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This article proposes that at least two agent-backgrounding operations with different syntactic and semantic properties have to be distinguished in Catalan Sign Language (LSC): the HIGH-LOCUS CONSTRUCTION and the NONAGREEING CENTRAL CONSTRUCTION. We show that the high-locus construction is a transitive structure with a nonspecific subject. We propose to analyze this construction as involving a null pro-subject, licensed by agreement and interpreted as an impersonal third plural, as in other agent-backgrounding constructions with an impersonal third plural subject, which are crosslinguistically restricted to human interpretation. We propose that the nonagreeing construction is an intransitivized verb form that allows passive interpretations with agents and causes and anticausative interpretations comparable to middle voice.
This chapter discusses phenomena associated with the Voice head responsible for introducing external arguments in a sentence. We suggest that Voice is not a special type of functional head, but rather has a set of properties that are shared by other functional heads: e.g., whether the head is present or absent, whether it requires a specifier, assigns case, or introduces a thematic interpretation. The defining feature of Voice is that it is the highest argument-introducing head, sitting at the boundary between the verb phrase and the inflectional domain. We also highlight some of the challenges in cross-linguistic comparison of Voice phenomena, including the fact that the Voice head may be realized in various forms, including affixes, light verbs, reflexive pronouns, and sets of phi-features. We argue that a precise understanding of Voice can lead to a more fine-grained set of questions that can be applied to other phenomena in syntax, and that uncovering more details about the properties of what is and isn’t attributable to Voice can help us identify the fundamental building blocks that languages use to express the presence, absence, and interpretation of arguments in general.
Cocaine is one of the most used recreational drugs. Whilst medical uses exist, chronic recreational nasal use of cocaine is associated with progressive destruction of the osseocartilaginous structures of the nose, sinuses and palate – termed cocaine-induced midline destructive lesions.
Case report
A 43-year-old male with a history of chronic cocaine use, presented with conductive hearing loss and unilateral middle-ear effusion. Examination under anaesthesia revealed a completely stenosed left Eustachian tube orifice with intra-nasal adhesions. The adhesions were divided and the hearing loss was treated conservatively with hearing aids. Whilst intra-nasal cocaine-induced midline destructive lesions are a well-described condition, this is the first known report of Eustachian tube stenosis associated with cocaine use.
Conclusion
This unique report highlights the importance of thorough history-taking, rhinological and otological examination, and audiometric testing when assessing patients with a history of chronic cocaine use. This paper demonstrates the complexity of managing hearing loss in such cases, with multiple conservative and surgical options available.
This chapter highlights the affinities between moderation, modesty, and humility. It uses the example of the Swedish term lagom, which connotes a certain form of humility and respect for limits.
This chapter considers the unobtrusive words, the conjunctions, and the grammar of Victorian realist prose, drawing on examples from Elizabeth Gaskell, Margaret Oliphant and Anthony Trollope. The styles of Victorian realist fiction are shown to lodge within their very grammar a psychology of style; they register in the turns and returns of their sentences, in their ‘forms of retardation, inference, and backwards-reappraisal’, thinking and reflection from within the midst of narrated experience.
As a preliminary to discussing the idea that, for Aristotle, sensibility and intelligence are “measures” of their respective objects, in this chapter I discuss Aristotle’s conception of “measure.” Though the devil is in the details, the fundamental point is tolerably clear. It is that measures for knowing the objects of some genus are prior to – enter into the very idea of – certain particular forms of that genus. The inch, for example, is a measure of length, and it enters into the very idea of certain particular lengths, e.g. one inch, two inches, three inches, and so on. Similarly, if straight is the measure of linear shape, it enters into the very idea of certain particular shapes, e.g. straight and curved. In this way and in this sense, measures are “forms of forms”: that is, what it is to be certain particular quantities or qualities of a genus is to stand in some relation to the “measure” of that genus.
In this chapter, we will discuss the core Voice alternations in Germanic languages. Different Voice alternations have in common that the argument structure of the underlying verb, in particular the semantic and syntactic properties of the verb’s external argument, are manipulated and this often goes along with changes in the morpho-syntax of the verb or the verbal phrase. In Section 1, we discuss inner-Germanic variation in the formation of analytic eventive and adjectival passives. In Section 2, we discuss the Mainland Scandinavian s-passives and in Section 3 we discuss noncanonical get-passives and related constructions. In Section 4, we turn to the morpho-syntactic variation in anticausative formation. Finally, in Section 5, we discuss how dispositional statements known as generic middles are realized across the Germanic languages.
