Upregulation of the HLH Id gene family in neural progenitors and glial cells of the rat spinal cord following contusion injury.

Spinal cord injury (SCI) leads to a complex sequence of cellular responses, including astrocyte activation, oligodendrocyte death, and ependymal cell proliferation. Inhibitors of DNA binding (Id1, Id2, Id3) belong to a helix-loop-helix (HLH) gene family. Id genes have been implicated in playing a vital role in the proliferation of many cell types, including astrocytes and myoblasts. In the present study, the expression of Id family members in spinal cord after contusion injury was investigated by in situ hybridization. Id1, Id2, and Id3 mRNA expression was upregulated 5 mm rostral and caudal to the lesion center, and reached maximal levels 3 days after SCI. In addition, cell populations expressing Id1, Id2, and Id3 mRNA were maximally increased 3 days after SCI. The increase in Id2 and Id3 mRNA expression and Id2 and Id3 mRNA+ cells was still observed at 8 days. The Id mRNA expressing cells were phenotyped by combining immunostaining of cell-specific markers with in situ hybridization. Glial fibrillary acidic protein (GFAP)+ astrocytes were found to express all three Id mRNA, whereas S-100alpha+ astrocytes only expressed high levels of Id2 and Id3 mRNA. Cells having a neural progenitor morphology and the marker nestin appeared after SCI and they expressed Id1, Id2, and Id3 mRNA. Interestingly, some Rip+ oligodendrocytes located in the areas close to the central canal expressed Id3 mRNA after injury. In conclusion, Id genes are upregulated in a time-dependent manner in astrocytes, oligodendrocytes, and neural progenitor subpopulations after SCI, suggesting that they play major roles in cellular responses following SCI.     

Evaluation of the PEP mask in cystic fibrosis

Twenty-eight patients suffering from cystic fibrosis, with an age range of 8-21 years entered a randomised cross-over trial to study the efficacy of the Positive Expiratory Pressure (PEP) mask as a method of chest physiotherapy, both on its own and in conjunction with other physiotherapy techniques. Twenty-four of these patients completed the trial consisting of 4 treatment programmes each lasting one month and with no wash-out period between them. Five of these patients went on to a fifth programme of Forced Expiratory Technique (FET) alone. At the end of the trial, no significant difference was found between the programmes as regards growth, Shwachman score, Chrispin-Norman score or pulmonary function tests. Twenty-three patients chose to continue using the PEP mask in conjunction with FET long-term as their chest physiotherapy programme as they felt it was an effective treatment allowing increased independence, with postural drainage being kept to a minimum.     

Word recognition functions for the CID W-22 test in multitalker noise for normally hearing and hearing-impaired subjects

Word recognition functions for Auditec recordings of the CID W-22 stimuli in multitalker noise were obtained using subjects with normal hearing and with mild-to-moderate sensorineural hearing loss. In the first experiment, word recognition functions were generated by varying the signal-to-noise ratio (S/N); whereas in the second experiment, a constant S/N was used and stimulus intensity was varied. The split-half reliability of word recognition scores for the normal-hearing and hearing-impaired groups revealed variability that agreed closely with predictions based on the simple binomial distribution. Therefore, the binomial model appears appropriate for estimating the variability of word recognition scores whether they are obtained in quiet or in a competing background noise. The reliability for threshold (50% point) revealed good stability. The slope of the recognition function was steeper for normal listeners than for the hearing-impaired subjects. Word recognition testing in noise can provide insight into the problems imposed by hearing loss, particularly when evaluating patients with mild hearing loss who exhibit no difficulties with conventional tests. Clinicians should employ a sufficient number of stimuli so that the test is adequately sensitive to differences among listening conditions.     

