Portion Of Wall Research Articles

A novel approach to mapping the atrial ganglionated plexus network by generating a distribution probability atlas.

IntroductionThe ganglionated plexuses (GPs) of the intrinsic cardiac autonomic system are implicated in arrhythmogenesis. GP localization by stimulation of the epicardial fat pads to produce atrioventricular dissociating (AVD) effects is well described. We determined the anatomical distribution of the left atrial GPs that influence atrioventricular (AV) dissociation.Methods and ResultsHigh frequency stimulation was delivered through a Smart‐Touch catheter in the left atrium of patients undergoing atrial fibrillation (AF) ablation. Three dimensional locations of points tested throughout the entire chamber were recorded on the CARTO™ system. Impact on the AV conduction was categorized as ventricular asystole, bradycardia, or no effect. CARTO maps were exported, registered, and transformed onto a reference left atrial geometry using a custom software, enabling data from multiple patients to be overlaid. In 28 patients, 2108 locations were tested and 283 sites (13%) demonstrated (AVD‐GP) effects. There were 10 AVD‐GPs (interquartile range, 11.5) per patient. Eighty percent (226) produced asystole and 20% (57) showed bradycardia. The distribution of the two groups was very similar. Highest probability of AVD‐GPs (>20%) was identified in: inferoseptal portion (41%) and right inferior pulmonary vein base (30%) of the posterior wall, right superior pulmonary vein antrum (31%).ConclusionIt is feasible to map the entire left atrium for AVD‐GPs before AF ablation. Aggregated data from multiple patients, producing a distribution probability atlas of AVD‐GPs, identified three regions with a higher likelihood for finding AVD‐GPs and these matched the histological descriptions. This approach could be used to better characterize the autonomic network.

Development of an in vitro method to determine rumen undigested aNDFom for use in feed evaluation

A portion of the forage cell wall, defined as neutral detergent fiber (NDF), is indigestible to anaerobic microbial digestion in ruminants. This fraction has been characterized by surface area relationships between acid detergent lignin, but recently, data have been published describing the dynamic nature of this relationship. In situ approaches have been described to estimate indigestible NDF, recovering the undigested NDF after long-term fermentations (uNDF). To be applicable to nutritionists and diet formulation, determining uNDF needs to be conducted in a commercial laboratory similar to other routine analyses of forage chemistry. A series of studies were conducted to evaluate an in vitro approach, to describe uNDF, which is repeatable and adaptable for routine feed evaluation. One hundred and two forages of several species were analyzed for NDF, acid detergent lignin, and uNDF. The uNDF was estimated by several approaches involving long-term fermentations and filtration steps to evaluate the length of time necessary to exhaust the digestible NDF and a filtration method necessary to maintain sample integrity by ensuring low sample loss and uniform recovery with residues from long-term in vitro fermentation. To determine uNDF, in vitro fermentations were conducted on 0.50 or 0.75 g of dry matter samples, in triplicate, at multiple time points up to 504 h and initially used Gooch crucibles with Celite (Thermo Fisher Scientific, Waltham, MA) as a filtering aid. The final method utilized a 1.5-µm pore size glass microfiber filter, which allowed for increased repeatability and improved sample recovery (lowest standard deviation). In this study, in vitro fermentations of 240 h were adequate to characterize and identify uNDF, which was repeatable among conventional forages provided the samples, after NDF analyses, were filtered through the same glass fiber filter. This approach could be adapted by commercial laboratories and would provide opportunities to develop near-infrared reflectance spectroscopy equations and calibrations.

The Rhetoric and Revelations of Scale at Lucera’s Fortress (1269–84): State Building in the Angevin Kingdom of Naples

This article examines the fortress of Lucera in northern Apulia (1269–84) as a sign of state building in late medieval southern Italy. First, I assess the completed complex as a physical marker of Angevin territorial consolidation in the newly conquered Kingdom of Naples. Encompassing an area of approximately 49,000 square meters (about 12 acres) with two palaces, housing for Provençal settlers and their families, and facilities for soldiers, workers, royal administrators, and equipment, Lucera’s fortress is paradigmatic of Angevin construction, resettlement, and urban development patterns that connected territory in the kingdom politically, economically, and socially. Second, I consider how the process of construction employed at the fortress relied on the increasingly unified kingdom and the Angevin king Charles I’s firm control over integration. By examining the surviving documents related to the fortress’s construction as well as the physical remains, especially a 600-meter-long portion of the perimeter walls mentioned in the texts as the murus ex parte Florentini (i.e., facing toward the city of Fiorentino), I analyze the costs of construction and the sources of funds, the workers and materials needed and their origins, and the bureaucracy that the crown established for procuring funds, workers, and materials. I argue that Lucera’s fortress and Angevin architecture in general are embodiments of the Angevin state and demonstrate how examining Angevin history by means of its building fabric contributes to studies concerning the processes of medieval building construction, the role of architecture in late medieval political consolidation, and the examination of castle architecture beyond its military value.

