bluuebunny/crossref_metadata_2025 huggingface dataset:
Introduction
Authors: Milhaupt Curtis J. , West Mark D.
Published: August 2004

Outlines the author's institutional and empirical approach, which is to look at the ‘big picture’ rules of the game (institutions, in the form of both formal laws and informal norms and practices) and the fine detail of how those rules are actually impacting incentives, information, and bargaining in the Japanese economy (empirics). In each chapter, the authors explain behaviour in the Japanese economy as a function of the rules of the game. Where applicable, they describe how these rules are changing and why. This approach, novel to studies of Japan, offers compelling answers to heretofore unanswered questions, and provides new perspectives on debates scholars may have thought to be settled.
Sokaiya
Authors: Milhaupt Curtis J. , West Mark D.
Published: August 2004

Chapters 5 and 6 examine the dark side of Japanese economic institutions. Discusses the unusual and problematic form that shareholder activism has traditionally taken in Japan—professional disturbers of shareholders meetings, or ‘sokaiya’. Again we see the impact of institutions on behaviour, as the workings of the sokaiya are directly linked to the quality of corporate information disclosure in Japan, a function of the institutional environment in which Japanese firms operate.
Organized Crime
Authors: Milhaupt Curtis J. , West Mark D.
Published: August 2004

Examines the problem of organized crime. Shows how Japan's institutional environment for economic activity—specifically gaps between legal rights ‘on the books’ and the state's ability to enforce those rights in practice—have provided incentives for entrepreneurship on the dark side of society. Japanese organized crime syndicates, like other actors in the economy, respond to the rules of the game.
Mergers and Acquisitions
Authors: Milhaupt Curtis J. , West Mark D.
Published: August 2004

Chapters 7 and 8 show how institutional changes can lead to positive results. Explains why there are so few changes of corporate control in Japan, and examines how legal and other reforms relating to mergers and acquisitions are bringing about potentially far‐reaching changes in the way Japanese firms are governed.
Looking Ahead
Authors: Milhaupt Curtis J. , West Mark D.
Published: August 2004

Provides the authors’ concluding observations. They note Japan's ‘move toward law’, discuss some limitations of their study, and end with a mildly optimistic assessment of the institutional changes taking place in Japan over the past decade.
Pantoprazole for Sleepiness Associated with Acid Reflux and Obstructive Sleep Disordered Breathing
Authors: Steward David L.
Published: August 2004

Objective: To determine the effectiveness of Pantoprazole (Wyeth Pharmaceuticals Inc., Philadelphia, PA) therapy for daytime sleepiness in patients with symptoms of acid reflux and obstructive sleep‐disordered breathing (OSDB).

Study Design: Prospective interventional cohort study.

Methods: Twenty‐seven adult subjects (67% men) with symptoms of acid reflux disease and mild to moderate OSDB were included in a 3‐month study of proton pump inhibitor therapy (Pantoprazole 40 mg once daily). Primary outcomes included changes in daytime sleepiness, reflux symptoms, and bed partner assessment of snoring. Secondary outcomes included changes in snoring quantification, apnea, and apnea‐hypopnea indices (AHI) with SNAP Laboratories (Glenview, IL) home sleep study and self‐reported global symptom improvement.

Results: At baseline, patients were typically middle‐aged, obese men with mild to moderate sleep apnea (mean AHI = 15) with excessive daytime somnolence (mean Epworth Sleepiness Score = 13). After 3‐month treatment with Pantoprazole, a statistically significant improvement was noted for daytime sleepiness (P = .002) and total reflux symptoms (P = .0006). Subjects also reported a significant reduction in reflux awakening them from sleep (P < .0001). Bed‐partner assessment of snoring significantly improved (P = .03); however, no significant improvements were noted in snoring quantification, apnea, or AHI. When compared with a disease‐severity matched historic placebo‐control group, this cohort demonstrated a significantly greater reduction in daytime sleepiness (P = .04).

Conclusions: This cohort of subjects had significant improvements in daytime sleepiness and reflux symptoms, including reflux awakening from sleep, with Pantoprazole therapy. Further controlled studies are indicated to confirm these results. Improvement in daytime somnolence likely resulted from a reduction in reflux‐related arousals because no improvements occurred in OSDB.
Cricoid Chondrosarcoma Presenting as Arytenoid Hypertelorism
Authors: Koufman Jamie A. , Cohen Jacob T. , Gupta Sumeer , Postma Gregory N.
Published: August 2004

Background: Arytenoid hypertelorism (arytenoid cartilages spaced too widely apart) appears to be the most common initial recognizable physical finding of cricoid chondrosarcoma. Nine cases from the Center for Voice Disorders are presented. With arytenoid hypertelorism caused by cricoid chondrosarcoma, usually the posterior larynx is open. In fact, patients with arytenoid hypertelorism caused by cricoid chondrosarcoma may be aphonic even though the anterior membranous vocal folds make contact during attempted phonation.

Methods: Between 1991 and 2002, nine patients were diagnosed with cricoid chondrosarcoma. Patients' charts and video examinations were retrospectively evaluated for symptoms and the presence of arytenoid hypertelorism on endoscopic evaluation. Two were women, and seven were men, with a mean age of 70 (range 53–72) years at diagnosis.

