Revision cochlear implantation: The Irish experience

Objectives: To report a long-term experience on revision cochlear implantation (RCI) in a single institution, categorize their indications and to identify predictive parameters of implant failure. Methods: A retrospective study was conducted on a prospective database of a national cochlear implant unit. Patients requiring RCI between January 1995 and June 2016 were identified and stratified into adult and paediatric group. Medical records, investigation reports and device analysis reports were reviewed and analysed. Results/Discussion: A total of 37 children and 21 adults were identified requiring RCI on 60 devices. 63.3% of the RCI was indicated due to the device failure, while 36.7% was due to various medical reasons. Higher device failure rate was reported in the paediatric group, due to the high number of direct head trauma, which was not observed in the adult group. The leading medical indication for RCI was due to wound infection (10%). The overall RCI rate was 5.0%, among which 3.1% was due to device failures. A brief discussion on various medical indications, surgical challenges, and the mechanism of thought process to consider RCI, including treatment planning was outlined. Conclusion: RCI in the paediatric population poses a unique challenge. Integrity testing is helpful in identifying a potential device malfunction; however, regular clinical follow-up with multidisciplinary assessments is invaluable in the decision process for RCI.

In Silico Study to Develop a Lectin-Like Protein from Mushroom Agaricus bisporus for Pharmaceutical Application

A lectin-like protein of unknown function designated as LSMT was recently discovered in the edible mushroom Agaricus bisporus. The protein shares high structural similarity to HA-33 from Clostridium botulinum (HA33) and Ricin-B-like lectin from the mushroom Clitocybe nebularis (CNL), which have been developed as drug carrier and anti-cancer, respectively. These homologous proteins display the ability to penetrate the intestinal epithelial cell monolayer, and are beneficial for oral administration. As the characteristics of LSMT are unknown, a structural study in silico was performed to assess its potential pharmaceutical application. The study suggested potential binding to target ligands such as HA-33 and CNL although the nature, specificity, capacity, mode, and strength may differ. Further molecular docking experiments suggest that interactions between the LSMT and tested ligands may take place. This finding indicates the possible use of the LSMT protein, initiating new research on its use for pharmaceutical purposes.