bluuebunny/crossref_metadata_2025 huggingface dataset:
Stigma Directed toward Chronic Illness is Resistant to Change through Education and Exposure
Authors: Hayes Robert A. , Vaughan Christopher , Medeiros Traci , Dubuque Erick
Published: January 2017

In the mid-1980s, research reported that people living with HIV were viewed differently on measures of competence, dependence, morbidity, depression, and moral worth from those living with other chronic illnesses. 443 students were surveyed to evaluate present attitudes in comparison to this earlier research. The usefulness of imaginal exposure, i.e., imagining a loved one living with HIV, in reducing stigma toward people with HIV was also investigated. Analysis indicated no difference in the rating of AIDS and cancer patients on measures of competence, depression, and morbidity and patients with heart disease, the latter being rated significantly less competent and more depressed than AIDS or cancer patients. AIDS patients were rated significantly less dependent than cancer and heart disease patients. While these results suggest that stigma associated with an HIV/AIDS diagnosis, in general, may have decreased over the years, ratings of moral worth were still lower for AIDS patients than for patients with cancer and heart disease. Robustness of this specific aspect of stigma may be associated with sexual prejudice. Also, an imagined loved one who lives with HIV was rated significantly more favorably on all 5 composite scales than a generic person living with HIV, suggesting the usefulness of exposure as an intervention for attitude change. Limitations of the research are discussed.
Convergent and Discriminant Validity of the Arabic Obsessive-Compulsive Scale for Kuwaiti and American College Students
Authors: Abdel-Khalek Ahmed , Lester David
Published: January 2017

In two samples of 87 Kuwaiti and 73 American undergraduates, scores on the Arabic Obsessive-Compulsive Scale correlated .71 and .63 with those on another obsession scale, respectively, while they correlated .49 and .19 with scores on a depression scale. The differences between these correlations in the two samples indicated good convergent and discriminant validity of the Arabic Obsessive-Compulsive Scale in both cultures.
Doing and using educational research: collaborative approaches in changing contexts
Authors: Moore Alex
Published: January 2017

This paper suggests that, while continuing to critically address abiding issues concerning the nature and purposes of mass education, educational research needs to embrace new contexts and emphases as we move deeper into the 21st century. These contexts and emphases – in particular those related to globalization in its various forms, and to rapid developments in digital technologies – require new approaches to how, and perhaps by whom, educational research is undertaken. Such approaches might involve ‘pooling’ knowledge and understandings in arriving at more nuanced and thorough understandings of learning, society and human development – breaking down or weakening, in the process, existing barriers both between traditional research disciplines and between research and its implementation: in particular, challenging existing identifications of those who ‘do’ educational research and those who might make use of it. Referencing Guattari’s notion of the ‘group subject’, it is argued that such changed relationships within research-and-practice communities must be accompanied by parallel changes in the relationships between central education policy and research, resulting in more collaborative approaches to policy formation.
Evolving theology of mission: Its conceptualization, development, and contributions
Authors: Pachuau Lalsangkima
Published: January 2017

“Should we stop using the term ‘Mission’?” asked Klauspeter Blaser in his 1987 article. The crisis in mission in the second half of the 20th century, well accounted by historians of missions, had led to what Lamin Sanneh famously called “the Western guilt complex” about missions. Reviewing the conceptual development of the missionary enterprise, this article makes some historical-theological interpretations of the missionary enterprise since the later half of the 20th century and argues that the concept and practice of mission have changed and we are in a new day of missiological renewal. Arguably, missiology can now be seen as providing a hub of global theological trends, especially in the light of the theology behind missio Dei and the emerging contextual theologies at the dawn of world Christianity.
Modernisation without Westernisation in Saudi Arabia: Perceptions of the Country’s Urban Dwellers
Authors: Zain Mohamed , Kassim Norizan , Ayub Nailah
Published: January 2017

This paper investigates the various changes and innovations implemented by the Government of Saudi Arabia, especially over the last two decades, in order to examine whether the country is undergoing modernisation without at the same time adopting Westernisation. We also investigated the differences in the perceptions towards modernisation and Westernisation between genders. Generally, from the results of our questionnaire survey, involving 264 respondents, we found that Saudi urban dwellers are now more receptive to both the concepts of modernisation and Westernisation as long as they do not contradict the country’s religious values and/or culture. Further, we found that females desire more individual rights and equal employment opportunities than their male counterparts. The findings also indicate a significant difference in the effect of age on the urban style and occupational structure of modernisation between males and females. Some implications of the findings in terms of practice and suggestions for future research are also provided.
Domestic Violence: Causes, Impact and Remedial Measures
Authors: Susmitha B.
Published: January 2017

It is apparent, that over the past few decades, a host of issues related to women are discussed and vigorously debated on various platforms. One of the most important aspects of this discourse has been that of violence against women and within that area close attention is being paid to domestic violence, that is, violence that occurs within the victim’s house or by members of her family. In this paper, issues related to the growing spread of domestic violence have been discussed citing some international references for a clearer understanding of the problem prevalent at the global level. The paper hopes to draw the attention of readers to the causative factors of domestic violence and its impact on the victim, her family and on society as a whole. Further, the paper deliberates on some measures to curb the presence of domestic violence which clearly becoming a growing menace.
Book Review: Siri Hettige and Eva Gerharz (eds), Governance, Conflict and Development in South Asia, Perspectives from India, Nepal and Sri Lanka
Authors: Arora Gazal
Published: January 2017

