bluuebunny/crossref_metadata_2025 huggingface dataset:
Facial nerve stimulation with cochlear implantation
Authors: Niparko John K. , Oviatt Dana L. , Coker Newton J. , Sutton Lois , Waltzman Susan B. , Cohen Noel L. ,   VA COOPERATIVE STUDY GROUP ON COCHLEAR IMPLANTATION
Published: November 2015

The course of the facial nerve may place it within the current field generated by an activated cochlear implant to produce incidental facial movement. We investigated the presence of facial nerve stimulation associated with cochlear implants in the VA Cooperative Study of Advanced Cochlear Implants. Twelve of 82 patients enrolled in this study demonstrated facial nerve stimulation within 2 years of implant activation. Facial nerve stimulation in six patients with multiple channel implants (Nucleus or Ineraid devices) either resolved spontaneously (n = 2), or was eliminated by deactivating basal (n = 2) or apical (n = 2) electrodes. Two of six patients with single‐channel electrodes (3‐M/Vienna devices) demonstrated facial nerve stimulation that resolved spontaneously (n = 2), resolved with lowering current output (n = 2), or was refractory to processor adjustment (n = 2). Intraoperative assessment in one of the refractory cases indicated that facial nerve stimulation resulted from current spread through the modiolus to activate the facial nerve. A variety of factors, including implant design, stimulus parameters, and local tissue impedances, may interact to produce incidental facial stimulation. Low‐impedance pathways between the scala tympani and the modiolus may deserve increased recognition as an interactive factor in cochlear implant performance.
Monoclonal Antibody‐Porphyrin Conjugate for Head and Neck Cancer: The Possible Magic Bullet
Authors: Donald Paul. J. , Cardiff Robert D. , He Da‐Er , Kendall Katherine
Published: November 2015

Although photodynamic therapy in the treatment of large head and neck cancers showed some initial promise, the results in the final analysis have been somewhat disappointing. Lack of specificity and nonhomogeneous uptake of the porphyrin by the tumor are only some of the problems. The conjugation of a monoclonal antibody (UCD/AB 6.01) with hematoporphyrin derivative that preferentially binds to tumor cells offers promise as a therapeutic agent that will not only improve specificity, but vastly enhances tumor cell kill when exposed to light in its photodynamic range. The application of the monoclonal antibody‐hematoporphyrin conjugate (AB:HPD) to A‐431 squamous cell carcinoma cells in vitro, followed by exposure to light in the 630 nm range, increases the kill ratio by a factor of 105 times. The active tumor cell binding site on the cell surface has been found to be on the microvilli, a site at which a 52k Da protein that is very similar to keratin 8 is found. The clearance of the conjugate from nude mice who have grown an A‐431 tumor shows a retention of AB:HPD of ∼15% and less than 1% in skin and internal organs when measured at 48 hours. Direct application of AB:HPD to fresh pathology specimens containing human squamous cell carcinomas shows binding exclusively limited to the tumor.
Anaphylaxis in Immunotherapy
Authors: Davis William E. , Cook Paul R. , McKinsey Joel P. , Templer Jerry W.
Published: November 2015

Although anaphylactic reactions resulting from immunotherapy rarely occur, when they do occur they can be life‐threatening. The literature reveals more than 30 deaths attributed to immunotherapy but numerous reports of anaphylaxis. We reviewed a 5‐year experience of immunotherapy in a University practice and their experience with systemic reactions is presented. More than 125,000 injections were given in this time period. Of the 550 patients receiving immunotherapy, 14% experienced anaphylactic reactions, the majority of which were mild.
Efficacy of Videostroboscopy in the Diagnosis of Voice Disorders
Authors: Casiano Roy R. , Zaveri Vijaykumar , Lundy Donna S.
Published: November 2015

While videostrobolaryngoscopy is not a new technique, its acceptance as a routine part of the voice evaluation has not been as forthcoming. Many are in agreement that the rigid fiberoptic telescopes in combination with standard VHS equipment provide a clear, magnified image that can be recorded and used for pretreatment and post‐treatment comparisons, documentation, teaching, and research. Yet, some skepticism persists with regard to the ability of videolaryngoscopy and/or videostrobolaryngoscopy in changing the diagnosis and treatment outcome of patients with voice disorders as compared to indirect laryngoscopy. Two hundred ninety‐two dysphonic patients were identified who underwent indirect as well as videolaryngoscopy with and without stroboscopic examination. Videostrobolaryngoscopy was found to alter the diagnosis and treatment outcome in 14% of the patients. It is most useful in patients with a diagnosis of functional dysphonia and vocal fold paralysis by indirect laryngoscopy. The increased illumination and magnification afforded by rigid fiberoptic telescopes during videolaryngoscopy, combined with the detailed assessment of glottic closure, mucosal wave, and amplitude characteristics provided by stroboscopic examination, allowed detection of subtle vocal fold pathology, otherwise missed by indirect laryngoscopy.
Vestibular Rehabilitation Reduces Functional Disability
Authors: Cohen Helen
Published: November 2015

