Usefulness of image guidance in the surgical treatment of petrous apex cholesterol granuloma

The petrous apex is a pyramid-shaped structure, located medial to the inner ear and the intrapetrous segment of the internal carotid artery. Lesions of the petrous apex can be surgically treated through different surgical routes. Because of the important neurovascular structures located inside the temporal bone, anatomical 3D knowledge is paramount. For this reason, image-guided surgery could represent a useful tool. We report the case of a young woman who came to our observation for a trigeminal neuralgia due to a petrous apex cholesterol granuloma. The lesion was treated through the placement of a drainage tube via an infracochlear approach, with the aid of neuronavigation and intraoperative MRI. Preoperative CT scan images and intraoperative MRI images were fused for surgical planning. The accuracy of the neuronavigation system has proved to be good, and the safety of the procedure was enhanced. Therefore, neuronavigation and intraoperative MRI, though not available in all neurootological centres, should be considered useful tools in these challenging procedures

Examining the assumption of homogeneous horizontal layers within seismic site response analysis

One-dimensional analyses can be conducted to estimate the impact of superficial soil layers on earthquake ground motions. Such analyses are based on the assumption that all boundaries are horizontal and that the response of a soil deposit is predominantly caused by horizontal shear waves propagating vertically from the underlying bedrock. This assumption is made even for sites with a relative large surface area, e.g. the footprint of large infrastructure such as power plants. An important step then is to create a model of the near subsurface that is representative of the overall area under analysis. This means it is essential to evaluate geomechanical characteristics of the soil at certain locations and extend these measurements over the whole site. As a consequence of this, it is assumed that the soil characteristics, which include stratigraphy, geometry and geotechnical properties, are homogeneous. Recent observations, however, have clearly demonstrated that even over a small area (~1km2) ground conditions can vary greatly. The purpose of this study is to examine the impact of relaxing the assumption of infinite horizontal layers by undertaking a parametric study of the variability in amplification across areas with gently dipping subsurface layers. Starting from a 1D approach the influence of dipping layers is evaluated through simplified but geometrically representative models. Randomization of shear-wave velocity profiles using the Toro (1995) method, as implemented in STRATA, is used to compute the variability in site amplification that would be captured by a standard 1D technique. This provides a baseline for comparison with the variability introduced by the dipping layers. Subsequently, two-dimensional simulations are conducted for the same sites with dipping layers to estimate the error made through the assumption of 1D response. The goal of this study is to understand when the 1D assumption can be used in the presence of dipping layers

Intralabyrinthine Vestibular Schwannoma Responsive to Intratympanic Gentamicin Treatment

Intralabyrinthine schwannoma (ILS) is a rare benign tumor that affects the ends of cochlear and vestibular nerves. In a majority of the cases, it occurs with unilateral progressive sensorineural hearing loss. Less frequent symptoms include tinnitus, imbalance, vertigo, or fullness. The advent of magnetic resonance imaging allows early diagnosis and enables an appropriate therapeutic protocol. This report describes a case of intravestibular schwannoma, with fluctuating hearing loss and intractable vertigo, treated with intratympanic gentamicin. The patient was a 28-year-old woman with intractable vertigo and fluctuating left-side hearing loss caused by left intravestibular schwannoma. Because surgery was temporarily rejected by the patient, a single dose of intratympanic gentamicin was administered. Following this, the patient showed a significant improvement in the symptoms. However, moderate to flat sensorineural hearing loss was also observed. Intratympanic gentamicin infiltration is a valid therapeutic option for patients with ILS, affected by intractable vertigo, when the patient refuses surgery

Simultaneous Contralateral Vestibular Schwannoma and Middle Ear Paraganglioma Tumor

To the best of our knowledge, only 2 cases of a simultaneous contralateral vestibular schwannoma (VS) and middle ear paraganglioma (MEP) have previously been reported in literature. We report the third case observed in a 43-year-old male, who presented with an 11-year history of right-sided hearing loss and a 1-year history of left-sided pulsatile tinnitus. A magnetic resonance imaging (MRI) showed a VS on the right side and computer tomography (CT) identified a Fisch type A1 paraganglioma on the left side. The VS was treated using a translabyrinthine approach and the MEP was kept under radiological observation for 1 year. Due to the growth of the MEP (Fisch type A2), it was treated with excision via a retroauricular approach. Our case was very challenging because there was a different and important pathology on each side, both carrying a risk of deafness as a consequence of the disease and/or the treatments

