bluuebunny/crossref_metadata_2025 huggingface dataset:
Medial orbital wall fractures: Classification and clinical profile
Authors: Nolasco Felix P. , Mathog Robert H.
Published: December 2010

This article reports our experience and proposes a clinical classification regarding medial orbital wall fractures. After a retrospective analysis of 2741 patients with facial fractures, we were able to evaluate 273 patients with 304 medial orbital wall fractures. The male‐to‐female ratio was 5:1, and most injuries involved the left orbit. Most fractures were caused by personal altercations, but more complex injuries were noted with automobile accidents and falls. Fractures were divided into types based on location and severity of injury: type I (confined to the medial orbital wall), type II (medial orbital wall continuous with floor), type III (medial orbital wall with floor‐malar fractures), and type IV (medial orbital wall and complex midfacial injuries). Although visual loss (2%), diplopia (41%), and enophthalmos (12%) were seen, diplopia and enophthalmos were commonly observed with type II injuries. Imaging studies showed that about 52% of the fractures were associated with prolapse of orbital fat, but only 43% could be diagnosed with plain x rays. Type I fractures were generally explored through a frontoethmoid incision; other types were treated with subciliary or transconjunctival approaches. The usual treatment consisted of repositioning the fragments and repair of the wall with polyethylene mesh or cranial bone graft. Type I and type II fractures seemed best explained by the hydraulic mechanism of injury, whereas the type III and type IV fractures best fitted the buckling theory.
Otologic and systemic manifestations of experimental influenza a virus infection in the ferret
Authors: Buchman Craig A. , Swarts J. Douglas , Seroky James T. , Panagiotou Nicholas , Hayden Frederick , Doyle William J.
Published: December 2010

In an effort to further validate an animal model and to better define the mechanisms relating viral upper respiratory tract infections and acute otitis media, we infected 10 ferrets intranasally with influenza A virus. Infection was monitored by cultures and antibody titers, illness was monitored by signs and temperatures, and otologic complications were monitored by otoscopy, tympanometry, and eustachian tube function testing. All animals became infected. Forced‐response test results showed progressive increases in the passive function variables after inoculation. Inflation‐deflation test results documented progressive impairment of active tubal function, which was accompanied by the development of middle ear underpressures. No otitis media was seen. The results suggest that influenza A virus infection results in progressive, subtotal occlusion of the eustachian tube lumen, which compromises the ventilatory function of the tube, thereby promoting the development of middle ear underpressures. These findings support the hypothesized pathophysiologic relationship between viral upper respiratory tract infections, eustachian tube dysfunction, middle ear underpressures, and acute otitis media. Given these pathophysiologic changes and previously documented physiologic similarities to the eustachian tube‐middle ear system of human beings, we conclude that the ferret represents an appropriate animal model for studying the pathogenic processes related to viral upper respiratory tract infections, eustachian tube dysfunction, and otitis media and for testing of potential prophylactic and therapeutic regimens.
Classification of facial translocation approach to the skull base
Authors: Janecka Ivo P.
Published: December 2010

OBJECTIVE

To categorize a surgical approach to the skull base.

DESIGN

Retrospective assessment of an evolving concept pertaining to the facial translocation procedure.

SETTING

Schematic/conceptual.

MAIN OUTCOME MEASURES

To allow favorable surgical reach of the essential anatomy at the cranial base with the potential for functional and esthetic reconstruction.

INTERVENTION

Systematic craniofacial disassembly.

RESULTS

The facial translocation technique of modular craniofacial disassembly of facial units permits a satisfactory match between, a skull base tumor and a selected surgical approach. Individual units have a complementary relationship to one another, allowing an expansion of the surgical approach as needed.
First Place — Resident Basic Science Award 1995: Reinnervation of the Allograft Larynx in the Rat Laryngeal Transplant Model
Authors: Weed Donald T. , Chongkolwatana Cheerasook , Kawamura Yuji , Burkey Brian B. , Netterville James L. , Ossoff Robert H. , Zealear David L.
Published: December 2010

The rat model for a vascularized laryngeal allograft is duplicated with significant technical modifications. We report the addition of unilateral host‐to‐allograft recurrent laryngeal nerve anastomosis to this model. Long‐term survival experiments determine the feasibility of reinnervation studies of the allograft larynx with this new model. A total of 59 transplants have been performed on histocompatible Munich Wistar rats, 36 with attempted unilateral allograft reinnervation. Because of the initially high operative mortality rates, additions and modifications of the original technique resulting in reproducibly enhanced survival are detailed. Factors critical to the functional study of this model with regard to reinnervation are elucidated. Preliminary data on allograft reinnervation are reported as confirmed by videodocumentation of vocal fold mobility, evoked and spontaneous electromyography, and glycogen‐depletion Studies.
Management of Otitis Media Using Agency for Health Care Policy and Research Guidelines
Authors: Hsu Griffith S. , Levine Samuel C. , Giebink G. Scott
Published: December 2010

