LNR was more significant when adjusted for adequate lymph node yield of ≥ 18 nodes (HR 5.05, 95% confidence interval [CI] 1.38-18.47). The minimal P generated cutoff point at LNR ≥ 17% demonstrated a HR 4.34 (95% CI 1.24-15.2) for disease-free survival.

Conclusion: For HPV-related OPSCC, continuous LNR and an LNR threshold of 17% could be helpful in identifying recurrent disease in addition to measures such as lymph node number alone.

Level Of Evidence: 4.
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http://dx.doi.org/10.1002/lary.28689DOI Listing
January 2021

The Effects of Viewing an Uplifting 360-Degree Video on Emotional Well-Being Among Elderly Adults and College Students Under Immersive Virtual Reality and Smartphone Conditions.

Cyberpsychol Behav Soc Netw 2020 Mar 2;23(3):157-164. Epub 2019 Nov 2.

School of Journalism and Communication, Beijing Normal University, Beijing, People's Republic of China.

Positive emotions are important for the physical and mental health of elderly adults. Previous research has suggested that the emotion processing mechanisms of elderly adults differ from those of young people. The current study used a mixed-methods approach to explore the emotional impacts of viewing an uplifting 360° videos under immersive (using a virtual reality [VR] headset) and nonimmersive (using a smartphone) conditions on elderly populations and young people. In Study 1, we conducted a pre-post treatment between-subject field experiment (smartphone vs. VR) among 58 seniors (aged 60 years and above) in a community center in Beijing, China. One-on-one semistructured interviews of each participant were conducted after the experiment. In Study 2, we conducted a between-subject laboratory experiment with the same design among college students. The results show that while both VR and smartphone viewing conditions led to a significant positive effect on the self-reported emotions of the college students, only the smartphone viewing condition had a significant impact on the emotional well-being of the elderly participants. For college students, immersive VR had a stronger effect on inducing positive emotions than smartphone, but for elderly people, the smartphone viewing condition was more effective in improving emotional wellbeing than immersive VR. An analysis of the qualitative data from interviewing the elderly participants also revealed a divergence in the acceptance of VR technologies among elderly adults, and the sense of telepresence had both positive and negative effects on the elderly participants' emotions and experiences.
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http://dx.doi.org/10.1089/cyber.2019.0273DOI Listing
March 2020

American Head and Neck Society Endocrine Surgery Section update on parathyroid imaging for surgical candidates with primary hyperparathyroidism.

Head Neck 2019 07 19;41(7):2398-2409. Epub 2019 Apr 19.

Division of Head and Neck Endocrine Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland.

Health care consumer organizations and insurance companies increasingly are scrutinizing value when considering reimbursement policies for medical interventions. Recently, members of several American Academy of Otolaryngology-Head & Neck Surgery (AAO-HNS) committees worked closely with one insurance company to refine reimbursement policies for preoperative localization imaging in patients undergoing surgery for primary hyperparathyroidism. This endeavor led to an AAO-HNS parathyroid imaging consensus statement (https://www.entnet.org/content/parathyroid-imaging). The American Head and Neck Society Endocrine Surgery Section gathered an expert panel of authors to delineate imaging options for preoperative evaluation of surgical candidates with primary hyperparathyroidism. We review herein the current literature for preoperative parathyroid localization imaging, with discussion of efficacy, cost, and overall value. We recommend that planar sestamibi imaging, single photon emission computed tomography (SPECT), SPECT/CT, CT neck/mediastinum with contrast, MRI, and four dimensional CT (4D-CT) may be used in conjunction with high-resolution neck ultrasound to preoperatively localize pathologic parathyroid glands. PubMed literature on parathyroid imaging was reviewed through February 1, 2019.
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http://dx.doi.org/10.1002/hed.25781DOI Listing
July 2019

Percutaneous versus surgical tracheostomy: timing, outcomes, and charges.

Laryngoscope 2018 12 3;128(12):2844-2851. Epub 2018 Oct 3.

Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A.

Objectives/hypothesis: The purpose of this study was to compare timing of procedure, patient characteristics, outcomes, and charges for patients who underwent percutaneous versus surgical tracheostomy.

Study Design: Retrospective cohort study.

Methods: A retrospective analysis was performed for all patients who underwent tracheostomy in 2015 to 2016 in New York State. Patients were identified using International Classification of Diseases, 10th Revision, Clinical Modification codes and stratified to the type of tracheostomy performed. The primary outcome of interest was mortality at index stay. Secondary outcomes of interest included length of stay and total hospitalization charges.

