Management of cholesterol granuloma due to eosinophilic otitis media using large ventilation tube.

A 46-year-old man who had been diagnosed with eosinophilic otitis media (EOM) and eosinophilic chronic rhinosinusitis was referred to our department. He suffered from bilateral earache, clogged ear sensation, and otorrhea associated with EOM. He had been treated with a myringotomy and a ventilation tube (VT) insertion. However, his symptoms did not improve, and the VT repeatedly fell out. We performed canal wall down mastoidectomy via a retro-auricular incision to remove the presumed cholesterol granuloma (CG) and a long-term VT insertion. The VT fell out repeatedly. Therefore, a large VT that Komune devised was inserted. Four months after reinsertion, there was no evidence of recurrent otorrhea or fallout of a large VT. A large VT insertion could be useful in the severe case of EOM with CG.

Bilateral Congenital Preauricular Fistula of the Cavum Conchae.

A 16-year-old female who had left auricular sinus infections was admitted to our hospital. On physical examination, bilateral sinus tract openings were noted at the cavum conchae. We used a surgical microscope to complete the total resection of the bilateral sinus at the cavum conchae. Also dissected was the cartilage from the cavum conchae. To our knowledge, surgical excision of cavum conchae sinuses has not been previously described.

Pressure Dependence of Superconducting Properties, Pinning Mechanism, and Crystal Structure of the Fe0.99Mn0.01Se0.5Te0.5 Superconductor.

We have investigated the pressure (P) effect on structural (up to 10 GPa), transport [R(T): up to 10 GPa], and magnetic [(M(T): up to 1 GPa)] properties and analyzed the flux pinning mechanism of the Fe0.99Mn0.01Se0.5Te0.5 superconductor. The maximum superconducting transition temperature (T c) of 22 K with the P coefficient of T c dT c/dP = +2.6 K/GPa up to 3 GPa (dT c/dP = -3.6 K/GPa, 3 ≤ P ≥ 9 GPa) was evidenced from R(T) measurements. The high-pressure diffraction and density functional theory (DFT) calculations reveal structural phase transformation from tetragonal to hexagonal at 5.9 GPa, and a remarkable change in the unit cell volume is observed at ∼3 GPa where the T c starts to decrease, which may be due to the reduction of charge carriers, as evidenced by a reduction in the density of states (DOS) close to the Fermi level. At higher pressures of 7.7 GPa ≤ P ≥ 10.2 GPa, a mixed phase (tetragonal + hexagonal phase) is observed, and the T c completely vanishes at 9 GPa. A significant enhancement in the critical current density (J C) is observed due to the increase of pinning centers induced by external pressure. The field dependence of the critical current density under pressure shows a crossover from the δl pinning mechanism (at 0 GPa) to the δT c pinning mechanism (at 1.2 GPa). The field dependence of the pinning force at ambient condition and under pressure reveals the dense point pinning mechanism of Fe0.99Mn0.01Se0.5Te0.5. Moreover, both upper critical field (H C2) and J C are enhanced significantly by the application of an external P and change over to a high P phase (hexagonal ∼5.9 GPa) faster than a Fe0.99Ni0.01Se0.5Te0.5 (7.7 GPa) superconductor.

Characteristics of aspiration pneumonia patients in acute care hospitals: A multicenter, retrospective survey in Northern Japan.

BACKGROUND: Pneumonia is a common cause of illness and death of the elderly in Japan. Its prevalence is escalating globally with the aging of population. To describe the latest trends in pneumonia hospitalizations, especially aspiration pneumonia (AP) cases, we assessed the clinical records of pneumonia patients admitted to core acute care hospitals in Miyagi prefecture, Japan. METHODS: A retrospective multi-institutional joint research was conducted for hospitalized pneumonia patients aged ≥20 years from January 2019 to December 2019. Clinical data of patients were collected from the medical records of eight acute care hospitals. RESULTS: Out of the 1,800 patients included in this study, 79% of the hospitalized pneumonia patients were aged above 70 years. The most common age group was in the 80s. The ratio of AP to total pneumonia cases increased with age, and 692 out of 1,800 patients had AP. In univariate analysis, these patients had significantly older ages, lower body mass index (BMI), a lower ratio of normal diet intake and homestay before hospitalization, along with more AP recurrences and comorbidities. During hospitalization, AP patients had extended fasting periods, more swallowing assessments and interventions, longer hospitalization, and higher in-hospital mortality rate than non-AP patients. A total of 7% and 2% AP patients underwent video endoscopy and video fluorography respectively. In multivariate analysis, lower BMI, lower C-reactive protein, a lower ratio of homestay before hospitalization, a higher complication rate of cerebrovascular disease, dementia, and neuromuscular disease were noted as a characteristic of AP patients. Swallowing interventions were performed for 51% of the AP patients who had been hospitalized for more than two weeks. In univariate analysis, swallowing intervention improved in-hospital mortality. Lower AP recurrence before hospitalization and a lower ratio of homestay before hospitalization were indicated as characteristics of AP patients of the swallowing intervention group from multivariate analysis. Change in dietary pattern from normal to modified diet was observed more frequently in the swallowing intervention group. CONCLUSION: AP accounts for 38.4% of all pneumonia cases in acute care hospitals in Northern Japan. The use of swallowing evaluations and interventions, which may reduce the risk of dysphagia and may associate with lowering mortality in AP patients, is still not widespread.