Imaging of non-operated cholesteatoma: Clinical practice guidelines

SummaryMiddle ear cholesteatoma is an aggressive form of chronic otitis media requiring surgical therapy. The surgical strategy depends on the location of the lesion, its extensions to the middle ear and mastoid, the anatomical conformation of the tympanomastoid cavities and the health status of the patient (as well as his or her interest in aquatic leisure activities). For several years, imaging of the ear has been a routine test in the preoperative work-up of the disease. National guidelines for the topic “Imaging of non-operated middle ear cholesteatoma” were prepared in October 2010, for the annual congress of the French Society of Otolaryngology Head and Neck Surgery (SFORL), by a panel of experts from the SFORL, represented by the French Association of Otology and Neuro-otology (AFON), and the French Radiological Society (SFR), represented by the French Society of Head and Neck Imaging (CIREOL). These guidelines are presented in the present article

A quantitative test of Jones NTC beaming theory using CLUSTER constellation

Non-thermal continuum (NTC) radiation is, with auroral kilometric radiation (AKR), one of the two electromagnetic emissions generated within the Earth's magnetosphere and radiated into space. The location of the source of NTC has been sought for several decades, with only limited success. The constellation formed by the four CLUSTER spacecraft provides the possibility of triangulation in the vicinity of the source, thus allowing progress in source localisation, while simultaneously revealing the beaming properties of NTC radio sources. <br><br> We present a case event showing two beams localised on opposite sides of the magnetic equator. At any selected frequency, triangulation points to a single region source of small size. Its position is compatible with the range of possible loci of sources predicted by the radio window theory of Jones (1982) in a frame of constraints relaxed from the simple sketch proposed in early works. The analysis of similar observations from the Dynamics Explorer 1 by Jones et al. (1987) enabled the authors to claim validation of the radio window theory. CLUSTER observations, however, reveal a large beaming cone angle projected onto the ecliptic plane, a feature unobservable by Dynamics Explorer which had a different spin axis orientation. According to the radio window theory, such a large observed cone angle can only be formed by a series of point sources, each beaming in a narrow cone angle. This study demonstrates the difficulty of validating NTC linear generation mechanisms using global beaming properties alone

Complicanze infettive locali precoci e tardive nella chirurgia otologica

La via retroauricolare rappresenta l’approccio di scelta nel trattamento dell’otite media cronica. Nelle procedure “sporche” l’incidenza della complicanza infettiva locale è del 10%. Il presente studio analizza le infezioni del sito chirurgico dopo la chirurgia dell’otite media cronica e ne investiga i potenziali fattori predittivi. Il presente studio, dal design osservazionale prospettico, ha incluso pazienti affetti da otite media cronica e candidati alla chirurgia mediante approccio retroauricolare. Sono state definite precoci le complicanze postoperatorie insorte entro i 30 giorni e tardive quelle insorte oltre i 30 giorni. Sono stati analizzati i dati di 102 pazienti. Sono stati registrati 4 casi (3,9%) di infezione precoce, per la quale è stata evidenziata un’associazione significativa con l’antibioticoterapia preoperatoria, l’orecchio in fase secernente all’esame otoscopico preoperatorio, una classe III (contaminato) nella classificazione delle ferite chirurgiche, indice NNIS (National Nosocomial Infection Surveillance) >1 e assunzione di antibiotici per OS nel postoperatorio. Sono state inoltre registrate 7 complicanze tardive (7,1%), occorse fra i 90 e i 160 giorni dall’intervento, significativamente correlate alla presenza di otorrea nei sei mesi precedenti la chirurgia, una durata del tempo chirurgico inferiore o uguale a 60 minuti, una tecnica aperta e all’uso della colla di fibrina. L’infezione del sito chirurgico sembra essere associata ai fattori correlati allo stato infiammatorio dell’orecchio medio al momento della chirurgia nelle infezioni precoci e all’infiammazione cronica nelle infezioni tardive

The Evolution of Respiratory Chain Complex I from a Smaller Last Common Ancestor Consisting of 11 Protein Subunits

The NADH:quinone oxidoreductase (complex I) has evolved from a combination of smaller functional building blocks. Chloroplasts and cyanobacteria contain a complex I-like enzyme having only 11 subunits. This enzyme lacks the N-module which harbors the NADH binding site and the flavin and iron–sulfur cluster prosthetic groups. A complex I-homologous enzyme found in some archaea contains an F420 dehydrogenase subunit denoted as FpoF rather than the N-module. In the present study, all currently available whole genome sequences were used to survey the occurrence of the different types of complex I in the different kingdoms of life. Notably, the 11-subunit version of complex I was found to be widely distributed, both in the archaeal and in the eubacterial kingdoms, whereas the 14-subunit classical complex I was found only in certain eubacterial phyla. The FpoF-containing complex I was present in Euryarchaeota but not in Crenarchaeota, which contained the 11-subunit complex I. The 11-subunit enzymes showed a primary sequence variability as great or greater than the full-size 14-subunit complex I, but differed distinctly from the membrane-bound hydrogenases. We conclude that this type of compact 11-subunit complex I is ancestral to all present-day complex I enzymes. No designated partner protein, acting as an electron delivery device, could be found for the compact version of complex I. We propose that the primordial complex I, and many of the present-day 11-subunit versions of it, operate without a designated partner protein but are capable of interaction with several different electron donor or acceptor proteins