Tinnitus and Cochlear Functions in Hearing Impaired and Normal Hearing Individuals

Background: In order to determine the pathophysiology of tinnitus and deciding on treatment, the function of peripheral hearing organs is very important. Objective: To evaluate the cochlear functions in tinnitus patients with or without hearing-loss(HL). Methods: Participants with tinnitus were divided into two groups; 16 participants with accompanying HL were included in the first study group (SG-I), and 15 participants without HL were included in the second group (SG-II). 21 normal-hearing subjects without tinnitus included as control group(CG). Tinnitus discomfort levels was determined with Tinnitus Handicap Inventory(THI). Besides pure-tone audiometry, Otoacoustic Emissions, to evaluate cochlear functions and to decide dead regions (DR), Threshold Equalizing Noise-(TEN) was used. Results: The threshold-shift was observed with TEN in subjects in SG-I and these levels were statistically different from SG-II and CG. There were both threshold-shift and DR in SG-II according to TEN. TEOAEs did not differ between SG-II and CG. The DPOAE results for SG-II showed significant decreases in emission amplitudes at 6 & 8 kHz. Conclusion: While Tinnitus patients with HL can be evaluated with conventional tests, evaluating patients with normal hearing tinnitus with additional tests such as OAE and TEN allows us to get more precise results on the functions of peripheral hearing organs

Clinical results of carotid artery stenting versus carotid endarterectomy

Objective: To review our results of carotid artery stenting (CAS) and carotid endarterectomy (CEA). Methods: We evaluated the medical records of patients undergoing carotid artery revascularization procedure, between 2001 and 2013 in Baskent University Hospital, Ankara, Turkey. Carotid artery stenting or CEA procedures were performed in patients with asymptomatic carotid stenosis (=70%) or symptomatic stenosis (=50%). Demographic data, procedural details, and clinical outcomes were recorded. Primary outcome measures were in 30-day stroke/transient ischemic attacks (TIA)/amaurosis fugax or death. Secondary outcome measures were nerve injury, bleeding complications, length of stay in hospital, stroke, restenosis (ICA patency), and all-cause death during long-term follow-up. Results: One hundred ninety-four CEA and 115 CAS procedures were performed for symptomatic and/or asymptomatic carotid artery stenosis. There is no significant differences 30-day mortality and neurologic morbidity between CAS (13%) and CEA procedures (7.7%). Length of stay in hospital were significantly longer in CEA group (p=0.001). In the post-procedural follow up, only in symptomatic patients, restenosis rate was higher in the CEA group (p=.045). The other endpoints did not differ significantly. Conclusions: Endovascular stent treatment of carotid artery atherosclerotic disease is an alternative for vascular surgery, especially for patients that are high risk for standard CEA. The increasing experience, development of cerebral protection systems and new treatment protocols increases CAS feasibility

Debt and Default from a Post-Keynesian Perspective: A Historical Case Study of the Argentine Puzzle

The subject of sovereign debt and default has received intense focus since the beginning of this century. This interest was fuelled by the largest default in history - by Argentina in 2001 - but it was the Global Financial Crisis of 2007-2008 and its effects that placed the issue of debt in the centre of attention. The ensuing debate has been stuck, however, in the contrived opposition between ‘fiscally irresponsible governments’ and ‘evil creditors’ in both mainstream neoclassical circles and among so-called critical scholars. This thesis overcomes this, and similarly untenable positions, by taking a long-term look at the nature and implications of sovereign defaults, focusing specifically on the experience of Argentina since its independence. With its complex and unique history of debt, Argentina provides the perfect vantage point and case study to compare different causes and impacts of sovereign default. In a contribution to the post-Keynesian literature on government debt, and particularly to the Modern Monetary Theory (MMT) school of economics, the thesis argues that sovereign defaults are not necessarily harmful to the health of an economy, and to the well-being of the people. Elaborating on MMT, it argues that preventing or postponing an inevitable default is sometimes more detrimental for the indebted country in the long-run. That being said, under certain conditions a sovereign default can also have devastating effects. Argentina’s history contains examples of both outcomes. This raises a puzzle: What determines the outcomes of sovereign defaults? What makes them beneficial or harmful? To answer these questions, this study investigates the range of episodes during which Argentina fell into default (or restructuring) over a period of two centuries. It combines a historical process-tracing methodology with a theoretically informed and nuanced political-economic analysis of data in order to understand what determines the different outcomes. The main claim defended here is that it all depends on how governments approach defaults. If default is not seen as an inevitable evil to be avoided at all costs, but as a strategic option, space is created for government policy to prevent potential damage, and to exploit the opportunity to address underlying structural problems in the economy Both the historical and political-economic analysis support this conclusion, and indicate the need for a broader reappraisal of official and public perceptions of defaults and their dynamics

