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Sample records for cochlear marginal cells

  1. The dual role of poly(ADP-ribose) polymerase-1 in modulating parthanatos and autophagy under oxidative stress in rat cochlear marginal cells of the stria vascularis.

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    Jiang, Hong-Yan; Yang, Yang; Zhang, Yuan-Yuan; Xie, Zhen; Zhao, Xue-Yan; Sun, Yu; Kong, Wei-Jia

    2018-04-01

    Oxidative stress is reported to regulate several apoptotic and necrotic cell death pathways in auditory tissues. Poly(ADP-ribose) polymerase-1 (PARP-1) can be activated under oxidative stress, which is the hallmark of parthanatos. Autophagy, which serves either a pro-survival or pro-death function, can also be stimulated by oxidative stress, but the role of autophagy and its relationship with parthanatos underlying this activation in the inner ear remains unknown. In this study, we established an oxidative stress model in vitro by glucose oxidase/glucose (GO/G), which could continuously generate low concentrations of H 2 O 2 to mimic continuous exposure to H 2 O 2 in physiological conditions, for investigation of oxidative stress-induced cell death mechanisms and the regulatory role of PARP-1 in this process. We observed that GO/G induced stria marginal cells (MCs) death via upregulation of PARP-1 expression, accumulation of polyADP-ribose (PAR) polymers, decline of mitochondrial membrane potential (MMP) and nuclear translocation of apoptosis-inducing factor (AIF), which all are biochemical features of parthanatos. PARP-1 knockdown rescued GO/G-induced MCs death, as well as abrogated downstream molecular events of PARP-1 activation. In addition, we demonstrated that GO/G stimulated autophagy and PARP-1 knockdown suppressed GO/G-induced autophagy in MCs. Interestingly, autophagy suppression by 3-Methyladenine (3-MA) accelerated GO/G-induced parthanatos, indicating a pro-survival function of autophagy in GO/G-induced MCs death. Taken together, these data suggested that PARP-1 played dual roles by modulating parthanatos and autophagy in oxidative stress-induced MCs death, which may be considered as a promising therapeutic target for ameliorating oxidative stress-related hearing disorders. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  2. Cochlear implant

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    Hearing loss - cochlear implant; Sensorineural - cochlear; Deaf - cochlear; Deafness - cochlear ... of the cochlear implant. WHO USES A COCHLEAR IMPLANT? Cochlear implants allow deaf people to receive and process ...

  3. Cochlear nucleus whole mount explants promote the differentiation of neuronal stem cells from the cochlear nucleus in co-culture experiments.

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    Rak, Kristen; Völker, Johannes; Jürgens, Lukas; Völker, Christine; Frenz, Silke; Scherzad, Agmal; Schendzielorz, Philipp; Jablonka, Sibylle; Mlynski, Robert; Radeloff, Andreas; Hagen, Rudolf

    2015-08-07

    The cochlear nucleus is the first brainstem nucleus to receive sensory input from the cochlea. Depriving this nucleus of auditory input leads to cellular and molecular disorganization which may potentially be counteracted by the activation or application of stem cells. Neuronal stem cells (NSCs) have recently been identified in the neonatal cochlear nucleus and a persistent neurogenic niche was demonstrated in this brainstem nucleus until adulthood. The present work investigates whether the neurogenic environment of the cochlear nucleus can promote the survival of engrafted NSCs and whether cochlear nucleus-derived NSCs can differentiate into neurons and glia in brain tissue. Therefore, cochlear nucleus whole-mount explants were co-cultured with NSCs extracted from either the cochlear nucleus or the hippocampus and compared to a second environment using whole-mount explants from the hippocampus. Factors that are known to induce neuronal differentiation were also investigated in these NSC-explant experiments. NSCs derived from the cochlear nucleus engrafted in the brain tissue and differentiated into all cells of the neuronal lineage. Hippocampal NSCs also immigrated in cochlear nucleus explants and differentiated into neurons, astrocytes and oligodendrocytes. Laminin expression was up-regulated in the cochlear nucleus whole-mounts and regulated the in vitro differentiation of NSCs from the cochlear nucleus. These experiments confirm a neurogenic environment in the cochlear nucleus and the capacity of cochlear nucleus-derived NSCs to differentiate into neurons and glia. Consequently, the presented results provide a first step for the possible application of stem cells to repair the disorganization of the cochlear nucleus, which occurs after hearing loss. Copyright © 2015 Elsevier B.V. All rights reserved.

  4. Cochlear gene therapy with ancestral AAV in adult mice: complete transduction of inner hair cells without cochlear dysfunction.

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    Suzuki, Jun; Hashimoto, Ken; Xiao, Ru; Vandenberghe, Luk H; Liberman, M Charles

    2017-04-03

    The use of viral vectors for inner ear gene therapy is receiving increased attention for treatment of genetic hearing disorders. Most animal studies to date have injected viral suspensions into neonatal ears, via the round window membrane. Achieving transduction of hair cells, or sensory neurons, throughout the cochlea has proven difficult, and no studies have been able to efficiently transduce sensory cells in adult ears while maintaining normal cochlear function. Here, we show, for the first time, successful transduction of all inner hair cells and the majority of outer hair cells in an adult cochlea via virus injection into the posterior semicircular canal. We used a "designer" AAV, AAV2/Anc80L65, in which the main capsid proteins approximate the ancestral sequence state of AAV1, 2, 8, and 9. Our injections also transduced ~10% of spiral ganglion cells and a much larger fraction of their satellite cells. In the vestibular sensory epithelia, the virus transduced large numbers of hair cells and virtually all the supporting cells, along with close to half of the vestibular ganglion cells. We conclude that this viral vector and this delivery route hold great promise for gene therapy applications in both cochlear and vestibular sense organs.

  5. Prestin is required for electromotility of the outer hair cell and for the cochlear amplifier

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    Liberman, M. Charles; Gao, Jiangang; He, David Z. Z.; Wu, Xudong; Jia, Shuping; Zuo, Jian

    2002-09-01

    Hearing sensitivity in mammals is enhanced by more than 40dB (that is, 100-fold) by mechanical amplification thought to be generated by one class of cochlear sensory cells, the outer hair cells. In addition to the mechano-electrical transduction required for auditory sensation, mammalian outer hair cells also perform electromechanical transduction, whereby transmembrane voltage drives cellular length changes at audio frequencies in vitro. This electromotility is thought to arise through voltage-gated conformational changes in a membrane protein, and prestin has been proposed as this molecular motor. Here we show that targeted deletion of prestin in mice results in loss of outer hair cell electromotility in vitro and a 40-60dB loss of cochlear sensitivity in vivo, without disruption of mechano-electrical transduction in outer hair cells. In heterozygotes, electromotility is halved and there is a twofold (about 6dB) increase in cochlear thresholds. These results suggest that prestin is indeed the motor protein, that there is a simple and direct coupling between electromotility and cochlear amplification, and that there is no need to invoke additional active processes to explain cochlear sensitivity in the mammalian ear.

  6. Cochlear epithelial of dog fetuses: a new source of multipotent stem cells.

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    Santos, Ana Carolina M; Borghesi, Jéssica; Mario, Lara Carolina; Anunciação, Adriana Raquel A; Mess, Andrea Maria; Carreira, Ana Claudia O; Favaron, Phelipe O; Miglino, Maria Angélica

    2017-02-01

    Hearing loss caused by the damage of cochlea sensory cells or neurons is a common human disease, but also affects dogs and other animals. To test their progenitor nature as potential value for future therapies, we characterized cells derived from the cochlear epithelium in dog fetuses. In total, 8 fetuses of 35-40 days of gestation, derived from castration campaigns, were investigated. Cells were analysed by the MTT colorimetric assay and in regard to cell cycle, differentiation capacities, immunophenotypes and qPCR analysis. In culture, cells had a fibroblast-like morphology. Phenotypic immunocharacterization showed positive staining for mesenchymal stem cell and pluripotency markers and were negative for hematopoietic cell markers. Cells possessed differentiation capacity for the three main cell lineages: osteogenic, adipogenic and chondrogenic, altogether indicating their nature as mesenchymal stem cells. Thus, cells derived from fetal cochlear tissues indeed may provide valuable sources of progenitor cells for cell therapy of canine deafness and other diseases.

  7. The origin of marginal zone B cells in the rat

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    Dammers, PM; de Boer, NK; Deenen, GJ; Nieuwenhuis, P; Kroese, FGM

    The marginal zone is a unique compartment that is only found in the spleen. Rat marginal zone B cells (MZ-B) can be distinguished from other B cells, e.g. recirculating follicular B cells (RF-B), by several phenotypic characteristics. Typically MZ-B cells are surface (s)IgM(hi), sIgD(lo) and

  8. Cochlear Implants

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    ... implant procedure Welcome to the Food and Drug Administration (FDA) website on cochlear implants. Cochlear implants are electronic hearing devices. Doctors implant cochlear implants into people ...

  9. Stria vascularis and cochlear hair cell changes in syphilis: A human temporal bone study.

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    Hızlı, Ömer; Kaya, Serdar; Hızlı, Pelin; Paparella, Michael M; Cureoglu, Sebahattin

    2016-12-01

    To observe any changes in stria vascularis and cochlear hair cells in patients with syphilis. We examined 13 human temporal bone samples from 8 patients with syphilis (our syphilis group), as well as 12 histopathologically normal samples from 9 age-matched patients without syphilis (our control group). We compared, between the two groups, the mean area of the stria vascularis (measured with conventional light microscopy connected to a personal computer) and the mean percentage of cochlear hair cell loss (obtained from cytocochleograms). In our syphilis group, only 1 (7.7%) of the 13 samples had precipitate in the endolymphatic or perilymphatic spaces; 8 (61.5%) of the samples revealed the presence of endolymphatic hydrops (4 cochlear, 4 saccular). The mean area of the stria vascularis did not significantly differ, in any turn of the cochlea, between the 2 groups (P>0.1). However, we did find significant differences between the 2 groups in the mean percentage of outer hair cells in the apical turn (Psyphilis group, we observed either complete loss of the organ of Corti or a flattened organ of Corti without any cells in addition to the absence of both outer and inner hair cells. In this study, syphilis led either to complete loss of the organ of Corti or to significant loss of cochlear hair cells, in addition to cochleosaccular hydrops. But the area of the stria vascularis did not change. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  10. An electrical tuning mechanism in turtle cochlear hair cells.

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    Crawford, A C; Fettiplace, R

    1981-03-01

    1. Intracellular recordings were made from single cochlear hair cells in the isolated half-head of the turtle. The electrical responses of the cells were recorded under two conditions: (a) when the ear was stimulated with low-intensity tones of different frequencies and (b) when current steps were injected through the intracellular electrode. The aim of the experiments was to evaluate the extent to which the cochlea's frequency selectivity could be accounted for by the electrical properties of the hair cells.2. At low levels of acoustic stimulation, the amplitude of the hair cell's receptor potential was proportional to sound pressure. The linear tuning curve, which is defined as the sensitivity of the cell as a function of frequency when the cell is operating in its linear range, was measured for a number of hair cells with characteristic frequencies from 86 Hz to 425 Hz.3. A rectangular current passed into a hair cell elicited a membrane potential change consisting of a damped oscillation superimposed on a step. Small currents produced symmetrical oscillations at the beginning and end of the pulse. Larger currents increased the initial ringing frequency if depolarizing and decreased it if hyperpolarizing.4. For small currents the frequency of the oscillations and the quality factor (Q) of the electrical resonance derived from the decay of the oscillations were close to the characteristic frequency and Q of the hair-cell linear tuning curve obtained from sound presentations.5. The hair cell's membrane potential change to small-current pulses or low-intensity tone bursts could be largely described by representing the hair cell as a simple electrical resonator consisting of an inductance, resistor and capacitor.6. When step displacements of 29-250 nm were applied to a micropipette, placed just outside a hair cell in the basilar papilla, an initial periodic firing of impulses could be recorded from single fibres in the auditory nerve. Currents of up to 1 nA, injected

  11. Specific and efficient transduction of Cochlear inner hair cells with recombinant adeno-associated virus type 3 vector.

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    Liu, Yuhe; Okada, Takashi; Sheykholeslami, Kianoush; Shimazaki, Kuniko; Nomoto, Tatsuya; Muramatsu, Shin-Ichi; Kanazawa, Takeharu; Takeuchi, Koichi; Ajalli, Rahim; Mizukami, Hiroaki; Kume, Akihiro; Ichimura, Keiichi; Ozawa, Keiya

    2005-10-01

    Recombinant adeno-associated virus (AAV) vectors are of interest for cochlear gene therapy because of their ability to mediate the efficient transfer and long-term stable expression of therapeutic genes in a wide variety of postmitotic tissues with minimal vector-related cytotoxicity. In the present study, seven AAV serotypes (AAV1-5, 7, 8) were used to construct vectors. The expression of EGFP by the chicken beta-actin promoter associated with the cytomegalovirus immediate-early enhancer in cochlear cells showed that each of these serotypes successfully targets distinct cochlear cell types. In contrast to the other serotypes, the AAV3 vector specifically transduced cochlear inner hair cells with high efficiency in vivo, while the AAV1, 2, 5, 7, and 8 vectors also transduced these and other cell types, including spiral ganglion and spiral ligament cells. There was no loss of cochlear function with respect to evoked auditory brain-stem responses over the range of frequencies tested after the injection of AAV vectors. These findings are of value for further molecular studies of cochlear inner hair cells and for gene replacement strategies to correct recessive genetic hearing loss due to monogenic mutations in these cells.

  12. Imaging living hair cells within the cochlear epithelium of mice using two-photon microscopy

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    Yuan, Tao; Gao, Simon S.; Saggau, Peter; Oghalai, John S.

    2009-02-01

    Mice are an excellent model for studying mammalian hearing and transgenic mouse models of human hearing loss are commonly available for research. However, the mouse cochlea is substantially smaller than other animal models routinely used to study cochlear physiology. This makes the study of their hair cells difficult. We developed a novel methodology to optically image calcium within living hair cells left undisturbed within the excised mouse cochlea. Fresh cochleae were harvested, left intact within their otic capsule bone, and glued upright in a recording chamber. The bone overlying the region of the cochlear epithelium to be studied was opened and Reissner's membrane was incised. A fluorescent indicator was applied to the preparation to image intracellular calcium. A custom-built upright two-photon microscope was used to image the preparation using three dimensional scanning. We were able to image about 1/3 of a cochlear turn simultaneously, in either the apical or basal regions. Within one hour of animal sacrifice, we found that outer hair cells demonstrated increased fluorescence compared with surrounding supporting cells. Thus, this methodology can be used to visualize hair cell calcium changes and mechanotransduction over a region of the epithelium. Because the epithelium is left within the cochlea, dissection trauma is minimized and artifactual changes in hair cell physiology are reduced.

  13. Sonic hedgehog initiates cochlear hair cell regeneration through downregulation of retinoblastoma protein

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    Lu, Na [Otology Skull Base Surgery Department, Hearing Research Institute, Eye and ENT Hospital of Shanghai Medical School, Fudan University, Shanghai 200031 (China); Department of Otolaryngology and Program in Neuroscience, Harvard Medical School and Eaton Peabody Laboratory, Massachusetts Eye and Ear Infirmary, Boston, MA 02114 (United States); Chen, Yan [Central Laboratory, Hearing Research Institute, Eye and ENT Hospital of Shanghai Medical School, Fudan University, Shanghai 200031 (China); Wang, Zhengmin [Otology Skull Base Surgery Department, Hearing Research Institute, Eye and ENT Hospital of Shanghai Medical School, Fudan University, Shanghai 200031 (China); Institute of Biomedical Sciences, Fudan University, Shanghai 200032 (China); Chen, Guoling [Otology Skull Base Surgery Department, Hearing Research Institute, Eye and ENT Hospital of Shanghai Medical School, Fudan University, Shanghai 200031 (China); Lin, Qin [Otology Skull Base Surgery Department, Hearing Research Institute, Eye and ENT Hospital of Shanghai Medical School, Fudan University, Shanghai 200031 (China); Department of Otolaryngology, First Affiliated Hospital of Fujian Medical University, Otolaryngology Institute of Fujian Province, Fuzhou (China); Chen, Zheng-Yi, E-mail: Zheng-yi_chen@meei.harvard.edu [Department of Otolaryngology and Program in Neuroscience, Harvard Medical School and Eaton Peabody Laboratory, Massachusetts Eye and Ear Infirmary, Boston, MA 02114 (United States); Li, Huawei, E-mail: hwli@shmu.edu.cn [Otology Skull Base Surgery Department, Hearing Research Institute, Eye and ENT Hospital of Shanghai Medical School, Fudan University, Shanghai 200031 (China); Institute of Biomedical Sciences, Fudan University, Shanghai 200032 (China)

    2013-01-11

    Highlights: Black-Right-Pointing-Pointer Shh activation in neonatal cochleae enhances sensory cell proliferation. Black-Right-Pointing-Pointer Proliferating supporting cells can transdifferentiate into hair cells. Black-Right-Pointing-Pointer Shh promotes proliferation by transiently modulating pRb activity. Black-Right-Pointing-Pointer Shh inhibits pRb by inhibiting transcription and increasing phosphorylation of pRb. -- Abstract: Cell cycle re-entry by cochlear supporting cells and/or hair cells is considered one of the best approaches for restoring hearing loss as a result of hair cell damage. To identify mechanisms that can be modulated to initiate cell cycle re-entry and hair cell regeneration, we studied the effect of activating the sonic hedgehog (Shh) pathway. We show that Shh signaling in postnatal rat cochleae damaged by neomycin leads to renewed proliferation of supporting cells and hair cells. Further, proliferating supporting cells are likely to transdifferentiate into hair cells. Shh treatment leads to inhibition of retinoblastoma protein (pRb) by increasing phosphorylated pRb and reducing retinoblastoma gene transcription. This results in upregulation of cyclins B1, D2, and D3, and CDK1. These results suggest that Shh signaling induces cell cycle re-entry in cochlear sensory epithelium and the production of new hair cells, in part by attenuating pRb function. This study provides an additional route to modulate pRb function with important implications in mammalian hair cell regeneration.

  14. Innervation of Cochlear Hair Cells by Human Induced Pluripotent Stem Cell-Derived Neurons In Vitro

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    Niliksha Gunewardene

    2016-01-01

    Full Text Available Induced pluripotent stem cells (iPSCs may serve as an autologous source of replacement neurons in the injured cochlea, if they can be successfully differentiated and reconnected with residual elements in the damaged auditory system. Here, we explored the potential of hiPSC-derived neurons to innervate early postnatal hair cells, using established in vitro assays. We compared two hiPSC lines against a well-characterized hESC line. After ten days’ coculture in vitro, hiPSC-derived neural processes contacted inner and outer hair cells in whole cochlear explant cultures. Neural processes from hiPSC-derived neurons also made contact with hair cells in denervated sensory epithelia explants and expressed synapsin at these points of contact. Interestingly, hiPSC-derived neurons cocultured with hair cells at an early stage of differentiation formed synapses with a higher number of hair cells, compared to hiPSC-derived neurons cocultured at a later stage of differentiation. Notable differences in the innervation potentials of the hiPSC-derived neurons were also observed and variations existed between the hiPSC lines in their innervation efficiencies. Collectively, these data illustrate the promise of hiPSCs for auditory neuron replacement and highlight the need to develop methods to mitigate variabilities observed amongst hiPSC lines, in order to achieve reliable clinical improvements for patients.

  15. An investigation of dendritic delay in octopus cells of the mammalian cochlear nucleus

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    Spencer, Martin J.; Grayden, David B.; Bruce, Ian C.; Meffin, Hamish; Burkitt, Anthony N.

    2012-01-01

    Octopus cells, located in the mammalian auditory brainstem, receive their excitatory synaptic input exclusively from auditory nerve fibers (ANFs). They respond with accurately timed spikes but are broadly tuned for sound frequency. Since the representation of information in the auditory nerve is well understood, it is possible to pose a number of questions about the relationship between the intrinsic electrophysiology, dendritic morphology, synaptic connectivity, and the ultimate functional role of octopus cells in the brainstem. This study employed a multi-compartmental Hodgkin-Huxley model to determine whether dendritic delay in octopus cells improves synaptic input coincidence detection in octopus cells by compensating for the cochlear traveling wave delay. The propagation time of post-synaptic potentials from synapse to soma was investigated. We found that the total dendritic delay was approximately 0.275 ms. It was observed that low-threshold potassium channels in the dendrites reduce the amplitude dependence of the dendritic delay of post-synaptic potentials. As our hypothesis predicted, the model was most sensitive to acoustic onset events, such as the glottal pulses in speech when the synaptic inputs were arranged such that the model's dendritic delay compensated for the cochlear traveling wave delay across the ANFs. The range of sound frequency input from ANFs was also investigated. The results suggested that input to octopus cells is dominated by high frequency ANFs. PMID:23125831

  16. Heterogeneity of memory marginal zone B cells in the rat

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    Hendricks, Jacobus

    2015-01-01

    The spleen is an important organ of the immune system. Like other lymphoid organs, the spleen is compartmentalized. Different compartments harbor different populations of lymphocytes, subpopulation of the white blood cells. One of these compartments in the spleen is the so-called marginal zone. Most

  17. Re-Emergent Inhibition of Cochlear Inner Hair Cells in a Mouse Model of Hearing Loss.

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    Zachary, Stephen Paul; Fuchs, Paul Albert

    2015-07-01

    Hearing loss among the elderly correlates with diminished social, mental, and physical health. Age-related cochlear cell death does occur, but growing anatomical evidence suggests that synaptic rearrangements on sensory hair cells also contribute to auditory functional decline. Here we present voltage-clamp recordings from inner hair cells of the C57BL/6J mouse model of age-related hearing loss, which reveal that cholinergic synaptic inputs re-emerge during aging. These efferents are functionally inhibitory, using the same ionic mechanisms as do efferent contacts present transiently before the developmental onset of hearing. The strength of efferent inhibition of inner hair cells increases with hearing threshold elevation. These data indicate that the aged cochlea regains features of the developing cochlea and that efferent inhibition of the primary receptors of the auditory system re-emerges with hearing impairment. Synaptic changes in the auditory periphery are increasingly recognized as important factors in hearing loss. To date, anatomical work has described the loss of afferent contacts from cochlear hair cells. However, relatively little is known about the efferent innervation of the cochlea during hearing loss. We performed intracellular recordings from mouse inner hair cells across the lifespan and show that efferent innervation of inner hair cells arises in parallel with the loss of afferent contacts and elevated hearing threshold during aging. These efferent neurons inhibit inner hair cells, raising the possibility that they play a role in the progression of age-related hearing loss. Copyright © 2015 the authors 0270-6474/15/359701-06$15.00/0.

  18. Mammalian Cochlear Hair Cell Regeneration and Ribbon Synapse Reformation

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    Xiaoling Lu

    2016-01-01

    Full Text Available Hair cells (HCs are the sensory preceptor cells in the inner ear, which play an important role in hearing and balance. The HCs of organ of Corti are susceptible to noise, ototoxic drugs, and infections, thus resulting in permanent hearing loss. Recent approaches of HCs regeneration provide new directions for finding the treatment of sensor neural deafness. To have normal hearing function, the regenerated HCs must be reinnervated by nerve fibers and reform ribbon synapse with the dendrite of spiral ganglion neuron through nerve regeneration. In this review, we discuss the research progress in HC regeneration, the synaptic plasticity, and the reinnervation of new regenerated HCs in mammalian inner ear.

  19. Reduced climbing and increased slipping adaptation in cochlear hair cells of mice with Myo7a mutations

    NARCIS (Netherlands)

    Kros, CJ; Marcotti, W; van Netten, SM; Self, TJ; Libby, RT; Brown, SDM; Richardson, GP; Steel, KP

    Mutations in Myo7a cause hereditary deafness in mice and humans. We describe the effects of two mutations, Myo7a(6J) and Myo7a(4626SB). on mechano-electrical transduction in cochlear hair cells. Both mutations result in two major functional abnormalities that would interfere with sound transduction.

  20. Comparison of Cochlear Cell Death Caused by Cisplatin, Alone and in Combination with Furosemide

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    Xia, Li; Chen, Zhengnong; Su, Kaiming; Yin, Shankai; Wang, Jian

    2014-01-01

    Establishment of appropriate animal models is an important step in exploring the mechanisms of drug-induced ototoxicity. In the present study, using guinea pigs we compared cochlear lesions induced by cisplatin administered in two regimens: consecutive application alone and in combination with furosemide. The effects of furosemide alone were also evaluated; it was found to cause temporary hearing loss and reversible damage to the stria vascularis. Consecutive application of cisplatin alone appeared to be disadvantageous because it resulted in progressive body weight loss and higher mortality compared to the combined regimen, which used a smaller cisplatin dose. The combined regimen resulted in comparable hearing loss and hair cell loss but a markedly lower mortality. However, their coadministration failed to cause similar damage to spiral ganglion neurons (SGN), as seen in animals that received cisplatin alone. This difference suggests that the combined regimen did not mimic the damage to cochlear neuronal innervation caused by the clinical application of cisplatin. The difference also suggests that the SGN lesion is not caused by cisplatin entering the cochlea via the stria vascularis. PMID:23548607

  1. Ginkgo Biloba Extract Attenuates Oxidative Stress and Apoptosis in Mouse Cochlear Neural Stem Cells.

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    Wang, Congpin; Wang, Bin

    2016-05-01

    In the organ or Corti, oxidative stress could result in damage to the hearing, and neural stem cells (NSCs) hold great therapeutic potential in treating hearing loss. Ginkgo biloba extract (GBE) has been widely shown to exhibit anti-oxidative and anti-apoptotic effects in treatments of neural damage and disorder. Using hydrogen peroxide to induced oxidative stress as a model, we investigated the anti-oxidative role of GBE in isolated mouse cochlear NSCs. GBE treatment was found to significantly promote viability of NSCs, by markedly attenuating hydrogen peroxide induced oxidative stress. In addition, this anti-oxidative function of GBE was also able to prevent mitochondrial depolarization and subsequent apoptosis. Moreover, the anti-apoptotic role of GBE was mediated by antagonizing the intrinsic mitochondrial apoptotic pathway, where GBE could reverse the changes in key intrinsic apoptosis pathway factors including Bcl-2, Bax, and Caspase-3. Our data provided the first report on the beneficial role of GBE in protecting cochlear NSCs, by attenuating oxidative stress triggered intrinsic apoptosis, therefore supporting the potential therapeutic value of GBE in preventing oxidative stress-related hearing loss. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  2. Static length changes of cochlear outer hair cells can tune low-frequency hearing.

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    Nikola Ciganović

    2018-01-01

    Full Text Available The cochlea not only transduces sound-induced vibration into neural spikes, it also amplifies weak sound to boost its detection. Actuators of this active process are sensory outer hair cells in the organ of Corti, whereas the inner hair cells transduce the resulting motion into electric signals that propagate via the auditory nerve to the brain. However, how the outer hair cells modulate the stimulus to the inner hair cells remains unclear. Here, we combine theoretical modeling and experimental measurements near the cochlear apex to study the way in which length changes of the outer hair cells deform the organ of Corti. We develop a geometry-based kinematic model of the apical organ of Corti that reproduces salient, yet counter-intuitive features of the organ's motion. Our analysis further uncovers a mechanism by which a static length change of the outer hair cells can sensitively tune the signal transmitted to the sensory inner hair cells. When the outer hair cells are in an elongated state, stimulation of inner hair cells is largely inhibited, whereas outer hair cell contraction leads to a substantial enhancement of sound-evoked motion near the hair bundles. This novel mechanism for regulating the sensitivity of the hearing organ applies to the low frequencies that are most important for the perception of speech and music. We suggest that the proposed mechanism might underlie frequency discrimination at low auditory frequencies, as well as our ability to selectively attend auditory signals in noisy surroundings.

  3. Cochlear bionic acoustic metamaterials

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    Ma, Fuyin; Wu, Jiu Hui; Huang, Meng; Fu, Gang; Bai, Changan

    2014-11-01

    A design of bionic acoustic metamaterial and acoustic functional devices was proposed by employing the mammalian cochlear as a prototype. First, combined with the experimental data in previous literatures, it is pointed out that the cochlear hair cells and stereocilia cluster are a kind of natural biological acoustic metamaterials with the negative stiffness characteristics. Then, to design the acoustic functional devices conveniently in engineering application, a simplified parametric helical structure was proposed to replace actual irregular cochlea for bionic design, and based on the computational results of such a bionic parametric helical structure, it is suggested that the overall cochlear is a local resonant system with the negative dynamic effective mass characteristics. There are many potential applications in the bandboard energy recovery device, cochlear implant, and acoustic black hole.

  4. Calcium imaging of inner ear hair cells within the cochlear epithelium of mice using two-photon microscopy

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    Yuan, Tao; Gao, Simon S.; Saggau, Peter; Oghalai, John S.

    2010-01-01

    Mice are an excellent model for studying mammalian hearing and transgenic mouse models of human hearing, loss are commonly available. However, the mouse cochlea is substantially smaller than other animal models routinely used to study cochlear physiology. This makes study of their hair cells difficult. We develop a novel methodology to optically image calcium within living hair cells left undisturbed within the excised mouse cochlea. Fresh cochleae are harvested, left intact within their otic capsule bone, and fixed in a recording chamber. The bone overlying the cochlear epithelium is opened and Reissner's membrane is incised. A fluorescent calcium indicator is applied to the preparation. A custom-built upright two-photon microscope was used to image the preparation using 3-D scanning. We are able to image about one third of a cochlear turn simultaneously, in either the apical or basal regions. Within one hour of animal sacrifice, we find that outer hair cells demonstrate increased fluorescence compared with surrounding supporting cells. This methodology is then used to visualize hair cell calcium changes during mechanotransduction over a region of the epithelium. Because the epithelium is left within the cochlea, dissection trauma is minimized and artifactual changes in hair cell physiology are expected to be reduced.

  5. Induction of Functional Hair-Cell-Like Cells from Mouse Cochlear Multipotent Cells

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    Quanwen Liu

    2016-01-01

    Full Text Available In this paper, we developed a two-step-induction method of generating functional hair cells from inner ear multipotent cells. Multipotent cells from the inner ear were established and induced initially into progenitor cells committed to the inner ear cell lineage on the poly-L-lysine substratum. Subsequently, the committed progenitor cells were cultured on the mitotically inactivated chicken utricle stromal cells and induced into hair-cell-like cells containing characteristic stereocilia bundles. The hair-cell-like cells exhibited rapid permeation of FM1-43FX. The whole-cell patch-clamp technique was used to measure the membrane currents of cells differentiated for 7 days on chicken utricle stromal cells and analyze the biophysical properties of the hair-cell-like cells by recording membrane properties of cells. The results suggested that the hair-cell-like cells derived from inner ear multipotent cells were functional following differentiation in an enabling environment.

  6. Characterization of slow-cycling cells in the mouse cochlear lateral wall.

    Directory of Open Access Journals (Sweden)

    Yang Li

    Full Text Available Cochlear spiral ligament fibrocytes (SLFs play essential roles in the physiology of hearing including ion recycling and the generation of endocochlear potential. In adult animals, SLFs can repopulate after damages, yet little is known about the characteristics of proliferating cells that support SLFs' self-renewal. Here we report in detail about the characteristics of cycling cells in the spiral ligament (SL. Fifteen P6 mice and six noise-exposed P28 mice were injected with 5-bromo-2'-deoxyuridine (BrdU for 7 days and we chased BrdU retaining cells for as long as 60 days. Immunohistochemistry revealed that the BrdU positive IB4 (an endotherial marker negative cells expressed an early SLF marker Pou3f4 but negative for cleaved-Caspase 3. Marker studies revealed that type 3 SLFs displayed significantly higher percentage of BrdU+ cells compared to other subtypes. Notably, the cells retained BrdU until P72, demonstrating they were dividing slowly. In the noise-damaged mice, in contrast to the loss of the other types, the number of type 3 SLFs did not altered and the BrdU incorporating- phosphorylated Histone H3 positive type 3 cells were increased from day 1 to 14 after noise exposure. Furthermore, the cells repopulating type 1 area, where the cells diminished profoundly after damage, were positive for the type 3 SLF markers. Collectively, in the latral wall of the cochlea, type 3 SLFs have the stem cell capacity and may contribute to the endogenous regeneration of lateral wall spiral ligament. Manipulating type 3 cells may be employed for potential regenerative therapies.

  7. Cytosolic calcium elevation induced by orexin/hypocretin in granule cell domain cells of the rat cochlear nucleus in vitro.

    Science.gov (United States)

    Nakamura, Yuki; Miura, Shinya; Yoshida, Takashi; Kim, Juhyon; Sasaki, Kazuo

    2010-08-01

    Using rat brain slice preparations, we examined the effect of orexin on cytosolic Ca(2+) concentrations ([Ca(2+)](i)) in the granule cell domain (GCD) cells of the cochlear nucleus that carry non-auditory information to the dorsal cochlear nucleus. Application of orexin concentration-dependently increased [Ca(2+)](i), and in two thirds of GCD cells these increases persisted in the presence of tetrodotoxin. There was no significant difference between the dose-response curve for orexin-A and that for orexin-B. Extracellular Ca(2+) removal abolished the [Ca(2+)](i) elevation induced by orexin-B, whereas depletion of intracellular Ca(2+) stores had no effect. The orexin-B-induced elevation of [Ca(2+)](i) was not blocked by inhibitors of reverse-mode Na(+)/Ca(2+) exchanger (NCX) and nonselective cation channel, whereas it was blocked by lowering the extracellular Na(+) or by applying inhibitors of forward-mode NCX and voltage-gated R- and T-type Ca(2+) channels. The ORX-B-induced increase in [Ca(2+)](i) was also blocked by inhibitors of adenylcyclase (AC) and protein kinase A (PKA), but not by inhibitors of phosphatidylcholine-specific and phosphatidylinositol-specific phospholipase C. In electrophysiological experiments using whole-cell patch clamp recordings, half of GCD cells were depolarized by orexin-B, and the depolarization was abolished by a forward-mode NCX inhibitor. These results suggest that orexin increases [Ca(2+)](i) postsynaptically via orexin 2 receptors, and the increase in [Ca(2+)](i) is induced via the AC-PKA-forward-mode NCX-membrane depolarization-mediated activation of voltage-gated R- and T-type Ca(2+) channels. The results further support the hypothesis that the orexin system participates in integrating neural systems that are involved in arousal, sensory processing, energy homeostasis and autonomic function. Copyright 2010 Elsevier Inc. All rights reserved.

