Letter to the editor in response to the article of Dekkers and Søballe (Activities and impairments in the early stage of rehabilitation after Colles' fracture; Vol. 26, No. 11, June 3, 2004)

Aim.?To study psychological well-being (health-related quality of life) in a population of adults 20 years and over with hearing impairment (HI) and its relation to audiological factors, consequences of the HI, sense of humour, and use of communication strategies.

Subjects and methods.?Consecutive adults (n = 343) at the outpatient Unit of Audiology of a Norwegian university hospital answered the Psychological General Well-being inventory (PGWB), Hearing Disability and Handicap Scale (HDHS), Sense of Humour Questionnaire-6 (SHQ-6), and Communication Strategies Scale (CSS) in relation to an audiological examination and medical consultation.

Results.?Mean PGWB index for the whole sample was 81.4 (SD 14.3) and females reported a significantly lower psychological well-being. In multiple linear regression analyses well-being was negatively associated with high levels of activity limitation and participation restriction. PGWB index was positively associated with high sense of humour, but was neither explained by audiological factors nor use of communication strategies.

Conclusions.?Psychological well-being was associated with the outcome of a standard HI assessment of activity limitation and participation restriction, but not with degree of HI and use of communication strategies.     

Identification of a novel complex between human kallikrein 2 and protease inhibitor-6 in prostate cancer tissue.

Human kallikrein (hK) 2 is an arginine-selective serine protease expressed predominantly in the prostate that has an 80% sequence identity with prostate-specific antigen. Expression of hK2 is elevated in the tumor epithelium compared to benign prostate tissue. We have purified, sequenced, and identified a novel hK2 complex in prostate tissue consisting of hK2 and a serine protease inhibitor known as protease inhibitor-6 (PI-6). This 64-kDa SDS-PAGE stable complex is elevated in the tumor and is approximately 10% of total hK2. No comparable complex of prostate-specific antigen was detected. PI-6, also known as cytoplasmic antiprotease, has been characterized as an intracellular inhibitor of trypsin and chymotrypsin-like proteases, which has high homology to plasminogen activator inhibitor 1 and 2. The physiological role of PI-6 in the prostate and its relationship to hK2 and prostate cancer are under investigation.     

Anatomical and electrophysiological study of multitransmitter neuron R14 of Aplysia

This study provides detailed information on the Aplysia neuron R14, including its endogenous electrical activity and extensive axonal projections to a variety of vascular and vascular-related tissues. With the aid of intracellular recording techniques, R14 was found to display in vitro variable spontaneous patterns of silent, beating, or bursting activity. Electrophysiological tracing and intracellular cobalt staining revealed the peripheral processes and target tissues of R14. The white-colored axons of R14 exit the parietovisceral ganglion in the genito-pericardial, spermathecal, branchial, and vulvar nerves. These processes extended 20 mm or more into peripheral tissues: the pericardial wall and lumen, digestive gland sheath, aortae, arteries, and veins. R14 axons also project to the right bag cell cluster. Its extensive axonal projections to tissues associated with the cardiovascular system verify physiological studies that show that R14 plays a role in cardiovascular regulation. This neuron appears to have a wide influence over several aspects of circulation in contrast to individual neurons of the R3-13 group, each of which projects to limited numbers of vascular and vascular-related tissues. R14 also uniquely innervates digestive tissues, thus suggesting that it may act as a nexus between influences on digestive and renal physiology such as ion/water regulation, in addition to modulating cardiovascular homeostasis.     

