bluuebunny/crossref_metadata_2025 huggingface dataset:
Retropharyngeal Hematoma Secondary to Minor Blunt Head and Neck Trauma
Authors: Daniello Nicholas J. , Goldstein Steven I.
Published: May 2019

Retropharyngeal hematomas are relatively rare. They are clinically important because of the close proximity of the retropharyngeal space to the upper airway. Any swelling in the space may cause the posterior pharyngeal wall to bulge anteriorly into the airway and cause airway obstruction. Management starts with securing and maintaining the patient's airway. Diagnosis rests upon clinical examination and radiographic studies. Treatment depends upon the size of the hematoma as well as the clinical course of the patient. Smaller hematomas may be observed. Larger hematomas and those that fail to reabsorb should undergo drainage. A case of retropharyngeal hematoma following minor blunt head and neck trauma is presented. We review the literature and present management and treatment principles for this group of patients.
Long-Term follow-up with the Bone-Anchored Hearing Aid: A Review of the First 100 Patients between 1977 and 1985
Authors: Tjellström Anders , Granström Gösta
Published: May 2019

Skin-penetrating implants have been used since 1977 for retention of Bone Anchored Hearing Aids, or BAHA. This paper analyzes the stability of the implants and the frequency of skin reactions in the first one hundred consecutive patients operated upon at Sahlgrens Hospital, Göteborg. The follow-up time varied between 8 and 16 years. Ninety percent of the implants were found to be stable. Five percent were explanted due to direct trauma. Another five percent lost integration but often after many years in use. Adverse skin reactions were seen, but 79% of the patients had no or one single episode of soft tissue reaction.

A percutaneous coupling in the mastoid process will give rise to only minor clinical problems and could be considered as a simple, predictable and safe device.
Speech Recognition with the Bone-Anchored Hearing Aid Determined Objectively and Subjectively
Authors: Snik AFM , Mylanus EAM , Cremers CWRJ
Published: May 2019

Some patients with a bone-conduction hearing aid experience serious problems such as skin irritation or headaches and inconsistency in the sound quality due to shifting of the transducer over the mastoid. The Bone Anchored Hearing Aid (BAHA) provides direct bone-conduction and therefore evades these problems.

Results of 58 patients fitted with either the head level BAHA HC200 or the more powerful HC220 were available for evaluation. Speech recognition-in-quiet and in-noise tests were performed in order to make a comparison between the patients’ performance with their individually adapted BAHA and their previous hearing aid. Furthermore, all the patients filled out a questionnaire, involving questions on speech recognition-in-quiet and in-noisy surroundings. Individual comparisons of the audiological and questionnaire results in the subgroup of patients who had used a bone-conduction hearing aid showed that the results with the BAHA were comparable with or significantly better than those with the previous bone-conduction hearing aid. The results in the patients who had previously used an air-conduction hearing aid were ambiguous.
Restoration of Binaural Hearing with the Audiant Implant following Acoustic Neuroma Surgery
Authors: Pulec Jack L.
Published: May 2019

Experience with the use of The Audiant Bone Conductor hearing implant in 8 patients who had unilateral profound hearing loss following acoustic neuroma surgery shows it to beneficial. Patients must have good hearing by bone conduction in the opposite uninvolved ear to be a candidate. Patients with unilateral hearing loss have the choice of doing nothing and getting along with one ear, they may be fitted with a CROS (contralateral routing of the signal) hearing aid or they may use the bone conductor hearing implant. Our experience suggests that patients prefer the bone conductor hearing implant since the resulting binaural hearing sounds more natural and an instrument needs to be worn on only one side. A surgical technique and new instrumentation to minimize the size and extent of the surgeries is described. The surgical implantation is usually done one month after acoustic neuroma surgery and is performed under local anesthesia in the outpatient surgery.
Performance of Prelingually or Postlingually Deafened Adults who were using a Single or Multichannel Cochlear Implant
Authors: Hinderink JB , Snik AFM , Mens LHM , Brokx JPL , van den Broek P
Published: May 2019

Long-term (two-year post-implantation) speech recognition was evaluated of prelingually and postlingually deafened adult cochlear implant users who had received either a single or a multichannel device. The patient group comprised 8 pairs of patients matched according to the onset and duration of deafness; in each pair one patient had an extra-cochlear single-channel implant and one had an intra-cochlear multichannel implant.

A CDT (Continuous Discourse Tracking) test and a closed-set speech recognition test were used for speech recognition. The results of the postlingually deafened pairs of patients showed that the multichannel implant was superior to the single-channel implant, which is in agreement with other studies. In the pairs of prelingually deafened adult patients, the multichannel system was not found to be superior. This warrants further study and further application of single-channel implants in prelingually deafened patients.
Natural Course of Meniere's Disease in Surgically-Selected Patients
Authors: Filipo R. , Barbara M.
Published: May 2019