  8. Gentamicin rapidly inhibits mitochondrial metabolism in high-frequency cochlear outer hair cells.

    Directory of Open Access Journals (Sweden)

    Heather C Jensen-Smith

    Full Text Available Aminoglycosides (AG, including gentamicin (GM, are the most frequently used antibiotics in the world and are proposed to cause irreversible cochlear damage and hearing loss (HL in 1/4 of the patients receiving these life-saving drugs. Akin to the results of AG ototoxicity studies, high-frequency, basal turn outer hair cells (OHCs preferentially succumb to multiple HL pathologies while inner hair cells (IHCs are much more resilient. To determine if endogenous differences in IHC and OHC mitochondrial metabolism dictate differential sensitivities to AG-induced HL, IHC- and OHC-specific changes in mitochondrial reduced nicotinamide adenine dinucleotide (NADH fluorescence during acute (1 h GM treatment were compared. GM-mediated decreases in NADH fluorescence and succinate dehydrogenase activity were observed shortly after GM application. High-frequency basal turn OHCs were found to be metabolically biased to rapidly respond to alterations in their microenvironment including GM and elevated glucose exposures. These metabolic biases may predispose high-frequency OHCs to preferentially produce cell-damaging reactive oxygen species during traumatic challenge. Noise-induced and age-related HL pathologies share key characteristics with AG ototoxicity, including preferential OHC loss and reactive oxygen species production. Data from this report highlight the need to address the role of mitochondrial metabolism in regulating AG ototoxicity and the need to illuminate how fundamental differences in IHC and OHC metabolism may dictate differences in HC fate during multiple HL pathologies.

  9. Determination of ototoxicity of common otic drops using isolated cochlear outer hair cells.

    Science.gov (United States)

    Jinn, T H; Kim, P D; Russell, P T; Church, C A; John, E O; Jung, T T

    2001-12-01

    Otic drops are commonly used not only for otitis externa, but also for otorrhea in the presence of tympanostomy tubes or tympanic membrane perforations. Many studies have demonstrated the ototoxicity of common otic preparations such as Cortisporin otic drops (Monarch Pharmaceuticals, Bristol, TN). The purpose of this study was to assess the relative ototoxicity of common otic preparations by direct exposure to isolated cochlear outer hair cells (OHCs). OHCs from adult chinchilla cochlea were exposed to standard bathing solution (control), acetic acid, Acetasol HC (Alpharma USPD Inc., Baltimore, MD), Gentacidin (CIBA Vision Ophthalmics, Atlanta, GA), and Tobradex (Alcon, Fort Worth, TX). The cells were observed using an inverted microscope, and the images were recorded in digital still-frame and video, and analyzed on the Image Pro-Plus 3.0 program (Media Cybernetics, Silver Spring, MD). As measured by time to cell death and change in morphology of OHCs, acetic acid with or without hydrocortisone was most toxic to OHCs. Cortisporin was more cytotoxic than gentamicin and Tobradex.

  10. Effects of common topical otic preparations on the morphology of isolated cochlear outer hair cells.

    Science.gov (United States)

    Russell, P T; Church, C A; Jinn, T H; Kim, D J; John, E O; Jung, T T

    2001-01-01

    Otic drops are commonly used not only for otitis externa but also for otorrhea in the presence of tympanostomy tube or tympanic membrane perforation. Many studies have demonstrated the ototoxicity of common otic preparations such as Cortisporin otic drops. Recent studies have suggested the use of fluoroquinolone antibiotic drops as an alternative owing to their excellent antimicrobial coverage and no ototoxic effect. The purpose of this study was to assess the relative ototoxicity of four common otic preparations by direct exposure to isolated cochlear outer hair cells (OHCs). OHCs from adult chinchilla cochlea were exposed to standard bathing solution (control), Cortisporin, Cipro HC, Ciloxan, and Floxin. The cells were observed using an inverted microscope, and the images recorded in digital still-frame and video, and analyzed on the Image Pro-Plus 3.0 program. As measured by time to cell death and change in morphology of OHCs, Cortisporin was most toxic to OHCs. Among the fluoroquinolone drops, Floxin was more toxic than Ciloxan or Cipro HC.

  11. CLRN1 is nonessential in the mouse retina but is required for cochlear hair cell development.

    Science.gov (United States)

    Geller, Scott F; Guerin, Karen I; Visel, Meike; Pham, Aaron; Lee, Edwin S; Dror, Amiel A; Avraham, Karen B; Hayashi, Toshinori; Ray, Catherine A; Reh, Thomas A; Bermingham-McDonogh, Olivia; Triffo, William J; Bao, Shaowen; Isosomppi, Juha; Västinsalo, Hanna; Sankila, Eeva-Marja; Flannery, John G

    2009-08-01

    Mutations in the CLRN1 gene cause Usher syndrome type 3 (USH3), a human disease characterized by progressive blindness and deafness. Clarin 1, the protein product of CLRN1, is a four-transmembrane protein predicted to be associated with ribbon synapses of photoreceptors and cochlear hair cells, and recently demonstrated to be associated with the cytoskeleton. To study Clrn1, we created a Clrn1 knockout (KO) mouse and characterized the histological and functional consequences of Clrn1 deletion in the retina and cochlea. Clrn1 KO mice do not develop a retinal degeneration phenotype, but exhibit progressive loss of sensory hair cells in the cochlea and deterioration of the organ of Corti by 4 months. Hair cell stereocilia in KO animals were longer and disorganized by 4 months, and some Clrn1 KO mice exhibited circling behavior by 5-6 months of age. Clrn1 mRNA expression was localized in the retina using in situ hybridization (ISH), laser capture microdissection (LCM), and RT-PCR. Retinal Clrn1 transcripts were found throughout development and adulthood by RT-PCR, although expression peaked at P7 and declined to undetectable levels in adult retina by ISH. LCM localized Clrn1 transcripts to the retinas inner nuclear layer, and WT levels of retinal Clrn1 expression were observed in photoreceptor-less retinas. Examination of Clrn1 KO mice suggests that CLRN1 is unnecessary in the murine retina but essential for normal cochlear development and function. This may reflect a redundancy in the mouse retina not present in human retina. In contrast to mouse KO models of USH1 and USH2, our data indicate that Clrn1 expression in the retina is restricted to the Müller glia. This is a novel finding, as most retinal degeneration associated proteins are expressed in photoreceptors, not in glia. If CLRN1 expression in humans is comparable to the expression pattern observed in mice, this is the first report of an inner retinal protein that, when mutated, causes retinal degeneration.

  12. CLRN1 is nonessential in the mouse retina but is required for cochlear hair cell development.

    Directory of Open Access Journals (Sweden)

    Scott F Geller

    2009-08-01

    Full Text Available Mutations in the CLRN1 gene cause Usher syndrome type 3 (USH3, a human disease characterized by progressive blindness and deafness. Clarin 1, the protein product of CLRN1, is a four-transmembrane protein predicted to be associated with ribbon synapses of photoreceptors and cochlear hair cells, and recently demonstrated to be associated with the cytoskeleton. To study Clrn1, we created a Clrn1 knockout (KO mouse and characterized the histological and functional consequences of Clrn1 deletion in the retina and cochlea. Clrn1 KO mice do not develop a retinal degeneration phenotype, but exhibit progressive loss of sensory hair cells in the cochlea and deterioration of the organ of Corti by 4 months. Hair cell stereocilia in KO animals were longer and disorganized by 4 months, and some Clrn1 KO mice exhibited circling behavior by 5-6 months of age. Clrn1 mRNA expression was localized in the retina using in situ hybridization (ISH, laser capture microdissection (LCM, and RT-PCR. Retinal Clrn1 transcripts were found throughout development and adulthood by RT-PCR, although expression peaked at P7 and declined to undetectable levels in adult retina by ISH. LCM localized Clrn1 transcripts to the retinas inner nuclear layer, and WT levels of retinal Clrn1 expression were observed in photoreceptor-less retinas. Examination of Clrn1 KO mice suggests that CLRN1 is unnecessary in the murine retina but essential for normal cochlear development and function. This may reflect a redundancy in the mouse retina not present in human retina. In contrast to mouse KO models of USH1 and USH2, our data indicate that Clrn1 expression in the retina is restricted to the Müller glia. This is a novel finding, as most retinal degeneration associated proteins are expressed in photoreceptors, not in glia. If CLRN1 expression in humans is comparable to the expression pattern observed in mice, this is the first report of an inner retinal protein that, when mutated, causes retinal

  13. Unconventional molecular regulation of synaptic vesicle replenishment in cochlear inner hair cells.

    Science.gov (United States)

    Vogl, Christian; Cooper, Benjamin H; Neef, Jakob; Wojcik, Sonja M; Reim, Kerstin; Reisinger, Ellen; Brose, Nils; Rhee, Jeong-Seop; Moser, Tobias; Wichmann, Carolin

    2015-02-15

    Ribbon synapses of cochlear inner hair cells (IHCs) employ efficient vesicle replenishment to indefatigably encode sound. In neurons, neuroendocrine and immune cells, vesicle replenishment depends on proteins of the mammalian uncoordinated 13 (Munc13, also known as Unc13) and Ca(2+)-dependent activator proteins for secretion (CAPS) families, which prime vesicles for exocytosis. Here, we tested whether Munc13 and CAPS proteins also regulate exocytosis in mouse IHCs by combining immunohistochemistry with auditory systems physiology and IHC patch-clamp recordings of exocytosis in mice lacking Munc13 and CAPS isoforms. Surprisingly, we did not detect Munc13 or CAPS proteins at IHC presynaptic active zones and found normal IHC exocytosis as well as auditory brainstem responses (ABRs) in Munc13 and CAPS deletion mutants. Instead, we show that otoferlin, a C2-domain protein that is crucial for vesicular fusion and replenishment in IHCs, clusters at the plasma membrane of the presynaptic active zone. Electron tomography of otoferlin-deficient IHC synapses revealed a reduction of short tethers holding vesicles at the active zone, which might be a structural correlate of impaired vesicle priming in otoferlin-deficient IHCs. We conclude that IHCs use an unconventional priming machinery that involves otoferlin. © 2015. Published by The Company of Biologists Ltd.

  14. Intraoperative Margin Assessment in Early Oral Squamous Cell Carcinoma.

    Science.gov (United States)

    Chiosea, Simion I

    2017-03-01

    The surgical method of margin sampling affects local control, pathologists' approach to margin sampling, and clarity of pathology reports. Studies have shown that exclusive reliance on tumor bed margins is associated with worse local control and should be avoided. En bloc resections and margins obtained from the resection specimen remain the "gold standard." Successful surgical treatment of early carcinomas of the oral cavity relies on close cooperation between surgeons and pathologists on issues of specimen orientation and margin sampling. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Cochlear implant assessment: imaging issues

    Energy Technology Data Exchange (ETDEWEB)

    Marsot-Dupuch, K. E-mail: kathlyn.marsot-dupuch@bct.ap-hop-paris.fr; Meyer, B

    2001-11-01

    Cochlear implants are electronic auditory prostheses used to rehabilitate deafened persons who have lost their hair cells. They are partly worn externally and partly implanted in the ear. They provide a direct stimulation of the spiral ganglion cells of the cochlear nerve by bypassing the destroyed hair cells. The objectives of this article are to summarise what head and neck surgeons need to know before cochlear implantation and to describe the imaging study protocol used and anomalies to look for. A few explanations are resumed about placement of a brainstem implant.

  16. Paediatric nodal marginal zone B cell lymphadenopathy of the neck : a Haemophilus influenzae driven immune disorder?

    NARCIS (Netherlands)

    Kluin, Philip M.; Langerak, Anton W.; Beverdam-Vincent, Jannetta; Geurts-Giele, Willemina R. R.; Visser, Lydia; Rutgers, Bea; Schuuring, Ed; Van Baarlen, Joop; Lam, King H.; Seldenrijk, Kees; Kibbelaar, Robby E.; de Wit, Peter; Diepstra, Arjan; Rosati, Stefano; van Noesel, Max M.; Zwaan, C. Michel; Hunting, Jarmo C. B.; Hoogendoorn, Mels; van der Gaag, Ellen J.; van Esser, Joost W. J.; de Bont, Eveline; Kluin-Nelemans, Hanneke C.; Winter, Rik H.; Lo ten Foe, Jerome R.; van der Zanden, Adri G. M.

    Many hyperplasias and lymphomas of marginal zone B-cells are associated with infection. We identified 6 children and 1 adolescent with cervical lymphadenopathy showing a prominent polyclonal nodal marginal zone hyperplasia (pNMZH) and 4 adolescents with monoclonal paediatric nodal marginal zone

  17. Cochlear coiling pattern and orientation differences in cochlear implant candidates.

    Science.gov (United States)

    Martinez-Monedero, Rodrigo; Niparko, John K; Aygun, Nafi

    2011-09-01

    Detailed studies of cochlear morphology can guide our approach to cochleostomy and electrode insertion to optimize neuronal and hair cell preservation and ultimate electrode location. Normal developed cochleae from 124 cochlear implant candidates were studied. We performed morphometric analysis of the right cochleae in all subjects based on computed tomographic data. The length and width of the cochlear base, the angle between the first and second turn of the cochlea, and the cochlear orientation within the cranial base were measured and compared across age groups. In cochlear implant candidates with underdeveloped cochleae (n = 7), we performed similar measurements and assessed the modiolar inlet area on 3D volume rendered images. The birth to 1 year and 1- to 2-year age groups showed insignificant differences in the lengths and widths of the cochlear base, although variability was considerable, and a significantly wider angle (from the midsagittal line) than that of the older age groupings (p cochlear base were significantly smaller and angled between the first and second turn differed from the normal developed group. The modiolar inlet also was significantly smaller in the underdeveloped cochleae compared with normal cochleae. We observed that perspective 3D-volume rendering of the cochlea enables the determination of key features of cochlear morphology and orientation that may escape detection with routine computed tomographic scanning. Infants and young toddler candidates demonstrate greater variability in the dimensions of the cochlear base and in the orientation of the cochlea within the cranium. As evolving surgical techniques and device design enhance the ability of the surgeon to avoid cochlear damage and optimize electrode location, refined morphometric information may assist the surgeon in tailoring strategies of scala tympani implantation.

  18. Clinicopathological study of surgical margins in squamous cell carcinoma of buccal mucosa

    Directory of Open Access Journals (Sweden)

    S.M. Azeem Mohiyuddin

    2016-03-01

    Full Text Available Objective: To evaluate the margins of resected specimen of oral squamous cell carcinoma (SCC and to document the surgical margin (measured at the time of resection and margins at the time of pathological examination (after immersion of the specimen in formalin. Methods: Patients who were diagnosed and confirmed with squamous carcinoma of buccal mucosa were included in the study. Patients underwent resection of the tumor with a margin of 1 cm. Soon after resection, the distance between outermost visible margin of the tumor and the margin of the specimen was measured and documented. Specimens were fixed in 10% formalin and submitted for gross and histopathological examination. The closest histopathologic margin was compared with the in situ margin (10 mm to determine and document any shrinkage of the margin and the percentage of discrepancy if any. Results: A total of 52 specimens were collected from patients between January 2014 and December 2014. All specimens were obtained from the oral cavity (n = 52 of which 43 (82.7% were squamous cell carcinoma and 9 (17.3% were verrucous variant of squamous cell carcinoma. The average decrease in tumor margins measured after fixation in formalin was found to be statistically significant (P < 0.05 in 65% of cases. Conclusion: Tumor margin shrinks significantly after formalin fixation by about 25%. The operating surgeon and pathologist should be well aware of such changes while planning for further management thereby ensuring adequate margin of resection and adjuvant treatment wherever required to prevent possible local recurrence of the disease. Keywords: Oral squamous cell carcinoma, Formalin fixation, Margin of resection, Recurrence

  19. Selective hair cell ablation and noise exposure lead to different patterns of changes in the cochlea and the cochlear nucleus.

    Science.gov (United States)

    Kurioka, Takaomi; Lee, Min Young; Heeringa, Amarins N; Beyer, Lisa A; Swiderski, Donald L; Kanicki, Ariane C; Kabara, Lisa L; Dolan, David F; Shore, Susan E; Raphael, Yehoash

    2016-09-22

    In experimental animal models of auditory hair cell (HC) loss, insults such as noise or ototoxic drugs often lead to secondary changes or degeneration in non-sensory cells and neural components, including reduced density of spiral ganglion neurons, demyelination of auditory nerve fibers and altered cell numbers and innervation patterns in the cochlear nucleus (CN). However, it is not clear whether loss of HCs alone leads to secondary degeneration in these neural components of the auditory pathway. To elucidate this issue, we investigated changes of central components after cochlear insults specific to HCs using diphtheria toxin receptor (DTR) mice expressing DTR only in HCs and exhibiting complete HC loss when injected with diphtheria toxin (DT). We showed that DT-induced HC ablation has no significant impacts on the survival of auditory neurons, central synaptic terminals, and myelin, despite complete HC loss and profound deafness. In contrast, noise exposure induced significant changes in synapses, myelin and CN organization even without loss of inner HCs. We observed a decrease of neuronal size in the auditory pathway, including peripheral axons, spiral ganglion neurons, and CN neurons, likely due to loss of input from the cochlea. Taken together, selective HC ablation and noise exposure showed different patterns of pathology in the auditory pathway and the presence of HCs is not essential for the maintenance of central synaptic connectivity and myelination. Copyright © 2016 IBRO. Published by Elsevier Ltd. All rights reserved.

  20. Resveratrol attenuates CoCl2-induced cochlear hair cell damage through upregulation of Sirtuin1 and NF-κB deacetylation.

    Directory of Open Access Journals (Sweden)

    Ping Wang

    Full Text Available The goals of this study were to investigate the effects of hypoxia on cochlear hair cell damage, and to explore the role of sirtuin1 in hypoxia-induced hair cell damage. Cochlear organotypic cultures from postnatal day 4 rats were used in this study. Hypoxia was induced by treating cochlear explants with CoCl2. Cochlear cultures were treated with CoCl2 alone or in combination with the sirtuin1 activator resveratrol and the sirtuin1 inhibitor sirtinol. Hair cell damage was identified by phalloidin staining and imaged using scanning electron microscopy. RT-PCR and Western blot analyses were used to detect the expression of sirtuin1 and acetylated nuclear factor-κB (NF-κB. Low concentrations of CoCl2 (100-200 μM did not cause an obvious change in the number and morphology of hair cells, whereas higher concentrations of CoCl2 (300-400 μM induced swelling of hair cells, accompanied by cell loss. Increased sirtuin1 expression was induced by CoCl2 at 100 to 200 μM, but not at 400 μM. NF-κB acetylation was significantly increased in explants treated with 400 μM CoCl2. Pretreatment with resveratrol prevented CoCl2-induced hair cell loss and acetylation of NF-κB. The protective effect of resveratrol was significantly reduced by sirtinol. CoCl2 induces hair cell damage in organotypic cochleae cultures. Resveratrol attenuates CoCl2-induced cochlear hair cell damage possibly via activation of sirtuin1, which deacetylates NF-κB.

  1. Surgical margins for resection of squamous cell carcinoma of the lower lip

    NARCIS (Netherlands)

    de Visscher, JGAM; Gooris, RJJ; Vermey, A; Roodenburg, JLN

    A prospective studs was undertaken to evaluate the efficacy of 3 mm margins of resection with surgical excision of squamous cell carcinoma of the lower lip (SCCLL) in its earls stages hereby the margins were checked with the systematic use of frozen-section examination. During the period of

  2. Cochlear implant by adult

    OpenAIRE

    Kratochvílová, Tereza

    2011-01-01

    Bachelor thesis "The cochlear implant in an adult deaf" deals primarily with the cochlear implant. The most extensive part of the thesis talks about this topic, which also talks about the development and design of cochlear implants, explains the difference between cochlear implantation and tribal implantation and describes operation of implant and the subsequent setting of the implant. This section is also dedicated to binaural cochlear implantation, myths of cochlear implants and problems wh...

  3. Expression and functional role of Nav1.9 sodium channel in cartwheel cells of the dorsal cochlear nucleus.

    Science.gov (United States)

    Yan, Zhiyu; Xu, Yanjun; Liang, Min; Ren, Xiaowei

    2015-03-01

    In the central auditory system, cartwheel cells (CWCs) are a group of interneurons in the dorsal cochlear nucleus (DCN). While other DCN neurons respond to stimuli with a simple discharge pattern of single action potentials (SAPs), CWCs respond with complex action potentials (CAPs), consisting of SAPs superimposed on a slow depolarization. The CAPs in CWCs may participate in various auditory or non‑auditory signaling processing but its intrinsic mechanisms are largely unknown. In the present study, in vitro whole‑cell current clamp recordings on neonatal mice brain slices were used to demonstrate that CWCs respond to brief voltage stimulation with CAPs. Western blotting and immunohistochemistry were also utilized to demonstrate that Nav1.9 was expressed in the CWCs. Finally, when Nav1.9 was genetically silenced, CWCs responded to voltage stimulation with SAPs, not CAPs. The results strongly suggested that Nav1.9 was expressed and functionally contributed to the signaling processing in the central auditory pathway.

  4. Evaluation of surgical margins according to the histological type of basal cell carcinoma.

    Science.gov (United States)

    Godoy, Charles Antonio Pires de; Neta, Alice Lima de Oliveira; Leão, Sofia Silveira de Souza; Dantas, Raul Lima; Carvalho, Valeska Oliveira Fonseca; Silva, Samuel Freire da

    2017-01-01

    Basal cell carcinoma is the most common skin cancer in the world. The aim of this study was to evaluate the surgical margin of basal cell carcinoma and correlate this with its histologic subtype. A retrospective analysis of pathology laboratory records from 1990 to 2000 was performed and the following data was collected: age, sex, race, anatomical location, histological type, and state of the excision margins in 1,428 histopathological reports of basal cell carcinoma. Ages ranged from 6 to 99 years, with an average of 57. There was a slight predominance of lesions in white women patients, and the most common histological subtype was the nodular, followed by the superficial. The most common locations were in the head and neck, with highest prevalence appeared in the nose. Surgical margins revealed a lateral involvement of 20.14% and a deep involvement of 12.47%. The fibrosing basal cell carcinoma is the histological type that most often presented positive surgical margins.

  5. Hearing loss caused by progressive degeneration of cochlear hair cells in mice deficient for the Barhl1 homeobox gene.

    Science.gov (United States)

    Li, Shengguo; Price, Sandy M; Cahill, Hugh; Ryugo, David K; Shen, Michael M; Xiang, Mengqing

    2002-07-01

    The cochlea of the mammalian inner ear contains three rows of outer hair cells and a single row of inner hair cells. These hair cell receptors reside in the organ of Corti and function to transduce mechanical stimuli into electrical signals that mediate hearing. To date, the molecular mechanisms underlying the maintenance of these delicate sensory hair cells are unknown. We report that targeted disruption of Barhl1, a mouse homolog of the Drosophila BarH homeobox genes, results in severe to profound hearing loss, providing a unique model for the study of age-related human deafness disorders. Barhl1 is expressed in all sensory hair cells during inner ear development, 2 days after the onset of hair cell generation. Loss of Barhl1 function in mice results in age-related progressive degeneration of both outer and inner hair cells in the organ of Corti, following two reciprocal longitudinal gradients. Our data together indicate an essential role for Barhl1 in the long-term maintenance of cochlear hair cells, but not in the determination or differentiation of these cells.

  6. Deletion of PDZD7 disrupts the Usher syndrome type 2 protein complex in cochlear hair cells and causes hearing loss in mice.

    Science.gov (United States)

    Zou, Junhuang; Zheng, Tihua; Ren, Chongyu; Askew, Charles; Liu, Xiao-Ping; Pan, Bifeng; Holt, Jeffrey R; Wang, Yong; Yang, Jun

    2014-05-01

    Usher syndrome type 2 (USH2) is the predominant form of USH, a leading genetic cause of combined deafness and blindness. PDZD7, a paralog of two USH causative genes, USH1C and USH2D (WHRN), was recently reported to be implicated in USH2 and non-syndromic deafness. It encodes a protein with multiple PDZ domains. To understand the biological function of PDZD7 and the pathogenic mechanism caused by PDZD7 mutations, we generated and thoroughly characterized a Pdzd7 knockout mouse model. The Pdzd7 knockout mice exhibit congenital profound deafness, as assessed by auditory brainstem response, distortion product otoacoustic emission and cochlear microphonics tests, and normal vestibular function, as assessed by their behaviors. Lack of PDZD7 leads to the disorganization of stereocilia bundles and a reduction in mechanotransduction currents and sensitivity in cochlear outer hair cells. At the molecular level, PDZD7 determines the localization of the USH2 protein complex, composed of USH2A, GPR98 and WHRN, to ankle links in developing cochlear hair cells, likely through its direct interactions with these three proteins. The localization of PDZD7 to the ankle links of cochlear hair bundles also relies on USH2 proteins. In photoreceptors of Pdzd7 knockout mice, the three USH2 proteins largely remain unchanged at the periciliary membrane complex. The electroretinogram responses of both rod and cone photoreceptors are normal in knockout mice at 1 month of age. Therefore, although the organization of the USH2 complex appears different in photoreceptors, it is clear that PDZD7 plays an essential role in organizing the USH2 complex at ankle links in developing cochlear hair cells. GenBank accession numbers: KF041446, KF041447, KF041448, KF041449, KF041450, KF041451.

  7. Cochlear Schwannomas

    OpenAIRE

    Barbieri, Marco; Bruzzo, Michel; Mora, Renato; MELLER, Renaud; Chays, André; Magnan, Jacques

    2001-01-01

    In a series of 179 cerebellopontine angle (CPA) tumors, the authors present nine cases (5%) that were cochlear nerve neuromas. There were six men and three women (mean age, 51 years). Preoperative magnetic resonance imaging confirmed the diagnosis in one case with a labyrinthine extension and raised suspicions in the other four cases, which were confirmed during surgery. The remaining neuromas were discovered intraoperatively. The mean time between first observation and surgery was 9 months. ...

  8. lmmunohistochemical and Molecular Characterization of Extranodal Marginal Zone B-Cell Lymphoma in Salivary Glands

    Science.gov (United States)

    2016-06-10

    in its classification to refer to a primary extranodal lymphoma composed of morphologically heterogeneous small B- cells (marginal zone cells...this review. In addition to characteristic morphologic appearance during microscopic evaluation, immunohistochemical (IHC) staining techniques...lymphocytic lymphoma/chronic lymphocytic leukemia , mantle cell lymphoma, and follicular lymphoma.40 The ten cases (59%) with κ light-chain

  9. Cochlear schwannomas.

    Science.gov (United States)

    Barbieri, M; Bruzzo, M; Mora, R; Meller, R; Chays, A; Magnan, J

    2001-11-01

    In a series of 179 cerebellopontine angle (CPA) tumors, the authors present nine cases (5%) that were cochlear nerve neuromas. There were six men and three women (mean age, 51 years). Preoperative magnetic resonance imaging confirmed the diagnosis in one case with a labyrinthine extension and raised suspicions in the other four cases, which were confirmed during surgery. The remaining neuromas were discovered intraoperatively. The mean time between first observation and surgery was 9 months. Preoperatively, all patients underwent a complete otoneurological assessment. The middle fossa approach was used for the patient with the labyrinthine extension, and the retrosigmoid approach was used for the other eight cases. In all patients facial nerve function was preserved. Sudden or major hearing loss without associated vestibular symptoms or preoperative facial paralysis may be predictive of a cochlear component of a CPA tumor. The near-field relationships of cochlear neuromas located at the level of the acoustic and facial nerves can be appreciated because of their small size and strong contrast enhancement.

  10. Noise-Induced Loss of Hair Cells and Cochlear Synaptopathy Are Mediated by the Activation of AMPK.

    Science.gov (United States)

    Hill, Kayla; Yuan, Hu; Wang, Xianren; Sha, Su-Hua

    2016-07-13

    Noise-induced hearing loss (NIHL) is a major unresolved public health problem. Here, we investigate pathomechanisms of sensory hair cell death and suggest a novel target for protective intervention. Cellular survival depends upon maintenance of energy homeostasis, largely by AMP-activated protein kinase (AMPK). In response to a noise exposure in CBA/J mice, the levels of phosphorylated AMPKα increased in hair cells in a noise intensity-dependent manner. Inhibition of AMPK via siRNA or the pharmacological inhibitor compound C attenuated noise-induced loss of outer hair cells (OHCs) and synaptic ribbons, and preserved auditory function. Additionally, noise exposure increased the activity of the upstream AMPK kinase liver kinase B1 (LKB1) in cochlear tissues. The inhibition of LKB1 by siRNA attenuated the noise-increased phosphorylation of AMPKα in OHCs, reduced the loss of inner hair cell synaptic ribbons and OHCs, and protected against NIHL. These results indicate that noise exposure induces hair cell death and synaptopathy by activating AMPK via LKB1-mediated pathways. Targeting these pathways may provide a novel route to prevent NIHL. Our results demonstrate for the first time that the activation of AMP-activated protein kinase (AMPK) α in sensory hair cells is noise intensity dependent and contributes to noise-induced hearing loss by mediating the loss of inner hair cell synaptic ribbons and outer hair cells. Noise induces the phosphorylation of AMPKα1 by liver kinase B1 (LKB1), triggered by changes in intracellular ATP levels. The inhibition of AMPK activation by silencing AMPK or LKB1, or with the pharmacological inhibitor compound C, reduced outer hair cell and synaptic ribbon loss as well as noise-induced hearing loss. This study provides new insights into mechanisms of noise-induced hearing loss and suggests novel interventions for the prevention of the loss of sensory hair cells and cochlear synaptopathy. Copyright © 2016 the authors 0270-6474/16/367497-14$15.00/0.

  11. Modelling Cochlear Mechanics

    Directory of Open Access Journals (Sweden)

    Guangjian Ni

    2014-01-01

    Full Text Available The cochlea plays a crucial role in mammal hearing. The basic function of the cochlea is to map sounds of different frequencies onto corresponding characteristic positions on the basilar membrane (BM. Sounds enter the fluid-filled cochlea and cause deflection of the BM due to pressure differences between the cochlear fluid chambers. These deflections travel along the cochlea, increasing in amplitude, until a frequency-dependent characteristic position and then decay away rapidly. The hair cells can detect these deflections and encode them as neural signals. Modelling the mechanics of the cochlea is of help in interpreting experimental observations and also can provide predictions of the results of experiments that cannot currently be performed due to technical limitations. This paper focuses on reviewing the numerical modelling of the mechanical and electrical processes in the cochlea, which include fluid coupling, micromechanics, the cochlear amplifier, nonlinearity, and electrical coupling.

  12. Risk factors for and consequences of inadequate surgical margins in oral squamous cell carcinoma

    DEFF Research Database (Denmark)

    Lawaetz, Mads; Homøe, Preben

    2014-01-01

    OBJECTIVE: The purpose of this study was to examine which factors are associated with inadequate surgical margins and to assess the postoperative consequences. STUDY DESIGN: A retrospective cohort of 110 patients with oral squamous cell carcinoma treated with surgery during a 2-year period...... was examined. Clinical, histopathologic, and operative variables were related to the surgical margin status. Furthermore postoperative treatment data were compared with margin status. RESULTS: Univariate statistically significant associations were found between the tumor site in the floor of mouth, more...

  13. How do the medial olivocochlear efferents influence the biomechanics of the outer hair cells and thereby the cochlear amplifier? Simulation results

    Science.gov (United States)

    Saremi, Amin; Stenfelt, Stefan; Verhulst, Sarah

    2015-12-01

    The bottom-up signal pathway, which starts from the outer ear and leads to the brain cortices, gives the classic image of the human sound perception. However, there have been growing evidences in the last six decades for existence of a functional descending network whereby the central auditory system can modulate the early auditory processing, in a top-down manner. The medial olivocochlear efferent fibers project from the superior olivary complex at the brainstem into the inner ear. They are linked to the basal poles of the hair cells by forming synaptic cisterns. This descending network can activate nicotinic cholinergic receptors (nAChR) that increase the membrane conductance of the outer hair cells and thereby modify the magnitude of the active force generated inside the cochlea. The aim of the presented work is to quantitatively investigate how the changes in the biomechanics of the outer hair cells, caused by the efferent activation, manipulate the cochlear responses. This is done by means of a frequency-domain biophysical model of the cochlea [12] where the parameters of the model convey physiological interpretations of the human cochlear structures. The simulations manifest that a doubling of the outer hair cell conductance, due to efferent activation, leads to a frequency-dependent gain reduction along the cochlear duct with its highest effect at frequencies between 1 kHz and 3.5 kHz and a maximum of approximately 10 dB gain reduction at 2 kHz. This amount of the gain inhibition and its frequency dependence reasonably agrees with the experimental data recorded from guinea pig, cat and human cochleae where the medial olivococlear efferents had been elicited by broad-band stimuli. The simulations also indicate that the efferent-induced increase of the outer hair cell conductance increases the best frequency of the cochlear responses, in the basal region. The presented simulations quantitatively confirm that activation of the medial olivocochlear efferents can

  14. Development and function of the voltage-gated sodium current in immature mammalian cochlear inner hair cells.

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    Tobias Eckrich

    Full Text Available Inner hair cells (IHCs, the primary sensory receptors of the mammalian cochlea, fire spontaneous Ca(2+ action potentials before the onset of hearing. Although this firing activity is mainly sustained by a depolarizing L-type (Ca(V1.3 Ca(2+ current (I(Ca, IHCs also transiently express a large Na(+ current (I(Na. We aimed to investigate the specific contribution of I(Na to the action potentials, the nature of the channels carrying the current and whether the biophysical properties of I(Na differ between low- and high-frequency IHCs. We show that I(Na is highly temperature-dependent and activates at around -60 mV, close to the action potential threshold. Its size was larger in apical than in basal IHCs and between 5% and 20% should be available at around the resting membrane potential (-55 mV/-60 mV. However, in vivo the availability of I(Na could potentially increase to >60% during inhibitory postsynaptic potential activity, which transiently hyperpolarize IHCs down to as far as -70 mV. When IHCs were held at -60 mV and I(Na elicited using a simulated action potential as a voltage command, we found that I(Na contributed to the subthreshold depolarization and upstroke of an action potential. We also found that I(Na is likely to be carried by the TTX-sensitive channel subunits Na(V1.1 and Na(V1.6 in both apical and basal IHCs. The results provide insight into how the biophysical properties of I(Na in mammalian cochlear IHCs could contribute to the spontaneous physiological activity during cochlear maturation in vivo.

  15. Recruitment and selection of marginal zone B cells is independent of exogenous antigens

    NARCIS (Netherlands)

    Dammers, PM; Kroese, FGM

    Marginal zone B (MZ-B) cells of the spleen contribute significantly to the immunity against invasive infections with polysaccharide-encapsulated bacteria. Recent evidence indicates that recruitment and selection of MZ-B cells occurs on the basis of positive selection constraints that likely operate

  16. Predictive value of basal cell carcinoma biopsies with negative margins: A retrospective cohort study.

    Science.gov (United States)

    Willardson, Hal Bret; Lombardo, Jamie; Raines, Matt; Nguyen, Tina; Park, Jisuk; Dalton, Scott; Ritchie, Simon

    2018-01-04

    Pathology reports of basal cell carcinoma (BCC) biopsies often contain comments of positive or negative margins, with only 1-2% of the margin evaluated. The negative predictive value (NPV) of biopsy margin status on residual BCC is unknown. The purpose of this study was to determine the NPV of BCC biopsy margin status on the absence of residual BCC in the corresponding excision. From our institution's archives, we collected BCC biopsies with negative margin readings that had subsequent excisions. For excisions read as negative for residual BCC, the excision blocks were sectioned at 150 μm intervals until exhausted. We collected 143 cases that met criteria. 34 (24%) were found to contain residual BCC in the corresponding excision leading to a NPV of 76%; in 31/34 (91%) of the cases the residual histologic subtype was superficial. Our sectioning technique did not evaluate 100% of the excision specimens. Negative margins in a BCC biopsy are a poor predictor of residual disease in the patient. We recommend that clinicians treat these lesions, and that pathologists who comment on margin status of BCC biopsies consider adding a caveat to reflect these findings. Copyright © 2018. Published by Elsevier Inc.