Results: Eight (88%) patients had aphonia or dysphonia caused by arytenoid hypertelorism as their presenting symptom. Six were diagnosed after failed medialization laryngoplasty or other laryngeal rehabilitation surgery. All nine patients had a low‐grade tumor. The initial treatment in eight patients was hemicricoidectomy, and one patient had a total laryngectomy. In four cases, a second procedure was needed 1 to 6 years later because of recurrence. Seven patients are alive without clinically significant disease; one is alive with moderate disease, and one has died from an unrelated cause.

Conclusions: Severely dysphonic, elderly patients presenting with arytenoid hypertelorism of unknown cause should be evaluated by fiberoptic laryngoscopy and by computed tomography scan to rule out cricoid chondrosarcoma. Because these tumors behave so benignly, the authors recommend conservative surgery (unilateral hemicricoidectomy) as the diagnostic/treatment modality of choice.
Chronic Rhizopus Invasive Fungal Rhinosinusitis in an Immunocompetent Host
Authors: Scharf Joshua L. , Soliman Ahmed M. S.
Published: August 2004

Hypothesis:
Rhizopus species may cause chronic invasive fungal rhinosinusitis in an immunocompetent host.

Study Design: Individual case report.

Methods: Review of inpatient and outpatient records, radiographic studies, pathologic examination, and microbiology of the presented case. Review of the literature.

Results:
Rhizopus species may be the cause of chronic invasive fungal rhinosinusitis in an immunocompetent host and result in intracranial extension.
Cochlear Implantation in Adults with Prelingual Deafness. Part I. Clinical Results
Authors: Wooi Teoh Su , Pisoni David B. , Miyamoto Richard T.
Published: August 2004

Objectives/Hypothesis: To examine the hypothesis that the newer generations of cochlear implants could provide considerable speech understanding to late‐implanted, prelingually deaf adult patients.

Study Design: Retrospective review.

Methods: Speech perception scores of 103 patients with long‐term prelingual deafness obtained from the recent clinical trials were compared with other previously published results.

Results: Unlike patients receiving implants in early childhood, the audiologic performance of most patients with long‐term prelingual deafness rapidly approached asymptotic levels within 1 year after implantation. Beginning at 3 months postimplantation, statistically significant improvement was noted in their speech perception scores compared with their preimplant levels. However, the average performance plateau achieved by this group of patients was significantly below the levels published for postlingual patients. No statistically significant differences were observed between the test scores at any testing interval among patients with different devices.

Conclusions: Most patients with long‐term prelingual deafness achieve their performance plateau within 1 year after implantation. The results suggest that patient characteristics, rather than device properties, are likely to be the major contributing factor responsible for the observed audiologic outcomes.
Is Nasal Packing Necessary Following Endoscopic Sinus Surgery?
Authors: Orlandi Richard R. , Lanza Donald C.
Published: August 2004

Objectives/Hypothesis: To determine the necessity of nasal packing or hemostatic agents or both following endoscopic sinus surgery.

Study Design: Retrospective review of cases in a tertiary care sinus practice at an academic medical center.

Methods: Records of 165 patients undergoing 169 endoscopic sinus surgeries were reviewed to determine the presence of adjunctive nasal procedures, the use of nasal packing or hemostatic agents or both, blood loss during surgery, and the incidence of bleeding complications following surgery.

Results: The median estimated blood loss during surgery was 50.0 mL (range, 5–1000 mL). In four surgeries (2.4%) hemostatic agents were placed in the nose at the conclusion of surgery, 19 (11.2%) had packing, and 147 (87.0%) had no material left in the nose. No patients had bleeding complications postoperatively. There was a significant decrease in the use of packing or hemostatic agents or both over time.

Conclusion: Placement of nasal packing or other hemostatic agents or both within the nasal cavity is not necessary in the majority of endoscopic sinus surgeries. The risks, costs, and discomforts associated with these interventions can often be avoided.
Pedicled Temporoparietal Fascial Flap Reconstruction of Select Intraoral Defects
Authors: Nayak Vijay K. , Deschler Daniel G.
Published: August 2004

Objectives/Hypothesis: Multiple modalities exist for reconstruction of oral cavity defects following resection. Although microvascular free tissue transfer is often the first choice for complex intraoral defect reconstruction, not all patients are suitable candidates for “free flaps.” The authors present their experience with the pedicled temporoparietal fascial flap (TPFF) for reconstruction of selected intraoral defects.

Study Design: Retrospective chart review.

Methods: Charts of patients who underwent a TPFF for reconstruction of intraoral defects at a tertiary academic institution between 2001 to 2003 were reviewed. Information regarding tumor, surgical procedure, complications, and results was gathered. The anatomy and surgical technique of using the TPFF for intraoral reconstruction were reviewed.

Results: Three patients underwent reconstruction of an intraoral defect with a TPFF. All defects were on the lateral buccal space with significant anterior or posterior extension. All patients had specific contraindications for free flaps, including compromised donor site or recipient site vascularity and medical comorbidity. The procedures were uncomplicated. There was no incidence of flap failure, and all flaps accepted a split‐thickness skin graft. The average hospital stay was 7 days. An oral diet was begun on the fifth postoperative day. The cosmetic result at the donor site was excellent. Follow‐up has ranged from 7 to 30 months. Mild contracture of the flap developed in two patients, limiting mandibular motion.

