Search

Purpose: CSOM is a common disease in lower socio-economic set-ups. Its incidence has decreased over time due to improved hygiene status increased use of antibiotics. It can be associated with cholesteatoma or granulation tissue as far as unsafe ears are considered. Cholesteatoma is defined as a well demarcated noncancerous cystic lesion derived from an abnormal growth of keratinising squamous epithelium in the temporal bone, commonly characterised as skin in the wrong place. Granulations are defined as the inflammatory response of middle ear mucosa to toxic insults. Overtime the incidence of granulations has increased. This study aims to observe the incidence trends of cholesteatoma in comparison to granulation tissue as intraoperative finding in CSOM patients and the association of these two with the age of the patient and associated complications if present. Materials and Methods: All the patients admitted to E.N.T ward of M.D.M. Hospital, Jodhpur, Rajasthan, India undergoing mastoid exploration surgery between the time period of 1 year from September 2017 to August 2018 were observed and their clinical findings along with patients data including age and sex were recorded and studied in regard with incidence of cholesteatoma, granulation tissue or both simultaneously along with associated complications. Results: Majority of the patients who required mastoid exploration surgery had the presence of granulation tissue as intraoperative finding (55.07%). The incidence of cholesteatoma and both cholesteatoma and granulations together was (21.73%) and (23.18%) respectively. Complication percentage was highest with that of cholesteatoma patients (44.45%). Most of the patients presented in the 3rd–4th decade of their lives (63.77%) and the incidence was low amongst the children (30.43%) and the elderly (5.8%). The complication rate was higher in children (55.56%). Conclusion: Granulation tissue showed an increased incidence trend as compared with cholesteatoma; although complication rate was higher in the latter. Incidence as a function of age was maximum in the middle ages but the complication rate was more amongst the children. [ABSTRACT FROM AUTHOR]

Embryos from females homozygous for a recessive maternal-effect mutation in the gene aura exhibit defects including reduced cortical integrity, defective cortical granule (CG) release upon egg activation, failure to complete cytokinesis, and abnormal cell wound healing. We show that the cytokinesis defects are associated with aberrant cytoskeletal reorganization during furrow maturation, including abnormal F-actin enrichment and microtubule reorganization. Cortical F-actin prior to furrow formation fails to exhibit a normal transition into F-actin-rich arcs, and drug inhibition is consistent with aura function promoting F-actin polymerization and/or stabilization. In mutants, components of exocytic and endocytic vesicles, such as Vamp2, Clathrin and Dynamin, are sequestered in unreleased CGs, indicating a need for CG recycling in the normal redistribution of these factors. However, the exocytic targeting factor Rab11 is recruited to the furrow plane normally at the tip of bundling microtubules, suggesting an alternative anchoring mechanism independent of membrane recycling. A positional cloning approach indicates that the mutation in aura is associated with a truncation of Mid1 interacting protein 1 like (Mid1ip1l), previously identified as an interactor of the X-linked Opitz G/BBB syndrome gene product Mid1. A Cas9/CRISPR-induced mutant allele in mid1ip1l fails to complement the originally isolated aura maternal-effect mutation, confirming gene assignment. Mid1ip1l protein localizes to cortical F-actin aggregates, consistent with a direct role in cytoskeletal regulation. Our studies indicate that maternally provided aura (mid1ip1l) acts during the reorganization of the cytoskeleton at the egg-to-embryo transition and highlight the importance of cytoskeletal dynamics and membrane recycling during this developmental period. [ABSTRACT FROM AUTHOR]