Meniere's disease (MD) is considered a complex otologic disorder characterized by exacerbation and remission periods which of ten make its natural course unpredictable. Several studies in the past have analyzed the evolutionary course of MD through comparison between patients under medical treatment and those surgically treated. The present paper aimed to study the evolution of MD in a group of patients who were selected for endolymphatic sac surgery on the basis of a fluctuating stage and uncontroll able recurrent vertigo; some of them, however, did not undergo surgery for different reasons and were used as control for MD at a homogenous stage. Vertigo and tinnitus were improved by surgery in a significant number of patients in comparison with the non-surgical gro up. Hearing function, which improved few months after surgery in some patients, was found to deteriora te in the long run, in surgical and non-surgical groups. Sac surgery yielded significantly better results for two out of three Meniere's symptoms, i.e. vertigo and tinnitus, and can be considered to play a significant role in the therapy of MD at the fluctuating stage.
Modern Imaging of Paranasal Sinuses and the Role of Limited Sinus Computerized Tomography; Considerations of Time, Cost and Radiation
Authors: Mafee Mahmood F.
Published: May 2019

The modern diagnostic radiology department is equipped with a variety of medical imaging systems that can be used for evaluation of diseases of the sinonasal cavities. Each has advantages and disadvantages. The imaging examinations of the paranasal sinuses may include conventional films, complex motion tomography, computed tomography (CT) and magnetic resonance imaging (MRI). The indications for these imaging methods are reviewed, along with a discussion on the role of imaging for endoscopic sinus surgery. A summary of CT anatomy relating to the ethmoidal sinuses and ostiomeatal complex is given, as is a review of the risk of radiation for radiologic sinus imaging.
The Use of Video in ENT Endoscopy: Its Value in Teaching
Authors: Yanagisawa Eiji
Published: May 2019

Videography is the most practical and effective method of documenting and teaching ENT endoscopy. Videography allows: (1) documentation of anatomy, physiology and pathology of deep structures of the ear, nose and throat; (2) teaching of delicate surgical procedures such as functional endoscopic sinus surgery (FESS), laryngeal surgery, and other endoscopic procedures; (3) instantaneous production of high quality hard copies of video images for teaching and patient records; (4) instant replay and repeated viewing by a slow motion or frame-by-frame analysis; (5) simultaneous viewing by a small or large audience; and (6) image digitalization for storage in the computer for later analysis. The author describes the value of videography in ENT endoscopy, namely video-otoscopy, video rhinoscopy and video-laryngoscopy. The use of video in endoscopy will continue to play a vital role in Continuing Medical Education (CME).
A Neural Network Approach to the Prediction of Pure Tone Thresholds with Distortion Product Emissions
Authors: Kimberley Barry P. , Roth Brent M. Kimberley Leah
Published: May 2019

Distortion Product Emission (DPE) growth functions, demographic data, and pure tone thresholds were recorded in 229 normal-hearing and hearing-impaired ears. Half of the data set (115 ears) was used to train a set of neural networks to map DPE and demographic features to pure tone thresholds at six frequencies in the audiometric range. The six networks developed from this training process were then used to predict pure tone thresholds in the remaining 114-ear data set. When normal pure tone threshold was defined as a threshold less than 20 dB HL, frequency-specific prediction accuracy varied from 57% (correct classification of hearing impairment at 1025 Hz) to 100% (correct classification of hearing impairment at 2050 Hz). Overall prediction accuracy was 90% for impaired pure tone thresholds and 80% for normal pure tone thresholds. This neural network approach was found to be more accurate than discriminant analysis in the prediction of pure tone thresholds. It is concluded that a general strategy exists whereby DPE measures can accurately categorize pure tone thresholds as normal or impaired in large populations of ears with purely cochlear hearing dysfunction.
Tumefactive Fibroinflammatory Lesion of the Head and Neck: A Management Strategy
Authors: Laurenzo John F. , Graham Scott M.
Published: May 2019

Tumefactive fibroinflammatory lesions are rare, benign, fibrosclerosing masses in the head and neck that appear clinically as malignancies. Twenty-one cases have been described since first reported in 1975. While all authors agree on the lesion's histopathologic characteristics, multiple variations in appearance, treatment, and results have been reported. We review a case and compile all previously reported cases. Common sites of involvement were sinonasal tract (41%), neck (37%), and parotid (23%). Symptoms frequently reported were pain (50%) and hard mass (55%). Five patients (23%) eventually developed extra-head and neck fibrosclerosing lesions. Treatments have included surgery, radiation, and corticosteroids, occasionally in combination. Results have varied depending on size and location of lesion. Based on this review, a discussion of this rare disease and recommendations regarding diagnosis and treatment are given.
The Human Immunodeficiency Virus and Facial Plastic Surgery
Authors: Maas Corey S. , Sussman Stephen A. , Hewett John Joseph
Published: May 2019

The Human Immunodeficiency Virus (HIV) has imparted a number of concerns involving patient care and management as well as health care worker safety upon most surgical practices. Although these concerns are not often discussed in the context of facial plastic surgery (or particularly cosmetic surgery), they remain important issues. These issues are discussed with respect to public health policy, ethics and legality. The pathophysiological considerations for decision-making and care for HIV disease in the facial plastic surgery practice are addressed.
Head and Neck Infections in Pediatric Cardiac Transplant Patients
Authors: Haddad Joseph , Inglesby Thomas V. , Addonizio Linda
Published: May 2019

