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BACKGROUND Overtreatment of prostate cancer (PCa) is a healthcare issue. Development of noninvasive imaging tools for improved characterization of prostate lesions might reduce overtreatment. PURPOSE To measure the distribution of tissue sodium concentration (TSC), proton T2 -weighted signal, and apparent diffusion coefficient (ADC) values in human PCa and to test the presence of a correlation between regional differences in imaging metrics and the Gleason grade of lesions determined from histopathology. STUDY TYPE Cross-sectional. SUBJECTS Ten men with biopsy-proven PCa. SEQUENCES/FIELD STRENGTH Sodium, proton T2 -weighted, and diffusion-weighted MRI data were acquired using Broad-Band 3D-Fast-Gradient-Recalled, 3D Cube (Isotropic 3D-Fast-Turbo-Spin-Echo acquisition) and 2D Spin-Echo sequences, respectively, with a 3.0T MR scanner. ASSESSMENT All imaging data were coregistered to Gleason-graded postprostatectomy histology, as the standard for prostate cancer lesion characterization. Regional TSC and T2 data were assessed using percent changes from healthy tissue of the same patient (denoted ΔTSC, ΔT2 ). STATISTICS Differences in ΔTSC, ADC, and ΔT2 as a function of Gleason score were analyzed for each imaging contrast using a one-way analysis of variance or a nonparametric t-test. Correlations between imaging data measures and Gleason score were assessed using a Spearman's ranked correlation. RESULTS Evaluation of the correlation of ΔTSC, ADC, and ΔT2 datasets with Gleason scoring revealed that only the correlation between ΔTSC and Gleason score was statistically significant (rs = 0.791, p

Background Anxiety and depression rates among ED patients are substantially higher than in the general population. Additionally, those with mental health issues often have difficulty accessing care. Unfortunately, issues of anxiety and depression are frequently not addressed in the ED due to competing care priorities. This may lead to increased burden and overcrowding in EDs. Objective This study related anxiety and depression with ED utilization and perceived barriers to care. Methods In order to limit the impact of insurance coverage on ED utilization and access to care, a convenience sample of adults 45-85 years of age in the ED were surveyed. The GAD-7 and PHQ-9 were used to measure anxiety and depression. Results A total of 251 subjects were enrolled. Severe anxiety was observed in 10% of patients, while moderately severe or severe depression was observed in 12%. Patients who were both severely anxious and depressed visited the ED nearly twice as often as non-anxious and non-depressed patients. The majority of patients cited at least one moderate barrier to care, and greater anxiety and depression scores were related to greater perceived barriers to care. Perceived barriers to care were > 3 times higher among patients who were both anxious and depressed compared to in patients who were neither depressed nor anxious and twice as high as in those who were either depressed or anxious (p

The attack on the World Trade Center (WTC) on September 11, 2001, was an act of terrorism that had many potential influences on the city and state, including influences on families. We analyzed divorce data from 1991 to 2005 for all 62 New York counties to assess divorce response to the attack on the WTC. The results suggested that there were lower observed divorce rates in New York following the attack on the WTC than the prevailing 10-year cubic divorce trend would have predicted. We also compared counties in and around New York City to those farther away, and we compared metropolitan to nonmetropolitan counties in New York. In metropolitan counties, divorces were lower in the predicted direction.

Nonmaternal care of infant children is increasingly common, but there is disagreement as to whether it is harmful for children. Using data from 9,185 children (5 years and older) who participated in the Children of the National Longitudinal Survey of Youth, the current study compared 2 groups: those for whom nonmaternal care was initiated in the first 3 years and those for whom it was not. Between-family comparisons showed that early nonmaternal care was associated with higher achievement and lower behavior problem scores in childhood and adolescence. However, within-family comparisons failed to detect differences between siblings who had different early nonmaternal care experiences. The study concludes that the timing of entry to nonmaternal care in the first 3 years has neither positive nor negative effects on children's outcomes.

The authors review key features in the development of a successful PhD program delivered at a distance, including students, cohorts, teaching, curriculum, administrative structure, and current and future challenges.