Siri Hettige and Eva Gerharz (eds), Governance, Conflict and Development in South Asia, Perspectives from India, Nepal and Sri Lanka, New Delhi, SAGE Publications, 2015, xx + 293 pp., ₹995, ISBN: 978935150100 (Hardback).
Trauma in Youth: Reactions and Interventions
Authors: Denigris Peter N.
Published: January 2017

Traumatic events can produce enduring psychological and physical effects on all those who are subjected to them. Trauma can encompass one-time, large-scale disasters or involve daily experiences that are more localized to a particular individual and his or her family or community. The effects of trauma can cross the cognitive, affective, behavioral, and physical realms in the individuals exposed to the event. Unfortunately, the youth of our society are not immune to the often devastating effects of trauma. Therefore, by understanding the reactions of young people to trauma, being mindful of their developmental periods, and becoming knowledgeable about the traditional and nontraditional treatments that are available, clinicians can tailor their interventions to provide the utmost support and assistance to youth. This article reviews the literature regarding common reactions to trauma in young people and the interventions that are available to assist them.
Cognitive/Behavioral Approaches to the Treatment Adult Sex Offenders
Authors: Witt Philip H. , Greenfield Daniel P. , Hiscox Sean P.
Published: January 2017

This article presents an overview of psychotherapeutic treatment modalities of adult sex offenders. It considers recent developments in treatment methods; discusses methods of measuring therapeutic change; presents a discussion of evaluation and outcome studies of these modalities.
Investigating Child Sex Abuse Allegations: A Guide to Help Legal Professionals Distinguish Valid from Invalid Claims
Authors: Piper August
Published: January 2017

This article is written to help prosecutors as well as defense counsel gain more knowledge of the science relevant to child sex abuse allegations. Increased knowledge reduces professionals' doubts about handling these enormously complex cases, and the greater confidence moves these professionals just a little way toward certainty.

The behavioral sciences can assist legal professionals in their efforts to determine the validity of a given child sex abuse (CSA) allegation. To provide some information from those fields, the author reviewed the pertinent literature. Some findings emerged: 1) clinicians' judgments about the veridicality of unconfirmed CSA allegations may well lack a firm scientific basis; 2) no psychological test or method reliably indicates whether a child has been sexually mistreated, or whether someone has committed an act of abuse; 3) children do sometimes falsely accuse; 4) the concepts of “memory repression” and “recovered memory” are not scientifically substantiated; 5) medical evaluations are often inadequate to determine the presence or absence of sex abuse; 6) the most reliable indicator of sexual mistreatment is often not the physical examination, but rather the child's own report; 7) certain features of the child's account suggest that the accusation is valid. It is concluded that conducting such interviews is of paramount importance; suggestions are made to improve these interviews' quality.
A Review of Research Findings Related to the Civil Commitment of Sex Offenders
Authors: Schneider Jennifer E.
Published: January 2017

Given the steady growth of civil commitment and the resources devoted to detaining and treating civilly committed sex offenders, research provides invaluable knowledge about this subsection of forensic mental health and a basis for the evaluation of treatment programs. Research published thus far emphasizes program characteristics and components, demographic and criminal characteristics, drug and alcohol use, diagnoses, and psychiatric comorbidity. Research regarding civil commitment is limited in scope due in part to the fact that programs are relatively new and continue to evolve. Additional documentation of program components and offender characteristics will demystify the treatment process, allow for comparisons between treatment programs, and assist in the development of an increased understanding of best practices in the field.
Conditional Release Programs for Civilly Committed Sex Offenders
Authors: Arkowitz Steve , Shale Jayne , Carabello Kenneth
Published: January 2017

Data relating to the community-based placement of post civilly committed sex offenders throughout the United States has been gathered through surveys, interviews, and through the personal observations and experiences of those working in this developing area. Although relatively few sex offenders have attained community-based placement after being civilly committed, emerging patterns in supervision tools and techniques, housing options due to residency restrictions, the impact of registration and notification laws, recidivism rates, the financial costs of conditional release, and the implementation barriers that conditional release programs encounter are increasingly being addressed by professionals managing this population. In general, these programs are well funded, comprehensive, and successfully focused on deterring re-offense. However, significant barriers in housing, community reaction, sex offender self-support, and costs threaten the long-term success of these programs.
To Treat or Not to Treat: Ethical Deliberation on Epilepsy Treatment
Authors: Richter Erich , Hyer Lee , Noorani Sarah P. , Toole Mary
Published: January 2017

