Head and Neck Manifestations of Eosinophilic Granulomatosis with Polyangiitis: A Systematic Review.

OBJECTIVE: To conduct the first and only systematic review of the existing literature on head and neck manifestations of eosinophilic granulomatosis with polyangiitis to guide clinical decision making for the otolaryngologist. DATA SOURCES: PubMed, Cochrane Library, Scopus, and LILACS. REVIEW METHODS: A systematic review of the aforementioned sources was conducted per the PRISMA guidelines. RESULTS: From an initial 574 studies, 28 trials and reports were included, accounting for a total of 1175 patients with eosinophilic granulomatosis with polyangiitis. Among clinical and cohort studies, 48.0% to 96.0% of all included patients presented with head and neck manifestations. In a distinct group of patients detailed in case reports describing patients presenting with head and neck manifestations, patients on average fulfilled 4.6 diagnostic criteria per the American College of Rheumatology. Furthermore, 95.8% of reported cases were responsive to steroids, and 60% required additional therapy. CONCLUSION: Otolaryngologists are in a unique position for the early diagnosis and prevention of late complications of eosinophilic granulomatosis with polyangiitis. The American College of Rheumatology criteria should be relied on in the diagnostic workup. Close surveillance of these patients in a multidisciplinary fashion and with baseline complete blood counts, chest radiographs, and autoimmune laboratory tests is often necessary. Such patients with head and neck manifestations of the disease are nearly always responsive to steroids and often require additional immunosuppressive therapy or surgical intervention in cases of cranial neuropathies, temporal bone involvement, and refractory symptoms

Biphenotypic Sinonasal Sarcoma-Case Report and Review of Clinicopathological Features and Diagnostic Modalities.

Background Biphenotypic sinonasal sarcoma is a recently described malignancy showing dual differentiation with both myogenic and neural elements. Due to its histologic similarities to other sinonasal malignancies, it is a diagnostic challenge. Objective The main purpose of this article is to report a case of biphenotypic sinonasal sarcoma and to consolidate data and provide a comprehensive review regarding pathological differences between biphenotypic sarcoma and other sinonasal malignancies and diagnostic modalities used for biphenotypic sarcoma. Material and Methods A systematic review of all cases of biphenotypic sinonasal sarcoma was performed using electronic databases (PubMed and Medline). Data collected included age, gender, symptoms, sub-site of origin, immunophenotyping, metastasis, recurrence, treatment, duration of follow-up, and survival outcomes. Results Ninety-five cases of biphenotypic sarcoma were found with mean age at diagnosis of 52.36 years (range, 24-87 years). Female to male ratio was 2.27:1. Extra-sinonasal extension was present in 28%. Immunophenotyping revealed that S-100 and SMA (smooth muscle actin) were consistently positive, while SOX-10 was consistently negative. PAX3-MAML3 fusion [t (2; 4) (q35; q31.1)] was the most common genetic rearrangement. Surgical excision with or without adjuvant radiotherapy was the most frequent treatment modality used. Recurrence was observed in 32% of cases with follow-up. None of the cases reported metastasis. Three patients had died at the time of publication that included one case with intracranial extension. Conclusion Biphenotypic sarcoma is distinct sinonasal malignancy with unique clinicopathological features. Testing involving a battery of myogenic and neural immunomarkers is essential for diagnostic confirmation and is a clinically useful endeavor when clinical suspicion is high. © 2019 Georg Thieme Verlag KG Stuttgart. New York

Direct measurement of the size of 2003 UB313 from the Hubble Space Telescope

We have used the Hubble Space Telescope to directly measure the angular size of the large Kuiper belt object 2003 UB313. By carefully calibrating the point spread function of a nearby field star, we measure the size of 2003 UB313 to be 34.3$\pm$1.4 milliarcseconds, corresponding to a diameter of 2400$\pm$100 km or a size $\sim5$% larger than Pluto. The V band geometric albedo of 2003 UB313 is $86\pm7$%. The extremely high albedo is consistent with the frosty methane spectrum, the lack of red coloring, and the lack of observed photometric variation on the surface of 2003 UB313. Methane photolysis should quickly darken the surface of 2003 UB313, but continuous evaporation and redeposition of surface ices appears capable of maintaining the extreme alebdo of this body

System using leo satellites for centimeter-level navigation

Disclosed herein is a system for rapidly resolving position with centimeter-level accuracy for a mobile or stationary receiver [4]. This is achieved by estimating a set of parameters that are related to the integer cycle ambiguities which arise in tracking the carrier phase of satellite downlinks [5,6]. In the preferred embodiment, the technique involves a navigation receiver [4] simultaneously tracking transmissions [6] from Low Earth Orbit Satellites (LEOS) [2] together with transmissions [5] from GPS navigation satellites [1]. The rapid change in the line-of-sight vectors from the receiver [4] to the LEO signal sources [2], due to the orbital motion of the LEOS, enables the resolution with integrity of the integer cycle ambiguities of the GPS signals [5] as well as parameters related to the integer cycle ambiguity on the LEOS signals [6]. These parameters, once identified, enable real-time centimeter-level positioning of the receiver [4]. In order to achieve high-precision position estimates without the use of specialized electronics such as atomic clocks, the technique accounts for instabilities in the crystal oscillators driving the satellite transmitters, as well as those in the reference [3] and user [4] receivers. In addition, the algorithm accommodates as well as to LEOS that receive signals from ground-based transmitters, then re-transmit frequency-converted signals to the ground

Scheme and Scale Dependence of Charm Production in Neutrino Scattering

We discuss some theoretical uncertainties in the calculation of the cross section for charm production in charged current deep inelastic neutrino scattering related to ambiguities in the treatment of terms which are singular in the limit of a vanishing charm mass. In particular we compare the so-called variable flavour scheme where these terms are absorbed in the parton distribution functions containing the charm as an active flavour, with the so-called fixed flavour scheme with no charm mass subtraction where the charm appears only in the final state of fixed-order scattering matrix elements. Using available parametrizations of parton distribution functions we find that the two schemes lead to largely differing results for separate structure functions whereas the differences cancel to a large extent in the total cross section in that kinematical region which has been measured so far.Comment: 20pages, uuencoded postscript, figures include