  17. Cochlear Implant

    Directory of Open Access Journals (Sweden)

    Mehrnaz Karimi

    1993-03-01

    Full Text Available People with profound hearing loss are not able to use some kinds of conventional amplifiers due to the nature of their loss. In these people, hearing sense is stimulated only when the auditory nerve is activated via electrical stimulation. This stimulation is possible through cochlear implant. In fact, for the deaf people who have good mental health and can not use surgical and medical treatment and also can not benefit from air and bone conduction hearing aids, this device is used if they have normal central auditory system. The basic parts of the device included: Microphone, speech processor, transmitter, stimulator and receiver, and electrode array.

  18. Cochlear Implant

    Directory of Open Access Journals (Sweden)

    Mehrnaz Karimi

    1992-04-01

    Full Text Available People with profound hearing loss are not able to use some kinds of conventional amplifiers due to the nature of their loss . In these people, hearing sense is stimulated only when the auditory nerve is activated via electrical stimulation. This stimulation is possible through cochlear implant. In fact, for the deaf people who have good mental health and can not use surgical and medical treatment and also can not benefit from air and bone conduction hearing aids, this device is used if they have normal central auditory system. The basic parts of the device included: Microphone, speech processor, transmitter, stimulator and receiver, and electrode array.

  19. Small margin (2 mm) excision of peri-ocular basal cell carcinoma with delayed repair.

    Science.gov (United States)

    David, D B.; Gimblett, M L.; Potts, M J.; Harrad, R A.

    1999-03-01

    Successful surgical treatment of peri-ocular basal cell carcinomas requires complete excision. Mohs' micrographic surgery achieves this, but is not readily available in all hospitals. The standard 3-4 mm margin does not guarantee complete excision and histology is often not available until after a repair has been undertaken. The 3-4 mm margin has evolved to deal with all forms of BCC. In our opinion, this margin is unnecessarily large for nodular/ulcerative BCC. We report our interim results of excision of localised BCCs using a 2 mm margin in conjunction with a delayed repair following confirmation of histological clearance. Thirty-one patients were treated in this manner; there have been no recurrences after an average follow-up period of 36 months (range 24-57 months).

  20. Cochlear-Meningitis Vaccination

    Science.gov (United States)

    ... with cochlear implants are more likely to get bacterial meningitis than children without cochlear implants. In addition, some ... two main types of meningitis, viral and bacterial. Bacterial meningitis is the more serious type and the type ...

  1. Engineering PLGA nano-based systems through understanding the influence of nanoparticle properties and cell-penetrating peptides for cochlear drug delivery.

    Science.gov (United States)

    Cai, Hui; Liang, Zhongping; Huang, Wenli; Wen, Lu; Chen, Gang

    2017-10-30

    The properties of poly(lactic-co-glycolic acid) (PLGA) nanoparticles (NPs) and penetration enhancers play a deciding role in the inner ear drug delivery of NPs across the round window membrane (RWM). Thus, PLGA nano-based systems with a variety of particle sizes and surface chemistries and those combined with cell-penetrating peptides (CPPs) as penetration enhancers were devised to explore their impact on the cochlear drug delivery in vivo. First, we demonstrated that the properties of NPs dictated the extent of NP cochlear entry by near-infrared fluorescence imaging. NPs with the sizes of 150 and 300nm had faster entry than that of 80nm NPs. At 0.5h, among the NPs unmodified and modified with chitosan (CS), poloxamer 407 (P407) and methoxy polyethylene glycol, CS-PLGA-NPs (positive surface charge) carried payload to the cochlea fastest, whereas P407-PLGA-NPs (surface hydrophilicity) showed the greatest distribution in the cochlea at 24h. Compared to other CPPs (TAT, penetratin and poly(arginine)8), low molecular weight protamine (LMWP) performed an outstanding enhanced NP cellular uptake in HEI-OC1 cells and cochlear entry. More importantly, NPs with optimized properties and CPPs may be combined to improve RWM penetration. For the first time, we confirmed that the combination of P407-PLGA-NPs (mean diameter: 100-200nm) and LMWP provided a synergistic enhancement in NP entry to the organ of Corti and stria vascularis without inducing pathological alteration of cochlear tissues and RWM. Taken together, we propose an effective PLGA nano-based strategy for enhanced drug delivery to the inner ear tissues that combines hydrophilic molecule-modified NPs and CPPs, ultimately opening an avenue for superior inner ear therapy. Copyright © 2017. Published by Elsevier B.V.

  2. Differential Impact of Close Surgical Margin on Local Recurrence According to Primary Tumor Size in Oral Squamous Cell Carcinoma.

    Science.gov (United States)

    Jang, Jeon Yeob; Choi, Nayeon; Ko, Young-Hyeh; Chung, Man Ki; Son, Young-Ik; Baek, Chung-Hwan; Baek, Kwan-Hyuck; Jeong, Han-Sin

    2017-06-01

    The extent of surgical safety margin (gross tumor border to resection margin) in oral cancer surgery remains unclear, and no study has determined the differential impact of close surgical margin and microscopic extension according to primary tumor size in oral cancers. We retrospectively analyzed the clinical data of 325 patients with surgically treated oral cavity squamous cell carcinomas to determine the effect of a close surgical margin (gross tumor border was significantly associated with primary tumor thickness (ρ = 0.390, p margin can be redefined according to the primary tumor size.

  3. Recurrence rate of basal cell carcinoma with positive histopathological margins and related risk factors.

    Science.gov (United States)

    Lara, Fernanda; Santamaría, Jesus Rodriguez; Garbers, Luiz Eduardo Fabricio de Melo

    2017-01-01

    The best way to approach surgically removed basal cell carcinoma with positive histopathological margins is a controversial issue. Some authors believe that the more appropriate treatment is an immediate reoperation while others prefer a periodic follow up. The rates of recurrence are variable in literature, between 10% and 67%. To define the recurrence rate of basal cell carcinoma with positive margins after surgery. Secondarily, identify morphological aspects that can suggest a more frequent tumoral recurrence. This was a retrospective and observational study made by analysis of medical records of 487 patients between January 2003 and December 2009 in Hospital de Clínicas da Universidade Federal do Paraná (HC-UFPR). From 402 basal cell carcinomas surgically treated, 41 fulfilled inclusion criteria and were evaluated for five years or more. Recurrence rate of these tumors was analyzed in all patients and clinical characteristics such as sex, age, tumor size, tumor site, ulceration, and histological type were evaluated in order to find if they were related to more common tumoral recurrence. The rate of positive margins after surgery was 12.18%. There were five cases of tumoral recurrence in the observation group and three cases in the re-excision group. Tumor size, site, histological type, ulceration and type of positive margin did not differ statistically between groups. It was not possible to consider if these factors were important in recurrence rates. Ideally, a prospective study with a larger sample would be more accurate. The treatment of choice in basal cell carcinoma with positive margins must be individualized to reduce recurrence rates.

  4. Shaved margin histopathology and imprint cytology for assessment of excision in canine mast cell tumors and soft tissue sarcomas.

    Science.gov (United States)

    Milovancev, Milan; Townsend, Kaitlin L; Gorman, Elena; Bracha, Shay; Curran, Katie; Russell, Duncan S

    2017-08-01

    To determine the feasibility and agreement of margin assessment by imprint cytology, shaved margin histopathology, and radial section histopathology in canine cutaneous and subcutaneous mast cell tumors (MCT) and soft tissue sarcomas (STS). Prospective clinical study. Three hundred and forty margins from 72 excised tumors (52 MCT and 20 STS) in 54 client-owned dogs. Imprint cytology samples were acquired by pressing glass slides to the cut surgical margin of the freshly excised surgical specimen. Shaved margin samples were obtained from the patient wound bed using a scalpel immediately prior to closure. Radial section histopathology was performed as part of routine histopathologic processing. All margins were assessed as either positive or negative for presence of tumor cells at the surgical margin. Agreement among methods was calculated using Fleiss Kappa coefficients and an association of method, margin direction, and tumor type with positive margin status was evaluated using a general linear mixed model. Positive margin detection rates differed for MCT (imprint cytology 21%, radial section histopathology 9%, and shaved margin histopathology 3%; P histopathology are feasible, but their results are frequently disparate from routine radial section histopathology. Future studies are needed to evaluate the correlation of each method with local recurrence rates. © 2017 The American College of Veterinary Surgeons.

  5. Balance of microtubule stiffness and cortical tension determines the size of blood cells with marginal band across species

    CERN Document Server

    Dmitrieff, Serge; Mathur, Aastha; Nédélec, François

    2016-01-01

    The fast blood stream of animals is associated with large shear stresses. Consequently, blood cells have evolved a special morphology and a specific internal architecture allowing them to maintain their integrity over several weeks. For instance, non-mammalian red blood cells, mammalian erythroblasts and platelets have a peripheral ring of microtubules, called the marginal band, that flattens the overall cell morphology by pushing on the cell cortex. In this article, we model how the shape of these cells stems from the balance between marginal band elasticity and cortical tension. We predict that the diameter of the cell scales with the total microtubule polymer, and verify the predicted law across a wide range of species. Our analysis also shows that the combination of the marginal band rigidity and cortical tension increases the ability of the cell to withstand forces without deformation. Finally, we model the marginal band coiling that occurs during the disc-to-sphere transition observed for instance at th...

  6. The cochlear implant; basic principles.

    Science.gov (United States)

    Brackmann, D E

    1976-03-01

    In recent years the cochlear implant has been a subject of much discussion and controversy. The clinician has often been confused by the conflicting reports of success and failure. In this paper the development of the cochlear implant is reviewed and its present status summarized. It is hoped that the clinician may thereby gain an understanding of this device so that he can better evaluate its present and future status. Selection of Patients for Cochlear Implantation. The cochlear implant will benefit only those patients with hair cell loss who have remaining viable auditory neurons. In order to determine whether viable neurons remain, an electric current is passed through a small needle which is place into the promontory through the tympanic membrane. If patients experience an auditory sensation as a result of this electrical stimulation, it is felt that they are suitable candidates for a cochlear implant. Feasibility of Long-Term VIIIth Nerve Stimulation. Many questions have been raised regarding the feasibility of long-term stimulation of the auditory nerve. The first question raised was whether the auditory nerve would survive severe hair cell degeneration. Studies have shown that in most cases at least a few auditory neurons remain. The next question was whether the cochlear implant itself would destroy the remaining auditory neurons. Preliminary studies have shown that the nerve will survive the placement of electrodes both into the modiolus and the scala tympani. Several electrode materials and insulation have been found to be well tolerated, and there has been minimal damage from thermal or electrolytic processes; therefore, it appears feasible to stimulate the auditory nerve over a long period. Information Transfer by Electrical Stimulation. Single-channel stimulation produces only periodicity pitch, and information transfer is insufficient for speech discrimination. Experience to date indicates that it will be possible to produce both place and volley

  7. The role of molecular strategies in the evaluation of surgical margins in oropharyngeal squamous cell carcinoma

    Directory of Open Access Journals (Sweden)

    Anastasios N. Kanatas

    2011-12-01

    Full Text Available The recurrence of a tumour at the resection margins in head and neck squamous cell carcinoma (HNSCC has profound implications on the morbidity and mortality of the patient. At present HNSCC does not undergo any form of molecular analysis to aid treatment strategy and prognosticate for those individuals at higher risk of recurrence. This article aims to review current research into molecular strategies for tumour evaluation, highlighting conflicting evidence and possible novel concepts for further exploration.

  8. Comparative analysis of glucagonergic cells, glia and the circumferential marginal zone in the reptilian retina

    Science.gov (United States)

    Todd, Levi; Suarez, Lilianna; Squires, Natalie; Zelinka, Christopher Paul; Gribbins, Kevin; Fischer, Andy J.

    2015-01-01

    Retinal progenitors in the circumferential margin zone (CMZ) and Müller glia-derived progenitors have been well-described in the eyes of fish, amphibians and birds. However, there is no information regarding a CMZ and the nature of retinal glia in species phylogenetically bridging amphibians and birds. Thus, the purpose of this study was to examine the retinal glia and investigate whether a CMZ is present in the eyes of reptilian species. We used immuno-histochemical analyses to study retinal glia, neurons that could influence CMZ-progenitors, the retinal margin, and non-pigmented epithelium (NPE) of ciliary body of garter snakes, queen snakes, anole lizards, snapping turtles, and painted turtles. We compare our observations in reptile eyes to the CMZ and glia of fish, amphibians and birds. In all species, Sox9, Pax6 and the glucocorticoid receptor are expressed by Müller glia and cells at the retinal margin. However, proliferating cells were found only in the CMZ of turtles, but not in the eyes of anoles and snakes. Similar to eyes of chickens, the retinal margin in turtles contains accumulations of GLP1/glucagonergic neurites. We find that filamentous proteins, vimentin and GFAP, are expressed by Müller glia, but have different patterns of sub-cellular localization in the different species of reptiles. We provide evidence that the reptile retina may contain Non-astrocytic Inner Retinal Glial (NIRG) cells, similar to those described in the avian retina. We conclude that the retinal glia, glucagonergic neurons and CMZ of turtles appears to be the most similar to that of fish, amphibians and birds. PMID:26053997

  9. Combined reflectance confocal microscopy-optical coherence tomography for delineation of basal cell carcinoma margins: an ex vivo study

    Science.gov (United States)

    Iftimia, Nicusor; Peterson, Gary; Chang, Ernest W.; Maguluri, Gopi; Fox, William; Rajadhyaksha, Milind

    2016-01-01

    We present a combined reflectance confocal microscopy (RCM) and optical coherence tomography (OCT) approach, integrated within a single optical layout, for diagnosis of basal cell carcinomas (BCCs) and delineation of margins. While RCM imaging detects BCC presence (diagnoses) and its lateral spreading (margins) with measured resolution of ˜1 μm, OCT imaging delineates BCC depth spreading (margins) with resolution of ˜7 μm. When delineating margins in 20 specimens of superficial and nodular BCCs, depth could be reliably determined down to ˜600 μm, and agreement with histology was within about ±50 μm.

  10. TMHS is an Integral Component of the Mechanotransduction Machinery of Cochlear Hair Cells

    Science.gov (United States)

    Xiong, Wei; Grillet, Nicolas; Elledge, Heather M.; Wagner, Thomas F.J.; Zhao, Bo; Johnson, Kenneth R.; Kazmierczak, Piotr; Müller, Ulrich

    2012-01-01

    SUMMARY Hair cells are mechanosensors for the perception of sound, acceleration and fluid motion. Mechanotransduction channels in hair cells are gated by tip links, which connect the stereocilia of a hair cell in the direction of their mechanical sensitivity. The molecular constituents of the mechanotransduction channels of hair cells are not known. Here we show that mechanotransduction is impaired in mice lacking the tetraspan TMHS. TMHS binds to the tip-link component PCDH15 and regulates tip-link assembly, a process that is disrupted by deafness-causing Tmhs mutations. TMHS also regulates transducer channel conductance and is required for fast channel adaptation. TMHS therefore resembles other ion channel regulatory subunits such as the TARPs of AMPA receptors that facilitate channel transport and regulate the properties of pore-forming channel subunits. We conclude that TMHS is an integral component of the hair cells mechanotransduction machinery that functionally couples PCDH15 to the transduction channel. PMID:23217710

  11. TMIE is an essential component of the mechanotransduction machinery of cochlear hair cells.

    Science.gov (United States)

    Zhao, Bo; Wu, Zizhen; Grillet, Nicolas; Yan, Linxuan; Xiong, Wei; Harkins-Perry, Sarah; Müller, Ulrich

    2014-12-03

    Hair cells are the mechanosensory cells of the inner ear. Mechanotransduction channels in hair cells are gated by tip links. The molecules that connect tip links to transduction channels are not known. Here we show that the transmembrane protein TMIE forms a ternary complex with the tip-link component PCDH15 and its binding partner TMHS/LHFPL5. Alternative splicing of the PCDH15 cytoplasmic domain regulates formation of this ternary complex. Transducer currents are abolished by a homozygous Tmie-null mutation, and subtle Tmie mutations that disrupt interactions between TMIE and tip links affect transduction, suggesting that TMIE is an essential component of the hair cell's mechanotransduction machinery that functionally couples the tip link to the transduction channel. The multisubunit composition of the transduction complex and the regulation of complex assembly by alternative splicing is likely critical for regulating channel properties in different hair cells and along the cochlea's tonotopic axis. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. Apoptotic cell responses in the splenic marginal zone: A paradigm for immunologic reactions to apoptotic antigens with implications for autoimmunity

    Science.gov (United States)

    McGaha, Tracy L.; Karlsson, Mikael C.I.

    2015-01-01

    Summary Apoptotic cells drive innate regulatory responses that result in tolerogenic immunity. This is a critical aspect of cell physiology as apoptotic cells expose potentially dangerous nuclear antigens on the surface in apoptotic blebs, and failure in their recognition, phagocytosis, or destruction can cause dramatic autoimmunity in experimental models and is linked to development and progression of systemic pathology in man. The marginal zone is a specialized splenic environment that serves as a transitional site from circulation to peripheral lymphoid structures. The marginal zone serves a key role in trapping of particulates and initiation of innate responses against systemic microbial pathogens. However in recent years it has become clear the marginal zone is also important for initiation of immune tolerance to apoptotic cells, driving a coordinated response involving multiple phagocyte and lymphocyte subsets. Recent reports linking defects in splenic macrophage function to SLE in a manner analogous to marginal zone macrophages in lupus-prone mice provides an impetus to better understand the mechanistic basis of the apoptotic cell response in the marginal zone and its general applicability to apoptotic cell-driven tolerance at other tissue sites. In this review we discuss immune responses to apoptotic cells in the spleen in general and the marginal zone in particular, the relationship of these responses to autoimmune disease, and comparisons to apoptotic cell immunity in humans. PMID:26683143

  13. Massive Tension Pneumocephalus Following Cochlear Implant Surgery.

    Science.gov (United States)

    Di Lella, Filippo; D'Angelo, Giulia; Iaccarino, Ilaria; Piccinini, Silvia; Negri, Maurizio; Vincenti, Vincenzo

    2016-10-01

    To report clinical presentation, management and outcomes of a rare complication of cochlear implant surgery. A 68-year-old man, affected by profound bilateral deafness because of superficial cerebral hemosiderosis, presented to Authors' Department 8 days after cochlear implant surgery with vomiting, fever, and mental confusion. Brain computed tomographic (CT) scan showed a massive collection of intracranial air from an osteodural defect in the right tegmen mastoideum because of repeated nose blowing in the postoperative period. A multilayer reconstruction of the tegmen with obliteration of the mastoid cavity using abdominal subcutaneous adipose tissue was performed, preserving the cochlear implant in place. Following surgery the patient showed rapid neurological improvement and CT scan performed 2 days later showed complete resolution of the intracranial air collection. He is currently using the cochlear implant with open set performances. Pneumocephalus is a rare complication of cochlear implant surgery. In patients with severe neurological signs following cochlear implantation (CI), pneumocephalus should be suspected. Drilling of mastoid air cells may expose dura mater and positive high pressure events may break meningeal layers and force air into the cranial cavity.

  14. The endocytic adaptor Eps15 controls marginal zone B cell numbers.

    Directory of Open Access Journals (Sweden)

    Benedetta Pozzi

    Full Text Available Eps15 is an endocytic adaptor protein involved in clathrin and non-clathrin mediated endocytosis. In Caenorhabditis elegans and Drosophila melanogaster lack of Eps15 leads to defects in synaptic vesicle recycling and synapse formation. We generated Eps15-KO mice to investigate its function in mammals. Eps15-KO mice are born at the expected Mendelian ratio and are fertile. Using a large-scale phenotype screen covering more than 300 parameters correlated to human disease, we found that Eps15-KO mice did not show any sign of disease or neural deficits. Instead, altered blood parameters pointed to an immunological defect. By competitive bone marrow transplantation we demonstrated that Eps15-KO hematopoietic precursor cells were more efficient than the WT counterparts in repopulating B220⁺ bone marrow cells, CD19⁻ thymocytes and splenic marginal zone (MZ B cells. Eps15-KO mice showed a 2-fold increase in MZ B cell numbers when compared with controls. Using reverse bone marrow transplantation, we found that Eps15 regulates MZ B cell numbers in a cell autonomous manner. FACS analysis showed that although MZ B cells were increased in Eps15-KO mice, transitional and pre-MZ B cell numbers were unaffected. The increase in MZ B cell numbers in Eps15 KO mice was not dependent on altered BCR signaling or Notch activity. In conclusion, in mammals, the endocytic adaptor protein Eps15 is a regulator of B-cell lymphopoiesis.

  15. The murine catecholamine methyltransferase mTOMT is essential for mechanotransduction by cochlear hair cells

    Science.gov (United States)

    Cunningham, Christopher L; Wu, Zizhen; Jafari, Aria; Zhao, Bo; Schrode, Kat; Harkins-Perry, Sarah; Lauer, Amanda; Müller, Ulrich

    2017-01-01

    Hair cells of the cochlea are mechanosensors for the perception of sound. Mutations in the LRTOMT gene, which encodes a protein with homology to the catecholamine methyltransferase COMT that is linked to schizophrenia, cause deafness. Here, we show that Tomt/Comt2, the murine ortholog of LRTOMT, has an unexpected function in the regulation of mechanotransduction by hair cells. The role of mTOMT in hair cells is independent of mTOMT methyltransferase function and mCOMT cannot substitute for mTOMT function. Instead, mTOMT binds to putative components of the mechanotransduction channel in hair cells and is essential for the transport of some of these components into the mechanically sensitive stereocilia of hair cells. Our studies thus suggest functional diversification between mCOMT and mTOMT, where mTOMT is critical for the assembly of the mechanotransduction machinery of hair cells. Defects in this process are likely mechanistically linked to deafness caused by mutations in LRTOMT/Tomt. DOI: http://dx.doi.org/10.7554/eLife.24318.001 PMID:28504928

  16. The murine catecholamine methyltransferase mTOMT is essential for mechanotransduction by cochlear hair cells.

    Science.gov (United States)

    Cunningham, Christopher L; Wu, Zizhen; Jafari, Aria; Zhao, Bo; Schrode, Kat; Harkins-Perry, Sarah; Lauer, Amanda; Müller, Ulrich

    2017-05-15

    Hair cells of the cochlea are mechanosensors for the perception of sound. Mutations in the LRTOMT gene, which encodes a protein with homology to the catecholamine methyltransferase COMT that is linked to schizophrenia, cause deafness. Here, we show that Tomt/Comt2, the murine ortholog of LRTOMT, has an unexpected function in the regulation of mechanotransduction by hair cells. The role of mTOMT in hair cells is independent of mTOMT methyltransferase function and mCOMT cannot substitute for mTOMT function. Instead, mTOMT binds to putative components of the mechanotransduction channel in hair cells and is essential for the transport of some of these components into the mechanically sensitive stereocilia of hair cells. Our studies thus suggest functional diversification between mCOMT and mTOMT, where mTOMT is critical for the assembly of the mechanotransduction machinery of hair cells. Defects in this process are likely mechanistically linked to deafness caused by mutations in LRTOMT/Tomt.

  17. TMHS is an integral component of the mechanotransduction machinery of cochlear hair cells.

    Science.gov (United States)

    Xiong, Wei; Grillet, Nicolas; Elledge, Heather M; Wagner, Thomas F J; Zhao, Bo; Johnson, Kenneth R; Kazmierczak, Piotr; Müller, Ulrich

    2012-12-07

    Hair cells are mechanosensors for the perception of sound, acceleration, and fluid motion. Mechanotransduction channels in hair cells are gated by tip links, which connect the stereocilia of a hair cell in the direction of their mechanical sensitivity. The molecular constituents of the mechanotransduction channels of hair cells are not known. Here, we show that mechanotransduction is impaired in mice lacking the tetraspan TMHS. TMHS binds to the tip-link component PCDH15 and regulates tip-link assembly, a process that is disrupted by deafness-causing Tmhs mutations. TMHS also regulates transducer channel conductance and is required for fast channel adaptation. TMHS therefore resembles other ion channel regulatory subunits such as the transmembrane alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA) receptor regulatory proteins (TARPs) of AMPA receptors that facilitate channel transport and regulate the properties of pore-forming channel subunits. We conclude that TMHS is an integral component of the hair cell's mechanotransduction machinery that functionally couples PCDH15 to the transduction channel. Copyright © 2012 Elsevier Inc. All rights reserved.

  18. Calcium entry into stereocilia drives adaptation of the mechanoelectrical transducer current of mammalian cochlear hair cells

    NARCIS (Netherlands)

    Corns, Laura F.; Johnson, Stuart L.; Kros, Corne J.; Marcotti, Walter

    2014-01-01

    Mechanotransduction in the auditory and vestibular systems depends on mechanosensitive ion channels in the stereociliary bundles that project from the apical surface of the sensory hair cells. In lower vertebrates, when the mechanoelectrical transducer (MET) channels are opened by movement of the

  19. The potential and electric field in the cochlear outer hair cell membrane.

    Science.gov (United States)

    Harland, Ben; Lee, Wen-han; Brownell, William E; Sun, Sean X; Spector, Alexander A

    2015-05-01

    Outer hair cell electromechanics, critically important to mammalian active hearing, is driven by the cell membrane potential. The membrane protein prestin is a crucial component of the active outer hair cell's motor. The focus of the paper is the analysis of the local membrane potential and electric field resulting from the interaction of electric charges involved. Here the relevant charges are the ions inside and outside the cell, lipid bilayer charges, and prestin-associated charges (mobile-transferred by the protein under the action of the applied field, and stationary-relatively unmoved by the field). The electric potentials across and along the membrane are computed for the case of an applied DC-field. The local amplitudes and phases of the potential under different frequencies are analyzed for the case of a DC + AC-field. We found that the effect of the system of charges alters the electric potential and internal field, which deviate significantly from their traditional linear and constant distributions. Under DC + AC conditions, the strong frequency dependence of the prestin mobile charge has a relatively small effect on the amplitude and phase of the resulting potential. The obtained results can help in a better understanding and experimental verification of the mechanism of prestin performance.

  20. Merkel cell tumor of the skin treated with localized radiotherapy: are widely negative margins required?

    Directory of Open Access Journals (Sweden)

    David Parda

    2011-03-01

    Full Text Available Merkel’s cell carcinoma is a rare cutaneous tumor that can affect a wide variety of sites throughout the body. Commonly, it affects the skin alone and the management of limited disease can be confusing since the natural history of the disease involves distant metastasis. Traditional management has required wide local excision with negative margins of resection. We describe a case treated with local therapy alone and review the literature to suggest that complete microscopic excision may not be required if adjuvant radiotherapy is used.

  1. Cell-type specific short-term plasticity at auditory nerve synapses controls feed-forward inhibition in the dorsal cochlear nucleus.

    Science.gov (United States)

    Sedlacek, Miloslav; Brenowitz, Stephan D

    2014-01-01

    Feed-forward inhibition (FFI) represents a powerful mechanism by which control of the timing and fidelity of action potentials in local synaptic circuits of various brain regions is achieved. In the cochlear nucleus, the auditory nerve provides excitation to both principal neurons and inhibitory interneurons. Here, we investigated the synaptic circuit associated with fusiform cells (FCs), principal neurons of the dorsal cochlear nucleus (DCN) that receive excitation from auditory nerve fibers and inhibition from tuberculoventral cells (TVCs) on their basal dendrites in the deep layer of DCN. Despite the importance of these inputs in regulating fusiform cell firing behavior, the mechanisms determining the balance of excitation and FFI in this circuit are not well understood. Therefore, we examined the timing and plasticity of auditory nerve driven FFI onto FCs. We find that in some FCs, excitatory and inhibitory components of FFI had the same stimulation thresholds indicating they could be triggered by activation of the same fibers. In other FCs, excitation and inhibition exhibit different stimulus thresholds, suggesting FCs and TVCs might be activated by different sets of fibers. In addition, we find that during repetitive activation, synapses formed by the auditory nerve onto TVCs and FCs exhibit distinct modes of short-term plasticity. Feed-forward inhibitory post-synaptic currents (IPSCs) in FCs exhibit short-term depression because of prominent synaptic depression at the auditory nerve-TVC synapse. Depression of this feedforward inhibitory input causes a shift in the balance of fusiform cell synaptic input towards greater excitation and suggests that fusiform cell spike output will be enhanced by physiological patterns of auditory nerve activity.

  2. Cell-type specific short-term plasticity at auditory nerve synapses controls feed-forward inhibition in the dorsal cochlear nucleus

    Directory of Open Access Journals (Sweden)

    Miloslav eSedlacek

    2014-07-01

    Full Text Available Feedforward inhibition represents a powerful mechanism by which control of the timing and fidelity of action potentials in local synaptic circuits of various brain regions is achieved. In the cochlear nucleus, the auditory nerve provides excitation to both principal neurons and inhibitory interneurons. Here, we investigated the synaptic circuit associated with fusiform cells (FCs, principal neurons of the dorsal cochlear nucleus (DCN that receive excitation from auditory nerve fibers and inhibition from tuberculoventral cells (TVCs on their basal dendrites in the deep layer of DCN. Despite the importance of these inputs in regulating fusiform cell firing behavior, the mechanisms determining the balance of excitation and feed-forward inhibition in this circuit are not well understood. Therefore, we examined the timing and plasticity of auditory nerve driven feed-forward inhibition (FFI onto FCs. We find that in some FCs, excitatory and inhibitory components of feed-forward inhibition had the same stimulation thresholds indicating they could be triggered by activation of the same fibers. In other FCs, excitation and inhibition exhibit different stimulus thresholds, suggesting FCs and TVCs might be activated by different sets of fibers. In addition we find that during repetitive activation, synapses formed by the auditory nerve onto TVCs and FCs exhibit distinct modes of short-term plasticity. Feed-forward inhibitory post-synaptic currents (IPSCs in FCs exhibit short-term depression because of prominent synaptic depression at the auditory nerve-TVC synapse. Depression of this feedforward inhibitory input causes a shift in the balance of fusiform cell synaptic input towards greater excitation and suggests that fusiform cell spike output will be enhanced by physiological patterns of auditory nerve activity.

  3. The Competition between the Noise and Shear Motion Sensitivity of Cochlear Inner Hair Cell Stereocilia.

    Science.gov (United States)

    Sasmal, Aritra; Grosh, Karl

    2018-01-23

    Acoustical excitation of the organ of Corti induces radial fluid flow in the subtectorial space (STS) that excites the hair bundles (HBs) of the sensory inner hair cell of the mammalian cochlea. The inner hair cell HBs are bathed in endolymphatic fluid filling a thin gap in the STS between the tectorial membrane and the reticular lamina. According to the fluctuation dissipation theorem, the fluid viscosity gives rise to mechanical fluctuations that are transduced into current noise. Conversely, the stochastic fluctuations of the mechanically gated channels of the HBs also induce dissipation. We develop an analytic model of the STS complex in a cross section of the gerbil organ of Corti. We predict that the dominant noise at the apex is due to the channel stochasticity whereas viscous effects dominate at the base. The net root mean square fluctuation of the HB motion is estimated to be at least 1.18 nm at the base and 2.72 nm at the apex. By varying the HB height for a fixed STS gap, we find that taller HBs are better sensors with lower thresholds. An integrated active HB model is shown to reduce the hydrodynamic resistance through a cycle-by-cycle power addition through adaptation, reducing the thresholds of hearing, hinting at one potential role for HB activity in mammalian hearing. We determine that a Couette flow approximation in the STS underestimates the dissipation and that modeling the entire STS complex is necessary to correctly predict the low-frequency dissipation in the cochlea. Finally, the difference in the noise budget at the base and the apex of the cochlea indicate that a sensing modality other than the shear motion of the TM that may be used to achieve low-noise acoustic sensing at the apex. Copyright © 2017 Biophysical Society. Published by Elsevier Inc. All rights reserved.

  4. Transoral robotic surgery for management of cervical unknown primary squamous cell carcinoma: Updates on efficacy, surgical technique and margin status.

    Science.gov (United States)

    Geltzeiler, Mathew; Doerfler, Sean; Turner, Meghan; Albergotti, William Greer; Kubik, Mark; Kim, Seungwon; Ferris, Robert; Duvvuri, Umamaheswar

    2017-03-01

    Management of cervical unknown primary squamous cell carcinoma (CUP) has evolved with the introduction of transoral robotic surgery (TORS). 1. To describe the efficacy of TORS lingual and palatine tonsillectomy in identifying the primary site of malignancy. 2. To explore how the extent of surgery affects diagnostic yield. 3. To report margin status of TORS resections. A retrospective, single-center cohort study utilizing a prospectively collected database of CUP patients in a high-volume tertiary referral center. Patient underwent operative laryngoscopy plus TORS as clinically indicated. Primary end point was successful identification of the primary. The extent of surgery and margin status were also examined. From 2010-2016, 64 patients with CUP were treated. The primary tumor was found in 51 patients (80%). Fourteen patients (22%) were identified with operative laryngoscopy alone. Fifty patients underwent TORS lingual tonsillectomy ± palatine tonsillectomy with 37 primary tumors identified (74%). The primary was located in the lingual tonsil in 32 patients (86%) and palatine tonsil in 5 patients (10%, p<0.001). Negative margins were achieved in 19 patients (51%). The deep margin was the most commonly positive margin (47%, p=0.049). Operative laryngoscopy with TORS is efficacious, localizing the primary in 80% of patients. If a margin was positive, it was most commonly the deep margin. This study provides valuable information that can help standardize surgical technique, further increasing the diagnostic yield and decreasing the negative margin rate of TORS for CUP. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. The ciliary margin zone of the mammalian retina generates retinal ganglion cells

    Science.gov (United States)

    Marcucci, Florencia; Murcia-Belmonte, Veronica; Coca, Yaiza; Ferreiro-Galve, Susana; Wang, Qing; Kuwajima, Takaaki; Khalid, Sania; Ross, M. Elizabeth; Herrera, Eloisa; Mason, Carol

    2016-01-01

    Summary The retina of lower vertebrates grows continuously by integrating new neurons generated from progenitors in the ciliary margin zone (CMZ). Whether the mammalian CMZ provides the neural retina with retinal cells is controversial. Live-imaging of embryonic retina expressing eGFP in the CMZ shows that cells migrate laterally from the CMZ to the neural retina where differentiated retinal ganglion cells (RGCs) reside. As Cyclin D2, a cell-cycle regulator, is enriched in ventral CMZ, we analyzed Cyclin D2−/− mice to test whether the CMZ is a source of retinal cells. Neurogenesis is diminished in Cyclin D2 mutants, leading to a reduction of RGCs in the ventral retina. In line with these findings, in the albino retina, the decreased production of ipsilateral RGCs is correlated with fewer Cyclin D2+ cells. Together, these results implicate the mammalian CMZ as a neurogenic site that produces RGCs and whose proper generation depends on Cyclin D2 activity. PMID:28009286

  6. Cochlear Outer-Hair-Cell Power Generation and Viscous Fluid Loss

    Science.gov (United States)

    Wang, Yanli; Steele, Charles R.; Puria, Sunil

    2016-01-01

    Since the discovery of otoacoustic emissions and outer hair cell (OHC) motility, the fundamental question of whether the cochlea produces mechanical power remains controversial. In the present work, direct calculations are performed on power loss due to fluid viscosity and power generated by the OHCs. A three-dimensional box model of the mouse cochlea is used with a feed-forward/feed-backward approximation representing the organ of Corti cytoarchitecture. The model is fit to in vivo basilar membrane motion with one free parameter for the OHCs. The calculations predict that the total power output from the three rows of OHCs can be over three orders of magnitude greater than the acoustic input power at 10 dB sound pressure level (SPL). While previous work shows that the power gain, or the negative damping, diminishes with intensity, we show explicitly based on our model that OHC power output increases and saturates with SPL. The total OHC power output is about 2 pW at 80 dB SPL, with a maximum of about 10 fW per OHC.