Increased costs of managing otitis media and its complications may result from delays in diagnosis and treatment. The Agency for Health Care Policy and Research developed guidelines to assist in the management of chronic otitis media with effusion. We examined the medical care adherence to Agency for Health Care Policy and Research guidelines in 59 consecutive patients referred because of chronic otitis media with effusion and recurrent acute otitis media. Patient history and examination data were collected prospectively. In the group with chronic otitis media with effusion, the rate of adherence to Agency for Health Care Policy and Research guidelines was 0%; in those with recurrent acute otitis media, adherence was 5%. Delayed referral occurred in 34% of patients; 25% of patients were referred early. The average duration of effusion in patients with chronic otitis media with effusion was 5.2 months; the duration of recurrent acute otitis media immediately before referral was 9.3 months. Eighteen patients (47%) in the chronic otitis media with effusion group had a history of recurrent chronic otitis media with effusion spanning an average of 22.7 months. On referral, hearing loss was discovered in 92% of all patients, and in 69% the tympanogram was flat. The complication and sequelae rate was 49.1%, and speech delay was the most frequent at 16.9%. We conclude that in our study patients there is a significant referral delay, long history of chronic otitis media with effusion in patients before referral, high rate of hearing loss, and high complication rate. Continued efforts should be directed toward improving education of all clinicians so that diagnostic tools and timely otolaryngologic referral are better used.
Current Trends in Laryngectomy Rehabilitation: A Survey of Speech‐Language Pathologists
Authors: Culton Gerald L. , Gerwin John M.
Published: December 2010

This study determined the perceptions of experienced speech‐language pathologists regarding current practices in the speech rehabilitation of laryngectomy patients since the introduction of the tracheoesophageal puncture‐voice prosthesis technique in 1980. The sample population consisted of 151 experienced speech‐language pathologists, or 43% of those who were sent questionnaires. The speech‐language pathologists ranked tracheoe‐sophageal puncture‐voice prosthesis as their most preferred speech rehabilitation method and the electrolarynx as their least preferred, even though the electrolarynx continues to be the most frequently used method. Variable use of the tracheoesophageal puncture procedure by otolaryngologists was reported, with only a small portion perceived as using it routinely. About 65% of the speech‐language pathologists reported that more than half of the laryngectomy patients were being given choices among speech rehabilitation methods. Nearly 50% of the speech‐language pathologists reported that fewer than six speech therapy sessions were necessary with tracheoesophageal puncture patients, whereas more than 20% reported the need for 10 sessions or more. Use of manual closure of the tracheostoma by tracheoesophageal puncture patients far outweighed their use of automatic speaking valves. Most speech‐language pathologists reported that they were involved in teams with otolaryngologists to determine patient suitability for tracheoesophageal puncture and to troubleshoot problems. Eighteen different categories of medical and speech production problems were reported.
Analysis of Short‐Term Outcome after Office‐Based Laser‐Assisted Uvulopalatoplasty
Authors: Astor Frank C. , Hanft Kendall L. , Benson Corazon , Amaranath Anand
Published: December 2010

To determine the short‐term effectiveness and outcome of office‐based laser‐assisted uvulopalatoplasty, a prospective statistically controlled study was done at the Department of Otolaryngology, Cleveland Clinic Florida. Thirty‐eight consecutive snoring patients underwent a total of 98 laser‐assisted uvulopalatoplasties, and data were gathered through examination, interview, and analog scales of snoring, pain, and other morbidity. In addition, a failure analysis was performed. Data were analyzed by descriptive statistics, confidence intervals, and adjusted analysis of variance (p < 0.008). Our results suggest that snoring decreased significantly around each laser‐assisted uvulopalatoplasty treatment performed (4 to 8 weeks apart). Postoperative pain diminished after the first two laserassisted uvulopalatoplasty treatments. The only morbidity in the series was the result of significant pain, causing 77% of laser‐assisted uvulopalatoplasty failures.
Interleukin‐4, interleukin‐5, and granulocyte‐macrophage colony‐stimulating factor receptor expression in chronic sinusitis and response to topical steroids
Authors: Wright Erin D. , Frenkiel Saul , Al‐Ghamdi Khalid , Ghaffar Omar , Small Peter , Troutt Tony , Tavernier Jan , Hamid Qutayba
Published: December 2010

