Multimodal Handheld Probe for Characterizing Otitis Media - Integrating Raman Spectroscopy and Optical Coherence Tomography.

Otitis media (OM) is a common disease of the middle ear, affecting 80% of children before the age of three. The otoscope, a simple illuminated magnifier, is the standard clinical diagnostic tool to observe the middle ear. However, it has limited contrast to detect signs of infection, such as clearly identifying and characterizing middle ear fluid or biofilms that accumulate within the middle ear.

Cost-effectiveness of polysomnography in the management of pediatric obstructive sleep apnea.

Objectives: At our institution, younger children require polysomnography (PSG) testing to confirm obstructive sleep apnea (OSA hereafter) before surgical intervention by adenotonsillectomy (T&A). Given that sleep studies can be costly, we investigated the cost-effectiveness of PSG as well as the possible role for symptom documentation in evaluation for T&A.

Methods: Pediatric patients age 1-3 years who received PSG testing between Jan.

Single cell analysis of human tissues and solid tumors with mass cytometry.

Background: Mass cytometry measures 36 or more markers per cell and is an appealing platform for comprehensive phenotyping of cells in human tissue and tumor biopsies. While tissue disaggregation and fluorescence cytometry protocols were pioneered decades ago, it is not known whether established protocols will be effective for mass cytometry and maintain cancer and stromal cell diversity.

Methods: Tissue preparation techniques were systematically compared for gliomas and melanomas, patient derived xenografts of small cell lung cancer, and tonsil tissue as a control.

Prevention of pressure ulcers after pediatric tracheotomy using a Mepilex Ag dressing.

Objectives/hypothesis: Skin irritation and ulceration beneath the tracheostomy tube or ties secondary to pressure and shearing forces on the skin frequently complicate pediatric tracheotomy in the immediate postoperative period. The aim of this study is to determine the effectiveness of Mepilex Ag dressings in reducing posttracheotomy wound complications.

Study Design: Retrospective study.

Detection of viruses in human adenoid tissues by use of multiplex PCR.

By PCR, we detected a high frequency of viruses in adenoids obtained from children without acute respiratory symptoms. Our results suggest that persistent/latent viral infection in the respiratory tract confounds interpretation of the association of pathogen detection by PCR with acute respiratory infection in these sources.

Tracheotomy in the preschool population: indications and outcomes.

Objective: Although more tracheotomy procedures are performed within the first year of life than in any other age group, preschool-aged children requiring tracheotomy remain understudied. We characterize the indications and outcomes for patients between the ages of 3 and 6 years undergoing tracheotomy.

Methods: Out of 480 pediatric tracheotomy procedures performed at a tertiary-care hospital between 1988 and 2004, 15 patients underwent primary tracheotomy between 3 and 6 years of age.

Tracheotomy in the first year of life: outcomes in term infants, the Vanderbilt experience.

Objective: In an era emphasizing critical care of preterm infants, we characterize the indications and outcomes of tracheotomies performed in the first year of life in term infants compared to preterm infants.

Methods: Retrospective study of 127 tracheotomies performed in the first year of life at a tertiary-care children's hospital between 1988-2004.

Results: Mean gestational ages of the term and preterm groups were 38.

Use of AlloDerm in type I tympanoplasty: a comparison with native tissue grafts.

Objectives: AlloDerm, an acellular human dermis allograft, has been shown to be an effective option as a tympanic membrane (TM) graft in animals and humans and has several potential advantages, including eliminating donor site morbidity, reducing operative time, and preserving native tissues for later use. We compared AlloDerm and native tissue grafts in type I tympanoplasty with regard to operative time, graft success rate, and audiologic outcome.

Study Design: A retrospective chart review of tympanoplasties performed at a major tertiary referral hospital over a 31 month period, starting with the first use of AlloDerm for TM grafting at this institution.

Growth of respiratory syncytial virus in primary epithelial cells from the human respiratory tract.

Respiratory syncytial virus (RSV) is the most important cause of lower respiratory tract disease in infants and children. To study RSV replication, we have developed an in vitro model of human nasopharyngeal mucosa, human airway epithelium (HAE). RSV grows to moderate titers in HAE, though they are significantly lower than those in a continuous epithelial cell line, HEp-2.

Microlaryngoscopy-airway management with anaesthetic techniques for CO(2) laser.

Carbon dioxide laser microlaryngoscopy requires planning and cooperation of both the anaesthesiologist and surgeon. While there are potentially significant complications, such as fire and difficulty ventilating the patient, laser microlaryngoscopy techniques provide the benefit of allowing for precise management of a wide range of upper airway conditions. Laryngoscopy and bronchoscopy require that the surgeon and anaesthesiologist cooperate in order to maximize exposure for the surgeon and allow for adequate ventilation of the patient.