Evaluation of bronchoalveolar lavage fluid from donkeys using four different cytological stains: A pilot study.

Bronchoalveolar lavage fluid (BALF) cytology is used for the diagnosis of non-infectious lower airway inflammation in equids. Discrepancies have been reported in the differential cell count when different staining methods were used both in humans and horses. The objective of this study was to compare the results of BALF cytology in donkeys using four different staining methods: modified May-Grunwald Giemsa (mMGG), Diff-Quick (DQ), Toluidine blue (TB) and Perls Prussian blue (PPB). Nine healthy Amiata female donkeys were enrolled. The BAL procedure was performed as previously described and pairs of cytocentrifuged BALF slides were stained with each method. No differences between mMGG and DQ were found for macrophages, neutrophils, and eosinophils, while differences were found in mast cell count between DQ vs.TB, but not between mMGG vs. DQ or mMGG vs. TB. Finally, no differences were obtained in the differential count for hemosiderophages comparing mMGG, DQ and PPB. The mMGG appears to be an excellent stain for the identification of all possible cell types, including mast cells in the BALF of donkeys. DQ, if used alone, may lead to inappropriate identification of mast cells. These results are consistent with the literature on BALF staining methods in horses.

The French Cochlear Implant Registry (EPIIC): General indicators.

Cochlear and brainstem implants have been included on the list of reimbursable products (LPPR) in France since March of 2009. The implants were initially inscribed for 5 years, after which an application for renewal with the French National Commission for the Evaluation of Medical Devices and Health Technologies (Commission Nationale d'évaluation des dispositifs médicaux et des technologies de santé - CNEDiMTS) was required [Haute Autorité de santé, 2009]. Upon registration to the list of reimbursable products, the companies and the reference centers for cochlear and brainstem implants were asked to set up a post-registration registry called EPIIC. This article reports the evolution in the EPIIC registry of the general indicators for 5051 patients over the five years from 2012-2016.

[Anatomical relationship between the frontal sinus ostium and the anterior ethmoidal artery: surgical implications]. / Rapports endoscopiques entre l'ostium du sinus frontal et l'artère ethmoïdale antérieure : implications chirurgicales.

OBJECTIVES: The anterior ethmoidal artery represents a major danger in the dissection of the anterior ethmoid roof. In addition to hemorrhage, its injury exposes the patient to the risk of orbital haematoma and requires intraoperative and postoperative vigilance. The goal of this study was to describe the anatomical relationship between the frontal sinus ostium and the anterior ethmoidal artery, such as they are observed with the endoscope during nasalization. MATERIALS AND METHODS: Consecutive patients with no surgical history or agenesia of the frontal sinuses, with an indication for ethmoidal complete exenteration with ablation of the mucous membrane (nasalization), were included in a prospective descriptive study. When dissection of the anterior ethmoidal roof was finished, the relationship between the frontal sinus ostium and the anterior ethmoidal artery were filmed and drawn on a diagram during surgery. A photograph of the relationship between the frontal sinus ostium and anterior ethmoidal artery was selected afterward from the film. RESULTS: Sixty-eight ethmoids were operated (30 bilateral, eight unilateral) with no complications. The anterior ethmoidal artery was visible in 60 cases (88%), 31 out of 34 cases on the left side (45%) and 29 out of 34 cases on the right side (43%); it was not visible in eight cases (12%), three cases on the left (4.5%) and five cases on the right (7.5%). In the most frequent anatomical configuration (45 cases, 66%), the frontal sinus ostium was separated from the anterior ethmoidal artery by a single ethmoidal cell. The other anatomical configurations were: presence of two cells between the frontal sinus ostium and the anterior ethmoidal artery in 11 cases (16%), and three cells in one case (1%) or absence of the ethmoidal cell between the frontal sinus ostium and the anterior ethmoidal artery (the anterior ethmoidal artery was located on the posterior wedge of the frontal ostium) in three cases (4%). The comparison of the 30 bilateral cases showed a symmetrical relationship between the frontal sinus ostium and the anterior ethmoidal artery in 20 cases (67%). CONCLUSIONS: These data are addressed to surgeons seeking the anterior ethmoidal artery starting from the frontal sinus ostium. Localization of the frontal sinus ostium, which can be achieved by retrograde cannulation of the frontal sinus or using a transcutaneous frontal drain, appears to be a reliable technique to dissect the roof of the anterior ethmoid and locate the anterior ethmoidal artery.

[Vestibular neurotomy by a retrosigmoid approach: functional results. Evaluation through a triple clinical approach (otoneurologic, orthoptic and physical medicine)]. / La neurotomie vestibulaire par voie rétrosigmoïde: résultats fonctionnels. Evaluation au travers d'une triple approche clinique (otoneurologique, orthoptique et médecine physique).

