Clara Olcott - Academia.edu (original) (raw)

Papers by Clara Olcott

Research paper thumbnail of Facial Plastic and Reconstructive Surgery

Presentation schedule is subject to change. The Official Program Abstracts supplement does not re... more Presentation schedule is subject to change. The Official Program Abstracts supplement does not reflect changes made after August 13, 2021. usage and total calcium supplementation were not predictive of readmission rates or ED visits. Conclusion: Higher preoperative PTH levels were independently predictive of 30-day readmission rates, 30-day ED visits related to hypocalcemia, and HBS following surgery. We note a PTH cutoff value of 1960 pg/mL, which identifies a high-risk group that can be used to guide calcium replacement protocols postoperatively. Thyroid imaging Reporting and Data systems (Ti-RADsTM) in Community setting Easwer Raman (Presenter); Jagdish K. Dhingra, MBBS, FRCS Introduction: Ultrasound (US)-guided fine-needle aspiration (FNA) forms the basis of investigation of thyroid nodules. Various risk stratification criteria based on US features have been proposed to help decide which nodules to investigate by FNA. The 2 most widely used systems are the American Thyroid Association (ATA) 2015 recommendations and the 2017 TI-RADS of the American College of Radiology (ACR). We aim to analyze the adoption and performance of the TI-RADS system over a 3-year period in a community setting. Method: All patients referred for FNA of thyroid nodule/s to a dedicated ultrasound clinic over a 3-year period between January 2018 and December 2020 were studied. Prior to performing the FNA, nodules were prospectively assigned to 1 of 5 ATA risk categories by the senior author (J.K.D.), who was blinded to the TI-RADS score. Radiology reports were retrospectively reviewed for the TI-RADS scores. The percentage of patients that had TI-RADS scores assigned was calculated for each of the 3 years. Using cytology as the gold standard, performance of the ATA risk stratification system and the ACR TI-RADS score was compared. Results: A total of 943 nodules were studied. Adoption of the ACR TI-RADS increased from 6.72% through 21.76% to 42.91% over 3 years. A total of 216 nodules had both the ATA risk category and TI-RADSTM score data. Some 38 of 216 nodules (17.59%) yielded positive FNA results-defined as either Bethesda category 5/6 or Bethesda category 3/4 with suspicious Afirma® Gene sequencing classifier. ATA system yielded sensitivity, specificity, and negative and positive predicted values of 62.5%, 95.1%, 96.3%, and 55.6%, respectively, compared with 50.0%, 28.6%, 72.3%, and 13.1%, respectively, with the TI-RADSTM scores. Conclusion: In our community, there has been a gradual but slow adoption of the TI-RADSTM by radiologists, with less than 50% adoption, more than 3 years after its implementation. In our experience, ATA stratification is associated with a higher degree of sensitivity and specificity compared with the TI-RADSTM system.

Research paper thumbnail of Mesoporous silica-supported lipid bilayers (protocells) for DNA cargo delivery to the spinal cord

Mesoporous silica-supported lipid bilayers (protocells) for DNA cargo delivery to the spinal cord

Journal of Controlled Release, 2013

Amorphous mesoporous silica nanoparticles (&a... more Amorphous mesoporous silica nanoparticles ('protocells') that support surface lipid bilayers recently characterized in vitro as carrier constructs for small drug and DNA delivery are reported here as highly biocompatible both in vitro and in vivo, involving the brain and spinal cord following spinal delivery into the lumbosacral subarachnoid space (intrathecal; i.t.). Specifically, positively charged, 1, 2-Dioleoyl-3-Trimethylammonium-Propane (DOTAP)-cholesterol (DOTAP:Chol) liposome-formulated protocells revealed stable in vitro cargo release kinetics and cellular interleukin-10 (IL-10) transgene transfection. Recent approaches using synthetic non-viral vector platforms to deliver the pain-suppressive therapeutic transgene, IL-10, to the spinal subarachnoid space have yielded promising results in animal models of peripheral neuropathy, a condition involving aberrant neuronal communication within sensory pathways in the nervous system. Non-viral drug and gene delivery protocell platforms offer potential flexibility because cargo release-rates can be pH-dependent. We report here that i.t. delivery of protocells, with modified chemistry supporting a surface coating of DOTAP:Chol liposomes and containing the IL-10 transgene, results in functional suppression of pain-related behavior in rats for extended periods. This study is the first demonstration that protocell vectors offer amenable and enduring in vivo biological characteristics that can be applied to spinal gene delivery.

