Hallmarks of diabetes mellitus and insights into the therapeutic potential of synergy-based combinations of phytochemicals in reducing oxidative stress-induced diabetic complications.

Diabetes mellitus (DM) is a serious health issue and is still one of the major causes of mortality around the globe. Natural products have progressively integrated into modern, advanced medical practices. Phytoconstituents from some medicinal plants have demonstrated therapeutic activity in treating different metabolic disorders and have been used to treat DM and its severe complications.

Safety of high-dose corticosteroids for the treatment of autoimmune inner ear disease.

Objective: To report the adverse effects associated with prolonged high-dose prednisone for the treatment of autoimmune inner ear disease (AIED).

Study Design: Prospective data collected as part of a multicenter, randomized, controlled trial for the treatment of corticosteroid-responsive AIED with methotrexate.

Setting: Tertiary referral centers.

Serial audiometry in a clinical trial of AIED treatment.

Objective: We analyzed pure-tone and speech audiometric results from a prospective trial of anti-inflammatory treatment of subjects with active autoimmune inner ear disease (AIED). We sought to characterize the pattern and size of the treatment effect as reflected in clinical audiometry and to identify audiometric predictors of response to steroid treatment of AIED.

Subjects: Adult participants demonstrated clinically established criteria for AIED (n = 116).

Treatment of corticosteroid-responsive autoimmune inner ear disease with methotrexate: a randomized controlled trial.

Context: A number of therapies have been proposed for the long-term management of corticosteroid-responsive, rapidly progressive, bilateral sensorineural hearing loss (autoimmune inner ear disease [AIED]). Methotrexate has emerged as the benchmark agent but has not been rigorously evaluated for hearing improvement in patients with AIED.

Objective: To assess the efficacy of long-term methotrexate in maintaining hearing improvements achieved with glucocorticoid (prednisone) therapy in patients with AIED.

The NIDCD's clinical trials cooperative groups: a brief overview.

The National Institute on Deafness and Other Communication Disorders (NIDCD) embarked on the establishment of two clinical trials cooperative groups in October 1996 in response to a scientific research need. It intended that the clinical trials cooperative groups (CTCGs) design and implement clinical trial protocols capable of addressing the efficacy of therapeutic interventions for diseases and disorders of human communication. Most commonly, owing to the substantial number of patients required, the trials are expected to involve multiple study sites, with each study site adhering to a uniform study protocol, standardized treatment regimens, and prescribed data collection procedures.

Growth of human paragangliomas in the subrenal capsule of the nude mouse.

Paragangliomas are generally benign, highly vascular, and slowly growing tumors of neural crest lineage that occur disproportionately in women. Surgery can manage small tumors expeditiously, but extirpation of large tumors is associated with morbidity and even mortality. Radiation therapy offers relatively good tumor control but also presents development of a secondary malignant neoplasm as a possible consequence.

Hearing aids. I. Conventional hearing devices.

State-of-the-art hearing aids incorporate advances in signal processing, miniaturization, and programmability. This technological progress has been accompanied by parallel enhancements in evaluating and fitting strategies. In addition, in the past several years, knowledge has increased about the influences of amplification on hearing ability and about the influences of hearing ability on benefit from amplification.

The scala vestibuli for cochlear implantation. An anatomic study.

Background: Traditionally, cochlear implantation has used the scala tympani (ST) for electrode insertion. When faced with ST ossification, the surgeon may elect to drill out the cochlea to accomplish partial electrode insertion. Theoretically, another option in this situation is to insert the electrode into the scala vestibuli (SV).

Flow-sensitive magnetic resonance imaging in the evaluation of cerebrospinal fluid leaks.

Cerebrospinal fluid (CSF) leaks involving the skull base are associated with considerable morbidity and mortality, and often present a diagnostic challenge. Current diagnostic methods are invasive and cumbersome and involve substantial radiation exposure of the patient. The authors identified seven patients with clinically suspected CSF leaks and evaluated them with a flow-sensitive magnetic resonance imaging (MRI) sequence in addition to more conventional studies.

Environmental tobacco smoke and otitis media.

Environmental tobacco smoke (secondhand smoke) is a health hazard experienced by one half to two thirds of the nation's children younger than 5 years of age. Although the role of environmental tobacco smoke in the genesis of pulmonary disease in children has been increasingly recognized, somewhat less attention has been paid to the role of environmental tobacco smoke in the development of childhood otitis. This presentation will review current data regarding environmental tobacco smoke, with a particular emphasis on its effects on the ears and eustachian tube.

Computer-assisted assessment of cochlear nerve fibers.

Quantitative assessment of cochlear nerve fibers, with statistical analysis of histologic specimens, is facilitated by the application of computer image processing techniques. Three algorithms, developed for the evaluation of cochlear sections, are presented, MANUAL, AIDED, and AUTO, in order of increasing degree of automation and decreasing requirement for operator intervention. All three algorithms demonstrate high accuracy and consistency in identifying cochlear nerve fibers and quickly provide statistics regarding the target nerve fiber population.

The glomus tumor and its biology.

This section has attempted to detail the histopathologic, biologic, pathophysiologic, and epidemiologic characteristics of jugulotympanic paragangliomas. These features do not stand devoid of clinical significance, but rather lay the foundation for the formulation of logical diagnostic and therapeutic approaches to these fascinating tumors.

Neurologic paraneoplastic syndromes with neurotologic manifestations.

Evidence supports the hypothesis that autoimmune mechanisms are operational in the etiopathogenesis of certain neurologic paraneoplastic syndromes (PNSs), including paraneoplastic encephalomyelitis (PEM) and paraneoplastic cerebellar degeneration (PCD). The antibodies (Anti-Hu and Anti-Yo), the antigens (Hu and Yo), and complementary DNA clones encoding Hu and Yo, central to PEM and PCD, respectively, have been isolated. In contrast, the antigens, and antibodies if any, involved in autoimmune cochleovestibular dysfunction remain unknown.

Facial nerve neuroma.

Facial nerve neuromas are an unusual cause of facial nerve dysfunction and hearing loss. As clinical manifestations do not accurately reflect tumor extent, imaging techniques can greatly assist the clinician in appropriate diagnostic evaluation and management.

Facial and trigeminal neural dysfunction by a primary cutaneous squamous cell carcinoma: MRI and clinicopathologic correlates.

Carcinomatous neural infiltration and subsequent neural dysfunction are phenomena associated with the facial nerve and parotid gland tumors, particularly adenoid cystic carcinoma. The association of primary cutaneous squamous cell carcinoma (PCSCC) with these phenomena is not as well recognized, especially with respect to the involvement of the trigeminal nerve. By presenting the case history of a man who successively developed facial and trigeminal neural dysfunction after Mohs chemosurgery of a PCSCC, this paper documents histologically the occurrence of such neural invasion, and illustrates the utility of gadolinium-enhanced magnetic resonance scanning in patient management.

Aspartame and dizziness: preliminary results of a prospective, nonblinded, prevalence and attempted cross-over study.

Aspartame is a low-calorie food sweetener recently approved by the FDA for general human consumption. One of us (AJG) treated a patient whose symptoms of episodic vertigo and continuous unsteadiness resolved upon ceasing aspartame intake. A literature review revealed that although dizziness has been associated with aspartame intake, no systematic study of the problem exists.