Tinnitus Suppression by Intracochlear Electrical Stimulation in Single Sided Deafness – A Prospective Clinical Trial: Follow-Up

IntroductionEarlier studies show that a Cochlear Implant (CI), capable of providing intracochlear electrical stimulation independent of environmental sounds, appears to suppress tinnitus at least for minutes. The current main objective is to compare the long-term suppressive effects of looped (i.e. repeated) electrical stimulation (without environmental sound perception) with the standard stimulation pattern of a CI (with environmental sound perception). This could open new possibilities for the development of a “Tinnitus Implant” (TI), an intracochlear pulse generator for the suppression of tinnitus.ResultsResults show that tinnitus can be suppressed with intracochlear electrical stimulation independent of environmental sounds, even long term. No significant difference in tinnitus suppression was found between the standard clinical CI and the TI.ConclusionIt can be concluded that coding of environmental sounds is no requirement for tinnitus suppression with intracochlear electrical stimulation. It is therefore plausible that tinnitus suppression by CI is not solely caused by an attention shift from the tinnitus to environmental sounds. Both the standard clinical CI and the experimental TI are potential treatment options for tinnitus. These findings offer perspectives for a successful clinical application of the TI, possibly even in patients with significant residual hearing.

Trial Registration

TrialRegister.nl NTR3374     

Naphthoquinone glycosides for bioelectroanalytical enumeration of the faecal indicator Escherichia coli

Microbial water quality monitoring for the presence of faecal indicator bacteria (FIB) is a mandatory activity in many countries and is key in public health protection. Despite technological advances and a need for methodological improvements, chromogenic and fluorogenic enzymatic techniques remain the mainstays of water quality monitoring for both public health agencies and regulated utilities. We demonstrated that bioelectroanalytical approaches to FIB enumeration are possible and can be achieved using commercially available enzyme‐specific resorufin glycosides, although these are expensive, not widely available or designed for purpose. Following this, we designed two naphthoquinone glycosides which performed better, achieving Escherichia coli detection in the range 5.0 × 10² to 5.0 × 10⁵ CFU ml^?1 22–54% quicker than commercially available resorufin glycosides. The molecular design of the naphthoquinone glycosides requires fewer synthetic steps allowing them to be produced for as little as US$50 per kg. Tests with environmental samples demonstrated the low tendency for abiotic interference and that, despite specificity being maintained between β‐glucuronidase and β‐galactosidase, accurate enumeration of E. coli in environmental samples necessitates development of a selective medium. In comparison to a commercially available detection method, which has U.S. Environmental Protection Agency (EPA) approval, our approach performed better at high organism concentrations, detecting 500 organisms in 9 h compared with 13.5 h for the commercial method. Bioelectroanalytical detection is comparable to current approved methods and with further development could result in improved detection times. A recent trend for low‐cost open‐source hardware means that automated, potentiostatically controlled E. coli detection systems could be constructed for less than US$100 per channel.     

Multiple Exposures to Ascaris suum Induce Tissue Injury and Mixed Th2/Th17 Immune Response in Mice

Ascaris spp. infection affects 800 million people worldwide, and half of the world population is currently at risk of infection. Recurrent reinfection in humans is mostly due to the simplicity of the parasite life cycle, but the impact of multiple exposures to the biology of the infection and the consequences to the host’s homeostasis are poorly understood. In this context, single and multiple exposures in mice were performed in order to characterize the parasitological, histopathological, tissue functional and immunological aspects of experimental larval ascariasis. The most important findings revealed that reinfected mice presented a significant reduction of parasite burden in the lung and an increase in the cellularity in the bronchoalveolar lavage (BAL) associated with a robust granulocytic pulmonary inflammation, leading to a severe impairment of respiratory function. Moreover, the multiple exposures to Ascaris elicited an increased number of circulating inflammatory cells as well as production of higher levels of systemic cytokines, mainly IL-4, IL-5, IL-6, IL-10, IL-17A and TNF-α when compared to single-infected animals. Taken together, our results suggest the intense pulmonary inflammation associated with a polarized systemic Th2/Th17 immune response are crucial to control larval migration after multiple exposures to Ascaris.     