Vertigo caused by vestibular disorder may be successfully treated with a physical therapy program of graded exercises to habituate the patient to the vertiginous stimulus and to increase the range of motion through which the patient can tolerate moving. Performance on daily self‐care tasks is an important indicator of the patient's tolerance for head movement and the success of treatment. In this study, self‐care skill in subjects with labyrinthine and brainstem lesions before and after receiving vestibular rehabilitation was examined. Subjects improved significantly after physical therapy, demonstrating greater independence in their abilities to care for themselves. These data provide further support for the value of vestibular rehabilitation procedures.
Incidence of Otitis Media in Vitamin A‐Deficient Guinea Pigs
Authors: Manning Scott C. , Wright Charles G.
Published: November 2015

After observing an association between vitamin A deficiency and otitis media among children in Micronesia, we sought to develop an animal model for vitamin A‐deficiency‐induced otitis media. Thirty juvenile guinea pigs were screened for absence for otitis and then divided into two groups. The experimental group was placed on a vitamin A‐free diet, whereas control animals were fed a standard formula. The animals were followed by means of otologic examination and serum retinol determinations. When experimental animals demonstrated vitamin A deficiency, they were killed along with one control and temporal bones were harvested and prepared for histologic examination. None of the 15 controls demonstrated middle ear abnormalities. In the experimental group, 77% of temporal bones showed middle ear pathology consisting of either of subepithelial edema (27%) or frank otitis media (50%). These results indicate that the guinea pig is a suitable species for study of otitis media in association with vitamin A deficiency. We postulate that eustachian tube dysfunction is the primary mechanism for inducing middle ear inflammation in this animal model.
Interdisciplinary Approach to Functional Voice Disorders: The Psychiatrisf's Role
Authors: Nichol Hamish , Morrison Murray D. , Rammage Linda A.
Published: November 2015

A review is given of the experience obtained over 6 years of having a psychiatric consultant available as part of the staff of the Voice Clinic, to which more than a thousand patients have been referred. The presenting features in a case that should alert the otolaryngologist to the need for psychiatric consultation and possible treatment are noted. Suggestions are made as to how to prepare the patient for the referral to a psychiatrist with the appropriate Interests and willingness to collaborate closely with the otolaryngologist and the speech pathologist.
Laser Cordectomy or Radiotherapy: Cure Rates, Communication, and Cost
Authors: Cragle Stephen P. , Brandenburg James H.
Published: November 2015

Health care costs have risen dramatically in recent years. Cost‐containment strategies have become necessary to ensure that adequate medical care is accessible to all who need it. These strategies Include choosing the least costly of several treatment modalities with equal efficacy. Radiotherapy has been considered by some as the treatment of choice for early glottic tumors. Rationale for this is based on two major assumptions: That cure rates are equal for radiotherapy and surgery, and that voice preservation and quality is superior with radiotherapy. Implicit In these assumptions is the idea that cost of therapy should not be a factor in selecting an alternative. This study presents a literature review of cure rates for laser cordectomy and radiotherapy for T1glottic cancers. An objective voice analysis was performed on 14 patients with T1glottic cancers treated with laser cordectomy and the results were compared to a group of 20 patients treated with radiotherapy for similar early tumors. Finally, the average total cost of each modality was calculated and compared. Our findings indicate that: (1) cure rates are equivalent; (2) voice quality after laser cordectomy is as good as that noted after radiotherapy; and (3) total cost of therapy is much less for laser cordectomy than for radiotherapy. We advocate laser cordectomy rather than radiotherapy for most early glottic tumors.
Middle Ear Ventilation with HydroxylVent Tube: Review of the Initial Series
Authors: Jahn Anthony F.
Published: November 2015

Thirty HydroxylVent tubes were implanted in twenty‐seven patients. The chief Indications were unresolving eustachian tube dysfunction, with either collapse or perforation of the tympanic membrane. Every patient had undergone a lengthy course of treatment with conventional ventilation tubes. Twenty ears (66%) showed good results, with prolonged ventilation and restoration of middle ear function. Two tubes appeared to be open, with the development of a pinpoint perforation of the drum. Eight tubes occluded as a result of displacement of the tube, middle ear pathology, or debris. Indications and techniques of management are discussed, along with an analysis of complications.
The Effect of Antihistamines on the Immediate Allergic Response: A Comparative Review
Authors: Naclerio Robert M.
Published: November 2015

Antihistamines are believed to reduce the sneezing and rhlnorrhea associated with allergic rhinitis, primarily by competitive antagonism of histamine for H1 cellular receptors, but additional mechanisms of action may contribute to their clinical efficacy. To Improve our understanding of H1 antihistamine action, we studied the effects of pretreatment with terfenadine, cetirizine, ketotifen, azatadine, diphenhydramine, and azelastine on increases in vascular permeability, mast cell activation, and sneezing Induced by nasal challenge with antigen. All studied antihistamines reduced sneezing, Indicating that they all effectively antagonize histamine after its release. In addition, terfenadine and topically administered azatadine blocked the release of histamine. Studies with cetlrizine and azelastine revealed that these antihistamines significantly reduced sulfldopeptide leukotriene levels. Terfenadine and azelastine also reduced klnin production. These results confirm that antihistamines are effective in reducing sneezing and, in some cases, vascular permeability. The findings of these studies also Illustrate that the various antihistamines have multiple and different mechanisms of action that may have Implications for their clinical uses.
The effects of etidronate disodium on progressive hearing loss from otosclerosis
Authors: Kennedy David W. , Hoffer Michael E. , Holliday Michael
Published: November 2015

