bluuebunny/crossref_metadata_2025 huggingface dataset:
The tadpole of Ramanella palmata (Anura: Microhylidae), a frog endemic to Sri Lanka
Authors: UKUWELA K. D. B. , SILVA E. I. L. , ATHUKORALA N. P.
Published: January 2019

Of the 107 species of amphibians known from Sri Lanka (Megaskumbura et al. 2009), the family Microhylidae is represented by 10 species (Pethiyagoda et al. 2006). The genus Ramanella Rao and Ramanna, 1925 is represented by four species in Sri Lanka (Pethyagoda et al. 2006). Except for R. variegata (Stoliczka, 1872), which is also found in neighboring India, the other three species are endemic to Sri Lanka. Larval stages and the breeding ethology of R. obscura (Guenther, 1864) and R. nagaoi Manamendraarachchi and Pethiyagoda, 2001 are well known (Morgan-Davis 1953; Meegaskumbura 2001; Manamendraarachchi & Pethyagoda 2001). Kirtisinghe (1958) briefly outlined the general morphology of the R. palmata tadpoles. Here we re-describe tadpoles of R. palmata highlighting some important characters that were initially not described by Kirtisinghe (1958), provide standard morphometric measurements of the tadpoles and also a photograph.
Caayguara, a new genus of huntsman spiders from the Brazilian Atlantic Forest (Araneae: Sparassidae)
Authors: RHEIMS CRISTINA A.
Published: January 2019

Caayguara gen. nov. is described to include Olios albus Mello-Leitão, 1918 and eleven new species, namely Caayguara pinda sp. nov., from Espírito Santo, Rio de Janeiro and São Paulo; C. juati sp. nov. and C. apiaba sp. nov., from Bahia, Minas Gerais and Espírito Santo; C. ajuba sp. nov., from Bahia and Espírito Santo; C. cupepemassu sp. nov., from Minas Gerais, Espírito Santo, Rio de Janeiro, São Paulo, Paraná and Rio Grande do Sul; C. cupepemayri sp. nov. and C. atyaia sp. nov., from Rio de Janeiro; C. itajucamussi sp. nov., C. ybytyriguara sp. nov., C. poi sp. nov. and C. catuoca sp. nov., from São Paulo. The genus seems to be restricted to the Atlantic Forest biome and can be easily distinguished from other Neotropical huntsman genera by the presence of intermarginal denticles on the chelicerae, only two pairs of spines on ventral tibiae and one lateral spine on metatarsi I–II, by the male palps with RTA arising from medial to basal retrolateral tibiae and emboli with keels and projections, and by the female vulvae with the median part of copulatory ducts expanded, forming a sac-like structure, and the posterior part with several linearly arranged lobes. In addition, Olios albus is redescribed and the female described for the first time.
A new species and a new record of Sphaeroma Bosc, 1802 (Sphaeromatidae: Isopoda: Crustacea) from intertidal marine habitats of the Persian Gulf
Authors: KHALAJI-PIRBALOUTY VALIALLAH , WÄGELE JOHANN-WOLFGANG
Published: January 2019

Two species of Sphaeroma (Sphaeromatidae: Isopoda) from the Iranian coasts of the Persian Gulf were studied and described. Sphaeroma khalijfarsi sp. nov. is described from the intertidal zone of the Strait of Hormuz. This species is distinguished by the smooth pereonites; pleon without prominent tubercles and bearing some scattered small tubercles; pleotelson with numerous scattered small tubercles and well upturned posterior margins. Sphaeroma walkeri Stebbing, 1905 is reported from Kish and Qeshm Islands and from the southern coasts of Iran. Among the non-Indian Ocean species, Sphaeroma intermedium Baker, 1926 is transferred to genus Lekanesphera Verhoeff, 1943.
A new species of Microglanis (Siluriformes, Pseudopimelodidae) from lower Rio Tocantins basin, Pará, Brazil, with description of superficial neuromasts and pores of lateral line system
Authors: RUIZ WILLIAM BENEDITO GOTTO , SHIBATTA OSCAR AKIO
Published: January 2019

Microglanis robustus, new species, is the first Microglanis to be described from the Rio Tocantins basin, Pará, Brazil, and differs from the congeners by the presence of a cordiform blotch in the nape, instead of a transverse light stripe; neuromasts of the superficial lines surrounded by melanophores; robust body with short snout, head and predorsal distance; and deep caudal peduncle. The mapping of superficial neuromasts and cephalic sensory canals evidenced intra and interespecific polymorphisms and, therefore, of little value for phylogenetic analysis within the genus.
Does the Patent Linkage System Prolong Effective Market Exclusivity? Recent Evidence From the Korea-U.S. Free Trade Agreement in Korea
Authors: Son Kyung-Bok , Bae SeungJin , Lee Tae-Jin
Published: January 2019

