Results of cochlear implants in totally deaf subjects]

Cochlear implants have been applied on a limited scale in the Netherlands since 1985. In a government sponsored health service trial the method was further explored from 1988 to 1991. During this period 20 persons were implanted, ten with a Vienna extracochlear system and ten with a 22-electrode Nucleus intracochlear system. The ages varied from 5 to 62, the duration of deafness from 2 to 47 years. Some patients were congenitally deaf. The major cause of deafness was meningitis. The effect of the implantation was tested with the 'minimal auditory capability' test battery adapted for the Dutch language. 18 persons were wearing their system for more than 8 h a day; one person, a prelingually deaf did no longer use his implant while another one only used it occasionally. Except for two persons, all scored above chance level on several tests. The postlingually deaf persons with the Nucleus system all achieved a certain degree of open set speech understanding without lipreading. With the aim of achieving better selection criteria a new trial has started with the same financial sources in cooperation with the Utrecht University Hospital.     

Function and structure of pressurized and perfused porcine carotid arteries: effects of in vitro balloon angioplasty

In this report we describe the application of an in vitro pressure-perfusion system for study of functional/structural changes after in vitro balloon dilation injury. Pig carotid arteries were perfused at P = 100 mm Hg and Q = 100 ml/min, balloon angioplastied (BA), and cultured under these hemodynamic conditions for 4 or 8 days (n = 5 BA and 6 controls for each time point). To assess endothelial function, outer diameter changes in response to bradykinin (BK) were measured daily. Remodeling was determined from the shift in pressure-passive diameter relation, as obtained after papaverine addition. Arterial samples were processed for histology. Control arteries showed spontaneous tone, BK-induced relaxation, and inward remodeling that was more pronounced at day 8 (ratio end-to-start passive diameter at P = 100 mm Hg, 0.69 +/- 0.04; P < 0.001) than at day 4 (0.85 +/- 0.03, P = 0.03). Intimal hyperplasia was detectable in these control vessels at day 8 with accumulation of alpha-smooth muscle actin-positive cells around the lumen. Angioplasty caused ruptures and dissections and abolished tone that returned after 5 days of perfusion along with BK-dependent relaxation. No significant inward remodeling or intimal hyperplasia was observed at day 8 after angioplasty. Thus, BA inhibits remodeling, which occurs after in vitro perfusion of conductance arteries.     

Effect of phosphoramidon - a selective enkephalinase inhibitor - on nociception and behaviour

Phosphoramidon (100-350 micrograms i.c.v.), a selective enkephalinase inhibitor, induced in the rat a decrease of nociception to pressure stimulation without evident respiratory depression. In addition, intensive behavioural changes such as grooming (licking the fur, face washing and scratching), mounting behaviour and wet dog shakes were observed. Naltrexone pretreatment (1 mg/kg i.p.) caused a significant decrease in the phosphoramidon-induced nociception and behavioural changes. Puromycin (30 micrograms i.c.v. or 7.5 mg/kg i.p.) caused no changes in nociception or behaviour.     

Three-dimensional head and upper arm orientations during kinematically redundant movements and at rest

The three rotational degrees of freedom of the head and the upper arm exceed the number needed in a two-dimensional (2-D) facing or pointing task, respectively. Previous studies reported a reduction of the number of degrees of freedom from three to two, with one degree of freedom being a unique function of the other two (Donders' law). This study investigated whether three-dimensional (3-D) orientations of the head and arm are the same at rest and during movement for corresponding pointing or facing directions. Two separate experiments were performed: one focused on head orientations, the other focused on upper arm orientations. We instructed subjects to direct the nose or to point the extended arm in the direction of targets, which appeared in a quasi-random order at 2-s intervals. The head and upper arm orientations at rest were described by a 2-D surface with a scatter less than 3 or 4 degrees, respectively. Both for the arm and the head, orientations started and ended near the 2-D surface, but for a number of the target pairs, the orientations deviated from those predicted by the 2-D surface during movement in a way that was consistent and reproducible for movements between each target pair. For upper arm movements, we often found that deviations of arm orientations from the 2-D surface increased with increasing movement velocity. Such a positive correlation between deviation and movement velocity was not found for head movements. These results clearly indicate violations of Donders' law during movement and argue against several models for movement control found in the literature.     

Ethnic disparities in the association of impaired fasting glucose with the 10-year cumulative incidence of type 2 diabetes

Aims

Evidence of ethnic disparities in the conversion of prediabetes to type 2 diabetes is scarce. We studied the association of impaired fasting glucose (IFG) and fasting plasma glucose (FPG) with the 10-year cumulative incidence of type 2 diabetes in three ethnic groups.

Methods

We analyzed data for 90 South-Asian Surinamese, 190 African-Surinamese, and 176 ethnic Dutch that were collected in the periods 2001–2003 and 2011–2012. We excluded those with type 2 diabetes or missing FPG data. We defined baseline IFG as FPG of 5.7–6.9 mmol/L. We defined type 2 diabetes at follow-up as FPG ≥ 7.0 mmol/L, HbA1c ≥ 48 mmol/mol (6.5%), or self-reported type 2 diabetes.

Results

10-Year cumulative incidences of type 2 diabetes were: South-Asian Surinamese, 18.9%; African-Surinamese, 13.7%; ethnic Dutch, 4.5% (p < 0.05). The adjusted association of baseline IFG and FPG with the 10-year cumulative incidence of type 2 diabetes was stronger for South-Asian Surinamese than for African-Surinamese and ethnic Dutch. The IFG (compared to normoglycaemia) ORs were 11.1 [3.0–40.8] for South-Asian Surinamese, 5.1 [2.0–13.3] for African-Surinamese, and 2.2 [0.5–10.1] for ethnic Dutch.

Conclusions

The 10-year cumulative incidence of type 2 diabetes was higher and associations with baseline IFG and FPG were stronger among South-Asian Surinamese and African-Surinamese than among ethnic Dutch. Our findings confirm the high risk of type 2 diabetes in South-Asians and suggest more rapid conversion in populations of South-Asian origin and (to a lesser extent) African origin than European origin.     

Management of ear keloids using custom-molded pressure clips: a preliminary study

Background

The application of mechanical pressure by compression devices has gained popularity in the treatment of keloid scars. In this present study, we analyze the long-term efficacy of our custom-molded pressure clip for ear keloids. Our secondary objective is to identify risk factors for the failure of the treatment in the group of the recurrence.

Methods

The patient group consisted of 9 men and 19 women with a mean age of 27 years and a mean follow-up of 8.5 years. For evaluation of the scars, scoring ratings, Patient and Observer Scar Assessment Scale (POSAS), and SF8-questionnaire have been used.

Results

Follow-up observations showed that 71 % were treated successfully. There were significant differences in the Fitzpatrick scale, cause of the ear keloids, overall opinion, and openness for re-treatment between the recurrence and nonrecurrence group. Furthermore, treatment with our custom-molded pressure ear clip resulted in a statistically significant improvement of all the item scores of the POSAS in both the patient and observer scales. Severe complications such as infections or necrosis were not noted.

Conclusions

In this study, we show that the results of adjuvant pressure therapy with our custom-molded ear clips are comparable with the recurrence rates of other studies recently published. The strength of this study is the long follow-up. Level of Evidence: Level III, therapeutic study