Inner Ear Active Hearing Device in Non-Otosclerotic, Severe, Mixed Hearing Loss

OBJECTIVE: To verify the efficacy of a powerful active hearing device in a patient different from far-advanced otosclerosis, specifically when the stapes footplate is mobile. PATIENT: A patient with severe-to-profound mixed hearing loss, who was not benefiting from the use of a conventional hearing aid, was selected for an inner ear active implant. This was justified by a bone conductive threshold above 60 dB, which had discouraged any other rehabilitative solutions such as a bone conductive implant, or an active middle ear implant (AMEI). INTERVENTION: The hearing device was surgically applied using a combined transmastoid/transcanal approach. During surgery, a mobile stapes were found and was perforated for the insertion of a piston prosthesis, crimped on the new-incus of the device. MAIN OUTCOME MEASURE: The bone conduction threshold was assessed postoperatively to identify any possible surgery-related hearing deterioration. Pure tone audiometry was conducted in a sound field, and a speech reception threshold test was performed with the contralateral ear masked. The hearing outcome was assessed soon after the implant activation (6 weeks after surgery), and 6 months after surgery. RESULTS: Upon activation of the device, a PTA of 45 dB was obtained (at 0.5, 1, 2 and 4 kHz). At 6 months after surgery, the speech discrimination score reached 90% at 80 dB SPL. CONCLUSION: The application of the Codacs device has shown to be compatible with a mobile stapes footplate, as demonstrated in this report. The footplate perforation did not cause any further hearing deterioration, and has allowed to achieve a favorable auditory outcome

Explicaciones que el empresario del Gran Teatro del Liceo de Barcelona, D. Alfredo Volpini, debe al público en general y a los abonados en particular, con motivo de la no reanudación de las funciones de la presente temporada de invierno

Amb una nota manuscrita al finalDonació de Lluís Boni

Helminth Infections: Recognition and Modulation of the Immune Response by Innate Immune Cells

The survival of helminths in the host over long periods of time is the result of a process of adaptation or dynamic co-evolution between the host and the parasite. However, infection with helminth parasites causes damage to the host tissues producing the release of danger signals that induce the recruitment of various cells, including innate immune cells such as macrophages (Mo), dendritic cells (DCs), eosinophils, basophils, and mast cells. In this scenario, these cells are able to secrete soluble factors, which orchestrate immune effector mechanisms that depend on the different niches these parasites inhabit. Here, we focus on recent advances in the knowledge of excretory-secretory products (ESP), resulting from helminth recognition by DCs and Mo. Phagocytes and other cells types such as innate lymphocyte T cells 2 (ILC2), when activated by ESP, participate in an intricate cytokine network to generate innate and adaptive Th2 responses. In this review, we also discuss the mechanisms of innate immune cell-induced parasite killing and the tissue repair necessary to assure helminth survival over long periods of time.Fil: Motran, Claudia Cristina. Universidad Nacional de Córdoba. Facultad de Ciencias Químicas. Departamento de Bioquímica Clínica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Córdoba. Centro de Investigaciones en Bioquímica Clínica e Inmunología; ArgentinaFil: Silvane, Leonardo Micael. Universidad Nacional de Córdoba. Facultad de Ciencias Químicas. Departamento de Bioquímica Clínica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Córdoba. Centro de Investigaciones en Bioquímica Clínica e Inmunología; ArgentinaFil: Chiapello, Laura Silvina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Córdoba. Centro de Investigaciones en Bioquímica Clínica e Inmunología; Argentina. Universidad Nacional de Córdoba. Facultad de Ciencias Químicas. Departamento de Bioquímica Clínica; ArgentinaFil: Theumer, Martín Gustavo. Universidad Nacional de Córdoba. Facultad de Ciencias Químicas. Departamento de Bioquímica Clínica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Córdoba. Centro de Investigaciones en Bioquímica Clínica e Inmunología; ArgentinaFil: Ambrosio, Laura Fernanda. Universidad Nacional de Córdoba. Facultad de Ciencias Químicas. Departamento de Bioquímica Clínica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Córdoba. Centro de Investigaciones en Bioquímica Clínica e Inmunología; ArgentinaFil: Volpini, Ximena. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Córdoba. Centro de Investigaciones en Bioquímica Clínica e Inmunología; Argentina. Universidad Nacional de Córdoba. Facultad de Ciencias Químicas. Departamento de Bioquímica Clínica; ArgentinaFil: Celias, Daiana Pamela. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Córdoba. Centro de Investigaciones en Bioquímica Clínica e Inmunología; Argentina. Universidad Nacional de Córdoba. Facultad de Ciencias Químicas. Departamento de Bioquímica Clínica; ArgentinaFil: Cervi, Laura Alejandra. Universidad Nacional de Córdoba. Facultad de Ciencias Químicas. Departamento de Bioquímica Clínica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Córdoba. Centro de Investigaciones en Bioquímica Clínica e Inmunología; Argentin

Cone beam computed tomography after round window vibroplasty. do the radiological findings match the auditory outcome?