A 2‐year prospective double‐blind study was performed to evaluate the role of etidronate disodium for the treatment of progressive hearing loss in patients with otosclerosis. A pulsed dosage regimen was used during the 2‐year period and the patients were followed up with otologic and audiometric examinations. Although statistically significant differences were not achieved between the study and control groups, the study did reveal a trend toward stabilization or improvement in air conduction thresholds in some frequencies (1000 and 4000 Hz) and in bone conduction thresholds at other frequencies (500, 1000, and 2000 Hz). The incidence of adverse side effects was similar in the treatment and control groups. Although no definite conclusions can be drawn from this pilot study, the findings provide encouragement for performing a larger and longer‐term study. (OTOLARYNGOL HEAD NECK SURG 1993;109:461‐7.)
Formation of mucosal polyps in the nasal and maxillary sinus cavities by infection
Authors: Norlander Tomas , Fukami M. , Westrin K. M. , Stierna P. , Carlsöö B.
Published: November 2015

Unilateral maxillary sinusitis was experimentally induced in New Zealand White rabbits with Streptococcus pneumoniae serotype 3, Bacteroides fragilis NCTC 9343, and Staphylococcus aureus V8. In another group of rabbits, sinusitis was induced by blocking of the sinus ostium only. Bacteriologic and light microscopic analysis was performed after 5 days to 1 month. Granulation‐like polyps developed after deep mucosal inflammatory trauma initiating fibroblast proliferation, angiogenesis, and epithetlial migration to cover the polyp. In regions of a more superficial trauma—characterized by epithetlial desquamation and fibroblast growth—proliferation and differentiation of basal cells resulted in the formation of microcavities dissecting off edematous polyps. Polyps could be found in all sinusitis groups, irrespective of inducing agent. The cellular events of polyp formation appear to be the result of a continuous inflammatory reaction and are not directly related to the presence of a certain microorganism. Instead, the potential of any microorganism to induce a deep mucosal trauma or epithelial desquamation seems essential for its ability to initiate polyp formation. (OTOLARYNGOL HEAD NECK SURG 1993;109:522‐9.)
Auditory p300 abnormalities and leukocyte activation in hiv infection
Authors: Birdsall Holly H. , Ozluoglu Levent N. , Lew Henry L. , Trial Joann , Brown Denice P. , Wofford Martha J. , Jerger James F. , Rossen Roger D.
Published: November 2015

To evaluate whether P300 testing might serve as a screening modality for the early detection of HIV‐related neuropathology, we tested 26 HIV‐infected men (23 without neurologic symptoms, 2 with peripheral neuropathy, 1 with AIDS‐associated dementia) and 15 controls. Although they had no overt neurologic symptoms, the P300 latency was delayed or undetectable in 30% of patients without clinically evident neurologic disease. P300 latencies did not correlate with peripheral blood CD4 T‐cell count, serum quinolinic acid or p24 antigen levels, or the numbers of activated peripheral blood monocytes. Three individuals with abnormal P300 latencies had been HIV‐seropositive for ≤ 1 year, suggesting that delayed evoked responses detect early neurologic dysfunction. P300 responses do not predict imminent dementia. In only one previously asymptomatic individual with abnormal P300 waveforms have overt neurologic symptoms developed during a 2‐year followup. Extended longitudinal studies will be necessary to define the predictive value of P300 latencies in the development of AIDS‐related dementia. However, the sensitivity, quantitative nature, and speed of administration of this test suggest that it may be useful for identification of early neurologic involvement in HIV infection.
Serotonin and serotonin receptors in the central auditory system
Authors: Thompson Glenn C. , Thompson Ann M. , Garrett Kennon M. , Britton B. Hill
Published: November 2015

Immunohistochemical and ligand‐binding techniques were used to visualize the neurotransmitter serotonin and one of its receptors, the 5‐HT1A subtype, in auditory nuclei of the brainstem. Serotonergic fibers and terminal endings were found in all auditory nuclei extending from the cochlear nucleus to the inferior colliculus, including the superior olivary complex and the nuclei of the lateral lemniscus. The density of the innervation varied between and within each nucleus. All serotonergic cell bodies were located outside the auditory nuclei. The 5‐HT1A receptor subtype was found in the cochlear nucleus as well as in the inferior colliculus. With no serotonergic cell bodies present in the auditory nuclei, the present neuroanatomic and neurochemical findings support behavioral and neurophysiologic findings that the serotonergic system may modulate central auditory processing.
Dizziness in aging: A retrospective study of 1194 cases
Authors: Katsarkas Athanasios
Published: November 2015

