Lateral pharyngotomy.

Based on a review of the medical literature, the authors document the key technical points, variants, technical errors to avoid and main functional results of lateral pharyngotomy for resection of cancers originating from the lateral oro and/or hypopharynx.

Otitis media with effusion in nasal polyposis and outcomes following surgery: A longitudinal observational study.

OBJECTIVE: In patients with nasal polyposis (NP), otitis media with effusion (OME) seems to be a marker of severity of the inflammatory process occurring in those patients. The aim was to assess whether OME could represent a marker of resistance to the surgical treatment of NP. DESIGN: Longitudinal observational cohort study including patients between January 1991 and January 2017. Mean follow-up was 7.4 years. SETTING: Tertiary-care hospital centre. PARTICIPANTS: Patients with NP who underwent surgery (radical bilateral sphenoethmoidectomy). MAIN OUTCOME MEASURES: Four outcomes reflecting resistance to the surgical treatment: a clinical score of rhinologic symptoms, the mean number of systemic corticosteroids treatment per year, the recurrence rate of polyps and the rate of reoperation. RESULTS: A total of 266 patients were included (63.9% of men, mean age 48 years). In multivariate linear mixed-effects regression, when compared to patients without OME, patients with OME presented a similar clinical score of symptoms (coefficient 0.09, 95% confidence interval (CI) -0.25 to 0.06, P-value = 0.24) and a borderline higher mean number of systemic corticosteroids treatments per year (coefficient 0.11, 95% CI 0.003-0.23, P-value = 0.04). In multivariate Cox regression analyses, patients with OME had a similar reoperation rate than patients without OME (hazard ratio (HR) 0.29, 95% CI 0.06-1.50) and a similar recurrence rate of polyps (HR 0.59, 95% CI 0.23-1.53). CONCLUSION: In patients with NP, OME is not a marker of surgical resistance. Those patients should be managed similarly than patients without, and similar outcomes following surgery should be expected.

Idiopathic unilateral vocal-fold paralysis in the adult.

GOAL: To analyze the characteristics of adult idiopathic unilateral vocal-fold paralysis. MATERIAL AND METHODS: Retrospective study of diagnostic problems, clinical data and recovery in an inception cohort of 100 adult patients with idiopathic unilateral vocal-fold paralysis (Group A) and comparison with a cohort of 211 patients with isolated non-idiopathic non-traumatic unilateral vocal-fold paralysis (Group B). RESULTS: Diagnostic problems were noted in 24% of cases in Group A: eight patients with concomitant common upper aerodigestive tract infection, five patients with a concomitant condition liable to induce immunodepression and 11 patients in whom a malignant tumor occurred along the path of the ipsilateral vagus and inferior laryngeal nerves or in the ipsilateral paralyzed larynx. There was no recovery of vocal-fold motion beyond 51 months after onset of paralysis. The 5-year actuarial estimate for recovery differed significantly (P<0.0001): 53.2% in Group A versus 17.9% in Group B. In Group A, recovery occurred before the end of the second year following paralysis onset in 93% of cases. On univariate analysis, recovery in Group A was associated with younger age (P=0.0033), shorter time to consultation (P<0.0001), and absence of oncologic history (P<0.028). In case of non-recovery in Group A, malignant tumor along the ipsilateral vagus or inferior laryngeal nerve was found in 17.2% of cases, 81% of which manifesting during the 30 months following the onset of vocal-fold paralysis. CONCLUSION: In non-traumatic vocal-fold paralysis in adult patients, without recovery of vocal-fold motion, a minimum three years' regular follow-up is recommended.

Impact of a multimedia support on the understanding of medical information by hearing-impaired patients before cochlear implantation.

INTRODUCTION: The medical information provided in medical consultations is exhaustive but poorly assimilated by patients and relatives. Hearing loss seems to be a further obstacle. The main objective of this study was to compare medical information about cochlear implantation delivered in oral and written form ("standard" group) versus oral, written and digital form ("multimedia" group). The secondary objective was to assess hearing loss as a negative factor for understanding medical information, by comparing understanding in patients with unilateral versus bilateral profound hearing loss. PATIENTS AND METHOD: A prospective single-center single-blind study was carried out from September 29, 2015 to June 22, 2016. Twenty-nine CI candidates were included: 11 in the "standard" group, 12 in the "multimedia" group and 6 in the "unilateral hearing loss" group. The primary endpoint was the result on a validated questionnaire (score from 0 to 14) assessing memorization of medical information. Patient satisfaction regarding the information delivered was assessed on a Likert scale. RESULTS: Memorization scores were 4.6±2.7 and 9.7±2.4 respectively for the "standard" and the "multimedia" group (P=0.0006) and 9.05±1.9 for the "unilateral hearing loss" group. Comparison between the "standard" and "unilateral hearing loss" groups showed a significant difference (P=0.01). Satisfaction scores were highest for digital compared to the other forms of medical information delivery. CONCLUSION: This study showed that a digital support improved understanding of medical information by candidates for cochlear implantation and that hearing loss was an obstacle to understanding medical information.

