bluuebunny/crossref_metadata_2025_split huggingface dataset:
Introduction: The Neo-medieval Paradigm
Authors: Zielonka Jan 
Published: June 2006

AbstractThe introductory chapter spells out the major arguments of the book, defines the basic terms used, and explains the genesis, structure, and the theoretical context of the book. Two contrasting models of the emerging EU system are identified: a Westphalian superstate and a neo-medieval empire. It explains why other possible alternatives are not considered, and the difference between a neo-Westphalian and neo-medieval type of empire.
European Power Politics
Authors: Zielonka Jan 
Published: June 2006

AbstractThis chapter examines the way the EU accession process contributed to greater convergence across the old East-West divide. It argues that the eastern enlargement was an impressive exercise in empire building. The Union tried to assert political and economic control over that unstable and impoverished neighborhood. However, this imperial exercise lacked a broader strategic vision — it was prone to parochial pressures and its implementation was fairly benign. The countries of Eastern Europe had to comply with an ever growing list of conditions, but were given access to the EU’s decision-making and resources at the end of the accession process.
A Rational Actor Approach
Authors: Toya Tetsuro , Amyx Jennifer 
Published: June 2006

AbstractThis chapter begins with an overview of existing literature on Japanese politics, focusing on Japanese financial politics in the 1990s. It identifies three issues of contention in the various approaches to Japanese politics, and explains how these debates help inform the study’s research design. It suggests five alternative explanations for the emergence of the Big Bang reforms, against which the explanation in later chapters will be weighed.
How do Systems Change?
Authors: Toya Tetsuro , Amyx Jennifer 
Published: June 2006

AbstractThis chapter has two main objectives. First, it introduces the theoretical frameworks of institutional change and organizational survival to be utilized in later chapters to make sense of the development in financial politics. Second, it constructs possible scenarios regarding financial reforms by identifying the actors and deriving their preferences based on observed behavioral regularities. It shows how the starting assumption — that organizations seek survival — applies more broadly to actors in the political economy. These actors include political parties, bureaucratic agencies, firms, and interest groups. Through this process, the institutions in Japanese finance (the Convoy) and public policymaking (bureaupluralism) that prevailed until the first half of the 1990s are identified.
The Financial Industry and the Big Bang
Authors: Toya Tetsuro , Amyx Jennifer 
Published: June 2006

AbstractThis chapter analyzes the process in which the initiative of November 1996 was embodied and implemented. The Big Bang is compared to three cases of past financial reforms (1991-93, 1992-94, and 1979-82) to assess the extent of change the Big Bang has brought about. The focus is on the influence of regulated industry actors — the economic ‘losers’ from the Big Bang — on public policymaking. The influence they had on the outcome as well as their inability to reverse the Big Bang reforms are assessed.
New Developments in Bureaupluralism: Comparing and Contrasting the Big Bang to the 1998 “Financial Diet”
Authors: Toya Tetsuro , Amyx Jennifer 
Published: June 2006

AbstractThis chapter examines what can be said about the new developments in financial politics since 1995. It considers the case of the Financial Diet of 1998, an extraordinary legislative session held to deal with the bad debt problem in banking. It is shown that the new developments observed in the case of the Big Bang represent a more general trend in financial politics, evident since 1995. This trend is one in which the public matters more than ever in the policymaking process.
Conclusion
Authors: Toya Tetsuro , Amyx Jennifer 
Published: June 2006

AbstractThis chapter examines the applicability of the study’s findings to other cases in the political economy, generating hypotheses about the determinants of regulatory reform. It discusses the policy implications of the analysis and identifies issues for additional research. It argues the need to shift the emphasis from ‘stability’ to ‘change’ in conceptualizing Japanese politics today. This shift should take place not only at the level of theory but also at the level of practice, given the fast pace of technological innovation, the deepening global integration, and change in the institutional environment. Accordingly, public administration must be carried out with the assumption of ‘change’ rather than the assumption of ‘continuity’, and the long-established emphasis on following precedents in policymaking abandoned.
Vestibular Evoked Myogenic Potentials in Young Children: Test Parameters and Normative Data
Authors: Kelsch Timothy A. , Schaefer Lynne A. , Esquivel Carlos R. 
Published: June 2006