In the Royal Victoria Hospital dizziness clinic, 1194 of 9767 (12.22%) patients were 70 years of age or older on the day of the first visit. There were 750 women and 444 men, with no difference in age distribution (p > 0.9). In 367 (27.04%) cases (percentages given as “cases” refer to the number of diagnoses [N = 1357], not the number of patients [N = 1194]), the symptoms were nonspecific, and the diagnosis was uncertain. In 530 (39.13%) patients, paroxysmal positional vertigo was either confirmed or strongly suspected. In the 241 of 254 (94.88%) confirmed cases, the observed paroxysmal nystagmus was compatible with excitation of the posterior semicircular canal. In 119 (8.77%) patients, the dizziness could not be attributed to neurologic or vestibular disease. Meniere's disease, vestibular neuronitis, vascular episodes, and tumors were next in prevalence. The following conclusions were reached: (1) although no difference was found in age distribution between women and men, dizziness was more prevalent among women, which may be because of the higher survival rate of women; (2) the prevalence of paroxysmal positional vertigo was high, with apparent Involvement of the posterior semicircular canal in most cases (It is strongly suspected that paroxysmal positional vertigo is frequently misdiagnosed as vascular disease in advanced age); and (3) multisensory deficits, drugs, or systemic diseases, common in the elderly, may cause dizziness. Syndromes affecting the vestibular function, however, may be more prevalent in advanced age than is generally estimated.
Management of the high jugular bulb in the translabyrinthine approach
Authors: Saleh Essam A. , Aristegui Miguel , Taibah Abdel Kader , Mazzoni Antonio , Sanna Mario
Published: November 2015

A high jugular bulb is a frequent problem in the translabyrinthine approach. This article described a safe technique for effective inferior displacement of the high bulb.
Effects of Air Pollution on the Upper Respiratory Tract of Children
Authors: Koltai Peter J.
Published: November 2015

The impact of the environment on the upper respiratory tract of children has become an issue of recent interest. Sulfur dioxide causes nasal congestion in children as well as an increase in both mast cells and lymphocytes in nasal lavage fluids. Chlorpheniramine blocks the effect of sulfur dioxide on the nasal mucosa. Ozone exposure results in nasal congestion, increased levels of histamine, neutrophils, eosinophils, and mononuclear cells in nasal lavage fluid. No data are available on the effects of nitrogen dioxide or wood‐burning stoves on the upper respiratory tracts of children. Formaldehyde in sufficient concentrations causes upper airway irritation; however, no data are available on its long‐term effects. Detriments in air quality cause adverse changes in the lower respiratory tracts of susceptible individuals. The effects on the upper respiratory tract are more difficult to document. There may be a causal relationship, but definitive proof of whether air pollution results in significant increases in pediatric otitis media, sinusitis, rhinitis, and pharyngitis has yet to be demonstrated.
Larynx Preservation with Combined Chemotherapy and Radiation Therapy in Advanced Hypopharynx Cancer
Authors: Kraus Dennis H. , Pfister David G. , Harrison Louis B. , Shah Jatin P. , Spiro Ronald H. , Armstrong John G. , Fass Daniel E. , Zelefsky Michael , Schantz Stimson P. , Weiss Michael H. , Wang Robert C. , Bosl George J. , Strong Elliot W.
Published: November 2015

Twenty‐five untreated patients with advanced, resectable squamous cell carcinoma of the hypopharynx, for whom standard treatment would have required total laryngectomy, were treated with one to three cycles of cisplatin‐based chemotherapy with larynx preservation as the goal. Patients with a major (complete or partial) response to chemotherapy at the primary site were treated with definitive radiation therapy, with total laryngectomy reserved for salvage; patients with less than a partial response to chemotherapy had total laryngectomy and postoperative radiation therapy recommended. Four patients had a poor response to chemotherapy and thus were not candidates for laryngectomy. Total largynectomy was required for initial induction chemotherapy failure in five patients and for local recurrence in five others. Three additional patients had unresectable recurrence. Successful larynx preservation was achieved in 32% (8 of 25). With a median follow‐up period of 41 months, the actuarial overall and failure‐free 2‐year survival rates were 44% and 32%, respectively. These preliminary data suggest larynx preservation is feasible in patients with advanced lesions of the hypopharynx. Improved local and regional control must be incorporated into the larynx preservation approach for hypopharyngeal lesions. A prospective, randomized study is necessary for a more valid comparison with conventional therapy, including comparative assessments of survival, morbidity, cost and functional results.
Angiographic Embolization for the Treatment of Epistaxis: A Review of 108 Cases
Authors: Elden Lisa , Montanera Walter , Terbrugge Karel , Willinsky Robert , Lasjaunias Pierre , Charles David
Published: November 2015

Ninety‐seven patients were referred to the Toronto Hospital (Western Division) between January 1984 and January 1992 for selective angiograpic embolization (108 embolizations, including repeat procedures) to control intractable or recurrent severe epistaxis. Eighty‐one patients (comprising 94 embolizations) were referred on an emergent basis because of failure of conventional conservative therapy, consisting of anterior and posterior packing. The remaining 16 patients (14 embolizations) were referred electively for recurrent epistaxis. A retrospective review of these cases was performed, with long‐term telephone follow‐up achieved in over 95% of cases. Embolization safely controlled active hemorrhage in 88% of the emergent cases. The success rate increased to 90% when two cases in which the source of epistaxis was found to be from the internal carotid artery were excluded (because these vessels could not be safely embolized). Of the patients whose epistaxis was initially controlled by embolization, 82% had no further nosebleeds (follow‐up time ranged from 2 to 82 months; average, 26.8 months). More than half of the long‐term failures were seen in patients with Osier‐Weber‐Rendu disease. Overall, the mortality rate was 0% and the long‐term morbidity rate was 2% (one cerebral vascular accident and one case of skin slough in the territory of the superficial temporal artery).
Transsphenoidal Hypophysectomy through the External Rhinoplasty Approach
Authors: Koltai Peter J. , Goufman Dimitry B. , Parnes Steven M. , Steiniger JOseph R.
Published: November 2015

