Faculty Bibliography

Epigallocatechin gallate (EGCG) of green tea and the nutraceutical CystiCran^®-40 (containing 40% proanthocyanidins) of the cranberry plant have been associated with antiviral activity. The purpose of this work was to determine the mechanism of antiviral synergy between each compound. Coliphage T4II (phage T4) and the rotavirus strain SA-11(RTV) were used as model virus systems. Individual and combined flavonoids structural and molecular weight analyses were performed by NMR and HPCL/MS, respectively. A suboptimal concentration of EGCG or C-40 alone or in combination reduced phage infectivity by ≤10%. Similarly, EGCG (30 µg/ml) and C-40 (25 µg/ml), respectively, reduced RTV titers by 3 and 13%. However, RTV titers were reduced by 32% (p < .05) with both flavonoids used in combination. RTV was not recognized in host cells by electron microscopy 24-h post-inoculation. NMR and HPLC/MS findings revealed significant structural and potential changes in molecular weight of the flavonoids in complex.

Objective/UNASSIGNED:Measure the effects of a structured morbidity and mortality conference format on the attitudes of resident and faculty participants. Study Design/UNASSIGNED:Prospective cohort study. Setting/UNASSIGNED:Otorhinolaryngology-head and neck surgery residency training program. Subjects and Methods/UNASSIGNED:Two changes were implemented to the structure of our morbidity and mortality conference: (1) we adopted a recently described presentation framework called situation-background-assessment-recommendation and (2) appointed a faculty moderator to lead the conference. Surveys were distributed to residents and faculty before and after these modifications were implemented to measure changes in attitude of conference attendees. Results/UNASSIGNED:< .01). Conclusion/UNASSIGNED:By implementing the situation-background-assessment-recommendation framework and appointing a faculty moderator to morbidity and mortality conference, participants reported significantly enhanced engagement during the conference, increased educational value of the session, and a positive impact on future patient care.

Due to their anatomical location, vocal folds are highly susceptible to injury from external and internal stressors that can lead to irreversible damage and changes in function. As the structure and composition of the vocal folds are heavily linked to their unique function, we hypothesize that a vocal fold-derived extracellular matrix (ECM) would be the ideal scaffold in a regenerative approach to vocal fold repair. Our group has previously described a porcine-derived vocal fold lamina propria ECM (VFLP-ECM)¹. In order to optimize the delivery modality of the VFLP-ECM, we have developed an injectable hydrogel form of the ECM scaffold and have studied the effects of tissue specificity using human vocal fold fibroblasts (hVFF) and human peripheral blood-derived macrophages (hPB-Macrophages). Both cell types play unique roles during the inflammatory and wound healing response at the site of vocal fold injury. In the present study, we compare VFLP-ECM with other ECM hydrogels (such as collagen, heart, bladder) in their ability to activate and modify gene expression of hVFFs and hPB-macrophages. This information will help us tailor the VFLP-ECM hydrogel to mod-ulate the environment present during vocal fold injury

The prognosis and recurrence rate of inverted papilloma (IP) with concomitant cellular dysplasia are not well-delineated. Demographic, clinical and imaging data of all patients who were surgically treated for sinonasal inverted papilloma (SNIP) in our center between 1996 and 2013 were reviewed. Data regarding the coexistence of dysplastic changes or malignancy within the resected tissues were also retrieved. After the exclusion of malignant cases and patients who were lost for follow-up, 92 patients were included in the study. Five patients had coexisting cellular dysplasia (4.7%), four of them had severe dysplasia and one had mild-to-moderate dysplasia. All four cases with severe dysplasia recurred, three were primarily treated endoscopically and one by external approach. Only the case with mild to moderate dysplasia which had been treated by subcranial approach did not recur. Patients with dysplasia had significantly higher recurrence rate than patients without dysplasia (80 vs. 14%, p = 0.019). This significant relation between histology and recurrence remained even after adjustment to tumor extent. The adjusted odd ratio of dysplasia (dysplasia vs. no dysplasia) is 9.7, p = 0.043. SNIP with dysplasia should be treated aggressively and followed closely. The histopathologic investigation of SNIP specimens should always note the presence of dysplasia and its severity. Further investigation on the clinical behavior of SNIP with dysplasia is needed. Multicenter studies are warranted due to the rarity of dysplastic SNIP.

OBJECTIVES/HYPOTHESIS:As our population ages, injuries attributable to falls continue to increase, impacting healthcare delivery. Evaluation of craniofacial trauma with focus on elderly patients remains an underappreciated concern. Our objectives were to evaluate injury trends associated with elderly bathroom falls, as this information may be useful for counseling and preventive purposes. STUDY DESIGN:Database review. METHODS:The National Electronic Injury Surveillance System was evaluated for craniofacial trauma among patients 60 years and older presenting to the emergency department (ED) (2010-2014). Injury descriptions were reviewed for mechanism of injury, patient demographics, and other injury characteristics. RESULTS:In total, 7.2% of the estimated 3.4 million ED visits for elderly craniofacial trauma were bathroom related. Females comprised the majority (60.9%) of patients, and a plurality of patients were in their 80s. A greater proportion of facial injuries resulted from syncope (16.6% vs. 10.9% compared to head injuries). Toilets facilitated a greater proportion of facial insults and were more likely to require admission; the most common mechanism was "falling off." Showers contributed a majority of head injuries and had a lower median age than toilet injuries. Fractures comprised 12.6% of facial injuries; of craniofacial fractures, common sites included the nose (54%), mandible (6%), and orbit (6%). Admitted patients were significantly older than those who were released. CONCLUSIONS:Bathroom falls result in a significant proportion of elderly traumatic injury. The trends we present offer the opportunity for targeted preventative measures to decrease the occurrence of these events. Additionally, this information may adjunct a detailed history and physical to ensure appropriate patient management. LEVEL OF EVIDENCE:4 Laryngoscope, 127:820-827, 2017.