Precisely Controlled Incorporation of Drug Nanoparticles in Polymer Vesicles by Amphiphilic Copolymer Tethers

In this paper, we describe the fabrication of nanoparticle (NP)-embedded nanovesicles by coassembly of diblock copolymer-tethered NPs and free diblock copolymers via the dissipative particle dynamics simulation technique. We use an improved quantitative model to characterize the angular and radial distributions of NPs within vesicle walls simultaneously. In a specific circumstance, the NPs can be localized in the central portion of the vesicle walls, which is in excellent agreement with the experimental work. On the basis of this model, we find that the distributions of the NPs can be well manipulated just by three physical quantities, which are easily controlled in the experiments. For instance, the radial distributions of the NPs can be precisely controlled by changing the grafted hydrophobic chain length and the tethered arm number affects the dispersity of the NPs in the angular direction of the vesicle walls. The results provide the experimentalists with a way to design carrier-assistant drug deliver...

Prediction of indigestible NDF in South African and Australian forages from cell wall characteristics

A portion of the forage cell wall is unavailable to microbial digestion in ruminants and in previous work this fraction was characterized by the relationship between lignin (sa) and neutral detergent fiber (NDF) as 2.4 × lignin and termed the indigestible NDF (iNDF). Further, this relationship was considered to be a static relationship between lignin (sa) and NDF with no genetic variation or observed effects of growing conditions on the plant. The objectives of this work were to further characterize the relationship between lignin and iNDF and to evaluate the concept of a fixed value, assuming that the relationship is more dynamic and dependent on agronomic and environmental factors. A further objective was to predict iNDF from cell wall composition. More than two hundred samples of several forage species from Australia and South Africa were analyzed for NDF, acid detergent fiber, lignin and iNDF. Forages were classified according to origins, type and species. The ratios of iNDF to ADL ranged between 1.6 and 8.0, demonstrating the dynamic nature of the relationship. Further, an attempt to predict iNDF based on the relationship between ADL/NDF and the ratio was made and the equations provided R2 values between 0.82 and 0.95, indicating that a prediction is possible, especially when considering one species at a time and more information within forage group and single forages on agronomic and environmental conditions would explain the extra variation. A single value of the ratio iNDF to ADL does not allow proper estimation of the size of the potentially digestible NDF and its rate of digestion, but species-specific equations can be developed and be effective in predicting iNDF. Long-term fermentations should however be preferred to correctly quantify these values and, if not available, data should allow for specific equations or near infrared spectroscopy calibration equations.

The architecture of the lower parts of submarine canyons on the western Nigerian continental margin

Multi-beam, sub-bottom and multichannel seismic data acquired from the western Nigerian continental margin are analysed and interpreted to examine the architectural characteristics of the lower parts of the submarine canyons on the margin. The presence of four canyons: Avon, Mahin, Benin, and Escravos, are confirmed from the multi-beam data map and identified as cutting across the shelf and slope areas, with morphological features ranging from axial channels, moderate to high sinuosity indices, scarps, terraces and nickpoints which are interpreted as resulting from erosional and depositional activities within and around the canyons. The Avon Canyon, in particular, is characterised by various branches and sub-branches with complex morphologies. The canyons are mostly U-shaped in these lower parts with occasional V-shapes down their courses. Their typical orientation is NE–SW. Sedimentary processes are proposed as being a major controlling factor in these canyons. Sediments appear to have been discharged directly into the canyons by rivers during the late Quaternary low sea level which allows river mouths to extend as far as the shelf edge. The current sediment supply is still primarily sourced from these rivers in the case of the Benin and Escravos Canyons, but indirectly in the case of the Avon and Mahin Canyons where the rivers discharge sediments into the lagoons and the lagoons bring the sediments on to the continental shelf before they are dispersed into the canyon heads. Ancient canyons that have long been buried underneath the Avon Canyon are identified in the multichannel seismic profile across the head of the Avon Canyon, while a number of normal faults around the walls of the Avon and Mahin Canyons are observed in the selected sub-bottom profiles. The occurrence of these faults, especially in the irregular portions of the canyon walls, suggests that they also have some effect on the canyon architecture. The formation of the canyons is attributed to the exposure of the upper marginal area to incisions from erosion during the sea level lowstand of the glacial period. The incisions are widened and lengthened by contouric currents, turbidity currents and slope failures resulting in the canyons.