Patients who have experienced two unprovoked seizures are diagnosed with epilepsy and are frequently prescribed anti-epileptic drugs (AEDs). However, many of these patients will be subject to only mild and infrequent seizures and thus every patient must be carefully evaluated on an individual basis to determine the anticipated cost vs. benefit of AED treatment. Not everyone who has had two unprovoked seizures should necessarily be prescribed AEDs, as there are many factors to consider before initiating AED treatment. AEDs have substantial adverse physical, cognitive, and psychosocial effects, and must be carefully chosen for each patient based on the patient's specific needs and circumstances. This article seeks to summarize current research and literature on AEDs, positing that the patient's knowledge of and preference for treatment must be considered, along with reasonable compliance concerns, such as history, pocketbook issues and side effects. In choosing to begin AED treatment, patients must be fully informed of all side effects, including potential effects on career and quality of life from the various side effects, as well as the financial impact of paying for AEDs on a routine basis. In sum, we attempt to remind physicians of their broader scope of care and provide a set of questions for determining the appropriateness of AED treatment.
Criminal Responsibility from a Clinical Perspective
Authors: Greenfield Daniel P.
Published: January 2017

What if the rule-breaking behaviors in which an individual (allegedly) engaged which brought him/her to the attention of law enforcement authorities were something which the individual simply had to do, or not do, and could not resist? In other words, what if the alleged offender could not have chosen to do otherwise? This situation takes us into the realm of what the law calls criminal responsibility, which is the broad subject of this aticle. In the law, the concept of criminal responsibility is an old one. It goes back in formal codified form, as far as we know, to the Code of Hammurabi from ancient Susa in Babylonia, ca. 1792–1750 BCE. This article looks at the types of criminal responsibility used in various jurisdictions, conceptions of diminished capacity, and attempts to discern truth using functional Magnetic Resonance Imaging (fMRI) technology.
The Facts about Fiction: What Grissom Could Learn about Forensic Psychology
Authors: Ramsland Katherine
Published: January 2017

Although few studies affirm it, there is much anecdotal evidence that the proliferation of media programming about forensic investigation has affected the way jurors listen to evidence and decide on verdicts. This is known as the “C.S.I. Effect.” By association, the media have recreated the image of forensic psychology, and as a result of pervasive cultural ideas, students can apply to college programs with the wrong expectations. While forensic psychology does offer a wide range of career choices, the media depictions often get it wrong. Thus, for educators in graduate programs in forensic psychology, it becomes important to address the C.S.I. Effect with prospective students, so as to assist them to decide if they really wish to pursue this career. This article addresses both the C.S.I. Effect's influence and the actual work of a forensic psychologist.
Atkins v. Virginia: Implications and Recommendations for Forensic Practice
Authors: Macvaugh Gilbert S. , Cummingham Mark D.
Published: January 2017

In 2002, the United States Supreme Court held in the landmark case of Atkins v. Virginia (2002) that the execution of individuals who have mental retardation is unconstitutional. Following the Atkins holding, courts in death penalty jurisdictions have relied heavily upon mental health professionals in making a determination of whether or not capital offenders have mental retardation. The determination of mental retardation in death penalty cases, however, presents complex challenges for both courts and mental health professionals. In addition, there is variability in how death penalty states define mental retardation and in the assessment methods used by mental health professionals to diagnose mental retardation in such cases. The purpose of this article is to (a) describe how statutes in death penalty jurisdictions have operationalized the various clinical definitions of mental retardation, (b) discuss issues confronting examiners in assessing and diagnosing mental retardation in Atkins cases, and (c) provide recommendations for forensic practice.
Aggravation and Mitigation: Findings and Implications
Authors: Sandys Marla , Pruss Heather C. , Walsh Sara M.
Published: January 2017

Sentencing decisions in capital cases are to be guided by a consideration of aggravating and mitigating circumstances. This article presents a review of the literature on what mock jurors and actual capital jurors find aggravating and mitigating. Although there is relatively little empirical research available that addresses those issues directly, what does exist is relatively consistent, especially as it pertains to aggravation. Jurors are most persuaded for death by evidence and even mere perceptions of a defendant's future dangerousness particularly when couched in terms of psychopathy. Likewise, defendants who are perceived as suffering from or experiencing traumatic life events that are out of their control are more likely to receive a sentence of life. The article concludes with a review of the research on how jurors respond to evidence presented in different modes that could help explain receptivity to aggravation and mitigation.
Once a Killer, Always a Killer? Prison Misconduct of Former Death-Sentenced Inmates in Arizona
Authors: Sorensen Jon R. , Cunningham Mark D.
Published: January 2017

Whether death-sentenced inmates represent the “worst of the worst” in terms of prison violence is the focus of this investigation. Capital offenders in Arizona who obtained relief from their death sentences during the modern era (1975–2005) were identified (N = 80) and their demographic characteristics and disciplinary records retrospectively reviewed for their years on death row (M = 6.4) and their subsequent years in the general prison population spent (M = 13.1). Consistent with other studies, prevalence rates of post-relief disciplinary infractions were inversely related to severity. Only 3.8% committed a prison assault with great bodily injury and only one in 100 killed again in prison. Predictive factors were limited: race, years on death row (inversely), assaultive misconduct on death row, and age at death penalty relief (inversely). A risk scale based on the latter three factors was moderately successful in classifying these offenders into three risk categories.
Government Transparency and Perceived Social Equity: Assessing the Moderating Effect of Citizen Trust in China
Authors: Wu Wei , Ma Liang , Yu Wenxuan
Published: January 2017