AbstractObjective: The vestibular evoked myogenic potential (VEMP) is a test of the vestibulocollic reflex that has been extensively studied in adults. Much is known about the normal values in adults as well as their changes with age. In children, the expected test values and their possible changes in development have not yet been described nor has the feasibility of reliable testing in this group. The aim of this prospective study is to accumulate normative data and to verify the viability of testing in young children. The study focused on optimal test parameters, reproducibility, and subject compliance in a pediatric population.Methods: Thirty normal‐hearing children (60 ears) ages 3 to 11 completed VEMP testing and audiograms for analysis. VEMP testing was performed with alternating clicks at three intensities (80‐, 85‐, and 90‐dB normalized hearing level) using averaged, unrectified electromyograms recorded by surface electrode on the sternocleidomastoid muscle ipsilateral to the stimulus. VEMP latencies, amplitude, compliance, and length of testing were recorded for each patient, as well as their feedback on the testing session. The subjects were divided into four age groups for analysis.Results: All but one of the subjects attempting VEMP testing was able to finish. Of 30 children completing VEMP tests, bilateral reflexes were recorded for all subjects with symmetric responses in 28 of 30 subjects (93%). The mean peak latencies (± standard deviation [SD]) of pI and nII were 11.3 msec (1.3 ms) and 17.6 msec (1.4 ms), respectively. The mean pI‐nII amplitude (± SD) was 122 μV (68 μV). There was a significantly shorter nII mean peak latency of group I (ages 3–5) left ear in comparison to other groups, with an absolute shorter mean latency nII in the right ear of group I (not significant). Average test time was 15 minutes with two researchers testing, and subjects were highly compliant.Conclusions: VEMP is a well‐tolerated test for screening vestibular function in young children, performed with minimal test time and reproducible results. Mean latencies in this study suggested a shorter initial negative peak (nII) than in adult studies, consistent with prolongation seen in previous research on the effects of age. Ninety‐decibel normalized hearing level clicks were adequate for uniform response rates. Expected latency and amplitude values in single‐channel VEMP‐unrectified electromyograms were established. This is the first study describing expected latencies and optimal testing parameters in children.
The Role of Positron Emission Tomography Scans in the Management of the N‐Positive Neck in Head and Neck Squamous Cell Carcinoma After Chemoradiotherapy
Authors: Brkovich Victoria S. , Miller Frank R. , Karnad Anand B. , Hussey David H. , McGuff H Stan , Otto Randal A. 
Published: June 2006

AbstractObjective: The objective of this study was to determine the sensitivity, specificity, and predictive value of 18‐fluorodeoxyglucose positron emission tomography (PET) in predicting residual cervical metastatic disease in patients with N‐positive necks undergoing curative radiotherapy and chemoradiotherapy for squamous cell carcinoma (SCC) of the upper aerodigestive tract.Methods: The authors studied a prospective case series of patients (2003–2005) of patients undergoing radiotherapy and chemoradiotherapy for advanced head and neck SSC. Study entry criteria included N‐positive neck disease, a complete response to treatment at the primary tumor site, posttreatment PET scan (8–12 weeks after completion of treatment), followed by salvage neck dissection. The posttreatment PET scan neck findings were correlated to the salvage neck dissection pathology report. The sensitivity, specificity, and predictive values of the PET scan to predict residual cervical metastatic disease after curative chemoradiotherapy were calculated.Results: Twenty‐one neck dissections (pretreatment N1 = 5, N2a = 2, N2b = 8, N3 = 6) were entered into the protocol. Four (19.0%) of the 21 neck specimens were positive for residual cervical metastatic disease, whereas the remaining 17 (80.9%) specimens demonstrated no residual carcinoma. The overall sensitivity and specificity were 75.0% and 64.7%, respectively. The positive predictive value was 33% and the negative predictive value was 91.7%.Conclusions: Although the role of posttreatment neck dissection remains controversial, the surgeon must rely on clinical examination and imaging studies. Our practice has been to perform planned staged neck dissections on all N2 and N3 necks, as well as N1 necks with an incomplete response to treatment. Based on this small prospective study, it appears that PET imaging lacks adequate sensitivity and specificity to reliably predict the presence of residual cervical metastatic disease after completion of chemoradiotherapy. With a negative predictive value of 91.7%, however, a negative PET scan appears to be a reliable predictor of the absence of residual tumor.
Tuberculous Otitis Media: A Clinical and Radiologic Analysis of 52 Patients
Authors: Cho Yang‐Sun , Lee Hyun‐Seok , Kim Sang‐Woo , Chung Kyu‐Hwan , Lee Dong‐Kyung , Koh Won‐Jung , Kim Myung‐Gu 
Published: June 2006

