Bone-anchored hearing aid quality of life assessed by Glasgow Benefit Inventory.

OBJECTIVE/HYPOTHESIS: The bone-anchored hearing aid (BAHA) is a well established mode of treatment and many studies show the audiological benefit, but none has assessed the benefit to the quality of life of patients. This study uses the validated Glasgow Benefit Inventory to quantify the changes in quality of life. STUDY DESIGN: Retrospective questionnaire study. METHODS: Sixty consecutive patients receiving treatment with BAHA were enrolled in the study. The male/female ratio was 1.26 to 1; mean patient age was 45 years. The most common indication was hearing loss secondary to mastoid disease and surgery followed by congenital atresia and chronic discharge from the ear. RESULTS: The response rate was 85%, which is high and adds weight to the results. The general benefit score was +34 (range, +27-+48), which is comparable to middle ear surgery but just below benefit from cochlear implantation. The social benefit was +21 (range, +12-+37) with only +10 (range, +2-+26) for the physical score. This pattern mirrors that reported for other ear interventions. Maximum benefit was noted in patients with congenital atresias followed by discharging mastoid cavities. CONCLUSION: This study is the first to demonstrate significant quality of life benefit from BAHA surgical intervention as measured by the Glasgow Benefit Inventory.

Improvement of HIV-specific immunity in HIV-infected twins treated with highly active antiretroviral therapy, interleukin 2, and syngeneic adoptively transferred cells.

Five HIV-seropositive twins were treated with HAART and given cycles of treatment consisting of adoptive cellular therapy from their HIV-seronegative identical twins followed by a 5-day course of intravenous IL-2. Changes in absolute and percent CD4(+) and CD8(+) cell count were monitored and compared with changes in these parameters occurring in seven age-, sex-, and disease stage-matched HIV-infected patients treated with HAART alone. Increase in the magnitude and breadth of HIV-specific immune responses was monitored in three twin subjects who received multiple treatment cycles. Absolute and percent CD4(+) cell counts rose dramatically and to significantly higher levels in the recipient twins than in control subjects treated with HAART only. The subjects who received multiple cycles of treatment developed new and increased levels of HIV-specific activated and memory cytotoxic T lymphocyte responses, and interferon gamma-secreting effector cells. Treatment consisting of HAART, adoptive cellular therapy, and IL-2 was superior to treatment with HAART alone for improving absolute and percent CD4(+) cell counts and inducing new, or increasing the magnitude of, HIV-specific immune responses in HIV infected patients.

Bone-anchored hearing aid: quality of life assess by glasgow benefit inventory

INTRODUCTION: The bone-anchored hearing aid (BAHA) uses the system of osseointegration described by Branemark. It is a well-established mode of treatment and many studies show the audiological benefit, but none have assessed the benefit to the quality of life of patients who underwent this surgical intervention. This study uses the validated Glasgow Benefit Inventory (GBI) to quantify the changes in quality of life. The GBI is a specific patient-orientated questionnaire designed to look at the changes in health status secondary to an ORL intervention.1 The GBI gives an overll scorek, but also subscores of general, social and physical benefits. METHOD: Sixty consecutive BAHA patients were enrolled in the study. The male: female ratio was 1 : 26, with a mean age of 45 years. The most common indication was hearing loss secondary to mastoid disease/surgery followed by congenital atresia and chronically discharging ear. The mean bone conduction of the better ear was 19 dB and the mean conductive loss across the speech frequencies was 58 dB. Only patients who were fitted with the classic model were included in the study. RESULTS: The response rate was > 70%, which is high and adds weight to the results. The general benefit score was + 40 which is comparable to middle ear surgery, but just below benefit from chochlear implantation. The social benefit was + 27 with only + 10 for the physical score. This pattern mirrors that reported for other ear interventions. CONCLUSION: This paper is the first to demonstrate that there is significant quality of life benefit from BAHA surgical intervention as measured by the GBI.

Flow cytometric analysis of nitric oxide production in human neutrophils using dichlorofluorescein diacetate in the presence of a calmodulin inhibitor.

Dichlorofluorescein (DCFH) oxidation assay measures hydrogen peroxide (H2O2), which is a derivative of superoxide anion. We found that a calmodulin antagonist, W-13, which is known to inhibit superoxide anion generation enhanced the capacity of human neutrophils to oxidize DCFH. To investigate this discrepancy we studied the role of nitric oxide (NO) in DCFH oxidation. Pure NO was capable of oxidizing DCFH, and the product formed had spectral properties identical to oxidized DCFH produced by H2O2. The arginine analog, NG-monomethyl-L-arginine (NMMA), which inhibits NO production, in combination with W-13 completely inhibited the stimulus-induced increase in DCFH oxidation. We conclude that the oxidation of DCFH in human neutrophils can occur by either H2O2 or NO.