A retrospective chart review was undertaken at Columbia Presbyterian Medical Center to assess the incidence, etiology and management of head and neck infections in pediatric cardiac transplant patients on immunosuppression. From June 1984 to February 1992, 59 cardiac-transplants were performed on 57 pediatric patients. Standard immunosuppressive therapy was used. Thirteen of these patients died within three months of transplant and were not included. Of the 44 patient charts reviewed, 82 head and neck infections were documented in 27 patients (61%). There were 26 episodes of sinusitis, 27 episodes of otitis media and 20 episodes of tonsillitis/pharyngitis. Unusual middle-ear pathogens seen included Morganella morgagni and Pseudomonas aeruginosa. These preliminary data suggest that children on immunosuppression for cardiac transplant may be at risk for head and neck infections from unusual or unsuspected organisms, and tympanocentesis plays an important role in diagnosis and treatment. A prospective study is planned to gain further data.
The Use of Molded Tympanic Heterograft (Lamb Peritoneum)
Authors: Ensari S. , Selampinar F. , Akalin Y. , Kara C.O. , Dagli S. , Ergin A. , Özdem C.
Published: May 2019

The molded heterograft tympanic membrane was applied to twenty-five ears during tympanoplasty. The advantages and disadvantages of the graft material are discussed. Although autograft use is the principal choice, we strongly believe that this heterograft technique may be an alternative for tympanic membrane grafting; especially in revision cases in which temporalis fascia has already been used.
Audiogram Construction Using Frequency-Specific Auditory Brainstem Response (ABR) Thresholds
Authors: Frattali Mark A. , Sataloff Robert Thayer , Hirshout Debra , Sokolow Caren , Hills James , Spiegel Joseph R.
Published: May 2019

Brainstem evoked response audiometry (ABR) permits auditory pathway assessment without the need for voluntary response. Brainstem responses are unaffected by attention, drugs, and most other confounding conditions. Consequently, if ABR could be used to determine hearing threshold in the speech frequencies, it would have great value for patients who are unable or unwilling to respond accurately during behavioral audiometric testing. Utilizing broad band clicks, one can only estimate hearing sensitivity in the frequency range of 2,000 to 4,000 Hz. This is inadequate for medical or legal purposes in which hearing in the speech frequencies must be assessed. Consequently, we have developed a modified ABR technique that permits a more accurate determination of hearing threshold at 500, 1,000, 2,000 and 3,000 Hz, as illustrated in tests on 27 normal ears. This technique has great potential value for neonatal and mentally handicapped populations, as well as for individuals involved in hearing loss litigation.
Airway Obstruction Secondary to Rhinoscleroma during Pregnancy
Authors: Armstrong William B. , Peskind Steven P. , Bressler Kyle L. , Crockett Dennis M.
Published: May 2019

Dyspnea is a fairly common complaint during pregnancy. However, if one excludes allergic nasal congestion of pregnancy, upper airway obstruction is a distinctly uncommon cause of dyspnea in the pregnant patient. Three cases of laryngeal rhinoscleroma in pregnant women requiring tracheostomy for airway management are reported. All three delivered healthy infants vaginally. Postpartum, two of the three were successfully decannulated, while the third became pregnant again before decannulation was accomplished. Treatment options and a review of the literature are presented.
Clinical Manifestations of Transdermal Scopolamine Addiction
Authors: Luetje Charles M. , Wooten James
Published: May 2019

Transdermal scopolamine patches have been extensively prescribed for nonspecific dizziness and vestibular disorders. Patient response may be favorable and side effects are generally limited to xerostomia and blurred vision. However, subtle dependency and outright addiction may develop. Tapered reduction and drug elimination will suffice to eliminate the dependency. However, hospitalization may be necessary to treat severe cases of physiological chemical dependency. Long-term use of transdermal scopolamine patches carries a risk of chemical dependency. Prescribing physicians should review and heed the manufacturer's recommended use.
Facial Nerve Angioma
Authors: Pulec Jack L.
Published: May 2019

Angioma of the facial nerve is a rare benign tumor. Symptoms include progressive or sudden facial paralysis and, often, a facial twitch. Although angiomas have unique features, diagnosis and treatment is similar to that for facial nerve neuroma. Magnetic Resonance Imaging (MRI) with gadolinium infusion and thin-section Computed Tomography (CT) can often identify the lesion. Treatment by total excision and facial nerve grafting can provide a permanent cure with good restoration of facial function. Four cases are discussed.
Clinical Evaluation and Treatment of Immune-Mediated Inner Ear Disease
Authors: Welling D. Bradley
Published: May 2019

Immune-mediated inner ear disease, first described by McCabe’ in 1979, typically presents with an idiopathic, rapidly progressive bilateral sensorineural hearing loss. The course of the hearing loss occurs over weeks to months. It may occur in both sexes and at a variety of ages, but is most common in middle-aged females. It may be accompanied by tinnitus, Meniere's-like vertigo, or more commonly, ataxia or unsteadiness. Approximately 30% of patients will have associated systemic immune-mediated disease. Although refinements in laboratory tests for specific inner ear antigens are being made,2-4 and nonspecific laboratory indicators of inflammatory or systemic immune disease may be useful in confirming the diagnosis, the most important diagnostic finding is the improvement in hearing seen with a trial of immunosuppressants.

