The standardization of pancreatic donors for islet isolations

BACKGROUND: Islet transplantation has proven to be a successful treatment for type 1 diabetes mellitus. The aim of this study was to establish an algorithm by which the combination of the donor quality and pancreas quality was given a numerical score from 0 to 100 for use in determining the quality of a pancreas for islet isolation. METHODS: We retrospectively analyzed 326 pancreases and the outcomes of their respective isolations. Specific donor variables and physical characteristics were identified and weighted according to their influence on the success of the isolation. For each variable, ranges and point weightings were established based on our laboratory experience and literature review. RESULTS: Analysis of the data showed a strong association of the donor point with isolation outcome. Pancreases with lower donor point scores had lower transplant success rates, whereas higher donor point scores in turn produced higher transplant rates. CONCLUSIONS: This scoring system has proven to be useful in guiding the decision process as to whether to accept a particular pancreas for a favorable isolation outcome.     

Bowen's disease of the nipple-a new method of treatment

Squamous cell carcinoma in situ (Bowen's disease) is a common skin condition but has only rarely been described on the nipple. All reported cases have been treated with wide local excision and observation. A new treatment for Bowen's disease is photodynamic therapy. This has been reported as being able to treat Bowen's disease in other sites effectively with an acceptable local recurrence rate. We describe two patients presenting with itching and scaling of the nipple which were histologically proven Bowen's disease, one of these patients was treated successfully with a combination of photodynamic therapy and cryotherapy: this is the first time such a lesion has been treated in this way.     

A nonspeech investigation of tongue function in Parkinson's disease

BACKGROUND: Nonspeech investigations of tongue function in persons with Parkinson's disease (PD) have generally reported impaired tongue strength, endurance, and fine force control. However, these investigations did not specifically evaluate the relative contribution of age effects to the deficits in tongue function observed. Furthermore, the relationship between these nonspeech measures of tongue function and the speech disorder present in PD remains equivocal. Therefore, the current study investigated the strength, rate of repetitive movement, fine force control, and endurance of the tongue in three groups of participants. METHODS: Participants in the study included 14 older adults with PD and imprecise consonant articulation, 11 neurologically healthy older adults, and 15 neurologically healthy young adults. All participants were assessed using a comprehensive nonspeech assessment battery of tongue function. RESULTS: The results of the investigation revealed similar levels of tongue strength, rate of repetitive movement, and endurance between the persons with PD and the older control participants. Significant age effects were noted, with both groups demonstrating significantly reduced functioning on those measures when compared to young control participants. However, the three participant groups had similar levels of fine force control. No relationship was found between the nonspeech measures of tongue function employed and the severity of consonant imprecision. CONCLUSION: The nonspeech measures used failed to provide useful diagnostic information regarding the physiologic basis of perceived articulatory dysfunction in the persons with PD who were examined.     

Down's syndrome: an atheroma-free model?

Postmortem examination of five institutionalised patients with Down's syndrome (DS) aged 40-66 years showed a complete absence of atheroma, while a similar number of mental defectives with DS were found to have mild or severe atheroma. Previous investigation of risk factors for atheroma in 70 patients with DS and 70 age-and sex-matched mental defectives living in the same institution showed significantly lower systolic and diastolic blood pressures in the DS group, with the exception of systolic pressure in men under 40. Fasting serum cholesterol and triglyceride concentrations were similar in the two groups, but triglyceride concentrations were significantly lower than in normal people without a history of vascular disease. These unexplained observations may be relevant in further studies of the pathogenesis of atheroma.     

Colon perforation following percutaneous nephrostomy and renal calculus removal

Two patients had colonic perforation as a result of percutaneous nephrostomy placement followed by track dilatation and renal calculus removal. We present the technical aspects of nephrostomy placement and stone removal, as well as the clinical diagnosis and management of these cases. Both patients recovered well with conservative therapy and required no surgical intervention. This report reviews the anatomic considerations for percutaneous nephrostomy in patients undergoing renal stone removal.     

Lingual kinematic strategies used to increase speech rate: comparison between younger and older adults

The primary objective of this study was to assess the lingual kinematic strategies used by younger and older adults to increase rate of speech. It was hypothesised that the strategies used by the older adults would differ from the young adults either as a direct result of, or in response to a need to compensate for, age-related changes in the tongue. Electromagnetic articulography was used to examine the tongue movements of eight young (M = 26.7 years) and eight older (M = 67.1 years) females during repetitions of /ta/ and /ka/ at a controlled moderate rate and then as fast as possible. The younger and older adults were found to significantly reduce consonant durations and increase syllable repetition rate by similar proportions. To achieve these reduced durations both groups appeared to use the same strategy, that of reducing the distances travelled by the tongue. Further comparisons at each rate, however, suggested a speed-accuracy trade-off and increased speech monitoring in the older adults. The results may assist in differentiating articulatory changes associated with normal aging from pathological changes found in disorders that affect the older population.