Late Presentation of Hirayama Disease With "Snake Eye Sign": A Case Report.

Hirayama disease, also called non-progressive juvenile muscular atrophy of distal upper limbs, is a type of cervical myelopathy associated with flexion movements of the neck. It is a type of benign motor neuron disease seen typically in young males in the age group of 15 to 25. The disease has an insidious onset with a stationary stage following a progressive phase.

Cerebral Venous Sinus Thrombosis Complicating Middle Ear Infections: A Rare Complication in Post-Antibiotic Era.

In the post-antibiotic era, intracranial and extracranial complications of middle ear infections have become rare. Similarly, cerebral venous sinus thrombosis (CVST), a frequent complication of middle ear infections, has become rare now. Here, we present a case of a 27-year-old male who presented with a short history of severe headache and associated episodes of intractable vomiting.

OXA-23 and OXA-40 producing carbapenem-resistant Acinetobacter baumannii in Central Illinois.

We reviewed susceptibility of 840 A. baumannii complex isolates at two academic medical centers and explored their mechanism of carbapenem resistance. Carbapenem resistance rates among A.

Bacteria-fungal Confrontation and Fungal Growth Prevention Assay.

There are some bacteria which can grow and multiply at the cost of living fungal biomass. They can potentially utilize fungi as a source of nutrients to forage over them. Such phenomenon is known as bacterial mycophagy, however, its mechanistic insights need to be explored to identify the molecules involved in mycophagy for potential utilization in controlling various fungal diseases.

A prophage tail-like protein is deployed by Burkholderia bacteria to feed on fungi.

Some bacteria can feed on fungi, a phenomenon known as mycophagy. Here we show that a prophage tail-like protein (Bg_9562) is essential for mycophagy in Burkholderia gladioli strain NGJ1. The purified protein causes hyphal disintegration and inhibits growth of several fungal species.

Draft Genome Sequence of Broad-Spectrum Antifungal Bacterium Burkholderia gladioli Strain NGJ1, Isolated from Healthy Rice Seeds.

We report here the draft genome sequence of Burkholderia gladioli strain NGJ1. The strain was isolated from healthy rice seeds and exhibits broad-spectrum antifungal activity against several agriculturally important pathogens, including Rhizoctonia solani, Magnaporthe oryzae, Venturia inaequalis, and Fusarium oxysporum.

Modified incision for maxillectomy: our experience.

Radical maxillectomy has usually been done by the classical Weber Ferguson incision since age old times and still is being used widely due to its advantage of excellent exposure and minimal scarring as the incision follows the natural skin crease. In our modification of radical maxillectomy incision we avoid a scar on the midface by performing a midface degloving and combining it with a subconjunctival eye incision thus avoiding any cosmetic deformity and associated eye complication. It also avoids the late complication of cutaneous fistula following radiotherapy to these areas and due to early healing of the wound, early radiotherapy can be started.

Transconjunctival incision for total maxillectomy--an alternative for subciliary incision.

A subciliary incision may be associated with various complications of the lower eyelid when it is used during a total maxillectomy. The use of the transconjunctival incision instead is an alternative in suitable patients. The records of 17 patients were reviewed in whom a transconjunctival incision was used during total maxillectomy.

Postauricular, transpetrous, presigmoid approach for extensive skull base tumors in the petroclival region: the successes and the travails.

Purpose: Postauricular, transpetrous, presigmoid approach combines a supra/infratentorial exposure with partial petrosectomy to access third to the twelfth cranial nerves and extraaxial lesions situated anterolateral to brainstem. It provides a shorter working distance to large petrosal, petroclival, cerebellopontine, and cerebellomedullary cisternal lesions and their extensions to the subtemporal-infratemporal areas. This study reviews the surgical technique, corridors of extension, and complications encountered utilizing this approach for excising extensive lesions in these locations.

Laryngotracheal reconstruction using iliac crest graft: an institutional experience.

The treatment of laryngotracheal stenosis has always been a challenge for otolaryngologists. Results of this operation is often not very satisfactory due to many reasons. Often modifications of available modality of treatment are required to suit a particular case.

Tentorial meningiomas: operative nuances and perioperative management dilemmas.

Purpose: Tentorial meningiomas, comprising approximately 3-6% of all intracranial meningiomas, are complex entities with an intricate relationship to surrounding structures and require multiple surgical approaches. In the present study, the rationale for deciding the approaches for TMs and the perioperative management dilemmas were evaluated.

Methods: Thirty-seven patients (28 primary [supratentorial (2), infratentorial (20) and both (6)] and nine complex [cerebellopontine (CP) angle (5) and petroclival (4)] underwent surgery using the occipital transtentorial, supracerebellar infratentorial, subtemporal transtentorial, bioccipital suboccipital, midline suboccipital, retrosigmoid, and combined pre and retrosigmoid approaches.