Chronic sinusitis and its associated eosinophilic infiltrate are believed to be mediated, at least in part, by the upregulation of Th‐2 cytokines, including interleukin‐4, interleukin‐5, and granulocyte‐macrophage colony‐stimulating factor (GM‐CSF). Interleukin‐4 is involved in IgE production and in eosinophil recruitment through upregulation of vascular cell adhesion molecule‐1. Interleukin‐5 and GM‐CSF are involved in eosinophil growth and survival. The aim of this study was to investigate the expression of receptors for these cytokines in the sinus mucosa of subjects with chronic sinusitis. Using the technique of in situ hybridization to detect specific cytokine receptor messenger RNA, we studied the sinus mucosa of subjects with nonallergic chronic sinusitis, subjects with allergic chronic sinusitis, subjects with allergic chronic sinusitis treated with topical steroids, and normal controls. Our data demonstrate higher expression of interleukin‐4 receptor in subjects with allergic chronic sinusitis than in controls (p <0.001) and higher expression of interleukin‐5 receptor in both subjects with nonallergic chronic sinusitis and subjects with allergic chronic sinusitis than in controls (p <0.001, p <0.001). The expression of interleukin‐4 receptor and interleukin‐5 receptor was higher in subjects with allergic chronic sinusitis than in subjects with nonallergic chronic sinusitis (p <0.001). GM‐CSF receptor expression was also found to be higher in subjects with allergic chronic sinusitis and subjects with nonallergic chronic sinusitis than in controls (p <0.001,p <0.001). In contrast to interleukin‐4 receptor and interleukin‐5 receptor, however, expression of GM‐CSF receptor was higher in subjects with non‐allergic chronic sinusitis than in subjects with allergic chronic sinusitis (p <0.001). In subjects with allergic chronic sinusitis treated with topical corticosteroids, the expression of interleukin‐4 receptor and interleukin‐5 receptor messenger RNA levels was significantly lower than levels in patients with allergic chronic sinusitis who were not taking topical steroids (p <0.001, p <0.001). Steroid treatment had no effect on GM‐CSF receptor messenger RNA expression. In conclusion, our data support a role for Th‐2 cytokine receptors in the pathophysiology of chronic sinusitis. Further, our data lend support to the theory that differential activation of distinct cytokine pathways mediates inflammation in chronic sinusitis depending on whether there is associated allergy. Finally, treatment with topical corticosteroids has been demonstrated in chronic sinusitis to downregulate receptors for interleukin‐4 and interleukin‐5.
Changes in laryngeal muscle activities during hypercapnia in the cat
Authors: Adachi Tomoyuki , Umezaki Toshiro , Matsuse Toshiaki , Shin Takemoto
Published: December 2010

The larynx has three functions: phonation, airway protection, and respiration. Few studies have dealt with laryngeal respiratory function. To elucidate respiratory regulation by the larynx, we studied the changes in the activity of the intrinsic laryngeal muscles during hypercapnia in decerebrated cats. The electromyographic activities of the posterior cricoarytenoid (PCA) and thyroarytenoid (TA) muscles were recorded simultaneously with an electromyogram of the diaphragm, endotracheal pressure, and concentrations of O2 and CO2. The activity of the intrinsic laryngeal muscles during hypercapnia (end‐tidal CO2, 8% to 10%) was analyzed in comparison with that during eucapnia. In hypercapnia, both the PCA and TA muscles increased their activities, and the endotracheal pressure during expiration was elevated to a higher level than that in eucapnia. TA muscle activities returned to the level during eucapnia after ligation of the common carotid arteries. These findings suggest that hypercapnia causes a further widening of the glottis during inspiration to decrease inspiratory resistance and a further narrowing of the glottis during expiration to prevent alveolar collapse. Thus it may be concluded that the larynx actively participates in respiratory regulation under the control of the brain stem through a process of peripheral inputs from the carotid receptors.
Objective scaling of facial nerve function based on area analysis (OSCAR)
Authors: Meier‐Gallati Verena , Scriba Henning , Fisch Ugo
Published: December 2010

An objective scaling of facial nerve function based on area analysis (OSCAR) was developed using the variations of luminance produced by changes of facial expression. The presented method of scaling facial motions has the advantage of being continuous, objective, and reproducible. It is fast and simple to use.
Phase I Trial of Retinoic Acid and cis‐Platinum for Advanced Squamous Cell Cancer of the Head and Neck Based on Experimental Evidence of Drug Synergism
Authors: Weisman Robert A. , Christen Randolph , Los Gerrit , Jones Vicky , Kerber Charles , Seagren Stephen , Glassmeyer Sherrie , Orloff Lisa A. , Wong Wade , Kirmani Saeda , Howell Stephen
Published: December 2010

OBJECTIVE

Cis‐platinum and 13‐cis‐retinoic acid have received much attention in the treatment of head and neck squamous cell cancer. Even though they have different mechanisms of action, little information is available on their interaction. This paper reviews experimental evidence for retinoic acid‐cis‐platinum synergy and presents toxicity data from patients with stage IV head and neck squamous cell cancer participating in a phase I trial combining 13‐cis‐retinoic acid and cis‐platinum.

METHODS

Patients were given 13‐cis‐retinoic acid orally daily for 7 days before and daily during high‐dose (150 mg/m2 per week for 4 weeks) intraarterial cis‐platinum treatment with concurrent radiation. Toxicity was scored with use of the cancer and leukemia group B scale.

RESULTS

In the phase I clinical trial, 15 patients were treated to determine a maximum tolerated dosage for 13‐cis‐retinoic acid of 20 mg/day. Grade 4 hematologic toxicity was dose limiting in 3 of 8 patients treated with 40 mg/day and in 1 patient treated with 60 mg/day. There were no deaths caused by toxicity; 12 of the 15 patients received all four weekly doses and the remaining 3 received three doses. Of 10 patients with fully evaluable data, all achieved a complete response at the primary site and 9 had a complete response in the neck. One patient had persistent neck disease after chemoradiation, and this tumor was removed with neck dissection.

