Predictability of speech-in-noise performance from real ear measures of directional hearing AIDS

OBJECTIVE: Inability to understand speech in noise has been cited repeatedly as the principal complaint of hearing aid users. While data exist documenting the benefit provided by hearing aids with directional microphones when listening to speech in noise, little work has been done to develop a standard clinical protocol for fitting these hearing aids. Our goal was to evaluate a clinical measure of the acoustic directivity of a directional hearing aid, including its association with a test of speech perception in noise. DESIGN: The performance of two commercially available directional behind-the-ear (BTE) hearing aids was evaluated using the Hearing in Noise Test (HINT) and the Real Ear Aided Response (REAR) on 24 adult participants with symmetric, mild to moderately severe, sensorineural hearing loss. The HINT was conducted with the speech signal presented from 0 degrees and the noise from 180 degrees and either 135 degrees or 225 degrees, depending on the ear tested. REAR was measured at the above three angles using swept pure tones, and these measures were used to compute in situ directivity for each subject and hearing aid. CONCLUSIONS: Directional benefit for the HINT was greatest when noise was presented from the azimuth of the published polar diagram null of a given hearing aid in its directional mode (180 or 135/225 degrees). The only significant correlation between HINT and REAR results, however, was found when the noise source was at 180 degrees. These results confirm the validity of using real ear measures as a way to assess directionality in situ, but also indicate the complexity of predicting perceptual benefit from them. These data suggest that factors beyond acoustic directionality may contribute to improvement in speech perception in noise when such improvements are found.     

Synthesis of flexible sulfur-containing heteroarotinoids that induce apoptosis and reactive oxygen species with discrimination between malignant and benign cells

Regulation of growth, differentiation, and apoptosis by synthetic retinoids can occur through mechanisms that are dependent and independent of their ability to bind and activate nuclear retinoic acid receptors. The objective of this study was to determine if increasing flexibility of the heteroarotinoid structure would affect the specificity of the synthetic retinoids for the receptors and for their regulation of cancerous and nonmalignant cells. Methods were developed to produce the first examples of heteroarotinoids 15a-15h, which contain urea and/or thiourea linking groups between two aryl rings. Substituents at the para position of the single phenyl ring were either an ester, a nitro group, or a sulfonamide group. Ovarian cancer cell lines Caov-3, OVCAR-3, SK-OV-3, UCI-101, and 222 were utilized, and the inhibitory prowess of the heteroarotinoids was referenced to that of 4-HPR (25). Similar to 4-HPR (25), the heteroarotinoids inhibited growth of all cell lines at micromolar concentrations. Although the heteroarotinoids did not activate retinoic acid receptors, the agents induced potent growth inhibition against the cancer cells with weak activity against normal and benign cells. The growth inhibition was associated with cell loss and induction of reactive oxygen species.     

Transforming growth factor-beta1 induced hepatocyte apoptosis--a possible mechanism for growth of colorectal liver metastasis

The mechanisms of colonization and growth of metastatic liver tumors from colorectal cancers remain obscure. Forty-three resected colorectal metastatic liver tumors with surrounding livers were evaluated for apoptotic index (AI), proliferation index (PI), and immunohistochemical expressions of TGF-beta1. TGF-beta receptor II, Fas, and Fas-ligand. All the parameters were significantly higher in the peri-tumoral livers than in the tumors with the exception of PI, which was significantly high in tumors. Enhanced TGF-beta1 expression was noticed at the interface between the metastatic tumor and the adjacent liver parenchyma. The AIs of hepatocytes in the TGF-beta1-positive areas (8.7 +/- 7.5%, n = 43) were significantly higher when compared with those in the TGF-beta1-negative areas (2.4 +/- 4.5%, n = 42) (p < 0.001). However, the same kind of correlation could not be found in metastatic tumors. The enhanced expression of TGF-beta1 and hepatocyte apoptosis in the peri-tumoral liver parenchyma may suggest that TGF-beta1 plays a substantial role in the development of colorectal liver metastasis.     

Therapeutic potential of monoisoamyl and monomethyl esters of meso 2,3-dimercaptosuccinic acid in gallium arsenide intoxicated rats

