Biomedical subjects
Steven M Silver
Publications and source records attributed to Steven M Silver.
Nasopharyngeal pleomorphic adenoma in the adult.
INTRODUCTION: Salivary gland tumors account for less than 5% of all neoplasms in the head and neck, with pleomorphic adenoma being the most common type. These typically arise in the palate, but we report a rare case of nasopharyngeal pleomorphic adenoma in an adult. MATERIALS AND METHODS: The authors conducted a case report and literature review. RESULTS: The patient presented with unilateral otalgia, tinnitus, and aural fullness. Nasal endoscopy revealed a pedunculated mass adjacent to the left torus tubarius and he was treated with an excisional biopsy. Histologic evaluation demonstrated pleomorphic adenoma. DISCUSSION: Pleomorphic adenomas seldom present as nasopharyngeal masses and have a nonspecific appearance on endoscopy. Microscopic examination has characteristic features to aid in an accurate diagnosis. Treatment is surgical and recurrence is unlikely.
Is EMDR an exposure therapy? A review of trauma protocols.
This article presents the well established theoretical base and clinical practice of exposure therapy for trauma. Necessary requirements for positive treatment results and contraindicated procedures are reviewed. EMDR is contrasted with these requirements and procedures. By the definitions and clinical practice of exposure therapy, the classification of EMDR poses some problems. As seen from the exposure therapy paradigm, its lack of physiological habituation and use of spontaneous association should result in negligible or negative effects rather than the well researched positive outcomes. Possible reasons for the effectiveness of EMDR are discussed, ranging from the fundamental nature of trauma reactions to the nonexposure mechanisms utilized in information processing models.
Rapid recovery from acoustic trauma: chicken soup, potato knish, or drug interaction?
OBJECTIVES: To describe the phenomenology and consider possible mechanisms mediating rapid and unexpected recovery from acoustic trauma after ingestion of a food substance (potato knish). STUDY DESIGN: Single subject with repeated test measures. SETTING: Regional Veteran's Administration Medical Center, tertiary care medical center. METHODS: Pure-tone audiometry and distortion product otoacoustic emissions (DPOAEs) performed at 6 days, 21 days, and 1 year postexposure. RESULTS: Medical treatment with corticosteriods and a diuretic alone failed to improve auditory function and related symptoms (tinnitus and aural fullness) over a 2-week period. Rapid recovery of auditory function (dramatic improvement in pure tone thresholds; reappearance of DPOAEs) and abatement of related symptoms directly followed physiologic reactions from ingesting a food substance. CONCLUSIONS: Rapid recovery from acoustic trauma was temporally correlated with urodynamic and cardiovascular reactions from ingesting food containing sulfite preservative, a substance to which the individual was allergic. Factors that may have contributed to recovery of function include massive diuresis, increased heart rate, release of biochemical mediators, mediator-induced vasodilatation, and changes in vascular or cell membrane permeability. Establishing relationships that lead to recovery of function from acoustic trauma may facilitate research and aid in the development of new treatment options for this condition.