AbstractObjective: This retrospective study reports on the clinical and radiologic features and the treatment outcomes of patients with tuberculous otitis media (TOM).Methods: We reviewed the medical records of 52 patients (53 ears) with TOM between 1993 and 2005 and analyzed temporal bone computed tomography scans of 23 patients. The diagnosis of TOM was made if a specimen of the middle ear revealed the presence of acid fast bacilli (AFB), grew Mycobacterium tuberculosis (M. Tb) on a culture, revealed characteristic histology, and/or was positive for polymerase chain reaction (PCR) for M. Tb.Results: The highest incidence of the disease was observed among patients in their 30s. The main symptom was otorrhea, and the duration of symptoms was shorter than with nonspecific chronic otitis media. Most patients demonstrated a moderate to severe hearing loss. Five patients (9.6%) demonstrated a peripheral‐type facial palsy. Temporal bone CT scans demonstrated relatively well‐pneumatized mastoids and occupation by soft tissue of the entire tympanum and mastoid air cells. Six patients demonstrated bone destruction that involved the cortex of the mastoid bone. In most patients, antituberculous medication was effective treatment. The patients who underwent chemotherapy after surgery achieved more rapid healing of the ear and more frequent closure of the tympanic membrane than those who did not receive surgery.Conclusions: Clinicians should have a high index of suspicion and be aware of the clinical and radiologic characteristics of TOM.
Laboratory versus Portable Sleep Studies: A Meta‐Analysis
Authors: Ghegan Mark D. , Angelos Patrick C. , Stonebraker Angela C. , Gillespie M Boyd 
Published: June 2006

AbstractObjective: The objective of this meta‐analysis study was to compare the accuracy of home sleep studies with laboratory polysomnography in the diagnosis of obstructive sleep apnea (OSA).Methods: Eligible studies included prospective cohort studies of portable and in‐laboratory sleep studies performed on the same groups of patients. A comparison of respiratory disturbance index (RDI), mean low oxygen saturation levels, sleep time, rate of inadequate studies, and average cost per examination was made between portable and in‐laboratory sleep studies. A total of 18 papers were identified in two independent Medline searches.Results: RDI values on portable sleep studies were 10% lower on average compared with laboratory studies (odds ratio [OR], 0.90; 95% confidence interval [CI], 0.87–0.92). There was no significant difference in the mean low oxygen saturation on portable versus laboratory studies (OR, 1.0; 95% CI, 0.94–1.10). Recorded sleep time was significantly higher by 13% for laboratory compared with portable studies (OR, 0.87; 95% CI, 0.86–0.89), and portable studies were significantly more likely to give a poor recording when compared with laboratory examinations (P = .0001). The cost of home studies ranged from 35% to 88% lower than laboratory studies across a number of countries.Conclusion: Home sleep studies provide similar diagnostic information to laboratory polysomnograms in the evaluation of sleep‐disordered breathing but may underestimate sleep apnea severity. The lower cost of home sleep studies makes it a viable screening tool for patients with suspected OSA; however, these lower costs are partially offset by the higher rate of inadequate examinations.
Sequential External Beam Radiotherapy and High–Dose‐Rate Intracavitary Brachytherapy in T1 and T2 Nasopharyngeal Carcinoma: An Evaluation of Long‐Term Outcome
Authors: Thiagarajan Anuradha , Lin Kong , Tiong Chua Eu , Tan Luke Kim Siang , Loh Thomas Kwok Seng , Goh Boon Cher , Lu Jiade J. 
Published: June 2006