Assessment of the bioavailability and depuration of uranium, cesium and thorium in snails (Cantareus aspersus) using kinetics models.

Uranium ore waste has led to soil contamination that may affect both environmental and soil health. To analyze the risk of metal transfer, metal bioavailability must be estimated by measuring biological parameters. Kinetic studies allow taking into account the dynamic mechanisms of bioavailability, as well as the steady state concentration in organisms necessary to take into account for relevant risk assessment. In this way, this work aims to model the snail accumulation and excretion kinetics of uranium (U), cesium (Cs) and thorium (Th). Results indicate an absence of Cs and Th accumulation showing the low bioavailability of these two elements and a strong uranium accumulation in snails related to the levels of soil contamination. During the depuration phase, most of the uranium ingested was excreted by the snails. After removing the source of uranium by soil remediation, continued snails excretion of accumulated uranium would lead to the return of their initial internal concentration, thus the potential trophic transfer of this hazardous element would stop.

Writing otorhinolaryngology head & neck surgery operative reports.

Only about ten articles devoted to operative reports have been published in the medical literature, but this document is essential, both medically and legally, to ensure optimal management of operated patients. In this technical note, based on published studies on this subject, the authors describe the key features of operating reports after otorhinolaryngology head & neck surgery and emphasize the need to write this document during the minutes after the end of the operation, the importance of standardization and its teaching role during surgical training.

Electrophysiological exploration of hearing.

Electrophysiologic hearing tests have been developed since the 1960s to determine hearing thresholds objectively. They are now implemented in newborn hearing screening. While they determine thresholds, interpretation requires subjective pure-tone and speech audiometry to determine the type of hearing loss. Each examination tests a different anatomic region, enabling the auditory system to be explored from the organ of Corti to the auditory cortex. Thus, the various objective audiometric examinations are complementary.

The effect of the transducers on paediatric thresholds estimated with auditory steady-state responses.

The objective of this study was to investigate the usefulness of auditory steady-state responses (ASSRs) for estimating hearing thresholds in young children, compared with behavioural thresholds. The second objective was to investigate ASSR thresholds obtained with insert earphones versus supra-aural headphones to determine which transducer produces ASSR thresholds most similar to behavioural thresholds measured with supra-aural headphones. This retrospective study included 29 participants (58 ears): 12 children (24 ears) in the insert group and 17 children (34 ears) in the supra-aural group. No general anaesthesia was used. For both groups, there was a strong correlation between behavioural and ASSR thresholds, with a stronger correlation for the insert group. When behavioural thresholds are difficult to obtain, ASSR may be a useful objective measure that can be combined with other audiometric procedures to estimate hearing thresholds and to determine appropriate auditory rehabilitation approaches.

Widely tunable mid-infrared generation via frequency conversion in semiconductor waveguides.

Phase matching in a multilayer AlGaAs waveguide is used to generate mid-IR (7.5-8.5 µm) light through difference frequency generation (DFG) between a 1550 nm pump and 1950 nm signal. This represents the longest wavelength generated through DFG in a 2D waveguide mode in a semiconductor waveguide. It was produced with an efficiency of 1.2×10(-4) %/W in a 1 mm long sample. The process is shown to be tunable across >2 µm through appropriate tuning of the input pump and signal wavelengths and/or waveguide geometry, and is therefore a viable platform for monolithic, tunable, mid-IR sources.

Solitary fibrous tumour of the liver with IGF-II-related hypoglycaemia. A case report.

INTRODUCTION: We report a rare case of solitary fibrous tumour (SFT) of the liver associated with non-islet cell tumour hypoglycaemia (NICTH), which caused a hypoglycaemic coma due to over-production of big-insulin-like growth factor-II. DISCUSSION: Although generally benign, SFTs are better characterised, lately due to Western blot, but less than 40 cases have been reported where the liver is the target organ. In only two benign cases has hypoglycaemia been a feature. CONCLUSION: We report for the first time a demonstrable relationship between benign liver SFT and NICTH.

Field study of the efficacy of halofuginone and decoquinate in the treatment of cryptosporidiosis in veal calves.

