Cochlear implantation in mitochondrial deafness due to A7445G mutation

OBJECTIVE

This study aimed to determine if cochlear implantation (CI) improved speech discrimination in the New Zealand pedigree with the A7445G mitochondrial DNA (mtDNA) mutation and sensorineural hearing loss (SNHL).

METHODS

Nine patients had their speech discrimination and pure tone audiograms evaluated. Pre- and post-implant results were compared. Type of CI and patient age at implantation was recorded.

RESULTS

Speech discrimination testing shows greatly improved functional hearing after CI in this group of patients.

DISCUSSION

Individuals with mtDNA-related SNHL should be identified by screening and offered assessment for CI suitability because functional hearing improves after CI.

Peritonsillar infection in Christchurch 2006-2008: epidemiology and microbiology

AIM

Peritonsillar infection is a complication of acute tonsillitis. It is common and complications can be life-threatening. This study audits all cases of peritonsillar infection presenting to our unit between 2006 and 2008 in order to determine if the epidemiology, bacteriology and antibiotic sensitivity has changed since previous audits in our unit in 1981-1984 and 1990-1992.

METHODS

Retrospective chart review.

RESULTS

213 patients were admitted acutely with peritonsillar infection between January 2006 and December 2008. The average age was 29 years with 30.5% patients in the modal age group of 15-19 years. Male to female ratio was 1.5:1. 54% presented with their first episode. 39% received antibiotics prior to presentation. In two-thirds of cases, the duration of admission was less than 24 hours. Culture results were obtained from 69% of specimens. Cultures mostly contained mixed anaerobic and aerobic bacteria. The most common aerobes were streptococcal species. Organisms were almost uniformly sensitive to penicillin. 21% of patients subsequently underwent tonsillectomy, usually as a delayed procedure.

CONCLUSION

Peritonsillar infection is a common complication of tonsillitis and can be life-threatening. The number of cases presenting at Christchurch Hospital has increased disproportionate to the population increase since the previous audits. Culture results demonstrate a preponderance of mixed organisms, which may be pathological. Organisms and their sensitivities have not changed since the previous audits. Infection usually responds favourably to drainage in combination with penicillin as the first-line antimicrobial agent.

Nasal fractures: patient satisfaction following closed reduction

AIM

Nasal fractures are commonly treated by primary closed reduction. However, studies suggest this produces unacceptable functional and aesthetic results. Many patients require revision surgery. We aimed to assess patient satisfaction following closed reduction of nasal fractures.

METHODS

Retrospective chart review of patients with nasal fractures treated by closed reduction at the Wellington Regional Plastic, Maxillofacial and Burns Unit, New Zealand over a 2-year period was undertaken. Digital manipulation under general anaesthetic was performed. Patients were followed-up by telephone with a structured interview.

RESULTS

Of 116 consecutive patients, 74 (65%) were successfully contacted. 65 (88%) were satisfied with functional outcome, and 64 (86%) with aesthetic outcome. Of the 34 patients reporting incomplete correction, 12 (35%) would consider revision surgery.

CONCLUSION

Patients treated with closed reduction of nasal fracture performed under general anaesthetic with digital manipulation reported high levels of satisfaction with functional and aesthetic outcomes. Revision rate is low.

Acute squamous cell carcinoma arising within a recent burn scar in a 14-year-old boy

We have described the case of a 14-year-old boy who developed an acute squamous cell carcinoma within a healed burn scar 6 weeks after thermal injury. This is a rare condition necessitating early excision and histopathologic confirmation of clearance. The authors recommend early skin grafting of deep partial- and full-thickness burns to prevent future malignant transformation and a low index of suspicion of any nodules or ulceration appearing within a healed burn.

Angle grinder injuries: a cause of serious head and neck trauma

Over the past 12 months, the Victorian Trauma Centre at the Alfred Hospital, Melbourne, has dealt with serious head and neck injuries associated with angle grinder use. Three cases are presented, documenting the circumstances and severity of these injuries and subsequent management. Angle grinder injuries are a source of serious morbidity and mortality, much of which is preventable.

Effects of fenfluramine and para-chloroamphetamine on sexual behavior of male rats

The present studies have evaluated the effects of pharmacologically induced release serotonin on sexual responses of male rats during exposure to a sexually receptive female rat. Following acute administration of fenfluramine or para-chloroamphetamine (PCA), significant dose-related decreases in copulatory rate and copulatory efficiency, and increases in ejaculatory latency were observed. These effects were not observed when the animals were pretreated with LY53857, a 5-HT1c/2 antagonist. These studies indicate that acute release of serotonin evoked by these releasing agents has inhibitory effects on sexual sexual drive, capacity to achieve erection and threshold for ejaculation, and these effects are mediated by either the 5-HT1c or 5-HT2 receptor.

The role of the 5-HT2 receptor in the regulation of sexual performance of male rats

The present studies have attempted to evaluate the role of 5-HT2 receptors in the regulation of sexual behavior of male rats by determining the effects of 5-HT2 receptor antagonists, pirenperone, LY53857 and LY281067, and a 5-HT2 receptor agonist, DOI. The administration of 1 mg/kg s.c. pirenperone produced a total suppression of ejaculatory response and lower doses had no effect. However, the administration 0.1 mg/kg s.c. of either LY53857 or LY281067 restored ejaculatory capacity to rats that were unable to ejaculate and produced significant decreases in ejaculatory latency in rats with full sexual capacity. Although all of these agents are 5-HT2 antagonists, LY53857 and LY281067 lack the additional monoaminergic activity of pirenperone. Since the effects of pirenperone were opposite from the effects of the selective 5-HT2 antagonists, the suppressive effects of this agent were probably related to its other monoaminergic activity e.g. alpha 1 antagonist activity. This proposal was supported by the observation that the administration of prazosin, an alpha 1 antagonist, significantly increased ejaculatory latency and suppressed the stimulatory effects of LY53857. In contrast to the stimulatory effects of the selective 5-HT2 antagonists, the administration of DOI, resulted in a suppression of sexual performance, which was blocked by pretreatment with LY53857.

An evaluation of the use of mini-computers for computer assisted instruction in allied health curricula

This paper reports the results of an evaluation of computer assisted instruction in a school of allied health technologies. This evaluation was conducted to determine how students rated computer assisted instruction as a learning tool. Areas rated were: (1) ease of use of computer hardware, (2) ease of use of computer instructions, (3) difficulty of content and (4) learning value. The results of 1,507 student questionnaires were tabulated. Student evaluation was favorable in all areas. Comments by the students have led to revisions in specific programs.