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Hopkins News for You
This is a monthly service for our patients and friends around the world from Johns Hopkins International. To receive monthly reports via e-mail, please send e-mail to patientnewsletter@jhmi.edu.
September 2002
1. Treating Meniere's Disease
2. ARVD Patients and Families Sought for International Registry
Vitamin E and Alzheimer's Disease
1. Treating Meniere's Disease
Meniere's disease is a miserable condition in which fluid accumulation in the inner ear can rupture its membranes. The result can be a constant ringing, hearing loss and nauseating vertigo, or dizzyness. Until now, treatments have included surgery or use of the drug Gentamicin. The drug, which controls vertigo as successfully as surgery, is usually administered directly into the ear in multiple doses for several days. Unfortunately, both treatments pose the risk of further hearing loss. A third option is now being offered by Hopkins otolaryngologists Lloyd Minor and John Carey. They also treat Meniere's patients with Gentamicin but they cure the vertigo with just a single dose, reducing the risk of hearing loss to as little as 2 percent.
Their treatment is based on studies of the drug's effect on chinchillas. They found that the drug hides in damaged cells in the animal's middle ear. Weeks later, the drug goes off like a time bomb and disables the cells. Doctors who had previously used the drug were unaware of this delayed reaction, so knowing how much to give was mostly a guess. The new dosage has been effective in 90 percent of patients who receive it and no patients have lost any of their hearing.
2. ARVD Patients and Families Sought for International Registry
Doctors at Hopkins are looking for families around the world to help them learn more about a rare heart condition that kills athletes and seems to run in families. ARVD, or arrhythmogenic right ventricular dysplasia, is a type of arrhythmia that occurs when the healthy muscle tissue of the right ventricle of the heart is replaced by fat and scar tissue. Usually associated with vigorous exercise, ARVD is believed to cause 20 percent of cases of sudden cardiac death in people younger than 35.
According to cardiologist Hugh Calkins, "The heart rapidly speeds up and patients die, many of them before they are diagnosed. Getting the right diagnosis, with tests such as cardiac MRI, echocardiogram and a biopsy of heart tissue, is key." Researchers worldwide are collaborating with Calkins to find the best way to diagnose this deadly condition and identify the genetic abnormalities that may be responsible for it. While no cure exists, many patients are treated with an implantable defibrillator, a device that monitors heart beat and automatically delivers a shock to the heart if a dangerous arrhythmia occurs. Others are managed with medications.
Vitamin E and Alzheimer's Disease
Researchers in Amsterdam and Chicago studying Alzheimer's disease have concluded that people who take Vitamin E may lower by up to 70 percent their risk for getting the devastating disease. Johns Hopkins neuroscientist Constantine Lyketsos says the finding is intriguing because Vitamin E is an anti-oxidant, which may reduce accumulation of amyloid proteins that kills brain cells and is linked with Alzheimer's.
"The idea is if amyloid is accumulating but it kills cells by oxidation, if you put in an anti-oxidant like Vitamin E, maybe you are introducing a barrier that will make it less likely that the cells die, and it's the death of the cells that causes the symptoms," he explains. Dr. Lyketsos says he will not recommend taking Vitamin E for Alzheimer's, however, until a large-scale study has been conducted.
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