Conclusion: The TPFF is a thin, vascular, durable flap that is a viable option for reconstruction of selected intraoral defects in patients who are not suitable candidates for other methods.
Development and Validation of the Voice Handicap Index‐10
Authors: Rosen Clark A. , Lee Annie S. , Osborne Jamie , Zullo Thomas , Murry Thomas
Published: August 2004

Objectives/Hypothesis: The objective was to develop an abbreviated voice handicap assessment instrument and compare it with the Voice Handicap Index (VHI).

Study Design: Item analysis of the VHI in individuals without voice disorders and patients with voice disorders and creation and validation of the abbreviated VHI.

Methods: Clinical consensus review of the VHI items was held to prioritize the clinical value of each of the VHI items (30 items in all). Item analysis of the VHI was performed using the VHI responses of 100 patients with voice problems and 159 control subjects. The 10 most robust VHI items were selected using the item analysis and clinical consensus results to form the Voice Handicap Index‐10 (VHI‐10). Statistical analysis comparing the validity of the VHI‐10 with the VHI was performed with 819 patients representing a wide spectrum of voice disorders.

Results: Statistical analysis of the VHI and VHI‐10 scores from the study group showed no statistically significant differences between the VHI and the VHI‐10. Irrespective of diagnosis, the correlation between the VHI and the VHI‐10 was greater than .90 (P = .01). The ratios of the VHI‐10 to VHI scores for a variety of voice disorder categories were analyzed and found to be consistently greater than the expected value (33%). This suggests that the VHI‐10 may be a more robust instrument than the VHI.

Conclusion: The VHI‐10 is a powerful representation of the VHI that takes less time for the patient to complete without loss of validity. Thus, the VHI‐10 can replace the VHI as an instrument to quantify patients' perception of their voice handicap.
Laryngeal Findings in Users of Combination Corticosteroid and Bronchodilator Therapy
Authors: Mirza Natasha , Kasper Schwartz Sandra , Antin‐Ozerkis Danielle
Published: August 2004

Educational Objective: At the conclusion of this article, the readers should be able to 1) describe the laryngeal findings in patients who use combination therapy for asthma, 2) discuss the mechanism of laryngeal irritation from the use of inhalers, and 3) describe possible mechanisms for reducing laryngeal irritation and secondary dysphonia from the use of inhalers.

Objectives: To describe voice changes and laryngeal findings in patients who are started on combination corticosteroid and bronchodilator therapy in the form of a dry powder inhaler (DPI).

Study Design: Retrospective, single‐subject design.

Methods: Retrospective review of 10 consecutive patients meeting inclusion criteria, who presented at the voice center with more than 4 weeks of dysphonia after being started on a combination form of asthma medication for control and maintenance therapy. All patients were nonsmokers and without history of previous identification or excision of vocal pathology. All patients were treated previously with a proton pump inhibitor for gastroesophageal reflux. Laryngeal videostroboscopic evaluations were performed on all patients. Patients were asked to complete a questionnaire regarding their perceived voice change and history of medical maintenance therapy for asthma.

Results: Dysphonia was present in the patients selected for greater than 4 weeks. Patients had been switched to combination therapy after previously using traditional two‐drug asthma regimens. In eight of nine patients, the vocal folds demonstrated areas of hyperemia, with plaque‐like changes on the surface mucosa. Reduced amplitude of vibration and a reduction in mucosal wave propagation were present on videostroboscopy. Questionnaires revealed that all patients were initiated on combination DPI treatment within the last 6 months.

Conclusions: Dysphonia caused by a change in the surface mucosa is a side effect from the use of DPI therapy for asthma. The high‐impact force during inhalation of the medication and carrier leads to deposition of particles in the upper airway. We believe the extent of mucosal irritation can be minimized by patient education in the proper delivery of DPI. In some cases, however, return of the two medications delivered separately was necessary. The irritation of the laryngeal mucosa and return of normal vibratory parameters occurred in all patients.
Retrograde Weight Implantation for Correction of Lagophthalmos
Authors: Kao Chuan‐Hsiang , Moe Kris S.
Published: August 2004

Objectives: Gold weight implantation is the most commonly used method for surgical correction of paralytic lagophthalmos. Numerous techniques for placement of the weight have been described, yet complications with these methods continue to occur (implant migration or extrusion, wound infection, failure to correct the lagophthalmos, and excessive postoperative ptosis). We developed a retrograde, postlevator aponeurosis method for implantation to improve the placement and fixation of the weight. This study describes the rationale, technique, and surgical outcome of the retrograde approach.

Study Design: Retrospective analysis.

Methods: Data maintained and collected on 25 consecutive cases of retrograde upper lid weight implantation for paralytic lagophthalmos. Pre‐ and postoperative photographs were obtained, and patients were followed for at least 6 months. All procedures were performed by or under the direction of a single surgeon at tertiary academic medical centers (University of California, San Diego and University of Zurich, Switzerland).

Results: Twenty‐five consecutive patients were evaluated, 16 male and 9 female, ranging in age from 27 to 86 years. There were no surgical failures or perioperative complications and no instances of implant migration or extrusion. One patient developed a delayed infection requiring removal of the implant, and one patient required replacement of the gold weight with a platinum chain implant to better fit the contour of her eyelid.