This study evaluated the effect of the patent linkage system, fully introduced by the Korea-U.S. Free Trade Agreement in 2015, on patent challenges and the effective market exclusivity of new medicines in Korea. We used pharmaceutical approval data and pharmaceutical litigation data to detect new medicines and their counterparts, to collect patent challenges against new medicines, and to calculate effective market exclusivity for new medicines. Then, a nonparametric event history model was applied to statistically explain the duration of the market exclusivity of new medicines. Between 2007 and 2011, a total of 94 new medicines, consisting of 82 new chemical entities and 12 new biologics, were approved. The patent linkage system encouraged patent litigations to occur sooner, with a race to challenge the patents by various generic applicants. However, it was difficult to conclude that patent challenges had a significant impact on the prolongation of effective market exclusivity. The patent linkage system had a neutral effect on the effective market exclusivity of new medicines and encouraged patent challenges without abbreviating effective market exclusivity. In addition, this study highlights an important issue regarding biologics that has not been the subject of market competition, even for patent challenges.
Osteoporotic Changes in the Periodontium Impair Alveolar Bone Healing
Authors: Arioka M. , Zhang X. , Li Z. , Tulu U.S. , Liu Y. , Wang L. , Yuan X. , Helms J.A.
Published: January 2019

Osteoporosis is associated with decreased bone density and increased bone fragility, but how this disease affects alveolar bone healing is not clear. The objective of this study was to determine the extent to which osteoporosis affects the jaw skeleton and then to evaluate possible mechanisms whereby an osteoporotic phenotype might affect the rate of alveolar bone healing following tooth extraction. Using an ovariectomized mouse model coupled with micro–computed tomographic imaging, histologic, molecular, and cellular assays, we first demonstrated that the appendicular and jaw skeletons both develop osteoporotic phenotypes. Next, we demonstrated that osteoporotic mice exhibit atrophy of the periodontal ligament (PDL) and that this atrophy was accompanied by a reduction in the pool of osteoprogenitor cells in the PDL. The paucity of PDL-derived osteoprogenitor cells in osteoporotic mice was associated with significantly slower extraction socket healing. Collectively, these analyses demonstrate that the jaw skeleton is susceptible to the untoward effects of osteoporosis that manifest as thinner, more porous alveolar bone, PDL thinning, and slower bone repair. These findings have potential clinical significance for older osteopenic patients undergoing reconstructive procedures.
Institutions, Ideology, and Nonideal Social Ontology
Authors: Brännmark Johan
Published: January 2019

Analytic social ontology has been dominated by approaches where institutions tend to come out paradigmatically as being relatively harmonious and mutually beneficial. This can however raise worries about such models potentially playing an ideological role in conceptualizing certain politically charged features of our societies as marginal phenomena or not even being institutional matters at all. This article seeks to develop a nonideal theory of institutions, which neither assumes that institutions are beneficial or oppressive, and where ideology is understood as a structuring and stabilizing phenomenon that helps maintain specific distributions of rights and duties by conferring perceived legitimacy onto them.
Otitic Hydrocephalus: A Report of 2 Cases
Authors: Viswanatha Borlingegowda
Published: January 2019

Otitic hydrocephalus is a rare intracranial complication of otitis media. It is characterized by elevated cerebrospinal fluid (CSF) pressure with normal CSF biochemistry and without any focal neurologic abnormality other than those related to the increased intracranial pressure. The pathophysiology of this rare condition is unknown. The incidence of intracranial complications was reduced dramatically with the introduction of newer antibiotics, but complicated cases still occur. Serious consequences can ensue if complications are not identified and treated properly. The author reviews the literature on otitic hydrocephalus and describes 2 new cases.
Report of a Complete Second Branchial Fistula
Authors: Khan Mohammad Habibullah , Gheriani Heitham , Curran Aongus James
Published: January 2019

We report a case of complete congenital branchial fistula with an internal opening near the tonsillar fossa. Cysts, fistulas, and sinuses of the second branchial cleft are the most common developmental anomalies arising from the branchial apparatus. In our case, a 43-year-old man presented with a several-year history of a discharging sinus from the right side of his neck, consistent with a branchial fistula. He underwent various investigations and finally was treated with a one-stage complete surgical excision of the fistula tract. We describe the general clinical presentation, investigations, and surgical outcome of this case.
Malignant Fibrous Histiocytoma of the Mandible
Authors: Brahmakulam Lana E. , Noronha Bosco E.
Published: January 2019

Malignant fibrous histiocytoma (MFH) of the mandible is rare. We describe a case of MFH of the mandible with metastatic disease to the lungs. To our knowledge only 30 cases have been reported prior to the present case. In previously reported cases, there was a strong tendency for the posterior portion of the mandible to be affected by MFH; ours is only the second reported case involving the anterior portion of the mandible. We review the diagnosis, pathology, and treatment of this rare malignancy.
Concurrent Nasal Surgery and Tympanoplasty in Adults
Authors: Schuman Theodore A. , Labadie Robert F.
Published: January 2019

We conducted a retrospective chart review to determine if performing simultaneous nasal surgery and tympanoplasty jeopardizes tympanic membrane graft survival and the surgical outcome. Our study population consisted of 14 consecutively presenting adults with nasal septal deviation and otologic pathology who had undergone simultaneous nasal and otologic procedures at an academic tertiary care medical center. Surgical procedures included septoplasty and bilateral inferior turbinate submucous reduction with concurrent primary or revision tympanoplasty with or without mastoidectomy and ossicular chain reconstruction. Follow-up ranged from 1.8 to 29.8 months (mean: 12.8 ± 10.8). The primary outcomes measures were tympanic membrane graft survival and surgical success; the latter was defined as an absence of middle ear effusion and a lack of need for pressure-equalization tube placement in patients with intact grafts. We found that 13 of the 14 tympanic membrane grafts (92.9%) survived at the most recent follow-up and that 11 patients (78.6%) achieved an aerated middle ear without the need for a pressure-equalization tube. These rates compare favorably with those quoted in the literature for tympanoplasty performed without concomitant nasal surgery. We conclude that septoplasty can be safely and effectively performed at the same time as tympanoplasty with or without mastoidectomy with no increase in the risk of surgical failure.
Laryngeal Alveolar Rhabdomyosarcoma Involving the True Vocal Fold in an Adult: Case Report
Authors: Leventhal Douglas D. , Spiegel Joseph , Keane William
Published: January 2019

