New measurements of acoustical transmission through the eustachian tube (ET) have been obtained in a series of experiments directed toward the development of a clinical instrument to assess ET function behind an intact tympanic membrane (TM). Using a sound conduction method, a sound source was placed in one nostril, and the acoustical energy that was transmitted through the ET was measured by a microphone placed in the ear canal. The present study used a broadband noise as the acoustical stimulus, in contrast to the tonal stimuli employed in previous investigations. This stimulus was chosen because it is believed to reduce the variability in the data due to intersubject differences in the acoustics of the nasopharynx and ET, and to avoid any a priori assumptions concerning the specific frequencies that would be of greatest diagnostic significance. Averaged spectra of the sound transmitted to the ear canal were obtained for three experimental conditions: acoustical source present during subject swallowing, source present with no swallowing, and subject swallowing with source absent. A Bayesian classification scheme based on the statistics of these spectra was used in classifying subjects into one of two possible categories, normal and abnormal ET function. A comparison was made between sonometric classification and classification based on a tympanometric ET function test. Correlation between the two methods was 87.1%.
therapies to reduce these symptoms. Gastric and pancreatic lipases are key enzymes in fat digestion, and hydrolyze fat into fatty acids and monoglycerides. The aims of this study were to characterize the effects of a high fat meal on upper gastrointestinal symptoms and gastric myoelectrical activity, and to evaluate the effect of acid-resistant lipase supplementation on the same outcomes. Methods: Sixteen healthy volunteers enrolled in a double-blind, placebo controlled, cross-over trial were given a high fat meal (Pulmocare Ò ) that was 55% fat, 28% carbohydrates, and 17% protein (237 ml; 355 Kcal). A capsule containing 280 mg of acid-resistant lipase (Amano Enzyme USA) or placebo was administered immediately before ingestion of the meal. The order of conditions was counterbalanced, and visits were separated by at least one week. At each visit, individuals completed a Visual Analog Scale (VAS) concerning symptoms of nausea, stomach fullness, hunger, bloating, and abdominal discomfort at baseline, immediately after the meal, and at 10, 20, 30, 45, and 60 minutes after the meal. Electrogastrograms (EGGs) were recorded throughout each visit to assess gastric myoelectrical activity. Results: Nausea, bloating, and stomach fullness were significantly increased 10 min after ingestion of the meal (ps < 0.05), and hunger was significantly decreased (p < 0.001); there was also a significant decrease in normal gastric myoelectrical activity (3 cycles min )1 ), and a significant increase in tachygastria (3.7-10 cycles min )1 ) at 10 min after the meal (ps < 0.05). By 45 min after the meal, dyspepsia symptoms and tachygastria had decreased significantly from immediately after the meal, and normal gastric myoelectrical activity had increased significantly (ps < 0.05). Stomach fullness was significantly lower with lipase supplementation than with placebo condition at 20 and 30 min after the meal (p < 0.05); no effect of lipase supplementation on gastric myoelectrical activity was detected. Conclusions: (1) The high fat meal induced dyspepsia symptoms and gastric dysrhythmias, suggesting the meal may be a useful test for assessing gastric neuromuscular disorders; and (2) Acidresistant lipase supplementation decreased stomach fullness after ingestion of the meal, and warrants further study in individuals with functional dyspepsia. 26Protein and ginger for the treatment of chemotherapy-induced delayed nausea and gastric dysrhythmia levine me 1 , gillis m 1 , yanchis s 1 , voss ac 2 , stern rm 3 & koch kl 1 1 Section of Gastroenterology, Wake Forest University, Winston -Salem, NC, USA 2 Ross Products Division, Columbus, OH, USA 3 Department of Psychology, The Pennsylvania State University, University Park, PA, USA Background: Delayed nausea occurs in many cancer patients during the three days following administration of a cytotoxic agent. Meals high in protein content decrease the nausea of motion sickness and pregnancy, possibly by enhancing normal gastric myoelectrical activity and/or by reducing gastric dysrhythmias. Ginger ma...
Juvenile nasopharyngeal angiofibroma (JNA) is the most common benign neoplasm of the nasopharynx. While histologically benign, it has the propensity for aggressive local growth. This highly vascular tumor predominantly occurs in adolescent males. The literature fails to provide a thorough description of ocular complications and their incidence in JNA. This report summarizes the data from those clinical series detailing ocular findings in a total of 218 JNA cases. Exophthalmos was found in 14% of all cases. Decreased visual acuity and partial ophthalmoplegia occurred in 5% and 2% respectively. Recognition of ocular involvement in JNA is of the utmost importance, for it is often a manifestation of orbital or intracranial extension or both. We describe the diagnosis and management of a case of JNA in a five-year-old white male. The patient developed ocular findings of marked exophthalmos and optic atrophy. Early multidisciplinary diagnostic evaluation (otolaryngological, neurosurgical, and ophthalmological) followed by a team surgical approach to excision is most likely to yield efficacious results.
The net thoracic magnetic moment of 58 highly exposed nonsmoking shipyard welders and 13 unexposed nonsmoking electricians was measured with an alternating current susceptibility bridge. The welding cohort exhibits a thorax magnetic moment, which on the average is less diamagnetic than that of the controls. This shift is consistent with a median lung burden of 110 mg Fe3O4, or 220 mg of the welding fumes characteristic for shipyard exposures. Among welders with 5+ yr of exposure, there is a slight but statistically significant correlation (r = 0.49) (p less than .0001) between inferred lung burden and lifetime occupational exposure. Although chronic bronchitis incidence and average lung function parameter values of the welders are different from those of the nonexposed cohort, respiratory status does not correlate further with either self-reported exposure or measured lung retention.
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