CONCLUSIONS

13‐cis‐retinoic acid and cis‐platinum are strongly synergistic against head and neck squamous cell cancer in vitro. Pretreatment with retinoic acid results in stronger synergy than concurrent drug exposure alone. Preliminary clinical experience with combined retinoic acid and cis‐platinum in a design that parallels the in vitro study indicates that toxicity is acceptable with 13‐cis‐retinoic acid dosages of 20 mg/day in a high‐dose‐intensity intraarterial chemoradiation regimen. (Otolaryngol Head Neck Surg 1998;118:597–602.)
Speech and Swallowing in Irradiated and Nonirradiated Postsurgical Oral Cancer Patients
Authors: Pauloski Barbara Roa , Rademaker Alfred W. , Logemann Jerilyn A. , Colangelo Laura A.
Published: December 2010

The effect of radiation on speech and swallowing function was assessed for 18 patients surgically treated for oral and oropharyngeal cancer. Nine patients received surgical intervention and postoperative radiation therapy, and nine received surgery only. Patients were matched regarding percentage of oral tongue resected, percentage of tongue base resected, locus of resection, and method of reconstruction. Speech and swallowing function was assessed before and at 1, 3, 6, and 12 months after surgery following a standardized protocol. Speech tasks included an audio recording of a brief conversation and of a standard articulation test; swallowing function was examined with videofluoroscopy. Statistical testing indicated that overall speech function did not differ between the irradiated and nonirradiated patients. Irradiated patients had significantly reduced oral and pharyngeal swallowing performance, specifically, longer oral transit times on paste boluses, lower oropharyngeal swallow efficiency, increased pharyngeal residue, and reduced cricopharyngeal opening duration. Impaired function may be the result of radiation effects such as edema, fibrosis, and reduced salivary flow. Increased use of tongue range‐of‐motion exercises during and after radiation treatment may reduce the formation of fibrotic tissue in the oral cavity and may improve pharyngeal clearance by maintaining adequate tongue base‐to‐pharyngeal wall contact. (Otolaryngol Head Neck Surg 1998;118:616–24.)
Effects of Topical Oral Antiseptic Rinses on Bacterial Counts of Saliva in Healthy Human Subjects
Authors: Balbuena Luis , Stambaugh Kweon I. , Ramirez Sylvester G. , Yeager Curtis
Published: December 2010

Wound infections remain a significant source of morbidity in patients undergoing major head and neck operations that invade the aerodigestive tract. Infection rates have been significantly reduced by the administration of perioperative intravenous antibiotics; however, the incidence of infection remains unacceptably high. This study was undertaken to help identify an oral antiseptic that could significantly reduce the bacterial colony count of human saliva. A randomized, prospective clinical trial was conducted to analyze and compare the effects of Listerine antiseptic and Peridex oral rinse on the aerobic and anaerobic bacterial counts in healthy human subjects. Thirty healthy adult volunteers between the ages of 18 and 61 participated in the study. The patients were randomized to receive normal saline solution, Listerine antiseptic, or Peridex oral rinse. Aerobic and anaerobic bacterial colony counts of saliva were measured before treatment and at 1 and 4 hours after treatment. Both Listerine antiseptic and Peridex oral rinse significantly reduced bacterial counts at 1 hour after treatment in our volunteers. At 4 hours after treatment, Peridex oral rinse showed a further reduction in the bacterial colony count whereas Listerine antiseptic showed no difference compared with normal saline solution. At 4 hours after treatment, Peridex oral rinse reduced the total bacterial colony count by 85%. (Otolaryngol Head Neck Surg 1998;118:625–9.)
Airway Management in Pierre Robin Sequence
Authors: Myer Charles M. , Reed J. Mark , Cotton Robin T. , Willging J. Paul , Shott Sally R.
Published: December 2010

There is a great deal of controversy regarding the long‐term management of airway obstruction in children with Pierre Robin sequence. All 23 pediatric otolaryngology fellowship programs were surveyed to determine their current practice patterns. Issues that were addressed included methods of evaluation of airway obstruction, including polysomnography, choices for home care in children in whom observation and positioning treatment failed, and complications of the various treatment modalities. The lack of unanimity among the respondents mirrors the controversy found in the literature. Though tracheotomy appears to be favored as the method of long‐term management, responses from those surveyed often were based on emotions as much as on scientific data. This report details those findings and offers suggestions to clinicians involved with the management of patients with Pierre Robin sequence with airway compromise. (Otolaryngol Head Neck Surg 1998;118:630–5.)
Nasal Patency and the Effectiveness of Nasal Continuous Positive Air Pressure in Obstructive Sleep Apnea
Authors: Schechter Gary L. , Ware J. Catesby , Perlstrom James , Mcbrayer Reuben H.
Published: December 2010