Rhabdomyosarcoma of the larynx is extremely rare in adults, as only 17 well-documented cases have been previously reported in the English-language literature. Of these, only 2 cases (both male) involved the alveolar subtype of rhabdomyosarcoma, and neither involved the true vocal folds. We report a case of alveolar rhabdomyosarcoma of the true vocal fold in 54-year-old woman. She was successfully treated with conservative surgery, radiation, and chemotherapy. Management of head and neck rhabdomyosarcoma has evolved from radical surgery to less morbid procedures supplemented with radiation and chemotherapy. However, because this tumor is so rare in the adult population, no adult-specific treatment regimen has emerged. Nevertheless, the success of treatment in the pediatric population supports its use in adults.
Cyanoacrylate (“Superglue”) Injury to the Nasal Cavity: Case Report and a Proposed Management Algorithm
Authors: Sira James , Uppal Sandeep , Dezso Atilla
Published: January 2019

We report the case of a deliberate application of cyanoacrylate adhesive (commonly called “superglue”) to the nose of a 9-year-old boy during a fight. The glue was successfully removed under general anesthesia without causing trauma to the nasal mucosa. To the best of our knowledge, only 1 other case of cyanoacrylate injury to the nasal cavity has been published in the literature. We also provide an algorithm to guide clinicians in the future management of this unusual circumstance.
Bilateral Vestibular Hypofunction in Neurosarcoidosis: A Case Report
Authors: Smith Jonathan H. , Stovall Kyndra C. , Coons Stephen , Fife Terry Douglas
Published: January 2019

We describe the case of a 59-year-old woman who presented with progressive bilateral vestibidar hypofunction and who was found to have bilateral granulomatous mass lesions of the mesial temporal lobe. Initially, her condition stabilized neurologically with corticosteroids, but a diagnosis of neurosarcoidosis was delayed because of the unusual presentation and persistently normal chest imaging results and serum angiotensin-converting enzyme (ACE) levels. Approximately 1 year after her initial presentation, the patient died of complications of a myocardial infarction and pulmonary embolism. Sarcoidosis should be considered in the differential diagnosis of idiopathic bilateral vestibular hypofunction even if the chest imaging and serum ACE levels are normal, particularly when there is evidence of a multisystem process.
Skull Base Presentation of Multiple Myeloma
Authors: Joshi Anil , Jiang Dan , Singh Pranay , Moffat David
Published: January 2019

Pathologic proliferation of the plasma cell population can produce a wide spectrum of disorders, ranging from benign solitary plasmacytoma to malignant multiple myeloma. The presentation of the resulting disease can be either localized or systemic, depending on the affected area. Multiple myeloma typically presents with systemic symptoms secondary to skeletal lytic lesions, anemia, renal failure, infection, and hyperviscosity syndrome; a diagnosis of multiple myeloma is not suspected in the absence of these features. Multiple myeloma of the skull base is very rare. We present the case of a 66-year-old man who came to us with a 2-year history of disequilibrium and who was found to have multiple myeloma with extensive involvement of the skull base.
Bilateral Multicanal Benign Paroxysmal Positional Vertigo Coexisting with a Vestibular Schwannoma: Case Report
Authors: Karatayli-Ozgursoy Selmin , Stamper Greta C. , Lundy Larry B. , Zapala David A.
Published: January 2019

We describe a rarely encountered case of coexisting bilateral multicanal benign paroxysmal positional vertigo (BPPV) and vestibular schwannoma in a 56-year-old woman. The patient had presented with a 10-year history of dizziness and imbalance, and her vestibular findings were perplexing. We decided on a working diagnosis of BPPV and began treatment. After several months of canalith repositioning maneuvers had failed to resolve her symptoms, we obtained magnetic resonance imaging, which revealed the presence of the vestibular schwannoma. This case serves as a reminder of the importance of differentiating between central and peripheral vestibular disorders, as well as central and anterior canal BPPV-induced down-beating nystagmus in order to establish the correct diagnosis and initiate appropriate treatment.
MRSA Otorrhea: A Case Series and Review of the Literature
Authors: Baugher Katherine M. , Hemme Troy Sommers , Hawkshaw Mary , Sataloff Robert T.
Published: January 2019

Methicillin-resistant Staphylococcus aureus (MRSA) has become an increasingly common cause of difficult-to-treat head and neck infections. We report a retrospective analysis of 3 cases of MRSA otorrhea treated in our clinic between 2007 and 2009. Culture analysis of otorrhea isolates revealed MRSA infections with identical drug sensitivities. Treatment success was achieved using combinations of linezolid with gentamicin ear drops for 3 to 4 weeks or trimethoprim/sulfamethoxazole (TMP/SMX) with gentamicin drops for 6 weeks. This study illustrates the importance of determining individual drug sensitivities for optimal treatment and maintaining current knowledge of the local MRSA strains. Empiric combination therapy of TMP/SMX with gentamicin is an effective first-line treatment for MRSA otorrhea. Regional differences in clindamycin sensitivities warrant clinical discretion. Fluoroquinolones should be avoided because of high rates of resistance unless culture sensitivity determines that they are appropriate. First-line agents for severe infections include combination therapy with vancomycin or linezolid.
Jaw-Opening Dystonia: Quality of Life after Botulinum Toxin Injections
Authors: Charous Steven J. , Cornelia Cynthia L. , Fan Wenqing
Published: January 2019