Results: Of the 8,682 patients, 2,488 (28.7%) underwent percutaneous and 6,194 (71.3%) underwent surgical tracheostomy. At hospitals where both procedures were performed, percutaneous tracheostomy patients were older, had more comorbidities, and had lower income (P < .05). Timing of the tracheostomy relative to admission did not affect the type of tracheostomy performed. While controlling for patient characteristics and complications during the visit, percutaneous tracheostomy was associated with increased mortality (odds ratio [OR]: 1.17, 95% confidence interval [CI]: 1.03-1.33, P = .0153) and increased hospital charges (OR: + 7.76%, 95% CI: 5.4-10.11, P < .0001). Length of stay was not affected by procedure type.

Conclusions: Surgical tracheostomies are more commonly performed than percutaneous tracheostomies across New York State. Older, lower-income, and sicker patients have a higher chance of receiving percutaneous tracheostomies. Percutaneous approaches were associated with statistically significant increased mortality and higher charges despite no difference in length of stay. Further studies are needed to determine if these differences in outcomes are clinically significant.

Level Of Evidence: NA Laryngoscope, 128:2844-2851, 2018.
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http://dx.doi.org/10.1002/lary.27334DOI Listing
December 2018

Application of the Eighth Edition American Joint Committee on Cancer Staging System for HPV-Related Oropharyngeal Cancer Treated With Transoral Robotic Surgery.

Laryngoscope 2018 05 9;128(5):1133-1139. Epub 2017 Oct 9.

Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York.

Objective: Analyze patients treated with transoral robotic surgery (TORS) in the context of the eighth edition of the American Joint Committee on Cancer (AJCC) staging system.

Methods: Retrospective cohort study including 110 human papillomavirus-related oropharyngeal cancer (HPV+OPC) patients with a minimum 1-year follow-up treated with TORS between 2007 to 2016. Kaplan-Meier methods were used to estimate 3-year disease-free survival and assess differences in recurrence.

Results: One hundred and ten patients with a median follow-up of 54 months were analyzed. Of those, 85% of patients were male, with a median age of 60. Twenty-two percent of patients received no adjuvant therapy; 43% received adjuvant radiation; and 35% underwent adjuvant chemoradiation. Extracapsular spread was identified in 24% of patients. Overall survival was 100%, with estimated 3-year disease-free survival (DFS) (95% confidence interval) of 87% (77, 93). Under the seventh edition of the AJCC, 5% of patients were stage I; 11% were stage II; 26% were stage III; and 57% were stage IVa. Twenty-seven patients (25%) were upstaged on final pathology, whereas 15 patients (14%) were downstaged. Under the eighth edition of the AJCC, 94% of patients were stage I for both clinical and pathologic staging systems. Six patients (6%) were upstaged on final pathology, whereas six patients (6%) were downstaged. No factors demonstrated statistical significance for DFS. Within pathologic stage I, Kaplan-Meier estimates for DFS did not reach statistical significance.

Conclusion: The majority of patients undergoing TORS for HPV + OPC are stage I under the eighth edition of the AJCC staging system, with limited pathologic re-staging compared with the prior system. Oncologic outcomes are favorable for this group. No clinicopathologic features are significant for DFS within pathologic stage I.

Level Of Evidence: 2b. Laryngoscope, 128:1133-1139, 2018.
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http://dx.doi.org/10.1002/lary.26948DOI Listing
May 2018

A Rare Case of Vagus Nerve Schwannoma Presenting as a Neck Mass.

Am J Case Rep 2017 Aug 21;18:908-911. Epub 2017 Aug 21.

Department of Medicine, Icahn School of Medicine at Mount Sinai, Queens Hospital Center, Jamaica, NY, USA.

BACKGROUND Vagus nerve schwannoma is a benign neoplasm that usually presents as an asymptomatic slow growing mass, and its presentation as a neck mass is rare. The diagnosis can be difficult to make and complete surgical excision is challenging due to the proximity of the vagus nerve fibers from which it originates. The most common symptom associated with vagus nerve schwannoma arising in the neck is hoarseness due to vocal cord palsy. CASE REPORT We report a case of a 55-year-old woman who presented to the clinic complaining of throat irritation and feeling of something stuck in her throat for the past three months. On examination, a bulging left parapharyngeal mass was noted, displacing the left tonsil and uvula medially. A contrast-enhanced computed tomography (CT) scan of the neck showed a large, hypervascular soft tissue mass with splaying of the left internal carotid artery. Intraoperatively, the tumor was found to be arising from the vagus nerve. Macroscopic surgical pathology examination showed a tan-red, ovoid, and firm mass. Histopathology showed a benign spindle cell tumor with Antoni A areas with palisading cell nuclei and some degenerative change, confirming the diagnosis of vagus nerve schwannoma. CONCLUSIONS Vagus nerve schwannomas should be distinguished from other tumors that arise in the neck before planning surgery, to minimize the risk of nerve injury. Physicians need to be aware of the differential diagnosis of a neck mass, investigations required, the surgical treatment and the potential postoperative complications.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5574523PMC
http://dx.doi.org/10.12659/ajcr.904084DOI Listing
August 2017