AbstractObjectives/Hypothesis: The standard treatment for nonmetastatic nasopharyngeal carcinoma (NPC) is external beam radiotherapy (EBRT), with or without chemotherapy. Because local control in NPC is an independent prognostic factor for distant metastases and survival, various dose‐escalation strategies have been used to reduce recurrences at the primary site. The objective of this report was to evaluate the outcome of adjuvant high–dose‐rate intracavitary brachytherapy (HDRIB) in patients with T1 and T2 NPC.Study Design and Methods: Thirty‐three consecutive patients with T1 and T2 NPC were treated prospectively according to a standardized institutional protocol between March 1999 and July 2001. Seventeen patients with stage I/II disease were treated with EBRT to 66 Gy followed by HDRIB (10 Gy in 2 weekly 5 Gy fractions). The remaining 16 patients with Stage III to IVb disease received chemotherapy in addition to radiation. All patients were assessed for treatment response, local control, survival, and toxicity.Results: Median follow‐up for all surviving patients was 67 (range 52–76) months. Local failure occurred in two patients; both subsequently underwent successful salvage treatments. Three patients died of metastatic disease, whereas two died of unrelated causes. Five year local control, overall survival, and disease‐free survival rates were 93.8%, 83.9% and 78.4%, respectively. All patients experienced acute or late radiotherapy‐related sequelae. However, no grade 4/5 toxicities were reported. Specifically, toxicities that could be attributed to brachytherapy were not seen, except for in one patient who developed severe choanal stenosis.Conclusions: EBRT supplemented by HDRIB produced superior local control rates for T1 and T2 NPC at 5 years of follow‐up, with acceptable rates of acute and late toxicities.
Usefulness of Autologous Cartilage and Fibrin Glue for the Prevention of Septal Perforation during Septal Surgery: A Preliminary Report
Authors: Lee Jae Yong , Lee Sang Hag , Kim Shi Chan , Koh Yoon Woo , Lee Seung Won 
Published: June 2006

AbstractObjectives: Septal surgery is one of the most common causes of nasal septal perforation. In cases in which a septal mucosal defect at the corresponding area has occurred, autologous cartilage is usually inserted between the injured mucosal flaps. In addition, we applied fibrin glue to the margins of injured mucosal surface to fix the inserted cartilage and to promote mucosal regeneration. The aim of this study was to evaluate the efficacy of this method in the prevention of nasal septal perforation.Study Design: Retrospective analysis of medical records.Methods: A total of 463 septal surgeries were performed between March 2003 and August 2005. Septal mucosal defect at the corresponding area occurred in 34 patients. In group 1 (23 patients), septal or auricular cartilage was inserted between the injured mucosal flaps. In group 2 (11 patients), septal or auricular cartilage was inserted, and fibrin glue was applied on the mucosal margins of cartilage insertion site. We compared the perforation rate between the two groups.Results: In group 1, nasal septal perforation occurred 8 of 23 (34.8%) patients, and in group 2, 1 of 11 (9.1%) patients experienced perforation. Although the occurrence rate of perforation was significantly lower in group 2, statistical significance between the two groups could not be established because of the small number of patients who experienced septal perforation.Conclusion: The application of fibrin glue at the bilaterally injured mucosal surface after cartilage insertion is thought to be very useful as a preventive measure of nasal septal perforation. We report these results as preliminary data for further study to determine the usefulness of fibrin glue in the prevention of nasal septal perforation.
Ultrasonic Technology Facilitates Minimal Access Thyroid Surgery
Authors: Terris David J. , Seybt Melanie W. , Gourin Christine G. , Chin Edward 
Published: June 2006