Vestibular neurotomy remains the surgical procedure of choice in the management of peripheral vertigo resistant to the usual medical treatment, for patients with preserved hearing. Menière's disease generally sums up most of the surgical indications. The authors report a personnel series of patients who underwent vestibular neurotomy during the last five years, from January to December 1998. The aim of this study was to assess with a 6 months to 3.5 years follow-up, postoperative complications and functional results, particularly the improvement of dizziness, residual unsteadiness and its impact on quality of life, and the recovery of socio-professional and physical activities. Of a total of 41 patients, 21 were evaluated by both an otoneurologic and physical medicine approach, to analyze the main sensory components of equilibrium (vestibular, proprioceptive, cervical, visual). In most of the cases, the results show disappearance of vertigo which was the main complaint. However, disabling residual instability is common in those patients who was present both a cervical pathology and binocular visual impairment or a defect in convergence, often unrecognised. The authors emphasise the necessity of a cervical examination and orthoptic investigations in addition to the vestibular assessment. This multi-disciplinary approach allows better identification of the different factors (vestibular, cervical, orthoptic) and lead to specific rehabilitation which can permit the patient with residual unsteadiness to return to work and lifestyle, the real measure of success of vestibular neurotomy.

[Regenerative potential in the organ of Corti after otic intoxication]. / Potentiel régénératif de l'organe de Corti après ototoxicité.

The auditory sensory cells are sensitive to a variety of influences such as noise, ototoxic drugs and aging. In the cochlea of mammals, the destroyed sensory cells are not replaced by new sensory cells. That leads to cochlear deafness, a frequent disease in human. Unfortunately, such auditory impairment is out of reach of treatment. The development of new therapeutic strategies in this field requires a precise knowledge of the mechanisms involved in auditory sensory cells disappearance and in organ of Corti's degeneration. The aim of our study was to characterize cellular and molecular changes in the cochlea of rats which had been intoxicated with the ototoxic antibiotic amikacin. The animals were sacrificed at different survival times during and after the antibiotic treatment and their cochleas were investigated using transmission and scanning electron microscopy and using confocal microscopy after tissue labellings with different fluorescent probes. The results revealed the existence of three periods. The first one corresponds to the disappearance of the sensory cells which die by apoptosis. During the second period, the organ of Corti undergoes a scarring process; concomitantly, a contingent of nonsensory supporting cells attempts to transdifferentiate directly into sensory cells. This process however fails, and the supporting cells never reach the status of hair cells. A general process of dedifferentiation of all the epithelial cells of the organ of Corti followed by a massive apoptosis of numerous epithelial cells and of most ganglion cells occurs during the third period. After that, the organ of Corti is definitely reduced to a simple monolayered epithelium. On the basis of these data, experimental strategies aimed i) to protect the sensory cells against apoptosis and ii) to promote sensory cell regeneration are now under study. They might have important implications in human therapy.

[Regenerative potential of the sensory epithelium of the mammalian organ of Corti after poisoning with ototoxic antibiotics]. / Potentiel régénératif de l'épithélium sensoriel de l'organe de corti du mammifère après intoxication aux antibiotiques ototoxiques.

Cochlear sensory hair cells are very sensitive to noxious influences such as ageing, noise and ototoxic drugs. Whereas lost auditory hair cells are replaced by new hair cells in the avian and lower vertebrates, cochlear sensory hair cells do not regenerate in mammals. Recently, we have observed transient atypical cells in the cochlea of amikacin intoxicated rats. We have related their presence to an attempt at sensory hair cell neodifferentiation. The aim of the present study was to i) investigate the mechanisms responsible for sensory hair cell losses during the intoxication and the subsequent appearance of atypical cells, ii) characterise the phenotype of these atypical cells and iii) evaluate the influence of cochlear immaturity in such an attempt at sensory hair cells neo-differentiation.

Attempt at hair cell neodifferentiation in developing and adult amikacin intoxicated rat cochleae.

Recent studies have shown that an attempt at auditory hair cell neodifferentiation occurs in vivo in the rat organ of Corti after amikacin intoxication during the last stages of cochlear maturation. Atypical cells, with morphological characteristics reminiscent of very immature sensory hair cells, were transiently observed after outer hair cell losses. The aim of the present study was to assess (i) if this attempt at hair cell neodifferentiation was related to the degree of maturity of the organ of Corti and (ii) to characterise morphological and molecular changes in the scarring epithelium. We therefore investigated, using electron and confocal microscopy, morphological and molecular changes in cochleae from rats treated with amikacin at two different periods: from post natal day (PND) 1 to PND 8, when the organ of Corti is very immature; and from PND 30 to 37, when the organ of Corti is morphologically and functionally mature. In both groups, transient atypical cells were observed, attesting that the attempt at hair cell neodifferentiation is not strictly related to the immaturity of the cochlea. The results also suggest that Deiters cells are involved in the appearance of atypical cells, possibly through a transdifferentiation process. Finally, it appears that non-sensory epithelial cells from the outer spiral sulcus progressively colonize the region of pre-existing outer hair cells.