[Surgical Risk Profile and Audiological Outcome in the Elderly after Cochlea-implantation]

BACKGROUND

The number of elderly patients with indication for cochlear implantation is increasing. Our aim was to investigate whether seniors with cochlea implants differ from younger patients with regard to hearing improvement, surgical complications and rehabilitation.

PATIENTS AND METHODS

Patients older than 60 years (ys) having received a cochlea implant in 2007-2012 were included (Group I 60-70 ys; Group II <70 ys). Preoperative risk factors according to ASA-Criteria and postoperative complications were analyzed. Improvements in quality of live were evaluated by questionnaire. Audiological outcome was tested by Freiburger speech test and OLSA sentence test with background noise. Patients with comparable conditions for cochlea implantation between 40 and 59 years of age served as control group (Group K).

RESULTS

Patient cohort consisted of 94 patients, 29 of which being older than 70 years. Severe complications were inexistent postoperatively. Gr. II achieved a speech perception for numbers of 95% (65 dB) and 50% (65 dB) for monosyllables. The speech perception in Gr. II was not significantly different from Gr. I or K. According to the quality of life test all groups experienced an improvement in their social life.

CONCLUSION

Old age itself is no contraindication to cochlea implantation. It has little influence on the postoperative speech perception even though the learning curve of the elderly rises slower. However, careful assessment with regard to surgical risk factors and expected outcome is necessary.

[Molecular approaches to systemic therapy of adenoid cystic carcinoma of the head and neck area]

The adenoid cystic carcinoma (ACC) is a neurotropic salivary gland tumor with a high blood-borne metastasis tendency. The treatment of choice for localized disease consists of radical surgical resection and, depending on resection status, adjuvant radiotherapy. Due to the high recurrence rate with limited local therapeutic options and frequent occurrence of distant metastases, one is confronted inevitably with the search for an adequate systemic therapy. ACC shows little response to a variety of chemotherapeutic agents, partial or complete remissions are extremely rare. Beside classical chemotherapies, immunotherapeutics and targeted therapies with more favorable side effect profiles were tested in trials, but due to the small number of patients, a definitive statement on the effectiveness can be hardly made. This results in the need for prospective multicenter studies that allow clear recommendations for systemic therapy of the tumor. The present paper gives an overview of the sub-cellular and genetic characteristics of ACC, which represent possible targets for systemic therapies and have partly already been included in running clinical trials.

Effect of mycorrhizal fungi on some defense enzymes against Gaeumannomyces gaminis in wheat

At this research, the effect of mycorrhizal fungi (Glomus etunicatum) On Pero Xidase (POX) and Phenylalanine Ammonia Lyase (PAL) activities and isozymatic pattern against Gaeumannomyces graminis were studied in wheat plants. Seeds were planted in inoculated soils in 4 treatment groups including Control (C), Mycorrhiza (M), Pathogen (P) and Pathogen- Mycorrhiza (PM). Plants were harvested 17 days after inoculation. POX activities in PM group were significantly greater than control group. Significant differences were not observed between P and C groups. POX activities significantly decreased in M group. PAL activities in M group were significantly greater than other groups. PAL activities in P and PM groups were significantly greater than C group. The appearance of new isozyme was induced in PM group. It is highly probable that induced POX isozymic activity and/or appearance of new isozymes may be responsible for elevated POX activity. Present results showed that the isozymatic patterns of POX were changed by inoculation ofmycorrhiza and/or pathogen. The obtained results from this research is agreement with other researches about the enhancing effect of mycorrhizal fungi on PAL activity. The obtained results from the present research, confirm this opinion that defense related proteins is not induced in compatible interactions or is weak.

Relationship between erythrocyte lithium concentration and renal concentrating capacity

BACKGROUND

Studies investigating possible correlations between plasma lithium concentration, lithium treatment duration, and frequency of lithium administration, and lithium nephrotoxicity have yielded conflicting results.

OBJECTIVES

Our main objective was to investigate whether there was any relationship between erythrocyte lithium concentration (ELC) and renal side effects. Another objective of our study was to identify a parameter, which could be estimated inexpensively, for assessing possible renal side-effects of lithium.

METHOD

Seventy Iranian inpatients with bipolar disorder entered this case-control study. Medications taken concurrently by the patients were recorded. A direct method of measuring ELC was used in this study. The cases were patients on lithium who had urine specific gravity (SG) of 1.006 or less after 8-10 h water deprivation at night and the controls consisted of patients on lithium with urine SG of 1.011 or more after this period. Blood urea nitrogen, serum creatinine, sodium and potassium and urine SG, sodium, and potassium were measured in all patients during this time. Renal indices were compared by using independent sample t-test at a significance level of a P-value of 0.05 or less. Non-parametric Spearman's rank correlation test was used to investigate the relationship between clinical variables and the indices of renal function.

RESULTS

Results revealed that in case group mean serum sodium concentrations were significantly higher (P = 0.008) and mean urine sodium and potassium were significantly lower than those of controls (P = 0.004 and 0.007 respectively). We found no statistically difference in lithium ratios between the two groups. However, ELCs were significantly higher in the cases (P = 0.026). There were no significant correlation between concomitant use of neuroleptics, benzodiazepines or carbamazepine and ELC or lithium renal side-effects.

CONCLUSION

This study showed that ELC may reflect lithium renal side-effects better than plasma lithium level.