Nasal airway obstruction may exacerbate sleep apnea and is difficult to quantify on clinical examination. In this study, we examined the relationship among nasal patency, the frequency of sleep apnea events, and effective nasal continuous positive air pressures. Acoustic rhinometry was used as an objective measurement of nasal cross‐sectional areas in 76 patients without nasal symptoms who underwent study with diagnostic polysomnography because of obstructive sleep apnea. Patients with persistent obstructive sleep apnea were titrated to nasal continuous positive air pressure in a split night study. All subjects had a mean apnea/hypopnea index of 28, and those with obstructive sleep apnea had a mean apnea/hypopnea index of 43. Mean cross‐sectional areas 1 to 4 cm into the nose were 1.7, 1.1, 2.1, and 2.8 cm2, respectively (F = 39, p < 0.001). However, there was no correlation between the apnea/hypopnea index and the cross‐sectional area at the four distances (r = 0.03, 0.06, 0.02, and 0.02, respectively, p = not significant). Correlations between nasal continuous positive air pressures and cross‐sectional areas did not reveal a significant relationship at any of the four sites (r = 0.09, 0.07, −0.03, 0.00, respectively). Findings in patients with apnea were also compared with those in patients without apnea and significant differences were not found (F = 0.019, p = not significant). Although it would seem intuitive that increased nasal obstruction is associated with the severity of obstructive sleep apnea and difficulty with the use of nasal continuous positive air pressure, this study shows that nasal patency, as measured by acoustic rhinometry, does not correlate with the severity of obstructive sleep apnea, as determined by the apnea/hypopnea index or the effective nasal continuous positive air pressure. (Otolaryngol Head Neck Surg 1998;118:643–7.)
Assessment by Nasal Biopsy of Long‐Term Use of Mometasone Furoate Aqueous Nasal Spray (Nasonex) in the Treatment of Perennial Rhinitis
Authors: Minshall E. , Ghaffar O. , Cameron L. , O'Brien F. , Quinn H. , Rowe‐Jones J. , Davies R. J. , Prior A. , Lund V. J. , Mackay I. S. , Nolop K. , Lutsky B. , Durham S. R. , Hamid Q.
Published: December 2010

Allergic rhinitis is associated with specific histopathologic changes in the nasal mucosa including squamous metaplasia and local eosinophilia. Previous studies have shown that mometasone furoate aqueous nasal spray is effective and well tolerated in reducing perennial rhinitis and seasonal allergic rhinitis symptoms. We undertook a multicenter, open‐label study to evaluate, by nasal biopsy, the tissue changes associated with mometasone furoate use (200 μg/day) during a 12‐month treatment period in patients with perennial rhinitis. Of the 69 patients enrolled in the study, 52 completed all 12 months of treatment. Nasal biopsy specimens obtained from patients at baseline and after treatment were evaluated in a blinded fashion by computerized image analysis, qualitative histologic examination, and immunocytochemistry. Morphologic examination of nasal biopsy specimens showed a decrease in focal metaplasia, no change in epithelial thickness, and no sign of atrophy after treatment with mometasone furoate. Immunocytochemical analyses of nasal biopsy specimens obtained before and after treatment revealed a significant decrease in major basic protein‐positive eosinophils and tryptase‐positive mast cells in the epithelium and lamina propria after treatment. Mometasone furoate appeared to attenuate the inflammatory process by reducing the extent of inflammatory cell infiltration, particularly of eosinophils. This study demonstrated that long‐term administration of mometasone furoate is not associated with adverse tissue changes in the nasal mucosa of patients with perennial rhinitis. (Otolaryngol Head Neck Surg 1998;118:648–54.)
Analysis of Cellular Location and Concentration in Vocal Fold Lamina Propria
Authors: Catten Michael , Gray Steven D. , Hammond Thomas H. , Zhou Ruixia , Hammond Elizabeth
Published: December 2010

Studies have shown that the lamina propria plays an important role in voice production. Recent studies have analyzed the presence of different proteins and quantified their extent in the lamina propria, but no similar study has yet been done on cellular makeup. The distribution of three different cell types in the lamina propria of 22 human vocal folds was studied. These types are fibroblasts, macrophages, and myofibroblasts. The roles of these cells in the extracellular matrix are described. Their distribution was quantified with use of an image‐analysis system. We arbitrarily divided the lamina propria into five sections (each representing 20% of the lamina propria) and compared cell numbers among these sections. Gender comparisons were also made. From these studies it is evident that the cellular distribution in the lamina propria is not uniform. Fibroblasts were more abundant in the deepest 20% of the lamina propria (p < 0.008), myofibroblasts were more abundant in the most superficial 20% (p < 0.016), and in the 36% of our samples that contained macrophages in the lamina propria, there was a significantly higher number of macrophages in the first 20% of the lamina propria (p < 0.003). The only significant gender difference was that women had twice as many macrophages in the most superficial 20% of the lamina propria as men (p < 0.05). The higher myofibroblast activity in the first 20% could indicate that the superficial layer is a region of constant repair. The increased number of macrophages in the superficial layer likely indicates an inflammatory response to inhalants (because of the role of macrophages in the inflammatory response and the fact that only 36% of the patients showed any macrophage activity at all). (Otolaryngol Head Neck Surg 1998;118:663‐7.)
Comparative Efficacy of Terfenadine, Loratadine, and Astemizole in Perennial Allergic Rhinitis
Authors: Crawford William W. , Klaustermeyer William B. , Lee Peter H. , Placik Irma M.
Published: December 2010

Nonsedating H1antihistamines such as terfenadine, loratadine, and astemizole are widely prescribed for the treatment of allergic rhinitis. The comparative efficacy of these agents has not been thoroughly studied. We studied 14 subjects in an open‐label four‐way crossover trial. Patients were recruited from an outpatient allergy clinic. Inclusion criteria were documented rhinitis symptoms for at least 2 years before the study and skin‐test positivity in response to perennial allergens. Each subject underwent sequential 2‐week trials of each of four H1antihistamines: terfenadine, loratadine, astemizole, and chlorpheniramine. No placebo was included. Outcome measures were subjective rhinitis symptom scores, overall efficacy scores, and concomitant pseudoephedrine use. In addition, nasal‐examination scores were obtained by way of physician assessment at the end of each 2‐week trial, and side effects were tabulated. Nasal‐examination scores for each of the four H1antihistamines were significantly better than the baseline scores (p< 0.05). No statistically significant differences in rhinitis symptom scores, overall efficacy scores, or concomitant pseudoephedrine use were noted. We detected no clinically significant differences in efficacy among terfenadine, loratadine, astemizole, and chlorpheniramine in the treatment of perennial allergic rhinitis. (Otolaryngol Head Neck Surg 1998;118:668‐73.)
Effect of Increased Inner Ear Pressure on Middle Ear Mechanics
Authors: Murakami Shingo , Gyo Kiyofumi , Goode Richard L.
Published: December 2010