Conclusions: Retrograde implantation allows more accurate placement of the weight while creating a permanent circumferential seal for fixation. The procedure is minimally invasive, less traumatic than previous methods, and produces an excellent cosmetic result. The efficacy has been demonstrated in the outcome of the 25 cases described in this study.
Outcomes and Achievement of Students Who Grew Up with Access to Cochlear Implants
Authors: Spencer Linda J. , Gantz Bruce J. , Knutson John F.
Published: August 2004

Objectives/Hypothesis: To provide long‐term speech perception and production, educational, vocational, and achievement outcome data for pediatric cochlear implant recipients.

Study Design: This is a retrospective study using consecutive referrals of prelingually, profoundly deaf children at the University of Iowa Hospitals and Clinics.

Methods: Twenty‐seven prelingually deaf young adults who received a cochlear implant between the ages of 2 and 12 years participated. Outcome measures included device‐use information, perceptual information, reading results for all participants and educational achievement results for 17 of 27 participants, educational placement information/vocational information for all students, as well as a comparison of the child's educational/vocational outcome with that of the parent's educational/vocational outcome.

Results: Speech perception and production scores were highly correlated. Achievement test results indicated that scores were within 1 SD from normative data based on hearing individuals. Over 50% of the college‐age eligible students enrolled in college. This initial group of implant users had a nonuse rate of 11% in the first 3 years. Eighty‐nine percent of the users maintained full‐time use for 7 years, and 71% of this group have maintained full‐time use to date.

Conclusions: This cohort of cochlear implant users compared favorably with their hearing peers on academic achievement measures. Although there was a wide distribution of educational and vocational outcomes, the children tended to follow the educational/vocational patterns of their parents. As age of implantation decreases, it will be important to compare achievement outcomes of this first generation with those of subsequent generations of cochlear implant users.
Microaspiration in Infants with Laryngomalacia
Authors: Midulla Fabio , Guidi Roberto , Tancredi Giancarlo , Quattrucci Serena , Ratjen Felix , Bottero Sergio , Vestiti Katia , Francalanci Paola , Cutrera Renato
Published: August 2004

Objectives/Hypothesis: Laryngomalacia is the most common congenital laryngeal anomaly and the most frequent cause of stridor in infants. Infants with laryngomalacia may have associated respiratory symptoms other than stridor. In this study, we evaluated whether infants with laryngomalacia have episodes of microaspiration by calculating the amount of lipids present in the alveolar macrophages.

Study Design: We reviewed bronchoalveolar lavage (BAL) findings obtained in 14 infants with laryngomalacia and in 11 control children.

Methods: BAL was performed during flexible fiberoptic bronchoscopy (FFB) to diagnose persistent stridor. The presence of microaspiration was determined by evaluating the amount of lipid per single macrophage, assigning each cell a score from 0 to 4 according to the amount of lipid in the cytoplasm.

Results: The lipid‐laden macrophage index was similar in patients and controls (31.5, range 12–177 vs. 45, range 35–106). In 5 of the 14 (36%) patients the index exceeded 100, and more than 25% of the cells were graded 3 and 4, indicating the presence of microaspiration. The lipid‐laden macrophage index correlated significantly with the number and percentage of BAL neutrophils (Pearson correlation test, r = 0.83, P < .001 and r = 0.925, P < .001) as a marker of lung inflammation.

Conclusions: Infants with laryngomalacia may have episodes of microaspiration. BAL performed during FFB to evaluate stridor may add helpful therapeutic information without increasing the risks of the procedure.
Viscoelastic Properties of Three Vocal‐Fold Injectable Biomaterials at Low Audio Frequencies
Authors: Klemuk Sarah A. , Titze Ingo R.
Published: August 2004

Objectives: Previous measurements of viscoelastic properties of Zyderm were to be extended to low audio frequencies, and properties of two other biomaterials not previously measured, thiolated hyaluronic acid (HA‐DTPH) and Cymetra, were obtained.

Study Design: Rheologic investigation.

Methods: Oscillatory shear stress was applied to each sample using a controlled stress rheometer at frequencies between 0.01 and 100 Hz with a parallel plate apparatus. Versuscoelastic moduli were recorded at each frequency. The calculated resonance frequency of the machine and sample were then used to determine the maximum frequency at which reliable data existed. Extrapolation functions were fit to viscoelastic parameters, which predicted the properties up to 1,000 Hz.

Results: Frequency trends of Zyderm were similar to those previously reported, whereas magnitudes were different. The elastic moduli logarithmically increased with frequency, whereas dynamic viscosity demonstrated shear thinning, a condition of primary importance for humans to vocalize over a broad frequency range. Previous measurements were extended from 15 Hz up to 74 Hz. Differences in magnitude between a previous study and the present study were attributed to particulate orientation during testing. Cymetra was found to have nearly identical viscoelastic properties to those of bovine collagen, both in magnitude and frequency trend, with reliable measures extending up to 81 Hz. Rheologic properties of the hyaluronic acid gel were the closest match to cadaveric vocal fold mucosa in magnitude and frequency trend.

Conclusions: Viscoelastic properties of Cymetra and Zyderm are nearly the same and are significantly greater than those of vocal fold mucosa. HA‐DTPH possesses a good viscoelastic match to vocal fold mucosa and may be useful in future lamina propria repair.
Long‐Term Results of Type II Thyroplasty for Adductor Spasmodic Dysphonia
Authors: Chan Sor Way , Baxter Malcolm , Oates Jenni , Yorston Anne
Published: August 2004

Objectives: To assess the outcome of type II thyroplasty in the treatment of adductor spasmodic dysphonia (ASD).