Introduction and hypothesis: A terminology and standardized classification has yet to be developed for those complications arising directly from the insertion of synthetic (prostheses) and biological (grafts) materials in female pelvic floor surgery. Methods: This report on the above terminology and classification combines the input of members of the Standardization and Terminology Committees of two International Organizations, the International Urogynecological Association (IUGA) and the International Continence Society (ICS) and a Joint IUGA/ICS Working Group on Complications Terminology, assisted at intervals by many expert external referees. An extensive process of 11 rounds of internal and external review took place with exhaustive examination of each aspect of the terminology and classification. Decision-making was by collective opinion (consensus). Results: A terminology and classification of complications related directly to the insertion of prostheses and grafts in female pelvic floor surgery has been developed, with the classification based on category (C), time (T) and site (S) classes and divisions, that should encompass all conceivable scenarios for describing insertion complications and healing abnormalities. The CTS code for each complication, involving three (or four) letters and three numerals, is likely to be very suitable for any surgical audit or registry, particularly one that is procedure-specific. Users of the classification have been assisted by case examples, colour charts and online aids (www.icsoffice.org/complication). Conclusion: A consensus-based terminology and classification report for prosthesis and grafts complications in female pelvic floor surgery has been produced, aimed at being a significant aid to clinical practice and research. Neurourol. Urodynam. 30: 2-12, 2011. (C) 2010 Wiley-Liss, Inc.

Children raised without a biological father in the household have earlier average ages of first sexual intercourse than children raised in father-present households. Competing theoretical perspectives have attributed this either to effects of father absence on socialization and physical maturation or to nonrandom selection of children predisposed for early sexual intercourse into father-absent households. Genetically informative analyses of the children of sister dyads (N = 1,382, aged 14-21 years) support the selection hypothesis: This association seems attributable to confounded risks, most likely genetic in origin, which correlated both with likelihood of father absence and early sexual behavior. This holds implications for environmental theories of maturation and suggests that previous research may have inadvertently overestimated the role of family structure in reproductive maturation.

The current study uses a newly developed questionnaire, the Effects of Children Questionnaire, to examine the impact of having children on women's lives. Participants were lower- and lower-middle-class women. The questionnaire assessed women's perceptions of their own change and other women's experiences of change as a result of having children in a number of life domains. Exploratory analyses, repeated-measures analyses, factor analyses, and regression analyses were used to test hypotheses. Results suggested that women do compare themselves with other women, that there are two primary factors underlying perceptions of change, and that there are significant changes from having children in various life domains. Results are discussed in terms of the costs and benefits of having children.

Objectives: To test novel markers of acute coronary syndrome (ACS), monocyte chemoattractant protein-1 (MCP), myeloperoxidase (MPO), C-reactive protein (CRP), and brain natriuretic peptide (BNP) in low-risk emergency department (ED) patients who were evaluated for ACS in a chest pain unit (CPU). Methods: A convenience sample of 414 patients underwent CPU evaluation, including provocative testing, and were followed prospectively for 45 days for ACS, which was defined as death, myocardial infarction (MI), revascularization, or >60% coronary artery stenosis prompting new medical treatment, adjudicated by three blinded reviewers. Published diagnostic thresholds were used to calculate diagnostic indices for each marker and for the multimarker panel. Results: The prevalence of ACS was 7 in 414 (1.7%; 95% CI = 0.7% to 3.5%). Only MCP demonstrated a negative likelihood ratio [LR(–)] of less than 0.5, with a sensitivity of 85% (95% CI = 42% to 99%), specificity of 72% (95% CI = 67% to 76%), and LR(–) of 0.20 (95% CI = 0.04 to 0.71). For MPO, CRP, and BNP, LR(–) was 0.89 (95% CI = 0.26 to 2.05), 0.79 (95% CI = 0.40 to 1.01), and 0.90 (95% CI = 0.51 to 1.03), respectively. The sensitivity, specificity, and LR(–) of an abnormal multimarker panel were 86% (95% CI = 42% to 100%), 17% (95% CI = 13% to 21%), and 0.84 (95% CI = 0.15 to 3.12), respectively. Conclusions: The prevalence of ACS was very low but was similar to reports from other CPUs. BNP and CRP had high specificities, but had limited sensitivities, whereas MPO had a low specificity. Only MCP had a low LR(–) and should be studied further. The combined multimarker panel had an unexpectedly low sensitivity and specificity, yielding an LR(–) of 0.84, suggesting that the panel would not be an efficient screening test to decrease unnecessary CPU testing.