This report includes a typical evaluation of the patient with suspected immune-mediated inner ear disease and an illustrative case. Sensorineural hearing loss due to immune-mediated inner ear disease, although unusual as a cause of hearing loss, is important to recognize because early diagnosis and treatment can have a marked effect on the clinical outcome.
Bilateral Fat Graft Myringoplasty in Children
Authors: Mitchell Ron B. , Pereira Kevin D. , Younis Ramzi T. , Lazar Rande H.
Published: May 2019

The results after simultaneous bilateral fat graft myringoplasties in children have not been previously reported in the literature. We report on 28 children who underwent bilateral fat graft myringoplasties as outpatient procedures under general anesthesia. The success rate was 91% at final follow-up, with only 16% of children requiring insertion of pressure-equalizing (PE) tubes following surgery. No complications were documented. We conclude that bilateral fat graft myringoplasties are safe to perform, with an excellent success rate, and are suitable as outpatient procedures.
Microsporidium-Associated Sinusitis
Authors: Moss Ronald B. , Beaudet Lisa M. , Wenig Bruce M. , Nelson Ann M. , Firpo Adolfo , Punja Usha , Scott Thomas S. , Kaliner Michael A.
Published: May 2019

Two cases of biopsy-proven Microsporidium-associated chronic sinusitis in HIV-seropositive patients are presented. Spores of Septata intestinalis were identified by light microscopy and confirmed by electron microscopy in each case. Both patients displayed severe deficiencies of nasal mucosa CD4-positive cells, demonstrated by immunohistochemical methods. Only two other cases of Septata intestinalis-associated sinusitis have been reported previously. Our observations agree with the theory that functional defects in local mucosal immunity may partially explain the acquisition of opportunistic mucosal infections in many HIV-seropositive patients.
Semi-implantable Middle Ear Electromagnetic Hearing Device for Sensorineural Hearing Loss
Authors: Maniglia Anthony J. , Ko Wen H. , Garverick Steven L. , Abbass Hassan , Kane Michael , Rosenbaum Mary , Murray Gail
Published: May 2019

A semi-implantable middle ear electromagnetic hearing device (SIMEHD) is proposed for limited clinical trial in adult patients to evaluate the implantable hearing device for moderate to severe sensorineural hearing loss. Food and Drug Administration (FDA) investigational device exemption (IDE) approval has been granted (May 1996) for clinical trials. The implant unit has been evaluated acutely and chronically in animals (cats) with excellent results. Five cats undergoing chronic implantation were allowed to survive an average of 9.6 months, showing that the SIMEHD is biocompatible, functional and without untoward complications. All implant units recovered from the cats were functional, except for wire breakage of the internal antenna. A new antenna was redesigned for human implantation.

The SIMEHD system consists of an external and internal unit. The external unit consists of a microphone, audio amplifier, modulator, radio frequency (RF) amplifier, antenna and battery. The internal unit is composed of a receiving antenna, hybrid electronic circuit, air core driving coil, and a target magnet cemented to the incus. All materials in contact with the body are biocompatible and expected to survive indefinitely. The implant unit is miniaturized and manufactured with existing fabrication technology by our industrial collaborator, Wilson Greatbatch, Ltd.

The specific aims and major tasks of the proposed research are: a) to evaluate reliability, safety and efficacy of the SIMEHD system in a selected group of patients diagnosed with sensorineural hearing loss, due mainly to presbycusis or aging of the inner ear; and b) to obtain objective and subjective evaluation of audiologic and psychoacoustic performance as compared to the acoustic hearing aid. This paper describes the design, illustrates the actual device (newest prototype) and details the technique for surgical implantation in the attic and mastoid antrum in humans.
Late-Onset Life-Threatening Angioedema and Upper Airway Obstruction Caused by Angiotensin-Converting Enzyme Inhibitor: Report of a Case
Authors: Weng Ping-Kun , Wang Hsing-Won , Lin John K. , Su Wen-Yang
Published: May 2019

Angioedema is a rare but potentially lethal adverse effect when associated with upper airway obstruction. Sporadic cases of angioedema secondary to angiotensin converting enzyme inhibitors (ACEI) have been reported in the literature. The overall incidence is around 0.1% to 0.2%, and the time of onset is usually during the first week of ACEI therapy. Late-onset angioedema secondary to treatment with ACEIs is much more frequent than appreciated, and is largely unrecognized because of the absence of temporal correlation between ACEI therapy and the development of angioedema. Since angioedema may progress to upper airway obstruction, otolaryngologists must be aware of this association. Most importantly, late-onset angioedema should alert the clinician to discontinue the A CEI immediately to prevent further morbidity. This report presents an example of late-onset angioedema which was precipitated by taking a double dose of Captopril incidentally. The case is discussed, and the literature, pathophysiology and treatment of angioedema are reviewed.
“The Fog Index”— Writing for Clarity
Authors: Bruck Laura
Published: May 2019

A dominance of stromal fibrous component over cellular elements is seen in the sclerosing form and the solid type has a dominance of cellular component and a variety of subarchitectures in turn resembling vascular tumors, sarcomas, neurogenous neoplasms or fibrous histiocytomas.
Conservative Management of Traumatic Pseudodiverticulum in the Neonate
Authors: Flanary Valerie A. , Flanary Casey J.
Published: May 2019

Traumatic pseudodiverticulum of the pharynx is an uncommon entity which generally occurs in infants after traumatic intubation or suctioning.1–4 A case of an infant presenting with stridor, drooling and cervical crepitus is presented.
Revision Endoscopic Sinus Surgery: The Thomas Jefferson University Experience
Authors: Moses Ron L. , Cornetta Anthony , Atkins Joseph P. , Roth Maurice , Rosen Marc R. , Keane William M.
Published: May 2019

Since its introduction, functional endoscopic sinus surgery (FESS) has demonstrated success rates of 76% to 98%. A small group of the patients in whom initial FESS and optimal medical therapy fail require revision endoscopic sinus surgery (RESS). This group has recently been studied by several authors, and we have evaluated a group of 90 RESS patients selected from 753 consecutive primary FESS patients. Patients were followed for a mean of 22.8 months. Extent of disease, history of polyps, allergy, previous traditional endonasal sinus surgery, male gender, chronic steroid use, and the presence of a deviated septum all appeared to adversely affect RESS outcome.