Retrosternal Goiter: 30-Day Morbidity and Mortality in the Transcervical and Transthoracic Approaches.

Otolaryngol Head Neck Surg 2016 10 24;155(4):568-74. Epub 2016 May 24.

Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Medical Center, New York, New York, USA.

Objective: Retrosternal goiters pose a significant challenge in determining the indications and appropriate approach for surgical removal while limiting postoperative morbidity and mortality. The objective of this study is to use the National Surgical Quality Improvement Program (NSQIP) database to compare outcomes of transcervical and transthoracic approaches for retrosternal goiter removal and to review the literature regarding the varying indications for the 2 surgical approaches.

Study Design: Administrative database analysis.

Setting: NSQIP database.

Subjects And Methods: The NSQIP database was queried for all cases of retrosternal thyroid: 2716 patients were included, which represents one of the largest data reviews of patients with retrosternal thyroid pathology who underwent surgery. Data were analyzed to examine morbidity and mortality of the cervical and transthoracic approaches.

Results: Patient demographics and preoperative comorbidities were similar between groups. Patients undergoing a transthoracic approach experienced increased rates of unplanned intubations and need for transfusion and length of stay postoperatively.

Conclusions: A transthoracic approach is associated with increased rates of several critical postoperative morbidities, and the data indicate the potential of increased overall mortality. Given equivalent retrosternal extension, a transcervical approach should be attempted whenever anatomically possible, regardless of pathology.
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http://dx.doi.org/10.1177/0194599816649583DOI Listing
October 2016

Radiographic Thrombus within the External Jugular Vein: Report of a Rare Case and Review of the Literature.

Case Rep Radiol 2015 13;2015:807268. Epub 2015 Oct 13.

Department of Radiology, Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA.

We are reporting a case of a 91-year-old male with a primary malignancy of the right parotid gland with radiographic thrombus extension within the right external jugular vein. He was treated with palliative radiation therapy to the right parotid mass with a marked clinical response. The rarity of this occurrence as documented in the review of the literature provides for uncertainty with regard to proper management. Radiographic evidence of thrombus in the absence of clinical manifestations, the role of anticoagulation, and the proper radiation target delineation were all challenges encountered in the care of this patient. Our case represents a rare occurrence with unique radiologic findings that has implications for management.
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http://dx.doi.org/10.1155/2015/807268DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4621336PMC
November 2015

Aberrant lymphatic drainage and risk for melanoma recurrence after negative sentinel node biopsy in middle-aged and older men.

Head Neck 2016 04 14;38 Suppl 1:E754-60. Epub 2015 Jul 14.

Department of Dermatology, Pigmented Lesion and Melanoma Program, Stanford University School of Medicine, Stanford, California.

Background: Aberrant lymphatic drainage is believed to contribute to the high recurrence rate of head and neck melanomas. The purpose of this study was to identify the clinical significance of unexpected lymphatic drainage patterns.

Methods: A single institution retrospective analysis was performed of middle-aged and older men (mean age, 66.2 years; range, 41-87 years) who underwent successful lymphoscintigraphy with sentinel lymph node biopsy (SLNB) from 1997 through 2012. Node status, distribution, and recurrence were assessed comparing patients with expected and unexpected drainage patterns.

Results: Sixty-six patients were identified with 55.8 months median follow-up (range, 5.6-206.1 months). Unexpected sentinel lymph node drainage was associated with multiple basin drainage (p < .01) and greater recurrence after negative SLNB (p = .03). Both groups had similar anatomic distribution, sentinel lymph node sampling, histopathologic characteristics, follow-up, and survival.

Conclusion: Lymphatic drainage differing from expected patterns is associated with greater recurrence after negative SLNB in middle-aged and older men. © 2015 Wiley Periodicals, Inc. Head Neck 38: E754-E760, 2016.
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http://dx.doi.org/10.1002/hed.24094DOI Listing
April 2016

The influence of personality, parental behaviors, and self-esteem on Internet addiction: a study of Chinese college students.