An anatomical study was performed to describe the endoscopic anatomy and variations of the protympanum, including classification of the protiniculum and subtensor recess.
Methods
A retrospective review was conducted of video recordings of cadaveric dissections and surgical procedures, which included visualisation of the protympanum, across 4 tertiary university referral centres over a 16-month period. A total of 97 ears were used in the analysis.
Results
A quadrangular conformation of the protympanum was seen in 60 per cent of ears and a triangular conformation in 40 per cent. The protiniculum was type A (ridge) in 58 per cent, type B (bridge) in 23 per cent and type C (absent) in 19 per cent. The subtensor recess was type A (absent) in 30 per cent, type B (shallow) in 48 per cent and type C (deep) in 22 per cent.
Conclusion
The protympanum is an area that has been ignored for many years because of difficulties in visualising it with an operating microscope. However, modern endoscopic equipment has changed this, providing detailed anatomical knowledge fundamental to ensuring the safety of endoscopic surgical procedures in the region.
The major climatic variations that have affected the summit slopes of the higher Apennine massifs in the last 6000 yr are shown in alternating layers of organic matter-rich soils and alluvial, glacial and periglacial sediments. The burial of the soils, triggered by environmental–climatic variations, took place in several phases. For the last 3000 yr chronological correlations can be drawn between phases of glacial advance, scree and alluvial sedimentation and development of periglacial features. During some periods, the slopes were covered by vegetation up to 2700 m and beyond, while in other phases the same slopes were subject to glacial advances and periglacial processes, and alluvial sediments were deposited on the high plateaus. Around 5740–5590, 1560–1370 and 1300–970 cal yr B.P., organic matter-rich soils formed on slopes currently subject to periglacial and glacial processes; the mean annual temperature must therefore have been higher than at present. Furthermore, on the basis of the variations in the elevation of the lower limit reached by gelifraction, it can be concluded that the oscillations in the minimum winter temperatures could have ranged between 3.0°C lower (ca. 790–150 cal yr B.P.) and 1.2°C higher (ca. 5740–5590 cal yr B.P.) than present minimum winter temperatures. During the last 3000 yr the cold phases recorded by the Calderone Glacier advance in the Apennines essentially match basically the phases of glacial advance in the Alps.
Cholesteatoma is considered a benign, gradually expanding and destructive epithelial lesion of the temporal bone. The pathogenesis of different classifications of cholesteatoma is marked by similar underlying cellular and molecular processes. Stepwise explanations of the histopathogenesis have been described previously. The current paper focuses on expounding the molecular events of cholesteatoma.
Method and results:
Cholesteatoma pathogenesis encompasses a complex network of signalling pathways during: epidermal hyperplasia, perimatrix–matrix interactions and mucosal disease. This paper presents a review of the molecular events driven by inflammatory mediators and enzymes during: cholesteatoma growth (cell proliferation and apoptosis); maintenance and deterioration (angiogenesis and hypoxia, oxidative stress and toxicity); and complications (bone erosion and hearing loss). The cascade of molecular events applicable to atelectasis and cholesteatoma that coexist with chronic otitis media and bone erosion as sequelae is summarised.
Conclusion:
The role of lipids in this disease is relatively unexplored, but there is evidence in support of fatty acid role-players that needs confirmation. Future directions in lipid research to delineate molecular mechanisms are proposed.
In this study, we evaluated the effect of low-level lasers on the healing of tympanic membrane perforation, one of the most common otological pathologies.
Methods and materials:
Twenty-four guinea pigs were randomly assigned to either the experimental or control group. One day after the induction of a 2 mm diameter, centred myringotomy in all animals, the tympanic membranes in the experimental group were irradiated with 630 and 860 nm lasers for 10 days. Two weeks later, histological changes in the membranes were evaluated.
Results:
Tympanic membrane thickening and inflammatory cell infiltration in the tympanic membranes and surrounding tissues were significantly less in the experimental group (p < 0.001). The distance from the external auditory canal wall to the malleus tip did not differ significantly between the two groups (p = 0.42).