Comparison between CEA, TPA, CA 15/3 and hydroxyproline, alkaline phosphatase, whole body retention of 99mTc MDP in the follow-up of bone metastases in breast cancer

The development of bone metastases in cancer can be monitored easily using three markers: 24 h urinary hydroxyproline excretion (HOP) (an index of osteoclastic activity), serum alkaline phosphatase (Alk.Ph.) (an index of osteoblastic activity) and 24 h whole body retention of 99mTc-methylene diphosphonate (WBR%) (an index of bone turnover). To evaluate the effectiveness of this group of bone tumor markers in breast cancer we compared it with the following group of three markers which are commonly used in the monitoring of breast cancer and in the follow-up of advanced disease with or without bone metastases: carcinoembryonic antigen (CEA), tissue polypeptide antigen (TPA) and breast carcinoma antigen (CA 15/3). In 48 patients with bone metastases CEA, TPA and CA 15/3 were shown to be sensitive (79%, 85%, 90% respectively), while HOP, Alk.Ph. and WBR%, which are commonly accepted as reliable markers of bone activity, showed a lower sensitivity (67%, 46%, 75% respectively). These results may be explained by the lack of osteoclastic or osteoblastic (or both) activity at the time of diagnosis. This explanation is supported by the fact that the bone markers HOP, Alk.Ph. and WBR% were found to be more sensitive than the others in the subsequent follow-up study. We conclude that in our study, CEA, TPA and CA 15/3 are at first more sensitive than Alk.Ph., HOP and WBR% but during the follow-up Alk.Ph., HOP and WBR% are possibly both more specific and more sensitive.     

Effect of L-propranolol on the binding,internalization and degradation of 125I-low density lipoproteins by human skin fibroblasts

The effect of L-propranolol on the receptor mediated uptake of human LDL by fibroblasts was investigated. When L-propranolol was tested between 10^?6 and 10^?4 M at a ¹²⁵I LDL concentration ranging from 6.25 to 198 μg/ml, an increase in binding, internalization and degradation of the labelled lipoproteins was demonstrated with a maximal effect respectively of 52%, 680% and 105% observed with L-propranolol at 10^?4 M and a lipoprotein concentration of 37.5 μg/ml. The effect occurs rapidly and is seen 2 hrs after the addition of the drug. Lower drug concentrations, although less effective, still produced significant increase in lipoprotein uptake and degradation. Procaine, a local anesthetic, used at 10^?4 M has no effect on ¹²⁵I-LDL binding and internalization. D-propranolol, another local anesthetic and L-propranolol enantiomer, is also without effect. This, excluding a drug induced stabilization of the membrane as the responsible mechanism of action, indicates that stereospecificity is important.     

Relationship between the Accumulation of Putrescine and the Tolerance to Oxygen-Deficit Stress in Gramineae Seedlings

The accumulation of putrescine under anoxia was studied in seedlingsof 6 Gramineae species showing tolerance to the stress in thefollowing order: rice, barnyard grass>maize>rye, barleyand wheat. The accumulation of putrescine in shoots and rootsduring 6 h of oxygen deprivation was different among the speciesand correlated with their tolerance to anaerobic conditions.In both tissues, rice and barnyard grass accumulated more than0.6 µmol/g fresh weight. The lower increase in the putrescinetiter was observed in wheat tissues with less than 0.1 µmol/gfresh weight. Feeding experiments with [^l4C]arginine showedthat rice tissues have a greater capacity than wheat tissuesto synthesize putrescine under anoxia. The better tolerant speciesto anaerobic conditions showed high arginine decarboxylase activityin shoots and roots than the sensitive species. The presenceof exogenous Put partially increased the survival of wheat rootsafter 7.5 h of oxygen-deficit stress. The role of putrescinein determining differences in the tolerance to anoxia in Gramineaeseedlings is discussed. (Received December 20, 1989; Accepted March 12, 1990)