Assessment and management of dysphagia following pharyngolaryngectomy with free jejunal interposition: A series of eight case studies

The physiological and structural deficits contributing to swallowing complications in the pharyngolaryngectomy patient population are not homogeneous. Consequently, a team approach, involving medical investigations as well as clinical and radiological assessments of swallowing, is necessary to facilitate diagnosis of the underlying impairment and assist the medical/surgical and speech pathology team members in the process of individualizing the management plan for each patient. In the present study, the clinical assessment and management of eight pharyngolaryngectomy patients who presented with a decline in swallowing function unrelated to immediate postsurgical effects or direct effects of radiotherapy are reported. Clinical and radiological investigations revealed a heterogeneous group of factors contributing to their swallowing impairments and disability levels, including difficulty with graft and anastomotic patency and graft motility, impaired lingual coordination, increased bolus transit time, nasal and oral regurgitation, patient distress, and recurrence. Variation between the cases supported the need for differential intervention and management plans for all eight patients. Ratings of perceived swallowing disability, handicap, and well-being/distress levels at initial assessment and again six months following dysphagia intervention revealed a pattern of reduced levels of impairment, functional disability, and overall patient distress levels following informed intervention. The present case study data highlights the key role thorough clinical and radiological investigations play in the process of diagnosing the factors contributing to dysphagia and guiding the management of the resultant swallowing disability in the pharyngolaryngectomy population.

Universal state inversion and concurrence in arbitrary dimensions

Wootters [Phys. Rev. Lett. 80, 2245 (1998)] has given an explicit formula for the entanglement of formation of two qubits in terms of what he calls the concurrence of the joint density operator. Wootters's concurrence is defined with the help of the superoperator that flips the spin of a qubit. We generalize the spin-flip superoperator to a universal inverter, which acts on quantum systems of arbitrary dimension, and we introduce the corresponding generalized concurrence for joint pure states of D-1 X D-2 bipartite quantum systems. We call this generalized concurrence the I concurrence to emphasize its relation to the universal inverter. The universal inverter, which is a positive, but not completely positive superoperator, is closely related to the completely positive universal-NOT superoperator, the quantum analogue of a classical NOT gate. We present a physical realization of the universal-NOT Superoperator.

Phase sensitive pumping and coherence of superposition states

The continuous parametric pumping of a superconducting lossy QED cavity supporting a field prepared initially as a superposition of coherent states is discussed. In contrast to classical pumping, we verify that the phase sensitivity of the parametric pumping makes the asymptotic behaviour of the cavity field state strongly dependent on the phase theta of the coherent state \ alpha > = \ alpha \e(i theta)>. Here we consider theta = pi /4, -pi /4 and we analyse the evolution of the purity of the superposition states with the help of the linear entropy and fidelity functions. We also analyse the decoherence process quantitatively through the Wigner function, for both states, verifying that the decay is slightly modified when compared to the free decoherence case: for theta = -pi /4 the process is accelerated while for theta = pi /4 it is delayed.

Feedback-stabilization of an arbitrary pure state of a two-level atom

Unit-efficiency homodyne detection of the resonance fluorescence of a two-level atom collapses the quantum state of the atom to a stochastically moving point on the Bloch sphere. Recently, Hofmann, Mahler, and Hess [Phys. Rev. A 57, 4877 (1998)] showed that by making part of the coherent driving proportional to the homodyne photocurrent one can stabilize the state to any point on the bottom-half of the sphere. Here we reanalyze their proposal using the technique of stochastic master equations, allowing their results to be generalized in two ways. First, we show that any point on the upper- or lower-half, but not the equator, of the sphere may be stabilized. Second, we consider nonunit-efficiency detection, and quantify the effectiveness of the feedback by calculating the maximal purity obtainable in any particular direction in Bloch space.

