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

The Spatial and Temporal Distribution of Lunar Mare Basalts As Deduced From Analysis of Data for Lunar Meteorites

In this work we analyze chronological data for lunar meteorites with emphasis on the spatial and temporal distribution of lunar mare basalts. The data are mostly from the Lunar Meteorite Compendium (http://www-curator.jsc.nasa.gov/antmet/lmc/contents.cfm cited thereafter as Compendium) compiled by Kevin Righter and from the associated literature

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

Principles of Pituitary Surgery

Key Points 1. Understand the principles of pituitary surgery including the key-elements of surgical planning and decision-making 2. Identify the technical nuances distinguishing the endoscopic from the microscopic transsphenoidal approach 3. Understand the strategies utilized during the nasal, sphenoidal, and sellar stages of surgery that maximize tumor resection while minimizing complications and preserving sino- nasal anatomy/functio

Lunar Meteorites: What They Tell us About the Spatial and Temporal Distribution of Mare Basalts

Here we analyze the chronology and statistical distribution of lunar meteorites with emphasis on the spatial and temporal distribution of lunar mare basalts. The data are mostly from the Lunar Meteorite Compendium (http://www-curator.jsc.nasa.gov/ antmet/ lmc/contents.cfm cited hereafter as Compendium) compiled by Kevin Righter, NASA Johnson Space Center, and from the associated literature. The Compendium was last modified on May 12, 2008

The azimuth structure of nuclear collisions -- I

We describe azimuth structure commonly associated with elliptic and directed flow in the context of 2D angular autocorrelations for the purpose of precise separation of so-called nonflow (mainly minijets) from flow. We extend the Fourier-transform description of azimuth structure to include power spectra and autocorrelations related by the Wiener-Khintchine theorem. We analyze several examples of conventional flow analysis in that context and question the relevance of reaction plane estimation to flow analysis. We introduce the 2D angular autocorrelation with examples from data analysis and describe a simulation exercise which demonstrates precise separation of flow and nonflow using the 2D autocorrelation method. We show that an alternative correlation measure based on Pearson's normalized covariance provides a more intuitive measure of azimuth structure.Comment: 27 pages, 12 figure

Derivation of Apollo 14 High-Al Basalts from Distinct Source Regions at Discrete Times: New Constraints

Apollo 14 basalts occur predominantly as clasts in breccias, but represent the oldest volcanic products that were returned from the Moon [1]. These basalts are relatively enriched in Al2O3 (11-16 wt%) compared to other mare basalts (7-11 wt%) and were originally classified into 5 compositional groups [2,3]. Neal et al. [4] proposed that a continuum of compositions existed. These were related through assimilation (of KREEP) and fractional crystallization (AFC). Age data, however, show that at least three volcanic episodes are recorded in the sample collection [1,5,6]. Recent work has demonstrated that there are three, possibly four groups of basalts in the Apollo 14 sample collection that were erupted from different source regions at different times [7]. This conclusion was based upon incompatible trace element (ITE) ratios of elements that should not be fractionated from one another during partial melting (Fig. 1). These groups are defined as Group A (Groups 4 & 5 of [3]), Group B (Groups 1 & 2 of [3]), and Group C (Group 3 of [3]). Basalt 14072 is distinct from Groups A-C

A nanomechanical resonator shuttling single electrons at radio frequencies

We observe transport of electrons through a metallic island on the tip of a nanomechanical pendulum. The resulting tunneling current shows distinct features corresponding to the discrete mechanical eigenfrequencies of the pendulum. We report on measurements covering the temperature range from 300 K down to 4.2 K. We explain the I-V curve, which differs from previous theoretical predictions, with model calculations based on a Master equation approach.Comment: 5 pages, 4 jpeg-figure