The surgeon's knowledge of the sinus anatomy is critical, especially in revision sinus cases in which landmarks are distorted or absent. In our review, RESS was associated with a 1% major complication rate and was successful in 67% of patients. Computer-assisted endoscopic sinus surgery integrates preoperative imaging with realtime endoscopic visualization, augments the surgeon's knowledge of anatomy, and helps to minimize patient risk.
Effect of Corrective Make-Up Training on Patients with Facial Nerve Paralysis
Authors: Kanzaki Jin , Ohshiro Kimiko , Abe Tsuneyuki
Published: May 2019

Two women who suffered from facial nerve paralysis following surgical resection of a posterior fossa tumor were instructed by an expert beautician in the application of make-up to correct their facial imbalances. The results of a personality assessment administered before and after instruction showed positive changes including reductions in depression and feelings of inferiority.

Postoperative restoration of normal facial appearance and recovery of physiologic function are related and important concerns to patients. It is noteworthy that daily use of simple low-cost make-up techniques can significantly reduce the “psychological load” of patients with facial paralysis during the recovery period.
Cerumen Removal — Current Challenges
Authors: Grossan Murray
Published: May 2019

Each week in the United States, approximately 150,000 cerumen removals take place. Otologic complications include pain, perforated tympanum, dizziness, bleeding and infection. The prevention and management of such complications are discussed below. Accepted methods of removal should be used and all perforations and other forms of trauma, when they occur, must be evaluated for middle and inner ear pathology. Handicapped patients and those under custodial care represent a group that is underserved at this time. Possible solutions are discussed.
Granular Cell Tumor of the Larynx in a Six-Year-Old Child: Case Report and Review of the Literature
Authors: Holland Ruth S. , Abaza Nabil , Balsara Gulnar , Lesser Raymond
Published: May 2019

Granular cell tumors (granular cell myoblastomas) are uncommon neoplasms in the adult population, occurring predominantly in the head and neck and most frequently in the tongue. Laryngeal presentations are unusual, and granular cell tumors of the larynx in children are extremely rare, with a total of 19 cases reported in the literature in children under the age of] 7 years. We report an additional case of a laryngeal granular cell tumor, in a six-year-old boy, and discuss the clinical, histologic, ultrastructural and therapeutic aspects of these neoplasms.
Unusual Septoplasty Complication: Streptococcus Viridans Endocarditis
Authors: Leonard David W. , Thompson David H.
Published: May 2019

Infection is an infrequently reported complication following septoplasty and septorhinoplasty. Among the recognized but rare infections are toxic shock syndrome, spinal osteomyelitis, meningitis, septic cavernous sinus thrombosis and endocarditis. A high index of suspicion is required to diagnose these infections early and thereby minimize morbidity and mortality. We present a case of endocarditis following septoplasty in a patient who had no identifiable preoperative risk factors but who experienced recurrent fever and chills postoperatively.
The Effects of Kanamycin Injection into the Fetal Lamb Cochlea
Authors: Meixner Kathleen E. , Antonelli Patrick J. , Dohar Joseph E.
Published: May 2019

Mammalian auditory hair cells have minimal capacity for repair or regeneration after a variety of insults, including acoustic trauma and aminoglycoside exposure. Although fetal tissues have a greater potential for repair and regeneration than adult tissues, there have been no reported studies on fetal hair cell response to injury in mammals. The purpose of this research was to investigate the effects of local application of kanamycin on fetal lamb cochlear hair cells.

Eleven fetal lambs in the early third trimester underwent kanamycin injection through the left round-window membrane. The right ear served as a control. Click-evoked compound action potentials (CAPs) were serially recorded in 8 fetuses. CAPs were observed in all control ears. None of the 8 kanamycin-injected ears had measurable CAPs on postoperative day 1. One kanamycin-injected ear demonstrated definite CAPs, beginning on postoperative day 6. Hair cells were found to be intact in 6 of 9 kanamycin-treated ears. Hair cells were missing only in animals that went into premature labor.

The presence of intact hair cells despite the loss of measurable CAPs in kanamycin-perfused lamb cochleae was striking. This finding may indicate that the fetal auditory epithelium is relatively resistant to aminoglycoside injury or may be capable of prompt repair or regeneration. Further studies on the effects of aminoglycoside injury in the fetal cochleae seem to be warranted.
Surgical Excision of Pilomatrixoma of the Head and Neck: A Retrospective Review of 26 Cases
Authors: Thomas Richard W. , Perkins Jonathan A. , Ruegemer Joseph L. , Munaretto Joseph A.
Published: May 2019

The objective of this article is to describe our experiences in treating patients for head and neck pilomatrixoma at our institution during a 5-year period and to compare our findings with previously published results. To that end, we conducted a 5-year retrospective chart review to identify those patients who had a confirmed histopathologic diagnosis of pilomatrixoma involving the head and neck area. We reviewed medical records for presenting signs and symptoms, lesion characteristics, treatment rendered, and outcomes.