Velocity of malleus, umbo, and stapes footplate in response to stepwise increases up to +400 mm H2O in hydrostatic pressure of the inner ear was investigated in 10 fresh human temporal bones by using a laser Doppler interferometer. The sound‐pressure input was 114 dB SPL, and the frequency range was 0.4 to 5.0 kHz. Static displacement of these sites was also measured by a video measuring system. When the inner ear pressure was increased, the malleus and stapes moved outward. Amplitude of umbo velocity decreased below 1.0 kHz with a slight increase around 2.0 kHz, whereas stapes velocity decreased at all frequencies with the major effect below 1.0 kHz. The phase angle of malleus umbo velocity advanced markedly in response to the increased inner ear pressure between 1.0 and 1.4 kHz. Change in the vibration of the umbo was thought to be primarily caused by an increased stiffness of the middle ear conduction system, and that of the stapes was caused by distention of the annular ligament and increased cochlear impedance produced by the increased inner ear pressure. These changes in TM vibration and its phase angle may help detect indirectly an elevation of inner ear pressure. (Otolaryngol Head Neck Surg 1998;118:703–8.)
Myringoplasty in Children: Factors Influencing Surgical Outcome
Authors: Caylan Refik , Titiz Ali , Falcioni Maurizio , De Donato Guiseppe , Russo Alessandra , Taibah Abdelkader , Sanna Mario
Published: December 2010

Age, size, and site of perforation, condition of the ear, status of the contralateral ear, grafting materials, and more are considered factors influencing the success rates in myringoplasties in children. The ambivalence in results is mainly due to nonhomogeneous patient groups. In an effort to compose groups as homogeneous as possible for analysis of influencing factors, a retrospective study of 51 pediatric myringoplasty cases (51 ears) was undertaken. All patients had perforations caused by simple chronic otitis media. The overall surgical success rate was 82.3% at 18 months, and for young (5 to 10 years) and older (11 to 16 years) children it was 77.2% and 86.2%, respectively. Anterior, central, and total perforations healed without significant differences. Outcome in unilateral perforations was better than bilateral: 96.9% and 55%, respectively (p < 0.01). Discharging ears (100%) healed better compared with dry ears (75%) (p < 0.05). Analysis of the literature also revealed significant difference in success rates of discharging and dry ears: 92.5% and 80.6%, respectively (p < 0.01). We conclude that, contrary to comments in the literature, discharging ears in children favor good outcome and they should be operated on regardless of age and site of perforation. However, in bilateral perforations results may not be so rewarding. (Otolaryngol Head Neck Surg 1998;118:709–13.)
Evaluation of Expiratory Effort on Dysphonic Patients on Increasing Vocal Intensity
Authors: Makiyama Kiyoshi , Kida Akinori , Sawashima Masayuki
Published: December 2010

It is conceivable that the subjects who have phonatory disorders, in comparison with normal individuals, exert a greater expiratory effort when phonating loudly. Furthermore, we presume that the extent and pattern of the changes in the expiratory effort for increasing vocal intensity may vary according to the types of laryngeal lesions. To prove these hypotheses, we investigated the changes in expiratory effort for increments of the vocal intensity by measuring the expiratory lung pressure. The subjects included 10 each of normal controls, patients with Reinke's edema, and those with recurrent laryngeal nerve paralysis. For the normal controls, the increase in vocal intensity was achieved by slightly increasing the expiratory lung pressure. The patients with Reinke's edema showed a greater increase in expiratory lung pressure, as compared with the normal group. The patients with recurrent laryngeal nerve paralysis exhibited greater expiratory effort with extreme increases in airflow than normal group for louder phonation. It was concluded that the subjects who have phonatory disorders, in comparison with normal individuals, require a greater expiratory effort. This phonatory function test with an increase in voice intensity made the aerodynamic pathologic condition clearer. (Otolaryngol Head Neck Surg 1998;118:723–7.)
Efficacy of an insole shoe wedge and augmented pressure sensor for gait training in individuals with stroke: a randomized controlled trial
Authors: Sungkarat Somporn , Fisher Beth E , Kovindha Apichana
Published: December 2010

Objective: To determine whether external feedback to promote symmetrical weight distribution during standing and walking would improve gait performance and balance in people with stroke.

Design: Randomized, controlled, assessor-blinded trial.

Setting: Rehabilitation unit and physical therapy department.

Subjects: Thirty-five individuals with stroke (mean (SD) age = 53.0 (9.3) years) were randomly assigned to an experimental ( n = 17) or control group ( n = 18). Time post stroke was less than six months for most subjects ( n = 27, 77%).

