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Biomedical subjects

Hamid R Djalilian

Publications and source records attributed to Hamid R Djalilian.

At least 19 recordsLinked to original sources
PubMed2007

Efficacy of an osmotic pump delivered, GM-CSF-based tumor vaccine in the treatment of upper aerodigestive squamous cell carcinoma in rats.

PURPOSE: Upper aerodigestive tract (UADT) cancer has not experienced significant overall survival improvement for over 20 years, and no successful treatments for systemic disease exist. Most patients with UADT cancer experience immune suppression, therefore immune restorative therapies may offer promise for these patients. We presently tested the efficacy of granulocyte macrophage-colony stimulating factor (GM-CSF) delivered via 28-day continuous infusion pump, in combination with irradiated tumor cells, in a flank model of UADT cancer. METHODS: Five groups of rats were inoculated with syngeneic mucosally derived squamous carcinoma cells (FAT-7). Osmotic minipumps were implanted in the contralateral flank to deliver GM-CSF at 0 (PBS), 0.1, 1, 10, or 100 ng/day (n = 6 per group) for 28 days; 10(6) irradiated FAT-7 cells (ITC) were injected at the site of the GM-CSF infusion on days 0, 3, 7, 14, and 21 immune infiltrates in tumors were analyzed. RESULTS: Rats that received 10 or 100 ng/day GM-CSF/ITC had a significantly slower tumor growth rate compared to those who received 0, 0.1, or 1 ng/day (ANOVA, P < 0.01). There were increased CD 4+, CD 8+, and CD 68+ cells in tumors of GM-CSF/ITC treated animals over controls. CONCLUSION: GM-CSF (10 or 100 ng/day) delivered locally via osmotic pump with ITC slows the growth rate of mucosally derived squamous cell carcinoma in rats while improving immune cell infiltrates. The efficacy of locally delivered GM-CSF immunotherapy in this model may be a first step toward this immunotherapy strategy for humans.

Animals↗
PubMed2006

Treatment of culture-negative skull base osteomyelitis.

OBJECTIVE: To evaluate the efficacy of a therapeutic regimen in the treatment of patients with culture-negative skull base osteomyelitis. STUDY DESIGN: Retrospective case review. SETTING: Tertiary referral hospital. PATIENTS: Eight patients with diabetes mellitus presented with otalgia and were found to have positive technetium and gallium scans of the temporal bone. These patients, however, all had negative cultures of their external auditory canals. All patients had been treated with ototopic drops and two patients had undergone a 2-week course of oral quinolones. INTERVENTIONS: All patients were treated with a 6-week course of intravenous ceftazidime or aztreonam for penicillin-allergic patients, oral ciprofloxacin at a higher dose than normal, and topical aminoglycoside steroid drops. MAIN OUTCOME MEASURES: Resolution of the temporal bone gallium scan abnormality, recurrence rate, and time to discharge from the hospital. RESULTS: The patients were discharged from the hospital within 4 days from admission. All patients showed resolution of the temporal bone abnormality on the gallium scan at the 6-week time point. The median follow-up period was 6 months, and none of the patients had a recurrence of the infection. CONCLUSION: The above-described treatment regimen will result in a high cure rate and a short hospitalization period.

Administration, Topical↗
PubMed2006

Revision tympanoplasty using scar tissue graft.

OBJECTIVE: To evaluate the success rate of subcutaneous postsurgical scar tissue as graft material for revision tympanoplasty operations. STUDY DESIGN: Retrospective case review. SETTING: Tertiary referral center. PATIENTS: Thirty-five patients who underwent revision tympanoplasty with or without mastoidectomy procedures and 36 patients undergoing primary operations who had all the data necessary for the study and a minimum follow-up of 6 months. The mean follow-up period was 12 months (range, 6-18 mo). Mean age, perforation size, cholesteatoma presence, time required for harvesting, and adjunctive mastoidectomies were similar between the two groups. INTERVENTION: The patients undergoing revision tympanoplasty had graft material harvested from the subcutaneous scar tissue. In the control group, temporalis fascia graft was used as graft tissue. MAIN OUTCOME MEASURES: The rate of perforation closure and postoperative hearing change was measured. RESULTS: In the scar tissue tympanoplasty group, 32 of 35 patients (91%) had successful closure of the tympanic membrane perforation, whereas in the control group, the success rate was 92% (p > 0.05). Mean postoperative pure-tone average improvement was 21 dB in the scar tissue tympanoplasty group and 18 dB in the control group (p > 0.05). CONCLUSION: Subcutaneous scar tissue is as successful in perforation closure and hearing improvement as temporalis fascia graft. The use of subcutaneous scar tissue graft is advantageous to other graft materials used in revision tympanoplasty operations in that it can be harvested through the same incision, does not add to the operative time, and does not carry the cost or risk of acellular dermis.