  7. Otoferlin couples to clathrin-mediated endocytosis in mature cochlear inner hair cells.

    Science.gov (United States)

    Duncker, Susanne V; Franz, Christoph; Kuhn, Stephanie; Schulte, Uwe; Campanelli, Dario; Brandt, Niels; Hirt, Bernhard; Fakler, Bernd; Blin, Nikolaus; Ruth, Peter; Engel, Jutta; Marcotti, Walter; Zimmermann, Ulrike; Knipper, Marlies

    2013-05-29

    The encoding of auditory information with indefatigable precision requires efficient resupply of vesicles at inner hair cell (IHC) ribbon synapses. Otoferlin, a transmembrane protein responsible for deafness in DFNB9 families, has been postulated to act as a calcium sensor for exocytosis as well as to be involved in rapid vesicle replenishment of IHCs. However, the molecular basis of vesicle recycling in IHCs is largely unknown. In the present study, we used high-resolution liquid chromatography coupled with mass spectrometry to copurify otoferlin interaction partners in the mammalian cochlea. We identified multiple subunits of the adaptor protein complex AP-2 (CLAP), an essential component of clathrin-mediated endocytosis, as binding partners of otoferlin in rats and mice. The interaction between otoferlin and AP-2 was confirmed by coimmunoprecipitation. We also found that AP-2 interacts with myosin VI, another otoferlin binding partner important for clathrin-mediated endocytosis (CME). The expression of AP-2 in IHCs was verified by reverse transcription PCR. Confocal microscopy experiments revealed that the expression of AP-2 and its colocalization with otoferlin is confined to mature IHCs. When CME was inhibited by blocking dynamin action, real-time changes in membrane capacitance showed impaired synaptic vesicle replenishment in mature but not immature IHCs. We suggest that an otoferlin-AP-2 interaction drives Ca(2+)- and stimulus-dependent compensating CME in mature IHCs.

  8. Gain and frequency tuning within the mouse cochlear apex

    Energy Technology Data Exchange (ETDEWEB)

    Oghalai, John S.; Raphael, Patrick D. [Department of Otolaryngology, Stanford University School of Medicine, Stanford, California (United States); Gao, Simon [Department of Otolaryngology, Stanford University School of Medicine, Stanford, California (United States); Department of Bioengineering, Rice University, Houston, Texas (United States); Lee, Hee Yoon [Department of Otolaryngology, Stanford University School of Medicine, Stanford, California (United States); Department of Electrical Engineering, Stanford University, Stanford, California (United States); Groves, Andrew K. [Department of Neuroscience, Department of Molecular and Human Genetics, and Program in Developmental Biology, Baylor College of Medicine, Houston, Texas (United States); Zuo, Jian [Department of Developmental Neurobiology, St. Jude Children’s Research Hospital, Memphis, Tennessee (United States); Applegate, Brian E. [Department of Biomedical Engineering, Texas A& M University, College Station, Texas (United States)

    2015-12-31

    Normal mammalian hearing requires cochlear outer hair cell active processes that amplify the traveling wave with high gain and sharp tuning, termed cochlear amplification. We have used optical coherence tomography to study cochlear amplification within the apical turn of the mouse cochlea. We measured not only classical basilar membrane vibratory tuning curves but also vibratory responses from the rest of the tissues that compose the organ of Corti. Basilar membrane tuning was sharp in live mice and broad in dead mice, whereas other regions of the organ of Corti demonstrated phase shifts consistent with additional filtering beyond that provided by basilar membrane mechanics. We use these experimental data to support a conceptual framework of how cochlear amplification is tuned within the mouse cochlear apex. We will also study transgenic mice with targeted mutations that affect different biomechanical aspects of the organ of Corti in an effort to localize the underlying processes that produce this additional filtering.

  9. Stereotyped patterns of B-cell receptor in splenic marginal zone lymphoma

    KAUST Repository

    Zibellini, S.

    2010-05-29

    Antigen stimulation may be important for splenic marginal zone lymphoma pathogenesis. To address this hypothesis, the occurrence of stereotyped B-cell receptors was investigated in 133 SMZL (26 HCV+) compared with 4,414 HCDR3 sequences from public databases. Sixteen SMZL (12%) showed stereotyped BCR; 7 of 86 (8%) SMZL sequences retrieved from public databases also belonged to stereotyped HCDR3 subsets. Three categories of subsets were identified: i) SMZL-specific subsets (n=5), composed only of 12 SMZL (9 HCV- from our series); ii) Non-Hodgkin\\'s lymphoma-like subsets (n=5), comprising 5 SMZL (4 from our series) clustering with other indolent lymphomas; iii) "CLL-like subsets" (n=6), comprising 6 SMZL (3 from our series) that belonged to known CLL subsets (n=4) or clustered with public CLL sequences. Immunoglobulin 3D modeling of 3 subsets revealed similarities in antigen binding regions not limited to HCDR3. Overall, data suggest that the pathogenesis of splenic marginal zone lymphoma may involve also HCV unrelated epitopes or an antigenic trigger common to other indolent lymphomas. ©2010 Ferrata Storti Foundation.

  10. Nitric oxide synthase 2 (NOS2) expression in histologically normal margins of oral squamous cell carcinoma.

    Science.gov (United States)

    Morelatto, Rosana; Itoiz, María-Elina; Guiñazú, Natalia; Piccini, Daniel; Gea, Susana; López-de Blanc, Silvia

    2014-05-01

    The activity of Nitric Oxide Synthase 2 (NOS2) was found in oral squamous cell carcinomas (OSCC) but not in normal mucosa. Molecular changes associated to early carcinogenesis have been found in mucosa near carcinomas, which is considered a model to study field cancerization. The aim of the present study is to analyze NOS2 expression at the histologically normal margins of OSCC. Eleven biopsy specimens of OSCC containing histologically normal margins (HNM) were analyzed. Ten biopsies of normal oral mucosa were used as controls. The activity of NOS2 was determined by immunohistochemistry. Salivary nitrate and nitrite as well as tobacco and alcohol consumption were also analyzed. The Chi-squared test was applied. Six out of the eleven HNM from carcinoma samples showed positive NOS2 activity whereas all the control group samples yielded negative (p=0.005). No statistically significant association between enzyme expression and tobacco and/or alcohol consumption and salivary nitrate and nitrite was found. NOS2 expression would be an additional evidence of alterations that may occur in a state of field cancerization before the appearance of potentially malignant morphological changes.

  11. INCIDENCE OF TUMOR CELLS PRESENCE ON HISTOPATHOLOGICAL SPECIMENTS MARGINS IN RELATION TO WIDENESS OF INTRAORAL CARCINOMAS EXCISION

    Directory of Open Access Journals (Sweden)

    Dragan Mihailović

    2003-07-01

    Full Text Available Correct surgical therapy considers radical excision of tumor formation, what can be certificated by absence of tumor cells on histopathological specimen margins.The aim of this investigation is to estimate incidence of presence of tumor cells on histopathological specimen margins in cases of intraoral carcinomas, surgically excised in macroscopically normal tissue with different wideness of normal tissue zone and relation to postoperative survival of this patients with intraoral carcinomas.Fifty seven patients with intraoral carcinomas were divided in three groups according to wideness of zone of excision in macroscopically normal tissue. Lowest percent of presence of tumor cells on margins of histopathological specimens were in group of patients with zone of excision behind zone of indurations of soft tissue, but patients from this group had shortest postoperative survival period. Presence of tumor cells on margins of histopathological specimens of excided intraoral carcinomas was found in high number of 81,07%.It can be said that presence of tumor cells on margins of histopathological specimens of exceeded intraoral carcinomas was found in extremely high number of 81,07%, but direct statistical significant relation in-between wideness of surgical excision and postoperative survival period was not found what show that another factors connected with postoperative survival of this patients must be examine.

  12. Jxc1/Sobp, encoding a nuclear zinc finger protein, is critical for cochlear growth, cell fate, and patterning of the organ of corti.

    Science.gov (United States)

    Chen, Zheng; Montcouquiol, Mireille; Calderon, Rene; Jenkins, Nancy A; Copeland, Neal G; Kelley, Matthew W; Noben-Trauth, Konrad

    2008-06-25

    The mouse cochlea emerges from the ventral pole of the otocyst to form a one and three-quarter coil. Little is known about the factors that control the growth of the cochlea. Jackson circler (jc) is a recessive mutation causing deafness resulting from a growth arrest of the cochlea duct at day 13.5 of embryonic development. Here, we identify the vertebrate homolog of the Drosophila Sobp (sine oculis-binding protein) gene (named Jxc1) in the jc locus. Jxc1 encodes a nuclear protein that has two FCS-type zinc finger domains (PS51024) and bears nuclear localization signals and highly conserved sequence motifs. Transiently expressed wild-type protein is targeted to the nucleus, but mutant isoforms were mislocalized in the cytoplasm. In jc mutants, the cellular patterning of the organ of Corti is severely disrupted, exhibiting supernumerary hair cells at the apex, showing mirror-image duplications of tunnel of Corti and inner hair cells, and expressing ectopic vestibular-like hair cells within Kölliker's organ. Jxc1 mRNA was detected in inner ear sensory hair cells, supporting cells, and the acoustic ganglia. Expression was also found in the developing retina, olfactory epithelium, trigeminal ganglion, and hair follicles. Collectively, our data support a role for Jxc1 in controlling a critical step in cochlear growth, cell fate, and patterning of the organ of Corti.

  13. Prognostic value of molecular events from negative surgical margin of non-small-cell lung cancer

    Science.gov (United States)

    Cao, Bangrong; Feng, Lin; Lu, Dan; Liu, Yan; Liu, Yu; Guo, Suping; Han, Naijun; Liu, Xiangyang; Mao, Yousheng; He, Jie; Cheng, Shujun; Gao, Yanning; Zhang, Kaitai

    2017-01-01

    It is hypothesized that the molecular status in negative surgical margin (NSM) is associated with prognosis of cancer patients. In this study, the prognostic relevance of Epithelial-to-Mesenchymal Transition (EMT) molecular events in NSMs in patients with NSCLC was investigated. EMT model was developed, in which the mesenchymal transition of human immortalized bronchial epithelial cell line was induced by TGF-beta1. Gene expression of EMT-induced cells and NSMs from 60 lung squamous cell carcinoma (SCC) patients was profiled by microarray and validated by quantitative RT-PCR. Two independent cohorts (lung SCC, n = 50; NSCLC, n = 54) were employed to validate the prognostic value of candidate genes. A set of 1490 genes were identified in EMT model in vitro. An EMT-like gene-expression pattern by 33 essential genes was optimized in NSMs, and was significantly associated with tumor progression. The 33 genes also exhibited a site-dependent field cancerization effect in the normal-appearing airways adjacent to NSCLCs. In the independent lung SCC cohort, the EMT-like active pattern indicated poor outcome of patients (n = 50, log-rank p = 0.009). Furthermore, in the NSCLC cohort, patients with EMT-like active pattern had shorter predictive survival time (n = 54, log-rank p = 0.02). In conclusion, the existence of EMT-like gene expression in NSMs, may play critical role in tumor progression and be a potential biomarker for prognosis in patients with NSCLC. PMID:28881838

  14. Prevention of Noise Damage to Cochlear Synapses

    Science.gov (United States)

    2015-10-01

    deafness still suffices to cause a significant hearing impairment by destroying synapses between hair cells and cochlear (spiral ganglion) neurons. This...localized PSD and ribbon. Synapses are counted in the confocal image stacks with an optical disector technique. The total number of synapses on IHCs in each

  15. AIRE expressing marginal zone dendritic cells balances adaptive immunity and T-follicular helper cell recruitment.

    Science.gov (United States)

    Lindmark, Evelina; Chen, Yunying; Georgoudaki, Anna-Maria; Dudziak, Diana; Lindh, Emma; Adams, William C; Loré, Karin; Winqvist, Ola; Chambers, Benedict J; Karlsson, Mikael C I

    2013-05-01

    Autoimmune polyendocrine syndrome Type I (APS I) results in multiple endocrine organ destruction and is caused by mutations in the Autoimmune regulator gene (AIRE). In the thymic stroma, cells expressing the AIRE gene dictate T cell education and central tolerance. Although this function is the most studied, AIRE is also expressed in the periphery in DCs and stromal cells. Still, how AIRE regulated transcription modifies cell behaviour in the periphery is largely unknown. Here we show that AIRE is specifically expressed by 33D1(+) DCs and dictates the fate of antibody secreting cell movement within the spleen. We also found that AIRE expressing 33D1(+) DCs expresses self-antigens as exemplified by the hallmark gene insulin. Also, as evidence for a regulatory function, absence of Aire in 33D1(+) DCs led to reduced levels of the chemokine CXCL12 and increased co-stimulatory properties. This resulted in altered activation and recruitment of T-follicular helper cells and germinal centre B cells. The altered balance leads to a change of the early response to a T cell-dependent antigen in Aire(-/-) mice. These findings add to the understanding of how specific DC subtypes regulate the early responses during T cell-dependent antibody responses within the spleen and further define the role of AIRE in the periphery as regulator of self-antigen expression and lymphocyte migration. Copyright © 2012 Elsevier Ltd. All rights reserved.

  16. Single cell genomic study of Dehalococcoidites in deep sea sediments of Peru Margin 1230

    Science.gov (United States)

    Kaster, A.; Meyer-Blackwell, K.; Spormann, A. M.

    2013-12-01

    Dehalogenating Chloroflexi, such as Dehalococcoidites Dhc were originally discovered as the key microorganisms mediating reductive dehalogenation of the prevalent groundwater contaminants tetrachloroethene and trichloroethene. Molecular and genomic studies on their key enzymes for energy conservation, reductive dehalogenases rdh, have provided evidence for ubiquitous horizontal gene transfer. A pioneering study by Futagami et al. discovered novel putative rdh phylotypes in sediments from the Pacific, revealing an unknown and surprising abundance of rdh genes in pristine habitats. The frequent detection of Dhc-related 16S rRNA genes from these environments implied the occurrence of dissimilatory dehalorespiration in marine subsurface sediments, however, pristine Dhc could never be linked to this activity. Despite being ubiquitous in those environments, metabolic life style or ecological function of Dhc in the absence of anthropogenic contaminants is still completely unknown. We therefore analyzed a non-contaminated deep sea sediment sample of the Peru Margin 1230 site by a single cell genomic (SGC) approach. We present for the first time data on three single Dhc cells, helping to elucidate their role in the poorly understood oligotrophic marine sub-surface environment.

  17. CR2+ marginal zone B cell production of pathogenic natural antibodies is C3 independent.

    Science.gov (United States)

    Woods, Keith M; Pope, Michael R; Hoffman, Sara M; Fleming, Sherry D

    2011-02-01

    Intestinal ischemia-reperfusion (IR)-induced damage requires complement receptor 2 (CR2) for generation of the appropriate natural Ab repertoire. Pathogenic Abs recognize neoantigens on the ischemic tissue, activate complement, and induce intestinal damage. Because C3 cleavage products act as ligands for CR2, we hypothesized that CR2(hi) marginal zone B cells (MZBs) require C3 for generation of the pathogenic Abs. To explore the ability of splenic CR2(+) B cells to generate the damaging Ab repertoire, we adoptively transferred either MZBs or follicular B cells (FOBs) from C57BL/6 or Cr2(-/-) mice into Rag-1(-/-) mice. Adoptive transfer of wild type CR2(hi) MZBs but not CR2(lo) FOBs induced significant damage, C3 deposition, and inflammation in response to IR. In contrast, similarly treated Rag-1(-/-) mice reconstituted with either Cr2(-/-) MZB/B1 B cells (B1Bs) or FOBs lacked significant intestinal damage and displayed limited complement activation. To determine whether C3 cleavage products are critical in CR2-dependent Ab production, we evaluated the ability of the natural Ab repertoire of C3(-/-) mice to induce damage in response to IR. Infusion of C3(-/-) serum into Cr2(-/-) mice restored IR-induced tissue damage. Furthermore, Rag-1(-/-) mice sustained significant damage after infusion of Abs from C3(-/-) but not Cr2(-/-) mice. Finally, adoptive transfer of MZBs from C3(-/-) mice into Rag-1(-/-) mice resulted in significant tissue damage and inflammation. These data indicate that CR2 expression on MZBs is sufficient to induce the appropriate Abs required for IR-induced tissue damage and that C3 is not critical for generation of the pathogenic Abs.

  18. [Biomaterials in cochlear implants].

    Science.gov (United States)

    Stöver, T; Lenarz, T

    2009-05-01

    Cochlear implants (CI) represent the "gold standard" for the treatment of congenitally deaf children and postlingually deafened adults. Thus, cochlear implantation is a success story of new bionic prosthesis development. Owing to routine application of cochlear implants in adults but also in very young children (below the age of one), high demands are placed on the implants. This is especially true for biocompatibility aspects of surface materials of implant parts which are in contact with the human body. In addition, there are various mechanical requirements which certain components of the implants must fulfil, such as flexibility of the electrode array and mechanical resistance of the implant housing. Due to the close contact of the implant to the middle ear mucosa and because the electrode array is positioned in the perilymphatic space via cochleostomy, there is a potential risk of bacterial transferral along the electrode array into the cochlea. Various requirements that have to be fulfilled by cochlear implants, such as biocompatibility, electrode micromechanics, and although a very high level of technical standards has been carried out there is still demand for the improvement of implants as well as of the materials used for manufacturing, ultimately leading to increased implant performance. General considerations of material aspects related to cochlear implants as well as potential future perspectives of implant development will be discussed.

  19. Auditory Mechanics of the Tectorial Membrane and the Cochlear Spiral

    Science.gov (United States)

    Gavara, Núria; Manoussaki, Daphne; Chadwick, Richard S.

    2012-01-01

    Purpose of review This review is timely and relevant since new experimental and theoretical findings suggest that cochlear mechanics from the nanoscale to the macroscale are affected by mechanical properties of the tectorial membrane and the spiral shape. Recent findings Main tectorial membrane themes covered are i) composition and morphology, ii) nanoscale mechanical interactions with the outer hair cell bundle, iii) macroscale longitudinal coupling, iv) fluid interaction with inner hair cell bundles, v) macroscale dynamics and waves. Main cochlear spiral themes are macroscale low-frequency energy focusing and microscale organ of Corti shear gain. Implications Findings from new experimental and theoretical models reveal exquisite sensitivity of cochlear mechanical performance to tectorial membrane structural organization, mechanics, and its positioning with respect to hair bundles. The cochlear spiral geometry is a major determinant of low frequency hearing. Suggestions are made for future research directions. PMID:21785353

  20. Rapidly induced, T-cell independent xenoantibody production is mediated by marginal zone B cells and requires help from NK cells.

    Science.gov (United States)

    Li, Shengqiao; Yan, Yehong; Lin, Yuan; Bullens, Dominique M; Rutgeerts, Omer; Goebels, Jozef; Segers, Constant; Boon, Louis; Kasran, Ahmad; De Vos, Rita; Dewolf-Peeters, Christiane; Waer, Mark; Billiau, An D

    2007-12-01

    Xenoantibody production directed at a wide variety of T lymphocyte-dependent and T lymphocyte-independent xenoantigens remains the major immunologic obstacle for successful xenotransplantation. The B lymphocyte subpopulations and their helper factors, involved in T-cell-independent xenoantibody production are only partially understood, and their identification will contribute to the clinical applicability of xenotransplantation. Here we show, using models involving T-cell-deficient athymic recipient mice, that rapidly induced, T-cell-independent xenoantibody production is mediated by marginal zone B lymphocytes and requires help from natural killer (NK) cells. This collaboration neither required NK-cell-mediated IFN-gamma production, nor NK-cell-mediated cytolytic killing of xenogeneic target cells. The T-cell-independent IgM xenoantibody response could be partially suppressed by CD40L blockade.

  1. Wnt signaling during cochlear development.

    Science.gov (United States)

    Munnamalai, Vidhya; Fekete, Donna M

    2013-05-01

    Wnt signaling is a hallmark of all embryonic development with multiple roles at multiple developmental time points. Wnt signaling is also important in the development of several organs, one of which is the inner ear, where it participates in otic specification, the formation of vestibular structures, and the development of the cochlea. In particular, we focus on Wnt signaling in the auditory organ, the cochlea. Attempting to dissect the multiple Wnt signaling pathways in the mammalian cochlea is a challenging task due to limited expression data, particularly at proliferating stages. To offer predictions about Wnt activity, we compare cochlear development with that of other biological systems such as Xenopus retina, brain, cancer cells and osteoblasts. Wnts are likely to regulate development through crosstalk with other signaling pathways, particularly Notch and FGF, leading to changes in the expression of Sox2 and proneural (pro-hair cell) genes. In this review we have consolidated the known signaling pathways in the cochlea with known developmental roles of Wnts from other systems to generate a potential timeline of cochlear development. Copyright © 2013 Elsevier Ltd. All rights reserved.

  2. New 3-Tiered Circumferential Resection Margin Criteria in Esophageal Squamous Cell Carcinoma.

    Science.gov (United States)

    Lee, Geun Dong; Lee, Seung Eun; Kim, Kyoung-Mee; Kim, Yong-Hee; Ahn, Joong Hyun; Jung, Sinho; Choi, Yoon-La; Kim, Hyeong Ryul; Park, Seung-Il; Shim, Young Mog

    2015-12-01

    We aimed to investigate the optimal cutoff value of circumferential resection margin (CRM) of esophageal squamous cell carcinoma (ESCC) in patients who underwent radical esophagectomy. Tumor involvement of a CRM in ESCC has not been clearly defined. We reviewed 479 pT3 ESCC patients to find the optimal cutoff point of distance from CRM in addition to 0 μm for discriminating survival time. The partitions at and near the 500 μm distance from CRM generated the largest log-rank statistics (P = 0.0086). Therefore, we added 500 μm as an additional cutoff value for a positive CRM. Compared to patients with CRM greater than 500 μm, patients with CRM 0 μm showed worse overall survival (P CRM ≤ 500 μm vs CRM > 500 μm, hazards ratio (HR) = 1.875, 97.5% CI: 1.243-2.829, P = 0.002; CRM = 0 μm vs CRM > 500 μm, HR = 2.666, 97.5% CI: 1.745-4.076, P CRM (95% CI, P-value) were 1.969 (1.501-2.584, P CRM criteria providing more detailed prognostic information than the 2-tiered criteria.

  3. Survival after radiation for stage I and II non-small cell lung cancer with positive margins.

    Science.gov (United States)

    Gulack, Brian C; Cox, Morgan L; Yang, Chi-Fu Jeffrey; Speicher, Paul J; Kara, H Volkan; D'Amico, Thomas A; Berry, Mark F; Hartwig, Matthew G

    2018-03-01

    There is limited data guiding treatment for positive margins following lobectomy for early-stage non-small cell lung cancer (NSCLC). Using data from the National Cancer Data Base, we sought to determine whether radiation therapy following lobectomy for stage I or II NSCLC was associated with improved overall survival in patients with positive margins. Patients who underwent lobectomy without induction therapy for stage I or II NSCLC (1998-2006) with positive resection margins were selected. Patients were stratified by administration of radiation therapy following surgery, and overall survival was estimated using the Kaplan-Meier method. The association between radiation therapy and survival was adjusted for nonrandom treatment selection using Cox proportional hazards regression modeling. Positive margins were recorded in 1934 of 49,563 (3.9%) patients who underwent lobectomy for stage I or II NSCLC. Positive margin status was associated with significantly worse 5-year survival (34.5% versus 57.2%, P < 0.001). After selection of patients with positive margins and known radiation status and exclusion of patients who had upstaged disease or received radiation therapy for palliative indications, radiation therapy was used in 579 of 1579 patients (38.2%) but was not associated with a significant difference in the likelihood of death during subsequent follow-up (hazard ratio: 1.10, 95% confidence interval: 0.90, 1.35). Positive margins following lobectomy for stage I or II NSCLC are associated with reduced 5-year survival. Postsurgical radiation is not strongly associated with an improvement in overall survival among these patients. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Cockayne syndrome group B (Csb) and group a (Csa) deficiencies predispose to hearing loss and cochlear hair cell degeneration in mice.

    Science.gov (United States)

    Nagtegaal, A Paul; Rainey, Robert N; van der Pluijm, Ingrid; Brandt, Renata M C; van der Horst, Gijsbertus T J; Borst, J Gerard G; Segil, Neil

    2015-03-11

    Sensory hair cells in the cochlea, like most neuronal populations that are postmitotic, terminally differentiated, and non-regenerating, depend on robust mechanisms of self-renewal for lifelong survival. We report that hair cell homeostasis requires a specific sub-branch of the DNA damage nucleotide excision repair pathway, termed transcription-coupled repair (TCR). Cockayne syndrome (CS), caused by defects in TCR, is a rare DNA repair disorder with a broad clinical spectrum that includes sensorineural hearing loss. We tested hearing and analyzed the cellular integrity of the organ of Corti in two mouse models of this disease with mutations in the Csb gene (CSB(m/m) mice) and Csa gene (Csa(-/-) mice), respectively. Csb(m/m) and Csa(-/-) mice manifested progressive hearing loss, as measured by an increase in auditory brainstem response thresholds. In contrast to wild-type mice, mutant mice showed reduced or absent otoacoustic emissions, suggesting cochlear outer hair cell impairment. Hearing loss in Csb(m/m) and Csa(-/-) mice correlated with progressive hair cell loss in the base of the organ of Corti, starting between 6 and 13 weeks of age, which increased by 16 weeks of age in a basal-to-apical gradient, with outer hair cells more severely affected than inner hair cells. Our data indicate that the hearing loss observed in CS patients is reproduced in mouse models of this disease. We hypothesize that accumulating DNA damage, secondary to the loss of TCR, contributes to susceptibility to hearing loss. Copyright © 2015 the authors 0270-6474/15/354280-07$15.00/0.

  5. Cochlear Implant Using Neural Prosthetics

    Science.gov (United States)

    Gupta, Shweta; Singh, Shashi kumar; Dubey, Pratik Kumar

    2012-10-01

    This research is based on neural prosthetic device. The oldest and most widely used of these electrical, and often computerized, devices is the cochlear implant, which has provided hearing to thousands of congenitally deaf people in this country. Recently, the use of the cochlear implant is expanding to the elderly, who frequently suffer major hearing loss. More cutting edge are artificial retinas, which are helping dozens of blind people see, and ìsmartî artificial arms and legs that amputees can maneuver by thoughts alone, and that feel more like real limbs.Research, which curiosity led to explore frog legs dancing during thunderstorms, a snail shapedorgan in the inner ear, and how various eye cells react to light, have fostered an understanding of how to ìtalkî to the nervous system. That understanding combined with the miniaturization of electronics and enhanced computer processing has enabled prosthetic devices that often can bridge the gap in nerve signaling that is caused by disease or injury.

  6. Binaural and cochlear disparities.

    Science.gov (United States)

    Joris, Philip X; Van de Sande, Bram; Louage, Dries H; van der Heijden, Marcel

    2006-08-22

    Binaural auditory neurons exhibit "best delays" (BDs): They are maximally activated at certain acoustic delays between sounds at the two ears and thereby signal spatial sound location. BDs arise from delays internal to the auditory system, but their source is controversial. According to the classic Jeffress model, they reflect pure time delays generated by differences in axonal length between the inputs from the two ears to binaural neurons. However, a relationship has been reported between BDs and the frequency to which binaural neurons are most sensitive (the characteristic frequency), and this relationship is not predicted by the Jeffress model. An alternative hypothesis proposes that binaural neurons derive their input from slightly different places along the two cochleas, which induces BDs by virtue of the slowness of the cochlear traveling wave. To test this hypothesis, we performed a coincidence analysis on spiketrains of pairs of auditory nerve fibers originating from different cochlear locations. In effect, this analysis mimics the processing of phase-locked inputs from each ear by binaural neurons. We find that auditory nerve fibers that innervate different cochlear sites show a maximum number of coincidences when they are delayed relative to each other, and that the optimum delays decrease with characteristic frequency as in binaural neurons. These findings suggest that cochlear disparities make an important contribution to the internal delays observed in binaural neurons.

  7. Close-field electroporation gene delivery using the cochlear implant electrode array enhances the bionic ear.

    Science.gov (United States)

    Pinyon, Jeremy L; Tadros, Sherif F; Froud, Kristina E; Y Wong, Ann C; Tompson, Isabella T; Crawford, Edward N; Ko, Myungseo; Morris, Renée; Klugmann, Matthias; Housley, Gary D

    2014-04-23

    The cochlear implant is the most successful bionic prosthesis and has transformed the lives of people with profound hearing loss. However, the performance of the "bionic ear" is still largely constrained by the neural interface itself. Current spread inherent to broad monopolar stimulation of the spiral ganglion neuron somata obviates the intrinsic tonotopic mapping of the cochlear nerve. We show in the guinea pig that neurotrophin gene therapy integrated into the cochlear implant improves its performance by stimulating spiral ganglion neurite regeneration. We used the cochlear implant electrode array for novel "close-field" electroporation to transduce mesenchymal cells lining the cochlear perilymphatic canals with a naked complementary DNA gene construct driving expression of brain-derived neurotrophic factor (BDNF) and a green fluorescent protein (GFP) reporter. The focusing of electric fields by particular cochlear implant electrode configurations led to surprisingly efficient gene delivery to adjacent mesenchymal cells. The resulting BDNF expression stimulated regeneration of spiral ganglion neurites, which had atrophied 2 weeks after ototoxic treatment, in a bilateral sensorineural deafness model. In this model, delivery of a control GFP-only vector failed to restore neuron structure, with atrophied neurons indistinguishable from unimplanted cochleae. With BDNF therapy, the regenerated spiral ganglion neurites extended close to the cochlear implant electrodes, with localized ectopic branching. This neural remodeling enabled bipolar stimulation via the cochlear implant array, with low stimulus thresholds and expanded dynamic range of the cochlear nerve, determined via electrically evoked auditory brainstem responses. This development may broadly improve neural interfaces and extend molecular medicine applications.

  8. Marginal Models

    CERN Document Server

    Bergsma, Wicher; Hagenaars, Jacques A

    2009-01-01

    Presents an overview of the basic principles of marginal modeling and offers a range of possible applications. This book includes many real world examples, explains the types of research questions for which marginal modeling is useful, and provides a description of how to apply marginal models for a great diversity of research questions.

  9. The actin-binding proteins eps8 and gelsolin have complementary roles in regulating the growth and stability of mechanosensory hair bundles of mammalian cochlear outer hair cells.

    Directory of Open Access Journals (Sweden)

    Jennifer Olt

    Full Text Available Sound transduction depends upon mechanosensitive channels localized on the hair-like bundles that project from the apical surface of cochlear hair cells. Hair bundles show a stair-case structure composed of rows of stereocilia, and each stereocilium contains a core of tightly-packed and uniformly-polarized actin filaments. The growth and maintenance of the stereociliary actin core are dynamically regulated. Recently, it was shown that the actin-binding protein gelsolin is expressed in the stereocilia of outer hair cells (OHCs and in its absence they become long and straggly. Gelsolin is part of a whirlin scaffolding protein complex at the stereocilia tip, which has been shown to interact with other actin regulatory molecules such as Eps8. Here we investigated the physiological effects associated with the absence of gelsolin and its possible overlapping role with Eps8. We found that, in contrast to Eps8, gelsolin does not affect mechanoelectrical transduction during immature stages of development. Moreover, OHCs from gelsolin knockout mice were able to mature into fully functional sensory receptors as judged by the normal resting membrane potential and basolateral membrane currents. Mechanoelectrical transducer current in gelsolin-Eps8 double knockout mice showed a profile similar to that observed in the single mutants for Eps8. We propose that gelsolin has a non-overlapping role with Eps8. While Eps8 is mainly involved in the initial growth of stereocilia in both inner hair cells (IHCs and OHCs, gelsolin is required for the maintenance of mature hair bundles of low-frequency OHCs after the onset of hearing.

  10. Abnormal pitch perception produced by cochlear implant stimulation.

    Science.gov (United States)

    Zeng, Fan-Gang; Tang, Qing; Lu, Thomas

    2014-01-01

    Contemporary cochlear implants with multiple electrode stimulation can produce good speech perception but poor music perception. Hindered by the lack of a gold standard to quantify electric pitch, relatively little is known about the nature and extent of the electric pitch abnormalities and their impact on cochlear implant performance. Here we overcame this obstacle by comparing acoustic and electric pitch perception in 3 unilateral cochlear-implant subjects who had functionally usable acoustic hearing throughout the audiometric frequency range in the non-implant ear. First, to establish a baseline, we measured and found slightly impaired pure tone frequency discrimination and nearly perfect melody recognition in all 3 subjects' acoustic ear. Second, using pure tones in the acoustic ear to match electric pitch induced by an intra-cochlear electrode, we found that the frequency-electrode function was not only 1-2 octaves lower, but also 2 times more compressed in frequency range than the normal cochlear frequency-place function. Third, we derived frequency difference limens in electric pitch and found that the equivalent electric frequency discrimination was 24 times worse than normal-hearing controls. These 3 abnormalities are likely a result of a combination of broad electric field, distant intra-cochlear electrode placement, and non-uniform spiral ganglion cell distribution and survival, all of which are inherent to the electrode-nerve interface in contemporary cochlear implants. Previous studies emphasized on the "mean" shape of the frequency-electrode function, but the present study indicates that the large "variance" of this function, reflecting poor electric pitch discriminability, is the main factor limiting contemporary cochlear implant performance.