Cyberpsychol Behav Soc Netw 2014 Feb 4;17(2):104-10. Epub 2013 Sep 4.

1 Department of Media and Communication, City University of Hong Kong , Hong Kong .

A survey of 2,095 college students in five major cities in China was conducted to examine the influence of personality, parental behaviors, and self-esteem on Internet addiction. We found that psychoticism and neuroticism were both positively related to Internet addiction. The influence of parental behaviors on Internet addition was also significant. However, fathers' and mothers' behaviors had different impacts on their children's likelihood of being addicted to the Internet. Specifically, we found that fathers' rejection and overprotection, and mothers' rejection would increase the risk for Internet addiction. Furthermore, the influence of emotional warmth from parents on Internet addiction was partially mediated by self-esteem. Finally, we found that parental behaviors of mothers and fathers affected males and females differently in terms the risk of being addicted to the Internet.
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http://dx.doi.org/10.1089/cyber.2012.0710DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3924803PMC
February 2014

Impact of positron emission tomography/computed tomography surveillance at 12 and 24 months for detecting head and neck cancer recurrence.

Cancer 2013 Apr 7;119(7):1349-56. Epub 2012 Dec 7.

Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Palo Alto, CA, USA.

Background: In head and neck cancer (HNC), 3-month post-treatment positron emission tomography (PET)/computed tomography (CT) reliably identifies persistent/recurrent disease. However, further PET/CT surveillance has unclear benefit. The impact of post-treatment PET/CT surveillance on outcomes is assessed at 12 and 24 months.

Methods: A 10-year retrospective analysis of HNC patients was carried out with long-term serial imaging. Imaging at 3 months included either PET/CT or magnetic resonance imaging, with all subsequent imaging comprised of PET/CT. PET/CT scans at 12 and 24 months were evaluated only if preceding interval scans were negative. Of 1114 identified patients, 284 had 3-month scans, 175 had 3- and 12-month scans, and 77 had 3-, 12-, and 24-month scans.

Results: PET/CT detection rates in clinically occult patients were 9% (15 of 175) at 12 months, and 4% (3 of 77) at 24 months. No difference in outcomes was identified between PET/CT-detected and clinically detected recurrences, with similar 3-year disease-free survival (41% vs 46%, P = .91) and 3-year overall survival (60% vs 54%, P = .70) rates. Compared with 3-month PET/CT, 12-month PET/CT demonstrated fewer equivocal reads (26% vs 10%, P < .001). Of scans deemed equivocal, 6% (5 of 89) were ultimately found to be positive.

Conclusions: HNC patients with negative 3-month imaging appear to derive limited benefit from subsequent PET/CT surveillance. No survival differences were observed between PET/CT-detected and clinically detected recurrences, although larger prospective studies are needed for further investigation.
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http://dx.doi.org/10.1002/cncr.27892DOI Listing
April 2013

Targeted endoscopic salvage nasopharyngectomy for recurrent nasopharyngeal carcinoma.

Int Forum Allergy Rhinol 2012 Mar-Apr;2(2):166-73. Epub 2011 Dec 13.

Division of Rhinology, Stanford University School of Medicine, Stanford, CA 94305, USA.

Background: Despite modern radiotherapy and open surgical techniques, treatment of recurrent nasopharyngeal carcinoma (NPC) remains challenging, with substantial morbidity involved. Targeted endoscopic nasopharyngectomy was evaluated as a viable oncologic alternative to open nasopharyngectomy or radiation for recurrent NPC.

Methods: Thirteen patients who underwent endoscopic nasopharyngectomy for recurrent NPC between August 2005 and August 2010 were retrospectively reviewed. Average age at surgery was 55.7 years, with mean follow-up period 24.2 months. Two-year disease-free survival, 2-year overall survival, margin status, and complication rate were measured.

Results: Including resections for subsequent recurrences, 19 endoscopic procedures were performed with curative intent. Mean operating room (OR) time was 278 minutes, mean estimated blood loss was 197 mL, and mean length of hospitalization was 1.0 days. Negative margins were obtained in 78.9% of procedures: positive margins involved the parapharyngeal space, oropharynx, fossa of Rosenmuller, and infratemporal fossa. Stereotactic radiation was given postoperatively for localized positive margins. Four patients required repeat endoscopic nasopharyngectomy for re-recurrence, despite having their margins cleared or controlled with adjuvant treatment. Two-year local disease-free and overall survival rates were 69.2% and 100.0%, respectively. The overall minor complication rate was 52.6%, with no major complications.