Transparency, trust, and equity are all considered critical components of good governance. However, few studies have looked into the possible impacts of transparency and trust on public perceptions of social equity. This study empirically examines the relationship between government transparency and perceived public service equity, and the moderating effect of citizen trust on that relationship. Using large sample citizen survey data from 36 major cities in China, we find that government transparency is positively related to perceived social equity. The results also reveal that citizen trust plays a moderating role in the relationship between transparency and perceived social equity.
Ethos in Fukushima and the ICRP dialogue seminars
Authors: Ando R.
Published: January 2017

Ethos in Fukushima, a non-profit organisation, participated in 10 of the 12 International Commission on Radiological Protection (ICRP) dialogue seminars over the past 4 years. The slides and videos that were shown at the seminars are recorded on the Ethos in Fukushima website ( http://ethos-fukushima.blogspot.jp/p/icrp-dialogue.html ). I would like to introduce the activities of Ethos in Fukushima to date, and explain why the ICRP dialogue materials have come to be published on its website.
Eyes to the unseen, ears to the unheard
Authors: Ban Y.
Published: January 2017

I have learned a great deal by participating in the ICRP dialogue seminars. I will summarise what I have observed and felt regarding the thoughts of the inhabitants of Fukushima over the last four and a half years, and what the ICRP dialogue seminars meant to them.
For the day when I can return: the future is one step away
Authors: Kanno K.
Published: January 2017

Iitate, a village in Fukushima Prefecture, suffered little damage from the Great East Japan Earthquake that struck on 11 March 2011. However, all village residents were belatedly ordered to evacuate 1 month after the accident at Fukushima Daiichi nuclear power plant. My family and I had to evacuate to the city of Fukushima, located 40 km from our home in Iitate. This came at a time when my husband and I were planning to start research on Natsuhaze (a type of blueberry grown in Japan) after his retirement. There were conflicting reports. On one hand, the media reported that it was not possible to live in Fukushima. The village of Iitate organised a lecture by an expert to assuage the fear of the residents. The evacuation order 1 month after the disaster contradicted what the expert was saying, and appeared to amplify distrust among the residents. I tried to arrive at my own judgement by measuring the ambient radiation dose in and around my house. Participating in the International Commission on Radiological Protection dialogue seminars provided accurate understanding of the situation. Measurement of radiation doses of wild plants that my husband’s father had been cultivating for over 30 years has given me many insights, and I had no concerns about returning to Iitate.
The Distributional Impact of Social Security Policy Options
Authors: Couch Kenneth A. , Reznik Gayle L. , Tamborini Christopher R. , Iams Howard M.
Published: January 2017

Using microsimulation, we estimate the effects of three policy proposals that would alter Social Security’s eligibility rules or benefit structure to reflect changes in women’s labor force activity, marital patterns, and differential mortality among the aged. First, we estimate a set of options related to the duration of marriage required to receive divorced spouse and survivor benefits. Second, we estimate the effects of an earnings sharing proposal with survivor benefits, in which benefits are based entirely on earned benefits with spouses sharing their earnings during years of marriage. Third, we estimate the effects of adjusting benefits to reflect the increasing differential life expectancy by lifetime earnings. The results advance our understanding of the distributional effects of these alternative policy options on projected benefits and retirement income, including poverty and supplemental poverty status, of divorced and widowed women aged 60 or older in 2030.
Secretory Innervation of the Parotid Gland
Authors: Porto A. F. , Proud G. O'Neil , Norris Charley W. , Odoi H.
Published: January 2017

The reported failures of Jacobson‐nerve resection to eliminate parotid secretion in clinical cases suggest that alternative secretory routes to the parotid gland exist. By stimulating the inferior salivatory nucleus and successively transecting suspected pathways, it was found that only the facial nerve trunk carries accessory efferent fibers to the gland in the cat. No efferent fibers were found in the chorda tympani, but afferent fibers of the salivary reflex arc are provided by this nerve.
The Effect of Tonsillectomy on Impedance Audiometry
Authors: Holt G. Richard , Watkins Thomas M. , Yoder Milton G. , Garcia Alicia
Published: January 2017

In an experimental group of 22 patients undergoing elective tonsillectomies and having normal preoperative middle ear function, there is a significant development of abnormal tympanogram types, loss of crossed acoustic reflexes, and decrease in middle ear compliance on the first postoperative day when compared to a control group. Postoperative recovery of middle ear function begins at one week and is usually completed by one month. The loss of acoustic reflexes occurs in those patients with extreme changes in compliance and abnormal tympanogram types. The authors postulate that these changes in middle ear function in the immediate posttonsillectomy period might be due to the surgical disturbance of the peritubal lymphatic drainage, causing engorgement of the tympanic and tubular mucosa; and to abnormal swallowing with impaired coordination of the nasopharyngeal and tubal musculature. These data are helpful in investigating the tonsillar effect on middle ear function and disease.
The Midline Vertical Forehead Flap
Authors: Conley John J. , Price John C.
Published: January 2017