Adolescent↗
PubMed2006

Topical pimecrolimus 1% for the treatment of pruritic external auditory canals.

OBJECTIVES/HYPOTHESIS: To understand the role and efficacy of topical pimecrolimus in the treatment of refractory pruritus of the external auditory canals (EACs). STUDY DESIGN: Retrospective chart review. METHODS: Thirty-six patients with pruritic EACs who had failed conventional therapy with topical and systemic medications were treated with topical pimecrolimus 1% for a period of 3 months. Baseline and follow-up evaluation of the degree of pruritus among other variables was performed. A control group of 19 patients was instructed on aural toilet alone and was not treated with topical pimecrolimus 1%. RESULTS: Of the 36 patients who were treated with topical pimecrolimus for their pruritic EACs, 34 patients had resolution of their symptoms. There was evidence of return of cerumen production in 86% of patients. In the control group, 16% of patients had improvement of their symptoms with aural toilet. This difference was statistically significant (chi, P < .0001). CONCLUSIONS: Topical pimecrolimus appears to be more efficacious than aural toilet in the treatment of pruritic ears for chronic use without side effects.

Administration, Topical↗
PubMed2005

Bell's palsy.

Explore the source record for details and available documents.

Bell Palsy↗
PubMed2005

Transcanal cochlear implantation under monitored anesthesia care.

OBJECTIVE: Given the associated risk of general anesthesia in elderly patients with cardiovascular disease, the authors set out to determine the feasibility of transcanal cochlear implantation under local anesthesia with monitored anesthesia care. METHODS: A 70-year-old man with a history of coronary artery bypass grafting, diabetes mellitus, and an American Society of Anesthesiologists Class III cardiac status underwent cochlear implantation under local with monitored anesthesia care. RESULT: With the described technique and regimen of intravenous remifentanil and dexmedetomidine, the patient tolerated the 60-minute procedure without tachycardia, hyper- or hypotension, or cardiac ischemia. CONCLUSION: Cochlear implantation using the pericanal electrode technique performed under local anesthesia with monitored anesthesia care is possible in patients at risk for undergoing general anesthesia for cochlear implantation.

Aged↗
PubMed2005

Congenital lip pits and van der Woude syndrome.

Van der Woude syndrome is an autosomal dominant disease characterized by lower lip pits with or without cleft lip and/or cleft palate. The lip pits commonly have salivary glands that drain into them, which leads to salivary flow from the lip pits. Lip pits may be associated with submucosal palatal cleft, velopharyngeal insufficiency, or genitourinary or cardiovascular anomalies. The pits are treated by surgical resection. The authors report a case of van der Woude syndrome with isolated lip pits and speech difficulties that had been unrecognized until the patient was 6 years old. The surgical technique is described to ensure that the often-bifurcating tracts are removed entirely.

Child↗
PubMed2004

A new immune-competent animal model of mucosally derived squamous cell carcinoma.

OBJECTIVES: To develop an immune-competent animal model for mucosally derived squamous cell carcinoma (SCCA). STUDY DESIGN: Fifteen Fischer 344 rats were inoculated with 1, 2, 5, 10, or 20 x 10(6) FAT7 cells in their flanks. The animals were observed for tumor growth and metastasis. RESULTS: All animals developed tumors that grew exponentially. Pulmonary metastases developed in all animals and 13% developed lymph node metastases. CONCLUSION: The FAT7 flank tumor in Fischer 344 rats is a new animal model that closely resembles the behavior of human mucosal head and neck cancer. SIGNIFICANCE: The existence of an immune-competent, mucosally derived, and reliable animal model of SCCA that somewhat resembles human head and neck SCCA gives the opportunity to perform immune-modulating experiments on head and neck cancer in these animals. EBM RATING: B-3.