Study Design: Prospective case series.

Methods: Thirteen patients with the diagnosis of ASD who were previously treated successfully with botulinum toxin therapy were recruited. Type II thyroplasty as described by Nobuhiko Isshiki was performed on all the patients. A self‐rating assessment of the degree of severity and vocal effort were recorded and compared preoperatively and during postoperative follow‐up.

Results: There were four early failures in our series, with two caused by friable thyroid cartilage. In the early postoperative period, after excluding the early failures, six (66.7%) and seven (77.8%) patients had moderate‐good improvement in symptom severity and vocal effort, respectively. During the follow‐up period, a further five patients had deterioration of voice quality and were classified as failures. Of these five patients, two patients had reversal of their procedure. At the end of the follow‐up period (mean follow‐up period of 12 months), six (66.7%) and five (55.5%) patients sustained improvement in symptom severity and vocal effort, respectively. However, only two (22.2%) and three (33.3%) patients had moderate‐good improvements in symptom severity and vocal effort, respectively, after 12 months.

Conclusions: Botulinum toxin injection remains the gold‐standard treatment for ASD in our center. Potential patients for type II thyroplasty need to be carefully selected and counseled by a multidisciplinary team of otolaryngologists, neurologists, and speech pathologists.
Temporal Bone Histopathology in Alport Syndrome
Authors: Merchant Saumil N. , Burgess Barbara J. , Adams Joe C. , Kashtan Clifford E. , Gregory Martin C. , Santi Peter A. , Colvin Robert , Collins Bernie , Nadol Joseph B.
Published: August 2004

Objective: To determine the histopathologic abnormalities within the cochlea in Alport syndrome.

Background: Alport syndrome, which manifests as hereditary nephritis and sensorineural hearing loss (SNHL), is caused by mutations in genes that code for the ∝3, ∝4, and ∝5 chains of type IV collagen. The ∝3, ∝4, and ∝5 chains of type IV collagen are present in the basement membrane of the organ of Corti. Previous temporal bone studies have failed to identify histopathologic correlates for the SNHL.

Methods: We examined temporal bones from nine individuals with a clinical diagnosis of Alport syndrome. One of our cases also had genetic testing that showed a mutation in the type IV collagen ∝5 chain gene.

Results: By light microscopy, eight of nine cases demonstrated two unique pathologic changes: 1) a “zone of separation” between the basilar membrane and overlying cells of the organ of Corti and 2) presence of cells filling the tunnel of Corti and extracellular spaces of Nuel. The cytologic losses of hair cells, stria vascularis, and cochlear neuronal cells were insufficient to account for the observed SNHL in our cases. Electron microscopy was performed in four cases; all four demonstrated the following: 1) the zone of separation that was observed at light microscopy occurred between the basement membrane and the basilar membrane, 2) the cells within the tunnel of Corti and spaces of Nuel were morphologically similar to supporting cells, and 3) the basement membrane of strial capillaries and the spiral vessel (under the basilar membrane) were normal.

Conclusions: The histopathologic correlates of cochlear involvement in Alport syndrome are abnormalities of the basement membrane of cells of the organ of Corti and dysmorphogenesis (cellular infilling of the tunnel and extracellular spaces) of the organ of Corti. We hypothesize that these abnormalities result in SNHL by altering cochlear micromechanics.
Medicinal Use of Cocaine: A Shifting Paradigm Over 25 Years
Authors: Long Heather , Greller Howard , Mercurio‐Zappala Maria , Nelson Lewis S. , Hoffman Robert S.
Published: August 2004

Objectives/Hypothesis: Human cocaine research is predicated on data from the clinical practice of otolaryngology that are more than 25 years old and predate both the cocaine epidemic and the first reported association between cocaine use and myocardial infarction. The authors' objective was to reassess the epidemiology and toxicity of medicinal cocaine use among otolaryngologists and to compare current trends in usage and safety data with previously reported data.

Study Design: An anonymous closed‐question survey replicating the methodology of a previous study was used.

Methods: The survey was mailed to active members of the American Academy of Otolaryngology—Head and Neck Surgery. The survey used a closed‐question format asking about the use of cocaine, safety measures taken, and adverse outcomes and included information about practice type and location. Results were compared with previously published data using a χ2 test with P < .05 considered significant.

Results: In all, 7815 surveys were mailed. Four thousand seventeen otolaryngologists returned the survey, representing a 54% response rate. Of the respondents, only 50% had used cocaine in their practice during the previous year. Physicians who had been in practice for less than 10 years were less likely to have used cocaine than those who had been in practice for more than 10 years (78% vs. 93% [P < .001]). Compared with the data reported in 1977, fewer physicians reported ever using cocaine in their practice (88% vs. 92% [P < .001]), fewer physicians had used cocaine in their practice at any time in the previous 10 years (68% vs. 92% [P < .001]), and a greater number of adverse reactions were reported by current respondents (26% vs. 22% [P < .001]). Tachycardia and hypertension were the most commonly reported adverse effects. Other important adverse events included 14 deaths, survivable cardiac arrest, ventricular tachycardia, and seizures.