Interventions: Subjects participated in 15 rehabilitation sessions including 30 minutes of gait retraining per session. During gait retraining, the experimental group used an insole shoe wedge and sensors set-up (I-ShoWS) while the control group received a conventional programme. The I-ShoWS set-up consisted of a wedge insole and a footswitch for the non-paretic leg and a pressure sensor on the paretic leg.

Outcome measures: Gait speed, step length and single support time asymmetry ratio, balance and amount of load on paretic leg during stance were evaluated twice: one day before and after training.

Results: The experimental group demonstrated significant increase in standing and gait symmetry compared with the control group ( P < 0.05). They demonstrated 3 times greater improvement in gait speed than the control group ( P = 0.02). Balance improvement was significantly greater for the experimental than for the control group ( P < 0.05).

Conclusion: Gait retraining using the I-ShoWS set-up was more effective in restoration of gait speed, standing and walking symmetry and balance than a conventional treatment programme. These results indicate the benefit of implementing feedback during gait retraining.
City Managers’ Job Satisfaction and Frustration
Authors: Zhang Yahong , Yao Xiang , Cheong Jong One
Published: December 2010

As an organizational objective and social value, job satisfaction is important in itself. Various studies have investigated job satisfaction of government employees at the federal, state, and local government levels. This study focuses on job satisfaction of city managers. In particular, it develops Herzberg’s motivator-hygiene theory in the context of local government to identify distinct sets of motivators and hygiene factors for city managers. Using survey data collected from city managers in Georgia, this study suggests that performance of city government and managers’ community influence are important motivators for city managers. Salary and city population are hygiene factors, whereas managers’ policy-making influence, relationship with the council, and effectiveness of council exert significant impact on both satisfaction and frustration. Implications and suggestions are provided.
Auctions, Rituals and Emotions in the Art Market
Authors: Herrero Marta
Published: December 2010

This article explores the possibilities offered by Collins’ model of interaction rituals to an understanding of the emotional dynamics of art auctions. It argues that whilst it explains how the art object becomes the focus of attention, and thus the repository of solidarity and emotional energy, it also obliterates some of the institutional aspects of the auction market that can influence such outcomes. It discusses the need to include an examination of the specific practices of auction houses operating in an international market in their capacity to target specific audiences for their sales.
Visualizing Subjectivity: Social Theory and the Role of Art as Metaphor of Self and Habitus
Authors: Williams Linda
Published: December 2010

This paper considers the way social theorists draw on affective imagery to convey ideas about complex social processes such as the formation of subjectivity within a given habitus. The argument focuses on discussions of art in the work of Elias and Foucault to question whether imagery, and particularly imagery drawn from art, serves to simplify more complex processes of reasoning, or whether the image can be understood as a type of conceptual consolidation of an argument rather than a means to simply illustrate or augment it. The paper also raises the question of whether art is a more complex form of social agency than it was sometimes understood to be in its original social context.
Materiality of Marble: Explorations in the Artistic Life of Stone
Authors: Leitch Alison
Published: December 2010

This article is inspired by theoretical developments within the social sciences that focus on the materiality of everyday objects and processes. Based on ethnographic research in the city of Carrara, in central Italy, the article discusses the experiences of both quarry workers and sculptors who work with marble. Through an exploration of one of the ‘qualisigns’ of marble — veining — the article draws attention to the material life of marble in the artistic imagination of sculptors and why materiality might matter in social analysis.
Performing ‘Legitimate’ Torture: Towards a Cultural Pragmatics of Atrocity
Authors: Tognato Carlo
Published: December 2010

Scholars have traditionally explained away torture as an act of monstrosity. Hannah Arendt has proposed instead a socio-cultural explanation of the phenomenon. Modern rationality, she suggests, constitutes the legitimacy principle that grounds the bureaucracy of repression and that perpetrators can ultimately tap into for the purpose of justifying their deeds. I will suggest, instead, that modern technical rationality is per se not sufficient to justify torture. Rather, to do so, it must undergo a profound transformation as a result of its being linked to deeper moral logics. Linkage, in turn, is a matter of cultural performance. To tackle the question of legitimacy in torture, it is therefore necessary to address its cultural pragmatics. Jeffrey Alexander’s latest work on social performance can help in this respect.
Experimental Study of the Influences of Orientation and Altitude on Pyrolysis and Ignition of Wood
Authors: Junfang Qie  , Lizhong Yang  , Yafei Wang  , Jiakun Dai  , Xiaodong Zhou
Published: December 2010

On account of limited attention paid to the influence of orientation and altitude in previous research, the pyrolysis and ignition characteristics of wood in different orientations and altitudes were investigated experimentally. Two orientations were explored: vertical and horizontal. In addition, experiments were conducted in Lhasa and in Hefei, which are at very different altitudes. Ignition time, mass loss rate, and surface temperature are discussed. Compared with those in the horizontal orientation, shorter ignition times, faster mass loss rates, and lower surface temperatures were observed in the vertical orientation. In addition, there are shorter ignition times, faster mass loss rates, and higher surface temperatures in Lhasa (high altitude) than in Hefei (low altitude).
Perceiving Expatriate Coworkers as Foreigners Encourages Aid
Authors: Leonardelli Geoffrey J. , Toh Soo Min
Published: December 2010

