Microendoscopic Surgery of Middle Ear and Petrous Bone: Benefits Analysis

Objectives: Endoscopy has become routinely used in middle ear surgery. The aim of this study is to analyze where this tool may complement the traditional microscopic approach. This is a retrospective study done in single tertiary hospital. Methods: We reviewed 342 middle ear/petrous bone surgical procedures performed between 2005 and 2015. Only cases in which both microscopic and endoscope-assisted techniques were used have been included. Sixty-six patients received this double-technique surgery: 51 (77.2%) had middle ear/mastoid and petrous bone cholesteatomas (46 middle ear and mastoid and 5 acquired/congenital petrous bone cholesteatomas), 5 (7.5%) had glomus tympanicum tumors (GTT), 4 (6%) had an ossicular chain dislocation, 3 (4.5%) had purulent chronic otitis media, 2 (3%) had tympanosclerosis, and 1 (1.5%) had an ossicular chain malformation. Results: The endoscope was helpful to remove disease remnants not accessible by microscope in 41 (62%) of the cases; 37 (90%) were cholesteatomas, 3 (7%) were GTT, and only 1 (3%) was an open tympanosclerosis. In the remaining 25 (37.8%) cases, the endoscope was useful only to visualize the cavity since the microscope had already been successful in removing the entire lesion. Conclusions: The endoscopy can add valuable information and support to the usual microscope approach alone. The consensus of a single best technique does not yet exist, but the physician should choose the best modality or combination of modalities in order to cure the patient and prevent any possible complications or recurrence of the pathology

NKp46-expressing human gut-resident intraepithelial V\u3b41 T cell subpopulation exhibits high anti-tumor activity against colorectal cancer

\u3b3\u3b4 T cells account for a large fraction of human intestinal intraepithelial lymphocytes (IELs) endowed with potent anti-tumor activities. However, little is known about their origin, phenotype and clinical relevance in colorectal cancer (CRC). To determine \u3b3\u3b4 IEL gut-specificity, homing and functions, \u3b3\u3b4 T cells were purified from human healthy blood, lymph nodes, liver, skin, intestine either disease-free or affected by CRC or generated from thymic precursors. The constitutive expression of NKp46 specifically identifies a new subset of cytotoxic V\u3b41 T cells representing the largest fraction of gut-resident IELs. The ontogeny and gut-tropism of NKp46pos/V\u3b41 IELs depends both on distinctive features of V\u3b41 thymic precursors and gut-environmental factors. Either the constitutive presence of NKp46 on tissue-resident V\u3b41 intestinal IELs or its induced-expression on IL-2/IL-15 activated V\u3b41 thymocytes are associated with anti-tumor functions. Higher frequencies of NKp46pos/V\u3b41 IELs in tumor-free specimens from CRC patients correlate with a lower risk of developing metastatic III/IV disease stages. Additionally, our in vitro settings reproducing CRC tumor-microenvironment inhibited the expansion of NKp46pos/V\u3b41 cells from activated thymic precursors. These results parallel the very low frequencies of NKp46pos/V\u3b41 IELs able to infiltrate CRC, thus providing new insights to either follow-up cancer progression or develop novel adoptive cellular therapies

Analysis of end-to-end multi-domain management and orchestration frameworks for software defined infrastructures: an architectural survey

Over the last couple of years, industry operators' associations issued requirements towards an end-to-end management and orchestration plane for 5G networks. Consequently, standard organisations started their activities in this domain. This article provides an analysis and an architectural survey of these initiatives and of the main requirements, proposes descriptions for the key concepts of domain, resource and service slicing, end-to-end orchestration and a reference architecture for the end-to-end orchestration plane. Then, a set of currently available or under development domain orchestration frameworks are mapped to this reference architecture. These frameworks, meant to provide coordination and automated management of cloud and networking resources, network functions and services, fulfil multi-domain (i.e. multi-technology and multi-operator) orchestration requirements, thus enabling the realisation of an end-to-end orchestration plane. Finally, based on the analysis of existing single-domain and multi-domain orchestration components and requirements, this paper presents a functional architecture for the end-to-end management and orchestration plane, paving the way to its full realisation.This work was partially supported by the ICT14 5GExchange (5GEx) innovation project (grant agreement no.671636) co-funded by the European Union under the Horizon 2020 EU Framework Programme.Publicad

Small liver lesions in oncologic patients: characterization with CT, MRI and contrast-enhanced US

