A bronchogenic cyst of the right ventricular endocardium

In a 73-year-old male patient with a history of prostate cancer, a right ventricular endoluminal tumor was diagnosed by echocardiography. An endocardial papillary fibroelastoma or myxoma appeared possible; a malignant tumor could not be ruled out. The tumor was resected using extracorporeal circulation and cardioplegic arrest. Histopathology study revealed a bronchogenic cyst with ciliated epithelium.     

Detecting components of hearing aid fitting using a self-assessment-inventory

The evaluation of hearing-aid fitting includes numerous assessments such as electro- and psychoacoustic tests. The subjective estimation of the hearing aid user can be elicited with self-assessment inventories encompassing various parameters, e.g., benefit, satisfaction and usage. A questionnaire comprising 11 domains (disability, handicap, frequency and significance of the listening situation, importance of the hearing aid, expectation, demand, aided performance, benefit, satisfaction and usage) within three different conditions (speech in quiet and in noise and listening to sounds) was used to detect components underlying hearing aid fitting. The data show a three-factor structure (situation-, restriction- and aid-related variables) independent from the conditions. Usage depends on all of the three factors. Disability and handicap reveal the highest values for speech in noise, whereas the aid-related factor shows the lowest values for this condition. Global satisfaction with the hearing aid is significantly correlated with the aid-related factor, but independent from the restriction of hearing. The aid-related factor is positively influenced by the amount of social activity because more active persons report higher benefit and satisfaction for all listening conditions. Age does not exhibit a significant relationship to one of the components. Basically, all correlation coefficients are only intermediate, revealing that inter-individual differences of the patients are rather high. The data indicate that extra-audiological factors might also play an important role in the success of hearing aid fitting.     

Untersuchung von Faktoren bei der Erstversorgung mit Hörgeräten

OBJECTIVE: Systematic research on factors before the provision of hearing aids is scarce. In order to identify parameters which promote or impede the use of hearing aids, a questionnaire-based survey was conducted. SUBJECTS AND METHODS: A total of 35 randomly chosen, hard of hearing adults indicated for a hearing aid were examined. The importance of speech in quiet and in noise, wearing comfort, sound quality, appearance and costs, as well as expectations, willingness to use a hearing aid and reasons for and against provision were determined. RESULTS: Speech in noise and quiet were most important, followed by comfort of wearing and appearance of the aid. Expectations towards the hearing aids were in general high. The willingness to use hearing devices was positively affected by the expectation that it would improve quality of life and negatively by the amount of social activity of the person. The main reasons against the use of hearing aids were appearance and lack of confidence in hearing aid technology. CONCLUSIONS: This pilot-study identified several parameters which might affect willingness to use hearing aids. In particular, expectations towards the aids, personal attitude towards hearing and communication problems and the appearance of hearing aids should be subject to further examination.     

Tissue and lineage-specific variation in inactive X chromosome expression of the murine Smcx gene

To understand how gene expression patterns are established on the inactive X chromosome during development, we have studied the murine gene Smcx, which is expressed from both the active and inactive mouse X chromosomes. In all tissues assayed, Smcx only partially escapes X inactivation, with expression levels from the inactive X allele approximately 30-65% that of the active X allele. Additionally, inactive X expression levels differed between extraembryonic and embryonic tissues and among different tissues from newborn and adult mice. Imprinted extraembryonic tissue had the lowest levels of inactive X Smcx expression, whereas the highest levels were in heart. These data suggest that the chromosomal basis of X inactivation differs among tissues, perhaps reflecting differences in the timing or regulation of inactivation in these cell lineages.      

Basal membrane-depleted scar in lesioned CNS: characteristics and relationships with regenerating axons.

The lesion scar formed after CNS injury is an impediment to axonal regeneration and leads to growth arrest or misrouting of sprouting axons. Our previous study showed that pharmacological reduction of basal membrane formation within the scar can overcome this scar impermeability [Stichel C. C. et al. (1999) Eur. J. Neurosci. 11, 632-646]. The aim of the present study was to characterize the basal membrane-depleted scar and to analyse its relationships with penetrating axons. The experiments comprised two groups of animals in which the left postcommissural fornix was transected; in addition, one group received a local immediate injection of the collagen IV-reducing agent dipyridyl, while the other group received an injection of phosphate-buffered saline. Immunohistochemical methods were used to characterize scar formation and scar-axon relationships. Animals receiving dipyridyl showed reduction of collagen IV-immunopositive basal membrane in the lesion center, which was accompanied by: (i) a decrease in laminin, as well as chondroitin and heparan sulfate proteoglycan, deposition in the lesion center; (ii) an increase in chondroitin and keratan sulfate proteoglycan expression in the perilesional area; (iii) a typical activation pattern of astrocytes and microglia/macrophages; (iv) axons regenerating through this modified scar were closely associated with various glial cell types and crossed a prominent chondroitin/keratan sulfate proteoglycan matrix. Our results suggest that neither the formation of a reactive astroglial network nor the accumulation of microglia/macrophages or the deposition of chondroitin and keratan sulfate proteoglycans in the perilesional area represent a barrier to regrowing axons. The present approach demonstrates that the lesion-induced basal membrane itself is the primary determinant of scar impermeability.     

The emerging dental workforce: long-term career expectations and influences. A quantitative study of final year dental students' views on their long-term career from one London Dental School

Background  

Research into the motivation and expectations of the emerging workforce and their short-term expectations has already been reported with a view to informing professional and policy decisions. The objective of this component of the research programme was to examine the long-term goals and perceived influences on final year dental students' professional careers.     

EMPHYSEMATOUS PYELONEPHRITIS RESPONDING TO MEDICAL THERAPY

We describe two type 2 diabetic patients with unilateral emphysematous pyelonephritis who responded to medical treatment alone. Escherichia coli was isolated in both patients. The presence of gas was confirmed early by ultrasound and CT scan of abdomen. Following treatment, good functional recovery was demonstrable in the affected kidneys by isotope renogram. We stress the need for early diagnosis of this condition and aggressive treatment with broad spectrum antibiotics.