Rapid diagnosis and successful drug therapy of primary parotid tuberculosis in the pediatric age group: a case report and brief review of the literature.

Isolated parotid tuberculosis is difficult to diagnose in the pediatric age group. Often the problem leads to surgery. We describe the case of a 13-year-old female who presented with right parotid swelling with facial palsy.

Management of suprastomal tracheal obstruction following : a case report.

To demonstrate the importance of proper pre operative assessment of laryngotracheal stenosis especially if it acquired one. It also demonstrates the fact that the available treatment modalities for laryngotracheal obstruction can be easily modified as per the clinical presentation for better post operative results. Here we present a case of tracheal stenosis following percutaneous tracheostomy where there was suprastomal tracheal obstruction which was managed in an interesting way to give good post operative results.

Chikungunya virus induced sudden sensorineural hearing loss.

The aim of this study is to demonstrate the association of Chikungunya virus and sudden sensorineural hearing loss. In the case report described we had a case which developed sudden unilateral sensorineural hearing loss following chikungunya fever. A 15-year-old female presented to us with the complains of unilateral sudden onset of hearing loss following an episode of fever, arthralgia and rashes 1 month ago.

Apophysomyces elegans causing acute otogenic cervicofacial zygomycosis involving salivary glands.

Zygomycosis is an invasive, life threatening fungal infection that usually affects immunocompromised hosts. In the head and neck region, rhino-orbito-cerebral zygomycosis is more common than the cervicofacial variety. We report the first case of otogenic cervicofacial zygomycosis caused by Apophysomyces elegans involving the salivary glands, an uncommon site of infection.

Dentate filter function is altered in a proepileptic fashion during aging.

Purpose: The elderly have an increased incidence and prevalence for seizure disorders. Further, since up to 50% of these cases have no identifiable antecedent, it has been hypothesized that aging of the central nervous system itself may be epileptogenic. Aged rats, compared to adults, exhibit a greater susceptibility to and severity of seizures associated with hippocampal activation.

Multiple intraosseous hemangiomas-investigation and role of N-butylcyanoacrylate in management.

Background: Primary intraosseous hemangiomas are rare (0.7% of all osseous neoplasms), benign, slow-growing neoplasms. These lesions are usually solitary.

Unusual clinical and MRI features of a cerebellopontine angle medulloepithelioma. Case report and review of literature.

We describe for the first time an unusual location and clinical presentation of medulloepithelioma, a rare embryonal tumor. A 5-year-old child presented with sudden onset of bilateral hearing loss. On imaging, the lesion appeared to be extra axial and was located in the right cerebello-pontine (CP) angle, extending into middle fossa along the trigeminal ganglion and in front of the brain stem into the opposite CP angle.

Sac surgery results as a function of preoperative distress level.

Objective: To evaluate the postoperative status of the patients after endolymphatic sac decompression (ESD) for intractable unilateral definite Ménière's disease (MD) using the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) 1995 criteria and to discuss the current status of ESD in the management of MD, especially after the wide use of intratympanic administration of gentamicin for the treatment of intractable MD.

Study Design: Retrospective questionnaire-based analysis.

Methods: Thirty-nine patients who had undergone ESD between 1996 and May 2003 at Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India, were evaluated via a set format according to AAO-HNS 1995 guidelines.

Staging and surgical approaches in large juvenile angiofibroma--study of 95 cases.

Introduction: Surgery has been the treatment of choice for juvenile nasopharyngeal angiofibroma (JNA) and selection of proper surgical approach depends primarily upon the extensions of the tumor. Minimal external deformity/surgical scar without affecting growth pattern of facial skeleton of patient along with extensions of JNA were the basis of selecting surgical approach in present study.

Material And Methods: The medical records of 95 patients with histologically proven large JNA who underwent treatment in our institution between 1992 and 2002 were reviewed retrospectively.

Primary aneurysmal bone cyst of coronoid process.

Background: Aneurysmal bone cysts are relatively uncommon in the facial skeleton. These usually affect the mandible but origin from the coronoid process is even rarer. To the best of our knowledge, this is the first reported case of a coronoid process aneurysmal bone cyst presenting as temporal fossa swelling.

Cerebrospinal fluid otorhinorrhoea due to inner-ear malformations: clinical presentation and new perspectives in management.

Objective: In children cerebrospinal fluid (CSF) otorhinorrhoea can be due to congenital inner-ear malformations. Cochlear dysplasia associated with a defect in the stapes footplate is usually the cause of the CSF leak. Repair of the CSF leak in these cases is usually done by packing the vestibule with muscle or fascia.