Ninety, seven- to 10-day-old calves were allocated to three groups of 30 and treated daily for seven days with either 100 microg/kg halofuginone hydrobromide or 2.5 mg/kg decoquinate orally or left untreated as controls. The levels of diarrhoea and dehydration were monitored daily for 28 days from the first day of treatment (day 0) and samples of faeces were collected on days 0, 7, 14, 21 and 28, to quantify the excretion of Cryptosporidium parvum oocysts. The calves were weighed on days 3 and 28. The treatments had no effect on the levels of diarrhoea or dehydration, the proportions of diarrhoeic calves or the proportions of calves shedding oocysts. However, unlike decoquinate, halofuginone significantly reduced the excretion of oocysts on day 7 (P<0.0001), and decoquinate increased the average daily weight gain of the calves (P=0.049).

GermOnline, a cross-species community knowledgebase on germ cell differentiation.

GermOnline provides information and microarray expression data for genes involved in mitosis and meiosis, gamete formation and germ line development across species. The database has been developed, and is being curated and updated, by life scientists in cooperation with bioinformaticists. Information is contributed through an online form using free text, images and the controlled vocabulary developed by the GeneOntology Consortium. Authors provide up to three references in support of their contribution. The database is governed by an international board of scientists to ensure a standardized data format and the highest quality of GermOnline's information content. Release 2.0 provides exclusive access to microarray expression data from Saccharomyces cerevisiae and Rattus norvegicus, as well as curated information on approximately 700 genes from various organisms. The locus report pages include links to external databases that contain relevant annotation, microarray expression and proteome data. Conversely, the Saccharomyces Genome Database (SGD), S.cerevisiae GeneDB and Swiss-Prot link to the budding yeast section of GermOnline from their respective locus pages. GermOnline, a fully operational prototype subject-oriented knowledgebase designed for community annotation and array data visualization, is accessible at http://www.germonline.org. The target audience includes researchers who work on mitotic cell division, meiosis, gametogenesis, germ line development, human reproductive health and comparative genomics.

Septic peritonitis due to colonic perforation associated with aberrant migration of a Gasterophilus intestinalis larva in a horse.

An adult quarter horse mare was presented with acute colic and fever. Physical examination and abdominocentesis showed septic peritonitis, and the mare was euthanatized. Necropsy and histopathologic examination revealed a focal partial perforation of the right ventral colon, which contained a single bot fly larva, identified as a third-instar larva of Gasterophilus intestinalis. This larva was embedded deep within the muscularis and the submucosa. Although bot fly larvae are known to attach to aberrant sites within the digestive tract, this is the first known report of deep penetration of the colon by a gasterophilus larva, with the resulting leakage of intestinal content leading to septic peritonitis.

A targeted RNAi screen for genes involved in chromosome morphogenesis and nuclear organization in the Caenorhabditis elegans germline.

We have implemented a functional genomics strategy to identify genes involved in chromosome morphogenesis and nuclear organization during meiotic prophase in the Caenorhabditis elegans germline. This approach took advantage of a gene-expression survey that used DNA microarray technology to identify genes preferentially expressed in the germline. We defined a subset of 192 germline-enriched genes whose expression profiles were similar to those of previously identified meiosis genes and designed a screen to identify genes for which inhibition by RNA interference (RNAi) elicited defects in function or development of the germline. We obtained strong germline phenotypes for 27% of the genes tested, indicating that this targeted approach greatly enriched for genes that function in the germline. In addition to genes involved in key meiotic prophase events, we identified genes involved in meiotic progression, germline proliferation, and chromosome organization and/or segregation during mitotic growth.

Whence meiosis?

Sexual reproduction predominates among eukaryotic organisms on our planet. While debate continues over why this should be so, burgeoning genomic and functional information now allows us to begin to think reasonably about some of the events that may have occurred to make sex possible in the first place.

Nuclear reorganization and homologous chromosome pairing during meiotic prophase require C. elegans chk-2.

Analysis of mutants defective in meiotic chromosome pairing has uncovered a role for Caenorhabditis elegans chk-2 in initial establishment of pairing between homologous chromosomes during early meiotic prophase. chk-2 is also required for the major spatial reorganization of nuclei that normally accompanies the onset of pairing, suggesting a mechanistic coupling of these two events. Despite failures in pairing, nuclear reorganization, and crossover recombination, chk-2 mutants undergo many other aspects of meiotic chromosome morphogenesis and complete gametogenesis. Although chk-2 encodes a C. elegans ortholog of the Cds1/Chk2 checkpoint protein kinases, germ-line nuclei in chk-2 mutants are competent to arrest proliferation in response to replication inhibition and to trigger DNA damage checkpoint responses to ionizing radiation. However, chk-2 mutants are defective in triggering the pachytene DNA damage checkpoint in response to an intermediate block in the meiotic recombination pathway, suggesting that chk-2 is required either for initiation of meiotic recombination or for monitoring a specific subset of DNA damage lesions. We propose that chk-2 functions during premeiotic S phase to enable chromosomes to become competent for subsequent meiotic prophase events and/or to coordinate replication with entry into prophase.