  11. Abnormal pitch perception produced by cochlear implant stimulation.

    Directory of Open Access Journals (Sweden)

    Fan-Gang Zeng

    Full Text Available Contemporary cochlear implants with multiple electrode stimulation can produce good speech perception but poor music perception. Hindered by the lack of a gold standard to quantify electric pitch, relatively little is known about the nature and extent of the electric pitch abnormalities and their impact on cochlear implant performance. Here we overcame this obstacle by comparing acoustic and electric pitch perception in 3 unilateral cochlear-implant subjects who had functionally usable acoustic hearing throughout the audiometric frequency range in the non-implant ear. First, to establish a baseline, we measured and found slightly impaired pure tone frequency discrimination and nearly perfect melody recognition in all 3 subjects' acoustic ear. Second, using pure tones in the acoustic ear to match electric pitch induced by an intra-cochlear electrode, we found that the frequency-electrode function was not only 1-2 octaves lower, but also 2 times more compressed in frequency range than the normal cochlear frequency-place function. Third, we derived frequency difference limens in electric pitch and found that the equivalent electric frequency discrimination was 24 times worse than normal-hearing controls. These 3 abnormalities are likely a result of a combination of broad electric field, distant intra-cochlear electrode placement, and non-uniform spiral ganglion cell distribution and survival, all of which are inherent to the electrode-nerve interface in contemporary cochlear implants. Previous studies emphasized on the "mean" shape of the frequency-electrode function, but the present study indicates that the large "variance" of this function, reflecting poor electric pitch discriminability, is the main factor limiting contemporary cochlear implant performance.

  12. Selective preservation of bone marrow mature recirculating but not marginal zone B cells in murine models of chronic inflammation.

    Directory of Open Access Journals (Sweden)

    Elisabetta Traggiai

    Full Text Available Inflammation promotes granulopoiesis over B lymphopoiesis in the bone marrow (BM. We studied B cell homeostasis in two murine models of T cell mediated chronic inflammation, namely calreticulin-deficient fetal liver chimeras (FLC, which develop severe blepharitis and alopecia due to T cell hyper responsiveness, and inflammatory bowel disease (IBD caused by injection of CD4(+ naïve T cells into lymphopenic mice. We show herein that despite the severe depletion of B cell progenitors during chronic, peripheral T cell-mediated inflammation, the population of BM mature recirculating B cells is unaffected. These B cells are poised to differentiate to plasma cells in response to blood borne pathogens, in an analogous fashion to non-recirculating marginal zone (MZ B cells in the spleen. MZ B cells nevertheless differentiate more efficiently to plasma cells upon polyclonal stimulation by Toll-like receptor (TLR ligands, and are depleted during chronic T cell mediated inflammation in vivo. The preservation of mature B cells in the BM is associated with increased concentration of macrophage migration inhibitory factor (MIF in serum and BM plasma. MIF produced by perivascular dendritic cells (DC in the BM provides a crucial survival signal for recirculating B cells, and mice treated with a MIF inhibitor during inflammation showed significantly reduced mature B cells in the BM. These data indicate that MIF secretion by perivascular DC may promote the survival of the recirculating B cell pool to ensure responsiveness to blood borne microbes despite loss of the MZ B cell pool that accompanies depressed lymphopoiesis during inflammation.

  13. Efter cochlear implant

    DEFF Research Database (Denmark)

    Højen, Anders

    2007-01-01

      Dit barn har netop fået et cochlear implant. Hvad nu? Skal barnet fokusere udelukkende på at lære talt sprog, eller skal det også lære/fortsætte med tegnsprog eller støttetegn? Det er et vanskeligt spørgsmål, og før valget foretages, er det vigtigt at vurdere hvilke konsekvenser valget har, dels...... for den sproglige udvikling isoleret set, og dels for barnets udvikling ud fra en helhedsbetragtning. Dette indlæg fokuserer på, hvilke forventninger man kan have til cochlear implant-brugeres sproglige udvikling med talt sprog alene, hhv. med to sprog (tale og tegn). Disse forventninger er baseret på...

  14. Efter cochlear implant

    DEFF Research Database (Denmark)

    Højen, Anders

    Dit barn har netop fået et cochlear implant. Hvad nu? Skal barnet fokusere udelukkende på at lære talt sprog, eller skal det også lære/fortsætte med tegnsprog eller støttetegn? Det er et vanskeligt spørgsmål, og før valget foretages, er det vigtigt at vurdere hvilke konsekvenser valget har, dels...... for den sproglige udvikling isoleret set, og dels for barnets udvikling ud fra en helhedsbetragtning. Dette indlæg fokuserer på, hvilke forventninger man kan have til cochlear implant-brugeres sproglige udvikling med talt sprog alene, hhv. med to sprog (tale og tegn). Disse forventninger er baseret på...

  15. COCHLEAR IMPLANTATION IN IRAN

    Directory of Open Access Journals (Sweden)

    M.H. Khalessi

    1996-07-01

    Full Text Available Deafness has been considered a non - resolving problem until the invention of cochlear implantation (CI. We are reporting the pre- and post-operative results of 14 patients underwent CI, for the first time in Iran, at the cochlear implantation Clinic of Tehran University of Medical Sciences. Four of our patients were able to hold a telephone conversation without difficulty 3 months post-operatively and the rest achieved considerable scores on audiologic tests and a remarkable improvement over 9 month interval between the two sets of tests. Also we have addressed the dramatic improvement in the quality of life of these patients in this paper as well as the results of promontory stimulation and audiometry.

  16. Biomaterials in cochlear implants

    OpenAIRE

    Lenarz, Thomas; Stöver, Timo

    2011-01-01

    The cochlear implant (CI) represents, for almost 25 years now, the gold standard in the treatment of children born deaf and for postlingually deafened adults. These devices thus constitute the greatest success story in the field of ‘neurobionic’ prostheses. Their (now routine) fitting in adults, and especially in young children and even babies, places exacting demands on these implants, particularly with regard to the biocompatibility of a CI’s surface components. Furthermore, certain parts o...

  17. Expression of Immunoglobulin Receptors with Distinctive Features Indicating Antigen Selection by Marginal Zone B Cells from Human Spleen

    Science.gov (United States)

    Colombo, Monica; Cutrona, Giovanna; Reverberi, Daniele; Bruno, Silvia; Ghiotto, Fabio; Tenca, Claudya; Stamatopoulos, Kostas; Hadzidimitriou, Anastasia; Ceccarelli, Jenny; Salvi, Sandra; Boccardo, Simona; Calevo, Maria Grazia; De Santanna, Amleto; Truini, Mauro; Fais, Franco; Ferrarini, Manlio

    2013-01-01

    Marginal zone (MZ) B cells, identified as surface (s)IgMhighsIgDlowCD23low/−CD21+CD38− B cells, were purified from human spleens, and the features of their V(D)J gene rearrangements were investigated and compared with those of germinal center (GC), follicular mantle (FM) and switched memory (SM) B cells. Most MZ B cells were CD27+ and exhibited somatic hypermutations (SHM), although to a lower extent than SM B cells. Moreover, among MZ B-cell rearrangements, recurrent sequences were observed, some of which displayed intraclonal diversification. The same diversifying sequences were detected in very low numbers in GC and FM B cells and only when a highly sensitive, gene-specific polymerase chain reaction was used. This result indicates that MZ B cells could expand and diversify in situ and also suggested the presence of a number of activation-induced cytidine deaminase (AID)-expressing B cells in the MZ. The notion of antigen-driven expansion/selection in situ is further supported by the VH CDR3 features of MZ B cells with highly conserved amino acids at specific positions and by the finding of shared (“stereotyped”) sequences in two different spleens. Collectively, the data are consistent with the notion that MZ B cells are a special subset selected by in situ antigenic stimuli. PMID:23877718

  18. Cochlear labyrinth volume in Krapina Neandertals.

    Science.gov (United States)

    Beals, Michaela E; Frayer, David W; Radovčić, Jakov; Hill, Cheryl A

    2016-01-01

    Research with extant primate taxa suggests that cochlear labyrinth volume is functionally related to the range of audible frequencies. Specifically, cochlear volume is negatively correlated with both the high and low frequency limits of hearing so that the smaller the cochlea, the higher the normal range of audible frequencies. The close anatomical relationship between the membranous cochlea and the bony cochlear labyrinth allows for the determination of cochlear size from fossil specimens. This study compares Krapina Neandertal cochlear volumes to extant taxa cochlear volumes. Cochlear volumes were acquired from high-resolution computed tomography scans of temporal bones of Krapina Neandertals, chimpanzees, gorillas, and modern humans. We find that Krapina Neandertals' cochlear volumes are similar to modern Homo sapiens and are significantly larger than chimpanzee and gorilla cochlear volumes. The measured cochlear volume in Krapina Neandertals suggests they had a range of audible frequencies similar to the modern human range. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Positive surgical margins after nephron-sparing surgery for renal cell carcinoma: incidence, clinical impact, and management.

    Science.gov (United States)

    Borghesi, Marco; Brunocilla, Eugenio; Schiavina, Riccardo; Martorana, Giuseppe

    2013-03-01

    Nephron-sparing surgery (NSS) for renal cell carcinoma (RCC) offers comparable oncologic results but a lower risk of chronic kidney disease when compared with radical nephrectomy; however it can result in positive surgical margins (PSMs) and consequently to a possible risk of oncologic failure. The aim of this review is to evaluate the incidence of PSMs after nephron-sparing surgery, to assess their clinical and oncologic impact, and to provide an overview of the possible therapeutic management. We performed a nonsystematic review of the literature in the MEDLINE database using the following keywords: partial nephrectomy, nephron-sparing surgery, and positive margin. We reviewed articles published only in English from January 2002 to May 2012. The overall incidence of PSMs after NSS ranges from 0% to 7%, with no significant differences in open, laparoscopic, and robot-assisted techniques. Smaller tumor size could result in a higher risk of PSMs. Even if there is not a clear agreement in the clinical evidence, local recurrence seems to be more likely in patients with PSMs, especially in those with high-grade tumors. Development of metastases and cancer-specific survival, as seen in midterm follow-up studies, seems to be comparable to those in patients with negative surgical margins. Considering the globally low risk of local recurrence, development of metastasis, or cancer-specific mortality, careful surveillance could be the best management option for most patients with PSMs after NSS. Copyright © 2013 Elsevier Inc. All rights reserved.

  20. Nuclear marginalization of host cell chromatin associated with expansion of two discrete virus-induced subnuclear compartments during baculovirus infection.

    Science.gov (United States)

    Nagamine, Toshihiro; Kawasaki, Yu; Abe, Atsushi; Matsumoto, Shogo

    2008-07-01

    Chromatin structure is strictly regulated during the cell cycle. DNA viruses occasionally disturb the spatial organization of the host cell chromatin due to formation of the viral DNA replication compartment. To examine chromatin behavior in baculovirus-infected cells, we constructed recombinant plasmids expressing fluorescent protein-tagged histone H4 molecules and visualized the intracellular localization of chromatin by their transient expression in live infected cells. Similar to other DNA viruses, the baculovirus Bombyx mori nucleopolyhedrovirus induced marginal relocation of chromatin within the nuclei of BmN cells, simultaneously with expansion of the viral DNA replication compartment, the virogenic stroma (VS). In the late stage of infection, however, the peristromal region (PR), another virus-induced subnuclear compartment, was also excluded from the chromatin-localizing area. Provided that late-gene products such as PR proteins (e.g., envelope proteins of the occlusion-derived virus) were expressed, blockage of viral DNA synthesis failed to inhibit chromatin relocation, despite abrogation of VS expansion. Instead, chromatin became marginalized concomitantly with PR expansion, suggesting that the PR contributes directly to chromatin replacement. In addition, chromatin was excluded from relatively large subnuclear structures that were induced in uninfected cells by cotransfection with four baculovirus genes, ie1, lef3, p143, and hr. Omission of any of the four genes, however, failed to result in formation of the large structures or chromatin exclusion. This correlation between compartmentalization and chromatin exclusion suggests the possibility that a chromatin-exclusive property of viral molecules, at least in part, supports nuclear compartmentalization of virus-infected cells.

  1. Nuclear Marginalization of Host Cell Chromatin Associated with Expansion of Two Discrete Virus-Induced Subnuclear Compartments during Baculovirus Infection▿

    Science.gov (United States)

    Nagamine, Toshihiro; Kawasaki, Yu; Abe, Atsushi; Matsumoto, Shogo

    2008-01-01

    Chromatin structure is strictly regulated during the cell cycle. DNA viruses occasionally disturb the spatial organization of the host cell chromatin due to formation of the viral DNA replication compartment. To examine chromatin behavior in baculovirus-infected cells, we constructed recombinant plasmids expressing fluorescent protein-tagged histone H4 molecules and visualized the intracellular localization of chromatin by their transient expression in live infected cells. Similar to other DNA viruses, the baculovirus Bombyx mori nucleopolyhedrovirus induced marginal relocation of chromatin within the nuclei of BmN cells, simultaneously with expansion of the viral DNA replication compartment, the virogenic stroma (VS). In the late stage of infection, however, the peristromal region (PR), another virus-induced subnuclear compartment, was also excluded from the chromatin-localizing area. Provided that late-gene products such as PR proteins (e.g., envelope proteins of the occlusion-derived virus) were expressed, blockage of viral DNA synthesis failed to inhibit chromatin relocation, despite abrogation of VS expansion. Instead, chromatin became marginalized concomitantly with PR expansion, suggesting that the PR contributes directly to chromatin replacement. In addition, chromatin was excluded from relatively large subnuclear structures that were induced in uninfected cells by cotransfection with four baculovirus genes, ie1, lef3, p143, and hr. Omission of any of the four genes, however, failed to result in formation of the large structures or chromatin exclusion. This correlation between compartmentalization and chromatin exclusion suggests the possibility that a chromatin-exclusive property of viral molecules, at least in part, supports nuclear compartmentalization of virus-infected cells. PMID:18434402

  2. Cochlear nucleus neuron analysis in individuals with presbycusis.

    Science.gov (United States)

    Hinojosa, Raul; Nelson, Erik G

    2011-12-01

    The aim of this study was to analyze the cochlear nucleus neuron population in individuals with normal hearing and presbycusis. Retrospective study of archival human temporal bone and brain stem tissues. Using strict inclusion criteria, the temporal bones and cochlear nuclei from six normal hearing individuals and four individuals with presbycusis were selected for analysis. The spiral ganglion cell population, the cochlear nucleus neuron population, and the cell body size of the neurons were quantified in these cases. A relationship was not observed between age and the spiral ganglion cell population in the normal hearing group. Presbycusis subjects exhibited a reduced spiral ganglion cell population. The mean cochlear nucleus neuron population was observed to be significantly higher in the presbycusis group (mean ± standard deviation: 114,170 ± 10,570) compared to the normal hearing group (91,470 ± 9,510) (P = .019). This difference was predominantly the result of greater multipolar and granule cell neuron populations. Only the fusiform neuron type exhibited a significantly different mean cell body cross-sectional area between the normal hearing group (242 ± 27) and the presbycusis group (300 ± 37) (P = .033). This investigation is the first time, to our knowledge, that the populations of the eight neuron types in the cochlear nucleus have been quantified in both normal hearing individuals and individuals with presbycusis. The data support the concept that presbycusis is not an effect of aging alone but instead may be a condition that predisposes one to hearing loss with advancing age and is characterized by a congenitally elevated cochlear nucleus neuron population. Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.

  3. Intestinal Neuronal Dysplasia-Like Submucosal Ganglion Cell Hyperplasia at the Proximal Margins of Hirschsprung Disease Resections.

    Science.gov (United States)

    Swaminathan, Maya; Oron, Assaf P; Chatterjee, Sumantra; Piper, Hannah; Cope-Yokoyama, Sandy; Chakravarti, Aravinda; Kapur, Raj P

    2015-01-01

    Intestinal neuronal dysplasia type B (IND) denotes an increased proportion of hyperplastic submucosal ganglia, as resolved histochemically in 15-μm-thick frozen sections. IND has been reported proximal to the aganglionic segment in patients with Hirschsprung disease (HSCR) and is putatively associated with a higher rate of postsurgical dysmotility. We developed and validated histological criteria to diagnose IND-like submucosal ganglion cell hyperplasia (IND-SH) in paraffin sections and used the approach to study the incidence and clinical and/or genetic associations of IND-SH at the proximal margins of HSCR pull-through resection specimens. Full-circumference paraffin sections from the proximal margins of 64 HSCR colonic pull-through specimens and 24 autopsy controls were immunostained for neuron-specific Hu antigen, and nucleated ganglion cells in each submucosal ganglion were counted. In controls, an age-related decline in the relative abundance of "giant" ganglia (≥7 nucleated Hu-positive [Hu+] ganglion cells) was observed. A conservative diagnostic threshold for IND-SH (control mean ± 3× standard deviation) was derived from 15 controls less than 25 weeks of age. No control exceeded this threshold, whereas in the same age range, IND-SH was observed at the proximal margins in 15% (7 of 46) of HSCR resections, up to 15 cm proximal to the aganglionic segment. No significant correlation was observed between IND-SH and length of or distance from the aganglionic segment, sex, trisomy 21, RET or SEMA3C/D polymorphisms, or clinical outcome, but analysis of more patients, with better long-term follow-up will be required to clarify the significance of this histological phenotype.

  4. Primary Endobronchial Marginal Zone B-Cell Lymphoma of Bronchus-Associated Lymphoid Tissue: CT Findings in 7 Patients

    Science.gov (United States)

    Yoon, Ra Gyoung; Song, Jae Woo; Chae, Eun Jin; Choi, Chang Min; Jang, SeJin

    2013-01-01

    Objective To investigate CT and 18F-flurodeoxyglucose (18F-FDG) positron-emission tomography/CT findings of primary endobronchial marginal zone B-cell lymphoma of the bronchus-associated lymphoid tissue (BALT). Materials and Methods From June 2006 through April 2012, seven patients (six female, one male; age range, 21-61 years; mean age, 49 years) were examined who were pathologically diagnosed with the primary endobronchial marginal zone B-cell lymphoma of BALT. We evaluated the locations and characteristics of the lesions on CT and 18F-FDG-PET/CT scans. The lesions were classified into the following three patterns: 1) solitary intraluminal nodule; 2) several tiny nodular protrusions; and 3) diffuse wall thickening. Results A solitary intraluminal nodule was observed in four patients (57.1%), several tiny nodular protrusion in two patients (28.6%), and diffuse wall thickening in one patient (14.3%). The lesions were categorized into 3 major locations: confined to the trachea (n = 3), confined to the lobar bronchus (n = 2), and diffuse involvement of the trachea and both main bronchi (n = 2). All lesions demonstrated homogeneous iso-attenuation as compared with muscle on pre- and post-enhancement scans. Secondary findings in the lungs (n = 3; 42.9%) included postobstructive lobar atelectasis (n = 1), air trapping (n = 1), and pneumonia (n = 1). On 18F-FDG-PET/CT (n = 5), 4 lesions showed homogeneous uptake with maximum standardized uptake values (mSUV), ranging 2.3-5.7 (mean mSUV: 3.3). One lesion showed little FDG uptake. Conclusion Primary endobronchial marginal zone B-cell lymphoma of the BALT manifests as three distinct patterns on CT, with the solitary intraluminal nodule presenting as the main pattern. Most lesions demonstrate homogeneous but weak FDG uptake on 18F-FDG-PET/CT. PMID:23483549

  5. Primary endobronchial marginal zone B-cell lymphoma of bronchus-associated lymphoid tissue: CT findings 7 patients

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Ra Gyoung; Kim, Mi Young; Song, Jae Woo; Chae, Eun Jin; Choi, Chang Min; Jang, Se Jin [University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2013-04-15

    To investigate CT and 1{sup 8F}-fluorodeoxyglucose (1{sup 8F}-FDG) positron-emission tomography/CT findings of primary endobronchial marginal zone B-cell lymphoma of the bronchus-associated lymphoid tissue (BALT). From June 2006 through April 2012, seven patients (six female, one male; age range, 21-61 years; mean age, 49 years) were examined who were pathologically diagnosed with the primary endobronchial marginal zone B-cell lymphoma of BALT. We evaluated the locations and characteristics of the lesions on CT and 1{sup 8F}-FDG-PET/CT scans. The lesions were classified into the following three patterns: 1) solitary intraluminal nodule; 2) several tiny nodular protrusions; and 3) diffuse wall thickening. A solitary intraluminal nodule was observed in four patients (57.1%), several tiny nodular protrusion in two patients (28.6%), and diffuse wall thickening in one patient (14.3%). The lesions were categorized into 3 major locations: confined to the trachea (n 3), confined to the lobar bronchus (n = 2), and diffuse involvement of the trachea and both main bronchi (n = 2). All lesions demonstrated homogeneous iso-attenuation as compared with muscle on pre- and post-enhancement scans. Secondary findings in the lungs (n = 3; 42.9%) included postobstructive lobar atelectasis (n = 1), air trapping (n = 1), and pneumonia (n = 1). On 1{sup 8F}-FDG-PET/CT (n = 5), 4 lesions showed homogeneous uptake with maximum standardized uptake values (mSUV), ranging 2.3-5.7 (mean mSUV: 3.3). One lesion showed little FDG uptake. Primary endobronchial marginal zone B-cell lymphoma of the BALT manifests as three distinct patterns on CT, with the solitary intraluminal nodule presenting as the main pattern. Most lesions demonstrate homogeneous but weak FDG uptake on 1{sup 8F}-FDG-PET/CT.

  6. A study on the cochlear view in multichannel cochlear implantees

    Energy Technology Data Exchange (ETDEWEB)

    Kweon, Dae Cheol; Kim, Jeong Hee; Kim, Seong Lyong; Kim, Hae Seong; Lee, Yong Woo [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of)

    1999-04-01

    Cochlear implant poses a contraindication to the magnetic resonance imaging(MRI) process, because MRI generates artifacts, inducing an electrical current and causing device magnetization. CT is relatively expensive and the metal electrodes scatter the image. Post-implantation radiological studies using anterior-posterior transorbital, submental-vertex and lateral views, the intracochlear electrodes are not well displayed. Therefore, the authors developed a special view, which we call the cochlear view. The patient is sitting in front of a vertical device. Then the midsagittal plane is adjusted to form an angle of 15 .deg. , 30 .deg. , and 45 .deg. with the film. The flexion of the neck is adjusted to make the infraorbitomeatal line(IOML) is parallel with the transverse axis of the film. The central ray is directed to exit from the skull at point which is 3.0 cm anterior and 2.0 cm superior to the EAM(external auditory meatus). Results have shown that single radiography of the cochlear view provides sufficient information to demonstrate the position of the electrodes array and the depth of insertion in cochlear. Radiography of the cochlear view in angle of 45 .deg. is an excellent image. The cochlear view gives the greatest amount of medical information with the least radiation and lowest medical cost. It can be widely used in all cochlear implant clinics.

  7. Receptor Activator of NF-κB Orchestrates Activation of Antiviral Memory CD8 T Cells in the Spleen Marginal Zone

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    Mohamed Habbeddine

    2017-11-01

    Full Text Available The spleen plays an important role in protective immunity to bloodborne pathogens. Macrophages and dendritic cells (DCs in the spleen marginal zone capture microbial antigens to trigger adaptive immune responses. Marginal zone macrophages (MZMs can also act as a replicative niche for intracellular pathogens, providing a platform for mounting the immune response. Here, we describe a role for RANK in the coordinated function of antigen-presenting cells in the spleen marginal zone and triggering anti-viral immunity. Targeted deletion of RANK results in the selective loss of CD169+ MZMs, which provide a niche for viral replication, while RANK signaling in DCs promotes the recruitment and activation of anti-viral memory CD8 T cells. These studies reveal a role for the RANKL/RANK signaling axis in the orchestration of protective immune responses in the spleen marginal zone that has important implications for the host response to viral infection and induction of acquired immunity.

  8. Natural History Study of Monoclonal B Cell Lymphocytosis (MBL), Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma (CLL/SLL), Lymphoplasmacytic Lymphoma (LPL)/Waldenstrom Macroglobulinemia (WM), and Splenic Marginal Zone Lymphoma (SMZL)

    Science.gov (United States)

    2018-01-09

    B-Cell Chronic Lymphocytic Leukemia; Monoclonal B-Cell Lymphocytosis; Lymhoma, Small Lymphocytic; Chronic Lymphocytic Leukemia; Lymphoplasmacytic Lymphoma; Waldenstrom Macroglobulinemia; Splenic Marginal Zone Lymphoma

  9. gp49B-mediated negative regulation of antibody production by memory and marginal zone B cells.

    Science.gov (United States)

    Fukao, Saori; Haniuda, Kei; Nojima, Takuya; Takai, Toshiyuki; Kitamura, Daisuke

    2014-07-15

    The rapid Ab responses observed after primary and secondary immunizations are mainly derived from marginal zone (MZ) and memory B cells, respectively, but it is largely unknown how these responses are negatively regulated. Several inhibitory receptors have been identified and their roles have been studied, but mainly on follicular B cells and much less so on MZ B, and never on memory B cells. gp49B is an Ig superfamily member that contains two ITIMs in its cytoplasmic tail, and it has been shown to negatively regulate mast cell, macrophage, and NK cell responses. In this study, we demonstrate that gp49B is preferentially expressed on memory and MZ B cells. We show that gp49B(-/-) mice produce more IgM after a primary immunization and more IgM and IgG1 after a secondary immunization than gp49B(+/+) mice in T cell-dependent immune responses. Memory and MZ B cells from gp49B(-/-) mice also produce more Abs upon in vitro stimulation with CD40 than those from gp49B(+/+) mice. The in vitro IgM production by MZ B cells from gp49B(+/+), but not gp49B(-/-), mice is suppressed by interaction with a putative gp49B ligand, the integrin αvβ3 heterodimer. In addition, gp49B(-/-) mice exhibited exaggerated IgE production in the memory recall response. These results suggest that plasma cell development from memory and MZ B cells, as well as subsequent Ab production, are suppressed via gp49B. In memory B cells, this suppression also prevents excessive IgE production, thus curtailing allergic diseases. Copyright © 2014 by The American Association of Immunologists, Inc.

  10. A review: Cochlear implants

    OpenAIRE

    Batman, Ç.; Üneri, C.; Şehitoijlu, M.A.

    1991-01-01

    Electrical stimulation of the auditory system in deaf individuals has been first explained in 1935 by Andreev et al. and in 1940 by Jones et al, resulting in sensation of hearing (1,2). These attempts are facilitated by Djourno et al who first implanted electrical devices in two subjects in 1957 (3). But this type of stimulation has been a controversy until 1974, when cochlear implant was successfully implanted by W.F. House. Since that time over 5000 individuals have been implanted with a va...

  11. CD5-positive marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT of the lung

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    Terada Tadashi

    2012-02-01

    Full Text Available Abstract CD5-positive marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT of the lung is very rare. An 82-year-old Japanese woman was found to have an abnormal lung shadow on chest X-ray photography, and was admitted to our hospital. Imaging modalities including X-ray photography, computed tomography, and magnetic resonance imaging showed a small (2 × 1 × 1 cm opacity of the right upper lobe. Transbronchial lung biopsy was performed. It showed severe proliferation of small lymphocytes. The small lymphocytes were centrocytes-like, and minor plasma cell differentiation was recognized. Lymphoepithelial lesions were scattered. Immunohistochemically, the tumor cells were positive for CD5, CD20, CD43, CD45, CD79α, bcl-2, and κ-chain, but negative for CD2, CD3, CD10, CD21, CD23, CD35, CD45RO, CD56, IgA, IgG, IgM, IgD, λ-chain, TdT, and cyclin D1. The Ki-67 labeling was 10%. CD3-positive and CD45RO-positive inflammatory T-cells were scattered in small amount. The pathological diagnosis was CD5-positive marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT of the lung. The patient was treated with chemotherapy (CHOP: cyclophosphamide, hydroxydaunorbicin, vincristine, and predonisone, and the lung tumor disappeared. The patient is now free of the lymphoma 10 years after the first manifestation. Virtual slides The virtual slide(s for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1541653085652296

  12. COCHLEAR IMPLANTATION PREVALENCE IN ELDERLY

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    A. V. Starokha

    2014-01-01

    Full Text Available Current paper describes an experience of cochlear implantation in elderly. Cochlear implantation has become a widely accepted intervention in the treatment of individuals with severe-to-profound sensorineural hearing loss. Cochlear implants are now accepted as a standard of care to optimize hearing and subsequent speech development in children and adults with deafness. But cochlear implantation affects not only hearing abilities, speech perception and speech production; it also has an outstanding impact on the social life, activities and self-esteem of each patient. The aim of this study was to evaluate the cochlear implantation efficacy in elderly with severe to profound sensorineural hearing loss. There were 5 patients under our observation. Surgery was performed according to traditional posterior tympanotomy and cochleostomy for cochlear implant electrode insertion for all observed patients. The study was conducted in two stages: before speech processor’s activation and 3 months later. Pure tone free field audiometry was performed to each patient to assess the efficiency of cochlear implantation in dynamics. The aim of the study was also to evaluate quality of life in elderly with severe to profound sensorineural hearing loss after unilateral cochlear implantation. Each patient underwent questioning with 36 Item Short Form Health Survey (SF-36. SF-36 is a set of generic, coherent, and easily administered quality-of-life measures. The SF-36 consists of eight scaled scores, which are the weighted sums of the questions in their section. Each scale is directly transformed into a 0-100 scale on the assumption that each question carries equal weight. The eight sections are: physical functioning; physical role functioning; emotional role functioning; vitality; emotional well-being; social role functioning; bodily pain; general health perceptions. Our results demonstrate that cochlear implantation in elderly consistently improved quality of life

  13. Altered expression of epithelial cell surface glycoconjugates and intermediate filaments at the margins of mucosal wounds

    DEFF Research Database (Denmark)

    Dabelsteen, Erik; Grøn, B; Mandel, U

    1998-01-01

    Alterations in cell to cell adhesion are necessary to enable the type of cell movements that are associated with epithelial wound healing and malignant invasion. Several studies of transformed cells have related epithelial cell movement to changes in the cell surface expression of the carbohydrate...... structures represented by the ABO blood group antigens and, in particular, by Lewis antigens and their biosynthetic precursors. To study further the relationship between cell surface carbohydrates and keratinocyte cell movement, experimental wounds were created in human oral mucosa and examined......-T antigen. The changes induced by wounding in the expression of collagen IV, laminin gamma2-chain (laminin-5), and laminin alpha5-chain were similar to those found in skin wounds and served to define the region of epithelial movement. This region was found to show a marked increase in staining for both...

  14. Gross examination by the surgeon as an alternative to frozen section for assessment of adequacy of surgical margin in head and neck squamous cell carcinoma.

    Science.gov (United States)

    Chaturvedi, Pankaj; Datta, Sourav; Nair, Sudhir; Nair, Deepa; Pawar, Prashant; Vaishampayan, Sagar; Patil, Asawari; Kane, Shubhada

    2014-04-01

    The cost-effectiveness of the frozen section for assessment of margin in head and neck squamous cell carcinoma (HNSCC) is still contentious. The purpose of this study was to evaluate whether gross examination of margin is an alternative to frozen section. It was a prospective observational study in 145 consecutive patients undergoing surgery for HNSCC. Surgical margins were first assessed by the surgeons with a metallic scale. All specimens were then examined using frozen section and permanent section. Overall, 83% of inadequate margins were detected by frozen section. The chances of inadequate margin were very low if gross surgical margin were 7 mm or more. Gross examination alone (with 7 mm as cutoff) predicted 88% of the inadequate surgical margin. There was no difference in precision of frozen section vis-à-vis gross examination with 7 mm cut off (p ≤ .8). Achievement of 7 mm surgical margin measured by a surgeon obviates the need for frozen section. Copyright © 2013 Wiley Periodicals, Inc.

  15. The olivocochlear reflex strength and cochlear sensitivity are independently modulated by auditory cortex microstimulation.

    Science.gov (United States)

    Dragicevic, Constantino D; Aedo, Cristian; León, Alex; Bowen, Macarena; Jara, Natalia; Terreros, Gonzalo; Robles, Luis; Delano, Paul H

    2015-04-01

    In mammals, efferent projections to the cochlear receptor are constituted by olivocochlear (OC) fibers that originate in the superior olivary complex. Medial and lateral OC neurons make synapses with outer hair cells and with auditory nerve fibers, respectively. In addition to the OC system, there are also descending projections from the auditory cortex that are directed towards the thalamus, inferior colliculus, cochlear nucleus, and superior olivary complex. Olivocochlear function can be assessed by measuring a brainstem reflex mediated by auditory nerve fibers, cochlear nucleus neurons, and OC fibers. Although it is known that the OC reflex is activated by contralateral acoustic stimulation and produces a suppression of cochlear responses, the influence of cortical descending pathways in the OC reflex is largely unknown. Here, we used auditory cortex electrical microstimulation in chinchillas to study a possible cortical modulation of cochlear and auditory nerve responses to tones in the absence and presence of contralateral noise. We found that cortical microstimulation produces two different peripheral modulations: (i) changes in cochlear sensitivity evidenced by amplitude modulation of cochlear microphonics and auditory nerve compound action potentials and (ii) enhancement or suppression of the OC reflex strength as measured by auditory nerve responses, which depended on the intersubject variability of the OC reflex. Moreover, both corticofugal effects were not correlated, suggesting the presence of two functionally different efferent pathways. These results demonstrate that auditory cortex electrical microstimulation independently modulates the OC reflex strength and cochlear sensitivity.

  16. Protective role of hydrogen sulfide against noise-induced cochlear damage: a chronic intracochlear infusion model.

    Directory of Open Access Journals (Sweden)

    Xu Li

    Full Text Available BACKGROUND: A reduction in cochlear blood flow plays an essential role in noise-induced hearing loss (NIHL. The timely regulation of cochlear perfusion determines the progression and prognosis of NIHL. Hydrogen sulfide (H(2S has attracted increasing interest as a vasodilator in cardiovascular systems. This study identified the role of H(2S in cochlear blood flow regulation and noise protection. METHODOLOGY/PRINCIPAL FINDINGS: The gene and protein expression of the H(2S synthetase cystathionine-γ-lyase (CSE in the rat cochlea was examined using immunofluorescence and real-time PCR. Cochlear CSE mRNA levels varied according to the duration of noise exposure. A chronic intracochlear infusion model was built and artificial perilymph (AP, NaHS or DL-propargylglycine (PPG were locally administered. Local sodium hydrosulfide (NaHS significantly increased cochlear perfusion post-noise exposure. Cochlear morphological damage and hearing loss were alleviated in the NaHS group as measured by conventional auditory brainstem response (ABR, cochlear scanning electron microscope (SEM and outer hair cell (OHC count. The highest percentage of OHC loss occurred in the PPG group. CONCLUSIONS/SIGNIFICANCE: Our results suggest that H(2S plays an important role in the regulation of cochlear blood flow and the protection against noise. Further studies may identify a new preventive and therapeutic perspective on NIHL and other blood supply-related inner ear diseases.