Conclusion: Targeted endoscopic nasopharyngectomy is beneficial in locally recurrent NPC, with favorable morbidity and complication rates. Endoscopic surveillance and serial imaging together facilitate the early identification of re-recurrences, which often may be treated with additional directed resection. Postoperative stereotactic radiation may serve as an appropriate adjunct modality for disease control at positive margins.
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http://dx.doi.org/10.1002/alr.20111DOI Listing
August 2012

A novel aldehyde dehydrogenase-3 activator leads to adult salivary stem cell enrichment in vivo.

Clin Cancer Res 2011 Dec 13;17(23):7265-72. Epub 2011 Oct 13.

Department of Radiation Oncology, Stanford University, California, 94305, USA.

Purpose: To assess aldehyde dehydrogenase (ALDH) expression in adult human and murine submandibular gland (SMG) stem cells and to determine the effect of ALDH3 activation in SMG stem cell enrichment.

Experimental Design: Adult human and murine SMG stem cells were selected by cell surface markers (CD34 for human and c-Kit for mouse) and characterized for various other stem cell surface markers by flow cytometry and ALDH isozymes expression by quantitative reverse transcriptase PCR. Sphere formation and bromodeoxyuridine (BrdUrd) incorporation assays were used on selected cells to confirm their renewal capacity and three-dimensional (3D) collagen matrix culture was applied to observe differentiation. To determine whether ALDH3 activation would increase stem cell yield, adult mice were infused with a novel ALDH3 activator (Alda-89) or with vehicle followed by quantification of c-Kit(+)/CD90(+) SMG stem cells and BrdUrd(+) salispheres.

Results: More than 99% of CD34(+) huSMG stem cells stained positive for c-Kit, CD90 and 70% colocalized with CD44, Nestin. Similarly, 73.8% c-Kit(+) mSMG stem cells colocalized with Sca-1, whereas 80.7% with CD90. Functionally, these cells formed BrdUrd(+) salispheres, which differentiated into acinar- and ductal-like structures when cultured in 3D collagen. Both adult human and murine SMG stem cells showed higher expression of ALDH3 than in their non-stem cells and 84% of these cells have measurable ALDH1 activity. Alda-89 infusion in adult mice significantly increased c-Kit(+)/CD90(+) SMG population and BrdUrd(+) sphere formation compared with control.

Conclusion: This is the first study to characterize expression of different ALDH isozymes in SMG stem cells. In vivo activation of ALDH3 can increase SMG stem cell yield, thus providing a novel means for SMG stem cell enrichment for future stem cell therapy.
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http://dx.doi.org/10.1158/1078-0432.CCR-11-0179DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3544360PMC
December 2011

Primary intraosseous carcinoma of the anterior maxilla: an unusual case and review of the literature.

Ear Nose Throat J 2011 May;90(5):E35-7

Bobby R. Alford Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, USA.

Primary intraosseous carcinoma of the head and neck is rare, and lesions isolated to the anterior maxilla are obviously even more rare. The diagnosis of intraosseous carcinoma can be difficult, and it must be based on strict criteria. We report the case of a 40-year-old man who was referred for definitive treatment of a cancerous lesion of the anterior maxilla. The patient's mass had initially been thought to be a benign odontogenic cyst. The patient was treated with surgery and prosthetic rehabilitation. We describe the clinical presentation, pertinent workup including imaging, and the treatment of this case, and we review the literature.
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http://dx.doi.org/10.1177/014556131109000517DOI Listing
May 2011

Analysis of RNA from brush cytology detects changes in B2M, CYP1B1 and KRT17 levels with OSCC in tobacco users.

Oral Oncol 2011 Jun 5;47(6):532-6. Epub 2011 May 5.

Department of Oral and Maxillofacial Surgery, College of Dentistry, and University of Illinois at Chicago, 801 South Paulina Street, Chicago, IL 60610, USA.