Research paper thumbnail of The current trend of autologous costal cartilage harvest by facial plastic surgeons for rhinoplasty in the United States

Plastic and Aesthetic Research, 2019

Aim: To assess the safety profile and practice trend of autologous costal cartilage harvest by fa... more Aim: To assess the safety profile and practice trend of autologous costal cartilage harvest by facial plastic surgeons in the United States (US). Methods: A 10-question online survey was distributed by the American Academy of Facial Plastic and Reconstructive Surgery to its members. Results: Of the 2,639 members, 2,379 received the survey with 137 (5.76%) members responded. The majority (33.6%) of the respondents were expert facial plastic surgeons. One hundred and nine (79.6%) of the respondents performed rib harvest with 49.6% of them performing the procedure at a hospital facility. Among them, 21.5% exclusively performed their surgery at an ambulatory surgical center not physically attached to a hospital while 6.67% of them at the in-office accredited operating room. When comparing techniques, 64.7% performed only full-thickness rib grafts vs. 12.0% harvesting partial-thickness rib grafts. Most used an incision length between 2.1 and 4 cm (64.4%) while 2 surgeons used < 1 cm i...

Research paper thumbnail of Development of Upper Aerodigestive Tract Complications in Patients with Stage IV Thyroid Cancer Receiving Tyrosine Kinase Inhibitors

AACE Clinical Case Reports

Objective: Tyrosine kinase inhibitors (TKIs) are a class of systemic chemotherapy used in patient... more Objective: Tyrosine kinase inhibitors (TKIs) are a class of systemic chemotherapy used in patients with radioactive iodine-refractory metastatic thyroid cancer. TKIs have been linked with impaired wound healing, but their association with upper aerodigestive tract complications is not well defined. The objective of this case series was to demonstrate that upper aerodigestive tract complications can occur in thyroid cancer patients receiving TKIs. Methods: A retrospective chart review was conducted on 3 cases involving patients with stage IV differentiated or medullary thyroid cancer treated between the years from 2000 to 2015. Each patient received surgical management, external beam radiation therapy, and subsequent TKI therapy and they also developed upper aerodigestive tract complications during their clinical course. Results: Patient 1 received TKIs for radioactive iodine-refractory pulmonary metastases and developed a tracheoesophageal fistula 1 year after initiation of chemotherapy. Patient 2 received TKIs for pulmonary metastases and developed a tracheoesophageal fistula several months after initiation of chemotherapy. Patient 3 was placed on TKIs for progressive metastatic disease 9 years after initial intervention and later developed laryngeal necrosis. Conclusion: Systemic TKIs can offer a clinical benefit in patients with metastatic thyroid cancer. However, clinicians should monitor patients for upper aerodigestive tract fistula formation and tissue necrosis during and after TKI therapy. Although a history of external beam radiation therapy may place patients at increased risk for fistula development, further investigation is needed to determine the relative risk associated with subsequent TKI exposure in these patients. (AACE Clinical Case Rep. 2018;4:e270-e274) Abbreviations: DTC = differentiated thyroid cancer; EBRT = external beam radiation therapy; MKI = multikinase inhibitor; MTC = medullary thyroid cancer; RAI = radioactive iodine; TEF = tracheoesophageal fistula; TKI = tyrosine kinase inhibitor; VEGFR = vascular endothelial growth factor receptor e272 UADT complications and TKIs, AACE Clinical Case Rep. 2018;4(No. 4)

Research paper thumbnail of Anatomy of the superficial temporal artery in patients with unilateral microtia

Anatomy of the superficial temporal artery in patients with unilateral microtia

Journal of Plastic, Reconstructive & Aesthetic Surgery

Research paper thumbnail of A blue middle ear mass: Cholesterol granuloma mimicking a glomus tumor and endolymphatic sac tumor

A blue middle ear mass: Cholesterol granuloma mimicking a glomus tumor and endolymphatic sac tumor

American Journal of Otolaryngology

Research paper thumbnail of Innovative application of intraoperative laser-assisted fluorescence angiography in resection of an angiosarcoma of the scalp

Innovative application of intraoperative laser-assisted fluorescence angiography in resection of an angiosarcoma of the scalp

American Journal of Otolaryngology

Research paper thumbnail of A case of congenital agenesis of the common carotid artery