The midline vertical forehead flap is an unheralded flap that has valuable and specific application. It is ideal for certain reconstructions around the nose, orbit, and upper melonasal regions. The color match is excellent. The donor area is repaired per primum and because there is a double blood supply, it rarely fails when nondelayed and rotated 180°.
Diagnostic Value of Fine Needle Aspiration Biopsy in Neoplasms of the Head and Neck
Authors: Sismanis A. , Merriam Joseph , Yamaguchi Kent T. , Shapshay Stanley M. , Strong M. Stuart
Published: January 2017

In this paper, the cytologic findings of 90 aspirates obtained by the fine needle aspiration technique from head and neck masses are compared with the histology of the permanent section. The overall concurrence rate between cytologic and histologic findings for benign and malignant tumors is 80%. There is a 6.6% false negative rate. There are no false positive results. Fine needle aspiration biopsy is found to be safe, complication free, and most helpful in treatment planning.
Management of the Draining Open Mastoid Cavity
Authors: Smith Mansfield F.W.
Published: January 2017

Deafness, discharge, dizziness, and dependency partially define the discomforts of the patient with an open draining mastoid cavity. The open mastoid cavity remains a problem for some patients despite visits to numerous otolaryngologists. This report is based on outpatient and surgical management of more than 300 open draining mastoid cavities.
Observations on Optokinetic Nystagmus in Patients with Congenital Nystagmus
Authors: Leliever William C. , Barber Hugh O.
Published: January 2017

Nystagmus responses to horizontal optokinetic stimuli are studied in 15 patients with congenital nystagmus (CN). Varying waveforms of CN designed to prolong foveation are evident. Pendular, jerk, and inverted responses are recorded alone and in combination. As in acquired brain disease, flat and asymmetric optokinetic responses occur, but in the study group other features of CN are also invariably present, especially inversion. Optokinetic inversion may be confined to CN.
Denervation, Reinnervation, and Regeneration of Skeletal Muscle
Authors: Carlson Bruce M.
Published: January 2017

This paper reviews the responses of skeletal muscle tissue to denervation, with emphasis on the area of neuromuscular junction. In reinnervation, neuromuscular synapses are formed preferentially at the site of the old motor end plate, but the de novo synthesis of new neuromuscular junctions is possible. Skeletal muscle has a good regenerative capacity, and a regenerating muscle fiber can, essentially, return to original structure and functional ability.
Experimental Labyrinthotomy in Monkeys by Argon and Carbon Dioxide Lasers
Authors: Wilpizeski Chester
Published: January 2017

The horizontal semicircular canal of squirrel monkeys was irradiated unilaterally with either an argon or carbon dioxide laser. Postoperatively, there was a small but significant reduction in caloric‐induced ENG responses to 45° thermal stimulation. The principal morphologic effect of laser irradiation was a plug of fibrous tissue or new bone within the lumen of the lesioned semicircular canal.
Pretreatment Airway Management in Obstructing Carcinoma of the Larynx
Authors: Davis R. Kim , Shapshay Stanley M. , Vaughan Charles W. , Strong M. Stuart
Published: January 2017

Partial endoscopic excision of obstructing laryngeal carcinoma with the CO2 laser is an alternative to emergency tracheotomy or emergency laryngectomy whenever the airway control can be initially ensured by endotracheal intubation. The practical advantages of this approach are elimination of the septic complications of tracheotomy, the opportunity for planned preoperative chemotherapy or radiation therapy, and better nutritional and psychologic preparation of the patient for surgery.
Mucoepidermoid‐Adenosquamous Carcinoma of the Larynx and Hypopharynx: A Report of 21 Cases and a Review of the Literature
Authors: Damiani Joseph M. , Damiani Kathleen K. , Hauck Kenneth , Hyams Vincent J.
Published: January 2017

Twenty‐one cases of mucoepidermoid‐adenosquamous carcinoma (MEC/ASC) of the larynx and hypopharynx were collected and reviewed from the Armed Forces Institute of Pathology tumor registry from 1945 to 1979. This is the largest series of such lesions in this location reported to date. In addition, the literature was reviewed and 32 previous cases noted. The overall five‐year survival was 77%, although low‐grade mucoepidermoid carcinoma had a better survival than did adenosquamous—high‐grade mucoepidermoid carcinoma.
Otitis Media, Cleft Palate, and Middle Ear Ventilation
Authors: Meyerhoff William L. , Shea Donald A. , Foster Craig A.
Published: January 2017

Chinchillas with unilateral tympanostomy tubes in place underwent palate‐clefting in an effort to determine the histologic and bacteriologic effects of using tympanostomy tubes in the treatment of otitis media. The tympanostomy tube appeared to almost totally eliminate the occurrence of middle ear effusion but had much less, if any, effect on eliminating the middle ear inflammation which occurs in the clefted chinchilla.
Surface‐Active Substances of the Guinea Pig Tubotympanum: A Chemical and Physical Analysis
Authors: Maves Michael D. , Patil Gajanan S. , Lim David J.
Published: January 2017

