The current standard treatment of chronic otitic media with cholecteatoma

BACKGROUND: Currently there are two main techniques for cholesteatoma surgery: the closed technique (wall up) and the open technique (wall down). The canal wall down mastoidectomy in cholesteatoma can secure a good operation field and easy removal of the lesion. However, there are some problems: the lifelong care of the cavity, dizziness due to the exposed semicircular canal, difficulty with the fitting of a hearing aid as well as poor cosmetics. The canal wall up technique has a better hygienic status and better functional outcome. This technique is associated with a higher rate of residual disease and a higher rate of recurrent disease. To prevent both residual and recurrent cholesteatoma, we performed canal wall down technique with the obliteration of paratympanic spaces for patients with acquired cholesteatoma.MATERIAL AND METHODS: This paper studies the long-term outcomes of surgical treatment of chronic suppurative otitis media with cholesteatoma to prevent residual disease and its relapses. The results of the postoperative observation of 189 patients during the period from 2009 till 2014 are presented. All patients underwent sanation surgery with the obliteration of paratympanic spaces followed by the restoration of the posterior wall of the external auditory meatus and simultaneous tympanoplasty (closed-type surgery). The patients were examined one year after the treatment with the use of the MRI technology using the non-EPI DWI regime to monitor the residual and recurrence cholesteatoma.RESULTS: We analyzed the postoperative results from 189 patients. The follow-up observation revealed 11cases of residual cholesteatoma. Recurrent cholesteatoma was not observed during the follow-up periods.CONCLUSION: Long-term follow up indicated that the canal wall down technique with bony obliteration is a safe method with which to treat primary cases and to reconstruct unstable cavities. The MRI technology in the non-EPI DWI regime was successful in differentiating soft tissues and enabling the detection of residual or recurrent cholesteatoma after a canal wall down bony obliteration technique procedure

Surgical management of chronic rhinosinusitis. Analytical review

The modern opinion of chronic rhinosinusitis (CRS) treatment is described in this article from the viewpoint of evidential medicine. There is a review of researches concerning CRS medical therapy and evidence for surgery management is given. Functional endoscopic sinus surgery (FESS) is widely used today in CRS treatment but the more recent researches have shown that FESS does not ensure absolute recovery. A comprehensive treatment paradigm should entail medical therapy to control inflammation and infection and targeted surgery when indicated in medically recalcitrant cases. Surgery does not represent a cure to CRS but rather a key intervention in the overall management paradigm of CRS

Probability of Incipient Spanning Clusters in Critical Square Bond Percolation

The probability of simultaneous occurence of at least k spanning clusters has been studied by Monte Carlo simulations on the 2D square lattice at the bond percolation threshold $p_c=1/2$. It is found that the probability of k and more Incipient Spanning Clusters (ISC) has the values $P(k>1) \approx 0.00658(3)$ and $P(k>2) \approx 0.00000148(21)$ provided that the limit of these probabilities for infinite lattices exists. The probability $P(k>3)$ of more than three ISC could be estimated to be of the order of 10^{-11} and is beyond the possibility to compute a such value by nowdays computers. So, it is impossible to check in simulations the Aizenman law for the probabilities when $k>>1$. We have detected a single sample with 4 ISC in a total number of about 10^{10} samples investigated. The probability of single event is 1/10 for that number of samples.Comment: 7 pages, 1 table, 5 figures (1PS+4*Latex),uses epsf.sty Int.J.Mod.Phys. C (submitted to

Can CPAP be an option for treating tinnitus patients with obstructive sleep apnea syndrome? Review

Tinnitus is the perception of phantom sound in the absence of an external source. Its influence on quality of life varies from minimal to severe. Tinnitus has considerable heterogeneity, thus no single mechanism explains it. There is neither effective drug treatment for the vast majority of patients nor standard rehabilitation management. Keeping that in mind, any reliable option for treatment, even for a minor group, is worth investigating.The possible relationship between obstructive sleep apnea syndrome and tinnitus, and the effect of continuous positive airway pressure on organ of hearing are discussed.We have reviewed scientific literature using Medline, PubMed, Google, and conducted a manual search of reference lists of any incorporated paper. The key terms used were: “tinnitus”, “obstructive sleep apnea syndrome,” and “CPAP”.The following investigation can clarify the tinnitus prevalence in patients suffering from OSAS, specify whether tinnitus is the result of OSAS or its comorbid condition or just a coincidence, and assess the efficacy and indications of this approach to tinnitus treatment