Animals↗
PubMed2003

Resolution of facial stimulation in otosclerotic cochlear implants.

OBJECTIVES: We examined the incidence of facial nerve stimulation in a population of patients with otosclerosis implanted with the Nucleus 22, Clarion 1.2, or Clarion High Focus (CHF) device. STUDY DESIGN AND SETTING: A retrospective chart review was used for 147 patients who had been implanted with electronic cochlear devices at the University of Minnesota between June 1986 and February 2001. Seventy-four patients were implanted with the Nucleus 22, 41 patients were implanted with the Clarion 1.2 (without a positioner), and 32 patients were implanted with the CHF I or II. RESULTS: Eleven (14.9%) of the 74 patients implanted with the Nucleus 22 device had facial stimulation. There were 9 patients with otosclerosis. Seven (78%) of the 9 patients with otosclerosis had facial stimulation. One (2.4%) of the 41 patients implanted with the Clarion 1.2 device (without a positioner) had facial stimulation and that 1 (100%) patient in the group had otosclerosis. There were 4 patients in the CHF group with otosclerosis. One patient experienced stimulation, but it was possible to decrease maximum current levels and still use the electrode pair. CONCLUSION: Facial stimulation appears to be less problematic in patients with otosclerosis implanted with the CHF devices.

Adult↗
PubMed2002

Etiology, pathophysiology of symptoms, and pathogenesis of Meniere's disease.

Endolymphatic hydrops is the pathologic feature associated with Meniere's disease. The development of endolymphatic hydrops appears to arise from multifactorial inheritance with alteration of endolymphatic homeostasis. Various factors associated with the phenomenon of hydrops include functional or anatomic obstruction of endolymphatic flow, malabsorption of endolymph, genetic anomalies, vasodilation, allergy, viral infection, and autoimmunity.

Animals↗
PubMed2002

Metastatic head and neck squamous cell carcinoma to the brain.

BACKGROUND: To evaluate the natural history of patients with metastatic squamous cell carcinoma (SCCA) of the head and neck to the brain. METHODS: A retrospective review of patients with brain metastases treated over a 20-year period identified five that had a head and neck SCCA primary. RESULTS: Five cases of patients with SCCA of the head and neck that developed brain metastases are presented in detail. CONCLUSION: In patients with aggressive disease, large infiltrative lesions, and in late survivors with initially advanced disease, metastasis to the brain should be considered. Perineural metastasis appears to be the most common mode of spread of head and neck SCCA to the brain. Pain, paresis, or paresthesias in the distribution of cranial nerves or other neurological symptoms should alert the otolaryngologist to neural or central nervous system involvement in patients with SCCA of the head and neck. Surgery with or without post-operative whole brain radiation therapy is the mainstay of treatment in most patients. Stereotactic radiosurgery may play a major role in treating brain metastases from head and neck primary tumors.

Aged↗
PubMed2002

Feline immunodeficiency virus-mediated gene therapy of middle ear mucosa cells.

HYPOTHESIS: To investigate the feasibility of gene therapy of the middle ear mucosa using a novel vector. BACKGROUND: Given present medications are unable to affect chronic otitis media, cholesteatoma, or tympanic membrane perforation, newer methods of treatment like gene therapy for these diseases must be explored. These genes can then be used to alter cytokines in the middle ear, slow or stop cholesteatoma growth, or improve tympanic membrane perforation healing. Feline immunodeficiency virus (FIV), a new lentiviral vector has been found to have greater than 90% efficiency in transfecting epithelial cells. Therefore, in vivo gene therapy of middle ear mucosa cells was attempted. METHODS: Twenty microliter of 5x10(5) vectors per ml FIV carrying the gene for green fluorescence protein (GFP) was introduced into the middle ears of Sprague-Dawley rats via a bulla approach. RESULTS: Expression of the GFP gene was observed in the middle ear mucosa cells at 1 week post-inoculation indicating transfection. CONCLUSION: Gene therapy of the middle ear is feasible with a FIV-based vector.

