Cochlear implants for pre-lingually profoundly deaf adults

Introduction: Increasing numbers of pre-lingually profoundly deaf adults are seeking a cochlear implant (CI). Pre- and post-operative outcomes are presented on 20 of these patients.

Results: An Adult Pre-Lingually Profoundly Deaf Implant Profile (APDIP) weighted the pre-operative level of concern about potential CI benefit. Results indicated no group mean post-operative open-set improvement. However CUNY sentence testing (auditory plus lip-reading cues) revealed improved performance with a CI. Twelve out of 20 patients used their CIs for more than 10 hours per day, suggesting good usage. Moreover, hours of usage were positively associated with measured benefit on CUNY sentences in the lip-reading plus sound via CI condition. There was no apparent relationship between pre-operative level of concern and post-operative CI performance or hours of processor use.

Conclusion: Results suggest implantation is beneficial and effective in this group.     

Congenital pancreatic hypoplasia: a syndrome of exocrine and endocrine pancreatic insufficiency

We describe two brothers with small size at birth, early-onset insulin-dependent diabetes, and pancreatic exocrine insufficiency. In contrast to the findings in pancreatic aplasia, their serum C-peptide and glucagon levels were measurable. These findings, in concert with their clinical courses, are consistent with the diagnosis of congenital pancreatic hypoplasia.     

Endometrial cancer--revisiting the importance of pelvic and para aortic lymph nodes

In 1998, FIGO (International Federation of Gynecologists and Obstetricians) required a change from clinical to surgical staging in early endometrial cancer. This staging requirement raised numerous controversies around the importance of determining nodal status and its impact on outcomes. A diversity of opinions exists as to the actual benefits and toxicities associated with surgical staging which includes lymph node sampling, ranging from those whose opinion is that staging is required for all patients even when the a priori risk of nodal involvement is extremely low through to those who consider that staging is unnecessary in any patient. While knowledge of the presence or absence of extra uterine sites of disease may change treatment approaches and direct different treatment interventions in some patients, the impact of those changes on survival is much less clear. This paper examines recommendations for surgical staging in various subgroups of patients with clinically early endometrial cancer and the impact on survival and toxicity of the various approaches and the subsequent use of adjuvant irradiation and/or chemotherapy.     

The effects of thiosemicarbazide on development in the wood frog, Rana sylvatica. II. Critical exposure length and age sensitivity

Wood frog (Rana sylvatica) tadpoles were exposed to 50 mg thiosemicarbazide (TSC)/liter water for varying lengths of time and at different developmental stages. Short exposure periods (3 and 6 hr) resulted in no visible deformities. Exposure periods of 12 or more hr caused slight to severe abnormalities, with a direct relationship between length of exposure and degree of deformity. Tadpoles exposed to TSC from posthatching Days 24-30 were more seriously affected than were tadpoles exposed at an older age.     

Effects of skin storage conditions and concentration of applied dose on [3H]T-2 toxin penetration through excised human and monkey skin

Penetration of [3H]T-2 toxin through excised human and monkey skin stored at -60 degrees C was faster than through human and monkey skin stored at 4 degrees C, respectively. The permeability of refrigerated human skin was 34% of the permeability of refrigerated monkey skin. Increasing the concentration of [3H]T-2 toxin applied to the refrigerated monkey skin increased the amount of [3H]T-2 toxin penetrating the skin and enhanced the efficiency of penetration. Metabolites of [3H]T-2 toxin were identified in the receptor fluid bathing the dermal side of the excised human and monkey skin.     

The consequences of risk reducing salpingo-oophorectomy: the case for a coordinated approach to long-term follow up post surgical menopause

Women with germline mutations in BRCA1 and BRCA2 genes have significantly increased lifetime risks of breast and ovarian cancer. To manage both the ovarian and breast cancer risks the current recommendation is undergo a risk reducing salpingo-oophorectomy (RRSO) prior to natural menopause. To date, studies have focussed on quality of life and sexual dysfunction in women who undergo RRSO, but few have reported on the wider physical consequences. We performed a questionnaire study in women with BRCA 1 or 2 gene mutations known to the Peter MacCallum Familial Cancer Centre. We gathered information about ovarian surgery, ongoing follow-up, management of risk factors including osteoporosis, and current severity of menopausal symptoms. Two hundred and nineteen women were surveyed. One hundred and forty-three of 157 responding participants (91?%) reported having RRSO. Sixty one were pre-menopausal at RRSO. Post surgical follow-up rates were generally low, and a minority of women reported recent bone density imaging or pharmaceutical prevention or treatment of osteoporosis. Menopausal symptoms appeared generally mild. No significant differences in symptom severity were observed in women who underwent a pre-menopausal RRSO compared to RRSO after natural menopause. These data indicate that a formalised follow-up protocol is necessary to optimally manage the consequences of a RRSO.