Ectopic parathyroid adenomas can be encountered during four gland explorations, but nearly 80% of... more Ectopic parathyroid adenomas can be encountered during four gland explorations, but nearly 80% of adenomas are localized with ultrasound and sestamibi imaging. Ectopic adenomas are thought to arise from abnormal migration during development. As a cervical congenital anomaly, common carotid artery agenesis is an extremely rare anomaly characterized by separate origins of the internal and external carotid arteries directly from the aortic arch. Here we present a case of a 75 year old man with primary hyperparathyroidism who was found to have congenital agenesis of the common carotid artery associated with an ectopic parathyroid adenoma within the parapharyngeal space, which mimicked a carotid body tumor based on location and imaging. The successful identification and resection of the ectopic parathyroid adenoma presented here demonstrate the importance of preoperative imaging studies to allow appropriate operative planning as well as the utility of intraoperative parathyroid hormone assay in predicting cure during surgery.

Research paper thumbnail of Interleukin-9 and interleukin-17C in chronic rhinosinusitis

Interleukin-9 and interleukin-17C in chronic rhinosinusitis

International forum of allergy & rhinology, Aug 17, 2016

Interleukin (IL)-9 and IL-17C have been known to play a role in allergic inflammation, yet, their... more Interleukin (IL)-9 and IL-17C have been known to play a role in allergic inflammation, yet, their roles in chronic rhinosinusitis (CRS) are not well defined. IL-9 induces changes in epithelial cell gene expression leading to goblet cell metaplasia, whereas IL-17C is functionally distinct in that its expression can be induced by bacterial challenge and inflammatory stimuli. This study aimed to compare levels of IL-9 and IL-17C in CRS with nasal polyps (CRSwNP) and without nasal polyps (CRSsNP) as well as atopy. Nasal polyp or sinus mucosal specimens from CRSwNP (n = 36), CRSsNP (n = 9), and control (n = 9) groups were collected and processed. Patient atopy status was determined by history of skin-prick test and pulmonary function test. Immunohistochemistry was carried out using anti-human IL-9 and IL-17C antibodies. Positively-stained cells were enumerated under high-power (×400) magnification in 5 consecutive fields. The level of expression of IL-9 was higher in CRSwNP than CRSsNP a...

Research paper thumbnail of Facial Plastic and Reconstructive Surgery

Presentation schedule is subject to change. The Official Program Abstracts supplement does not re... more Presentation schedule is subject to change. The Official Program Abstracts supplement does not reflect changes made after August 13, 2021. usage and total calcium supplementation were not predictive of readmission rates or ED visits. Conclusion: Higher preoperative PTH levels were independently predictive of 30-day readmission rates, 30-day ED visits related to hypocalcemia, and HBS following surgery. We note a PTH cutoff value of 1960 pg/mL, which identifies a high-risk group that can be used to guide calcium replacement protocols postoperatively. Thyroid imaging Reporting and Data systems (Ti-RADsTM) in Community setting Easwer Raman (Presenter); Jagdish K. Dhingra, MBBS, FRCS Introduction: Ultrasound (US)-guided fine-needle aspiration (FNA) forms the basis of investigation of thyroid nodules. Various risk stratification criteria based on US features have been proposed to help decide which nodules to investigate by FNA. The 2 most widely used systems are the American Thyroid Association (ATA) 2015 recommendations and the 2017 TI-RADS of the American College of Radiology (ACR). We aim to analyze the adoption and performance of the TI-RADS system over a 3-year period in a community setting. Method: All patients referred for FNA of thyroid nodule/s to a dedicated ultrasound clinic over a 3-year period between January 2018 and December 2020 were studied. Prior to performing the FNA, nodules were prospectively assigned to 1 of 5 ATA risk categories by the senior author (J.K.D.), who was blinded to the TI-RADS score. Radiology reports were retrospectively reviewed for the TI-RADS scores. The percentage of patients that had TI-RADS scores assigned was calculated for each of the 3 years. Using cytology as the gold standard, performance of the ATA risk stratification system and the ACR TI-RADS score was compared. Results: A total of 943 nodules were studied. Adoption of the ACR TI-RADS increased from 6.72% through 21.76% to 42.91% over 3 years. A total of 216 nodules had both the ATA risk category and TI-RADSTM score data. Some 38 of 216 nodules (17.59%) yielded positive FNA results-defined as either Bethesda category 5/6 or Bethesda category 3/4 with suspicious Afirma® Gene sequencing classifier. ATA system yielded sensitivity, specificity, and negative and positive predicted values of 62.5%, 95.1%, 96.3%, and 55.6%, respectively, compared with 50.0%, 28.6%, 72.3%, and 13.1%, respectively, with the TI-RADSTM scores. Conclusion: In our community, there has been a gradual but slow adoption of the TI-RADSTM by radiologists, with less than 50% adoption, more than 3 years after its implementation. In our experience, ATA stratification is associated with a higher degree of sensitivity and specificity compared with the TI-RADSTM system.