We identified 26 patients, aged 6 to 77 (mean: 33), who met the criteria for inclusion in our study. All had been treated for solitary tumors with simple surgical excision and closure. We found no reported adverse outcomes and no tumor recurrences at the surgical sites. These findings support the use of simple surgical excision as the treatment of choice for these tumors.
Case Report of a Mass that Mimicked an Antrochoanal Polyp
Authors: Ku Peter K. M. , Tong Michael C. F. , Ho Ricky W. K. , van Hasselt Andrew
Published: May 2019

We describe the case of a patient who was originally diagnosed with an antrochoanal polyp. During avulsion of the mass by endoscopic polypectomy, it was discovered that the stalk of the polyp actually arose from the mucosa of the right superior turbinate rather than from the mucosa of the maxillary antrum. A diagnosis of choanal polyp was made.
Subglottic Carcinoma: Review of a Series and Characterization of its Patterns of Spread
Authors: Strome Scott E. , Robey Thomas C. , Devaney Kenneth O. , Krause Charles J. , Hogikyan Norman D.
Published: May 2019

The rarity of primary subglottic malignancies, along with the varied definitions of the anatomic confines of this region, have limited our understanding of the patterns of tumor spread within the subglottis. We conducted a retrospective chart review to analyze clinical and pathologic data in patients with subglottic carcinoma. A pattern of disease progression was identified, which is defined by the cartilaginous laryngeal framework, with the fibroelastic barriers susceptible to tumor invasion.

We conclude that although cartilaginous laryngeal structures are preserved until late in the disease course, the ability of tumors to invade the fibroelastic membranes provides them with an insidious means of escape. Specifically, tumor progression occurs primarily within the paraglottic space and extralaryngeal compartments; the potential for mucosal spread is limited. The lack of mucosal disease in patients whose cartilaginous laryngeal structures are intact may present a facade of normality in patients with advanced disease, and perhaps delay the early diagnosis of subglottic malignancies by physical and radiologic examination.
Thyroid Testing and Thyroid Hormone Replacement in Patients with Sleep Disordered Breathing
Authors: Mickelson Samuel A. , Lian Timothy , Rosenthal Leon
Published: May 2019

The current literature recommends that patients who have symptoms of sleep disordered breathing should be evaluated for hypothyroidism. Thyroid hormone replacement therapy has been reported by some authors to be effective in treating obstructive sleep apnea in hypothyroid patients. The present study prospectively evaluated the prevalence of hypothyroidism in 1,000 consecutively presenting patients who came to the office for evaluation of snoring or obstructive sleep apnea syndrome. The authors also examined the efficacy of treatment for hypothyroidism on sleep apnea in patients with both disorders.

Of the 1,000 patients, routine thyroid testing was performed on 834; only 10 of these patients (1.2%) were discovered to have previously undiagnosed clinical hypothyroidism. Four of the 10 patients with newly diagnosed clinical hypothyroidism had obstructive sleep apnea syndrome, and they received thyroid hormone replacement therapy. Once these four patients achieved a euthyroid state, repeat polysomnography showed that there was no significant difference between their pre- and posttreatment respiratoiy disturbance index.

Based on the results of our study, we conclude the following: 1) The prevalence of hypothyroidism in patients who are evaluated for sleep disordered breathing is no greater than that of the general population. 2) Thyroid replacement therapy results in little or no improvement in sleep apnea in patients with clinical hypothyroidism. 3) Routine thyroid function screening is not indicated for patients who are being evaluated for sleep disordered breathing.
The Interplay of Inter- and Intraprofessional Boundary Work in Multidisciplinary Teams
Authors: Comeau-Vallée Mariline , Langley Ann
Published: May 2019

The challenges of managing interprofessional boundaries within multidisciplinary teams are well known. However, the role of intraprofessional relations in influencing the dynamics of interprofessional collaboration remain underexplored. Our qualitative study offers a fine-grained analysis of the interplay between inter- and intraprofessional boundary work among three professional groups in a multidisciplinary team over a period of two years. Our contribution to the literature is threefold. First, we identify various forms of “competitive” and “collaborative” boundary work that may occur simultaneously at both inter- and intraprofessional levels. Second, we reveal the dynamic interplay between inter- and intraprofessional boundary negotiations over time. Third, we theorize relationships between the social position of professional groups, and the uses and consequences of competitive and collaborative boundary work tactics at intra- and interprofessional levels. Specifically, we show how intraprofessional conflict within high-status groups may affect interprofessional dynamics, we reveal how intraprofessional and interprofessional boundaries may be mobilized positively to support collaborative relations, and we show how mobilization within lower-status groups around interprofessional boundary grievances can paradoxically lead to further marginalization.
Ex-Incarceree/Convict Status: Beneficial for Self-Employment and Entrepreneurship?
Authors: Irankunda Armel , Price Gregory N. , Uzamere Norense E. , Williams Miesha J.
Published: May 2019

This article considers whether ex-incarceree/convict status favorably conditions the decision to be self-employed—a proxy for entrepreneurship. With data from the U.S. General Social Survey, we estimate the parameters of simple Probit and Bivariate Probit treatment specifications of individual self-employment outcomes as a function of ex-incarceree/convict status, and several measures of individual risk-taking propensities. Parameter estimates reveal that ex-incarceree/convict status has a positive and significant treatment effect on self-employment, particularly for Black Americans, after controlling for various measures of individual risk propensities. Our results suggest that the expansion of entrepreneurship training programs and the elimination of any barriers that restrict access to start-up capital for ex-incarcerees/convicts would reduce crime and recidivism, ameliorate mass incarceration, and complement pro-growth economic policies that induce more self-employment and entrepreneurship.