Focal liver lesions (FLLs) are frequently discovered during ultrasound examinations either in healthy subjects without a clinical history of cancer or during staging or follow-up procedures in oncologic patients or in routine surveillance of hepatopathic patients. In oncologic patients, the liver is the most common target of metastatic disease and accurate detection and characterisation of FLLs is prognostically fundamental during the initial staging as well as before and after pre-operative chemotherapy, as it can help to identify patients who are most likely to benefit from liver surgery. Moreover, early detection of primary or secondary liver malignancies increases the possibility of curative surgical resection or successful percutaneous ablation. As many FLLs in these patients are benign, a precise and preferably non-invasive method of differentiation from malignant metastatic nodules is needed. Moreover, the continuous follow-up of cancer patients requires an easily available, reliable and cost-effective diagnostic tool for the detection and characterization of FLLs

Treatment of endolymphatic sac tumour (Papillary adenocarcinoma) of the temporal bone

AimTo define a better treatment of sporadic endolymphatic sac tumours (ELST) analysing our experience and literature available data.BackgroundELST can arise as sporadic case (rare) or as a part of von Hippel–Lindau (VHL) disease. It is a low grade malignancy with local spread by continuity.Materials and methodswe described our experience with 7 cases with up to date follow up.ResultsFive cases were free of disease after first surgical procedure. One case had recurrence in the temporal lobe after 12 years. One case had two surgical procedures followed by irradiation and died five years after radiotherapy with a slow disease progression.ConclusionWith increasing expertise in the skull base surgery, complete tumour excisions are achieved in majority of the more recent cases and appear to be the treatment of choice. External irradiation is also used as palliative measures with doubtful effectiveness. Some recent reports showed encouraging results with gamma knife radiosurgery

Erythema annulare centrifugum: report of a case with neonatal onset

Darier’s erythema annulare centrifugum (EAC) is often associated with infectious, autoimmune or neoplastic disease, nevertheless, most cases of EAC remain unexplained. We report a case of EAC with neonatal onset and a clinical course of over 20 years. The patient presented from the 6th day of life with erythematous papules that enlarged centrifugally to form figurate, annular or policyclic plaques involving the entire cutaneous surface. The clinical picture had a chronic course, disappearing only during unrelated febrile episodes. Histologic examination revealed a normal epidermis and a dense perivascular lymphohistiocytic infiltrate and numerous eosinophils in the superficial and reticular dermis. Today the patient is 24 years old and his lesions are still unchanged. Recently, clinical evaluation revealed a diffuse sclerodermic induration. A second biopsy showed a diffuse thickening of collagen fibers in the dermis. To our knowledge, this is the second report of EAC with neonatal onset and such a long and peculiar clinical course

Magnetic Li-M (M = Ni, Ni0.8Cu0.2, Cr) layered oxides nanoparticles for Li-ion batteries electrodes

Nanoparticles of Li-Ni, Li-(Ni,Cu) and Li-Cr layered oxides, with potential applications as cathode materials in lithium batteries, have been prepared by solid-state reaction and sol-gel method. The combination of structural analysis and magnetic characterization allowed the clear identification of the phases present in the synthesized nanoparticles. The main component of Li-Ni oxide nanoparticles is the electrochemically active and ferrimagnetic phase Li1-zNi1+zO2, whereas those of Li-Cr oxide are the antiferromagnetic phases LiCrO2 and Cr2O3. A small substitution of Cu for Ni in Li-Ni oxide determines the formation of nanoparticles in which the main phase is the antiferromagnetic phase Li1-zNi1+zO2. Operation tests in lithium batteries and post-mortem analysis, aimed at assessing the potential of metal oxide nanoparticles as cathode materials, were performed on all samples

High-temperature magnetic coercivity of CNTs filled with multi-phase Fe-based nanoparticles

A system of Fe-filled multiwall carbon nanotubes (MWCNT) was grown by aerosol chemical vapor deposition with three different concentrations of ferrocene as precursor catalyst. The obtained samples were thoroughly analyzed from the point of view of their morphological, microstructural and magnetic properties. It was found that ferrocene concentration did not change the MWCNTs morphology. However, it increases the number of MWCNTs containing Fe and the Fe amount in each MWCNT. The Fe is located either in form of nanorods within the inner channel of the MWCNTs or as nanoparticles of various sizes, sometimes aggregated in clusters. The magnetic results indicate the presence of different phases, identified as α-Fe, Fe3C and Fe3O4, mostly in form of single-domain particles. A simple model of single domain non-interacting particles allows explaining the observed temperature behavior of coercivity and remanence over a wide temperature range, up to 950 K. The different ferrocene concentrations affect only the saturation magnetization but not the coercivity of the samples. As a further result, MWCNT/epoxy nanocomposites, with possible application as electromagnetic shields, were prepared by the “two factor mechanical method”. The nanocomposites exhibit the same magnetic properties of the Fe-filled MWCNTs, in terms of both coercivity and hysteresis loop shape