Animals↗
PubMed2002

Reconstruction of complicated skull base defects utilizing free tissue transfer.

We managed five patients with large skull base defects complicated by complex infections with microvascular free tissue transfer. The first patient developed an infection, cerebrospinal fluid (CSF) leak, and meningitis after undergoing a translabyrinthine resection of an acoustic neuroma. The second patient had a history of a gunshot wound to the temporal bone, with a large defect and an infected cholesteatoma that caused several episodes of meningitis. The third through the fifth patients had persistent CSF leakage and infection refractory to conventional therapy. In all cases prior attempts of closure with fat grafts or regional flaps had failed. Rectus abdominis myofascial free flap, radial forearm free flap or a gracilis muscle free flap was used after debridement of the infected cavities. The CSF leaks, local infections, and meningitis were controlled within a week. In our experience, microvascular free tissue provides the necessary bulk of viable, well-vascularized tissue, which not only assures a mechanical seal but also helps clear the local infection.

Case Reports↗
PubMed2002

High-resolution magnetic resonance imaging of human cochlea.

OBJECTIVES: High-resolution MRI (MRI) of human inner ear structures provides several advantages over other imaging modalities. High-resolution visualization of inner ear ultrastructure in a noninvasive manner may provide important information about inner ear disease that is not obtainable in other ways. The study was performed to demonstrate the capabilities of MRI at high resolution on the human cochlea, vestibular structures, and facial nerve. Comparative analyses of MRI anatomy with that seen on histological dissection were made. The aim of the study was to define the anatomy of human cadaveric cochlea using a 9.4-Tesla magnetic resonance scanner, currently the most powerful magnetic resonance magnet available. STUDY DESIGN: Experimental pilot study of cadaveric human cochleae. METHODS: Serial scanning using a 9.4-Tesla magnetic resonance imager on normal preserved and fresh cadaveric inner ears was performed in different planes. RESULTS: The images revealed detailed anatomy of the modiolus, utricle, saccule, semicircular canals, and facial nerve. Specifically, identifiable structures within the cochlea included the osseous spiral lamina, Reissner's membrane, membranous spiral lamina, spiral ligament, and others. CONCLUSIONS: Data established through the acquisition of images from cadaver cochlea, facial nerve, and vestibular complex provide a foundation for developing steps for testing temporal bones and, eventually, patients with Meniere's disease and other inner ear disease. The present ongoing project will provide information on baseline images of the inner ear using high-resolution MRI.

Cochlea↗
PubMed2002

Temporal bone histopathology related to cochlear implantation in congenital malformation of the bony cochlea.

HYPOTHESIS: Histopathologic findings in temporal bones with congenital malformations of the bony cochlea may provide insight into cochlear implantation planning, surgical approach, and complications. BACKGROUND: Patients with congenitally malformed cochleae account for an increasing percentage of candidates for cochlear implantation. Few studies on the relationship between histopathologic findings of temporal bones with malformation of the bony cochlea and cochlear implantation have been reported. METHODS: We studied 21 temporal bones from 12 cases with congenital malformations of the bony cochlea. Ages ranged from stillborn to 50 years. Length of the cochleae and dimensions of facial recesses were measured with light microscopy. Other malformations associated with a shortened cochlea were determined, emphasizing how they affect cochlear implantation. RESULTS: The average length of the malformed cochlear duct was 22.84 +/- 0.69 mm. Average dimensions of facial recesses were not significantly different between malformed cochleae and the controls. Other malformations included enlarged cochlear aqueduct (43%), abnormal facial nerve course (57%), enlarged vestibular aqueduct (52%), aplasia of the middle ear (19%), malformed ossicles (67%), abnormal oval window (57%), and abnormal round window (29%). CONCLUSION: A shortened cochlear duct may cause an incomplete insertion of the implant electrode. Because dimensions of the facial recesses are similar to normal cases, a facial recess surgical approach is recommended. An enlarged cochlear aqueduct may cause perilymphatic oozing or gushing on fenestration of the cochlea. An anomalous course of the facial nerve is a common finding. Tympanic malformations such as round and oval window deformities and small middle ear cleft should be noted preoperatively to better guide surgery.

Adolescent↗