A test of the ash-free dry weight technique on the developmental stages of Patiriella spp. (Echinodermata : Asteroidea)

Determination of the ash-free dry weight (AFDW) of marine specimens requires samples to be rinsed, soaked, and centrifuged. Problems associated with this technique were examined with the developmental stages of seastar species (Patiriella) with different modes of development. The influence of three rinsing solutions (ammonium formate [AF], filtered seawater [FSW], and reverse osmosis water [RO]) was assessed. The hypothesis that the AFDW technique is a measure of organic material was addressed by drying inorganic salts. Developmental stages of Patiriella calcar rinsed in FSW were twice as heavy as those rinsed in RO or AE indicating that samples should be rinsed in RO or AF before weighing. Soaking treatments had a significant effect on the AFDW of samples of P. calcar (planktonic developer), indicating that the rinsing period should be brief. Zygotes of Patiriella re gularis (planktonic developer) were significantly heavier than ova or gastrulae, regardless of treatment. In contrast, there were no significant differences in the AFDW of any stages or treatments of Patiriella exigua (benthic developer). This may be due to the presence of a modified fertilization envelope, which protects these benthic embryos. Inorganic salts with water of crystallization and FSW lost 20-75% and 14% of their dry weight, respectively, after ashing. We propose that salt ions may retain water, which does not evaporate during drying but is lost during ashing, resulting in the overestimation of sample AFDW. If a similar process occurs in the developmental stages of marine invertebrates, changes in the intracellular ionic composition through development may result in inaccurate estimates of biomass.

When state silence becomes persecution: The case of domestic violence refugees in minister for immigration and multicultural affairs v Khawar

In Minister for Immigration and Multicultural Affairs v Khawar, the Federal Court upheld a finding setting aside the refusal of the Refugee Review Tribunal (RRT) to grant a protection visa to a Pakistani woman - Tribunal's failure to consider the notion that state tolerance of violence for discriminatory reasons could amount to persecution under the definition of 'refugee' in the Convention Relating to the Status of Refugees.

State Banks and Economic Development in China

State-owned banks remain dominant in China's financial sector despite over two decades of gradual financial liberalization. Their performance is typically evaluated using commercial banking criteria. The standard view is that because state banks have experienced declining profitability and capital adequacy, they have been a drain on past economic development and endanger future growth prospects. However, we argue that state banks have strong development bank characteristics and hence warrant different performance criteria. The analysis in this paper suggests that while thier commercial performance may have been poor, the overall impact of state banks on China's economic development appears to have been both positive and sustainable. Copyright © 2001 John Wiley & Sons, Ltd.

The surface accessibility of the glycine receptor M2-M3 loop is increased in the channel open state

Mutations in the extracellular M2-M3 loop of the glycine receptor (GlyR) alpha1 subunit have been shown previously to affect channel gating. In this study, the substituted cysteine accessibility method was used to investigate whether a structural rearrangement of the M2-M3 loop accompanies GlyR activation. All residues from R271C to V277C were covalently modified by both positively charged methanethiosulfonate ethyltrimethylammonium (MTSET) and negatively charged methanethiosulfonate ethylsulfonate (MTSES), implying that these residues form an irregular surface loop. The MTSET modification rate of all residues from R271C to K276C was faster in the glycine-bound state than in the unliganded state. MTSES modification of A272C, L274C, and V277C was also faster in the glycine-bound state. These results demonstrate that the surface accessibility of the M2-M3 loop is increased as the channel transitions from the closed to the open state, implying that either the loop itself or an overlying domain moves during channel activation.

Peritoneal cytology: impact on disease-free survival in clinical stage I endometrioid adenocarcinoma of the uterus

The prognostic significance of positive peritoneal cytology in endometrial carcinoma has led to the incorporation of peritoneal cytology into the current FIGO staging system, While cytology was shown to be prognostically relevant in patients with stage II and III disease, conflicting data exists about its significance in patients who would have been stage I but were classified as stage III solely and exclusively on the basis of positive peritoneal cytology (clinical stage I). Analysis was based on the data of 369 consecutive patients with clinical stage I endometrioid adenocarcinoma of the endometrium. Standard treatment consisted of an abdominal total hysterectomy, bilateral salpingo-oophorectomy with or without pelvic lymph node dissection. Peritoneal cytology was obtained at laparotomy by peritoneal washing of the pouch of Douglas and was considered positive if malignant cells could be detected regardless of the number of malignant cells present. Disease-free survival (DFS) was considered the primary statistical endpoint. In 13/369 (3.5%) patients, positive peritoneal cytology was found. The median follow-up was 29 months and 15 recurrences occurred. Peritoneal cytology was independent of the depth of myometrial invasion and the grade of tumour differentiation, Patients with negative washings had a DFS of 96'7e at 36 months compared with 67% for patients with positive washings (log-rank P < 0.001). The presence of positive peritoneal cytology in patients with clinically stage I endometrioid adenocarcinoma of the endometrium is considered an adverse prognostic factor. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.