RNA expression analysis of oral keratinocytes can be used to detect early oral cancer, but a limitation is the inability to obtain high quality RNA from oral tissue without using biopsies. While oral cytology cell samples can be obtained from patients in a minimally invasive manner, they have not been validated for quantitative analysis of RNA expression. Earlier we showed RNA from brush cytology of hamster Oral Squamous Cell Carcinoma (OSCC) demonstrated differential expression of B2M and CYP1B1 using real time RT-PCR in a dibenz[a,I]pyrene, tobacco carcinogen, induced model of this disease. Here we show reproducibility of this approach to measuring gene expression in humans. Cytology brush samples from 12 tobacco and betel related OSCC and 17 nonmalignant oral lesions revealed B2M mRNA was enriched in tumor samples while CYP1B1 mRNA was reduced, similar to what was seen in the model system. Additionally, we showed that KRT17 mRNA, a gene linked to OSCC in another brush cytology study, was also enriched in OSCC versus nonmalignant lesions, again supporting the promise of using RNA from brush oral cytology to reproducibly monitor oral gene expression.
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http://dx.doi.org/10.1016/j.oraloncology.2011.03.029DOI Listing
June 2011

Sexual Priming, Gender Stereotyping, and Likelihood to Sexually Harass: Examining the Cognitive Effects of Playing a Sexually-Explicit Video Game.

Sex Roles 2010 Jan 22;62(1-2):77-88. Epub 2009 Sep 22.

The present study examines the short-term cognitive effects of playing a sexually explicit video game with female "objectification" content on male players. Seventy-four male students from a university in California, U.S. participated in a laboratory experiment. They were randomly assigned to play either a sexually-explicit game or one of two control games. Participants' cognitive accessibility to sexual and sexually objectifying thoughts was measured in a lexical decision task. A likelihood-to-sexually-harass scale was also administered. Results show that playing a video game with the theme of female "objectification" may prime thoughts related to sex, encourage men to view women as sex objects, and lead to self-reported tendencies to behave inappropriately towards women in social situations.
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http://dx.doi.org/10.1007/s11199-009-9695-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2807025PMC
January 2010

Parotid gland squamous cell carcinoma invading the temporomandibular joint.

J Am Dent Assoc 2009 Aug;140(8):992-9

Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, University of Illinois at Chicago, Chicago, IL 60612-7213, USA.

Background: Tumor invasion of the temporomandibular joint from the parotid gland is rare. Practitioners should be able to differentiate tumor involvement from temporomandibular disorders (TMDs).

Case Description: . The authors present case reports of two patients with parotid gland masses accompanied by pain, dysfunction and other symptoms not consistent with musculoskeletal disorders. In both cases, clinicians initially reached an incorrect diagnosis and treated the masses as if they were TMDs, which delayed a definitive diagnosis and provision of appropriate treatment.

Conclusions: Dentists must take a thorough patient history, perform a detailed clinical examination and request proper radiographic imaging, when necessary, to render an accurate diagnosis and avoid mistreatment. Dentists who treat TMDs must recognize the possibility that a head or neck malignancy may manifest with symptoms and signs that mimic TMDs. If dentists are in doubt about a diagnosis, referral to the appropriate specialist should be considered.

Clinical Implications: A thorough history, a comprehensive clinical examination and an understanding of salivary gland disorders should facilitate an accurate initial diagnosis, allowing delivery of the appropriate and necessary medical treatment.
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http://dx.doi.org/10.14219/jada.archive.2009.0309DOI Listing
August 2009

Predicting user concerns about online privacy in Hong Kong.

Cyberpsychol Behav 2008 Dec;11(6):779-81

Department of Media and Communication, City University of Hong Kong, Kowloon Tong, Hong Kong.

Empirical studies on people's online privacy concerns have largely been conducted in the West. The global threat of privacy violations on the Internet calls for similar studies to be done in non-Western regions. To fill this void, the current study develops a path model to investigate the influence of people's Internet use-related factors, their beliefs in the right to privacy, and psychological need for privacy on Hong Kong people's concerns about online privacy. Survey responses from 332 university students were analyzed. Results from this study show that people's belief in the right to privacy was the most important predictor of their online privacy concerns. It also significantly mediated the relationship between people's psychological need for privacy and their concerns with privacy violations online. Moreover, while frequent use of the Internet may increase concerns about online privacy issues, Internet use diversity may actually reduce such worries. The final model, well supported by the observed data, successfully explained 25% of the variability in user concerns about online privacy.
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http://dx.doi.org/10.1089/cpb.2007.0252DOI Listing
December 2008

Predicting self-protections of online privacy.

Cyberpsychol Behav 2008 Oct;11(5):615-7

Department of Media and Communication, City University of Hong Kong, Kowloon, Hong Kong.