Conclusion: The CBCT imaging technique has proved to be reliable for assessing the appropriate positioning of the FMT in the round window niche. However, when considering specific imaging parameters, such as lack of bony contacts and appropriate inferior support, they would not seem essential for achieving a satisfactory functional outcome. Objectives: To evaluate the value of some imaging parameters derived from a Cone Beam Computed Tomography of the temporal bone for predicting a good functional outcome after Round Window Vibroplasty (RW-VP). Method: A CBCT imaging has been carried out at certain time after RW-VP surgery in a homogenous group of patients who presented with a mixed-type hearing loss after open tympanoplasty for a cholesteatoma. Three arbitrary radiological parameters have been considered for the purpose: the FMT/RW membrane contact; eventual FMT bony contacts; appropriatmess of inferior FMT support. The audiological assessment has taken into consideration the PTA4 (500-4000 Hertz), the PTA2 (125.250 Hertz), the WRS in quiet and in noise (SNR=+10). A comparison between the unaided and the RW-VP aided condition has been performed

Study of the Quench Propagation and of the Protection System of the COS-theta NED Dipole Prototype

In this report we present our studies of the propagation of the quench in the NED dipole prototype, to derive a preliminary configuration of the protection system of the magnet (quench protection heaters, dump resistors, etc.). The simulations have been performed by using the code QLASA [1]. In this code, the geometry of the magnet is simplified to a series of solenoidal concentric magnets and the evolution of the quench is calculated with the Wilson's approach [2]. An analogous study has been performed with the CERN code QUABER [3],[4], and the results are discussed in section 3

Realización, lenguaje y elecciones narrativas de radioteatro: tres aproximaciones a la creación de espacios sonoros en el tiempo

To create on the sole ground of time a space that would not exist elsewhere, and make characters act in this space: that is what radiodrama is about. The radio drama format had great presence in Spanish Radio main chains and stations until the late eighties. With some exceptions, such as, between 1993 and 2003, the very popular Supernatural and Tales, by Juan José Plans in Radio 1, and the commitment of Radio 3 between 1999 and 2003, with the serial by Carlos Faraco When Juan and Tula went to Siritinga and many other fiction features, fiction had since little prominence in the Spanish radio. However, in the second decade of this century, that has even seen the summoning of an International Radio Drama Congress, patronized by the TEA FM School of Saragosse, now in its fourth Edition, the interest grows among professionals and students, and the “majors” in Radio Broadcasting, though timidly, seem to be recovering fiction and bringing it back to their programming schedules. Just two examples: in the public radio the serial Don Quixote of the 21st Century, in addition to other fictional features, programmed every six months; and, in commercial radio, the Cadena SER, the serial by Mónica León Criminal and Black or The Christmas Carol, wich has been it’s greeting to the audience the last three seasons. This article deals with the concept of radio theatre and other forms of fictional radio and with the evolution of the format in the radio broadcasting history. It finnaly offers three approaches to fictional drama for radio, and it’s results, through three different ways to face narration, action and radio language, in three plays produced by the National Radio of Spain: Cabeza de Vaca: the Many Lifes of Alvar Núñez, Heirs of Time and Heart of Darkness.Crear en el ámbito del tiempo un espacio que no existe en ningún otro lugar y hacer que en ese espacio actúen los personajes es lo que denominamos radioteatro. El radioteatro es un género de ficción que tuvo destacada presencia en las principales cadenas de radio españolas hasta finales de la década de los ochenta. Desde entonces, salvo excepciones como, entre 1994 y 2003, las celebradas Sobrenatural e Historias de Juan José Plans en Radio 1 y la apuesta de Radio 3 entre los años 1999 y 2003, con la emisión del serial de Carlos Faraco Cuando Juan y Tula fueron a Siritinga y otras muchas ficciones dramatizadas para radio, el formato ha tenido escaso protagonismo en la radio española. Sin embargo, a partir de la segunda década de este siglo, que ha asistido incluso a la convocatoria del Congreso Internacional de Radioteatro impulsado por la Escuela TEA FM de Zaragoza, ya por su IV edición, crece el interés entre profesionales y estudiantes por el radioteatro. Igualmente, las grandes cadenas empiezan a recuperar, aun tímidamente, este tipo de programas. Dos ejemplos: en la radio pública estatal espacios como su producción estelar serializada El Quijote del siglo XXI, además de otros contenidos de ficción con periodicidad semestral; y, desde la radio privada, en la Cadena SER, la serie de Mónica León Negra y Criminal o el Cuento de Navidad, con el que ha venido felicitando a los oyentes las tres últimas temporadas. En este artículo se aborda el concepto de radioteatro, otras expresiones de ficción radiofónica y el devenir de este género de programación por las parrillas de las principales cadenas de radio a lo largo de su historia. Finalmente, se ofrecen los resultados de tres aproximaciones a la ficción dramatizada para la radio, a través de diferentes maneras de abordar la narración, la acción y el lenguaje radiofónico en tres obras producidas por Radio Nacional de España: Cabeza de Vaca: Las vidas de Alvar Núñez, Herederos del tiempo y El corazón de las tiniebla