Unusual occurrence of orbital hemangiopericytoma in the zygomatic bone of an adolescent: a case report

BackgroundHemangiopericytoma and solitary fibrous tumor are considered related variants on the same spectrum and both may essentially be the same tumor. They are infrequently encountered in the orbital region while the zygomatic bone is an extremely rare location for these neoplasms to occur.Case presentationA 14-year-old boy presented with complaint of deformity of left infraorbital area and a firm, regular mass in the region. Orbital CT scan revealed a well-defined round isodense intraosseous lesion in the lowermost portion of the lateral orbital wall (zygomatic bone), expanding the bone and protruding anteriorly and medially. MRI showed the mass to be heterogenous and strongly enhancing with contrast medium. Inferior transconjunctival orbitotomy was performed and the mass was removed. The histopathologic examination and immunohistochemistry staining results (positive for CD34, CD31 and smooth muscle actin, but negative for CD99, S100, B-cell lymphoma 2 (bcl-2) and desmin) confirmed the diagnosis of hemangiopericytoma. The postoperative course was uneventful, with no evidence of recurrence after 5 years follow up.ConclusionsThis case represents the second hemangiopericytoma reported in the zygomatic bone. Although extremely rare, hemangiopericytoma/solitary fibrous tumor might be considered in the differential diagnosis of intraosseous lesions of the orbital and zygomatic region.

Modelling one-way out-of-plane response of single-leaf and cavity walls

Existing unreinforced masonry (URM) buildings have often exhibited both damage and collapse in the out-of-plane (OOP) direction due to the activation of a local mechanism when subjected to earthquake excitations. The assessment of the out-of-plane response of masonry structures has been largely studied in the literature, typically assuming walls responding as rigid blocks or assemblies of rigid bodies. This paper presents a single-degree-of-freedom (SDOF) numerical model for the analysis of the dynamic OOP behaviour of URM walls or portion of walls. It takes into account both the linear and the non-linear rocking response phase of URM walls. The numerical model has been developed to capture the experimental dynamic response of both single leaf and cavity wall specimens subjected to a pure one-way bending action with both top and bottom end supports of the wall moving simultaneously. A detailed investigation into the force–displacement relationships characterising both wall typologies has been carried out in order to provide reliable parameters for the simulation of their dynamic behaviour. Particular emphasis is placed on the energy dissipation involved in such mechanisms. Different equivalent viscous damping models have been adopted and compared in order to identify the most appropriate one to capture the dependency of the damping phenomenon on the oscillation amplitude and subsequently the system frequency.

Патологический нейрогенез - ключевое звено патогенеза тазовой боли, обусловленной аденомиозом