The objective of this study was to investigate quality-of-life outcomes in patients with jaw-opening oromandibular dystonia who had received treatment with botulinum neurotoxin injections. The Glasgow Benefit Inventory (GBI) was used as a post-intervention questionnaire to measure patient benefit. Twenty-five questionnaires were sent to patients. Of the 12 patients who returned the form (48% response rate), the mean scores for the general GBI subscore (p = 0.001), the social support GBI subscore (p = 0.031), and the physical health GBI subscore (p = 0.002) demonstrated statistically significant benefit from the injections. No scores demonstrated a negative impact. Botulinum neurotoxin injections were demonstrated to benefit the quality of life in patients suffering from jawopening oromandibular dystonia.
Bilateral Asymmetrical Mucoceles of the Paranasal Sinuses with Unilateral Orbital Complications
Authors: Chong Aun Wee , Prepageran Narayanan , Rahmat Omar , Subrayan Viswaraja , Jalaludin Mohd Amin
Published: January 2019

We report the rare occurrence of bilateral asymmetrical mucoceles of the paranasal sinuses that resulted in a unilateral orbital complication. The patient was a 47-year-old woman who presented with complaints of diplopia, blurred vision, and protrusion of her right eye that had progressed over a period of several months following an upper respiratory tract infection. Computed tomography detected the presence of two large, asymmetrical mucoceles. The lesion on the right involved the frontal and ethmoid sinuses, and the one on the left involved the ethmoid sinus. The mucoceles were locally expansile and had eroded the surrounding bony structures on the right. The expansile nature of the right-sided mass had displaced the right orbit, which was the cause of the vision deterioration. Transnasal endoscopic surgery was performed to excise and marsupialize the mucoceles. This modality was preferred over conventional open surgery because it affords good visualization, it is safe, and it is a less morbid procedure. The patient's recovery was uneventful, and she was discharged home on the third postoperative day. On continuing follow-up, her vision had improved, her intraocular pressure had returned to normal, and her orbits were in their normal position. Based on our literature search, no case of bilateral frontal and ethmoid sinus mucoceles has been previously reported.
EHR/EMR: “Meaningful Use,” Stimulus Money, and the Serenity Prayer
Authors: Lee K.J. , Smith Robyn M.
Published: January 2019

Theologian Reinhold Niebuhr said, “God, grant me the serenity to accept the things I cannot change; courage to change the things I can; and wisdom to know the difference.”
Delayed Pharyngoesophageal Reconstruction with Combined Local and Regional Flaps: A Case Report
Authors: Pinto Fábio Roberto , Kanda Jossi Ledo
Published: January 2019

We describe an unusual technique for performing delayed pharyngoesophageal reconstruction following circumferential pharyngolaryngectomy. The patient was a 52-year-old man who underwent a circumferential pharyngolaryngectomy for the treatment of hypopharyngeal carcinoma. In view of the patient's poor clinical status, we opted to perform a pharyngostomy and an esophagostomy and to postpone pharyngoesophageal reconstruction for a more appropriate occasion. After the patient's clinical condition had sufficiently improved, the repair was planned. Microsurgical flaps were contraindicated because the blood flow through the cervical vessels was unreliable. Pharyngoesophageal continuity was restored with a cervical flap vascularized by the prevertebral fascia, a pectoralis major myocutaneous flap, and a deltopectoralis flap. A reasonable degree of deglutition was achieved, and no signs of stricture were detected. Although our technique was unusual, we believed that it might provide a valid alternative when a delayed pharyngoesophageal reconstruction is required and free flaps are contraindicated for any reason.
The Role of Ultrahigh-Frequency Audiometry in the Early Detection of Systemic Drug-Induced Hearing Loss
Authors: Singh Chauhan Rajeev , Kumar Saxena Ravinder , Varshey Saurabh
Published: January 2019

In monitoring patients for drug-induced hearing loss, most audiometric evaluations are limited to the range of frequencies from 0.25 to 8 kHz. However, such testing would fail to detect ototoxicity in patients who have already experienced hearing loss in the ultrahigh frequencies from 10 to 20 kHz. Awareness of ultrahigh-frequency ototoxicity could lead to changes in a drug regimen to prevent further damage. We conducted a prospective study of 105 patients who were receiving a potentially ototoxic drug—either gentamicin, amikacin, or cisplatin—to assess the value of ultrahigh-frequency audiometry in detecting systemic drug-induced hearing loss. We found that expanding audiometry into the ultrahigh-frequency range led to the detection of a substantial number of cases of hearing loss that would have otherwise been missed.
Localized Oropharyngeal Amyloidosis
Authors: Grindle Christopher R. , Curry Joseph M. , Cantor Joshua P. , Malloy Kelly M. , Pribitkin Edmund A. , Keane William M.
Published: January 2019