Conclusion:
The results show that the combined application of 630 and 860 nm lasers had a significant effect on the healing of tympanic membrane perforation, and on the prevention of thick fibrotic or atelectatic neomembrane formation.
We investigated gustatory changes in patients with chronic otitis media, before and after middle-ear surgery.
Methods:
This prospective study included 38 patients with unilateral chronic otitis media. We used taste testing solutions to evaluate each patient's taste function. Intra-operative assessments of the chorda tympani nerve were also compared and analysed.
Results:
Patients with chronic otitis media had significantly worse ipsilateral perception of sour, bitter and salty tastes. In patients with good intra-operative preservation of the chorda tympani nerve, there was significant improvement in gustatory function one month post-operatively, compared with the pre-operative baseline. In patients who sustained intra-operative chorda tympani nerve injury, one month post-operative gustatory function was the same as the pre-operative baseline.
Conclusion:
Middle-ear surgery for chronic otitis media not only treats the ear but also improves gustatory function in the majority of patients. In patients with intra-operative injury to the chorda tympani nerve, post-operative taste decline is only temporary.
The insertion of a myringotomy tube is a common ENT procedure. Traditionally, this procedure is performed under otomicroscopic view. In this paper I describe a technique using rigid endoscopy with the Hopkins rod and a video monitor as a visual aid for the insertion of myringotomy tube in older children and adults. The technique is safe and effective; it allows demonstration of the entire tympanic membrane during surgery and also enables better teaching of the procedure than does the otomicroscope.
Narghile (water-pipe) smoking requires the generation of significant negative intrapharyngeal pressure, which may be transmitted to the middle ear through the Eustachian tube. A total of 80 ears from regular narghile smokers were examined otoscopically and by tympanometry. Seventy ears from heavy cigarette smokers were similarly examined and served as a control group. There was a highly significant increase in the prevalence of atticretractions (P < 0.01) in the narghile smokers. The tympanometric changes were not significantly different between the two groups (P > 0.05).
We report a case of mucoepidermoid carcinoma (MEC) originating from the eustachian tube and middle ear. A 31-year-old male who presented with otorrhoea and methicillin-resistant Staphylococcus aureus (MRSA) in the right ear was admitted to hospital due to cerebral infarction and deep vein thrombosis. After recovery, biopsies from a granulomatous mass found in the middle ear during operation for chro ic otitis media revealed intermediate-grade MEC and a nasopharyngeal mass identified after surgery also revealed the same result. He received combined radiation therapy and chemotherapy and no residual or recurrent tumour was detected after two years of follow-up.
The case of a five year old boy who presented with a lower motor neurone facial nerve palsy secondary to primary non-Hodgkin’s lymphoma (NHL) of the middle ear is discussed. Any child who presents with a facial nerve palsy and conductive hearing loss requires thorough evaluation to exclude the possibility of temporal bone malignancy.
Glomus tumours can present in several sites in the head and neck. A red mass in the middle ear, visible on otoscopy generally indicates a glomus tympanicum or glomus jugulare. We present photographic and radiologic evidence of such a lesion arising from the course of the intra-tympanic facial nerve, the Fallopian canal, and review the differential diagnoses.
We have developed a prototype middle-ear hearing implant which uses a multilayer piezoelectric actuator. In this series of experiments the actuator was attached to the medial wall of the attic so that it makes contact with the body of the incus. Initial in vitro evaluation has been carried out using a laser vibrometer (Polytec CLV) to measure stapes velocity. Stapes displacement is calculated by mathematical integration. The device used in this way is particularly effective at transmitting high frequency sound to the stapes. When switched off the actuator impairs the transmission of sound to the ossicular chain at low frequencies, but this effect is only 7 dB at most. The stapes displacements resulting from the action of the implant have a linear relationship with the voltages used to drive the system. The high capacitance of the present actuator means that its power requirements are higher than that of other comparable devices. An optimal method of coupling the device to the incus has yet to be identified.
Middle-ear adenoma has been reported only in small numbers by surgeons. The few large series reported have been presented by histopathologists. We add two cases of middle-ear adenoma to the published literature, together with pre-, per- and post-operative imaging of one case, as a demonstration of this rare clinical entity. We discuss the pathology of middle-ear adenoma, its diagnosis and treatment, and suggest ways of improving its management.