We propose that social categorization can encourage particular forms of intergroup cooperation because it differentiates a group in need from a group that can give aid. Moreover, social categorization is most likely to occur when individuals perceive procedural justice (i.e., fair treatment) from authorities in a superordinate group that includes the individuals’ subgroup. Two field studies investigating relations between local and foreign coworkers tested not only this prediction, but also whether high social categorization and procedural justice would yield a dual identity, in which group members identify simultaneously with their social category and the superordinate group. Both studies supported our predictions: Local employees engaged a dual identity and offered knowledge to aid a foreign coworker’s adjustment more often when local-foreign categorization and procedural justice from organizational authorities were high than when these variables were low. These discoveries point to controllable mechanisms that enable intergroup cooperation, and our findings have important implications for intergroup aid, expatriate adjustment, immigration, and multiculturalism.
Protective effects of epigallocatechin-3-gallate against lead-induced oxidative damage
Authors: Wei Haiying , Meng Ziqiang
Published: December 2010

A positive association of lead exposure with clinical cardiovascular outcomes has been identified. Epigallocatechin-3-gallate (EGCG) is one of the active polyphenols in green tea, it has not been reported as an antioxidant against lead toxicity. This study was carried out to investigate whether EGCG could protect the ventricular myocytes of rats against lead-induced oxidative damage. Isolated ventricular myocytes were exposed to lead and/or EGCG, then activities of superoxide dismutase (SOD), catalase (CAT), and malondialdehyde (MDA) and the levels of hydroxyl radical (OH·), hydrogen peroxide (H2O2), and superoxide anion (O2·−) were measured. The results showed that lead induced a significant decrease of SOD and CAT activities, while the levels of MDA increased significantly. Increases in intracellular OH·, O2·−, and H2O2were found as well. These processes were concentration-dependent and statistically significant different when compared to 2.0 µM lead exposure. The activity of SOD and CAT increased while the levels of MDA and reactive oxygen species (ROS) decreased after treatment with EGCG. While there were progressive benefits with increasing EGCG concentrations, there was no statistical significance at a 30 µg/mL dose when compared with the control. These results will provide more evidence for lead toxicity to tissue, cell, and biological macromolecule.
Scale development based on likelihood cross-validation
Authors: Knafl George J , Dixon Jane K , O'Malley Jean P , Grey Margaret , Deatrick Janet A , Gallo Agatha , Knafl Kathleen A
Published: December 2010

The use of likelihood cross-validation for guiding the scale development process is formulated and demonstrated, including choosing the number of factors, assessing item-factor allocations suggested by rotations, adjusting those allocations, reducing the number of factors, removing items, and assessing the applicability of scales to subjects other than those for whom it was originally developed. An example analysis is presented on the development of scales to measure how parents caring for a child with a chronic condition view their family's management of that condition.
Illness and Healing from a Korean Woman’s Intercultural Perspective
Authors: Chung Meehyun
Published: December 2010

In Korean culture, illness is frequently considered punishment for sin. In spite of the prevalence of Western medicine and advanced technologies, moral judgment is frequently confused with physical causality. There are certain religious dietary customs which people undertake in order to be healed. These customs are open to misinterpretation, and can become a basis for accusation, fear and guilt. Women and people of inferior social status are easily accused of being the cause of illness within families and society. The persecution of witchcraft in the medieval age developed from a similar mechanism: it is easier to scapegoat an individual or a small group than to take responsibility as an entire community. A religion that creates guilt and fear is not oriented towards health. Rather than being a blessing, it is, in fact, a problem. I consider whether religion is death or life oriented. Life giving energy for the sake of individual, as well as community, is an important component.
Reading Queer A/theology into Rabih Alameddine’s Koolaids
Authors: Shannahan Dervla
Published: December 2010

This paper explores Rabih Alameddine’s debut novel, Koolaids, from a queer a/theological perspective. It has been read as portraying an exilic in-betweenness and this paper looks at how this indeterminacy manifests in the text’s relationships to sexuality and Scripture. It argues that Alameddine dissects the stability of sexual norms and desires, and effectively queeries all compulsions to identify. It also discusses how Alameddine rereads and returns to Scripture, whilst rebuking blind faith in anything, and suggests that whilst his own relationship to theologies may be non-committal and ambiguous, the text embodies and exposes multiple possibilities for reconciling queerness of all kinds with Divine and self acceptance. It concludes with the suggestion that Koolaids can be read as offering myriad resources for theological reflection, resources that are at once a/theological, queerly positioned, and ever-open to diverse theological dreamscapes.
The Marian Paradox: Marian Practices as a Road to a New Mariology?
Authors: de Haardt Maaike
Published: December 2010

Disregarding trends of secularization, the Virgin Mary still plays an important role in religious devotions all over the world, even in the West. This does not diminish the controversies, debates and theo-political struggles that surround Mary and a Marian theology, as will be shown in this article. Western feminist theologies mostly choose, in general accordance with the Second Vatican Council, for a liberating, biblical, human Mary contra a more cosmological Mary, object of devotional piety. This contribution gives a critical sketch of the background of these developments in Mariology and argues for a closer look at Marian devotional practices in order to find some inspiring elements for rethinking divine presence, Mary and perhaps a new Mariology. Can feminists find inspiration in this approach without forfeiting critical power and without denying the paradoxical and dangerous dimensions of Mary?