An otherwise healthy 29-year-old woman presented with a complaint of odynophagia of several months’ duration. On examination, she was found to have a broadly based, yellow, exophytic lesion on the right lateral pharyngeal wall. Findings on biopsy were consistent with amyloidosis. The patient underwent tonsillectomy with resection of the oropharyngeal lesion. Final pathology established a diagnosis of nodular non-AL–type amyloidosis. Localized amyloidosis of the oropharynx is exceptionally rare. Additionally, most cases of localized amyloidosis are of the AL type, not the AA (i.e., non-AL) type seen in this patient.
Comparison of Hearing Thresholds Obtained with Baha Preoperative Assessment Tools and those Obtained with the Osseointegrated Implant
Authors: Heywood Rebecca L. , Patel Parag M. , Jonathan David A.
Published: January 2019

We conducted a study of the Baha bone-anchored hearing aid system to quantify the difference between (1) hearing thresholds obtained through preoperative testing methods with the Baha sound processor attached to three different bone-conduction testing devices and (2) thresholds obtained postoperatively with the sound processor attached to a surgically placed osseointegrated titanium implant. Twenty-three patients underwent free-field testing in four situations: with the Baha sound processor attached to (1) the Baha Testband (transcutaneous transmission), (2) the Baha Softband (transcutaneous transmission), (3) a test rod (bone conduction via the teeth), and (4) the osseointegrated implant (percutaneous transmission). The main outcome measure was the result of a comparison of the thresholds obtained with the three preoperative test methods and those obtained with the osseointegrated implant. We found that aided thresholds obtained with the osseointegrated implant were significantly better (p < 0.05) than those obtained with the three preoperative test methods. The degree of superiority increased with higher frequencies. We conclude that thresholds of 1 to 18 dB better than those obtained by preoperative test methods can be expected postoperatively with the osseointegrated implant. The damping effect of sound transmission via the teeth or transcutaneously must be accounted for in making predictions of postoperative outcome.
Is Virtual Endoscopy of the Middle Ear Useful?
Authors: Ho Ambrose Chung-Wai , Lee Raymond , Co Michael Tiong-Hong , Chow Chun-Kuen , Yeung Kai-Ming Au
Published: January 2019

Virtual endoscopy is a relatively new imaging technology in otology, and therefore data on its efficacy in clinical situations are limited. We conducted a prospective study to evaluate the clinical relevance of radiologic diagnoses based on virtual endoscopy of the middle ear. Our patient population was made up of 30 adults who were scheduled to undergo surgery to correct conductive hearing loss of unknown etiology. Virtual endoscopy was performed on three-dimensional images that were constructed from images obtained with conventional two-dimensional computed tomography (CT). Findings on virtual endoscopy were then compared with the subsequent surgical findings. Virtual endoscopy suggested a middle ear pathology in 19 patients and a normal middle ear in 11 patients. Postoperatively, we found that the virtual diagnoses correlated moderately well with the surgical findings in the group of patients with predicted pathology; 13 of these 19 patients were found to have middle ear problems such as ossicular chain anomalies, otosclerosis, and cholesteatoma (positive predictive value: 68%). However, among the 11 patients whose middle ear structures were radiologically predicted to be normal, only 2 had negative middle ear findings on surgical exploration; of the remaining 9 patients, 8 had otosclerosis and 1 had malleus fixation (negative predictive value: 18%). Thus, the sensitivity and specificity of virtual endoscopy were 59 and 25%, respectively. Virtual endoscopy provides images from a surgeon's perspective, and so it has the potential to be useful in the preoperative evaluation of the middle ear cavity. With ongoing advancements in computer systems and imaging techniques, the cost, reliability, and efficacy of virtual endoscopy may improve. However, further clinical validation and cost-benefit analysis are required before we can determine if it has any additional advantages over conventional two-dimensional CT.
Lateral Sinus Thrombosis in Children: A Review
Authors: Viswanatha Borlingegowd
Published: January 2019

A retrospective study was undertaken to review the clinical presentation, evaluation, management, and outcome of otogenic lateral sinus thrombosis (LST) in children. All pediatric patients with LST seen in our department between 1999 and 2007 were included; there were 9 cases involving 6 boys and 3 girls whose ages ranged from 8 to 12 years. They had all been treated with antibiotics elsewhere prior to admission, and the duration of symptoms before admission ranged from 5 to 18 days. The most common presenting symptoms were ear discharge, headache, otalgia, and fever. Radiologic evaluation included computed tomography and magnetic resonance imaging. All patients underwent radical mastoidectomy with incision of the lateral sinus and removal of its content. There were no deaths. Pseudomonas and Proteus spp were the most commonly identified organisms. Otogenic LST still poses a serious threat that warrants immediate attention and care. It is often associated with other intracranial complications, such as cerebellar abscess. Computed tomography and magnetic resonance imaging play an important role in the management of this disease. Early and aggressive surgical intervention of this otogenic complication can potentially minimize mortality.
Tracheoinnominate Fistula: Successful Management with Endovascular Stenting
Authors: Shepard Peter M. , Phillips Jeffrey M. , Tefera Girma , Hartig Gregory K.
Published: January 2019

Tracheoinnominate fistula is a rare complication of tracheostomy that is associated with high rates of morbidity and mortality. Recently, endovascular stents have been described as a viable treatment option for the management of this condition. We report a case of tracheoinnominate fistula in a 40-year-old man that was successfully managed with endovascular stent placement. Our evaluation included bronchoscopy, arteriography, and computed tomographic angiography. Intraoperative localization of the fistula required selective catheterization of the innominate artery.
Thyroidectomy for Goiter Relieves Obstructive Sleep Apnea: Results of 8 Cases
Authors: Agrama Mark T.
Published: January 2019