Research paper thumbnail of Mesoporous silica-supported lipid bilayers (protocells) for DNA cargo delivery to the spinal cord

Mesoporous silica-supported lipid bilayers (protocells) for DNA cargo delivery to the spinal cord

Journal of Controlled Release, 2013

Amorphous mesoporous silica nanoparticles (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;a... more Amorphous mesoporous silica nanoparticles (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;protocells&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;) that support surface lipid bilayers recently characterized in vitro as carrier constructs for small drug and DNA delivery are reported here as highly biocompatible both in vitro and in vivo, involving the brain and spinal cord following spinal delivery into the lumbosacral subarachnoid space (intrathecal; i.t.). Specifically, positively charged, 1, 2-Dioleoyl-3-Trimethylammonium-Propane (DOTAP)-cholesterol (DOTAP:Chol) liposome-formulated protocells revealed stable in vitro cargo release kinetics and cellular interleukin-10 (IL-10) transgene transfection. Recent approaches using synthetic non-viral vector platforms to deliver the pain-suppressive therapeutic transgene, IL-10, to the spinal subarachnoid space have yielded promising results in animal models of peripheral neuropathy, a condition involving aberrant neuronal communication within sensory pathways in the nervous system. Non-viral drug and gene delivery protocell platforms offer potential flexibility because cargo release-rates can be pH-dependent. We report here that i.t. delivery of protocells, with modified chemistry supporting a surface coating of DOTAP:Chol liposomes and containing the IL-10 transgene, results in functional suppression of pain-related behavior in rats for extended periods. This study is the first demonstration that protocell vectors offer amenable and enduring in vivo biological characteristics that can be applied to spinal gene delivery.

Research paper thumbnail of The current trend of autologous costal cartilage harvest by facial plastic surgeons for rhinoplasty in the United States

Plastic and Aesthetic Research, 2019

Aim: To assess the safety profile and practice trend of autologous costal cartilage harvest by fa... more Aim: To assess the safety profile and practice trend of autologous costal cartilage harvest by facial plastic surgeons in the United States (US). Methods: A 10-question online survey was distributed by the American Academy of Facial Plastic and Reconstructive Surgery to its members. Results: Of the 2,639 members, 2,379 received the survey with 137 (5.76%) members responded. The majority (33.6%) of the respondents were expert facial plastic surgeons. One hundred and nine (79.6%) of the respondents performed rib harvest with 49.6% of them performing the procedure at a hospital facility. Among them, 21.5% exclusively performed their surgery at an ambulatory surgical center not physically attached to a hospital while 6.67% of them at the in-office accredited operating room. When comparing techniques, 64.7% performed only full-thickness rib grafts vs. 12.0% harvesting partial-thickness rib grafts. Most used an incision length between 2.1 and 4 cm (64.4%) while 2 surgeons used < 1 cm i...

Research paper thumbnail of Development of Upper Aerodigestive Tract Complications in Patients with Stage IV Thyroid Cancer Receiving Tyrosine Kinase Inhibitors