Статья посвящена одной из актуальных проблем клинической гинекологии - тазовой боли при аденомиозе. Цель исследования: изучение морфологических особенностей нервного аппарата миометрия у женщин с синдромом хронической тазовой боли, обусловленной аденомиозом. Методика. Изучено 60 биоптатов, полученных после гистерэктомий у женщин с диффузным аденомиозом ІІ-ІІІ степени, сопровождающимся болевым синдромом выраженной степени тяжести, не получавших гормональную терапию. Группа морфологического сравнения составила 10 биоптатов, полученных у женщин с аденомиозом, без болевого синдрома, прооперированных по поводу аномальных маточных кровотечений, также не получавших гормональную терапию. У всех пациентов получено информированное согласие на использование биологического материала в исследовании. После гистерэктомии участки стенок маток, включавшие эндометрий и миометрий подвергали стандартным гистологическим процедурам, готовили парафиновые срезы (5 мкм). Общую морфологическую оценку проводили при окраске срезов гематоксилином и эозином. Визуализацию нервных волокон осуществляли после иммуногистохимического (ИГХ) окрашивания с использованием моноклональных антител (МАТ) к белкам нейрофиламентов (DAKO, Дания) по инструкциям фирмы. Результаты. Изучение иннервационного аппарата матки при аденомиозе с помощью моноклональных антител к белкам нейрофиламентов выявил разнообразие волокон по толщине, плотности и интенсивности окраски. Плотность нервных окончаний, сопряженных непосредственно с очагами эндометриоза, была невелика - в зоне желез 4,1 ± 0,3 на мм среза, в строме - 9,2 ± 0,6. Тонкие нервные волокна визуализировались преимущественно в строме вокруг кровеносных сосудов, сопровождающих зоны врастания эктопического эндометрия. Густое сплетение тонких нервных волокон также было обнаружено в субсерозном слое. Причем, как в субсерозном, так и в подслизистом слое миометрия превалировали разветвленные тонкие нервные волокна, количество которых статистически значимо (p<0,01) превышало аналогичный показатель в группе сравнения - 17,2 ± 1,4 против 11,8 ± 0,9 на мм. Сравнение иннервационного аппарата матки у женщин контрольной группы и у пациенток с аденомиозом с болевым синдромом позволяет утверждать, что именно расширение иннервационного поля в миометрии является наиболее вероятной причиной формирования тазовой боли у пациенток с аденомиозом. Выводы. Результаты проделанной работы продемонстрировали, что основным местом локализации нервов в матке и потенциальной причиной формирования гипералгезии при аденомиозе является миометрий с формированием аномально избыточного иннервационного аппарата вокруг очагов эктопического эндометрия, в периваскулярных регионах и в строме между пучками гладких миоцитов. Objective. To study morphological features of the myometrium neural apparatus in women with chronic pelvic pain syndrome associated with adenomyosis. Methods. 60 biopsy samples were studied, which were obtained from hysterectomies for grade I-III diffuse adenomyosis associated with severe pelvic pain syndrome. These women did not receive any hormonal therapy. The control group included 10 biopsies obtained from women with adenomyosis who had no pelvic pain syndrome and underwent a surgery for abnormal uterine bleeding. These women did not receive any hormonal therapy either. After hysterectomy, uterine wall samples including endometrium and myometrium were fixed in 10% neutral, buffered formalin (pH 7.4) for 24 hours. After dehydration, the material was embedded in paraffin highly purified with polymeric additives (Richard-Allan Scientific, USA) at a temperature <60°C. Overall morphological evaluation of sections was performed with H E staining. Imaging was performed after nerve fibers immunohistochemical (IHC) staining with monoclonal antibodies (MAbs) to neurofilament proteins (DAKO, Denmark) according to the manufacturer’s instructions. Results. Studying of the uterine innervation apparatus using monoclonal antibodies to neurofilament proteins in adenomyosis identified a variety of fiber thickness, density and color intensity. Density of nerve endings directly associated with endometriosis foci was low; 4.1 ± 0.3 per mm in the glandular zone and 9.2 ± 0.6 per mm in the stroma. Thin nerve fibers were visualized mainly in the stroma around blood vessels associated with the ectopic endometrium ingrowth zone. A dense plexus of thin nerve fibers was also found in the subserosal layer. Furthermore, both in myometrial subserosal and submucosal layers, ramified, thin nerve fibers predominated. The number of such fibers was significantly greater than in the comparison group (17.2 ± 1.4 vs. 11.8 ± 0.9 per mm, p<0.01). Comparison of the uterine innervation apparatus in women with and without chronic pelvic pain syndrome suggested that particularly the expansion of myometrium innervation field was the most likely cause for the development of pelvic pain in women with adenomyosis. Conclusions. The main location of uterine nerves and a potential cause for hyperalgesia in adenomyosis is the myometrium developing abnormally excessive innervation around foci of ectopic endometrium, perivascular areas, and the stroma between fibers of smooth myocytes.

Differential growth of pavement cells of Arabidopsis thaliana leaf epidermis as revealed by microbead labeling.