The author conducted a retrospective study of 8 adults with euthyroid goiter that had resulted in tracheal compression and led to moderate to severe obstructive sleep apnea (OSA). The purpose of the study was to evaluate the effects of thyroidectomy on the apnea-hypopnea index (AHI) in these patients and to determine if there is a relationship between tracheal compression and OSA. These patients had been treated by the author in a community hospital over a 4-year period. All 8 patients had reported compressive symptoms of orthopnea and dysphagia, and 3 of them also reported dyspnea. Computed tomography of the neck and chest had been used to confirm the extent of goiter and tracheal compression. OSA had been confirmed with preoperative polysomnography. At 90 days post-thyroidectomy, repeat polysomnography had been obtained. At follow-up, all 8 patients had reported symptomatic control of compressive symptoms, and 7 patients had demonstrated postoperative improvement in their AHI. Overall, the mean postoperative AHI had decreased from 52.1 to 36.6—a statistically significant reduction of 29.8% (p < 0.05). The results of this study suggest that thyroidectomy for tracheal compression secondary to goiter can significantly alleviate symptoms and improve AHI in those patients who experience OSA. Evaluation of all patients with OSA should include screening for goiter-induced tracheal compression.
Bilateral Tonsillar and Esophageal Kaposi Sarcoma in an HIV-Negative Patient
Authors: Ozbudak Irem Hicran , Guney Kenan , Mutlu Derya , Gelen Tekinalp , Ozbilim Gulay
Published: January 2019

Tonsillar involvement in Kaposi sarcoma is extremely rare, as only a few such cases have been reported; all but 1 of these previously reported cases occurred in patients with human immunodeficiency virus (HIV) infection. We describe what to the best of our knowledge is the first reported case of concurrent bilateral tonsillar and esophageal Kaposi sarcoma in an HIV-negative patient. A 68-year-old man presented with sore throat and dysphagia. Clinical examination revealed the presence of bilateral and asymmetrical tonsillar masses, as well as generalized lymphadenopathy in the cervical chain. The masses were resected, and findings on histopathologic analysis were consistent with Kaposi sarcoma. In addition, human herpesvirus 8 was demonstrated on a tonsil specimen by polymerase chain reaction, and microinvasive squamous cell carcinoma was also detected. Later, another Kaposi sarcoma lesion was detected in the lower third of the esophagus. We recommend that clinicians not discount the possibility of oral classic Kaposi sarcoma in the workup of an immunocompetent patient with oral vascular lesions.
Myoepithelioma of the Vallecula: A Case Report
Authors: Kermani Wassim , Belcadhi Malek , Ali Moncef Ben , Sriha Badreddine , Bouzouita Kamel
Published: January 2019

Myoepitheliomas are rare and generally benign neoplasms that account for fewer than 1% of all salivary gland tumors. A myoepithelioma neoplasm is almost entirely composed of myoepithelial cells and is most frequently located in the parotid gland and in the minor salivary glands of the hard palate. We report an extremely rare case of myoepithelioma of the vallecular region in a 65-year-old woman and describe this tumor's clinical peculiarity, diagnostic and therapeutic considerations, and prognosis.
Eccrine Porocarcinoma of the External Ear
Authors: Watkins Bruce , Urquhart Andrew C. , Holt James J.
Published: January 2019

Eccrine porocarcinoma (EP) is believed to arise from the intraepithelial portion of the eccrine sweat glands. The incidence rate of EP is reported to be 18 per 450,000 biopsies. Most of the diagnosed cases involve the lower extremities; a case of EP involving the ear is rare. We describe the clinical, radiologic, and histopathologic features of EP in an 11-year-old boy.
Delayed Facial Nerve Palsy after Endolymphatic Sac Surgery
Authors: Xu Helen X. , Deroee Armin Farajzadeh , Joglekar Shruti , Poliak Natasha , Hobson Francis , Santori Tristin , Paparella Michael M.
Published: January 2019

Data on delayed facial nerve palsy (DFNP) following endolymphatic sac enhancement surgery are limited. We conducted a retrospective chart review to determine the incidence, possible predisposing factors, treatment, and prognosis of DFNP in such cases. We reviewed the records of779patients who had undergone endolymphatic sac surgery for intractable Meniere disease from January 1997 through December 2007 at a tertiary care otologic referral center. We found 5 cases (0.64%) of postoperative DFNP. The length of time between surgery and the onset of DFNP ranged from 7 to 20 days (mean: 11). Paralysis was incomplete in all 5 patients. Four of these patients had an abnormal mastoid bone anatomy, as the sigmoid sinus was either anteriorly or anteromedially displaced. The 5patients had been treated with a steroid, either with or without an antiviral, and all 5 experienced a complete recovery of facial nerve function within 8 weeks of the onset of their paralysis. It is difficult to delineate the exact etiology of DFNP following endolymphatic sac surgery, but we speculate that factors such as physical injury to the nerve and/or a viral reactivation might have played a role. Also, the unusual mastoid bone anatomy seen in 4 of these patients might have been responsible, as well.
Chondromyxoid Fibroma of the Nasal Cavity and Palate
Authors: Thomas Brian , Black Candice , Maddox Tate , Venkatraman Giridhar
Published: January 2019