  17. Transmitter release from cochlear hair cells is phase-locked to cyclic stimuli of different intensities and frequencies

    Science.gov (United States)

    2013-01-01

    The auditory system processes time and intensity through separate brainstem pathways to derive spatial location as well as other salient features of sound. The independent coding of time and intensity begins in the cochlea where afferent neurons can fire action potentials at constant phase throughout a wide range of stimulus intensities. We have investigated time and intensity coding by simultaneous pre- and post-synaptic recording at the hair cell-afferent synapse from rats. Trains of depolarizing steps to the hair cell were used to elicit postsynaptic currents that occurred at constant phase, for a range of membrane potentials over which release probability varied significantly. To probe the underlying mechanisms, release was examined using single steps to various command voltages. As expected for vesicular release, first synaptic events occurred earlier as presynaptic calcium influx grew larger. However, synaptic depression produced smaller responses with longer first latencies. Thus, during repetitive hair cell stimulation, as the hair cell is more strongly depolarized, increased calcium channel gating hurries transmitter release, but the resulting vesicular depletion produces a compensatory slowing. Quantitative simulation of ribbon function shows that these two factors varied reciprocally with hair cell depolarization (stimulus intensity) to produce constant synaptic phase. Finally, we propose that the observed rapid vesicle replenishment would help maintain the vesicle pool, which in turn would equilibrate with the stimulus intensity (and therefore, the number of open Ca2+ channels), so for trains of different levels the average phase will be conserved. PMID:23175853

  18. Co-administration of Cisplatin and Furosemide Causes Rapid and Massive Loss of Cochlear Hair Cells in Mice

    Science.gov (United States)

    Li, Yongqi; Ding, Dalian; Jiang, Haiyan; Fu, Yong

    2011-01-01

    The expanding arsenal of transgenic mice has created a powerful tool for investigating the biological mechanisms involved in ototoxicity. However, cisplatin ototoxicity is difficult to investigate in mice because of their small size and vulnerability to death by nephrotoxicity. To overcome this problem, we developed a strategy for promoting cisplatin-induced ototoxicity by coadministration of furosemide a loop diuretic. A dose–response study identified 200 mg/kg of furosemide as the optimal dose for disrupting the stria vascularis and opening the blood–ear barrier. Our analysis of stria pathology indicated that the optimal period for administering cisplatin was 1 h after furosemide treatment. Combined treatment with 0.5 mg/kg of cisplatin and 200 mg/kg furosemide resulted in only moderate loss of outer hair cells in the basal 20% of the cochlea, only mild threshold shifts and minimal loss of distortion product otoacoustic emission (DPOAE). In contrast, 1 mg/kg of cisplatin plus 200 mg/kg of furosemide resulted in a permanent 40–50 dB elevation of auditory brainstem response thresholds, almost complete elimination of DPOAE, and nearly total loss of outer hair cells. The widespread outer hair cell lesions that develop in mice treated with cisplatin plus furosemide could serve as extremely useful murine model for investigating techniques for regenerating outer hair cells, studying the mechanisms of cisplatin and furosemide ototoxicity and assessing the perceptual and electrophysiological consequences of outer hair cell loss on central auditory plasticity. PMID:21455790

  19. Extranodal marginal zone B cell lymphoma: An unexpected complication in children with Sjögren's syndrome.

    Science.gov (United States)

    Collado, Paz; Kelada, Aml; Cámara, Maria; Zeft, Andrew; Flagg, Aron

    2017-03-08

    Sjögren's syndrome (SS) is a systemic autoimmune disease characterized by the infiltration of lymphocytes into exocrine glands, resulting in the typical sicca symptoms. Unlike adults, primary SS is a very rare condition in childhood, and the risk of malignancy in juvenile SS (JSS) has not been defined. We report the detection of extranodal marginal zone B-cell lymphoma (EMZL) occurring in two children with SS. Fine needle aspiration of the salivary glands (SG) showed nonspecific findings that led to delayed diagnosis of SS. The diagnosis of B-cell lymphoma associated with JSS was based on morphologic and immunohistochemical staining done during the biopsy. To highlight awareness of EMZL as a timely and appropriate update of an unusual complication in children with SS. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  20. Bilateral Bronchiectasis as a Presentation Form of Pulmonary Marginal Zone B-Cell Lymphoma of Bronchus Associated Lymphoid Tissue

    Directory of Open Access Journals (Sweden)

    Glenda Ernst

    2015-01-01

    Full Text Available The pulmonary marginal zone B-cell lymphoma of bronchus associated lymphoid tissue of the lung (BALT is a rare illness that can remain without symptoms. Radiological findings of pulmonary lymphoma are heterogeneous. In literature, bronchiectasis is only described in one patient who also had besides adenomegalies. We reported on a 48-year-old female patient. She showed symptoms consistent with dyspnea with productive cough; there were crepitant sounds in the auscultation. Pulmonary functional test has shown a severe restrictive pattern with a low FVC and DLCO. CT scan showed bronchiectasis in the medium lobule without adenomegalies. Echocardiogram was normal, and the laboratory findings only showed leukocytosis. There were no findings in the bronchoscopy, but the lung biopsy showed a B-cell pulmonary lymphoma (positive to CD20 and CD79a in immunostaining. A wide variety of radiological manifestations has been previously described; however, we have presented this rare case, with bronchiectasis, as unique radiological finding.

  1. Rosmarinic acid, active component of Dansam-Eum attenuates ototoxicity of cochlear hair cells through blockage of caspase-1 activity.

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    Hyun-Ja Jeong

    Full Text Available Cisplatin causes auditory impairment due to the apoptosis of auditory hair cells. There is no strategy to regulate ototoxicity by cisplatin thus far. Dansam-Eum (DSE has been used for treating the central nerve system injury including hearing loss in Korea. However, disease-related scientific investigation by DSE has not been elucidated. Here, we demonstrated that DSE and its component rosmarinic acid (RA were shown to inhibit apoptosis of the primary organ of Corti explants as well as the auditory cells. Administration of DSE and RA reduced the thresholds of the auditory brainstem response in cisplatin-injected mice. A molecular docking simulation and a kinetic assay show that RA controls the activity of caspase-1 by interaction with the active site of caspase-1. Pretreatment of RA inhibited caspase-1 downstream signal pathway, such as the activation of caspase-3 and 9, release of cytochrome c, translocation of apoptosis-inducing factor, up-regulation of Bax, down-regulation of Bcl-2, generation of reactive oxygen species, and activation of nuclear factor-κB. Anticancer activity by cisplatin was not affected by treatment with RA in SNU668, A549, HCT116, and HeLa cells but not B16F10 cells. These findings show that blocking a critical step by RA in apoptosis may be useful strategy to prevent harmful side effects of ototoxicity in patients with having to undergo chemotherapy.

  2. Cochlear injury and adaptive plasticity of the auditory cortex

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    ANNA R. eFETONI

    2015-02-01

    Full Text Available Growing evidence suggests that cochlear stressors as noise exposure and aging can induce homeostatic/maladaptive changes in the central auditory system from the brainstem to the cortex. Studies centered on such changes have revealed several mechanisms that operate in the context of sensory disruption after insult (noise trauma, drug- or age-related injury. The oxidative stress is central to current theories of induced sensory neural hearing loss and aging, and interventions to attenuate the hearing loss are based on antioxidant agent. The present review addresses the recent literature on the alterations in hair cells and spiral ganglion neurons due to noise-induced oxidative stress in the cochlea, as well on the impact of cochlear damage on the auditory cortex neurons. The emerging image emphasizes that noise-induced deafferentation and upward spread of cochlear damage is associated with the altered dendritic architecture of auditory pyramidal neurons. The cortical modifications may be reversed by treatment with antioxidants counteracting the cochlear redox imbalance. These findings open new therapeutic approaches to treat the functional consequences of the cortical reorganization following cochlear damage.

  3. Hyperbaric oxygen upregulates cochlear constitutive nitric oxide synthase

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    Kao Ming-Ching

    2011-02-01

    Full Text Available Abstract Background Hyperbaric oxygen therapy (HBOT is a known adjuvant for treating ischemia-related inner ear diseases. Controversies still exist in the role of HBOT in cochlear diseases. Few studies to date have investigated the cellular changes that occur in inner ears after HBOT. Nitric oxide, which is synthesized by nitric oxide synthase (NOS, is an important signaling molecule in cochlear physiology and pathology. Here we investigated the effects of hyperbaric oxygen on eardrum morphology, cochlear function and expression of NOS isoforms in cochlear substructures after repetitive HBOT in guinea pigs. Results Minor changes in the eardrum were observed after repetitive HBOT, which did not result in a significant hearing threshold shift by tone burst auditory brainstem responses. A differential effect of HBOT on the expression of NOS isoforms was identified. Upregulation of constitutive NOS (nNOS and eNOS was found in the substructures of the cochlea after HBOT, but inducible NOS was not found in normal or HBOT animals, as shown by immunohistochemistry. There was no obvious DNA fragmentation present in this HBOT animal model. Conclusions The present evidence indicates that the customary HBOT protocol may increase constitutive NOS expression but such upregulation did not cause cell death in the treated cochlea. The cochlear morphology and auditory function are consequently not changed through the protocol.

  4. Distinctive Features of the Human Marginal Zone and Cajal-Retzius Cells: Comparison of Morphological and Immunocytochemical Features at Midgestation.

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    Lyubov Aleksandrovna Tkachenko

    2016-03-01

    Full Text Available Despite a long history of research of cortical marginal zone (MZ organization and development, a number of issues remain unresolved. One particular issue is the problem of Cajal-Retzius cells (C‑R identification. It is currently based on morphology and Reelin expression. The aim of this research is to investigate MZ cytoarchitectonics and Reelin-producing cells morphotypes in the superior temporal, pre- and postcentral cortex at GW24-26. We used Reelin (Reln as the marker for Cajal-Retzius cells and microtubule-associated protein 2 (MAP2 and neurofilament heavy chain protein (N200 as markers of neuronal maturation. The MZ of all of the investigated areas had the distinct cytoarchitectonic of alternating cell sparse (MZP, SR and cell dense (SGL, DGL layers. The distribution of the neuromarkers across the MZ also showed layer specificity. MAP2-positive cells were only found in the SGL. N200 and Reelin-positive neurons in the MZP. N200-positive processes were forming a plexus at the DGL level. All of the N200-positive neurons found were in the MZP and had distinctive morphological features of C‑R cells. All of the N200-positive neurons in MZ were also positive for Reelin, whereas MAP2-positive cells lack Reelin. Thus, the joint use of two immunomarkers allowed us to discern the C‑R cells based on their morphotype and neurochemistry and indicate that the Reelin-positive cells of MZ at 24-26 GW were morphologically C‑R cells. In the current study, we identified three C‑R cells morphotypes. Using a 3D reconstruction, we made sure that all of them belonged to the single morphotype of triangular C‑R cells. This approach will allow future studies to separate C‑R cells from other Reelin-producing neurons which appear at later corticogenesis stages. In addition, our findings support the assumption that a plexus could be formed not only with C‑R cells processes but also possibly by other cell processes by the poorly researched DGL, which is

  5. Radiotherapy for marginally resected, unresectable or recurrent giant cell tumor of the bone: a rare cancer network study

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    Robert C. Miller

    2011-10-01

    Full Text Available The role of radiotherapy for local control of marginally resected, unresectable, and recurrent giant cell tumors of bone (GCToB has not been well defined. The number of patients affected by this rare disease is low. We present a series of 58 patients with biopsy proven GCToB who were treated with radiation therapy. A retrospective review of the role of radiotherapy in the treatment of GCToB was conducted in participating institutions of the Rare Cancer Network. Eligibility criteria consisted of the use of radiotherapy for marginally resected, unresectable, and recurrent GCToB. Fifty-eight patients with biopsy proven GCToB were analyzed from 9 participating North American and European institutions. Forty-five patients had a primary tumor and 13 patients had a recurrent tumor. Median radiation dose was 50 Gy in a median of 25 fractions. Indication for radiation therapy was marginal resection in 33 patients, unresectable tumor in 13 patients, recurrence in 9 patients and palliation in 2 patients. Median tumor size was 7.0 cm. A significant proportion of the tumors involved critical structures. Median follow- up was 8.0 years. Five year local control was 85% . Of the 7 local failures, 3 were treated successfully with salvage surgery. All patients who received palliation achieved symptom relief. Five year overall survival was 94%. None of the patients experienced grade 3 or higher acute toxicity. This study reports a large published experience in the treatment of GCToB with radiotherapy. Radiotherapy can provide excellent local control for incompletely resected, unresectable or recurrent GCToB with acceptable morbidity.

  6. Proliferation and differentiation of direct co‑culture of bone marrow mesenchymal stem cells and pigmented cells from the ciliary margin.

    Science.gov (United States)

    Li, Yan; He, Xinzheng; Li, Jun; Ni, Fangfang; Sun, Qingqing; Zhou, Yan

    2017-06-01

    Damage of retinal ganglion cells (RGCs) is the major consequence of glaucoma and regeneration of RGCs is extremely difficult once the damage has occurred. Retinal stem cells (RSCs) are considered an ideal choice for RGC regeneration. Pigmented cells from the ciliary margin (PCMs) have great retinal differentiation potential and may be an ideal RSC candidate. However, the ciliary margin is too small, so the number of cells that can be obtained is limited. Bone marrow‑derived mesenchymal stem cells (BMMSCs) are another type of stem cell that have been previously investigated for RGC regeneration. BMMSCs expand sufficiently, whereas the retinal differentiation of BMMSCs is insufficient. The aim of the present study was to investigate whether the co‑culture of PCMs and BMMSCs may combine the advantages of both cell types to establish a novel and effective stem cell source for RGC regeneration. Primary rat PCMs and BMMSCs were isolated and co‑cultured. Cell growth was observed by an inverted microscope and proliferation was monitored by an MTT assay. Cell cycle analysis was performed by using a flow cytometer, while the expression of the photoreceptor‑specific homeobox gene (cone‑rod homeobox, Crx) was determined by reverse transcription‑quantitative polymerase chain reaction and western blot analysis. In addition, retinal differentiation was confirmed by immunofluorescence staining of major markers of retinal differentiation, including rhodopsin, visual system homeobox 2 and heparin sulfate. The co‑cultured cells expanded successfully, in a similar way to BMMSCs. In addition, the expression of Crx and retinal markers were significantly upregulated following BMMSC and PCM co‑culture. The results of the present study demonstrated that the co‑culture of BMMSCs and PCMs may be used as a source of RSCs.

  7. Complications of cochlear implant surgery

    Directory of Open Access Journals (Sweden)

    Kosanović Rade

    2004-01-01

    Full Text Available During the last several decades, cochlear implant has been fully recognized in treatment of severe hearing loss. Development of modern technology enabled inconceivable possibilities of technical qualities of the device as well as development of usable coding strategies, which led to extraordinary results in patient rehabilitation. Although cochlear implantation has become one of the routine operative procedures throughout the world nowadays, it gives rise to certain complications. These complications, though rare, can sometimes be very serious, even with fatal outcome. If cochlear implantation is performed by experienced and well-educated team of experts, the possibility of complications is minimal and is certainly not the argument against cochlear implantation as a method of treatment of severe hearing impairments.

  8. Complications in cochlear implant surgery.

    Science.gov (United States)

    Gheorghe, D C; Zamfir-Chiru-Anton, A

    2015-01-01

    For the last 6 years, cochlear implantation has become a standard practice in our department. The number of patients rose from 5 to 21/ year. Using multiple types of cochlear implants and indicating the surgery also to malformed inner ears led to the encounter of some complications. to present the surgical complications from our department. all the patients admitted and operated in our clinic have been reviewed. 9 complications (8,86%) have occurred: the impossibility of establishing a reliable cochleostomy (due to ossification), air in the cochlea through lack of sealing of the cochleostomy (exteriorization of the electrode array), cochlear implant postoperative migration from its bed, weak hearing discrimination due to "double electrodes" in the scala tympani, gusher. cochlear implanting needs to respect the technical steps of the surgery and the best technical/ tactical solution has to be found to whatever complications arise in complex or malformed cases!

  9. Chronic hypothyroidism only marginally affects adult-type Leydig cell generation after EDS administration

    NARCIS (Netherlands)

    Rijntjes, E.; Kesteren-Buiting, van A.; Keijer, J.; Teerds, K.J.

    2010-01-01

    Chronic prenatally induced dietary hypothyroidism delays adult-type Leydig cell development, but does not block this process. Using a chemical model to induce hypothyroidism, it was suggested that development of a new population of Leydig cells was completely inhibited following the addition of the

  10. Overexpression of SK2 channels enhances efferent suppression of cochlear responses without enhancing noise resistance.

    Science.gov (United States)

    Maison, Stéphane F; Parker, Lisan L; Young, Lucy; Adelman, John P; Zuo, Jian; Liberman, M Charles

    2007-04-01

    Cochlear hair cells express SK2, a small-conductance Ca(2+)-activated K(+) channel thought to act in concert with Ca(2+)-permeable nicotinic acetylcholine receptors (nAChRs) alpha9 and alpha10 in mediating suppressive effects of the olivocochlear efferent innervation. To probe the in vivo role of SK2 channels in hearing, we examined gene expression, cochlear function, efferent suppression, and noise vulnerability in mice overexpressing SK2 channels. Cochlear thresholds, as measured by auditory brain stem responses and otoacoustic emissions, were normal in overexpressers as was overall cochlear morphology and the size, number, and distribution of efferent terminals on outer hair cells. Cochlear expression levels of SK2 channels were elevated eightfold without striking changes in other SK channels or in the alpha9/alpha10 nAChRs. Shock-evoked efferent suppression of cochlear responses was significantly enhanced in overexpresser mice as seen previously in alpha9 overexpresser mice; however, in contrast to alpha9 overexpressers, SK2 overexpressers were not protected from acoustic injury. Results suggest that efferent-mediated cochlear protection is mediated by other downstream effects of ACh-mediated Ca(2+) entry different from those involving SK2-mediated hyperpolarization and the associated reduction in outer hair cell electromotility.

  11. Cutaneous manifestations of B-cell chronic lymphocytic leukemia associated with Borrelia burgdorferi infection showing a marginal zone B-cell lymphoma-like infiltrate.

    Science.gov (United States)

    Kash, Natalie; Fink-Puches, Regina; Cerroni, Lorenzo

    2011-10-01

    We report on a 69-year-old female patient with specific cutaneous manifestations of B-cell chronic lymphocytic leukemia that arose at the site of erythema chronicum migrans due to Borrelia burgdorferi infection. Histological examination revealed the presence of dense infiltrates of small hyperchromatic lymphocytes admixed with clusters of plasma cells. Immunohistology showed a CD5+/CD20+ phenotype of the lymphocytes and monoclonal expression of kappa immunoglobulin light chain by the plasma cells. Presence of Borrelia DNA was confirmed by polymerase chain reaction studies. The unusual histopathological and phenotypic findings described in this case of cutaneous manifestations of B-cell chronic lymphocytic leukemia associated with Borrelia burgdorferi infection may lead to the misdiagnosis of cutaneous marginal zone B-cell lymphoma.

  12. Handheld optical coherence tomography-reflectance confocal microscopy probe for detection of basal cell carcinoma and delineation of margins

    Science.gov (United States)

    Iftimia, Nicusor; Yélamos, Oriol; Chen, Chih-Shan J.; Maguluri, Gopi; Cordova, Miguel A.; Sahu, Aditi; Park, Jesung; Fox, William; Alessi-Fox, Christi; Rajadhyaksha, Milind

    2017-07-01

    We present a hand-held implementation and preliminary evaluation of a combined optical coherence tomography (OCT) and reflectance confocal microscopy (RCM) probe for detecting and delineating the margins of basal cell carcinomas (BCCs) in human skin in vivo. A standard OCT approach (spectrometer-based) with a central wavelength of 1310 nm and 0.11 numerical aperture (NA) was combined with a standard RCM approach (830-nm wavelength and 0.9 NA) into a common path hand-held probe. Cross-sectional OCT images and enface RCM images are simultaneously displayed, allowing for three-dimensional microscopic assessment of tumor morphology in real time. Depending on the subtype and depth of the BCC tumor and surrounding skin conditions, OCT and RCM imaging are able to complement each other, the strengths of each helping overcome the limitations of the other. Four representative cases are summarized, out of the 15 investigated in a preliminary pilot study, demonstrating how OCT and RCM imaging may be synergistically combined to more accurately detect BCCs and more completely delineate margins. Our preliminary results highlight the potential benefits of combining the two technologies within a single probe to potentially guide diagnosis as well as treatment of BCCs.

  13. Cochlear implants and medical tourism.

    Science.gov (United States)

    McKinnon, Brian J; Bhatt, Nishant

    2010-09-01

    To compare the costs of medical tourism in cochlear implant surgery performed in India as compared to the United States. In addition, the cost savings of obtaining cochlear implant surgery in India were compare d to those of other surgical interventions obtained as a medical tourist. Searches were conducted on Medline and Google using the search terms: 'medical tourism', 'medical offshoring', 'medical outsourcing', 'cochlear implants' and 'cochlear implantation'. The information regarding cost of medical treatment was obtained from personal communication with individuals familiar with India's cochlear implantation medical tourism industry. The range of cost depended on length of stay as well as the device chosen. Generally the cost, inclusive of travel, surgery and device, was in the range of $21,000-30,000, as compared to a cost range of $40,000-$60,000 in the US. With the escalating cost of healthcare in the United States, it is not surprising that some patients would seek to obtain surgical care overseas at a fraction of the cost. Participants in medical tourism often have financial resources, but lack health insurance coverage. While cardiovascular and orthopedic surgery performed outside the United States in India at centers that cater to medical tourists are often performed at one-quarter to one-third of the cost that would have been paid in the United States, the cost differential for cochlear implants is not nearly as favorable.

  14. Optical coherence tomography for margin definition of basal cell carcinoma before micrographic surgery-recommendations regarding the marking and scanning technique.

    Science.gov (United States)

    De Carvalho, N; Schuh, S; Kindermann, N; Kästle, R; Holmes, J; Welzel, J

    2017-10-23

    Mohs Micrographic Surgery (MMS) is the preferred therapeutic treatment for high-risk basal cell carcinoma (BCC). Optical Coherence Tomography (OCT) is a non-invasive imaging technique that enables the diagnosis of BCC. We thought to determine the margins of BCCs with OCT, prior to MMS, to reduce the number of surgical steps. Different permanent markers were tested on the skin regarding line width, resistance against disinfection and brightness in the OCT image. The visible tumor margins of BCCs were defined by dermoscopy, adding a safety margin of 2 mm and labeled using the selected pen, causing a signal shadow in OCT. Scans of the center and of entire margin were performed. If parts of the BCC were visible outside the margin, another 2 mm were added and the scan was repeated until the tissue outside the labeling looked tumor free. Eight out of ten BCCs were totally excised in a single stage when margin delineation was done by OCT. Macroscopic margins were enlarged after OCT scanning in four patients, saving further stages of MMS. OCT may help to better define the microscopic dimensions of BCCs and therefore reduce the number of stages of MMS. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. Bounds for cell entries in contingency tables given marginal totals and decomposable graphs

    OpenAIRE

    Dobra, Adrian; Fienberg, Stephen E.

    2000-01-01

    Upper and lower bounds on cell counts in cross-classifications of nonnegative counts play important roles in a number of practical problems, including statistical disclosure limitation, computer tomography, mass transportation, cell suppression, and data swapping. Some features of the Fréchet bounds are well known, intuitive, and regularly used by those working on disclosure limitation methods, especially those for two-dimensional tables. We previously have describ...

  16. Influence of erythrocyte aggregation at pathological levels on cell-free marginal layer in a narrow circular tube.

    Science.gov (United States)

    Namgung, Bumseok; Sakai, Hiromi; Kim, Sangho

    2015-01-01

    Human red blood cells (RBCs) were perfused in a circular micro-tube (inner diameter of 25 μm) to examine the dynamic changes of cell-free marginal region at both physiological (normal) and pathophysiological (hyper) levels of RBC aggregation. The cell-free area (CFA) was measured to provide additional information on the cell-free layer (CFL) width changes in space and time domains. A prominent enhancement in the mean CFL width was found in hyper-aggregating conditions as compared to that in non-aggregating conditions (P <  0.001). The frequent contacts between RBC and the tube wall were observed and the contact frequency was greatly decreased when the aggregation level was increased from none to normal (P <  0.05) and to hyper (P <  0.001) levels. In addition, the enhanced aggregation from none to hyper levels significantly enlarged the CFA (P <  0.01). We concluded that the RBC aggregation at pathophysiological levels could promote not only the CFL width (one-dimensional parameter) but also the spatiotemporal variation of CFA (two-dimensional parameter).

  17. Real-Time Intracochlear Electrocochleography Obtained Directly Through a Cochlear Implant.

    Science.gov (United States)

    Harris, Michael S; Riggs, William Jason; Koka, Kanthaiah; Litvak, Leonid M; Malhotra, Prashant; Moberly, Aaron C; O'Connell, Brendan P; Holder, Jourdan; Di Lella, Federico Alberto; Boccio, Carlos Mario; Wanna, George B; Labadie, Robert F; Adunka, Oliver F

    2017-07-01

    Utilizing the cochlear implant to record electrophysiologic responses during device placement is a feasible and efficacious technique for monitoring near real-time cochlear physiology during and following electrode insertion. Minimizing intracochlear trauma during cochlear implantation has emerged as a highly researched area to help improve patient performance. Currently, conventional cochlear implant technology allows for the recording of electrically evoked compound action potentials (eCAPs). Acoustically evoked potentials may be more sensitive in detecting physiologic changes occurring as a result of electrode insertion. Electrocochleography obtained from within the cochlea allows hair cell and neural response monitoring along the cochlear spiral at locations where changes most likely would occur. Intracochlear electrocochleography (ECochG) was recorded from the cochlear implant during surgery in 14 subjects. A long acquisition time (54.5 ms), capable of measuring potentials from the low frequency-serving apical region of the cochlea (125 and 500 Hz) was employed. Two distinct intracochlear processing methods were used and compared in obtaining electrophysiologic data. Measureable intracochlear ECochG responses were obtained from all 14 participants. The 1st harmonic distortions (cochlear microphonic and auditory nerve neurophonic) generally increased steadily with electrode insertion. Electrode and frequency scan following insertion revealed that response amplitude varied based on location of recording electrode and frequency of stimulation. Exquisite sensitivity to manipulation during round window muscle packing was demonstrated. Intracochlear ECochG recorded from the electrode array of the cochlear implant is a highly feasible technique that sheds light on cochlear micromechanics during cochlear implant electrode placement.

  18. Is bone marrow biopsy always indicated in patients with primary cutaneous marginal zone B-cell lymphoma?

    Science.gov (United States)

    Muniesa, C; Hernández-Machín, B

    2013-10-01

    Bone marrow involvement at the time of diagnosis is uncommon in patients with primary cutaneous marginal zone B-cell lymphoma (PCMZL). Moreover, in these patients such involvement is rarely found in isolation on diagnosis. Typically the few patients with PCMZL who have early bone marrow involvement also present secondary nodal or visceral involvement, which is detected by other staging studies (usually computed tomography). In recent years, this has given rise to some debate about whether a bone marrow biopsy should be routinely performed in patients diagnosed with PCMZL in view of the good prognosis and low incidence of bone marrow infiltration and/or extracutaneous involvement in this type of lymphoma. Copyright © 2012 Elsevier España, S.L. and AEDV. All rights reserved.

  19. Racemic alkaloids from the fungus Ganoderma cochlear.

    Science.gov (United States)

    Wang, Xin-Long; Dou, Man; Luo, Qi; Cheng, Li-Zhi; Yan, Yong-Ming; Li, Rong-Tao; Cheng, Yong-Xian

    2017-01-01

    Seven pairs of new alkaloid enantiomers, ganocochlearines C-I (1, 3-8), and three pairs of known alkaloids were isolated from the fruiting bodies of Ganoderma cochlear. The chemical structures of new compounds were elucidated on the basis of 1D and 2D NMR data. The absolute configurations of compounds 1, 3-10 were assigned by ECD calculations. Biological activities of these isolates against renal fibrosis were accessed in rat normal or diseased renal interstitial fibroblast cells. Importantly, the plausible biosynthetic pathway for this class of alkaloids was originally proposed. Copyright © 2016 Elsevier B.V. All rights reserved.

  20. In HepG2 cells, coexisting carnitine deficiency masks important indicators of marginal biotin deficiency.

    Science.gov (United States)

    Bogusiewicz, Anna; Boysen, Gunnar; Mock, Donald M

    2015-01-01

    A large number of birth defects are related to nutrient deficiencies; concern that biotin deficiency is teratogenic in humans is reasonable. Surprisingly, studies indicate that increased urinary 3-hydroxyisovalerylcarnitine (3HIAc), a previously validated marker of biotin deficiency, is not a valid biomarker in pregnancy. In this study we hypothesized that coexisting carnitine deficiency can prevent the increase in 3HIAc due to biotin deficiency. We used a 2-factor nutrient depletion design to induce isolated and combined biotin and carnitine deficiency in HepG2 cells and then repleted cells with carnitine. To elucidate the metabolic pathogenesis, we quantitated intracellular and extracellular free carnitine, acylcarnitines, and acylcarnitine ratios using liquid chromatography-tandem mass spectrometry. Relative to biotin-sufficient, carnitine-sufficient cells, intracellular acetylcarnitine increased by 90%, propionylcarnitine more than doubled, and 3HIAc increased by >10-fold in biotin-deficient, carnitine-sufficient (BDCS) cells, consistent with a defensive mechanism in which biotin-deficient cells transesterify the acyl-coenzyme A (acyl-CoA) substrates of the biotin-dependent carboxylases to the related acylcarnitines. Likewise, in BDCS cells, the ratio of acetylcarnitine to malonylcarnitine and the ratio of propionylcarnitine to methylmalonylcarnitine both more than tripled, and the ratio of 3HIAc to 3-methylglutarylcarnitine (MGc) increased by >10-fold. In biotin-deficient, carnitine-deficient (BDCD) cells, the 3 substrate-derived acylcarnitines changed little, but the substrate:product ratios were masked to a lesser extent. Moreover, carnitine repletion unmasked biotin deficiency in BDCD cells as shown by increases in acetylcarnitine, propionylcarnitine, and 3HIAc (each increased by >50-fold). Likewise, ratios of acetylcarnitine:malonylcarnitine, propionylcarnitine:methylmalonylcarnitine, and 3HIAc:MGc all increased by >8-fold. Our findings provide strong

  1. Special considerations on operating a fuel cell power plant using natural gas with marginal heating value

    Energy Technology Data Exchange (ETDEWEB)

    Moses, L. Ng; Chien-Liang Lin [Industrial Technology Research Institute, Taiwan (China); Ya-Tang Cheng [Power Research Institute, Taiwan (China)

    1996-12-31

    In realizing new power generation technologies in Taiwan, a phosphoric acid fuel cell power plant (model PC2513, ONSI Corporation) has been installed in the premises of the Power Research Institute of the Taiwan Power Company in Taipei County of Taiwan. The pipeline gas supplying to the site of this power plant has a high percentage of carbon dioxide and thus a slightly lower heating value than that specified by the manufacturer. Because of the lowering of heating value of input gas, the highest Output power from the power plant is understandably less than the rated power of 200 kW designed. Further, the transient response of the power plant as interrupted from the Grid is also affected. Since this gas is also the pipeline gas supplying to the heavily populated Taipei Municipal area, it is conceivable that the success of the operations of fuel cells using this fuel is of vital importance to the promotion of the use of this power generation technology in Taiwan. Hence, experiments were set up to assess the feasibility of this fuel cell power plant using the existing pipeline gas in this part of Taiwan where fuel cells would most likely find useful.

  2. Cochlear Implantation Updates: The Dallas Cochlear Implant Program

    Science.gov (United States)

    Tobey, Emily A.; Britt, Lana; Geers, Ann; Loizou, Philip; Loy, Betty; Roland, Peter; Warner-Czyz, Andrea; Wright, Charles G.

    2013-01-01

    This report provides an overview of many research projects conducted by the Dallas Cochlear Implant Program, a joint enterprise between The University of Texas at Dallas, The University of Texas Southwestern Medical Center and Children’s Medical Center. The studies extend our knowledge of factors influencing communication outcomes in users of cochlear implants. Multiple designs and statistical techniques are used in the studies described including both cross sectional and longitudinal analyses. Sample sizes vary across the studies and many of the samples represent large populations of children from North America. Multiple statistical techniques are used by the team to analyze outcomes. The team has provided critical information regarding electrode placement, signal processing, and communication outcomes in users of cochlear implants. PMID:22668764

  3. Spatiotemporal expression of Ezh2 in the developing mouse cochlear sensory epithelium.

    Science.gov (United States)

    Chen, Yan; Li, Wenyan; Li, Wen; Chai, Renjie; Li, Huawei

    2016-09-01

    The enhancer of zeste 2 polycomb repressive complex 2 subunit (Ezh2) is a histone-lysine Nmethyltransferase enzyme that participates in DNA methylation. Ezh2 has also been reported to play crucial roles in stem cell proliferation and differentiation. However, the detailed expression profile of Ezh2 during mouse cochlear development has not been investigated. Here, we examined the spatiotemporal expression of Ezh2 in the cochlea during embryonic and postnatal development. Ezh2 expression began to be observed in the whole otocyst nuclei at embryonic day 9.5 (E9.5). At E12.5, Ezh2 was expressed in the nuclei of the cochlear prosensory epithelium. At E13.5 and E15.5, Ezh2 was expressed from the apical to the basal turns in the nuclei of the differentiating cochlear epithelium. At postnatal day (P) 0 and 7, the Ezh2 expression was located in the nuclei of the cochlear epithelium in all three turns and could be clearly seen in outer and inner hair cells, supporting cells, the stria vascularis, and spiral ganglion cells. Ezh2 continued to be expressed in the cochlear epithelium of adult mice. Our results provide the basic Ezh2 expression pattern and might be useful for further investigating the detailed role of Ezh2 during cochlear development.

  4. Congenitally Deafblind Children and Cochlear Implants

    DEFF Research Database (Denmark)

    Dammeyer, Jesper Herup

    2008-01-01

    There has been much research conducted demonstrating the positive benefits of cochlear implantation (CI) in children who are deaf. Research on cochlear implantation in children who are both deaf and blind, however, is lacking. The purpose of this article is to present a study of 5 congenitally...... deafblind children who received cochlear implants between 2.2 and 4.2 years of age.  Ratings of video observations were used to measure the children's early communication development with and without the use of their cochlear implants. In addition, parental interviews were used to assess the benefits...... parents perceived regarding their children's cochlear implants. Two examples are included in this article to illustrate the parents' perspectives about cochlear implantation in their deafblind children. Benefits of cochlear implantation in this cohort of children included improved attention and emotional...

  5. The majority of cutaneous marginal zone B-cell lymphomas expresses class-switched immunoglobulins and develops in a T-helper type 2 inflammatory environment

    NARCIS (Netherlands)

    van Maldegem, Febe; van Dijk, Remco; Wormhoudt, Thera A. M.; Kluin, Philip M.; Willemze, Rein; Cerroni, Lorenzo; van Noesel, Carel J. M.; Bende, Richard J.

    2008-01-01

    Extranodal marginal zone B-cell lymphomas (MZBCLs) arise on a background of chronic inflammation resulting from organ-specific autoimmunity, infection, or by unknown causes. Well-known examples are salivary gland MZBCL in Sjorgren's sialadenitis and gastric MZBCL in Helicobacter pylori gastritis.