Purpose To develop a rapid, robust, and accurate method for assessing myocardial energetics in mice and demonstrate its applicability to mouse models of acquired and genetic heart disease. Materials and Methods We combined surface coil localization (10-mm diameter, tunable between 1H and 31P, using adiabatic half-passage radiofrequency pulses) and surgery (electrocautery removal of anterior chest wall) to create an open-chest method for acquiring in vivo 31P nuclear magnetic resonance (NMR) cardiac spectra from mice at 4.7T within 12 minutes. Normal BALB/c mice, BALB/c with myocardial infarction (MI), cardiomyocyte-restricted peroxisome proliferator-activated receptor-delta knockout (KO) (CR-PPARd–/–) and control loxP-flanked Ppard (Ppardflox/flox) mice were examined. Results The mean phosphocreatine (PCr)/adenosine triphosphate (ATP) ratios in control BALB/c mice, BALB/c MI mice, Ppardflox/flox mice, and PPAR-δ KO mice were 2.13 ± 0.09 (N = 11), 1.35 ± 0.07 (N = 9, P < 0.001 vs. BALB/c control), 1.92 ± 0.09 (N = 5), and 1.31 ± 0.12 (N = 5, P < 0.005 vs. Ppardflox/flox control), respectively. The significant depression of myocardial PCr/ATP we observed in these genetic/acquired models of heart disease was in accord with previous data from analogous large animal models. No NMR signal contamination from chamber blood or adjacent skeletal muscle was identified. Conclusion This new technique provides cardiac 31P spectra suitable for accurate quantitative analysis in a relatively short acquisition time, is suitable for terminal studies of mouse myocardial energy metabolism, and could be installed in virtually any NMR laboratory to study myocardial energetics in numerous mouse models of human heart disease. J. Magn. Reson. Imaging 2006. © 2006 Wiley-Liss, Inc.

Background: Environmental mercury levels significantly increased in the past decades following its increase in industrial applications. In spite of an increasing concern on the potential harmful effects of mercury on children, there is no reported data for the Chinese population. The relationship between dietary habit and environmental mercury exposure in Chinese children was studied. Methods: The hair and blood mercury levels of Chinese children aged above 3 years in 2000 March to September, were studied. Sociodemographic data, dietary habits of the past 6 months, and other risk factors for environmental mercury exposure were collected. Those children with blood mercury levels above the toxic range (i.e. > 45 nmol/L) and their family members were further evaluated and their blood and hair mercury levels were monitored before and after Fishing-Moratorium period (June to August 2000) in South China Sea. Results: Altogether, 137 Chinese children (mean age, 7.2 years) were recruited. The mean hair mercury level was 2.2 p.p.m and the mean blood mercury level was 17.6 nmol/L. There was a strong correlation (r = 0.88) between hair and blood mercury levels in our cohort. Frequency of fish consumption correlated with hair (r = 0.51) and blood (r = 0.54) mercury levels. For those children who consumed fish more than 3 times/week, hair and blood mercury levels were twice as high as those who consumed fish l–3 times/week and threefold of those who never consumed fish. Five children and 12 family members had toxic blood mercury levels. Their blood (P