Otoacoustic emissions as a screening test for hearing impairment in children

Transient evoked otoacoustic emissions (TEOAEs) are low amplitude sound waves produced by the healthy cochlea. They can be recorded with a microphone in the external ear. TEOAEs are abolished by hearing losses of 30 dB or more. The feasibility of using TEOAEs as a screening test for hearing loss in children was studied. TEOAE recordings were attempted in 56 children attending an audiology clinic. Recordings were possible from both ears in 52 children; of these 104 ears, 32 had hearing deficits of 30 dB or more. Hearing status was compared with the results of six TEOAE screening criteria. All criteria had a sensitivity of 1.00. Four standard TEOAE criteria yielded specificities of 0.46-0.58. Two new criteria derived from analysis of limited frequencies from the TEOAE waveform gave specificities of 0.76 and 0.82. It can be concluded that, when appropriate pass/fail criteria are employed, TEOAEs are a feasible screening test in children.     

Pelvic ultrasound findings in different forms of sexual precocity

Recently produced reference curves for various ultrasound dimensions were used to retrospectively assess 67 pelvic ultrasound scans carried out at the initial presentation in girls with sexual precocity. At presentation the group with precocious puberty had significantly increased uterine lengths and ovarian volumes compared with the normal population, and a significantly increased fundal–cervical ratio. Ovarian volume was also significantly increased in thelarche and thelarche variant. The fundal–cervical ratio was significantly increased in thelarche variant. There was considerable overlap between individuals with sexual precocity and normal subjects. The ultrasound findings that best discriminated early or precocious puberty from other forms of sexual precocity were the presence of a midline endometrial echo, and a uterine length above the 97th centile for age. An entirely normal pelvic ultrasound at presentation did not rule out the possibility of precocious puberty.     

Reliability of threshold, slope, and PB max for monosyllabic words

The Auditec recordings of the CID W-22 monosyllables were used to generate test and retest intelligibility functions on normally hearing listeners and subjects with mild-to-moderate sensorineural hearing loss. The normally hearing subjects were tested with 50-word lists at SPLs ranging from 15 to 50 dB. Lists of 25 words were used with the hearing-impaired group. The functions were analyzed to assess the reliability of threshold (50% point), slope (20%-80% points), and maximum intelligibility (PB max). The 50% point was obtained at 28 dB SPL for the normally hearing listeners and at a sensation level (SL) of 12 dB respondaic thresholds for the hearing-impaired group. Very stable monosyllabic thresholds were found because 95% of the test-retest values were within 6 dB for both subject groups. Slopes of 4.9% per dB and 2.7% per dB were obtained for the normally hearing and hearing-impaired groups, respectively. Fair reliability was observed; 95% of the test-retest values encompassed a range of +/- 1.9% per dB for the normally hearing subjects and +/- 1.1% per dB for the hearing-impaired group. Although group slopes provide useful information for selecting the range and step size for generating psychometric functions, the value of routinely obtaining slope on an individual basis has not been demonstrated. Even though the same word lists were used for both test and retest measurements, reliability closely agreed with predicted results based on the binomial theorem. In contrast to the large variability for a single list of 25 words, very stable PB max scores were found when two or three scores were averaged on the plateau of the function.     

Latency and amplitude effects of electrode placement on the early auditory evoked response

This study examined the effects of electrode placement on the early auditory evoked response in normally hearing subjects. The electrodes are termed noninverting, inverting, and common. Ten commonly used electrode combinations were evaluated. Both amplitudes and latencies of Waves I, III, and V were measured for each electrode combination. No mean differences in latencies were observed for Waves I, III, or V with any of the 10 electrode combinations. Similarly, no statistically significant Wave I or Wave III amplitude differences were found among the 10 electrode montages. However, larger Wave V amplitudes were found with placement of the noninverting electrode at the vertex (0.53 mu v) as compared to the upper forehead (0.39 mu v). Moreover, Wave V amplitudes were larger for inverting/common electrode placements at the seventh cervical vertebra/forehead, neck/forehead, and neck/neck (approximately 0.50 mu v) than for mastoid/mastoid and mastoid/forehead placements (approximately 0.40 mu v). Thus, three combinations of electrodes gave the largest Wave V amplitudes. These placements for the noninverting, inverting, and common electrodes, respectively, were (a) vertex-seventh-forehead, (b) vertex-neck-forehead, and (c) vertex-neck-neck.