The dose dependent effects of monoisoamyl and monomethyl esters of meso 2,3-dimercaptosuccinic acid (DMSA) (0.1, 0.3 and 0.5 mmol kg(-1), intraperitoneally (i.p.) once daily for 5 days) to offset the characteristic biochemical, immunological, oxidative stress consequences and DNA damage (based on DNA fragmentation and comet assay) following sub-chronic administration of gallium arsenide and the mobilization of gallium and arsenic were examined. The effects of these chelators alone in normal animals too were examined on above-mentioned variables. Male Wistar rats were exposed to 10 mg kg(-1), GaAs, orally once daily for 12 weeks and were administered DMSA or two of its monoesters (monoisoamyl or monomethyl) for 5 consecutive days. DMSA was used as a positive control. DMSA and its derivatives, when given alone, generally have no adverse effects on various parameters. After 5 days of chelation therapy in GaAs pre-exposed rats, MiADMSA was most effective in the reduction of inhibited blood delta-aminolevulinic acid dehydratase (ALAD) activity and zinc protoporphyrin level while, all three chelators effectively reduced urinary ALA excretion, compared to GaAs alone exposed rats. MiADMSA was also effective, particularly at a dose of 0.3 mmol kg(-1), in enhancing the inhibited hepatic transaminase activities. Parameters indicative of oxidative stress responded less favorably to the chelation therapy, however, three chelators significantly restored the altered immunological variables. MiADMSA was relatively more effective than the other two chelators. GaAs produced significant DNA damage in the liver and kidneys and the chelation treatment had moderate but significant influence in reducing DNA damage. All three chelators significantly reduced arsenic concentration and, however, MiADMSA was more effective than the other two chelators in depleting arsenic concentration from blood and other soft tissues. A dose of 0.3 mmol kg(-1) was found to be relatively better than the other two doses examined. Gallium contents of blood and soft tissues remained uninfluenced by the chelation therapy. Significant loss of copper after MiADMSA administration, however, is of concern and requires further exploration. Additionally, further studies are required for the choice of appropriate dose, duration of treatment and possible toxic/side effects. Keeping in view the promising role of MiADMSA in the treatment of GaAs poisoning, these data will be needed for the registration of this chelating agent as licensed drug for the treatment of gallium arsenide intoxication.     

Malignant melanoma of the vagina: report of two cases

Two rare cases of malignant melanoma, (one amelanotic) arising in the vagina in middle-aged group are being reported. Clinical, histopathological and immunohistochemical studies supported the diagnosis. The neoplasm is highly malignant & carries a poor prognosis.     

A combination of physical examination and ECG detects the majority of hemodynamically significant heart defects in neonates with Down syndrome

Echocardiography has become the method of choice in the diagnosis of a congenital heart defect (CHD) in neonates with Down syndrome. The most compelling argument for diagnosis of CHD in the neonatal period is the need for early surgical intervention (ideally prior to 6 months of age) in those with a complete atrioventricular (AV) canal. We evaluated the efficacy of a combined approach of physical examination (PE) and electrocardiography (ECG) in the detection of CHD in 49 neonates with Down syndrome. Our findings indicate that most hemodynamically significant defects (78%), especially a complete AV canal, can be detected by this approach. Hemodynamically insignificant minor defects, such as a small patent ductus arteriosus (PDA) and a small atrial septal defect (ASD), may be missed. Thus, echocardiography remains the most sensitive way to diagnose CHD. However, given that the combination of PE and ECG detects the majority of complete AV canal defects, it can be used as an alternative approach when echocardiography is not easily accessible, due to geographic or economic constraints. Follow-up after a few weeks of those with normal PE and ECG findings should enable detection of new symptoms and signs and evolving ECG findings that may have been missed in the immediate newborn period. Patients who are judged by PE and ECG to have CHD will need echocardiographic confirmation.     

Parvalbumin and calbindin D-28K immunoreactive neurons in area MT of rhesus monkey

The chemical characteristics of the neurons of the motion sensitive visual area, area MT, remain to be established. We studied the distribution pattern of two calcium binding proteins, parvalbumin (PV) and calbindin D28K (CB) in this area, using specific monoclonal antibodies and the peroxidase-antiperoxidase (PAP) immunohistochemical technique. Aldehyde fixed 30-micron-thick cryostat sections from area MT of five animals were processed free floating for immunohistochemical staining. Besides studying the morphological characteristics of PV and CB positive neurons, quantitative analysis was carried out to determine their (1) perikaryal area (Pa) and diameter, (2) numerical densities (NV)/mm3 cortical tissue, (3) absolute number (NC) in a column of cortex under 1 mm2 cortical surface along with (4) layerwise absolute number (NL) under 1 mm2 cortical surface and (5) laminar percentage distribution of immunoreactive (IR) neurons. Quantitative analysis was carried out using a Leica QMC 500 image analysis system connected to a DMRE microscope. The results showed that both types of IR neurons were localized to all cortical layers except layer I. The PV +ve neurons were equidistributed between the supra- and infragranular layers, with the highest percentage being present in layer III (45%) followed by layer V (21%). The CB +ve neurons, on the other hand, were predominantly localized in supragranular layers, with the highest percentage being in layer III (54%) and the next highest percentage in layer II (18%). The average Pa and diameter of PV +ve neurons were found to be 96.90 +/- 28.43 micron 2 and 11.01 +/- 1.61 microns respectively. The CB +ve neurons were significantly smaller in size than the PV +ve neurons, with average Pa and diameter of the former being 92.23 +/- 26.18 micron 2 and 10.39 +/- 1.23 microns respectively. The NV for PV and CB +ve neurons showed ranges of 3157-3894 and 2303-2585, with means of 3347 +/- 285 (+/- SD) and 3436 +/- 100 respectively. The values for NC showed ranges of 5230-5444 and 4020-4268 with means of 5378 +/- 85 and 4167 +/- 95 for PV and CB neurons respectively. Variations in size together with the differential distribution of these neurons in the cortical layers may indicate their involvement in different functional circuitaries.