Changes in actin state and chemotactic peptide receptor expression in granulocytes during cytokine administration after autologous bone marrow transplantation.

We studied the changes in actin state and chemotactic peptide receptor expression in granulocytes from patients receiving different cytokines following high dose chemotherapy and autologous bone marrow transplantation (ABMT). The F-actin content in granulocytes was higher in all patients following ABMT. However, in patients receiving granulocyte colony-stimulating factor (G-CSF) and macrophage colony-stimulating factor (M-CSF) the increase in F-actin content was much greater than in those not receiving these cytokines (159, 149, and 90% for G-CSF, M-CSF, and noncytokine group, respectively). Patients receiving granulocyte-macrophage colony-stimulating factor (GM-CSF) had only a 62% increase in the F-actin content, which was not statistically significant from patients undergoing ABMT without any cytokines. Although the basal level of F-actin was high following ABMT, granulocytes from all patients showed an additional increase in F-actin content after stimulation with either the chemotactic peptide N-formyl-methionyl-leucyl-phenylalanine (FMLP) or phorbol myristate acetate (PMA). The chemotactic peptide receptor expression was significantly higher in patients treated with ABMT alone or ABMT plus G-CSF. These observations suggest that the granulocytes generated following ABMT and cytokine administration may have different functional potential depending on the cytokine administered. Further studies to evaluate these potential differences are essential to devise optimal therapeutic protocols for maximizing the granulocyte protective function in this clinical setting.

The nasal chondroma. 2 case reports and a survey of the literature.

Two cases of nasal chondroma are recorded and the past literature reviewed. The importance is stressed of wide surgical excision for these lesions.

Further studies on intestinal active transport during semistarvation.

1. The effect of semistarvation (sufficient to produce a loss of 18-28% of initial body weight) on the active transport of D-glucose and L-histidine by the rat, the guinea-pig and the golden hamster has been investigated by the use of sacs of everted small intestine (from upper jejunum to lower ileum).2. In the rat and the guinea-pig the dietary restriction resulted in increased active transport in all regions of the small intestine. In contrast, it caused no alteration in active transport in the hamster.3. The response in the rat was most impressive in the middle-to-lower ileum during D-glucose uptake. Whereas normal sacs from this area appeared unable to move the sugar against its concentration gradient, sacs from semistarved rats did so quite well.4. Although there was a considerable loss (24-29%) of intestinal dry weight in all three species when the food intake was reduced, shortening of the small intestine was not detectable in the guinea-pig or the hamster and was present to only a minor extent in the rat.5. Evidence is presented indicating that the enhanced active transport is not merely a reflexion of the thinning of the intestinal wall and that it occurs during complete as well as in partial starvation.

Effect of amino acids on sugar absorption.

1. Sacs of everted mid-small intestine of the hamster have been used to study the effect of amino acids on sugar absorption.2. The sugars employed were D-glucose, D-galactose, 3-O-methyl-D-glucose, D-fucose, L-glucose, alpha-glucoheptose, L-fucose, D-mannose and L-sorbose. The amino acids were L- and D-histidine, L- and D-methionine, L- and D-alanine, L- and D-valine, L- and D-glutamic acid, L-leucine, L-proline, L-ornithine and L-aspartic acid.3. Actively absorbed amino acids considerably inhibit the transport of actively absorbed sugars. The results give support for the view that D-histidine and L-glucose are actively transferred. Passively absorbed amino acids and sugars are not involved.4. As L-glutamic and L-aspartic acids in the mucosal fluid have no inhibitory effect on D-glucose absorption, although mucosal fluid L-alanine is quite potent, the step at which the latter exerts its inhibitory action must be before that at which the intracellular transamination of L-glutamic and L-aspartic acids occurs. It would seem likely, therefore, that L-alanine interferes with the process by which epithelial cells capture and concentrate sugars at the luminal border.5. More than one active transfer system may exist for D-glucose.6. The influence of actively absorbed L-amino acids on D-glucose active transport seems to be in some way related to the efficiency with which the amino acids are themselves concentrated.7. Inhibition of D-glucose active absorption by an amino acid may be a simple test of an amino acid's participation in an active transport system.