The CMS dataset bookkeeping service

The CMS Dataset Bookkeeping Service (DBS) has been developed to catalog all CMS event data from Monte Carlo and Detector sources. It provides the ability to identify MC or trigger source, track data provenance, construct datasets for analysis, and discover interesting data. CMS requires processing and analysis activities at various service levels and the DBS system provides support for localized processing or private analysis, as well as global access for CMS users at large. Catalog entries can be moved among the various service levels with a simple set of migration tools, thus forming a loose federation of databases. DBS is available to CMS users via a Python API, Command Line, and a Discovery web page interfaces. The system is built as a multi-tier web application with Java servlets running under Tomcat, with connections via JDBC to Oracle or MySQL database backends. Clients connect to the service through HTTP or HTTPS with authentication provided by GRID certificates and authorization through VOMS. DBS is an integral part of the overall CMS Data Management and Workflow Management systems

Features of the Chemical Composition and Structure of Birch Phloem Dioxane Lignin: A Comprehensive Study

Understanding the chemical structure of lignin in the plant phloem contributes to the systematics of lignins of various biological origins, as well as the development of plant biomass valorization. In this study, the structure of the lignin from birch phloem has been characterized using the combination of three analytical techniques, including 2D NMR, Py-GC/MS, and APPI-Orbitrap-HRMS. Due to the specifics of the phloem chemical composition, two lignin preparations were analyzed: a sample obtained as dioxane lignin (DL) by the Pepper’s method and DL obtained after preliminary alkaline hydrolysis of the phloem. The obtained results demonstrated that birch phloem lignin possesses a guaiacyl–syringyl (G-S) nature with a unit ratio of (S/G) 0.7–0.9 and a higher degree of condensation compared to xylem lignin. It was indicated that its macromolecules are constructed from β-aryl ethers followed by phenylcoumaran and resinol structures as well as terminal groups in the form of cinnamic aldehyde and dihydroconiferyl alcohol. The presence of fatty acids and flavonoids removed during alkaline treatment was established. Tandem mass spectrometry made it possible to demonstrate that the polyphenolic components are impurities and are not incorporated into the structure of lignin macromolecules. An important component of phloem lignin is lignin–carbohydrate complexes incorporating xylopyranose moieties

Rapid Simultaneous Quantification of 1-Formyl-2,2-Dimethylhydrazine and Dimethylurea Isomers in Environmental Samples by Supercritical Fluid Chromatography–Tandem Mass Spectrometry

When released to the environment, the rocket fuel unsymmetrical dimethylhydrazine (UDMH) undergoes oxidative transformations, resulting in the formation of an extremely large number of nitrogen-containing transformation products, including isomeric compounds which are difficult to discriminate by common chromatography techniques. In the present work, supercritical fluid chromatography–tandem mass spectrometry (SFC-MS/MS) was proposed for resolving the problem of fast separation and simultaneous quantification of 1-formyl-2,2-dimethylhydrazine (FADMH) as one of the major UDMH transformation products, and its isomers—1,1-dimethylurea (UDMU) and 1,2-dimethylurea (SDMU). 2-Ethylpyridine stationary phase provided baseline separation of analytes in 1.5 min without the distortion of the chromatographic peaks. Optimization of SFC separation and MS/MS detection conditions allowed for the development of rapid, sensitive, and “green” method for the simultaneous determination of FADMH, UDMU, and SDMU in environmental samples with LOQs of 1–10 µg L−1 and linear range covering three orders of magnitude. The method was validated and successfully tested on the real extracts of peaty and sandy soils polluted with rocket fuel and UDMH oxidation products. It was shown that both UDMU and SDMU are formed in noticeable amounts during UDMH oxidation. Despite relatively low toxicity, UDMU can be considered one of the major UDMH transformation products and a potential marker of soil pollution with toxic rocket fuel