We present an exceedingly rare case of chondromyxoid fibroma of the nasal cavity and palate. This rare tumor usually occurs in the metaphyses of the long bones. Our patient's tumor was diagnosed by biopsy, and it was resected en bloc. At the 2-year follow-up, the patient was doing well with no signs of recurrence. We review the pathologic characteristics, differential diagnosis, and treatment of chondromyxoid fibroma of the nasal cavity.
An analysis of Salivary Gland Neoplasms: A 12-Year, Single-Institution Experience in Turkey
Authors: Etit Demet , Ekinci Nese , Tan Ayca , Altinel Deniz , Dag Filiz
Published: January 2019

The epidemiology of salivary gland tumors worldwide is not very well defined. Although many studies on this subject have been undertaken, the data are generally focused on specific topics such as parotid gland neoplasms or tumors of the major salivary glands. We conducted a study to establish the prevalence and distribution of benign and malignant neoplasms of both the major and minor salivary glands at a single institution. We reviewed 244,204 cases that had come through our pathology department from January 1994 through December 2005 and found 235 cases of a salivary gland neoplasm (0.09%). The female-to-male ratio was 1.04:1, and the mean age of the patients was 47 years. Of the 235 neoplasms, 159 (67.66%) were located in the parotid gland, 34 (14.47%) in the submandibular gland, and 42 (17.87%) in the minor salivary glands. A total of 146 tumors (62.13%) were benign and 89 (37.87%) were malignant. Pleomorphic adenoma was the most common neoplasm, occurring in 98 cases (41.70%). The most common malignancy was mucoepidermoid carcinoma, with 27 cases (11.49%). Our data demonstrate that the characteristics of salivary gland tumors in a Turkish population at a single institution are similar to those reported in the literature worldwide.
Primary Intraosseous Cavernous hemangioma of the Zygoma: A Case Report and Literature Review
Authors: Marcinow Anna M. , Provenzano Matthew J. , Gurgel Richard K. , Chang Kristi E.
Published: January 2019

Intraosseous hemangiomas are rare. We report the case of a 47-year-old man who presented with a gradually enlarging left zygomatic mass that had caused pain, deformity, and superficial soft-tissue swelling. Computed tomography revealed a well-circumscribed 2.0 × 2.5-cm mass with a ground-glass matrix in the left zygoma. Following surgical excision, the patient's symptoms resolved. Findings on pathologic examination of the excised tissue were consistent with an intraosseous cavernous hemangioma. We describe the features of this rare case, we discuss the pertinent radiologic features and pathophysiology of intraosseous hemangiomas, and we review the available literature.
Intramuscular Lipoma of the Tongue Masquerading as Angioedema
Authors: Amirzadeh Ali , Klaustermeyer William
Published: January 2019

In most cases, the diagnostic evaluation of angioedema is challenging, as there are many possible etiologies. We report a case of an infiltrating lipoma of the tongue that masqueraded as angioedema. The patient, a 68-year-old man, presented with tongue swelling that had followed a waxing and waning course over a 6-month period. Physical examination showed a diffusely enlarged tongue with no discrete mass. A laboratory evaluation for angioedema was unremarkable. After the patient's condition did not respond to treatment with antihistamines and oral prednisone, a further workup was initiated. Magnetic resonance imaging of the neck and computed tomography of the oral cavity revealed only diffuse enlargement of the tongue. The patient underwent a tongue biopsy, which identified the cause of the swelling to be an infiltrating lipoma of the tongue. Clinicians should be aware that other causes of tongue swelling may mimic angioedema.
Unilateral Parotid Agenesis Associated with Pleomorphic Adenoma of Ipsilateral Accessory Parotid Gland
Authors: Seith Ashu Bhalla , Gadodia Ankur , Sharma Raju , Parshad Rajinder
Published: January 2019

Congenital agenesis of the parotid gland is rare, and its association with accessory parotid tissue is even rarer. We report an unusual case of unilateral agenesis of the left parotid gland associated with pleomorphic adenoma of the left accessory parotid gland. To best of our knowledge, this is only the second such published case in the literature.
Leiomyosarcoma of the Parapharyngeal Space: A Very Rare Entity
Authors: Gavriel Haim , Yeheskeli Eyal , Hermann Gratiana , Eviatar Ephraim
Published: January 2019

Leiomyosarcoma of the head and neck is very rare, as only about 100 cases have been reported; of these, only 3 cases have been previously reported in the parapharyngeal space. We report the fourth such case, and we review the features of this entity. The patient was an 84-year-old woman who presented to the emergency department for treatment of an 18-month history of right-sided headache, a 6-month history of right-sided hearing loss and nasal obstruction, and a 2-month history of dysphagia. Physical examination revealed a bulge in the right side of the soft palate and the right lateral nasopharyngeal wall and complete obstruction of the right eustachian tube. Indirect laryngoscopy detected a bulge in the right lateral hypopharyngeal wall. Otoscopy revealed otitis media with effusion in the right ear. Imaging demonstrated a space-occupying lesion in the right parapharyngeal space that extended from the base of the skull to the level of the hypopharynx. Biopsy and histology identified the mass as a leiomyosarcoma. Metastasis to the brain was discovered shortly thereafter, and the patient died 10 months later. The unusual presentation of head and neck leiomyosarcoma requires a high index of suspicion and appropriate diagnostic imaging. Surgical excision is the recommended treatment when feasible; chemoradiotherapy does not appear to affect disease progression.
Is the Location of a Septal Deviation Associated with the Degree of Postoperative Pain after Septoplasty?
Authors: Özler Gül Soylu
Published: January 2019