In numerous vascular plants, pavement cells of the leaf epidermis are shaped like a jigsaw-puzzle piece. Knowledge about the subcellular pattern of growth that accompanies morphogenesis of such a complex shape is crucial for studies of the role of the cytoskeleton, cell wall and phytohormones in plant cell development. Because the detailed growth pattern of the anticlinal and periclinal cell walls remains unknown, our aim was to measure pavement cell growth at a subcellular resolution. Using fluorescent microbeads applied to the surface of the adaxial leaf epidermis of Arabidopsis thaliana as landmarks for growth computation, we directly assessed the growth rates for the outer periclinal and anticlinal cell walls at a subcellular scale. We observed complementary tendencies in the growth pattern of the outer periclinal and anticlinal cell walls. Central portions of periclinal walls were characterized by relatively slow growth, while growth of the other wall portions was heterogeneous. Local growth of the periclinal walls accompanying lobe development after initiation was relatively fast and anisotropic, with maximal extension usually in the direction along the lobe axis. This growth pattern of the periclinal walls was complemented by the extension of the anticlinal walls, which was faster on the lobe sides than at the tips. Growth of the anticlinal and outer periclinal walls of leaf pavement cells is heterogeneous. The growth of the lobes resembles cell elongation via diffuse growth rather than tip growth.

A mechanism of banding failure in excessively dilated fistulas.

We present an unreported cause of banding failure for flow restriction in dramatically enlarged arteriovenous fistulas (AVFs). Four patients operated in different institutions by two different surgeons experienced band failure within 6 months of the initially successful operation for AVF flow restriction. Prior to the initial banding procedure, each patient's AVF was noted to have major dilatation of the post-anastomotic segment (>2 cm). All patients required a second operation for flow reduction with reconstruction of the AVF anastomosis to a tapered, smaller size. During this second procedure, the suture tie used for banding in each patient was found to have eroded a portion of the vessel wall and was extending into the fistula lumen. No thrombosis or bleeding was encountered and all AVFs have remained functional after revision. Identical findings in these four patients suggest that the extensive infolding and caliber diameter reduction created by banding these massively dilated fistulas, when combined with the pulsatility induced in the pre-banding segment, leads to a gradual incorporation of the suture tie into the vessel wall and finally within the lumen. We suggest erosion of banding material and failure of flow reduction may occur with any technique but may be more likely with a single polypropylene suture restricting very large AVF. We suggest such excessively dilated fistulas requiring flow reduction may be successfully treated by reconstruction of the AVF anastomosis to a much smaller size with tapering of the outflow vein to accommodate the revision.

Congenital Urethral Diverticulum in Male Subject: Report of Three Cases

Introduction: The urethral diverticulum or urethrocele corresponds to a saccular dilation of a portion of the urethral wall. Our objective was to report the clinical aspects, investigations and therapeutic aspects of three cases of congenital urethrocele. Observations: They were three male patients aged 11, 20 and 42 years, two of whom had consulted for terminal dribbling. The diagnosis of urethrocele was made for all patients with retrograde and voiding cystouretrography. Treatment consisted of resection of the urethrocele followed by urethroplasty for both cases. Conclusion: Diagnostic of congenital urethrocele must always be assessed when there is a persistent terminal dribbling, and systematically ask for a retrograde and voiding cystourethrography to confirm it.

Impact of clay type and water composition on low salinity water injection – visualisation approach

Low salinity water (LSW) injection as an enhanced oil recovery method has attracted much attention in the past two decades. Previously, it was found that the presence of clay such as kaolinite and water composition like the nature of cations affect the enhancement of oil recovery under LSW injection. In this study, a pore-scale visualisation approach was developed using a 2D glass micromodel to investigate the impact of clay type and water composition on LSW injection. The glass micromodels were coated by kaolinite and illite. A meniscus moving mechanism was observed and the oil–water interface moved through narrow throats to large bodies, displacing the wetting phase (oil phase). In the presence of kaolinite, the effect of LSW injection was reflected in the change to the wettability with a transition towards water-wetness in the large sections of the pore walls. The advance of the stable water front left behind an oil film on the oil-wet portions of pore walls; however, in water-wet surfaces, the interface moved towards the surface and replaced the oil film. As a result of wettability alteration towards a water-wet state, the capillary forces were not dominant throughout the system and the water–oil menisci displaced oil in large portions of very narrow channels. This LSW effect was not observed in the presence of illite. With regard to the water composition effect, systems containing divalent cations like Ca2+ showed the same extent of recovery as those containing only monovalent ions. The observation indicates a significant role of cation exchange in wettability alteration. Fines migration was insignificant in the observations.