The external rhinoplasty approach is a refinement of the well‐recognized sublabial transseptal technique for transsphenoidal hypophysectomy first introduced by Cushing in 1910. This article relates our experience with 111 cases of transsphenoidal hypophysectomy performed during a 10‐year period (1982–1992) and includes a detailed description of our use of the external technique. Fifty‐one patients were male, and 60 were female. Ages ranged from 12 years to 80 years, with an average of 46 years. One hundred one patients had pituitary adenomas, four had craniopharyngiomas, two had inverting papillomas, and there was one each of lymphoma, metastatic prostate cancer, pituitary abscess, and posttraumatic cerebrospinal fluid leak. Nine of the operations were for recurrent adenomas. Complications included 8 symptomatic anterior septal perforations and 13 asymptomatic posterior perforations. Five had transient cerebrospinal fluid rhinorrhea, five had perioperative hemorrhages, two had minor postoperative columellar deformities, and one had injury to the internal carotid artery requiring embolization. We have found the external technique for transsphenoidal hypophysectomy to be a reliable and facile means for nasal exposure of the sphenoid sinus and pituitary gland without loss of nasal tip projection or significant cosmetic deformity.
Presentation and Diagnosis of Small Acoustic Tumors
Authors: Dornhoffer John L. , Helms Jan , Hoehmann Dirk H.
Published: November 2015

With the recent advent of magnetic resonance imaging and auditory brain stem response, it is now possible to diagnose acoustic tumors while they are still quite small. As a result, it is becoming obvious that the clinical presentation of these smaller lesions can be somewhat variant to what is considered typical for an acoustic neuroma. Likewise, although the sensitivity of auditory brain stem response for larger tumors is believed to be quite good, the sensitivity for smaller tumors has recently been questioned, particularly when the patient is first seen early in the course of the disease with only mild otologic complications. To assess auditory brain stem response results as well as clinical and audiologic presentations, we conducted a retrospective study of patients treated for small acoustic tumors (less than 1 cm). Of the 70 patients included in the study, auditory brain stem response was abnormal in 65 (93%), on the basis of wave V latency prolongation and interaural latency differences. This would indicate that auditory brain stem response is a valid screening test for acoustic tumors, even in early stages of development. The clinical presentation of patients with small acoustic tumors was similar to that reported for acoustic tumors in general, but with vertigo occurring more frequently in patients with smaller tumors. Several atypical patterns of hearing loss were also noted.
Hearing Results in Surgery for Primary Petrous Apex Lesions
Authors: Gianoli Gerard J. , Amedee Ronald G.
Published: November 2015

Hearing preservation is a frequently mentioned phrase in the growing field of skull base surgery. Many authors have attempted to identify prognostic factors for successful hearing preservation, and many have suggested alternative procedures for preserving serviceable hearing. Few have mentioned hearing improvement with skull base surgical procedures. In this article we present the hearing results of 25 surgical procedures for primary petrous apex lesions. These Include 13 cholesterol granulomas, 5 cholesteatomas, 4 mucoceles, and 3 eosinophilic granulomas. Surgical approaches included 14 transmastoid/infralabyrinthine, 6 transphenoid, 3 suboccipital, and 2 transmastoid/translabyrinthine. Hearing was maintained In 14 patients (56%), Improved in 9 patients (36%), and worse in 1 patient with nonserviceable hearing before surgery (4%); 1 patient had profound hearing loss before surgery (4%). Results of this review should have significant implications on the choice of surgical approach for petrous apex lesions. Additionally, the standard method of determining salvageable hearing for most skull base procedures may not apply for this specific group of lesions. Implications for future treatment plans will be discussed in detail.
Protein Profile of Human Perilymph: In Search of Markers for the Diagnosis of Perilymph Fistula and other Inner Ear Disease
Authors: Thalmann Isolde , Kohut Robert I. , Ryu Jay , Comegys Thomas H. , Senarita Masamitsu , Thalmann Ruediger
Published: November 2015

Recent developments in high‐resolution two‐dimensional polyacrylamide gel electrophoresis, combined with amino acid sequencing and computer‐assisted image analysis, have allowed separation of approximately 100 proteins and identification and quantitation of some 30 proteins in human perilymph. The majority of proteins were found to be present in perilymph at levels in basic agreement with the total protein gradient between perilymph and plasma (1:35). However, several striking differences were observed: (1) β2‐transferrin, known to be absent from normal plasma but present in cerebrospinal fluid, was detected in perilymph at a concentration roughly equal to that in cerebrospinal fluid; and (2) two high‐density lipoprotein‐associated apolipoproteins—apo D (formerly PLS:33) and apo J or NA1 and NA2 (formerly PSL:29/30), the latter showing identity with 5P40/40, or cytolysis inhibitor—were found to be present at concentrations 1 to 2 orders of magnitude higher when examined in terms of total protein and to be comparable with or higher than plasma levels when examined in terms of absolute concentrations. The functional significance of the extremely high levels of the two apolipoproteins is not known at this time. An attempt was made to use β2‐transferrin, as well as apo D and apo J (NA1/NA2), as markers for the diagnosis of perilymph fistula, one of the most controversial and challenging problems for the otologist today. It was determined that the technique is indeed applicable when relatively pure fistula samples are analyzed. Limitations and potential improvements of the technique are discussed. In addition, the potential usefulness of two‐dimensional polyacrylamide gel electrophoresis in other pathologic conditions of the inner ear is discussed briefly.
The Subgame Imperfection of Financial Capitalism
Authors: Correa Amelia , Correa Romar , Rao D. Tripati , Tavares Graciella
Published: November 2015