  6. Loss of heterozygosity at 9p and p53 immunopositivity in surgical margins predict local relapse in head and neck squamous cell carcinoma

    NARCIS (Netherlands)

    Graveland, A.P.; Golusinski, P.J.; Buijze, M.; Douma, R.; Sons, N.; Kuik, D.J.; Bloemena, E.; Leemans, C.R.; Brakenhoff, R.H.; Braakhuis, B.J.M.

    2011-01-01

    A major problem in head and neck cancer surgery is the high rate of local relapse (LR). In at least 25% of the surgically treated head and neck squamous cell carcinoma (HNSCC) patients, a genetically defined preneoplastic lesion, also known as "field," can be detected in the surgical margins. A

  7. Biomaterials in cochlear implants

    Science.gov (United States)

    Stöver, Timo; Lenarz, Thomas

    2011-01-01

    The cochlear implant (CI) represents, for almost 25 years now, the gold standard in the treatment of children born deaf and for postlingually deafened adults. These devices thus constitute the greatest success story in the field of ‘neurobionic’ prostheses. Their (now routine) fitting in adults, and especially in young children and even babies, places exacting demands on these implants, particularly with regard to the biocompatibility of a CI’s surface components. Furthermore, certain parts of the implant face considerable mechanical challenges, such as the need for the electrode array to be flexible and resistant to breakage, and for the implant casing to be able to withstand external forces. As these implants are in the immediate vicinity of the middle-ear mucosa and of the junction to the perilymph of the cochlea, the risk exists – at least in principle – that bacteria may spread along the electrode array into the cochlea. The wide-ranging requirements made of the CI in terms of biocompatibility and the electrode mechanism mean that there is still further scope – despite the fact that CIs are already technically highly sophisticated – for ongoing improvements to the properties of these implants and their constituent materials, thus enhancing the effectiveness of these devices. This paper will therefore discuss fundamental material aspects of CIs as well as the potential for their future development. PMID:22073103

  8. Dendrodendritic connections between the cochlear efferent neurons in guinea pig.

    Science.gov (United States)

    Szabó, Zs; Bácskai, T; Deák, Á; Matesz, K; Veress, G; Sziklai, I

    2011-10-31

    The outer hair cells of organ of Corti are innervated by the efferent neurons of medial olivocochlear neurons (MOC) of the brainstem which modify the cochlear auditory processing and sensitivity. Most of the MOC neurons are excited by a dominant ear and only a small portion of them is excited by both ears resulting in a binaural facilitation. The functional role of the feedback system between the organ of Corti and the cochlear efferent neurons is the protection of the ear from acoustic injury. The rapid impulse propagation in the bilateral olivocochlear system is suggestive of an electrotonic interaction between the bilateral olivocochlear neurons. The morphological background of the MOC pathway is not yet completely characterized. Therefore, we have labeled the bilateral cochlear nerves with different neuronal tracers in guinea pigs. In the anesthetized animals the cochlear nerves were exposed in the basal part of the modiolus and labeled simultaneously with different retrograde fluorescent tracers. By using confocal laser scanning microscope we could detect close appositions between the dendrites of the neurons of bilateral MOC. The distance between the neighboring profiles suggested close membrane appositions without interposing glial elements. These connections might serve as one of the underlying mechanisms of the binaural facilitation mediated by the olivocochlear system. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  9. The influence of circumferential resection margin status on loco-regional recurrence in esophageal squamous cell carcinoma.

    Science.gov (United States)

    Park, Hae Jin; Kim, Hak Jae; Chie, Eui Kyu; Kang, Chang Hyun; Kim, Young Tae

    2013-06-01

    To analyze treatment outcomes and patterns of recurrence, and to examine the impact of adjuvant postoperative radiotherapy (PORT) after esophagectomy in esophageal squamous cell carcinoma (SqCC) regarding the status of circumferential resection margin (CRM). We performed a retrospective review of esophageal cancer patients operated in Seoul National University Hospital between 2003 and 2010. Pathologically proven T3 SqCC patients with written reports mentioning the status of CRM were selected. Fifty-nine out of 71 patients (83.1%) had CRM+. Twenty-eight patients had radiotherapy in CRM+ and CRM-, respectively. The median follow-up period was 17.1 months (range: 5.2-63.1). Median survival and 2-year overall survival were 13.8 months and 41.9% in CRM+, and 27.3 months and 74.1% in CRM-, respectively. Loco-regional relapse-free survival (LRRFS) rate at 2 years was 33.6% and 74.1% in each groups (P = 0.029). Loco-regional recurrence was the major pattern of failure in CRM+. PORT did not improve LRRFS. The esophageal SqCC patients with CRM+ after resection showed worse LRRFS. This finding validated the prognostic value of CRM status. Nevertheless, we failed to demonstrate the benefits of adjuvant PORT in CRM+. This might suggest the necessity of neoadjuvant therapy to decrease the CRM+ rate after esophagectomy. Copyright © 2012 Wiley Periodicals, Inc.

  10. Methods of Hearing Preservation during Cochlear Implantation.

    Science.gov (United States)

    Khater, Ahmed; El-Anwar, Mohammad Waheed

    2017-07-01

    Introduction  Recent advances in surgical techniques and electrode design have made residual hearing preservation during cochlear implantation (CI) possible, achievable, and desirable. Objectives  The objective of this study was to review the literature regarding methods used for hearing preservation during CI surgery. Data Synthesis  We performed a search in the LILACS, MEDLINE, SciELO, PubMed databases, and Cochrane Library, using the keywords CI, hearing preservation, CI electrode design, and CI soft surgery. We fully read about 15 studies that met the criteria described in "study selection". The studies showed that several factors could contribute to possible cochlear damage during or after CI surgery and must be kept in mind; mechanical damage during electrode insertion, shock waves in the perilymph fluid due to implantation, acoustic trauma due to drilling, loss of perilymph and disruption of inner ear fluid homeostasis, potential bacterial infection, and secondary intracochlear fibrous tissue formation. The desire to preserve residual hearing has led to the development of the soft-surgery protocols with its various components; avoiding entry of blood into the cochlea and the use of hyaluronate seem to be reasonably supported, whereas the use of topical steroids is questionable. The site of entry into the cochlea, electrode design, and the depth of insertion are also important contributing factors. Conclusion  Hearing preservation would be useful for CI patients to benefit from the residual low frequency, as well as for the children who could be candidate for future regenerative hair cell therapy.

  11. Patient benefit from Cochlear implantation in single-sided deafness: a 1-year follow-up.

    Science.gov (United States)

    Louza, Julia; Hempel, John-Martin; Krause, Eike; Berghaus, Alexander; Müller, Joachim; Braun, Thomas

    2017-06-01

    The objective of the study was to evaluate the quality of life and benefit in patients with single-side deafness before and 1 year after cochlear implantation. In a prospective observational study design, ten adult patients with single-sided deafness undergoing cochlear implantation were included. All patients had on the implantation side no speech discrimination with normal hearing aids. The contralateral side was normal or marginal hearing loss. For determining the subject benefit from cochlear implantation, each patient answered standardized questionnaires directly before implantation and 1 year after. Regarding the questionnaire Speech, Spatial and Qualities of Hearing (SSQ), the tests yielded a significant difference in the subdomains "speech intelligibility" and "spatial hearing". The Nijmegen Cochlear Implant Questionnaire (NCIQ) showed a significant difference in the subdomain "basic sound perception", but not in the total score. The Glasgow Hearing Aid Benefit Profile (GHABP) showed on average moderate satisfaction in the subdomains "hearing aid benefit" and "residual disability". In general quality of life, no significant difference was found measured by the questionnaire EQ-5D-3L. One year after cochlear implantation, most patients with single-sided deafness showed benefits in hearing as measured by validated questionnaires However, not all patients reported a significant improvement in general quality of life. Therefore, it is important to inform patients adequately and offer alternative treatments before implantation.

  12. Half-Octave Shift in Mammalian Hearing Is an Epiphenomenon of the Cochlear Amplifier

    Science.gov (United States)

    Ramamoorthy, Sripriya; Nuttall, Alfred L.

    2012-01-01

    The cochlear amplifier is a hypothesized positive feedback process responsible for our exquisite hearing sensitivity. Experimental evidence for or against the positive feedback hypothesis is still lacking. Here we apply linear control theory to determine the open-loop gain and the closed-loop sensitivity of the cochlear amplifier from available measurements of basilar membrane vibration in sensitive mammalian cochleae. We show that the frequency of peak closed-loop sensitivity is independent of the stimulus level and close to the characteristic frequency. This implies that the half-octave shift in mammalian hearing is an epiphenomenon of the cochlear amplifier. The open-loop gain is consistent with positive feedback and suggests that the high-frequency cut-off of the outer hair cell transmembrane potential in vivo may be necessary for cochlear amplification. PMID:23049829

  13. Piezoelectric materials mimic the function of the cochlear sensory epithelium

    Science.gov (United States)

    Inaoka, Takatoshi; Shintaku, Hirofumi; Nakagawa, Takayuki; Kawano, Satoyuki; Ogita, Hideaki; Sakamoto, Tatsunori; Hamanishi, Shinji; Wada, Hiroshi; Ito, Juichi

    2011-01-01

    Cochlear hair cells convert sound vibration into electrical potential, and loss of these cells diminishes auditory function. In response to mechanical stimuli, piezoelectric materials generate electricity, suggesting that they could be used in place of hair cells to create an artificial cochlear epithelium. Here, we report that a piezoelectric membrane generated electrical potentials in response to sound stimuli that were able to induce auditory brainstem responses in deafened guinea pigs, indicating its capacity to mimic basilar membrane function. In addition, sound stimuli were transmitted through the external auditory canal to a piezoelectric membrane implanted in the cochlea, inducing it to vibrate. The application of sound to the middle ear ossicle induced voltage output from the implanted piezoelectric membrane. These findings establish the fundamental principles for the development of hearing devices using piezoelectric materials, although there are many problems to be overcome before practical application. PMID:22025702

  14. Advancing Binaural Cochlear Implant Technology.

    Science.gov (United States)

    Dietz, Mathias; McAlpine, David

    2015-12-30

    This special issue contains a collection of 13 papers highlighting the collaborative research and engineering project entitled Advancing Binaural Cochlear Implant Technology-ABCIT-as well as research spin-offs from the project. In this introductory editorial, a brief history of the project is provided, alongside an overview of the studies. © The Author(s) 2015.

  15. Advancing Binaural Cochlear Implant Technology

    Directory of Open Access Journals (Sweden)

    Mathias Dietz

    2015-12-01

    Full Text Available This special issue contains a collection of 13 papers highlighting the collaborative research and engineering project entitled Advancing Binaural Cochlear Implant Technology—ABCIT—as well as research spin-offs from the project. In this introductory editorial, a brief history of the project is provided, alongside an overview of the studies.

  16. Reading skills after cochlear implantation

    NARCIS (Netherlands)

    Vermeulen, Agnes Maria

    2007-01-01

    It has frequently been found that profoundly deaf children with conventional hearing aids have difficulties with the comprehension of written text. Cochlear Implants (CIs) were expected to enhance the reading comprehension of these profoundly deaf children because they provide auditory access to

  17. Cortical plasticity after cochlear implantation

    DEFF Research Database (Denmark)

    Petersen, B; Gjedde, A; Wallentin, M

    2013-01-01

    The most dramatic progress in the restoration of hearing takes place in the first months after cochlear implantation. To map the brain activity underlying this process, we used positron emission tomography at three time points: within 14 days, three months, and six months after switch-on. Fifteen...

  18. Cochlear implant optimized noise reduction

    Science.gov (United States)

    Mauger, Stefan J.; Arora, Komal; Dawson, Pam W.

    2012-12-01

    Noise-reduction methods have provided significant improvements in speech perception for cochlear implant recipients, where only quality improvements have been found in hearing aid recipients. Recent psychoacoustic studies have suggested changes to noise-reduction techniques specifically for cochlear implants, due to differences between hearing aid recipient and cochlear implant recipient hearing. An optimized noise-reduction method was developed with significantly increased temporal smoothing of the signal-to-noise ratio estimate and a more aggressive gain function compared to current noise-reduction methods. This optimized noise-reduction algorithm was tested with 12 cochlear implant recipients over four test sessions. Speech perception was assessed through speech in noise tests with three noise types; speech-weighted noise, 20-talker babble and 4-talker babble. A significant speech perception improvement using optimized noise reduction over standard processing was found in babble noise and speech-weighted noise and over a current noise-reduction method in speech-weighted noise. Speech perception in quiet was not degraded. Listening quality testing for noise annoyance and overall preference found significant improvements over the standard processing and over a current noise-reduction method in speech-weighted and babble noise types. This optimized method has shown significant speech perception and quality improvements compared to the standard processing and a current noise-reduction method.

  19. Alternative Techniques in Cochlear Implantation.

    Science.gov (United States)

    Sürmelioğlu, Özgür; Özdemir, Süleyman; Tarkan, Özgür; Tuncer, Ülkü; Çetik, Fikret; Kara, Karahan; Kıroğlu, Mete

    2016-04-01

    To review the alternative techniques in cochlear implantation and to compare the complications with different techniques. Patients who had undergone cochlear implantation were reviewed. Those patients who were operated using alternative techniques were selected and evaluated for the cause of their hearing loss and for the type of alternative technique that was utilized. Complication types and rates in these patients were evaluated. In total, 38 patients were operated using alternative techniques following preoperative or intraoperative findings. The mean age of the patients was 8.3 (1-51) years. There were 20 male and 18 female patients. Thirteen patients were operated with a suprameatal approach and 18 with a transcanal approach. Resection of the bony part of the external ear canal and reconstruction (canal wall down technique) was performed in seven patients. Postoperative complications included wound infection, hematoma, chorda tympani injury, and tympanic membrane perforation. Cochlear implantation is an effective method in the rehabilitation of sensorineural hearing loss. Complications are rare but can sometimes cause hematoma, taste impairment, tympanic membrane perforation, or wound infections. The standard procedure is not always suitable for patients with temporal bone abnormalities. Surgeons performing cochlear implantation should be aware of these variations and should be able to perform alternative implant techniques in these cases.

  20. Chronic Exposure to Malaria Is Associated with Inhibitory and Activation Markers on Atypical Memory B Cells and Marginal Zone-Like B Cells

    Directory of Open Access Journals (Sweden)

    Itziar Ubillos

    2017-08-01

    Full Text Available In persistent infections that are accompanied by chronic immune activation, such as human immunodeficiency virus, hepatitis C virus, and malaria, there is an increased frequency of a phenotypically distinct subset of memory B cells lacking the classic memory marker CD27 and showing a reduced capacity to produce antibodies. However, critical knowledge gaps remain on specific B cell changes and immune adaptation in chronic infections. We hypothesized that expansion of atypical memory B cells (aMBCs and reduction of activated peripheral marginal zone (MZ-like B cells in constantly exposed individuals might be accompanied by phenotypic changes that would confer a tolerogenic profile, helping to establish tolerance to infections. To better understand malaria-associated phenotypic abnormalities on B cells, we analyzed peripheral blood mononuclear cells from 55 pregnant women living in a malaria-endemic area of Papua Nueva Guinea and 9 Spanish malaria-naïve individuals using four 11-color flow cytometry panels. We assessed the expression of markers of B cell specificity (IgG and IgM, activation (CD40, CD80, CD86, b220, TACI, and CD150, inhibition (PD1, CD95, and CD71, and migration (CCR3, CXCR3, and CD62l. We found higher frequencies of active and resting aMBC and marked reduction of MZ-like B cells, although changes in absolute cell counts could not be assessed. Highly exposed women had higher PD1+-, CD95+-, CD40+-, CD71+-, and CD80+-activated aMBC frequencies than non-exposed subjects. Malaria exposure increased frequencies of b220 and proapoptotic markers PD1 and CD95, and decreased expression of the activation marker TACI on MZ-like B cells. The increased frequencies of inhibitory and apoptotic markers on activated aMBCs and MZ-like B cells in malaria-exposed adults suggest an immune-homeostatic mechanism for maintaining B cell development and function while simultaneously downregulating hyperreactive B cells. This mechanism would keep the B cell

  1. An Unusual Case of Marginal Zone B-Cell Lymphoma Arising in the Breast - Its Diagnosis and the Role of Radiotherapy in its Management.

    LENUS (Irish Health Repository)

    Rock, Kathy

    2011-10-01

    BACKGROUND: Primary lymphoma of the breast accounts for 0.04-0.5% of all breast malignancies and approximately 1% of all extranodal lymphomas. For stage IE node-negative disease, involved field radiotherapy is recommended except for very young women in whom the risk of breast cancer is a concern. The rate of complete response for limited stage extranodal marginal B-cell lymphoma is in excess of 90%. CASE REPORT: We report the case of a 62-year-old lady who presented with a unilateral painless palpable right breast lump. She subsequently underwent a trucut biopsy of the lesion. The histology revealed a low-grade B-cell non-Hodgkin\\'s lymphoma (NHL). Immunohistochemistry showed that more than 95% of the cells were B cells which were CD 20+\\/CD 45+ and BC L6+. This confirmed the diagnosis of marginal zone lymphoma. Staging work-up was negative for distant metastases. Serum alkaline phosphatase and lactate dehydrogenase were normal. The patient had no \\'B\\' symptoms. Her final diagnosis was clinical stage IAE NHL, and she was referred for curative radiotherapy. CONCLUSION: Radiation treatment is a safe and extremely effective modality of treatment for early stage I marginal zone B-cell lymphomas of the breast.

  2. Diversity in cochlear morphology and its influence on cochlear implant electrode position.

    Science.gov (United States)

    van der Marel, Kim S; Briaire, Jeroen J; Wolterbeek, Ron; Snel-Bongers, Jorien; Verbist, Berit M; Frijns, Johan H M

    2014-01-01

    To define a minimal set of descriptive parameters for cochlear morphology and study its influence on the cochlear implant electrode position in relation to surgical insertion distance. Cochlear morphology and electrode position were analyzed using multiplanar reconstructions of the pre- and postoperative CT scans in a population of 336 patients (including 26 bilaterally implanted ones) with a CII HiFocus1 or HiRes90K HiFocus1J implant. Variations in cochlear diameter and cochlear canal size were analyzed. The relationship between the outer and inner walls was investigated. Size differences based on sex, age, and ear side were investigated using linear mixed models. Two new methods, spiral fitting and principal component analysis, were proposed to describe cochlear shape, and the goodness of fit was investigated. The relationship between cochlear shape and electrode position, in terms of modiolus proximity and insertion depth, was analyzed using clustering, one-way analysis of variance (ANOVA) and simple linear regression analysis. Large variations in cochlear morphology were found, with cochlear canal sizes ranging from 0.98 to 2.96 mm and average cochlear diameters between 8.85 and 5.92 mm (with standard deviations of around 0.4 mm). The outer and inner walls were significantly correlated (p cochlear shape variance. A significant sex difference was also found with spiral fitting and PCA. Cochlear size was found to have a significant influence on modiolus proximity and insertion depth of the electrode (p Cochlear size explained around 13% of the variance in electrode position. When cochlear size was combined with surgical insertion, more than 81% of the variance in insertion depth can be explained. This study demonstrates a large variety in cochlear morphology, which significantly impacts electrode position in terms of modiolus proximity and insertion depth. The effect size is, however, relatively small compared with surgical insertion distance. PCA is shown to be

  3. Aging after Noise Exposure: Acceleration of Cochlear Synaptopathy in “Recovered” Ears

    Science.gov (United States)

    Fernandez, Katharine A.; Jeffers, Penelope W.C.; Lall, Kumud; Liberman, M. Charles

    2015-01-01

    Cochlear synaptic loss, rather than hair cell death, is the earliest sign of damage in both noise- and age-related hearing impairment (Kujawa and Liberman, 2009; Sergeyenko et al., 2013). Here, we compare cochlear aging after two types of noise exposure: one producing permanent synaptic damage without hair cell loss and another producing neither synaptopathy nor hair cell loss. Adult mice were exposed (8–16 kHz, 100 or 91 dB SPL for 2 h) and then evaluated from 1 h to ∼20 months after exposure. Cochlear function was assessed via distortion product otoacoustic emissions and auditory brainstem responses (ABRs). Cochlear whole mounts and plastic sections were studied to quantify hair cells, cochlear neurons, and the synapses connecting them. The synaptopathic noise (100 dB) caused 35–50 dB threshold shifts at 24 h. By 2 weeks, thresholds had recovered, but synaptic counts and ABR amplitudes at high frequencies were reduced by up to ∼45%. As exposed animals aged, synaptopathy was exacerbated compared with controls and spread to lower frequencies. Proportional ganglion cell losses followed. Threshold shifts first appeared >1 year after exposure and, by ∼20 months, were up to 18 dB greater in the synaptopathic noise group. Outer hair cell losses were exacerbated in the same time frame (∼10% at 32 kHz). In contrast, the 91 dB exposure, producing transient threshold shift without acute synaptopathy, showed no acceleration of synaptic loss or cochlear dysfunction as animals aged, at least to ∼1 year after exposure. Therefore, interactions between noise and aging may require an acute synaptopathy, but a single synaptopathic exposure can accelerate cochlear aging. PMID:25972177

  4. Aging after noise exposure: acceleration of cochlear synaptopathy in "recovered" ears.

    Science.gov (United States)

    Fernandez, Katharine A; Jeffers, Penelope W C; Lall, Kumud; Liberman, M Charles; Kujawa, Sharon G

    2015-05-13

    Cochlear synaptic loss, rather than hair cell death, is the earliest sign of damage in both noise- and age-related hearing impairment (Kujawa and Liberman, 2009; Sergeyenko et al., 2013). Here, we compare cochlear aging after two types of noise exposure: one producing permanent synaptic damage without hair cell loss and another producing neither synaptopathy nor hair cell loss. Adult mice were exposed (8-16 kHz, 100 or 91 dB SPL for 2 h) and then evaluated from 1 h to ∼ 20 months after exposure. Cochlear function was assessed via distortion product otoacoustic emissions and auditory brainstem responses (ABRs). Cochlear whole mounts and plastic sections were studied to quantify hair cells, cochlear neurons, and the synapses connecting them. The synaptopathic noise (100 dB) caused 35-50 dB threshold shifts at 24 h. By 2 weeks, thresholds had recovered, but synaptic counts and ABR amplitudes at high frequencies were reduced by up to ∼ 45%. As exposed animals aged, synaptopathy was exacerbated compared with controls and spread to lower frequencies. Proportional ganglion cell losses followed. Threshold shifts first appeared >1 year after exposure and, by ∼ 20 months, were up to 18 dB greater in the synaptopathic noise group. Outer hair cell losses were exacerbated in the same time frame (∼ 10% at 32 kHz). In contrast, the 91 dB exposure, producing transient threshold shift without acute synaptopathy, showed no acceleration of synaptic loss or cochlear dysfunction as animals aged, at least to ∼ 1 year after exposure. Therefore, interactions between noise and aging may require an acute synaptopathy, but a single synaptopathic exposure can accelerate cochlear aging. Copyright © 2015 the authors 0270-6474/15/357509-12$15.00/0.

  5. Anatomic considerations of cochlear morphology and its implications for insertion trauma in cochlear implant surgery.

    NARCIS (Netherlands)

    Verbist, B.M.; Ferrarini, L.; Briaire, J.J.; Zarowski, A.; Admiraal-Behloul, F.; Olofsen, H.; Reiber, J.H.C.; Frijns, J.H.

    2009-01-01

    HYPOTHESIS: The goal of this study is to analyze the 3-dimensional anatomy of the cochlear spiral and to investigate the consequences of its course to insertion trauma during cochlear implantation. BACKGROUND: Insertion trauma in cochlear implant surgery is a feared surgical risk, potentially

  6. Heptanol application to the mouse round window: a model for studying cochlear lateral wall regeneration.

    Science.gov (United States)

    Stevens, Shawn M; Xing, Yazhi; Hensley, Christopher T; Zhu, Juhong; Dubno, Judy R; Lang, Hainan

    2014-04-01

    Identify cells supporting cochlear lateral wall regeneration. Prospective controlled trial. Laboratory. Human presbyacusis occurs, in part, secondary to age-related degeneration of cochlear lateral wall structures such as the stria vascularis and spiral ligament fibrocytes. This degeneration is likely linked to the diminished regenerative capacity of lateral wall cells with age. While lateral wall regeneration is known to occur after an acute insult, this process remains poorly understood and the cells capable of self-replication unidentified. We hypothesized that spiral ligament fibrocytes constitute these proliferative cells. To test the hypothesis, an acute ototoxic insult was created in 65 normal-hearing, young adult mice via cochlear exposure to heptanol. Sacrifice occurred at 1 to 60 days posttreatment. Auditory brainstem responses, 5-ethynyl-2'-deoxyuridine assay, and immunostaining were used to assess regeneration. Posttreatment hearing thresholds were elevated in nearly all treated mice. Selective fibrocyte apoptosis and strial injury were observed at the time of peak hearing loss around 1 to 7 days posttreatment. Cellular proliferation was detected in the region of type II fibrocytes during this time. Hearing thresholds plateaued at 7 days posttreatment followed by a significant recovery of both hearing and morphologic appearance. Permanent outer hair cell degeneration was observed. Heptanol application to the round window of young adult mice is a rapid, selective, and reliable technique for investigating proliferation in the cochlear lateral wall. The data indirectly showed that spiral ligament fibrocytes may be the proliferative cells of the cochlear lateral wall. Further studies of this process are needed.

  7. Cochlear pathology of long term neomycin induced deafness in cats.

    Science.gov (United States)

    Leake, P A; Hradek, G T

    1988-04-01

    The long term sequelae of hair cell destruction consequent from administration of the ototoxic aminoglycoside antibiotic, neomycin sulfate, were evaluated in histological and ultrastructural studies of cochlear morphology in cats. Complete hearing loss, as defined by an absence of brainstem evoked responses to click stimulation at 120 dB peak SPL, was induced by intramuscular injections of neomycin at 50 mg/kg body weight/day, and cochlear pathology was studied at 6 months and 1, 3 and 4 years following onset of profound deafness. In these long term ototoxicity cases the organ of Corti was collapsed and resorbed over the basal one-quarter to three-quarters of the cochlear spiral, depending on duration of deafness. Significant progressive reduction in the spiral ganglion cell population and sequential degenerative alterations in the remaining neurons were observed with increasing time elapsed after induced hearing loss. The sequence of pathological alterations in spiral ganglion neurons appeared to be: a) swelling, demyelination and degeneration of the peripheral dendrites; b) demyelination and shrinkage of the cell soma with preservation of the central axon; and c) demyelination of the central axon and degeneration of the cell perikaryon. In apical cochlear regions, severe degeneration of the spiral ganglion preceded the collapse of the tunnel of Corti and regional loss of pillar cells. Residual populations of spiral ganglion neurons were as low as 1-2% of the normal values in the most severely degenerated cochleae in the series. Light microscopic and ultrastructural studies revealed a selective survival advantage for the unmyelinated type II neurons over the myelinated type I neurons with these long survival periods. The prolonged time course and atrophic nature of these pathological alterations suggests that degeneration of spiral ganglion neurons progresses continuously following drug-induced insult to the cochlea. Some possible factors contributing to this long

  8. [Conventional audiometry versus cochlear microphone audiometry].

    Science.gov (United States)

    Sanjuán Juaristi, Julio

    2007-04-01

    The recording and processing of cochlear microphone potentials in hearing studies is currently in the definitive validation phase against results obtained with other objective procedures. The purpose of this work is to contribute to its validation. The equipment used was exclusively designed for recording cochlear microphone potentials. The study has been carried out in adults to compare subjective audiometric results with those obtained from cochlear microphones. We present a statistical concordance study between subjective audiometry and cochlear microphone audiometry. In view of the results obtained, this method is particularly valid for early diagnosis. We obtained an identical profile to the subjective audiogram at audiometric frequencies of 250, 500, 1000, 2000, and 4000 Hz.

  9. Cochlear implants: system design, integration, and evaluation.

    Science.gov (United States)

    Zeng, Fan-Gang; Rebscher, Stephen; Harrison, William; Sun, Xiaoan; Feng, Haihong

    2008-01-01

    As the most successful neural prosthesis, cochlear implants have provided partial hearing to more than 120000 persons worldwide; half of which being pediatric users who are able to develop nearly normal language. Biomedical engineers have played a central role in the design, integration and evaluation of the cochlear implant system, but the overall success is a result of collaborative work with physiologists, psychologists, physicians, educators, and entrepreneurs. This review presents broad yet in-depth academic and industrial perspectives on the underlying research and ongoing development of cochlear implants. The introduction accounts for major events and advances in cochlear implants, including dynamic interplays among engineers, scientists, physicians, and policy makers. The review takes a system approach to address critical issues in cochlear implant research and development. First, the cochlear implant system design and specifications are laid out. Second, the design goals, principles, and methods of the subsystem components are identified from the external speech processor and radio frequency transmission link to the internal receiver, stimulator and electrode arrays. Third, system integration and functional evaluation are presented with respect to safety, reliability, and challenges facing the present and future cochlear implant designers and users. Finally, issues beyond cochlear implants are discussed to address treatment options for the entire spectrum of hearing impairment as well as to use the cochlear implant as a model to design and evaluate other similar neural prostheses such as vestibular and retinal implants.

  10. Cochlear implant in incomplete partition type I.

    Science.gov (United States)

    Berrettini, S; Forli, F; De Vito, A; Bruschini, L; Quaranta, N

    2013-02-01

    In this investigation, we report on 4 patients affected by incomplete partition type I submitted to cochlear implant at our institutions. Preoperative, surgical, mapping and follow-up issues as well as results in cases with this complex malformation are described. The cases reported in the present study confirm that cochlear implantation in patients with incomplete partition type I may be challenging for cochlear implant teams. The results are variable, but in many cases satisfactory, and are mainly related to the surgical placement of the electrode and residual neural nerve fibres. Moreover, in some cases the association of cochlear nerve abnormalities and other disabilities may significantly affect results.

  11. Marginal zone B-cell lymphoma with multiple extranodal locations in a patient with Sjögren’s syndrome – a diagnostic problem

    Directory of Open Access Journals (Sweden)

    Marta Domżalska

    2014-09-01

    Full Text Available Sjögren’s syndrome is a chronic autoimmune disease characterized by the presence of lymphocytic infiltrates in exocrine glands, mainly salivary and lacrimal glands, which result in xerophthalmia and xerostomia. About half of the patients develop systemic complications, including lymphoproliferative disorders. We report a case of a 27-year-old woman with a diagnosis of Sjögren’s syndrome and a suspicion of respiratory system involvement in the course of granulomatosis with polyangiitis. Histopathological examination of a skin lesion suggested marginal zone B-cell lymphoma. After pathological and immunohistochemical evaluation of all available previous biopsy samples and the medical documentation the diagnosis of extranodal marginal zone B-cell lymphoma stage IV according to the Ann Arbor classification was rendered. The patient was referred to the Department of Haematology and was treated with R-CVP (cyclophosphamide, vincristine, prednisone, rituximab.

  12. Cochlear neuropathy in human presbycusis: Confocal analysis of hidden hearing loss in post-mortem tissue.

    Science.gov (United States)

    Viana, Lucas M; O'Malley, Jennifer T; Burgess, Barbara J; Jones, Dianne D; Oliveira, Carlos A C P; Santos, Felipe; Merchant, Saumil N; Liberman, Leslie D; Liberman, M Charles

    2015-09-01

    Recent animal work has suggested that cochlear synapses are more vulnerable than hair cells in both noise-induced and age-related hearing loss. This synaptopathy is invisible in conventional histopathological analysis, because cochlear nerve cell bodies in the spiral ganglion survive for years, and synaptic analysis requires special immunostaining or serial-section electron microscopy. Here, we show that the same quadruple-immunostaining protocols that allow synaptic counts, hair cell counts, neuronal counts and differentiation of afferent and efferent fibers in mouse can be applied to human temporal bones, when harvested within 9 h post-mortem and prepared as dissected whole mounts of the sensory epithelium and osseous spiral lamina. Quantitative analysis of five "normal" ears, aged 54-89 yrs, without any history of otologic disease, suggests that cochlear synaptopathy and the degeneration of cochlear nerve peripheral axons, despite a near-normal hair cell population, may be an important component of human presbycusis. Although primary cochlear nerve degeneration is not expected to affect audiometric thresholds, it may be key to problems with hearing in noise that are characteristic of declining hearing abilities in the aging ear. Copyright © 2015 Elsevier B.V. All rights reserved.

  13. Heterogeneous calretinin expression in the avian cochlear nucleus angularis.

    Science.gov (United States)

    Bloom, S; Williams, A; MacLeod, K M

    2014-08-01

    Multiple calcium-binding proteins (CaBPs) are expressed at high levels and in complementary patterns in the auditory pathways of birds, mammals, and other vertebrates, but whether specific members of the CaBP family can be used to identify neuronal subpopulations is unclear. We used double immunofluorescence labeling of calretinin (CR) in combination with neuronal markers to investigate the distribution of CR-expressing neurons in brainstem sections of the cochlear nucleus in the chicken (Gallus gallus domesticus). While CR was homogeneously expressed in cochlear nucleus magnocellularis, CR expression was highly heterogeneous in cochlear nucleus angularis (NA), a nucleus with diverse cell types analogous in function to neurons in the mammalian ventral cochlear nucleus. To quantify the distribution of CR in the total NA cell population, we used antibodies against neuronal nuclear protein (NeuN), a postmitotic neuron-specific nuclear marker. In NA neurons, NeuN label was variably localized to the cell nucleus and the cytoplasm, and the intensity of NeuN immunoreactivity was inversely correlated with the intensity of CR immunoreactivity. The percentage of CR + neurons in NA increased from 31 % in embryonic (E)17/18 chicks, to 44 % around hatching (E21), to 51 % in postnatal day (P) 8 chicks. By P8, the distribution of CR + neurons was uniform, both rostrocaudal and in the tonotopic (dorsoventral) axis. Immunoreactivity for the voltage-gated potassium ion channel Kv1.1, used as a marker for physiological type, showed broad and heterogeneous postsynaptic expression in NA, but did not correlate with CR expression. These results suggest that CR may define a subpopulation of neurons within nucleus angularis.

  14. Immediate and delayed cochlear neuropathy after noise exposure in pubescent mice

    DEFF Research Database (Denmark)

    Jensen, Jane Bjerg; Lysaght, Andrew C; Liberman, M Charles

    2015-01-01

    Moderate acoustic overexposure in adult rodents is known to cause acute loss of synapses on sensory inner hair cells (IHCs) and delayed degeneration of the auditory nerve, despite the completely reversible temporary threshold shift (TTS) and morphologically intact hair cells. Our objective...... only TTS. Amplitude of wave I of the auditory brainstem response, which reflects the summed activity of the cochlear nerve, was complemented by synaptic ribbon counts in IHCs using confocal microscopy, and by stereological counts of peripheral axons and cell bodies of the cochlear nerve from 24 hours...