Conclusion: The clinical use of cocaine in otolaryngology has decreased significantly in the past 25 years as a result of discontinuation of use by physicians who had previously used cocaine and an increasing number of otolaryngologists who have never used it. This decline may reflect a better understanding of its potential toxicities, problems associated with storing and dispensing of a tightly controlled substance, increased availability of safer alternative medications, or a combination of these.
Effect of Edaravone on Streptomycin‐Induced Vestibulotoxicity in the Guinea Pig
Authors: Horiike Osamu , Shimogori Hiroaki , Yamashita Hiroshi
Published: August 2004

Objectives/Hypothesis: The effect of topical administration of edaravone to the inner ear was investigated in guinea pigs with streptomycin‐induced vestibulotoxicity.

Methods: Vestibulotoxicity was induced in 20 animals by delivery of streptomycin into the inner ear through osmotic pump for 24 hours. Edaravone (n = 8, systemic administration group) or saline (n = 6, control group) was injected intraperitoneally once a day for 7 days or edaravone‐soaked Gelfoam was placed on the round window before wound closure (n = 6, topical administration group).

Results: Yaw head tilt and spontaneous nystagmus were observed in all animals after the operation. The number of spontaneous nystagmus beats in the topical administration group was statistically less than that in other two groups at 12, 18, and 24 hours after the operation.

Conclusion: The study results suggest that topical administration of edaravone better suppresses streptomycin‐induced vestibulotoxicity than systemic administration.
Infratemporal Fossa Approach to the Hypoglossal Canal: Practical Landmarks for Elusive Anatomy
Authors: Hadley Kevin S. , Shelton Clough
Published: August 2004

Objective: At the conclusion of the article the readers should be able to safely and reliably find the hypoglossal canal using the infratemporal fossa approach.

Hypothesis: Very little has been written on the regional anatomy of the hypoglossal canal as seen through a transtemporal approach. This project attempts to further define the anatomy of the hypoglossal canal and provide the surgeon with guidelines for reaching it. Our hypothesis is that the hypoglossal canal can be safely and consistently reached by way of the temporal bone with preservation of hearing and cranial nerves (CN) IX to XI.

Study Design: Prospective anatomic study.

Methods: The study was performed using cadaver temporal bones. Infratemporal fossa Fisch type‐A dissections were performed. The hypoglossal canal was then completely exposed. The distance from the canal to the jugular bulb, carotid artery, round window, lateral canal, and roots of CN IX to XI were recorded.

Results: Fifteen temporal bones were dissected and measured. The position of the hypoglossal canal is consistently located anterior, inferior, and medial to the jugular bulb. The distance from midcanal to the jugular bulb and the roots of CN IX to XI at the posterior fossa dura was 5.3 mm ± 0.82 and 7.1 mm ± 2.49, respectively. The distance from the carotid artery where it meets the jugular vein to the midcanal was 15.3 mm ± 2.09. The distance from the round window to the canal was 21.7 mm ± 3.17.

Conclusions: The hypoglossal canal can be consistently reached using the infratemporal fossa approach. Hearing and CN IX to XI can be preserved. The distance from the jugular bulb and roots of CN IX to XI can be used as guideposts. If a tumor is involving the bulb, then the carotid artery and the round window are the next most reliable indicators of position.
Tumors of the Accessory Lobe of the Parotid Gland: A 10‐Year Experience
Authors: Lin Derrick T. , Coppit George L. , Burkey Brian B. , Netterville James L.
Published: August 2004

Objectives/Hypothesis: The differential diagnosis of midcheek masses include pathology arising from normal anatomic structures or from variations of normal accessory parotid gland tissue. Accessory parotid gland tissue has been described as salivary tissue adjacent to Stenson's duct that is separate from the main body of the parotid gland. We report our 10‐year experience with the diagnosis and treatment of eight accessory parotid gland neoplasms that have been followed by the senior authors.

Study Design: This is a retrospective review of our experience with eight accessory parotid gland neoplasms.

Methods: A literature review and retrospective chart review of our experience with accessory parotid gland tumors over the past 10 years. The presentation, evaluation, management, treatment, and outcome were recorded.

Results: Eight cases of accessory lobe parotid tumors were identified, which have been followed since the date of initial treatment. All of the patients presented with a slowly growing cheek mass. There was one case of carcinoma expleomorphic adenoma, one case of undifferentiated carcinoma (small cell carcinoma), one case of basal cell adenocarcinoma, one case of benign salivary cyst, two cases of pleomorphic adenoma, and two cases of monomorphic adenoma. A standard facelift approach or modified Blair incision was used to excise these tumors.

Conclusions: Neoplasms of the accessory parotid gland are rare. Management of these tumors include a high index of suspicion, good understanding of the anatomy, and meticulous surgical approach.
Efficacy Of Anti‐Adhesive Barriers in Secondary Thyroidectomy: An Experimental Study
Authors: Yigit Ozgur , Uslu Coskun Berna , Coskun Halil , Yilmaz Banu , Alkan Seyhan , Cinar Ugur , Dadas Burhan
Published: August 2004

Hypothesis: This study was conducted to compare the effectiveness of two anti‐adhesive barriers (Seprafilm and Interceed) for reducing adhesions after thyroidectomy in a rat model. The anti‐adhesive barriers are suggested for use in repeated surgeries in general and the gynecologic fields in particular.

Study Design: Controlled, randomized study.