JEL Classification: J01, J24, L26, Z13
AA5052 sheets welded by protrusion friction stir spot welding: High mechanical performance with considering sheets thickness at low dwelling time and tool rotation speed
Authors: Farmanbar N , Mousavizade SM , Elsa M , Ezatpour HR
Published: May 2019

In the present work, AA5052 sheets with thickness of 1 mm were successfully welded by protrusion friction stir spot welding as a low cost single-step method with a simple design that produces the no-keyhole joints with special mechanical properties at short dwell time and low tool rotation speed. By using suitable process parameters, the process is able to produce welds with superior mechanical performance in items of peak load and energy absorption compared to other techniques. The plunging depth and dwell time in this method were set as 0.2 mm and 6 s, respectively. The tool rotation speed was changed as 500, 800, 1250, and 1600 r/min to determine the optimum condition based on the microstructural and mechanical properties. Welds strength produced by the protrusion friction stir spot welding was directly related to the joint thickness, and the effective thickness of the upper sheet was maximum at 500 r/min. Protrusion friction stir spot welding joints presented circumferential failure mode after tensile shear testing. Regarding the sheets thickness used in this study, the joints produced by the current work presented high load bearing ability at dwell time of 6 s and tool rotation speed of 500 r/min compared to other techniques.
Deontic authority in intervention discourse: Insights from bystander intervention
Authors: Ran Yongping , Huang Xu
Published: May 2019

Our study offers a linguistic–pragmatic examination of instances of bystander intervention, a social action that takes place when a bystander or a group of bystanders intervenes when a wrongdoer abuses a victim or behaves outside socially acceptable norms. We approach this social phenomenon by analyzing data drawn from a database of 11 video-recordings that all involve naturally occurring interactions in public settings in China. The notion of intervention discourse is tentatively introduced in this study to distinguish it from those used to achieve other communicative purposes and to disclose some recurrent patterns of language use in bystander intervention. The data analysis summarizes six categories of intervention discourse along the continuum of strong to weak intervention: terminating, consequence-stating, advising, judging, appealing and stance-taking. Our study demonstrates that the skillful exercise of deontic authority embodied in intervention discourse might have a tangible influence on the outcome of the intervention.
Correlation Between Uptake of 18F-FDG During PET/CT and Ki-67 Expression in Patients Newly Diagnosed With Multiple Myeloma Having Extramedullary Involvement
Authors: Li Qian , Ma Jing , Li Han , Xu Wengui , Cao Zeng , Liu Su , Chen Lin , Gao Shuang , Yan Tinghui , Li Dongying , Wang Xue , Yue Yuanfang , Zhao Zhigang , Wang Xiaofang , Yang Hongliang , Zhao Haifeng , Yu Yong , Zhang Yizhuo , Fan Feiyue , Wang Yafei
Published: May 2019

The aim of this study was to evaluate the relationship of prognosis of patients with multiple myeloma having extramedullary involvement (EMM) with the 18F- fluorodeoxyglucose(18F-FDG) maximum standardized uptake value and the expression of Ki-67 in biopsy samples. Sixty-five patients were newly diagnosed with multiple myeloma presenting with EMM at our hospital from January 2005 to January 2015. Of these 65 patients, 20 were enrolled in this study. Over the last decade, both the maximum standardized uptake value and Ki-67 expression in these extramedullary lesions significantly correlated with progression-free survival, respectively ( P= .039, P =.009). After combining—the maximum standardized uptake value and the Ki-67 expression as an integral—there was a significant correlation between both the overall survival ( P = .027) and progression-free survival ( P= .014). Patients have poor outcomes when EMM is detected at presentation. Both the maximum standardized uptake value and Ki-67 expression could aid in accurately evaluating EMM patient prognosis.
Wisdom of the Goddess: Uncovering the Provenance of a Twelfth-Century Indian Sculpture at the National Gallery of Australia
Authors: Folan Lucie
Published: May 2019

The history of Prajnaparamita, Goddess of Wisdom, a twelfth-century Indian Buddhist sculpture in the National Gallery of Australia collection, has been researched and evaluated through a dedicated Asian Art Provenance Project. This article describes how the sculpture was traced from twelfth-century Odisha, India, to museums in Depression-era Brooklyn and Philadelphia, through dealers and private collectors Earl and Irene Morse, to Canberra, Australia, where it has been since 1990. Frieda Hauswirth Das (1886–1974), previously obscured from art-collecting records, is revealed as the private collector who purchased the sculpture in India in around 1930. Incidental discoveries are then documented, extending the published provenance of objects in museum collections in the United States and Europe. Finally, consideration is given to the sculpture’s changing legal and ethical position, and the collecting rationales of its various collectors. The case study illustrates the contributions provenance research can make to archeological, art-historical, and collections knowledge, and elucidates aspects of the heterodox twentieth-century Asian art trade, as well as concomitant shifts in collecting ethics.
Breakdown of Democratic Norms? Understanding the 2016 US Presidential Election Through Online Comments
Authors: Masullo Chen Gina , Riedl Martin J. , Shermak Jeremy L. , Brown Jordon , Tenenboim Ori
Published: May 2019