The Oklahoma City bombing in April 1995 was an act of terrorism that had many potential influences on the city and state, including influences on families. We analyzed divorce data from 1985 to 2000 for all 77 counties in Oklahoma to assess the divorce response to the Oklahoma City bombing. Our prediction was that divorce rates in Oklahoma would decrease in response to the bombing, a prediction derived from two different theoretical orientations, terror management theory and attachment theory. We test this prediction in the context of two relatively powerful quasi-experimental designs, an interrupted time series design, and a nonequivalent control group design. We analyze the time series data with polynomial regression. Results suggested that there were lower observed divorce rates following the Oklahoma City bombing than the prevailing 10-year cubic divorce trend would have predicted, with the effect dampening over time. We analyzed the nonequivalent control group design using an analysis of covariance (ANCOVA) linear model to compare counties in and around Oklahoma City to those farther away, and to compare metropolitan to nonmetropolitan counties in Oklahoma. In each case, divorces were lower in the predicted directions. Key Words: disaster, divorce, marital dissolution, Oklahoma City bombing, terrorism. Natural disasters (e.g., tornadoes, fires, floods, earthquakes, hurricanes) are catastrophic events (Stressors) that can challenge the adaptive capabilities of individuals, families, and communities (Monat & Lazarus, 1991). The bombing of the Alfred P. Murrah Federal Building in Oklahoma City on April 19, 1995, was at that time the worst nonwartime man-made disaster in the history of the United States. As a result of this act of domestic terrorism, 168 persons were killed, 19 of whom were children, and more than 700 persons were injured (Tucker, Pfefferbaum, Nixon, & Dickson, 2000). The explosion damaged 312 buildings in a one-square mile area, which resulted in more than $510 million in damage (Sitterle & Gurwitch, 1999). Research on the effect of large-scale community disasters has proliferated over the past several years. Most disaster research, however, including recent studies on the Oklahoma City bombing, has focused on the psychopathology (e.g., posttraumatic stress disorder) of individuals who experienced the disaster (e.g., Nolen-Hoeksema & Morrow, 1991; North et al., 1999; Powell & Penick, 1983; Shore, Tatum, & Vollmer, 1986). There has been little research attention given to the effect of disasters on family and marital relationships-including divorce-and what has been conducted has produced inconclusive results. Some studies (e.g., Aguirre, 1980; Cohan & Cole, 2002; Erikson, 1976; Morrow & Enarson, 1996) found that natural disasters (e.g., tornadoes, floods, hurricanes) resulted in increased marital disruption and divorce, whereas other studies (e.g., Davis & Ender, 1999; Drabek & Key, 1984; Drabek, Key, Erickson, & Crowe, 1975; Taylor, 1977) found an increase in family and marital solidarity following a natural disaster. It is possible, of course, for disasters to result in polarization, leading to simultaneous increases in both marital solidarity and divorce. A few studies, however, found that natural disasters either had no effect on marriage and divorce rates (e.g., Aguirre; Taylor) or led to a decrease in divorce (e.g., Adams & Adams, 1984). These inconclusive findings are perhaps due in part to methodological and measurement variability in the different studies, the use of various units of analysis (e.g., counties, individuals), and the type and magnitude of the disaster examined. Further, most previous research studied the response to a natural disaster rather than a man-made disaster, and only short-term effects were studied, not long-term effects. Nonetheless, in an ecological study of natural disasters, Aguirre failed to find long-term effects of natural disasters on marriage and divorce. …

Background Usage of cyclosporin (the Hong Kong Hospital Authority's single largest item of drug expenditure) continues to increase, mainly due to increasing numbers of renal allograft patients taking it as long-term antirejection therapy. Diltiazem, an antihypertensive agent, interferes with the first pass extraction of oral cyclosporin, thus serving to conserve its dosage. Aims In renal transplant patients, to assess whether diltiazem co-treatment could achieve worthwhile dosage conservation of Neoral® (a relatively new microemulsified cyclosporin formulation), safely. Methods A randomized, placebo-controlled, double-blind clinical trial was undertaken at three local hospitals. Renal transplant recipients receiving Neoral® as prophylactic immunosuppression were randomized to two treatment arms. Active treatment consisted of diltiazem tablets 30 or 60 mg twice daily for patients weighing

Using a repeated-measures design, we found a significant birth-order relationship suggesting lower ages of smoking onset in later born siblings of a 1979 National Longitudinal Survey of Youth cohort. Two social learning mechanisms, modeling and opportunity, were explored to help illuminate the causes of trends in the within-family means. When empirical patterns were compared to predictions derived from our specifications of how opportunity and modeling processes should work, the results were unsuccessful in explaining the birth-order effect. As a third explanation of the birth-order effect, telescoping did show a significant influence. The effect size was small, however, and had little effect on the group means assessed. Finally, a pattern did emerge that was consistent with a reformulation of the opportunity process in which sisters play a particularly strong role. We develop future research implications of this pattern and speculate on genetic and social conservatism explanations.

The present study examined the effect of later life parental divorce on solidarity in the relationship between the adult child and older parent. This examination was achieved by testing the buffering hypothesis. A cross-sectional quasiexperimental pre-post treatment design was used (Cook & Campbell, 1979), with retrospective pretests and data from 100 adult-child/older-parent dyads. The ANOVA results show that the mother/adult-child relationship with a higher degree of predivorce solidarity responded to later life parental divorce with less disruption of affectional solidarity and associational solidarity than those with a lower degree of predivorce solidarity. Thus, the current research provides modest evidence (for the mother/adult-child relationship) to support the buffering hypothesis. We found no evidence of a buffering effect for the father-child relationship.