Methods: Twenty‐eight male Wistar Albino rats that underwent right subtotal thyroidectomy were randomly assigned to three groups. One group received Seprafilm (n = 10), and the other received Interceed (n = 10) as anti‐adhesive barriers. The third group was the control group (n = 8). At postoperative day 14, the rats were killed under general anesthesia, and the surgical fields were evaluated for the adhesion formation. The extent of the adhesion formation is scored from 0 (no adhesions) to 2 (fibrous adhesions that required sharp dissection). Histopathologically, chronic inflammation, histiocyte, fibroblast, fibrosis, collagen, vascularization, granuloma, giant cell, and fat necrosis were examined.

Results: All the subjects in the control group, 7 of 10 in the Interceed group, and 4 of 10 in the Seprafilm group needed to be dissected bluntly or sharply. There was significant difference between the Seprafilm and the control group (P < .05) whereas there was no significant difference between the Interceed group and the control group (P > .05). When examined histopathologically, the criteria showing adhesion, such as fibrosis, fibroblast, and collagen were higher in the control group compared with the Seprafilm and Interceed groups. There was no significant difference between the Seprafilm and Interceed groups, whereas a significant difference was found between these two groups and the control group.

Conclusion: This study suggests that both Seprafilm and Interceed decrease the incidence of posthyroidectomy adhesions in a rat model. Both agents showed no foreign body reaction.
On functions and quantities derived from the experimental electron density
Authors: Tsirelson Vladimir , Stash Adam
Published: August 2004

Calculation of properties of molecules and crystals as obtained from a multipole electron-density model restored from the accurate X-ray diffraction data is considered. Electronic and exchange energy-density distributions are presented along with those of local temperature and local entropy. Integration of the local functions over atomic basins defined by the zero-flux condition allows properties of molecules and crystals to be expressed in terms of atomic contributions derived directly from X-ray diffraction experiments. Distributions of local Fermi momentum and one-electron potential are considered as well. The approach has been applied to diamond, sodium fluoride, sodium chloride, solid chlorine, α-oxalic acid dihydrate and YBa2Cu3O6.98.
Electron densities in relation to magnetism: γ-ray diffraction from transition-metal monoxides and difluorides
Authors: Jauch W.
Published: August 2004

In this article, results are described from an area of solid-state physics that heretofore has remained unexplored by Bragg charge-scattering experiments. It is shown that γ-ray electron densities can provide detailed information on magnetic ground-state properties at a subatomic resolution. The use of 316 keV γ radiation has allowed low-order structure factors at better than 0.1% accuracy to be determined and, at the same time, extended data sets to be collected up to high momentum transfer. Prototypic antiferromagnets such as the late 3d transition-metal monoxides and difluorides have been systematically investigated, in most cases both in the paramagnetic and in the fully ordered phase. At transitions with a lowering of symmetry, multidomain formation was suppressed by application of external mechanical stress or magnetic fields. The results are considered in the context of information provided by recent magnetic neutron and X-ray studies.
On the role of data quality in experimental charge-density studies
Authors: Destro Riccardo , Loconte Laura , Lo Presti Leonardo , Roversi Pietro , Soave Raffaella
Published: August 2004

High-resolution X-ray diffraction data were collected at T = 19 K from two similar spherical crystals of the fungal metabolite citrinin, C13H14O5. The two data sets were of markedly different quality, one data set (MQ, medium quality) comprising a single octant of the reciprocal lattice and including reflections with obviously peculiar intensity profiles while the second (HQ, high quality) comprised a hemisphere of reflections and showed no flawed profiles. Parallel multipolar refinements were carried out for both. While most of the resulting geometric parameters, including bond lengths and angles, were in close agreement (the standard uncertainties were approximately twice as large for the MQ data, reflecting the smaller number of observations), the agreement is noticeably worse for electronic properties such as electron densities and their Laplacians at the bond and ring critical points. These latter features are especially sensitive to the quality of the low-angle (and strong) intensities, which was not high for the MQ data. By contrast, the magnitudes of the molecular dipole moment from the two experiments are the same within 1 standard uncertainty, with an angle of about 13° between the two vectors. It is concluded that only true high-quality data allow a fully significant and quantitative analysis of the details of the experimental electron density ρexp, while high-resolution medium-quality data, measured at very low temperature and adequately processed, can still be used for a qualitative analysis, or for the derivation of overall electronic properties.
The charge density of urea from synchrotron diffraction data
Authors: Birkedal Henrik , Madsen Dennis , Mathiesen Ragnvald H. , Knudsen Kenneth , Weber Hans-Peter , Pattison Philip , Schwarzenbach Dieter
Published: August 2004

The charge density of urea is studied using very high precision single-crystal synchrotron-radiation diffraction data collected at the Swiss–Norwegian Beam Lines at ESRF. An unprecedented resolution of 1.44 Å−1 in sinθ/λ is obtained at 123 K. The optimization of the experiment for charge-density studies is discussed. The high precision of the data allowed the refinement of a multipole model extending to hexadecapoles and quadrupoles on the heavy and H atoms, respectively, as well as a liberal treatment of radial functions. The topological properties of the resulting electron density are analysed and compared with earlier experimental results as well as with periodic Hartree–Fock calculations. The properties of the strongly polarized C—O bond agree with trends derived from previous experimental results while the ab initio calculations differ significantly. The results indicate that the description of the C—O bond requires more flexible basis sets in the theoretical calculations. The calculated integrated atomic charges are much larger than the observed ones. It is suggested that the present experimental results provide new target values for validation of future ab initio calculations. The molecular dipole moment derived from the integrated atomic properties is the same as the one obtained from the multipole model even though the individual atomic contributions differ. Comparison with literature data for urea in solution and the gas phase yields a dipole enhancement in the solid of about 1.5 D. The thermal expansion of urea is determined using synchrotron powder diffraction data. With decreasing temperature, an increasing anisotropic strain is observed.
An experimental (120 K) and theoretical electron-density study of KMnO4 and KClO4
Authors: Marabello D. , Bianchi R. , Gervasio G. , Cargnoni F.
Published: August 2004