We formulate and solve the Pasinetti (1962) model as a dynamic game played between capitalists and workers. The interest rate is shown to be bounded above. If the discount rates of capitalists and workers required to sustain cooperation between them exceed this interest rate the Nash equilibrium unravels. We introduce a bank whose sole objective is to lower the rate of interest. The financial intermediary cannot ensure the equality through time of the supply of and the demand for assets in general.
Toward a Theory of Policy Leadership: Three Propositions
Authors: Wallis Joe , Dollery Brian
Published: November 2015

This paper formulates a theory of policy leadership based on propositions that relate to the conditions under which rival leadership coalitions engage in a contest for authority over the system-wide direction of the policy process and differentiate themselves according to distinctive styles in respect of which the demand shifts due to the endogenous accumulation of disappointment over distinct phases of a process of paradigmatic policy change. It both draws from concepts familiar to policy theorists and the work of economic revisionists who have sought to make the expressive dimension of phenomena such as leadership more amenable to deductive analysis.
Man, Institutions and Bioeconomics
Authors: Gil Javier Alfonso
Published: November 2015

Because bioeconomics is born of the interaction between the biological activity system and its socio-economic activity system, a holistic methodological approach is essential to study the relations between them. However, it must search for increasing levels of reductionism within each discipline to delve into the ultimate nature of each one of the intervening forces, whether economic or biological. This paper explores the economic forces.

Through the biological capacity to comprehend, man and by extension, society, accumulates knowledge, the fulcrum from which he is able to dominate over his natural habitat. From this ‘point d’appui’, man builds two basic tools to assist him in achieving the goal of bettering his social condition. On the one hand, he creates institutions that allow him to “live with others” and, on the other, he develops technology that helps him to “live better with others”. Institutions, also referred to as ‘social technology’, tend toward stability over time while technology or ‘material technology’, tends toward instability, which would suggest that, normally, the mechanics of change will originate in material technology and, from there, progress to social technology by way of the political market.

The level of progress and development attained depends on the quantity and rate of growth of knowledge applied by a society. In the process, man and his collectivity are forced to adopt new views of their environment through new shared mental models. The concurrence of equipment and political market will ultimately become the prime mover of institutional and economic change as well as change in mentality. Both technologies must keep on an adaptive course of stable evolution since discrepancies arising between them can cause tension between the various social groups. Adequate management of technological shock is essential to avoid extreme situations of social conflict. Herein lie the most important political decisions that a government must confront over the long term.
Targeted support for high growth firms: Theoretical constraints, unintended consequences and future policy challenges
Authors: Brown Ross , Mawson Suzanne
Published: November 2015

High growth firms are now a major focus within enterprise policy. This paper provides a theoretically informed analysis of the rationale and effectiveness of targeted public sector support designed to develop these firms. Drawing on empirical research undertaken in the UK, this paper challenges the appropriateness of the theoretical assumptions embodied in these state-backed support instruments. It outlines the nature of these programmes and provides a critique of some of their inherent weaknesses, revealing that the assumptions underpinning these programmes are often flawed. The paper examines the limitations of their selection procedures, the thematic nature of support and exit dynamics. It found that offering early stage firms intensive levels of resources may have important (and detrimental) unintended consequences previously overlooked by policy makers. The paper offers some suggestions for how policy instruments could be better attuned to the needs of these growth-oriented firms.
A Comparison of Defective Platelet Count and Aggregation between the Valve Replacement and Cyanotic Congenital Heart Cases during Cardiopulmonary Bypass
Authors: Gu Yan-Ji , Wang Yi-Shan , Ye Chun-Xiu
Published: November 2015