An attempt to describe the nature of the surface‐active substances of the eustachian tube lining layer that influence normal tubal function was undertaken. Under sterile conditions, guinea pig tubotympanic washings were collected, centrifuged, and pooled. Analysis of the pooled lavages using standard surface chemistry techniques confirmed the presence of significant surface‐tension‐lowering activity in the mucous lining layer of the eustachian tube, but the surface pressure obtained is neither as great nor displays the same degree of hysteresis as pulmonary surfactant. Following separation into aqueous and lipid fractions, measurable amounts of surface activity can be found in both isolates. The chemical composition and concentration of the lipid fraction, and its relative contribution to the surface activity of the tubotympanic washings, however, is smaller and radically different from the phospholipids found in surfactant. A significantly higher concentration of protein was recovered in comparison with the lipid portion, and it was observed that the surface activity of the total washings and the aqueous phase bore remarkable similarities. Although the surface‐tension‐lowering properties of the tubal lining layer may be the consequence of a combined synergistic action of the lipid and protein moieties, we believe that the current evidence points toward the proteins as being the primary tubal surface‐tension‐lowering substances.
Arachnoid Cysts of the Posterior Fossa
Authors: Pappas Dennis G. , Brackmann Derald E.
Published: January 2017

The clinical symptoms and signs of four patients with arachnoid cysts in the posterior fossa are discussed. In three patients, the cyst was in the internal auditory canal; one patient had an acoustic neuroma and two large cysts in the cerebellum. Whereas the conventional diagnostic tests for acoustic neuroma cannot differentiate between neuromas and arachnoid cysts, the newer thin section body scanners can show a lesion with no enhancement in the case of the cyst. Surgical approaches for removal of this lesion must take into consideration the preservation of hearing in the involved ear.
Syndromes Associated with Congenital Facial Paralysis
Authors: Bergstrom Lavonne , Baker Bruce B.
Published: January 2017

Thirty‐five of 1,488 pediatric otologic cases had congenital facial nerve weakness. A cause was generally not found, but two probably had nuclear dysgenesis; one may have had an intracanalicular lesion; two cases resulted from teratogens, one from poor intrauterine environment, and three from genetic complications. Five had total unilateral paralysis; one had bilateral palsy. Frequent associated anomalies were microtia‐atresia, hemifacial microsomia, facial clefts, Moebius syndrome, and congenital conductive sensorineural loss.
Otosclerotic Involvement of the Cochlea: A Histologic and Audiologic Study
Authors: Elonka Dennis R. , Applebaum Edward L.
Published: January 2017

This study sought correlations between sensorineural hearing loss and otosclerotic endosteal involvement in 29 temporal bones examined histologically. The sensorineural hearing loss of the affected parts of the cochlea was determined by the last antemortum bone conduction audiogram available. There were eight temporal bones with only stapes footplate involvement, six with one discrete focus of otosclerotic endosteal involvement, and 15 with two or more foci of endosteal involvement. Analysis of audiometric data showed that the group of bones with two or more foci of endosteal involvement had a similar incidence of 45 dB sensorineural loss (9 of 15 or 60%) as did the group with no endosteal involvement (5 of 8 or 62%). The group with two or more foci had a greater incidence of 60 dB or greater sensorineural loss (46%) compared with the groups with none (12%) or one focus (16%) involved. Correlation between hearing toss and involvement of cochlear endosteum was poor. Correlation existed in only 2 of 15 ears with two or more foci involving the cochlear endosteum. There was no correlation in the other groups. It appears that cochlear endosteal involvement alone may not be sufficient explanation for the sensorineural hearing loss found with otosclerosis, except in the most severely involved ears.
Epidural Mucopyocele: Diagnosis and Management
Authors: Schaefer Steven D. , Anderson Robert G. , Carder Henry M.
Published: January 2017

Mucopyoceles of the frontoethmoid sinuses occurring as an epidural mass are uncommon. Four patients with this condition have been managed over the last eight years by the authors. Two patients had early recurrence of their disease following carefully performed ablation and frontal craniectomy. Marsupialization, or permanently draining the ablated frontal sinus cavity into the nose, was the initial treatment of the other two patients, and subsequently the therapy of choice for all patients in this series.
Epstein‐Barr Virus Infection and Neoplasia
Authors: Sprinkle Philip M. , Veltri Robert W.
Published: January 2017

Once acquired, Epstein‐Barr virus (EBV), a latent virus, remains in the body for what appears to be the lifetime of the human host. Circumstantial data suggest EBV is involved in clinical disease including malignancies far more often than previously recognized. A serologic test for early antigen (EA) is more specific for diagnosing active EBV disease than the monospot or heterophile test. A case study of active Epstein‐Barr infection is reported showing persistently elevated early antigen titers prior to and following malignant transformation.
Ulcerating Tumor of Tonsil and Neck Mass as Occurrence of Acute Myelocytic Leukemia
Authors: Zapf Burger , Carpenter Robert J. , Snyder G. Gordon
Published: January 2017

A case of acute myelocytic leukemia (AML) occurring in the tonsillar fossa as an ulcerating lesion with a neck mass is described. Other common occurrences of AML in the upper respiratory tract are discussed. This disease entity may be confused with squamous cell carcinoma on initial examination.
Mandibular Fracture Reduction with Eccentric Dynamic Compression Plate: New Treatment for an Old Problem
Authors: Levine Paul A. , Goode Richard L.
Published: January 2017