Debt and Default from a Post-Keynesian Perspective: A Historical Case Study of the Argentine Puzzle

The subject of sovereign debt and default has received intense focus since the beginning of this century. This interest was fuelled by the largest default in history - by Argentina in 2001 - but it was the Global Financial Crisis of 2007-2008 and its effects that placed the issue of debt in the centre of attention. The ensuing debate has been stuck, however, in the contrived opposition between ‘fiscally irresponsible governments’ and ‘evil creditors’ in both mainstream neoclassical circles and among so-called critical scholars. This thesis overcomes this, and similarly untenable positions, by taking a long-term look at the nature and implications of sovereign defaults, focusing specifically on the experience of Argentina since its independence. With its complex and unique history of debt, Argentina provides the perfect vantage point and case study to compare different causes and impacts of sovereign default. In a contribution to the post-Keynesian literature on government debt, and particularly to the Modern Monetary Theory (MMT) school of economics, the thesis argues that sovereign defaults are not necessarily harmful to the health of an economy, and to the well-being of the people. Elaborating on MMT, it argues that preventing or postponing an inevitable default is sometimes more detrimental for the indebted country in the long-run. That being said, under certain conditions a sovereign default can also have devastating effects. Argentina’s history contains examples of both outcomes. This raises a puzzle: What determines the outcomes of sovereign defaults? What makes them beneficial or harmful? To answer these questions, this study investigates the range of episodes during which Argentina fell into default (or restructuring) over a period of two centuries. It combines a historical process-tracing methodology with a theoretically informed and nuanced political-economic analysis of data in order to understand what determines the different outcomes. The main claim defended here is that it all depends on how governments approach defaults. If default is not seen as an inevitable evil to be avoided at all costs, but as a strategic option, space is created for government policy to prevent potential damage, and to exploit the opportunity to address underlying structural problems in the economy Both the historical and political-economic analysis support this conclusion, and indicate the need for a broader reappraisal of official and public perceptions of defaults and their dynamics

Combined cremaster muscle and inner thigh skin composite flap: A novel experimental flap model in the rat

Unlike the composite musculocutancous flap models, the combined composite muscle-skin flap model allows evaluating muscle and skin viability independently, because it has an independent blood supply to the muscle and skin component. However, to our knowledge, only two combined muscle-skin flaps have been reported to date. During our cremaster dissection in our laboratory, we perceived a new vessel as a terminal continuation of the pudic-epigastric artery (PEA) on which the cremaster muscle flap is raised. Therefore, we designed this study to determine whether the scrotal and inner thigh skin can be harvested with the cremaster muscle as a combined cremaster muscle-skin composite flap. Thirty male Sprague-Dawley rats were used in this experiment. In five rats, ink study selective to the PEA marked a skin territory. In 15 rats, cremaster muscle and 4 x 3 cm ipsilateral scrotal and medial thigh skin flap was raised on the PEA. Fluorescein study after 4 hours showed fluorescein stain in the skin island. On postoperative day 7, both muscle and skin components of the flaps were viable. Microangiographic study after the flap elevation revealed the vascularity of all components of the flap and clearly identified the branch to the skin island. To the best of our knowledge, this is the first report describing the combined flap model including the cremaster muscle. Our flap seems to have an important advantage over the other combined muscle-skin flap models in terms of the cremaster muscle being suitable for the intravital microscopy. Additionally, the two components of the flap have separate nutrient vessels with adequate length, which gives the flap flexibility in the placement of the skin component in a location distant from the muscle component. The flap may be also be raised as a skin flap without the cremaster muscle. It can be used for different applications, including microcirculatory, pharmacological, physiological, biochemical, and immunological studies as well as for transplantation studies

A new composite flap model in the rat - Combined cremaster muscle and pubic bone flap

Background: We introduce a new model of combined cremaster muscle and pubic bone flap based on a single pedicle consisting of the osseous branch of pubic bone and external spermatic vessels of cremaster muscle in continuity with the pudic-epigastric artery (PEA)

Postradiation Sarcoma From a Free Flap

Introduction: Postradiation sarcomas constitute approximately 0.5% to 5.5% of all sarcomas. They develop locally approximately 3 to 20 years after the administration of radiotherapy (RT). They are generally high-grade tumors. Osteosarcomas, fibrosarcomas, malignant fibrous histiocytoma, angiosarcomas, and leiomyosarcomas are the most frequently observed. It is rare for these tumors to originate from free flaps, and this patient report is one of the first in the literature