Optimization of speech processor fitting strategies for Chinese-speaking cochlear implantees.

OBJECTIVES: To compare speech recognition performance in Chinese-speaking cochlear implant patients with a speech processor program selected by the clinical audiologist in Taiwan and with a new speech processor program based on the Washington University clinical procedure developed by Skinner et al. STUDY DESIGN: Six adult Chinese-speaking patients implanted with the Nucleus cochlear implant system participated in this study. METHODS: A fitting procedure developed in 1995 by Skinner et al. at Washington University School of Medicine was used to create a new speech processor program to optimize each patient's hearing in everyday life. Speech tests (vowels, consonants, tones, and words), sound-field thresholds, and a self-report questionnaire were used to evaluate each patient's performance with his or her previous speech processor program and a new one. RESULTS: Four of the six patients had significant changes from the previous to the new speech processor program. These changes were associated with improvement in score on at least one speech test, more sensitive sound field thresholds, and reported improvement in some everyday listening situations on the questionnaire. CONCLUSIONS: These results suggest that use of this procedure with adult cochlear implantees may improve benefit in everyday life. Analysis of the speech test stimuli and patients' responses provides a basis for modification or creation of new Mandarin Chinese speech tests for preoperative and postoperative evaluation of adult cochlear implant patients.

Revision of hypo-osmotic swelling (HOS) test with a proposition of classified grading system: its comparisons with four different types of human sperm separation technique.

In this study, we arbitrarily classified the morphological changes of sperm under hypo-osmotic condition and compared the results with four different sperm separation techniques. The morphology of classification ranged from a good swelling (SG 3 > SG 2 > SG 1), to non-swelling but reactive (SG 0-R), and completely non-swelling (SG 0). Thirty fresh semen from patients were divided into 4 groups and each processed by washing, swim up, 2-layer column and real time micro-separation system. The prevalent patterns of the swollen sperm in sequence after treatment was SG 0 > SG 1 > SG 3 > SG2 > SG 0-R in fresh semen, and the proportion of SG 0 was almost half of the total % HOS test results. However, SG 3 became the most common swollen form with a significant increase in number with any method of sperm preparation after treatment. The real time technique yielded the highest % rate of SG 3 type of swollen spermatozoa and was the richest in concentration (53+/-3.9%, P < 0.05) as compared with that of swim up (26+/-4.6%), 2-layer (20+/-4.4%), sperm washing (23+/-3.9%), and fresh semen (17+/- 2.8%), respectively. By contrast, 2-layer collected more number of SG0-R (5.3+/-1.2%, P < 0.05) pattern of spermatozoa when compared to real time and swim up. A positive correlation (r = 0.81, P < 0.002) was shown between the % total HOS spermatozoa and total motility of fresh semen but not with morphology. Collectively, an abnormally functional sperm may exist in almost half of a total sperm count from men. It would appear that a better potential fertilization capacity may reside in the more swollen sperm from HOS test than the less swollen sperm and that may be more related with the motility rather than the morphology. The HOS classification and grading system appears valuable in further evaluating sperm quality.

Real-time sperm separation system: a review of Wang tubes and related technologies.

This paper discusses real-time sperm separation technology and the use of Wang tubes for isolating high-quality and fertile sperm. Several methods have been developed and used to prepare a better sperm specimen, including the conventional swim-up technique, Percoll discontinuous density gradient, Sephadex gel filtration, centrifugation, migration-sedimentation, albumin column, and Sperm-prep. However, none of these methods has the ability to isolate from the original ejaculum a large number of highly motile, morphologically normal, and normal-chromatin sperm, while retaining in an adequate volume of physiological medium, free of less-motile and nonmotile sperm, and free of microorganisms, cell debris, seminal plasma, leukocytes, and foreign bodies. These methods should be classified as incomplete techniques of sperm separation and are of only limited effectiveness in infertility treatment. They may also cause irreparable damage to the mother or fetus. Real-time sperm separation technology is based on the observations that nonpathological spermatozoa do not transfer organisms, that the motility pattern and swim-up capacity of pathological sperm are limited or disturbed, and that the movement of sperm differs from the passive motion of nonciliated microorganisms and the random active motion of ciliated microorganisms in terms of velocity and direction. Real-time sperm separation technology encompasses the Wang tube system, which has two main functions: to isolate organisms-free, normal-chromatin, morphologically normal, and highly motile spermatozoa that are suitable for use in infertility treatment, and to prevent sex-linked inherited diseases. The results of these evaluations indicate that real-time sperm separation technology is the most effective and precise method of isolating and decontaminating sperm to date.

Modification of the Wang tube to improve in vitro semen manipulation.

The Wang tube was modified to improve in vitro semen manipulation, by adding another two racks to the anterior (posterior) wall of the low component of the Wang tube and supplying another four convex lenses symmetrical to those on the bottom wall. The former provides a slanted position leading to a complete real-time sperm separation image and benefiting low-quality sperm preparation when the modified Wang tube is turned on its side. The latter converses the microscope's light better and gives a clearer objective image.

Techniques for selection of normal-chromatin sperm preparations.

