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To investigate hearing and the take rate of crushed cartilage grafts in tympanoplasty.
In this double-blinded, randomised, controlled trial, 46 patients with tympanic membrane perforation were enrolled. A conchal cartilage graft was used for reconstruction in both intervention and control groups. In the intervention group, crushed cartilage was used. The success rate and hearing results were ascertained every four months over a one-year follow-up period.
A total of 36 patients – 20 in the intervention group and 16 in the control group – completed one year of follow up. There were no statistically significant differences between the two groups in mean air–bone gap, bone conduction threshold, speech discrimination score or speech reception threshold.
The reduction in living cells after crushed cartilage tympanoplasty may decrease the rigidity and the volume of the graft, but may not necessarily improve the hearing results.
In this paper, a novel thrusting manoeuvre control scheme is proposed for a small spacecraft which is based only on the gimbaled thrust vector control (TVC) system. The spacecraft structure is composed of a body and a gimbaled thruster where common attitude control systems such as reaction control system (RCS) and spin stabilisation are not employed. A nonlinear two-body model is considered for the characterisation of the gimbaled-nozzle spacecraft where the gimbal actuator provides the only active control input. The spacecraft attitude is affected by a large exogenous disturbance torque which is generated by a thrust vector misalignment from the centre of mass (CM). To achieve some performance goals in the both transient and steady-state modes, a new control scheme is derived based on the combination of two linear and nonlinear controllers. The proposed method ensures the attitude and thrust vector stability during an impulsive orbital manoeuvre while eliminating and rejecting an exogenous disturbance torque. The numerical simulations illustrate the applicability of this method for using in a small spacecraft and its efficiency in sustained operation.
In January 2011, a group of 11 Indo-Pacific common dolphins Delphinus capensis tropicalis stranded in the central estuary of Bandar-e-Jask in Hormozgan Province (near the entrance to the Persian Gulf), Iran. All of them were females and just one is believed to have survived. Two individuals were pregnant. All carcasses were examined for biometry and genetic samples were obtained for subsequent analysis. They all appeared to have been in a good state of health prior to death without any signs of human-related injuries. A comprehensive investigation into the possible causes for mortality could not be conducted. However, the available evidence suggests that the most likely reason for the stranding was the complex topographic and oceanographic conditions, which may have caused the animals to be trapped by the rapidly falling spring tide.
An anomalously strong increase of nuclear fusion gains for laser driven compression and thermal ignition of hydrogen-boron11 has been discovered from computations by using the latest results of Newins and Swain about details of a resonance maximum of the astrophysical S-function at 148 keV for the reaction cross-sections. Extensive computations based on volume ignition showed some usual improvements of the fusion gains. However, for a very narrow range of parameters, the increase of the gain was found to be higher by more than a factor 6. This is very unusual in all similar computations and is related to retrograde properties which were known for other parameter values. On top it is most important that the anomalous range is in the practically very interesting range for incorporation of laser pulse energies of few megajoules. The gains of up to 20 may be of interest for power generation in future by the high density fusion scheme.
In contrast to the usual laser fusion scheme with spherical irradiation and very high compression and ignition of fuel, the alternative scheme with side-on ignition of uncompressed solid density of fuel (Chu) may lead to a solution by using the now available picosecond laser pulses with higher than petawatt power. A necessary condition is to use clean laser pulses with better than 108 contrast ratio for suppression of relativistic self-focusing. When updating the analysis of Chu for fusion of deuterium-tritium and proton-11B, one problem is that the correct use of the stopping power of the alpha particles had to be solved. Discrepancies are evaluated in view of the stopping power at the low temperature range of the plasmas where the change of the emitted bremsstrahlung is involved.
We report a rare case of auricular involvement by leishmaniasis, in order to demonstrate the importance of thorough investigation of cutaneous head and neck lesions, and also the importance of inclusion of infections such as leishmaniasis in the differential diagnosis of auricular lesions, especially in endemic areas.
A 42-year-old man with multiple lesions on his head, neck and hands was referred to our centre. He had the following lesions: a painful, crusted, 8 × 8 cm plaque with indurated margins on the left parotid region and auricle; a red papule on the right temporal region; an ulcerative lesion on the skin overlying the proximal interphalangeal joint of the fifth finger of the right hand; and a bluish papule on the neck. Although histopathological examination of the Geimsa-stained specimen was misleading, a direct smear prepared from biopsies showed amastigotes, and therapy resulted in complete recovery.
Leishmaniasis can be both under- or over-diagnosed. Especially in endemic areas, parasitic causes of chronic infections should always be kept in mind.
One hundred and nine patients with primary antibody deficiencies were selected in order to determine the frequency of ENT complications.
Demographic information and ENT medical histories were collected for each patient. Duration of study for each patient was divided into two periods of before diagnosis and after diagnosis and the initiation of treatment.
Eighty-two of 109 patients (75.2 per cent) experienced ENT infections during the course of the disease (63: otitis media, 75: sinusitis and nine: mastoiditis). At the time of diagnosis, 52 (47.7 per cent) out of 109 patients presented with an ENT symptom. The frequencies of episodes were 27 for sinusitis and 25 for otitis media (one complicated with mastoiditis). After immunoglobulin replacement therapy the incidence of otitis media was reduced from 1.75 before treatment to 0.39 after treatment per patient per year (p = 0.008). The incidence of sinusitis also significantly decreased from 2.38 to 0.78 (p value = 0.011).
ENT infections are common medical problems in primary antibody deficiency patients. Persistent and recurrent ENT infections should be suspected as originating from a possible underlying immunodeficiency.
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