The endothelium is a highly metabolic monolayer of cells regulating numerous physiological and pathological functions that maintain the permeability and thromboresistant functions of the endothelium. The structure and function of the endothelial cytoskeleton prevents vascular disease by regulating the structure of the endothelium to act as a resting molecular barrier to atherogenic proteins and by becoming an activated layer of migrating cells to repair denuding injuries. The purpose of this review is to examine the structure of the endothelial cytoskeleton and its roles in cell-cell and cell-substratum adhesion, cell signaling, and regulation of wound repair. Studies focused on the cellular and molecular biology of the structure and function of the endothelial cytoskeleton and in wound repair are reviewed. The cytoskeleton is a key regulator in maintaining endothelial integrity and in restoring integrity following injurious denudation, such as those that occur in the pathogenesis of atherosclerosis. Actin microfilaments and their associated adherens junctions and focal adhesions are important regulators of cell signaling, cell locomotion, cell adhesion, and wound repair mechanisms. Various proteins have been implicated in controlling cytoskeletal-based endothelial function and repair such as tyrosine kinases/phosphatases and the Rho family of proteins. The normal function of the endothelium is highly dependent on the endothelial cytoskeleton. Disruption and dysfunction of the cytoskeleton may result in impairment of endothelial function, subsequently tipping the balance towards vascular disease. Thus, an understanding of the cellular and molecular biology of the endothelial cytoskeleton is essential in our understanding of the pathogenesis of vascular disease, especially atherosclerosis.

This paper explores whether fertility behavior is in the genes. The study sample includes birth cohorts of Danish twins ranging from 1870 to 1910 and from 1953 to 1964. The two periods of substantial fertility change which are represented through the experiences of the samples include: 1) demographic transition with the emergence of deliberate fertility control and low fertility levels; and 2) Europes second demographic transition below replacement fertility and widespread use modern contraception as well as individualism. Data were obtained from the Danish Twin Registry. It presents various variables along with the description of sample composition. The heritability of fertility outcomes and changes over time was investigated. It determines whether genetic influences of fertility are mediated through genetic influences on education and scholastic attainment. It reveals whether the genetic effects influence the transitions to higher parities or the transition from zero to the first child. The analysis of the pattern of heritability which differs across cohorts and genders is explored. Yet it did not include the aspects of human reproduction that influenced by genetic dispositions. The respective estimates for shared environmental and genetic influences for the age at first attempt to have a child is also reported. An appendix is included containing the technical details of the estimation that are omitted in the main text.

Rokeach proposed that switching between denominations is governed by their perceived similarity on a unidimensional continuum. Resulting research has been based on unidimensional methods assuming symmetric interdenominational exchanges. Both assumptions are questionable. We use two data sources, a local survey accounting for ministers' perceptions of similarity between religions and the General Social Surveys accounting for actual switching behavior. Analytic methods, including multidimensional scaling, seriation, and nearest neighbor analysis, were chosen for their ability to account for multidimensionality and asymmetry. Results support a relationship between multidimensional similarity and gaining members but less to losing members. We conclude that religious switching is best understood as a multidimensional asymmetric process. Applied examples are presented.

In order to delineate the effects of death on the immunofluorescence of autonomic nerves supplying the human ventricular myocardium, we studied percutaneous myocardial samples obtained postmortem from 5 individuals within 3 h of death. Subsequent samples were obtained daily from the same individuals up to a total of 5-11 d. The antibodies employed included those against protein gene product 9.5 to demonstrate nervous tissue, dopamine beta-hydroxylase and tyrosine hydroxylase to reveal catecholaminergic neural tissue and neuropeptide Y. An indirect immunofluorescence technique using the avidin-biotin method was employed. The density of myocardial protein gene product 9.5 immunoreactive nerves declined on the 7th day, and became markedly diminished by the 11th day. Immunoreactive dopamine beta-hydroxylase nerves decreased on the 5th day, and were difficult to identify by the 9th day. The density of tyrosine hydroxylase and neuropeptide Y containing nerves rapidly diminished on the 3rd and 4th days, and became undetectable by the 7th and 8th days, respectively. The present results indicate that, depending on the type of antibodies used, immunohistochemical techniques can be used on human hearts obtained up to within 6 d of death to study cardiac innervation.