A healable filamentous Dacron surgical fabric. Experimental studies and clinical experience

A strong, lightweight, highly compliant Dacron surgical fabric of warp-knit, velour construction has been developed as an outgrowth of research on filamentous tubular vascular prostheses. This material has excellent suturability and conformability, high preclotting efficiency, and is imprinted with calibration marks at 2 cm intervals. Experimentally, iliac artery and descending thoracic aorta patch grafts of this material were completely healed 28 days after implantation in dogs. Light and electron microscopy showed excellent healing. This paper reports clinical results of 119 patches implanted in 109 patients who have been followed for a mean of 26.4 months (range: 16--34 months). Of these, 20 patches were used in arterial reconstructions, and 99 were used in the heart for repair of 95 congenital and four acquired defects. The 20 patch angioplasties were performed in the carotid artery (four patches), subclavian artery, (one patch), common femoral artery, profunda femoris artery, or superficial femoral artery (10 patches), and in the popliteal artery (five patches). This new surgical fabric is easily adaptable to complex angioplasties and for repair of intracardiac abnormalities. No complications intrinsic to the surgical fabric have been observed in clinical use of this material in 109 patients.     

Patent ductus arteriosus in premature infants. Indications for surgery.

In order to establish more objective criteria for surgical intervention, the literature and our clinical experience with operative closure of patent ductus arteriosus in 11 premature infants was reviewed. A wide range of age at the time of operation underscored the spectrum of clinical presentation and the difficulty of interpreting the course of therapy. The presence of a typical continuous murmur established the diagnosis of patent ductus arteriosus in patients with respiratory distress syndrome. Cardiac catheterization confirmed the diagnosis and provided quantitation of the left-to-right shunt flow through the ductus arteriosus in 6 patients but did not influence the decision to operate. Progress of the clinical course as determined by the heart size on chest roentgenogram and the presence of hypercarbia (Paco2greater than60 mm. Hg) after respiratory assistance and medical decongestive measures were the two most helpful signs indicating the need for surgical intervention.     

Expression of a new mucin-type glycoprotein in select epithelial dysplasias and neoplasms detected immunocytochemically with Mab A-80

We studied by immunocytochemistry 573 tissue and 106 cytologic samples of human tumors, non-neoplastic proliferative lesions and normal tissues with the monoclonal antibody (Mab) A-80 that recognizes a mucinous glycoprotein from the colon carcinoma cell line LS-174T. The spectrum of benign and malignant breast lesions was studied as were epithelial tumors of the colon, stomach, pancreas, lung, salivary glands, thyroid, prostate, kidney, endometrium, skin and mesothelium; non-epithelial tumors included lymphomas, melanomas, gliomas, meningiomas, and sarcomas of soft tissue and bone. With a single exception, breast carcinomas regardless of histologic type were reactive while few fibroadenomas stained weakly and focally. In fibrocystic disease, the presence and intensity of the reactivity paralleled the severity of the epithelial proliferation, e.g. staining was strong in foci of severe or atypical hyperplasia, borderline lesions and carcinomas in situ; apocrine metaplasia stained often but less strongly. Barrett's mucosa, colonic polyps and most gastric and colonic carcinomas stained regardless of glandular features while small cell neuroendocrine carcinomas did not. Adenocarcinomas of the pancreas and lung, and a subset of large cell lung carcinomas reacted whereas neuroendocrine carcinomas of those sites did not. Carcinomas of endometrium, ovary and prostate reacted variably whereas thyroid and renal carcinomas and mesotheliomas were either negative or weakly reactive despite the presence of glands. Lymphomas, skin adnexal tumors, nevi, schwannomas, melanomas, gliomas and sarcomas generally did not react but occasional A-80-positive cells were seen in rare sarcomas and meningiomas. Immunostaining patterns in cytologic specimens were similar to the aforementioned. We conclude that Mab A-80 is an excellent marker for breast carcinomas, and for certain proliferative forms of fibrocystic disease that may precede or be associated with carcinomatous transformation. In colonic, pulmonary and gastric carcinomas, staining with Mab A-80 revealed exocrine features regardless of the absence of glands whereas in renal and thyroid carcinomas and in mesotheliomas staining was focal and weak or absent irrespective of glandular features. We suggest that Mab A-80 is a very promising immunolabel for select exocrine carcinomas, and for some of the dysplasias that may precede their development; its ease of application on tissue sections and cytologic specimens should broaden its usefulness.