Platelet count and ADP-induced platelet aggregation were studied in 10 single valve replacement (VR) patients and 10 cyanotic congenital heart disease (CCHD) patients undergoing cardiopulmonary bypass (CPB). The mean platelet count dropped to 78% in VR group and 73% in CCHD group at 30 minutes CPB as compared with the prebypass levels (being corrected for haemodilution). The mean prebypass platelet aggregation value was 65·5% ± 7·5% (Mean ± SEM) in VR group and 56·5% ± 5·2% in CCHD group; the values dropped to 54·2% ± 4·5% and 28·2% ± 4·8% respectively in VR and CCHD groups ( P < 0·01) at 30 minutes CPB. Both groups had a slight further drop at the end of the CPB, but only CCHD group had a further drop in platelet aggregation function after protamine administration. Mean plasma haemoglobin was much higher in the CCHD group than that in VR group at the termination of the bypass ( P < 0·05). Increased blood transfusion volumes were needed and greater blood losses noticed in the CCHD group. A significant negative correlation ( r = 0·5044. P < 0·05) was found between platelet function measured at the termination of CPB and postoperative bleeding. Cardiopulmonary bypass in patients with CCHD appears to be associated with greater platelet dysfunction and this results in more serious haemostatic defects after CPB. It is necessary to have further studies of the defective haemorrhagic status in these patients. More advanced perfusion techniques should be applied to preserve platelets during cardiopulmonary bypass.
Decrease of Total Serum Cholesterol and Apolipoproteins A1 and B Levels during and after Extracorporeal Circulation
Authors: Seguin Jacques R , de Paulet Pierrette Crastes , de Paulet Jacques Crastes , Chaptal Paul A
Published: November 2015

Cholesterol, apolipoproteins A1 and B and triglycerides were evaluated before, during and after extracorporeal circulation during cardiac surgery to a precise degree and chronology of variations. Cholesterol, apolipoprotein B and triglycerides show a significant and persistent decrease following initiation of extracorporeal circulation. Triglycerides decrease is due to factors such as heparin administration. Cholesterol and apolipoprotein B decrease does not appear to be due either to contact with extracorporeal circulation circuit nor hypothermia. Decrease of hepatic VLDL and HDL production or modifications of LDL-cholesterol cell clearance are possible explanations.
An Automatically Regulated Low Prime Heart-Lung Machine for Infants: A Rabbit Model
Authors: Wabeke Erik , Mook Piet H , Elstrodt Jan M , Wildevuur Charles RH
Published: November 2015

A new compact heart-lung machine for paediatric use was designed. The total volume of this system of only 90ml allows for priming without the use of donor blood. The priming volume could be kept small mainly by replacing gravity drainage with drainage by a negative pressure in the venous reservoir. To avoid volume shifts between the extracorporeal circuit and the infant's circulation and to safely operate this minimal volume circuit, the heart-lung machine was automatically controlled. In this study we show that the miniaturized system functioned reliably under various conditions during cardiopulmonary bypass in rabbits.
Symbol, Metaphor and Story: The Function of Group Art Therapy in Palliative Care
Authors: Mayo Sheila
Published: November 2015

The links are described between analytic linear thinking and the associate modes of imagination and metaphor, explored and experienced in a weekly art therapy group held in the Studio, St. Catherine's Hospice, Crawley, West Sussex.
Crime and Disorder: Perceptions of Business People in Cornwall, England
Authors: Mawby R.I.
Published: November 2015

While there has, recently, been a spate of research on the victimisation of businesses, rather less research has focused on the perceptions of the business community, and — in contrast to studies of the general public — little emphasis has been placed on explaining variations in concern over crime and disorder. This article uses data from the 2001 Cornwall Business Crime Survey to explore the extent to which business people in a rural county of England perceive crime and disorder to be a problem locally and are concerned at its impact on their businesses.

The findings suggest that crime and disorder were not considered the most serious problems facing local businesses, but nevertheless evoked some concern, particularly among a significant minority of respondents. The article then focuses on explaining variations in perceptions and concludes that these can be understood in terms of the nature of the businesses, their location, and the extent to which businesses had experienced crime. These findings largely parallel Hough's (1995) earlier work explaining anxiety among the general public.
Art, Economy, and the Differentiation of Value
Authors: Rajan Roby
Published: November 2015

The question of value comes to the fore in early modernity with the delineation of the distinct discursive fields of economics, ethics, and aesthetics, and their respective development into the self-sufficient practical forms of economic rationality, private morality, and modern art. Lying as it does at the intersection of the modern subject's internal world of needs and desires and the external world of the sources of their gratification or deferral, value begins to assume a considerable importance. Although the three realms of value co-emerge as differentiated with the inauguration of modernity, and each has been accompanied by a discourse concerned to elaborate its own autonomy and self-referentiality, they nevertheless stand in a complex relation to one another to define themselves mutually in a crisscrossing network of relations.
Crime, Criminological Research, and Criminal Policy in West and East Germany before and after Their Unification
Authors: Schneider Hans Joachim
Published: November 2015

In October 1990 the two German states united after 40 years of separation. Since crime rate figures had been manipulated and empirical studies had not been carried out for decades, criminological research needs to be started afresh in the new federal states. This is because in consequence of the differing standards of living and economic situations criminality is almost certain to climb and change its structure and appearance. The population must learn to trust the newly emerging judicial and criminal justice system.
Where the Wild Things Are: Primary Level Taxa in Israelite Zoological Thought
Authors: Whitekettle Richard
Published: November 2015

