Perineurioma: an unusual cause of an external auditory canal polyp

BACKGROUND: Home parenteral nutrition (HPN) is used to treat intestinal failure. A minority of HPN patients are dependent on opiates and benzodiazepines to control pain and anxiety. The aim of this study was to determine what effects such drug dependence had on patient outcomes. METHODS: Ten dependent patients were prospectively compared with 10 well-matched, nondependent HPN patients for the same 12-month period. Episodes of line sepsis and other complications were documented and the cost of treatment estimated. Health status was measured using the SF36 and EuroQol instruments. RESULTS: The dependent group had significantly more episodes of central line sepsis (p = .0007) as well as other complications (p = .0002). This led to significantly longer periods of inpatient care (p = .0004) and therefore higher costs of treatment. Health status was lower in the dependent group; they reported more pain (p = .04) and less energy (p = .04). CONCLUSIONS: The complication rate and increased cost of treatment for opiate- and sedative-dependent patients receiving HPN significantly detract from the overall outcome of this therapy.     

Experience With Nocturnal Hemodialysis

In order to provide a highly efficient, long-duration form of hemodialysis, we developed nocturnal hemodialysis. Patients were dialyzed nightly at home for 8 – 10 hours, 6 – 7 nights/week. We kept the dialysate flow at 100 mL/min and the blood flow at 250 – 300 mL/min. Patients were monitored remotely from the hospital through a computer connection. An internal jugular line was used as an access. We have trained 12 patients over 30 months and have accumulated 160 patient-months worth of data. The patients tolerated the dialysis very well and slept through the night. There was a significant improvement in their sense of well-being. Nightly Kt/V was 0.99. Weekly removal of phosphate was two times as high and β ₂ -microglobulin four times as high as conventional hemodialysis. All patients have discontinued their phosphate binders and have increased their dietary phosphate and protein intake. Hypertension was controlled with fewer medications, and erythropoietin dosages decreased. Complications were infrequent and included catheter occlusion and infections. Reusing the dialyzers decreased the cost of the treatment to levels similar to continuous ambulatory peritoneal dialysis. Nocturnal hemodialysis represents a viable dialysis modality that combines high quality, low cost, and excellent tolerance.     

Evaluating the impact of CASE: an empirical comparison of retrospective and cross-sectional survey approaches

The purpose of this paper is to evaluate two methods of assessing the productivity and quality impact of Computer Aided Software Engineering (CASE) and Fourth Generation Language (4GL) technologies: (1) by the retrospective method; and (2) the cross-sectional method. Both methods involve the use of questionnaire surveys. Developers' perceptions depend on the context in which they are expressed and this includes expectations about the effectiveness of a given software product. Consequently, it is generally not reliable to base inferences about the relative merits of CASE and 4GLs on a cross-sectional comparison of two separate samples of users. The retrospective method that requires each respondent to directly compare different products is shown to be more reliable. However, there may be scope to employ cross-sectional comparisons of the findings from different samples where both sets of respondents use the same reference point for their judgements, and where numerical rather than verbal rating scales are used to measure perceptions.     

Effects of sinus surgery on speech

The human 4 hour patch test provides an opportunity to identify substances with significant skin irritation potential without recourse to the use of animals. The protocol is designed to avoid the production of more than mild irritant reactions and meets the highest ethical standards. This paper provides the background to the development of the method and comments on its performance in the light of recent intra- and inter-laboratory investigations. In particular, the value of the method in providing 'gold standard' data for the identification of those substances (or preparations) which should, or should not, be classified as irritant to skin in European legislation is discussed. On the basis of the published data and supplementary investigations, recommendations are made on both the conduct and interpretation of the human 4 hour patch test. Finally, the lack of any necessity for formal validation of this assay is addressed.     

Electrical linewidth test structures fabricated in monocrystallinefilms for reference-material applications

The physical widths of reference features incorporated into electrical linewidth test structures patterned in films of monocrystalline silicon have been determined from Kelvin voltage measurements. The films in which the test structures are patterned are electrically insulated from the bulk-silicon substrate by a layer of silicon dioxide provided by SIMOX (Separation by the IMplantation of OXygen) processing. The motivation is to facilitate the development of linewidth reference materials for critical-dimension (CD) metrology-instrument calibration. The selection of the (110) orientation of the starting silicon and the orientation of the structures' features relative to the crystal lattice enable a lattice-plane-selective etch to generate reference-feature properties of rectangular cross section and atomically planar sidewalls. These properties are highly desirable for CD applications in which feature widths are certified with nanometer-level uncertainty for use by a diverse range of CD instruments. End applications include the development and calibration of new generations of CD instruments directed at controlling processes for manufacturing devices having sub-quarter-micrometer features     

Biodegradation of indole at high concentration by persolvent fermentation with Pseudomonas sp. ST-200

The value of flexible videoendoscopy as a biofeedback tool in conservative swallowing rehabilitation of patients suffering from aspiration after head and neck surgery was examined. For this purpose, the outcomes of conventional swallowing therapy and of swallowing therapy with support of videoendoscopic biofeedback were compared. In the first 40 days of swallowing therapy, videoendoscopic biofeedback significantly increased the chance of therapeutic success, shortening the period of functional rehabilitation in comparison to conventional swallowing therapy. Limitations of this visual biofeedback procedure are poor cognitive skills of the patient, rejection of the procedure by the patient and local factors that make the positioning of the endoscope difficult.     

Low-truncation-error finite difference equations for photonicssimulation. II. Vertical-cavity surface-emitting lasers

For part I see, ibid., p. 134, 1998. The basic approach outlined in the previous article is applied to the difficult problem of computing the optical modes of a vertical-cavity surface-emitting laser. The formulation utilizes a finite difference equation based upon the lowest order term of an infinite series solution of the scalar Helmholtz equation in a local region. This difference equation becomes exact in the one-dimensional (1-D) limit, and is thus ideally suited for nearly 1-D devices such as vertical-cavity lasers. The performance of the resulting code is tested on both a simple cylindrical cavity with known solutions and an oxide-confined vertical-cavity laser structure, and the results compared against second-order-accurate code based upon Crank-Nicolson differencing