AbstractObjectives: Options for controlling the vasculature during thyroid surgery include suture ligatures, vessel clips, and bipolar cautery. Ultrasonic technology represents an alternative to conventional techniques in which the vessels are simultaneously sealed and divided. We sought to determine the safety and efficacy of thyroidectomy with ultrasonic technology.Design: Nonrandomized, prospective analysis of a series of patients undergoing thyroidectomy at the Medical College of Georgia.Methods and Materials: The records of 51 consecutive patients who underwent thyroid surgery between December 2004 and June 2005 were reviewed. Patients in whom ultrasonic technology (Harmonic‐ACE™, Ethicon Endo‐Surgery, Cincinnati, OH) was used comprised the study population.Results: Forty‐four of 51 patients underwent thyroidectomy with the assistance of ultrasonic technology. There were 4 males and 40 females with a mean age of 43.5 ± 15.8 years. Twenty‐two patients had a total thyroidectomy, 18 underwent unilateral lobectomy, and 4 underwent completion thyroidectomy. The overall mean incision length was 5.0 ± 2.6 (range 2–12) cm. A subgroup of patients underwent minimally invasive video‐assisted thyroidectomy (n = 13) and had a mean incision length of 29.3 ± 0.8 mm. There were no cases of permanent injury to the recurrent laryngeal nerve and no cases of persistent hypoparathyroidism. Blood loss ranged from 5 mL to 100 mL, with a mean of 26.7 ± 21.8 mL.Conclusions: Ultrasonic technology facilitates thyroid surgery, particularly when a minimally invasive approach is undertaken. It reliably seals and divides the thyroid vasculature and will likely replace other methods of managing the thyroid blood supply.
A Randomized, Prospective, Double‐Blind Study on the Efficacy of Dead Sea Salt Nasal Irrigations
Authors: Friedman Michael , Vidyasagar Ramakrishnan , Joseph Ninos 
Published: June 2006

AbstractObjective: The objective of this randomized, prospective, double‐blind study was to compare nasal irrigation using hypertonic Dead Sea salt (DSS) solution with hypertonic saline in the treatment of chronic rhinosinusitis and improvement of quality of life (QOL).Methods: With Institutional Review Board approval, 42 adults seeking treatment for chronic rhinosinusitis in a tertiary university‐affiliated medical center were studied. After history and endonasal examination, computed tomography imaging, and QOL survey (Standardized Rhinoconjunctivitis Quality of Life Questionnaire [RQLQ(S)]), patients were randomized to self‐administered hypertonic saline spray and irrigation twice daily or hypertonic DSS spray and irrigation. Patients were reassessed weekly and at 1 month.Results: Both groups had similar symptoms and RQLQ(S) scores before treatment and had significant improvement after treatment. However, the DSS patients had significantly better symptom relief and only the DSS group showed improved RQLQ(S) scores.Conclusions: We present a short‐term study providing level I evidence on the superiority of DSS over saline nasal irrigation for treatment of chronic rhinosinusitis.
Safety Study of the Cochlear Nucleus® 24 Device with Internal Magnet in the 1.5 Tesla Magnetic Resonance Imaging Scanner
Authors: Gubbels Samuel P. , McMenomey Sean O. 
Published: June 2006

AbstractObjectives: To evaluate the effect of the 1.5 Tesla magnetic resonance imager (MRI) on the Cochlear Nucleus® 24 Device without removing the internal magnet. To determine whether device fixation using a compression dressing could prevent internal magnet displacement in the MRI scanner and potentially obviate the need for surgical removal of the internal magnet.Study Design: Prospective cadaveric study.Methods: Four cadaver heads were implanted bilaterally with the Nucleus device with the internal magnet in place and placed into the 1.5 Tesla MRI scanner. The devices were then explanted after interaction with the MRI and evaluated for displacement of the internal magnet. Conditions tested include device fixation with a commercially available compression dressing and no fixation (worst‐case scenario). Magnet strength was measured before and after each of the test conditions.Results: Moderate to severe displacement of the magnet from the internal device occurred in 14 of 16 (87%) implants when no compression dressing was placed. Displacement occurred in 0 of 16 (0%) implants when the compression dressing was applied. No decrease in the strength of the implant magnet was found with the initial or subsequent MRI/implant interactions.Conclusions: Use of the 1.5 Tesla MRI on subjects with Cochlear Nucleus® 24 implants did not result in any significant demagnetization of the internal magnet and did not cause displacement of the magnet when an external compression dressing was applied. Surgical removal of the internal magnet before scanning with the 1.5 Tesla MRI may not be necessary if a compression dressing is applied.