A polymorphism in intron 2 of the p53 gene, which gives rise to 2 alleles, A1 and A2, was analyzed by polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) and direct DNA-sequencing techniques. The distribution of this allele in the peripheral blood in the Chinese population comprising 27 healthy individuals, 30 bronchiectasis patients, 34 non-small-cell lung cancer (NSCLC) patients and 27 SCLC patients was analyzed. The genotypic distributions for this marker were significantly different between the blood of healthy individuals and SCLC patients. There was no significant difference between genotypes of Caucasians and Chinese. Tumors, normal lungs and peripheral blood of 83 adenocarcinoma and 10 squamous cell carcinoma patients were also studied. There was a significant difference in the distribution of the genotypes detected in tumor tissues vs. blood of adenocarcinoma patients. The frequency of detection of the A1/A1 genotype in the tumor tissues was increased in adenocarcinoma patients as compared with the blood of adenocarcinoma patients and was decreased in the blood of SCLC patients as compared with the blood of healthy individuals. Survival rates in Hong Kong adenocarcinoma patients with the A1/A1 genotype were lower than those in patients with A1/A2 and A2/A2 genotypes up to 30 months post-operation. Point mutations were detected at the p53 intron 2 polymorphic locus in NSCLC specimens, with a mutation rate of 15.4% (8/52). All mutations were GC transversions. The significance of this instability in p53 intron 2 remains to be elucidated.

Tumor necrosis factor-alpha (TNF alpha) is a proinflammatory cytokine with negative inotropic effects. Recently, elevated levels of TNF alpha have been identified in patients with advanced heart failure. Although the clinical significance of this finding is unclear at present, there is increasing evidence that this cytokine may play a primary pathophysiologic role in the development and pathogenesis of heart failure in humans. Indeed, many of the clinical hallmarks of heart failure, including left ventricular dysfunction, cardiomyopathy, and pulmonary edema can be explained by the known biological effects of TNF alpha in humans. The present review will summarize recent evidence with regard to the biological role for TNF alpha in the adult mammalian heart, as well as summarize the increasing body of clinical information that implicates this cytokine in the pathophysiology of heart failure.

Picosecond absorption spectroscopy is used to examine electron transfer and radical ion pair diffusional separation for the contact radical ion pair and solvent-separated radical ion pair for trans-stilbene/fumaronitrile, trans-4-chlorostilbene/fumaronitrile, trans-stilbene/dimethyl fumarate, and trans-4-chlorostilbene/dimethylfurmarate in acetonitrile. The decay of the solvent-separated radical ion pair proceeds by long-range electron transfer to form ground-state reactants and diffusional separation to form free radical ions. The rate of radical ion pair diffusional separation for the contact radical ion pair is independent of the structure of the diffusing species. However, the rate for ion pair diffusion for the solvent-separated radical ion pair is dependent upon the structure of the diffusing species

Picosecond absorption spectroscopy is used to examine the temperature depend quenching of the first excited singlet state of trans-stilbene (TS * ) by tetramethylethylene (TME) in hexane. The rate of quenching TS * by TME is 3.6×10 9 M -1 s -1 and it is virtually independent of temperature over the temperature range of -8.0 to 36.8 o C. There is no kinetic evidence for reversible exciplex formation

ObjectiveTo determine the usefulness of cervical vestibular-evoked auditory potential (cVEMP) testing for the evaluation of patients with and without a third mobile window (superior canal dehiscence or large vestibular aqueduct).MethodsA retrospective review of charts from patients who underwent cVEMP testing at a single tertiary referral center was performed. The cVEMP is a vestibular reflex generated by an air-conducted stimuli, causing an inhibitory potential in the ipsilateral sternocleidomastoid muscle measured by external electrodes. cVEMP results were correlated with demographic characteristics, hearing testing, diagnosis, and imaging. Mean cVEMP thresholds (at 500 Hz) and amplitudes (@ 95dB nHL and 500 Hz) were compared between ears and between patients with and without a third mobile window (TMW). Unequal variance t-Test was used to determine significance. Patients were excluded if they had a history of Meniere's disease, middle ear disease or otologic surgery.Results63 patients received cVEMP te...