Structural characterization of protective non-neutralizing antibodies targeting Crimean-Congo hemorrhagic fever virus.

Crimean-Congo Hemorrhagic Fever Virus (CCHFV) causes a life-threatening disease with up to a 40% mortality rate. With no approved medical countermeasures, CCHFV is considered a public health priority agent. The non-neutralizing mouse monoclonal antibody (mAb) 13G8 targets CCHFV glycoprotein GP38 and protects mice from lethal CCHFV challenge when administered prophylactically or therapeutically. Here, we reveal the structures of GP38 bound with a human chimeric 13G8 mAb and a newly isolated CC5-17 mAb from a human survivor. These mAbs bind overlapping epitopes with a shifted angle. The broad-spectrum potential of c13G8 and CC5-17 and the practicality of using them against Aigai virus, a closely related nairovirus were examined. Binding studies demonstrate that the presence of non-conserved amino acids in Aigai virus corresponding region prevent CCHFV mAbs from binding Aigai virus GP38. This information, coupled with in vivo efficacy, paves the way for future mAb therapeutics effective against a wide swath of CCHFV strains.

Anatomy of the transarcuate approach to the petrous apex.

OBJECTIVE: Determine the dimensions of the approach to the petrous apex through the crura of the superior semicircular canal (SSC). STUDY DESIGN: Measurements obtained from high-resolution computed tomography (HRCT) images. SUBJECTS AND METHODS: One hundred ninety-two HRCTs were screened and 58 temporal bones with pneumatized posterior petrous apex cell tracts in 39 patients were identified and reviewed. Measurements were obtained with the assistance of the standard PACS (picture archiving and communication system) software. RESULTS: The mean anterior-posterior (AP) dimension of the intercrural space of the SSC was 4.88 +/- 0.49 mm. The mean superior-inferior (SI) dimension of this space was 4.90 +/- 0.62 mm. When air cells were present in the intercrural space, the dimensions of the approach increased to 5.27 +/- 0.50 mm for the AP dimension (P = 0.014) and 5.27 +/- 0.70 mm for the SI dimension (P = 0.056). CONCLUSION: The subarcuate approach is a potential route for the drainage of petrous apex cholesterol granulomas with minimal risk to the SSC, as demonstrated on HRCT measurements.

Avicenna's treatise on otology in Medieval Persia.

Avicenna (AD 980-1037) was one of the best-known physicians of his time. Born in Persia, he gained notoriety both in the local and international scenes. Avicenna's best-known book, Canon of Medicine, was the standard textbook of medicine for more than five centuries in Europe and the Persian Empire. Because no English translation of the entire Canon of Medicine exists, the authors have recently translated the treatise on otologic diseases from Persian into English. Correlation was made with the Arabic text as well to ensure accuracy. This study provides a review of Avicenna's significant contributions to the concepts in anatomy and the pathophysiology of ear diseases. Herbal and nonherbal medications used in the treatment of otologic disorders are also discussed.

A study of middle cranial fossa anatomy and anatomic variations.

We conducted a study to establish standardized measurements of the common anatomic landmarks used during surgery via the middle cranial fossa approach. Results were based on high-resolution computed tomography (CT) images of 98 temporal bones in 54 consecutively presenting patients. Measurements were obtained with the assistance of the standard PACS (picture archiving and communication system) software. We found that the superior semicircular canal (SSC) dome was not the highest point on the temporal bone (i.e., the arcuate eminence) in 78 of the temporal bone images (79.6%). Pneumatization above the SSC and above the internal auditory canal (IAC) was found in 27 (27.6%) and 39 (39.8%) temporal bone images, respectively. The anterior wall of the external auditory canal was always anterior to the anterior wall of the IAC. The mean angles between the SSC and the posterior and anterior walls of the IAC were 42.3 degrees and 60.8 degrees, respectively. We also measured other distances, and we compared our findings with those published by others. We hope that the results of our study will help surgeons safely and rapidly locate anatomic landmarks when performing surgery via the middle cranial fossa approach.