A modern approach to noise induced hearing loss in military operations.

The symposium successfully brought together key military medical and personnel managers with civilian experts in hearing disorders and charities to help streamline our knowledge of the aetiology, investigation, prevention and management of NIHL. A requirement for seamless medical care for veterans with NIHL was recognised and collaborative work has commenced.

Macrogeographical population differentiation in oceanic environments: a case study of European hake (Merluccius merluccius), a commercially important fish.

Polymorphism at six microsatellite loci was used to study genetic variability and population structure in six geographically distant natural populations of European hake (Merluccius merluccius L.). Four hundred and eighty-three individuals were sampled from Trondheimsfjord in Norway, the Celtic Sea, the southern Bay of Biscay, Faro off Portugal, the Mediterranean Sea north of the coast of Tunisia and the Adriatic Sea. Population subdivision was found between Mediterranean and Atlantic samples, theta = 0.029 (P < 0. 001). No substructuring was found between samples within the Mediterranean Sea, theta = 0.003 and RST = 0.007 (P > 0.05). The Atlantic population structure appears to be more complex than previously suggested by the placement of stock boundaries by the International Council for the Exploration of the Seas (ICES). Analyses based on various models of microsatellite evolution all suggest that differentiation exists between Bay of Biscay and Portugese samples, theta = 0.013 (P < 0.001), RST = 0.036 (P < 0. 001) which are currently managed as one stock. By contrast, fixation indices indicated no differentiation between southern Bay of Biscay samples and Celtic Sea samples, theta = 0.003 (P = 0.02), phiST = 0. 007 (P = 0.10) which are managed as separate stocks. These results suggest that if the observed trends are stable through time, current management policy of European hake may need revision.

Orthopedic aspects of the Marfan phenotype.

Thirty-six patients with the phenotypic features of Marfan's syndrome (arachnodactyly, abnormal ratio of arm span to height, ligamentous laxity, and tall stature) were evaluated and classified into three groups. Group 1 represented definite Marfan's syndrome and included patients with two or more major signs, with additional minor signs as described by McKusick (18 patients). Group 2 represented probable Marfan's syndrome and included patients with one major sign and multiple minor signs (nine patients). Group 3 represented the Marfan phenotype and included patients with multiple minor signs (nine patients). A high incidence of scoliosis occurred in all groups (100% in Group 1 and 89% in Groups 2 and 3 combined). Group 1 patients had longer, multiple, and more progressive spinal curves. Protrusio acetabuli (Type II and III hips) was present in 22 patients (11 in Group 1, six in Group 2, and five in Group 3), with more severe involvement noted in Group 1. Foot deformities of varying types and severity occurred in all groups but were seen most often in Group 1 patients. Patients with the features of Marfan's syndrome (even without major diagnostic criteria) have a high incidence of progressive scoliosis, protrusio acetabuli, and foot deformities.

Malignant transformation of spontaneously regressed retinoblastoma, retinoma/retinocytoma variant.

The authors report on a case of a 7-year-old girl who was found on routine preschool screening at age 4 years to have unilateral decreased vision and a retinal lesion consistent clinically with the retinoma or retinocytoma variant of "spontaneously regressed retinoblastoma." The patient was followed closely with photographic documentation. After remaining stable for 3 years, her tumor grew rapidly and seeded the vitreous, prompting enucleation. Histopathologic examination disclosed that the newer elevated part of the tumor was an undifferentiated retinoblastoma, whereas the base of the tumor had the characteristic benign histopathologic features of retinoma/retinocytoma including bland nuclei, a fibrillar eosinophilic stroma, scattered fleurettes, calcific foci within viable tumor, and no mitoses. Immunohistochemical stains disclosed that immunoreactivity for retinal S antigen, S-100 protein, and glial fibrillary acidic protein was confined to cells in the differentiated basal part of the tumor. These histopathologic observations support the concept that tumors with the clinical characteristics of the patient's original lesion are benign variants of retinoblastoma that have arisen de novo rather than retinoblastomas that have undergone spontaneous regression. The clinical developments in this case suggest that retinomas or retinocytomas rarely undergo malignant transformation after a period of clinical dormancy and underscore the necessity for close follow-up of patients with presumed regressed retinoblastoma.