This paper examines Israel's system(s) of zoological classification in an effort to understand how the Israelites gave conceptual order to their inventory of animals. In particular, the paper examines the primary taxonomic level, which consists of the broad, inclusive taxa that are situated at the most general level of taxonomic discrimination (e.g. Animals → Land Animals/Aerial Animals/Aquatic Animals). The paper demonstrates that there are several primary legal divisions found in the textual record, including a twofold (Terrestrial Animals/Aquatic Animals), a threefold (Land Animals/Aerial Animals/Aquatic Animals), several fourfold (e.g. Land Animals/Two-legged Aerial Animals/Four-Legged Aerial Animals/Aquatic Animals), and several fivefold schemas (e.g. Domesticated Land Animals/High Carriage Wild Land Animals/Low Carriage Wild Land Animals/Aerial Animals/Aquatic Animals).
Homophobia and Rape in Sodom and Gibeah: A Response to Ken Stone
Authors: Carden Michael
Published: November 2015

Readings of Genesis 19 and Judges 19 that highlight homosexuality as an interpretive device ignore the different historical and cultural context behind these texts and the contemporary politics in which these texts are enmeshed. The anthropological literature on Mediterranean and Middle Eastern cultures reveals a phallocentric construction of gender and male sexuality. Under this structure, men who are penetrated by other men are stigmatized as queer, in Western terms, considered homosexual. The penetrators are not stigmatized and are equivalent to heterosexual men in Western culture. Male rape of outsiders in this context relieves the homosexual panic of the insiders, reinforcing their heterosexuality (honour) by inscribing the outsider as queer and the queer as outsider. Male rape in Genesis 19 and Judges 19 is an act of homophobic violence signifying the abuse of outsiders and the breach of the community of Israel.
“I Don't Know Who to Blame”: Hiv-Positive South African Women Navigating Heterosexual Infection
Authors: Long Carol
Published: November 2015

Women who become HIV infected through heterosexual transmission are faced with the task of making sense of how they became infected. This paper presents a qualitative analysis based on interviews with 35 HIV-positive South African Black women. A specific theme, that blame of a male partner was avoided or disavowed in interviews, is explored in relation to broader contexts concerning gender and HIV. It is suggested that the repeated phrase “I don't know who to blame” expresses gender-differentiated speaking rights. It also protects women from voicing their own anger, guilt and internalization of badness as a result of an HIV-positive diagnosis. Further, it protects women from exposure to male destructiveness and from confronting the possibility that they themselves are implicated in the infection of others. Analysis offers opportunities for exploring how women both resist and repeat dominant discourses and dominant fears related to HIV-infected womanhood.
Linking Characteristics Discovered in Spelling Assessment to Intervention Goals and Methods
Authors: Masterson Julie J. , Apel Kenn
Published: November 2015

This article presents two approaches to determining the goals and methods of instruction in spelling. One approach is to administer a standardized test, document the student's grade-level performance, present lists of words at that grade level to the student, and then test his or her performance each week. The other approach is prescriptive and tailored in both assessment and treatment methods. A sample of words at the appropriate developmental level is elicited, and the student's spellings for each sound are scored to identify the orthographic patterns that are not mastered. Next, the misspellings are analyzed to determine a likely cause for each. Omissions are classified as problems in phonemic awareness, illegal misspellings as difficulties in orthographic knowledge, and legal misspellings as deficiencies in storing mental graphemic representations. Finally, problems with juncture modifications or affixes are considered deficits in morphological knowledge. A case study illustrating treatment ramifications of each assessment approach is presented.
Introduction to the Special Issue on Technology Integration
Authors: Smith Sean J.
Published: November 2015

This article offers a rationale for why efforts to further technology integration into the lives of students with learning disabilities (LD) should be considered within the ever-growing response to intervention (RTI) approach permeating prevention and intervention efforts for struggling students and those with LD. This introduction is followed by an overview of the five articles that make up this special issue of the Learning Disability Quarterly. Each article seeks to build on the previous one in order to assist the reader in understanding current and future ramifications of technology integration within the RTI framework.
Graphic Organizers and Students with Learning Disabilities: A Meta-Analysis
Authors: Dexter Douglas D. , Hughes Charles A.
Published: November 2015

This meta-analysis reviews experimental and quasi-experimental studies in which upper-elementary, intermediate, and secondary students with learning disabilities learned from graphic organizers. Following an exhaustive search for studies meeting specified design criteria, 55 standardized mean effect sizes were extracted from 16 articles involving 808 participants. Students at levels ranging from grade 4 to grade 12 used graphic organizers to learn in core-content classes (English/reading, science, social studies, mathematics). Posttests measured near and far transfer. Across several conditions, settings, and features, the use of graphic organizers was associated with increases in vocabulary knowledge, comprehension, and inferential knowledge. Mean effect sizes varied from moderate to large based on type of measure, type of graphic organizer, and subject area. Conclusions, implications for future research, and practical recommendations are presented.
Maintaining ethnic dominance: Diversity, power, and violent repression
Authors: Rørbæk Lasse Lykke , Knudsen Allan Toft
Published: November 2015

While ethnically diverse countries are generally believed to be more violent than homogenous ones, previous research has been unable to establish a clear connection between ethnic diversity and violent repression. We argue that political authorities’ tendency to violently repress their citizens cannot be explained by the ethnic composition of society per se but by the power distribution between ethnic groups. In a global sample of countries for the period 1977–2010, we find statistical evidence that the level of violent repression increases with the share of the population excluded from state power on the basis of ethnic affiliation. We combine this with a case study of the Republic of Guinea and conclude that political authorities come to see excluded ethnic groups as threats and rely on violent repression to maintain their ethnic dominance.