The experimental electron density ρ(r) of the two isomorphic salts KMnO4 and KClO4 was determined by a multipole analysis of accurate X-ray diffraction data at 120 K. The quantum theory of atoms in molecules was applied to ρ(r) and to its Laplacian ∇2ρ(r). The bonds were characterized using the topological parameters at the bond critical points of the density ρ(r), ∇2ρ(r), G(r) (kinetic energy density), V(r) (potential energy density) and H(r) (total energy density). According to the classification recently proposed by Espinosa, Alkorta, Elguero & Molins [J. Chem. Phys. (2002), 117, 5529–5542], the K—O and Cl—O bonds have a pure ionic and covalent character, respectively, while the Mn—O bonds show an intermediate behaviour. The results of the topological analysis of the experimental and theoretical (fully periodic Hartree–Fock and density functional calculations) electron density are in good agreement, even on a quantitative level. The atomic charges, determined by performing an integration over the topological basins, are about +2 e for Mn and Cl atoms. The ionic radius, estimated with the distance of the bond critical point from the nucleus, is in agreement with a charge of +2 e for the Mn atom.
Electronic structure of the nickel(II) complex of the Schiff base of (S)-N-(2-benzoylphenyl)-1-benzylprolinamide and glycine
Authors: Kožíšek Jozef , Fronc Marek , Skubák Pavol , Popkov Alexander , Breza Martin , Fuess Hartmut , Paulmann Carsten
Published: August 2004

The experimental charge density of the NiII complex of the Schiff base of (S)-N-(2-benzoylphenyl)-1-benzylprolinamide and glycine was derived from high-resolution single-crystal X-ray diffraction data (λ = 0.5604 Å) at low temperature (100 K) with synchrotron radiation at the beamline F1 using a CCD area detector. The central Ni atom is pseudo-square-planar coordinated by three N atoms [1.9414 (3), 1.8559 (3) and 1.8533 (3) Å] and by one O atom [1.8620 (4) Å]. The N(1) atom is 0.359 Å above the plane defined by the atoms Ni(1), N(2) and N(3). The d-orbital population analysis reveals an oxidation state for the Ni atom of +2 with the configuration d
8 and a hole mainly in the d

x
2

−y
2
orbital, located in the plane of the four ligating atoms. The prochiral reaction centre was examined by topological analysis.
`In-situ' charge-density studies of photoinduced phenomena: possibilities for the future?
Authors: Cole Jacqueline M.
Published: August 2004

Over the past decade, there has been much development in the structure determination of photoinduced species by single-crystal X-ray diffraction. Such work is key to understanding many photoactivated chemical processes and physical properties that are behind phenomena such as photoisomerism, photoinduced chemical reactions, light-induced spin-crossover transitions and molecular excited states that are responsible for many types of fluorescence and phosphorescence. A brief overview of these experimental developments is presented in relation to the attraction of conducting charge-density studies on photoinduced structures. The technical issues regarding possible charge-density studies using these developments, both in the metastable and time-resolved domain, are highlighted in the form of a perspective towards future possibilities for photoinduced charge-density studies. The paper concludes with a summary of further experimental developments that are unfolding and how these may contribute to the ultimate viability of `in-situ' charge-density studies on photoinduced phenomena.
The metal–insulator phase transition in mixed potassium–rubidium electro-sodalites
Authors: Madsen Georg K. H.
Published: August 2004

The collapse under pressure of the antiferromagnetic ground state of the potassium–rubidium electro-sodalite is studied using the linearized augmented plane wave with local orbitals method. Special considerations needed for setting up this basis for systems such as the electro-sodalites are discussed. It is demonstrated that the magnetism collapses at a unit-cell volume similar to potassium electro-sodalite and rubidium electro-sodalite. A critical pressure of 8 GPa is predicted. The mechanism behind the collapse is a mixing of the F-center states with the highly diffuse unoccupied p states of the alkali atoms.
Performance evaluation of different hardener for epoxy resin
Authors: Sankar S. , Paruthimal Kalaignan G. , Vasudevan T. , Selvaraj M.
Published: August 2004

Coatings with outstanding chemical and physical properties can be obtained from two‐pack formulations without stoving. The epoxy resin was cured with different amine‐based compounds, such as polyamide (PA), the aniline copolymer of triethanolamine titanate and aniline formaldehyde. The thermal resistance properties of the cured films were analysed using the thermo‐gravimetric method. This study also examined the effect of coating resistance of 3 per cent sodium chloride solution by means of electrochemical impedance measurements. Coatings that included the epoxy triethanolamine titanate showed superior behaviour, compared to the other two systems tested. This hardener can be recommended instead of using conventional PA and polyamidoamide hardeners for epoxy two‐pack systems that are to be used to protect the steel structures from highly corrosive chemical and marine environments.