Various sperm preparation techniques, swim-up and Percoll gradient, and the newly developed Wang's tube system, were evaluated for their ability to recover normal-chromatin sperm. Twenty human semen samples, collected by masturbation, were studied simultaneously with the three methods. Analysis by Acridine orange fluorescence test was performed on all samples. Pretreated semen contains 58 +/- 22% green sperm (fertile/normal). Treatment with Wang's tube system resulted in 99 +/- 1.0% green sperm; Percoll gradient, 78 +/- 11%; and swim-up technique, 72 +/- 15%. It would appear that Wang's tube system yields a high-quality sperm preparation with enough concentration, very active forward progression, and greatly improved sperm morphology, while containing normal-chromatin, double-stranded DNA.

Medicinal plants: conception / contraception.

PIP: Researchers have conducted considerable experiments on the effectiveness and therapeutic values of Chinese herbs and parts of plants. We should not ignore the significance of natural medicine. The Chinese have been perfecting medicinal therapy based on the raw ingredients of plants/herbs and their derivatives for thousands of years. Chinese practitioners of traditional medicine prescribe medicines based on yin and yang. Traditional medicine is communicated in a verb or written form. Natural resources used in traditional medicine to treat diseases are not limited to just medicinal plants but also include animals, shell fish, and minerals. Parts of plants used in traditional medicine are leaves, stems, flowers, bark, and root. Chinese medicine is the world's oldest continuous surviving tradition. The Chinese experimented with local plants, often resulting in mild to violent reactions. This process allowed them to become familiar with poisonous plants and those that could relieve pain or successfully treat illness. Current allopathic medicines are composed of synthetic compounds copied from natural chemical derivatives, which tend to be more potent than the original compound. Some medicinal plants used to effect conception/contraception include Striga astiatica (contraceptive); Eurycoma longifolia (male virility); and a mixture of lengkuas, mengkudu masak, black pepper seeds, ginger, salt, and 2 eggs (increase libido). Women in Malaysia take jamu to preserve their body shape and to provide nutrition during pregnancy. Praneem causes local cell-mediated immunity in the uterus. Clinical trials of Praneem with or without the hCG vaccine are planned.^ieng

Molecular characterization of a novel form of (A gamma delta beta)zero thalassemia deletion in a Chinese family.

We have identified and molecularly characterized a novel deletion in the beta-globin gene cluster that is associated with elevated fetal hemoglobin in the adult. The propositus is a homozygote from the Yunnan province of China. The deletion spans about 90 kb of DNA and removes the A gamma, delta, and beta-globin genes. The 5' breakpoint of the deletion is located about 0.13 kb upstream from the A gamma-globin gene, whereas the 3' breakpoint is located about 66 kb downstream from the beta-globin gene, about 13 kb upstream from the breakpoint of the Chinese (A gamma delta beta)zero-thalassemia. Heterozygotes for this Yunnanese form of (A gamma delta beta)zero-thalassemia express between 9% and 17% of fetal hemoglobin, whereas the homozygote present with a mild anemia (Hb = 10.7 g/dl). Comparison of the sites of 3' breakpoints of the Yunnanese and the Chinese (A gamma delta beta)zero-thalassemia mutants is compatible with the hypothesis that an enhancer element is located between the 3' breakpoints of these two mutants. Juxta-position to the G gamma gene of this element may be responsible for the efficient gamma-gene expression in the Yunnanese mutant.

Intrauterine devices Wang S.S Cu 380 as compared to ML Cu 375, Nova T, T Cu 300, 7 Cu 200, Lippes Loop and Ohta Ring: clinical / physiopathological parameters.

PIP: IUDs are rigid and heavy thus irritating the endometrium. Their design accounts for many side effects and encourages pelvic infections. IUDs may even facilitate transmission of HIV. Since some health professionals and patients consider some IUDs to be harmful or unacceptable, researchers have worked on developing a newly designed IUD which meets the criteria for and ideal IUD. Some criteria include soft and flexible in nature and inside the uterus, safe, no migration, and light in weight. Taiwanese researchers have developed such an IUD. The silicone skeleton of the Wang SS (soft and safe) Copper 380 and 300 IUDs is bow-shaped with each arm of the bow tapering off from the middle and ending with a small rounded knob. Copper wire (0.31 mm x 380 sq mm or 0.31 mm x 300 sq mm) coils around the holeless vertical stem (3 cm). The monofilament nylon string is fixed in the middle of the stem by an enlarged top. Researchers designed the Wang SS Cu 300 for nulliparous women and the Wang SS Cu 380 for multiparous women. If physicians use a Wang IUD from a sterilized package, they can insert it without wearing sterile gloves. They need to clean the cervix. They must use a single tooth tenaculum to stabilize the uterus and to straighten the uterine axis. After placing the Wang IUD in the inserter, adjusting the flange, and putting the plunger on the inserter, they need to safely introduce the inserter into the uterine cavity to the point where the inserter touches the fundus or the flange touches the cervix. They then must push the plunger to insert the IUD. Insertion should be done immediately after menstruation. Clinicians need to conduct clinical trials to test the safety and effectiveness of the Wang Ss Cu IUDs.^ieng