Subxiphoid Minimally Invasive Epicardial Ablation (Convergent Procedure) With Left Thoracoscopic Closure of the Left Atrial Appendage

The Convergent Procedure is a combined epicardial and endocardial ablation performed by a cardiac surgeon and electrophysiologist to treat symptomatic persistent and long standing persistent atrial fibrillation. The epicardial ablation is performed on the entire width of the posterior left atrial wall using monopolar radiofrequency via a subxiphoid incision. There is no sternotomy and cardiopulmonary bypass is not utilized. The surgical ablation is then followed by endocardial voltage mapping and ablation, allowing for complete lesion set creation. Left atrial appendage exclusion can be performed via left thoracoscopic approach at the same time as the surgical ablation. The Convergent Procedure is a truly hybrid, collaborative procedure which combines the strengths of minimally invasive cardiac surgery and percutaneous electrophysiologic techniques to treat a challenging disease process.

MODELING FOR LATERAL RESISTANCE CHARACTERISTICS OF RETAINING WALL IN COLLISION OF BASE-ISOLATED BUILDING

When extra-large earthquake which exceeds the input level of designing occurs, a base-isolated building may collide with surrounding retaining wall. To evaluate accurately the acceleration of superstructure and the deformation of base isolator at that time, restoring force characteristics of the retaining wall including the back soil should be clarified. In this study, the collision analyses of base-isolated building using 3D-FEM are carried out, and the restoring force characteristics of retaining wall are investigated. Simple modeling of the collision spring which have the initial rigidity and the maximum strength are proposed as for parameters of height and length of retaining wall, collision speed of building, collision height, and the shear wave velocity of back ground. The obtained results are summarized as follows. 1) By collision analysis and evaluation of restoring force characteristics of a real base-isolated building model, retaining wall thickness, height and length greatly affect retaining wall restoring force characteristics. Initial stiffness and maximum load stress of retaining wall portion increase when the retaining wall thickness, height and length are increased. On the other hand, the weight of building and the ground at the bottom of the foundation board have little influence on the restoring force characteristic of retaining wall. In addition, the collision speed of the building exerts a large influence on the restoring force characteristic, and the initial stiffness increases as the collision speed increases, but when it reaches a certain collision speed or more, it reaches a certain limit and becomes constant. The maximum load increases with the square root of collision speed. Since the collision speed varies with the assumed input seismic motion, it is important to perform the earthquake response analysis on the building in advance and to use the speed at the time of displacement by the clearance between the building and the retaining wall. The initial stiffness and Maximum load increases as shear wave velocity increases. 2) We propose Equation 7 for initial rigidity and Equation 8 for maximum load as a simplified retaining wall collision evaluation formula. By this formula, it is possible to install the collision phenomenon of the retaining wall of the base-isolated building in parallel with the spring of the base isolation device as a collision spring, by changing the shape (thickness, height, length) of the retaining wall and collision condition (Height, impact velocity), and the surrounding ground (shear wave velocity).

Incremental sheet metal formed square-cup obtained through multi-stepped process

In this paper, we present a new strategy for the single point incremental forming (SPIF). This process involves the use of non-horizontal path planes of a tool tip and is oriented to produce steep wall portions. In the most SPIF operations, a set of closed contour tool paths existing on horizontal planes or a spiral tool path interpolated from the contours was used. When the process is single-step operation, the final thickness after forming can be predicted using the sine law. The law suggests that the final thickness of a vertical wall becomes zero. Therefore, steep or vertical walls are impossible to produce through the single-step SPIF. The vertical wall was produced only by the multi-step approach. The aim of this study is to control the material translation by modifying the direction of the path planes of a tool tip and develop the process to produce the steep wall portions. This multi-step approach was applied to the process for a square cup and the thickness distribution was examined in detail.

Paraganglioma of the External Auditory Canal : A Case Report

Paragangliomas are benign tumors originating from paraganglia and characterized by a collection of small neuroendocrine organs. In the ear, paragangliomas are commonly found in the middle ear or jugular bulb. Paragangliomas of the external auditory canal (EAC) are extremely rare. Here, we present our experience with a 25-year-old woman who was admitted to our otology department for intermittent scanty left otorrhea. A physical examination revealed a 3×4 mm-sized pedunculated mass on upper portion of the anterior wall of the left EAC. Computed tomography revealed a non-specific, soft tissue mass in the left EAC without erosion of the underlying bony canal. An excisional biopsy was performed. Histopathological features favored a diagnosis of paraganglioma. At a 9 month post-operative follow-up, the patient had a patent external auditory canal without recurrence. Paragangliomas tend to be locally destructive, and can lead to disability in the form of hearing loss especially in EAC. Although paraganglioma is a very rare disease, our results indicate that it should be included in the differential diagnosis of an EAC mass. (J Clinical Otolaryngol 2017;28:234-237)

The subependymal microvascular network revealed by endoscopic fluorescence angiography.