The author conducted a prospective study of patients who underwent septoplasty for nasal obstruction secondary to a septal deviation to determine if the location of the deviation had any association with the degree of postoperative pain. Patients with an anteroposterior deviation were not included in this study, nor were patients with vasomotor rhinitis, allergic rhinitis, nasal polyposis, turbinate pathologies, or a systemic disease; also excluded were patients who were taking any medication and those who had undergone any previous nasal surgery. The final study population included 140 patients, who were divided into two groups on the basis of the location of their deviation. A total of 64 patients (35 men and 29 women; mean age: 29.8 yr) had an anterior deviation, and 76 patients (35 men and 41 women; mean age: 30.3 yr) had a posterior deviation; there were no statistically significant differences between the two groups in terms of sex (p = 0.309) or age (p = 0.848). During the postoperative period, pain intensity in both groups was self-evaluated on a visual analog scale on days 1, 3, and 7 and again at 3 and 6 months. The mean postoperative pain scores on days 1, 3, and 7 were significantly higher in the posterior deviation group than in the anterior group; scores in the two groups were similar at 3 and 6 months.
Community Influence Capacity on Firms: Lessons from the Peruvian Highlands
Authors: Arenas Daniel , Murphy Matthew , Jáuregui Kety
Published: January 2019

While much research has studied corporate management of stakeholders, this research focuses on the capacity of stakeholders to influence firms. Using a grounded theory research design, we draw on a comparative analysis of the relations between two neighbouring communities in the Peruvian highlands and the mining project that affects them. Our analysis suggests that control of resources and structural configurations are insufficient for explaining divergent actions and influence capacity, and highlights the role played by factors that we refer to as community vigour and the community’s pool of knowledge. We argue that these factors explain a community’s ability to develop an informed and shared interpretation of the situation in relation to firms and, therefore, to identify and carry out actions that will be more likely to influence firms to the community’s satisfaction. Thus, community vigour and pool of knowledge are additional sources of influence capacity. These findings contribute to the literature on stakeholder influence by providing a conceptual model that explains variance in stakeholder influence capacity that theories of resource dependence, structural position or network centrality do not fully explain.
Beyond “Treatment Versus Control”: How Bayesian Analysis Makes Factorial Experiments Feasible in Education Research
Authors: Kassler Daniel , Nichols-Barrer Ira , Finucane Mariel
Published: January 2019

Background:

Researchers often wish to test a large set of related interventions or approaches to implementation. A factorial experiment accomplishes this by examining not only basic treatment–control comparisons but also the effects of multiple implementation “factors” such as different dosages or implementation strategies and the interactions between these factor levels. However, traditional methods of statistical inference may require prohibitively large sample sizes to perform complex factorial experiments.

Objectives:

We present a Bayesian approach to factorial design. Through the use of hierarchical priors and partial pooling, we show how Bayesian analysis substantially increases the precision of estimates in complex experiments with many factors and factor levels, while controlling the risk of false positives from multiple comparisons.

Research design:

Using an experiment we performed for the U.S. Department of Education as a motivating example, we perform power calculations for both classical and Bayesian methods. We repeatedly simulate factorial experiments with a variety of sample sizes and numbers of treatment arms to estimate the minimum detectable effect (MDE) for each combination.

Results:

The Bayesian approach yields substantially lower MDEs when compared with classical methods for complex factorial experiments. For example, to test 72 treatment arms (five factors with two or three levels each), a classical experiment requires nearly twice the sample size as a Bayesian experiment to obtain a given MDE.

Conclusions:

Bayesian methods are a valuable tool for researchers interested in studying complex interventions. They make factorial experiments with many treatment arms vastly more feasible.
Do Firm- and Board-specific Characteristics Corroborate Underpricing? A Study on the Indian IPOs
Authors: Anand Ramit , Singh Balwinder
Published: January 2019

The present research article is an attempt to add something new and revalidate the influence of already existing corporate governance dimensions related to the board of directors on listing-day performance of the Indian initial public offering (IPO) firms measured through underpricing. Like other emerging market economies, firms in the Indian economy are also characterized by concentrated ownership held by an owner or a promoter in the context of the Indian corporate environment. In the backdrop of this concentrated complex ownership structure, the present study analyses the influence of the board of directors on underpricing when the appointment of such directors is largely an affair handled by such owners, whom they are given the task to monitor. The sample consists of 471 IPO firms which went public during the time period from January 2003 to December 2017. Results obtained from the regression analysis show that the board size and board committees act as information signals for Indian IPO firms having a significant and negative relation with listing-day initial excess returns. Other board-related dimensions of governance do not have significant influence on underpricing. Overall board variables have a very miniscule contribution in explaining the underpricing in Indian IPO firms.
Bangladeshi ‘Boat People’: Context, Drivers And Policy Implications
Authors: Hasan Mubashar
Published: January 2019

Based on field research, this article focuses on the little-known phenomenon of Bangladeshi ‘boat people’ seeking entry to Thailand and Malaysia. It identifies how in a populous country of the Global South, familiar with various kinds of worker migration and movements of people, changing political, social and ecological contexts may generate and drive yet more manifestations of migration, also related to trafficking. In particular, certain developments in international relations connected to religious politics are shown to be instrumental in facilitating migration through legal and illegal channels. The interviews identify significant motivating factors that suggest an urgent need to develop policy recommendations, also in South Asia, to alleviate risks and suffering for irregular migrants and their families.