AACE Clinical Case Reports

Objective: Tyrosine kinase inhibitors (TKIs) are a class of systemic chemotherapy used in patient... more Objective: Tyrosine kinase inhibitors (TKIs) are a class of systemic chemotherapy used in patients with radioactive iodine-refractory metastatic thyroid cancer. TKIs have been linked with impaired wound healing, but their association with upper aerodigestive tract complications is not well defined. The objective of this case series was to demonstrate that upper aerodigestive tract complications can occur in thyroid cancer patients receiving TKIs. Methods: A retrospective chart review was conducted on 3 cases involving patients with stage IV differentiated or medullary thyroid cancer treated between the years from 2000 to 2015. Each patient received surgical management, external beam radiation therapy, and subsequent TKI therapy and they also developed upper aerodigestive tract complications during their clinical course. Results: Patient 1 received TKIs for radioactive iodine-refractory pulmonary metastases and developed a tracheoesophageal fistula 1 year after initiation of chemotherapy. Patient 2 received TKIs for pulmonary metastases and developed a tracheoesophageal fistula several months after initiation of chemotherapy. Patient 3 was placed on TKIs for progressive metastatic disease 9 years after initial intervention and later developed laryngeal necrosis. Conclusion: Systemic TKIs can offer a clinical benefit in patients with metastatic thyroid cancer. However, clinicians should monitor patients for upper aerodigestive tract fistula formation and tissue necrosis during and after TKI therapy. Although a history of external beam radiation therapy may place patients at increased risk for fistula development, further investigation is needed to determine the relative risk associated with subsequent TKI exposure in these patients. (AACE Clinical Case Rep. 2018;4:e270-e274) Abbreviations: DTC = differentiated thyroid cancer; EBRT = external beam radiation therapy; MKI = multikinase inhibitor; MTC = medullary thyroid cancer; RAI = radioactive iodine; TEF = tracheoesophageal fistula; TKI = tyrosine kinase inhibitor; VEGFR = vascular endothelial growth factor receptor e272 UADT complications and TKIs, AACE Clinical Case Rep. 2018;4(No. 4)

Research paper thumbnail of Anatomy of the superficial temporal artery in patients with unilateral microtia

Anatomy of the superficial temporal artery in patients with unilateral microtia

Journal of Plastic, Reconstructive & Aesthetic Surgery

Research paper thumbnail of A blue middle ear mass: Cholesterol granuloma mimicking a glomus tumor and endolymphatic sac tumor

A blue middle ear mass: Cholesterol granuloma mimicking a glomus tumor and endolymphatic sac tumor

American Journal of Otolaryngology

Research paper thumbnail of Innovative application of intraoperative laser-assisted fluorescence angiography in resection of an angiosarcoma of the scalp

Innovative application of intraoperative laser-assisted fluorescence angiography in resection of an angiosarcoma of the scalp

American Journal of Otolaryngology

Research paper thumbnail of A case of congenital agenesis of the common carotid artery

Ectopic parathyroid adenomas can be encountered during four gland explorations, but nearly 80% of... more Ectopic parathyroid adenomas can be encountered during four gland explorations, but nearly 80% of adenomas are localized with ultrasound and sestamibi imaging. Ectopic adenomas are thought to arise from abnormal migration during development. As a cervical congenital anomaly, common carotid artery agenesis is an extremely rare anomaly characterized by separate origins of the internal and external carotid arteries directly from the aortic arch. Here we present a case of a 75 year old man with primary hyperparathyroidism who was found to have congenital agenesis of the common carotid artery associated with an ectopic parathyroid adenoma within the parapharyngeal space, which mimicked a carotid body tumor based on location and imaging. The successful identification and resection of the ectopic parathyroid adenoma presented here demonstrate the importance of preoperative imaging studies to allow appropriate operative planning as well as the utility of intraoperative parathyroid hormone assay in predicting cure during surgery.

Research paper thumbnail of Interleukin-9 and interleukin-17C in chronic rhinosinusitis

Interleukin-9 and interleukin-17C in chronic rhinosinusitis

International forum of allergy & rhinology, Aug 17, 2016

Interleukin (IL)-9 and IL-17C have been known to play a role in allergic inflammation, yet, their... more Interleukin (IL)-9 and IL-17C have been known to play a role in allergic inflammation, yet, their roles in chronic rhinosinusitis (CRS) are not well defined. IL-9 induces changes in epithelial cell gene expression leading to goblet cell metaplasia, whereas IL-17C is functionally distinct in that its expression can be induced by bacterial challenge and inflammatory stimuli. This study aimed to compare levels of IL-9 and IL-17C in CRS with nasal polyps (CRSwNP) and without nasal polyps (CRSsNP) as well as atopy. Nasal polyp or sinus mucosal specimens from CRSwNP (n = 36), CRSsNP (n = 9), and control (n = 9) groups were collected and processed. Patient atopy status was determined by history of skin-prick test and pulmonary function test. Immunohistochemistry was carried out using anti-human IL-9 and IL-17C antibodies. Positively-stained cells were enumerated under high-power (×400) magnification in 5 consecutive fields. The level of expression of IL-9 was higher in CRSwNP than CRSsNP a...