We describe a technique and theory of application of the Eccentric Dynamic Compression Plate (EDCP) and the Dynamic Compression Plate (DCP) for mandibular fracture fixation, developed by Speissl in Switzerland, and our experience with the application of 15 plates in ten edentulous or nearly edentulous patients over the past 18 months. While we have had soft tissue infections in 4 of 15 fracture sites, our results reveal satisfactory bony healing in 14 of 15 fracture sites. We, therefore, believe that while this technique is still in the infant stages of clinical application in the United States, it has the potential to revolutionize the thinking and practice of mandibular fracture therapy.
Electron Microscopy and L‐Dopa Reaction in the Evaluation of an Unusual Amelanotic Malignant Melanoma of the Neck
Authors: Anderson Craig W. , Stevens Michael H. , Moatamed Farhad
Published: January 2017

A 28‐year‐old white man with a neck mass is described. A diagnosis of amelanotic melanoma was made by L‐dopa reaction and electron microscopy. This tumor could represent a metastasis from an unknown primary or a primary that had undergone spontaneous regression. It could also be a rare primary tumor of the cervical sympathetic chain. Electron microscopy and the L‐dopa reaction are emphasized as important adjuncts in the diagnoses of amelanotic melanoma.
Angiofibroma: A Rare Case in an Elderly Female
Authors: Ewing James A. , Shively Eugene H.
Published: January 2017

The authors present a rare case of nasopharyngeal angiofibroma occurring in a 71‐year‐old black woman. This appears to be the oldest female case ever reported.
Benign Adenoma of the Middle Ear Cavity Causing Facial Paralysis
Authors: Zahtz Gerald D. , Zielinski Benjamin , Abramson Allan L.
Published: January 2017

The otologic surgeon infrequently encounters tumors confined to the middle ear cavity. A 30‐year‐old man had a right facial nerve palsy that was believed to be secondary to chronic otitis media. At surgical exploration, an adenoma of the middle ear involving the ossicles and overlying the facial nerve was found, a radical mastoidectomy performed, and subsequent complete recovery of the facial nerve noted.

To our knowledge, this is the first case of a middle ear benign adenoma causing a facial paralysis and the pathology, cause, and differential diagnosis will be discussed.
Otologic Care in a School for the Deaf
Authors: Stool Sylvan E. , Black F. Owen , Craig Helen , Laird Margaret
Published: January 2017

Recent studies at the Western Pennsylvania School for the Deaf revealed both a high prevalence and a high incidence of external, middle, and inner ear disease among the students enrolled. This paper illustrates the role of the otolaryngologist in the otologic evaluation, diagnosis, treatment, and follow‐up in this special population and in the supervision and training of relevant health care personnel. Included in this discussion are (1) the implementation and results of an otologic surveillance and maintenance program at the school for the deaf, (2) the methods and results of vestibular evaluation in this population, and (3) an example of the procedures possible to prepare for and facilitate the hospitalization of a deaf child.
Comprehensive Treatment of Children with Recurrent Serous Otitis Media
Authors: Downs Marion P. , Jafek Bruce , Wood Raymond P.
Published: January 2017

Myringotomy and tube procedures provide effective relief in the majority of cases of serous otitis media, but at least 14% of children are estimated to have recurrence. These children may be at risk for language delays that have been suspected of causing later language problems. After three months' duration of serous otitis, a language evaluation should be given the infant or child. Any language delay should be promptly treated with a home language stimulation program and, in more extreme cases, there should be a consideration of hearing aid use.
Aminoglycoside Antibiotics in the Treatment of Otologic Infections
Authors: Matz Gregory J. , Lerner Stephen A. , Lanzl Elisabeth F.
Published: January 2017

Aminoglycoside antibiotics can be used successfully in the treatment of otologic infections caused by gram‐negative bacteria. They can be particularly valuable, sometimes in combination with a β‐lactam antibiotic such as carbenicillin, in malignant external otitis, acute middle ear infections caused by gram‐negative organisms, and central nervous system complications of cholesteatomas. On the basis of susceptibility tests and of the pharmacology of these drugs, we administer appropriate therapeutic doses of one of the following antibiotics: Kanamycin, gentamicin, tobramycin, or amikacin. All of these drugs may be ototoxic and nephrotoxic.
Symptomatic Cervical Thymic Cyst in a Neonate
Authors: Rosevear William H. , Singer Mark I.
Published: January 2017

Thymic cysts are unusual neck masses in adults and children and are rarely differentiated from other neck masses by physical examination. This is a case report of a thymic cyst producing airway obstruction in a neonate. The embryogenesis and differential diagnosis of thymic cysts are reviewed.
The Relationship of Hematocrit Levels to Skin Flap Survival Length in the Pig
Authors: Alperstein Jeffrey B. , Levine Howard L. , Tucker Harvey M.
Published: January 2017

The work of several investigators suggests that anemia may increase the survival length of skin flaps in the dog and the rabbit. The following experiment was designed to study the survival of standardized skin flaps of varying lengths in normocythemic, polycythemic, and anemic pigs. The pig was chosen because of the similarity of its skin to that of human skin.