An empirical study was conducted to examine the social psychological processes that may influence an individual's adoption of online privacy protection strategies. Building from the theory of planned behavior, a theoretical model predicting self-protection of online privacy was tested in the present study. This model accounted for nearly a quarter of the variability in actual adoption during a ten-day period immediately after participants completed the initial questionnaire. Overall, the present research provided a strong support for the theoretical utility of psychological factors and processes in online privacy related research.
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http://dx.doi.org/10.1089/cpb.2007.0208DOI Listing
October 2008

Pediatric squamous cell carcinoma arising in an alpha-fetoprotein-producing mature cystic teratoma of the mandible.

Pediatr Blood Cancer 2009 Jan;52(1):130-2

Department of Pathology, College of Medicine, University of Illinois at Chicago, Chicago, Illinois 60153, USA.

Teratomas, most often diagnosed in younger patients, represent the most frequently identified subtype of pediatric germ cell tumors. It is very uncommon for teratomas to present in the head and neck region and demonstrate malignant transformation. We present a case of squamous cell carcinoma arising in an alpha-fetoprotein-producing cystic teratoma of the mandible in a 2-year-old female that is, to the best of our knowledge, the first such published report. The patient was treated with surgical excision along with chemotherapy and has remained disease-free 2 years after the conclusion of therapy.
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http://dx.doi.org/10.1002/pbc.21748DOI Listing
January 2009

Complete response of CNS-involved olfactory neuroendocrine tumor using multimodal therapy.

Onkologie 2008 Mar 8;31(3):119-21. Epub 2008 Feb 8.

Department of Medicine, The University of Illinois at Chicago, IL 60612, USA.

Introduction: Locally advanced tumors in the olfactory area commonly have central nervous system (CNS) involvement and are often incurable.

Case Report: We report the treatment of a 25-year-old male patient who presented with a large, neuroendocrine tumor arising from the ethmoid complex. This locally invasive lesion extended beyond the orbits and into the anterior cranial fossa with associated intracranial involvement. An endoscopic nasal biopsy demonstrated a poorly differentiated neuroendocrine tumor. The patient was treated with 4 cycles of combination induction chemotherapy with irinotecan and cisplatin followed by radiation therapy with concurrent weekly cisplatin. He had a complete response to this therapy confirmed with biopsies that demonstrated no residual disease at 8 weeks after chemoradiotherapy. He remained disease free one and a half years following surgery.

Conclusion: To our knowledge, this combination treatment approach has not been reported in the literature.
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http://dx.doi.org/10.1159/000113505DOI Listing
March 2008

Diagnostic studies in obstructive sleep apnea.

Otolaryngol Clin North Am 2007 Aug;40(4):785-805

Department of Otolaryngology-Head and Neck Surgery, University of Illinois at Chicago, 1855 West Taylor Street, Room 3.87, Chicago, IL 60612, USA.

The standard for the diagnosis of obstructive sleep apnea (OSA) is polysomnography (PSG). Although PSG helps identify individuals who have OSA and guides medical management, it does not identify the obstruction site or predict surgical results. Radiologic and diagnostic studies have been used to direct surgical intervention and predict outcomes of sleep apnea surgery. These studies include lateral cephalometric radiographs, CT, MRI, asleep fluoroscopy, asleep and awake endoscopy, upper airway manometry, and acoustic reflection techniques. The ideal diagnostic study would identify individuals who have OSA, be cost-effective and readily accessible, and guide therapeutic, site-specific intervention with predictable results. In this article, the various modalities are reviewed in terms of their capability to effectively diagnose and guide treatment of OSA.
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http://dx.doi.org/10.1016/j.otc.2007.04.005DOI Listing
August 2007

Current surgical treatment of squamous cell carcinoma of the head and neck.

Oral Oncol 2007 Mar 15;43(3):213-23. Epub 2006 Sep 15.

University of Illinois at Chicago, Department of Otolaryngology, 1855 W. Taylor Street, M/C 648, Chicago, IL 60612, United States.

Historically treatment of head and neck cancers involved surgical resection followed by radiation therapy for advanced tumors. Concurrent chemoradiation therapies have shown equal survival to surgical resection with better preservation of function. However, concurrent therapy does entail significant morbidity, and recent advances have been used to minimize that morbidity. Newer tumor specific medical therapies are anticipated to be less toxic while maintaining a high degree of efficacy. For resectable cancer, transoral laser microsurgery is a new trend in surgery for complete resection of tumors with preservation of function. Advanced reconstructive techniques that allow free transfer of soft tissue and bone from all over the body improve the functional and aesthetic outcomes following major ablative surgery. With successful surgical reconstruction, dental and prosthetic rehabilitation choices are enhanced. Advances in rehabilitation of speech following removal of the larynx have improved the quality of life post-laryngectomy patients. With these newer therapies and methods of reconstruction, each patient needs to be carefully evaluated to maximize the possibility of cure and level of function, and minimize the morbidity associated with treatment. Combined chemotherapy and radiation protocols are associated with increased acute and chronic toxicities that may affect the quality of life due to the impact upon oral disease and oral function. Oral care providers must be aware of advances in cancer management and implications for patient care to effectively care for these patients.
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http://dx.doi.org/10.1016/j.oraloncology.2006.04.013DOI Listing
March 2007

Peep show establishments, police activity, public place, and time: a study of secondary effects in San Diego, California.