This study examined how comments posted on news stories about the 2016 presidential election reflected the disruptive discourses of the campaign itself. A quantitative content analysis and a qualitative textual analysis of user-generated comments ( N = 1,881) showed that while incivility was less frequent than impoliteness, overall there was ample evidence of the violation of democratic norms of political talk in these comment streams. Findings also showed that comments posted on stories in The New York Times were less uncivil than those posted on either Fox News or USA TODAY stories. However, comments posted on USA TODAY stories were more impolite than those posted on stories on the Times’ or Fox News’ websites. Norms of political talk that ascribe to some aspects of deliberative discourse were more frequent in comments posted later in the campaign, except among comments posted on Fox News stories.
Quercetin abates induction of hepatic and renal oxidative damage, inflammation, and apoptosis in carbendazim-treated rats
Authors: Owumi Solomon E , Nwozo Sarah O , Najophe Eseroghene S
Published: May 2019

Exposure to the fungicide carbendazim (CBZ) has been associated with hepatorenal dysfunction. Quercetin, a naturally occurring polyphenolic phytochemical, reportedly possesses beneficial health effects. However, there is paucity of scientific information on the impact of quercetin on CBZ-induced hepatorenal damage. The present study investigated the protective mechanism of quercetin in CBZ-induced hepatic and renal damage in rats. The treatment groups consisted of control, CBZ alone (50 mg/kg), quercetin alone (20 mg/kg), and rats co-treated with CBZ and quercetin for 14 consecutive days. Quercetin co-treatment significantly ( p < 0.05) abated CBZ-induced increase in biomarkers of hepatorenal damage when compared to CBZ alone. Also, quercetin abrogated CBZ-mediated decrease in antioxidant status as well as the increase in reactive oxygen and nitrogen species and lipid peroxidation in the treated rats. Furthermore, quercetin significantly suppressed CBZ-mediated increase in interleukin-1β, tumor necrosis factor alpha, and caspase-3 activity in the liver and kidney of the rats. Histopathological examination demonstrated that the severity of CBZ-induced hepatic and renal injury was ameliorated in rats co-treated with quercetin. Taken together, quercetin-mediated hepatorenal protection in CBZ-treated rats involves antioxidant, anti-inflammatory, and antiapoptotic mechanisms.
MiR-29b/Sp1/FUT4 axis modulates the malignancy of leukemia stem cells by regulating fucosylation via Wnt/β-catenin pathway in acute myeloid leukemia
Authors: Liu Bing , Ma Hongye , Liu Qianqian , Xiao Yang , Pan Shimeng , Zhou Huimin , Jia Li
Published: May 2019

Background

Acute myeloid leukemia (AML) is initiated and maintained by a unique, small subset of leukemia stem cells (LSCs). LSCs are characterized by unrestricted self-renewal and contribute to the malignancy of leukemia. Aberrant protein fucosylation is associated with AML progression. However, it is still less understood that the miR-29b/Sp1/FUT4 crosstalk involved in the fucosylation-mediated LSCs malignancy in AML.

Methods

AML cell lines were sorted by magnetic microbeads to obtain the CD34 + CD38- sub-population. The key biomarkers for LSCs were identified by flow cytometry. Fucosyltransferase genes were screened by qRT-PCR, and FUT4 was focused. Effect of FUT4 on LSCs malignancy was determined by CCK8 assay, sphere formation assay, immunofluorescence staining, apoptosis and in vivo xenografts experiments. The linkage of FUT4 promoter and Sp1 was confirmed by dual-luciferase reporter gene assay. ChIP-PCR assay was used to show the directly binding of Sp1 and FUT4 promoter. Activity of Wnt//β-catenin pathway was determined by western blot. Overall survival curves were diagrammed by Kaplan-Meier analysis.

Results

Here, the expressional profiles of 11 fucosyltransferase genes were different comparing LSCs and non-LSCs of KG-1a and MOLM13 cells, whereas CD34 + CD38- cells exhibited higher expression of FUT4. Functionally, alteration of FUT4 in CD34 + CD38- cells modulated LSCs malignant behaviors both in vitro and in vivo. Transcriptional inhibitor actinomycin D (Act D) or translational inhibitor cycloheximide (CHX) prevented LSCs progression, and Sp1 was identified as the efficient regulator of FUT4 transcription. Moreover, miR-29b directly affected the binding of Sp1 and FUT4 promoter region, which further mediated LSCs proliferation, apoptosis and drug-resistance through fucosylated-CD44 via activation of Wnt/β-catenin pathway. Clinically, Sp1 and FUT4 were up-regulated and positively correlated with poor overall survival of AML patients.

Conclusion

These data indicated that miR-29b/Sp1/FUT4 axis promoted the malignant behaviors of LSCs by regulating fucosylated CD44 via Wnt/β-catenin pathway. Identifying LSCs surface markers and targeting LSCs were important for the development of potential therapies in AML.