Twenty‐nine standardized random‐pattern flaps and six standardized arterial flaps were studied in pigs with varying hematocrits. A statistically significant increase was found in the survival lengths of skin flaps in the polycythemic animal as compared with the anemic one. No significant difference was found when the flap survival lengths of the normocythemic control animal were compared with those of the polycythemic animal or with those of the anemic animal. These findings suggest that relative polycythemia may allow improved flap length‐survival and, in contradistinction to the findings of previous investigators, that anemia does not result in improved survival length.
Chemodectoma Occurring as a Parotid Mass
Authors: Ossoff Robert H. , Jones James A. , Bytell David E.
Published: January 2017

A 55‐year‐old woman had a right‐sided neck mass overlying the angle of the mandible, which proved to be a chemodectoma. The occurrence, differential diagnosis, and relatively high frequency of incorrect preoperative diagnosis of carotid body tumors is reviewed. The essential role of angiography to substantiate the diagnosis is discussed.
Hamartoma of the Larynx: An Unusual Cause for Stridor in an Infant
Authors: Zapf Burger , Lehmann William B. , Snyder G. Gordon
Published: January 2017

An extremely rare laryngeal hamartoma causing inspiratory stridor in a 6‐week‐old infant is reported and the histology discussed. The tumor is benign and responds to simple excision. No other cases have been found in the 20th century American literature.
Electronic Probe for Eustachian Tube Patency and Objective Tinnitus
Authors: Epley John M.
Published: January 2017

The electronic probe provides a simple means to detect eustachian tube patency, and can be used as a sensitive probe of objective tinnitus. The basic unit consists of a battery‐operated, electronic amplifier connected by 18‐in leads to a sensitive microphone and to a small speaker (Fig 1). These transducers are each connected to rubber nipples of the type used for impedance audiometry (Fig 2).
The Role of Ige‐Mediated Hypersensitivity in Otitis Media with Effusion
Authors: Bernstein Joel M. , Ellis Elliot , Li Philip
Published: January 2017

Forty‐one children with recurrent otitis media with effusion (OME) were evaluated for IgE mediated allergy by critical analysis of history, physical findings, skin testing for selected antigens, and laboratory determination of total IgE and radioallergosorbent testing (RAST) for six inhalant and two food allergens. The children were divided into an allergic and nonallergic group. The allergic group clearly had higher total IgE in their serum. There was an elevation of middle ear effusion (MEE) IgE in 5 of 20 allergic cases. In three of these five patients or 15% of the allergic group, the IgE/mg protein was higher in the MEE than in the corresponding serum, suggesting the possibility of local production of IgE.

Specific IgE antibody as measured by RAST was noted in 9 of 20 MEE and 5 of 20 nasal washings in the allergic group and in only 2 of 21 MEE and in 10 nasal washings of the nonallergic group.

Nasal IgE was substantially increased in three patients of the allergic group; however, the corresponding MEE IgE was not increased in proportion to the nasal IgE. The MEE RAST was positive in 22% of the allergic group and in less than 1% of the nonallergic group. Nasal RAST was positive in 20% of the allergic group and in none of the nonallergic group.

We conclude that IgE‐mediated allergic reactions may play a role in the pathogenesis of OME in only about 15% of children defined as allergic on the basis of clinical and laboratory evidence. Allergy investigation as a diagnostic procedure in children with recurrent OME, but without a history of allergy on the basis of history, family history, or laboratory testing is likely to be nonproductive.
Tympanic Membrane Debridement with the CO2 Laser
Authors: Epley John M.
Published: January 2017

Precise control of tissue penetration can be provided by the CO2 laser at low power. At 1 W, superficial lesions of the tympanic membrane were successfully extirpated in ten patients. The beam produced immediate delamination and carbonization of the external layer, which usually included the lesion, with no apparent effect on the underlying tissue. This charred layer was easily removed mechanically in a bloodless field. No permanent perforations resulted. Extirpation of canal lesions was less effective.
Surgical Correction of Anatomic Abnormalities in Obstructive Sleep Apnea Syndrome: Uvulopalatopharyngoplasty
Authors: Fujita Shiro , Conway William , Zorick Frank , Roth Thomas
Published: January 2017

Excessive daytime sleepiness and loud snoring are the major symptoms of obstructive sleep apnea, often leading to serious medical complications if unrecognized and untreated. Tracheostomy has been the only effective treatment in most adult cases. This paper reports on a new surgical approach to treat obstructive sleep apnea by uvulopalatopharyngoplasty designed to enlarge the potential airspace in the oropharynx. Twelve patients underwent this operation. In nine there was relief of symptoms and in eight there was objective improvement in nocturnal respiration and sleep pattern, demonstrated by polysomnography.
Tracheal Obstruction by Recurrent Thyroid Carcinoma
Authors: Gardiner Linda J. , Sasaki Clarence T. , Hermansen Karen , Sugar Jerome , Geha Alexander S.
Published: January 2017

A case of tracheal obstruction by invasive papillary thyroid carcinoma is described. In this paper we will show how selection and interpretation of diagnostic studies including computed tomographic scan allowed accurate determination of tumor extent and, therefore, an accurate selection of surgical procedures.