The subependymal vascularization of the cerebral ventricles has been described in anatomical studies on human specimens. Its identification in vivo during neuroendoscopic navigation could have anatomical interest and may lead to a safer ventricular navigation, also avoiding unexpected bleeding. The traditional endoscopic visualization allows the certain identification of only the main vessels. In this study we describe the features of the subependymal vascular network (SEVN) enhanced by sodium fluorescein (SF) angiography. We compare these findings with the vascular patterns visible under white light to evaluate the sensitivity of this technique in unveiling the most distant branches of the SEVN. We reviewed the video records of 39 fluorescein-assisted neuroendoscopic procedures. Steerable fiberscopes equipped with a dual observation mode for both white light and fluorescence were used. After preliminary inspection of the ventricular cavities, the camera was switched to the blue light fluorescent mode. Identical portion of ventricular walls observed in both modalities were compared and analyzed to enhance potential differences of the vascular features. The main veins were positive (fluorescein enhanced) in 10 patients (25.6%), vessels of smaller diameter visible also under white light presented a detectable fluorescence in 27 patients (69.2%), the micro SEVN, not visible under with light, was revealed by SF in 21 patients (53.8%). Fluorescein-guided neuroendoscopy deserves closer investigation since it allows detection of small vessels, not otherwise visible, in the ventricle walls. This method could be applied to ameliorate the knowledge of the environment the surgeon is working on, leading as a result to a safer navigation, also by avoiding minor bleedings.

Microbiota associated with tubes of Escarpia sp. from cold seeps in the southwestern Atlantic Ocean constitutes a community distinct from that of surrounding marine sediment and water

As the depth increases and the light fades in oceanic cold seeps, a variety of chemosynthetic-based benthic communities arise. Previous assessments reported polychaete annelids belonging to the family Siboglinidae as part of the fauna at cold seeps, with the 'Vestimentifera' clade containing specialists that depend on microbial chemosynthetic endosymbionts for nutrition. Little information exists concerning the microbiota of the external portion of the vestimentiferan trunk wall. We employed 16S rDNA-based metabarcoding to describe the external microbiota of the chitin tubes from the vestimentiferan Escarpia collected from a chemosynthetic community in a cold seep area at the southwestern Atlantic Ocean. The most abundant operational taxonomic unit (OTU) belonged to the family Pirellulaceae (phylum Planctomycetes), and the second most abundant OTU belonged to the order Methylococcales (phylum Proteobacteria), composing an average of 21.1 and 15.4% of the total reads on tubes, respectively. These frequencies contrasted with those from the surrounding environment (sediment and water), where they represent no more than 0.1% of the total reads each. Moreover, some taxa with lower abundances were detected only in Escarpia tube walls. These data constitute on the first report of an epibiont microbial community found in close association with external surface of a cold-seep metazoan, Escarpia sp., from a chemosynthetic community in the southwestern Atlantic Ocean.

Percutaneous ureteroscopy laser unroofing-a minimally invasive approach for renal cyst treatment

Most simple renal cysts rarely require therapy. When it grows to such a large size, regardless of the presence of symptomatology, surgical intervention is required. In this study, we explored a new approach called percutaneous ureteroscopy laser unroofing for treatment renal cysts and evaluated its safety and efficacy. 71 simple renal cyst patients with surgical indications were enrolled, including 6 patients with a peripelvic cyst and 5 patients coexisting ipsilateral calculi. Under ultrasound guidance, an eighteen-gauge needle was placed inside the cyst cavity, and a guidewire was introduced followed by sequential dilation up to 28 F. The extra-parenchymal portion of cyst wall was dissociated and incised using either a Thulium or Holmium laser, and a pathological examination was performed. Renal calculi were treated simultaneously. For peripelvic cyst patients, one end of a double-J stent was inserted into the cyst cavity to prevent auto-closure. Mean of 11.7 months follow-up, the results showed that the cyst was completely resolved in 53 patients, its size was reduced to less than 50% in 15 patients, and treatment failed in only 3 anterior cyst patients, suggesting that percutaneous ureteroscopy laser unroofing is an effective and less invasive alternative for treatment of renal cysts in selected patients.