J Sex Res 2006 May;43(2):182-93; discussion 194-201

Department of Communication and Law and Society Program, University of California, Santa Barbara, Santa Barbara, CA 93106, USA.

An empirical study was undertaken in San Diego, California, to test assumptions made by the government and by conservative religious policy advocates that there is a greater incidence of crime in the vicinity of peep show establishments. We asked two questions: (a) Is criminal activity in San Diego particularly acute at peep show establishments compared to surrounding control locations? and (b) Is criminal activity in San Diego disproportionately greater at or near peep show establishments between the hours of 2 a.m. and 6 a.m. compared to other times of the day? The levels of crime activity and the expenditure of police resources were examined by measuring the number of calls-for-service (CFSs) to the police within a 1,000-ft. area on either side of the peep show establishments and comparably-sized control areas beyond the immediate 1,000-foot area. A more focused late-night (2 a.m. to 6 a.m.) analysis was also undertaken. The results showed no reliable evidence of differences in crime levels between the control and test areas, nor was there any evidence of disproportionately greater amounts of crime within the 2 a.m. to 6 a.m. time period in the areas surrounding the peep show establishments. We concluded that San Diego does not have a problem with crime at the peep show establishments generally, nor is there a heightened problem with crime during the 2 a.m. to 6 a.m. period. We discuss the implications of assuming that peep show establishments are associated with negative effects in the community and the possibility of viewpoint discrimination against sex communication.
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http://dx.doi.org/10.1080/00224490609552313DOI Listing
May 2006

Localizing hyperfunctioning parathyroid tissue: MRI or nuclear study or both?

Clin Imaging 2006 Jul-Aug;30(4):257-65

Department of Radiology, Section of Nuclear Medicine, University of Illinois at Chicago, 1740 West Taylor Street, 60612, USA.

The surgical approach to primary hyperparathyroidism patients has changed recently with minimally invasive surgery becoming more common. This retrospective study reviews the relative sensitivities of dual-phase sestamibi (DP-SI) and magnetic resonance imaging (MRI) in preoperative patients. We found that MRI was more sensitive, but the difference was not statistically significant. Magnetic resonance imaging enhanced the ability to localize abnormal tissues when the DP-SI was negative. Together, both tests demonstrated a sensitivity of 92%. We recommend performing DP-SI initially, and if negative, MRI. This should provide the highest imaging sensitivity at the lowest cost.
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http://dx.doi.org/10.1016/j.clinimag.2006.02.007DOI Listing
November 2006

Left-sided facial mass. Spindle cell lipoma of the parotid gland.

Arch Pathol Lab Med 2006 Jun;130(6):875-6

Department of Otolaryngology, Henry Ford Hospital, Detroit, Michigan, USA.

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http://dx.doi.org/10.1043/1543-2165(2006)130[875:LFM]2.0.CO;2DOI Listing
June 2006

Management of a tracheal tear during laryngopharyngoesophagectomy with gastric pull-up.

Ear Nose Throat J 2006 Apr;85(4):271-3

Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

Laceration of the posterior tracheal wall is one of the risks of transhiatal esophagectomy. Various methods of repairing such lacerations have been described; many of these methods involve a thoracotomy, but some do not. We describe a case of a posterior tracheal wall tear that occurred during a laryngopharyngectomy with a gastric pull-up. The tear was repaired with the transposed stomach and did not require a thoracotomy. The transposed stomach was used to patch the tear and block communication between the environment and the mediastinum. Bedside endoscopic examination on postoperative day 5 revealed that the tear had healed. Key management considerations in such a circumstance include having the patient breathe without positive pressure ventilation postoperatively and keeping the tracheal lumen and stoma clear during the healing process in order to prevent the development of positive tracheal pressure. With these safeguards in place, the transposed stomach approach is a safe method of repairing posterior tracheal wall tears.
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April 2006