  15. Remote programming of cochlear implants.

    Science.gov (United States)

    Samuel, Paola Angelica; Goffi-Gomez, Maria Valéria Schmidt; Bittencourt, Aline Gomes; Tsuji, Robinson Koji; Brito, Rubens de

    2014-01-01

    To verify the effectiveness of remote programming of cochlear implants by stimulation levels and results in the perception of speech and free-field audiometry tests. Twelve patients from both genders, aged between 18 and 59 years, users of internal cochlear implant and speech processor of the same model for at least 12 months, were selected. Both the remote programming (RP) and the live programming (LP) were performed on the same day, measuring the minimum (T) and maximum (C) stimulation levels of five electrodes with the interpolation of the remaining ones. Speech perception tests were applied using 65 dBSPL (recorded open context sentences and monosyllables). The patients were submitted to free-field audiometry at 250-8,000 Hz frequencies. The results for the RP and LP were compared. Differences in mean of the T levels for three electrodes and the C levels for one electrode were found. No difference between the results was obtained in the speech perception tests and audiometric thresholds in the RP and LP. The RP is a simple and effective procedure for programming cochlear implant devices and, although there were differences in the stimulation levels of some electrodes, it did not interfere in the speech perception outcomes.

  16. Preventing complications in pediatric cochlear implantation.

    Science.gov (United States)

    Melton, Myles F; Backous, Douglas D

    2011-10-01

    This review addresses four key areas of controversy in the prevention of common complications of pediatric cochlear implant surgery: reducing meningitis risk, managing acute otitis media (AOM) in the cochlear implant population, assessing the optimum age for implanting a child to take advantage of the critical periods of language acquisition, and managing the social risk in defining ethical issues still surrounding cochlear implant in children. Improved surgical techniques and the replacement of Prenvar-7 with Prenvar-13 significantly reduce the risk of cochlear implant related meningitis. AOM within 2 months of cochlear implant placement requires aggressive management to reduce the risk of complication. Tympanostomy tubes do not increase the risk of otitis media or meningitis and should be used when appropriate according to accepted AOM standards. Although the controversy over cochlear implant and the dissolution of Deaf Culture is decreasing, the use of cochlear implant in children remains an area for open dialogue between groups to ensure children are treated appropriately. Discussions ought to be based on fact and scientific evidence. Although cochlear implants remain the gold standard for hearing restoration in children with severe to profound hearing loss, several issues remain controversial and are in need of further scientific exploration.

  17. Cochlear Implants: The Young People's Perspective

    Science.gov (United States)

    Wheeler, Alexandra; Archbold, Sue; Gregory, Susan; Skipp, Amy

    2007-01-01

    Cochlear implantation is a relatively new procedure, which has already had significant impact on the lives of many profoundly deaf children and adults, in providing useful hearing to those unable to benefit significantly from hearing aids. After 16 years of cochlear implantation in the United Kingdom, there is now a body of evidence covering a…

  18. Libyan cochlear implant programme: achievements, difficulties, and ...

    African Journals Online (AJOL)

    Cochlear implantation has become established worldwide as a safe and effective method of auditory rehabilitation of selected severely and profound deaf children and adults. Over 100,000 patients have received cochlear implants worldwide with the paediatric population proving to be the main beneficiaries. The Libyan ...

  19. An overview of cochlear implant electrode array designs.

    Science.gov (United States)

    Dhanasingh, Anandhan; Jolly, Claude

    2017-12-01

    Cochlear implant electrode arrays are designed with specific characteristics that allow for the preservation of intra-cochlear structures during the insertion process, as well as during explantation. Straight lateral wall (LW) electrode arrays and pre-curved modiolar hugging (MH) electrode arrays are the two types that are commercially available. Although there is a third type of electrode array called the mid-scala (MS), which is positioned in the middle of the scala tympani (ST), and is usually considered as an MH type of electrode. Different lengths of straight LW electrode arrays are currently available which allow for insertion across a range of different sized cochleae; however, due to manufacturing limitations, pre-curved MH electrodes are generally only available to cover the basal turn of the cochlea, while the spiral ganglion cells are distributed in the Rosenthal's canal that extends into 1.75 turns of the cochlea. Both straight LW and pre-curved MH electrodes can cause a certain degree of intra-cochlear trauma, but pre-curved MH electrodes tend to deviate into the scala vestibuli from the scala tympani more often than the straight LW electrodes, resulting in damage to the osseous spiral lamina/spiral ligament which could initiate new bone formation and eventually affect the cochlear implant users' hearing performance. Structural damage to the cochlea could also affect the vestibular function. With pre-curved MH electrodes, higher degrees of trauma are related to the fixed curling geometry of the electrode in relation to the variable coiling pattern of individual cochleae, the orientation of the electrode contacts in relation to the modiolus wall, and how effectively the stylet was handled by the surgeon during the procedure. Wire management, metal density, and the shore hardness of the silicone elastomer all contribute to the stiffness/flexibility of the electrode. It is important to acknowledge the impact of bringing the stimulating contacts closer to

  20. Quality of Life in Pediatric Cochlear Implantations.

    Science.gov (United States)

    Yorgun, Meysem; Sürmelioğlu, Özgür; Tuncer, Ülkü; Tarkan, Özgür; Özdemir, Süleyman; Çekiç, Erdinç; Çetik, Fikret; Kıroğlu, Mete

    2015-12-01

    To evaluate the satisfaction of patients with a cochlear implant using a Parents' Perspective Questionnaire and analyze the significant parameters. Patients who received a cochlear implant in Çukurova University between March 2002 and November 2012 were included in the study. Parents were asked to answer the Parents' Perspective Questionnaire. The age ranges of 62 patients were 2-5 years and of 99 patients were 6-11 years and over. In total, 144 parents were satisfied with the cochlear implant. Patients who attended school had more self-confidence, and users of an implant aged over 18 months had better social relations and self-confidence. Cochlear implants' positive effect on the quality of life is a fact, but parents have concerns in the preoperative and postoperative periods. Patients and parents should be informed carefully about cochlear implants. Also, patients' satisfaction is correlated with increasing duration of the implant and age.

  1. Lexico-semantic and acoustic-phonetic processes in the perception of noise-vocoded speech: implications for cochlear implantation

    OpenAIRE

    McGettigan, Carolyn; Rosen, Stuart; Scott, Sophie K

    2014-01-01

    Noise-vocoding is a transformation which, when applied to speech, severely reduces spectral resolution and eliminates periodicity, yielding a stimulus that sounds "like a harsh whisper" (Scott et al., 2000, p. 2401). This process simulates a cochlear implant, where the activity of many thousand hair cells in the inner ear is replaced by direct stimulation of the auditory nerve by a small number of tonotopically-arranged electrodes. Although a cochlear implant offers a powerful means of restor...

  2. Enkephalin-like immunoreactivity in cochlear efferents in the bat, Rhinolophus ferrumequinum [corrected].

    Science.gov (United States)

    Tachibana, M; Senuma, H; Kumamoto, K

    1992-04-01

    The cochlear efferent of the bat is anatomically different from other mammals. The olivocochlear bundle of the greater horse shoe bat, Rhinolophus ferrumequinum, projects only to inner hair cells. To examine the neurochemical nature of the olivocochlear bundle, we examined methionine-enkephalin-like immunoreactivity in this species. We observed immunoreactivity in the inner spiral bundles and in nerve fibers in the osseous spiral lamina. Sometimes immunostained inner spiral bundles were found to project towards inner hair cells. These data, as well as data from previous studies, suggest that cochlear efferents of different species of mammals share some common neurochemical features [corrected].

  3. Cochlear changes in presbycusis with tinnitus.

    Science.gov (United States)

    Terao, Kyoichi; Cureoglu, Sebahattin; Schachern, Patricia A; Morita, Norimasa; Nomiya, Shigenobu; Deroee, Armin F; Doi, Katsumi; Mori, Kazunori; Murata, Kiyotaka; Paparella, Michael M

    2011-01-01

    The pathophysiology of tinnitus is obscure and its treatment is therefore elusive. Significant progress in this field can only be achieved by determining the mechanisms of tinnitus generation, and thus, histopathologic findings of the cochlea in presbycusis with tinnitus become crucial. We revealed the histopathologic findings of the cochlea in subjects with presbycusis and tinnitus. The subjects were divided into 2 groups, presbycusis with tinnitus (tinnitus) group and presbycusis without tinnitus (control) group, with each group comprising 8 temporal bones from 8 subjects. We quantitatively analyzed the number of spiral ganglion cells, loss of cochlear inner and outer hair cells, and areas of the stria vascularis and spiral ligament. There was a significantly greater loss of outer hair cells in the tinnitus group compared with the control group in the basal and upper middle turns. The stria vascularis was more atrophic in the tinnitus group compared with the control group in the basal turn. Tinnitus is more common in patients with presbycusis who have more severe degeneration of outer hair cells and stria vascularis. Copyright © 2011 Elsevier Inc. All rights reserved.

  4. Microparticle shape effects on margination, near-wall dynamics and adhesion in a three-dimensional simulation of red blood cell suspension.

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    Vahidkhah, Koohyar; Bagchi, Prosenjit

    2015-03-21

    We present a 3D computational modeling study of the transport of micro-scale drug carriers modeled as microparticles of different shapes (spherical, oblate, and prolate) in whole blood represented as a suspension of deformable red blood cells. The objective is to quantify the effect of microparticle shapes on their margination, near-wall dynamics and adhesion. We observe that the near-wall accumulation is highest for oblate particles of moderate aspect ratio, followed by spherical particles, and lowest for very elongated prolate particles. The result is explained using micro-scale dynamics of individual particles, and their interaction with red blood cells. We observe that the orientation of microparticles in 3D space and the frequency of their collisions with red blood cells are the key factors affecting their margination. We show that due to repeated collisions with red blood cells in the presence of a bounding wall, the axes of revolution of oblate particles align near the plane of the shear flow, but those of prolate particles shift towards the vorticity axis with a wider distribution. Such specific orientations lead to more frequent collisions and a greater lateral drift for oblate particles than microspheres, but less frequent collisions and a reduced lateral drift for elongated prolate particles, resulting in the observed differences in their near-wall accumulation. Once marginated, the particle shape has an entirely different effect on the likelihood of making particle-wall contacts. We find that marginated prolate particles, due to their alignment along the vorticity axis and large angular fluctuations, are more likely to make contacts with the wall than spherical and oblate particles. We further simulate the adhesion between flowing microparticles and the wall in the presence of red blood cells, and observe that once wall contacts are established, the likelihood of firm adhesion is greater for disk-like particles, followed by elongated prolates, and

  5. Validation of minimally invasive, image-guided cochlear implantation using Advanced Bionics, Cochlear, and Medel electrodes in a cadaver model.

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    McRackan, Theodore R; Balachandran, Ramya; Blachon, Grégoire S; Mitchell, Jason E; Noble, Jack H; Wright, Charles G; Fitzpatrick, J Michael; Dawant, Benoit M; Labadie, Robert F

    2013-11-01

    Validation of a novel minimally invasive, image-guided approach to implant electrodes from three FDA-approved manufacturers-Medel, Cochlear, and Advanced Bionics-in the cochlea via a linear tunnel from the lateral cranium through the facial recess to the cochlea. Custom microstereotactic frames that mount on bone-implanted fiducial markers and constrain the drill along the desired path were utilized on seven cadaver specimens. A linear tunnel was drilled from the lateral skull to the cochlea followed by a marginal, round window cochleostomy and insertion of the electrode array into the cochlea through the drilled tunnel. Post-insertion CT scan and histological analysis were used to analyze the results. All specimens ([Formula: see text]) were successfully implanted without visible injury to the facial nerve. The Medel electrodes ([Formula: see text]) had minimal intracochlear trauma with 8, 8, and 10 (out of 12) electrodes intracochlear. The Cochlear lateral wall electrodes (straight research arrays) ([Formula: see text]) had minimal trauma with 20 and 21 of 22 electrodes intracochlear. The Advanced Bionics electrodes ([Formula: see text]) were inserted using their insertion tool; one had minimal insertion trauma and 14 of 16 electrodes intracochlear, while the other had violation of the basilar membrane just deep to the cochleostomy following which it remained in scala vestibuli with 13 of 16 electrodes intracochlear. Minimally invasive, image-guided cochlear implantation is possible using electrodes from the three FDA-approved manufacturers. Lateral wall electrodes were associated with less intracochlear trauma suggesting that they may be better suited for this surgical technique.

  6. Optoacoustic effect is responsible for laser-induced cochlear responses

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    Kallweit, N.; Baumhoff, P.; Krueger, A.; Tinne, N.; Kral, A.; Ripken, T.; Maier, H.

    2016-06-01

    Optical stimulation of the cochlea with laser light has been suggested as an alternative to conventional treatment of sensorineural hearing loss with cochlear implants. The underlying mechanisms are controversially discussed: The stimulation can either be based on a direct excitation of neurons, or it is a result of an optoacoustic pressure wave acting on the basilar membrane. Animal studies comparing the intra-cochlear optical stimulation of hearing and deafened guinea pigs have indicated that the stimulation requires intact hair cells. Therefore, optoacoustic stimulation seems to be the underlying mechanism. The present study investigates optoacoustic characteristics using pulsed laser stimulation for in vivo experiments on hearing guinea pigs and pressure measurements in water. As a result, in vivo as well as pressure measurements showed corresponding signal shapes. The amplitude of the signal for both measurements depended on the absorption coefficient and on the maximum of the first time-derivative of laser pulse power (velocity of heat deposition). In conclusion, the pressure measurements directly demonstrated that laser light generates acoustic waves, with amplitudes suitable for stimulating the (partially) intact cochlea. These findings corroborate optoacoustic as the basic mechanism of optical intra-cochlear stimulation.

  7. Cochlear Implantation in Patient with Cochlear Nerve Deficiency: A Case Report.

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    Sürmelioğlu, Özgür; Tarkan, Özgür; Özdemir, Süleyman; Tuncer, Ülkü; Kıroğlu, Mete; Akar Atik, Funda

    2016-08-01

    Diagnostic imaging methods are very important for patients with bilateral sensourinoural hearing loss. Magnetic resonance imaging (MRI) is able to demonstrate the vestibulocochlear nerve and facial nerve in the internal acoustic canal. Also computed tomography can be helpful to determination of the deficiency of the cochlear nerve. Cochlear nerve anomalies are classified into three group according to the magnetic resonance imagings. Patients who have cochlear nerve deficiency may not hear with cochlear amplifications. Auditory brain stem implant (ABI) is most suitable for these cases. In this case report, we presented a 3 years old girls with bilateral totally hearing loss who performed cochlear implantation despite of cochlear nerve deficiency on magnetic resonance imaging (MRI) and computed tomography (CT).

  8. Profile of cochlear implant users of the city of Manaus.

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    Pedrett, Mariana Dos Santos; Moreira, Sandra Costa

    2012-10-01

     The cochlear implant is a device that is intended to substitute for the function of cochlear hair cells, electrically stimulate auditory nerve fibers, and contribute to the perception of speech sounds. However, the surgical procedure alone is not enough for the user to achieve favorable results in habilitation/rehabilitation.  To characterize the patients from Manaus who have received cochlear implants based on the criteria for surgery.  We conducted a retrospective cross-sectional study of 15 cases and recorded etiological aspects of deafness, age, gender, duration of implant use, use of hearing aids, and participation in individual therapy. Data were recorded in a protocol designed specifically for this purpose. All patients were natives of Manaus.  The leading etiological aspect was ototoxicity associated with prematurity in newborns undergoing treatment in the neonatal intensive care unit. The age at surgery is carefully observed in the evaluation of implant centers, as well as if the candidate is pre-or post-lingual. In this study, 73% of patients were pre-lingual and did not benefit from hearing aids. As to the degree and type of hearing loss, 93% had audiological reports indicating profound bilateral sensorineural hearing loss and 7% had severe bilateral sensorineural hearing loss. This latter finding confirmed one of the basic principles of implant placement.  This study allowed us to verify that there are reduced number of cochlear implant recipients in Manaus, but they have met the criteria required by implant centers located in other states of Brazil.

  9. Profile of cochlear implant users of the city of Manaus

    Directory of Open Access Journals (Sweden)

    Pedrett, Mariana dos Santos

    2012-01-01

    Full Text Available Introduction: The cochlear implant is a device that is intended to substitute for the function of cochlear hair cells, electrically stimulate auditory nerve fibers, and contribute to the perception of speech sounds. However, the surgical procedure alone is not enough for the user to achieve favorable results in habilitation/rehabilitation. Objective: To characterize the patients from Manaus who have received cochlear implants based on the criteria for surgery. Methods: We conducted a retrospective cross-sectional study of 15 cases and recorded etiological aspects of deafness, age, gender, duration of implant use, use of hearing aids, and participation in individual therapy. Data were recorded in a protocol designed specifically for this purpose. All patients were natives of Manaus. Results: The leading etiological aspect was ototoxicity associated with prematurity in newborns undergoing treatment in the neonatal intensive care unit. The age at surgery is carefully observed in the evaluation of implant centers, as well as if the candidate is pre-or post-lingual. In this study, 73% of patients were pre-lingual and did not benefit from hearing aids. As to the degree and type of hearing loss, 93% had audiological reports indicating profound bilateral sensorineural hearing loss and 7% had severe bilateral sensorineural hearing loss. This latter finding confirmed one of the basic principles of implant placement. Conclusion: This study allowed us to verify that there are reduced number of cochlear implant recipients in Manaus, but they have met the criteria required by implant centers located in other states of Brazil.

  10. Hearing preservation after cochlear reimplantation.

    Science.gov (United States)

    Helbig, Silke; Rajan, Gunesh P; Stöver, Timo; Lockley, Morag; Kuthubutheen, Jafri; Green, Kevin M

    2013-01-01

    The combination of electrical and acoustical hearing (EAS) is the aim of successful hearing preservation in patients with low-frequency residual hearing who receive a cochlear implant. With adequate surgical treatment and electrode arrays designed for hearing preservation, partial hearing preservation can nowadays be achieved in the majority of patients. Over recent years, the number of patients with EAS has increased, and device failures within this group are a problem that will need to be addressed. It remains unclear how reliably hearing can be preserved during revision surgery. The outcome of 3 subjects requiring cochlear reimplantation after surgery for hearing preservation is presented and discussed. Our aim was to investigate the influence of electrode reinsertion on hearing preservation. Three patients with measurable residual hearing were implanted with a flexible, free-fitting electrode array in 3 different centers. Two subjects received a 31.5-mm array inserted 24 mm into the cochlea, whereas a third was treated with a 24-mm array, which was inserted 21 mm into the cochlea. In all cases, hearing was preserved at the initial operation. All of these subjects subsequently represented with device problems, and reimplantation was performed. Hearing preservation was measured using preoperative and postoperative pure tone audiograms. In addition, speech perception with the implant was evaluated before and after reimplantation surgery. Reimplantation was feasible in all subjects also in cases where a slightly deeper reinsertion was performed. Speech understanding scores after reimplantation were comparable to those seen after the first intervention. Revision surgery in patients with preserved hearing after cochlear implantation does not necessarily lead to loss of natural residual hearing, and patients can continue to benefit from the combination of electric and acoustic hearing. Even deeper insertion is possible without hearing loss within residual frequencies.

  11. Determining marginal electricity for near-term plug-in and fuel cell vehicle demands in California: Impacts on vehicle greenhouse gas emissions

    Science.gov (United States)

    McCarthy, Ryan; Yang, Christopher

    California has taken steps to reduce greenhouse gas emissions from the transportation sector. One example is the recent adoption of the Low Carbon Fuel Standard, which aims to reduce the carbon intensity of transportation fuels. To effectively implement this and similar policies, it is necessary to understand well-to-wheels emissions associated with distinct vehicle and fuel platforms, including those using electricity. This analysis uses an hourly electricity dispatch model to simulate and investigate operation of the current California grid and its response to added vehicle and fuel-related electricity demands in the near term. The model identifies the "marginal electricity mix" - the mix of power plants that is used to supply the incremental electricity demand from vehicles and fuels - and calculates greenhouse gas emissions from those plants. It also quantifies the contribution from electricity to well-to-wheels greenhouse gas emissions from battery-electric, plug-in hybrid, and fuel cell vehicles and explores sensitivities of electricity supply and emissions to hydro-power availability, timing of electricity demand (including vehicle recharging), and demand location within the state. The results suggest that the near-term marginal electricity mix for vehicles and fuels in California will come from natural gas-fired power plants, including a significant fraction (likely as much as 40%) from relatively inefficient steam- and combustion-turbine plants. The marginal electricity emissions rate will be higher than the average rate from all generation - likely to exceed 600 gCO 2 equiv. kWh -1 during most hours of the day and months of the year - and will likely be more than 60% higher than the value estimated in the Low Carbon Fuel Standard. But despite the relatively high fuel carbon intensity of marginal electricity in California, alternative vehicle and fuel platforms still reduce emissions compared to conventional gasoline vehicles and hybrids, through improved

  12. X-linked Malformation and Cochlear Implantation.

    Science.gov (United States)

    Smeds, Henrik; Wales, Jeremy; Asp, Filip; Löfkvist, Ulrika; Falahat, Babak; Anderlid, Britt-Marie; Anmyr, Lena; Karltorp, Eva

    2017-01-01

    To evaluate if cochlear implantation is safe and constitutes an option for hearing rehabilitation of children with x-linked inner ear malformation. Retrospective patient review in combination with a multidisciplinary follow-up. Tertiary referral hospital and cochlear implant program. Ten children with severe-profound mixed hearing loss and radiological findings consistent with Incomplete Partition type 3 cochlear malformation received cochlear implants during the years 2007 to 2015. Nine of the children had a mutation affecting the gene POU3F4 on Xq21. Cochlear implantation. Surgical events, intraoperative measures and electrical stimulation levels, hearing and spoken language abilities. In all, 15 cochlear implantations were performed. In three cases the electrode was found to be in the internal auditory canal on intraoperative x-ray and repositioned successfully. One child had a postoperative rhinorrhea confirmed to be cerebrospinal fluid but this resolved on conservative treatment. No severe complications occurred. Postoperative electrical stimulation levels were higher in 9 of 10 children, as compared with typically reported average levels in patients with a normal cochlea. Eight patients developed spoken language to various degrees while two were still at precommunication level. However, speech recognition scores were lower than average pediatric cases. Cochlear implantation is a safe procedure for children with severe-profound mixed hearing loss related to POU3F4 mutation inner ear malformation. The children develop hearing and spoken language but outcome is below average for pediatric CI recipients.

  13. Audiovisual segregation in cochlear implant users.

    Directory of Open Access Journals (Sweden)

    Simon Landry

    Full Text Available It has traditionally been assumed that cochlear implant users de facto perform atypically in audiovisual tasks. However, a recent study that combined an auditory task with visual distractors suggests that only those cochlear implant users that are not proficient at recognizing speech sounds might show abnormal audiovisual interactions. The present study aims at reinforcing this notion by investigating the audiovisual segregation abilities of cochlear implant users in a visual task with auditory distractors. Speechreading was assessed in two groups of cochlear implant users (proficient and non-proficient at sound recognition, as well as in normal controls. A visual speech recognition task (i.e. speechreading was administered either in silence or in combination with three types of auditory distractors: i noise ii reverse speech sound and iii non-altered speech sound. Cochlear implant users proficient at speech recognition performed like normal controls in all conditions, whereas non-proficient users showed significantly different audiovisual segregation patterns in both speech conditions. These results confirm that normal-like audiovisual segregation is possible in highly skilled cochlear implant users and, consequently, that proficient and non-proficient CI users cannot be lumped into a single group. This important feature must be taken into account in further studies of audiovisual interactions in cochlear implant users.

  14. Immediate and delayed cochlear neuropathy after noise exposure in pubescent mice.

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    Jensen, Jane Bjerg; Lysaght, Andrew C; Liberman, M Charles; Qvortrup, Klaus; Stankovic, Konstantina M

    2015-01-01

    Moderate acoustic overexposure in adult rodents is known to cause acute loss of synapses on sensory inner hair cells (IHCs) and delayed degeneration of the auditory nerve, despite the completely reversible temporary threshold shift (TTS) and morphologically intact hair cells. Our objective was to determine whether a cochlear synaptopathy followed by neuropathy occurs after noise exposure in pubescence, and to define neuropathic versus non-neuropathic noise levels for pubescent mice. While exposing 6 week old CBA/CaJ mice to 8-16 kHz bandpass noise for 2 hrs, we defined 97 dB sound pressure level (SPL) as the threshold for this particular type of neuropathic exposure associated with TTS, and 94 dB SPL as the highest non-neuropathic noise level associated with TTS. Exposure to 100 dB SPL caused permanent threshold shift although exposure of 16 week old mice to the same noise is reported to cause only TTS. Amplitude of wave I of the auditory brainstem response, which reflects the summed activity of the cochlear nerve, was complemented by synaptic ribbon counts in IHCs using confocal microscopy, and by stereological counts of peripheral axons and cell bodies of the cochlear nerve from 24 hours to 16 months post exposure. Mice exposed to neuropathic noise demonstrated immediate cochlear synaptopathy by 24 hours post exposure, and delayed neurodegeneration characterized by axonal retraction at 8 months, and spiral ganglion cell loss at 8-16 months post exposure. Although the damage was initially limited to the cochlear base, it progressed to also involve the cochlear apex by 8 months post exposure. Our data demonstrate a fine line between neuropathic and non-neuropathic noise levels associated with TTS in the pubescent cochlea.

  15. Immediate and delayed cochlear neuropathy after noise exposure in pubescent mice.

    Directory of Open Access Journals (Sweden)

    Jane Bjerg Jensen

    Full Text Available Moderate acoustic overexposure in adult rodents is known to cause acute loss of synapses on sensory inner hair cells (IHCs and delayed degeneration of the auditory nerve, despite the completely reversible temporary threshold shift (TTS and morphologically intact hair cells. Our objective was to determine whether a cochlear synaptopathy followed by neuropathy occurs after noise exposure in pubescence, and to define neuropathic versus non-neuropathic noise levels for pubescent mice. While exposing 6 week old CBA/CaJ mice to 8-16 kHz bandpass noise for 2 hrs, we defined 97 dB sound pressure level (SPL as the threshold for this particular type of neuropathic exposure associated with TTS, and 94 dB SPL as the highest non-neuropathic noise level associated with TTS. Exposure to 100 dB SPL caused permanent threshold shift although exposure of 16 week old mice to the same noise is reported to cause only TTS. Amplitude of wave I of the auditory brainstem response, which reflects the summed activity of the cochlear nerve, was complemented by synaptic ribbon counts in IHCs using confocal microscopy, and by stereological counts of peripheral axons and cell bodies of the cochlear nerve from 24 hours to 16 months post exposure. Mice exposed to neuropathic noise demonstrated immediate cochlear synaptopathy by 24 hours post exposure, and delayed neurodegeneration characterized by axonal retraction at 8 months, and spiral ganglion cell loss at 8-16 months post exposure. Although the damage was initially limited to the cochlear base, it progressed to also involve the cochlear apex by 8 months post exposure. Our data demonstrate a fine line between neuropathic and non-neuropathic noise levels associated with TTS in the pubescent cochlea.

  16. Negative role of TAK1 in marginal zone B-cell development incidental to NF-κB noncanonical pathway activation.

    Science.gov (United States)

    Shinohara, Hisaaki; Kurosaki, Tomohiro

    2016-10-01

    The transcription factor nuclear factor-κB (NF-κB) signaling pathway is crucial in B-cell physiology. One key molecule regulating this pathway is the serine/threonine kinase TAK1 (MAP3K7). TAK1 is responsible for positive feedback mechanisms in B-cell receptor signaling that serve as an NF-κB activation threshold. This study aimed to better understand the correlation between TAK1-mediated signaling and B-cell development and humoral immune responses. Here we showed that a B-cell conditional deletion of TAK1 using mb1-cre resulted in a dramatic elimination of the humoral immune response, consistent with the absence of the B-1 B-cell subset. When monitoring the self-reactive B-cell system (the immunoglobulin hen egg lysozyme/soluble hen egg lysozyme double-transgenic mouse model), we found that TAK1-deficient B cells exhibited an enhanced susceptibility to cell death that might explain the disappearance of the B1 subset. In contrast, these mice gained numerous marginal zone (MZ) B cells. We consequently examined the basal and B-cell receptor-induced activity of NF-κB2 that is reported to regulate MZ B-cell development, and demonstrated that the activity of NF-κB2 increased in TAK1-deficient B cells. Thus, our results present a novel in vivo function, the negative role of TAK1 in MZ B-cell development that is likely associated with NF-κB2 activation.

  17. Ototoxicity of paclitaxel in rat cochlear organotypic cultures

    Energy Technology Data Exchange (ETDEWEB)

    Dong, Yang [Shanghai University of Traditional Chinese Medicine, Shanghai 201203 (China); Center for Hearing and Deafness, University at Buffalo, NY 14214 (United States); Ding, Dalian; Jiang, Haiyan [Center for Hearing and Deafness, University at Buffalo, NY 14214 (United States); Shi, Jian-rong [Shanghai University of Traditional Chinese Medicine, Shanghai 201203 (China); Salvi, Richard [Center for Hearing and Deafness, University at Buffalo, NY 14214 (United States); Roth, Jerome A., E-mail: jaroth@buffalo.edu [Department of Pharmacology and Toxicology, University at Buffalo, NY 14214 (United States)

    2014-11-01

    Paclitaxel (taxol) is a widely used antineoplastic drug employed alone or in combination to treat many forms of cancer. Paclitaxel blocks microtubule depolymerization thereby stabilizing microtubules and suppressing cell proliferation and other cellular processes. Previous reports indicate that paclitaxel can cause mild to moderate sensorineural hearing loss and some histopathologic changes in the mouse cochlea; however, damage to the neurons and the underlying cell death mechanisms are poorly understood. To evaluate the ototoxicity of paclitaxel in more detail, cochlear organotypic cultures from postnatal day 3 rats were treated with paclitaxel for 24 or 48 h with doses ranging from 1 to 30 μM. No obvious histopathologies were observed after 24 h treatment with any of the paclitaxel doses employed, but with 48 h treatment, paclitaxel damaged cochlear hair cells in a dose-dependent manner and also damaged auditory nerve fibers and spiral ganglion neurons (SGN) near the base of the cochlea. TUNEL labeling was negative in the organ of Corti, but positive in SGN with karyorrhexis 48 h after 30 μM paclitaxel treatment. In addition, caspase-6, caspase-8 and caspase-9 labeling was present in SGN treated with 30 μM paclitaxel for 48 h. These results suggest that caspase-dependent apoptotic pathways are involved in paclitaxel-induced damage of SGN, but not hair cells in cochlea. - Highlights: • Paclitaxel was toxic to cochlear hair cells and spiral ganglion neurons. • Paclitaxel-induced spiral ganglion degeneration was apoptotic. • Paclitaxel activated caspase-6, -8 and -8 in spiral ganglion neurons.

  18. The dolphin cochlear nucleus: topography, histology and functional implications.

    Science.gov (United States)

    Malkemper, E P; Oelschläger, H H A; Huggenberger, S

    2012-02-01

    Despite the outstanding auditory capabilities of dolphins, there is only limited information available on the cytology of the auditory brain stem nuclei in these animals. Here, we investigated the cochlear nuclei (CN) of five brains of common dolphins (Delphinus delphis) and La Plata dolphins (Pontoporia blainvillei) using cell and fiber stain microslide series representing the three main anatomical planes. In general, the CN in dolphins comprise the same set of subnuclei as in other mammals. However, the volume ratio of the dorsal cochlear nucleus (DCN) in relation to the ventral cochlear nucleus (VCN) of dolphins represents a minimum among the mammals examined so far. Because, for example, in cats the DCN is necessary for reflexive orientation of the head and pinnae towards a sound source, the massive restrictions in head movability in dolphins and the absence of outer ears may be correlated with the reduction of the DCN. Moreover, the same set of main neuron types were found in the dolphin CN as in other mammals, including octopus and multipolar cells. Because the latter two types of neurons are thought to be involved in the recognition of complex sounds, including speech, we suggest that, in dolphins, they may be involved in the processing of their communication signals. Comparison of the toothed whale species studied here revealed that large spherical cells were present in the La Plata dolphin but absent in the common dolphin. These neurons are known to be engaged in the processing of low-frequency sounds in terrestrial mammals. Accordingly, in the common dolphin, the absence of large spherical cells seems to be correlated with a shift of its auditory spectrum into the high-frequency range above 20 kHz. The existence of large spherical cells in the VCN of the La Plata dolphin, however, is enigmatic asthis species uses frequencies around 130 kHz. Copyright © 2011 Wiley Periodicals, Inc.

  19. Notch-RBP-J-independent marginal zone B cell development in IgH transgenic mice with VH derived from a natural polyreactive antibody.

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    Zhang, Zhuo; Zhou, Lanhua; Yang, Xinwei; Wang, Yaochun; Zhang, Ping; Hou, Lihong; Hu, Xinbin; Xing, Ying; Liu, Yufeng; Li, Wei; Han, Hua

    2012-01-01

    Both the B cell antigen receptor (BCR) signaling and Notch signaling pathway play important roles in marginal zone (MZ) B cell development; however, if and how these two signaling pathways engage in crosstalk with each other remain unclear. In the present study, IgH transgenic mice (TgV(H)3B4) were crossed with mice with Notch downstream transcription factor RBP-J floxed alleles (RBP-J(f/f)) and Mx-Cre transgene. Subsequently, MZ B cell development was analyzed in 3B4/Cre/RBP-J(f/f) mice that expressed the transgenic 3B4 IgH and exhibited a deficiency in Notch signaling in B cells upon poly (I:C) injection. We observed that MZ B cell numbers were severely reduced, but still detectable in 3B4/Cre/RBP-J(f/f) mice, in contrast to increased numbers of MZ B cells in TgV(H)3B4 mice and almost no MZ B cells in Cre/RBP-J(f/f) mice. The majority of the MZ B cells in the 3B4/Cre/RBP-J(f/f) mice had the same antigen specificity with that of 3B4 antibody, indicating that a particular BCR specificity might direct MZ B cell development in the absence of Notch signaling. The number of MZ B precursor (MZP) cells was reduced sharply in 3B4/Cre/RBP-J(f/f) mice, and the number of transitional stage 1 and transitional stage 2 cells did not change that much, indicating that the interaction between BCR and Notch signaling likely occurred during the T2-MZP stage. Based on the transgenic mouse model, our data indicate that MZ B cells with certain BCR specificity can develop in a Notch-RBP-J independent manner.

  20. Notch-RBP-J-independent marginal zone B cell development in IgH transgenic mice with VH derived from a natural polyreactive antibody.

    Directory of Open Access Journals (Sweden)

    Zhuo Zhang

    Full Text Available Both the B cell antigen receptor (BCR signaling and Notch signaling pathway play important roles in marginal zone (MZ B cell development; however, if and how these two signaling pathways engage in crosstalk with each other remain unclear. In the present study, IgH transgenic mice (TgV(H3B4 were crossed with mice with Notch downstream transcription factor RBP-J floxed alleles (RBP-J(f/f and Mx-Cre transgene. Subsequently, MZ B cell development was analyzed in 3B4/Cre/RBP-J(f/f mice that expressed the transgenic 3B4 IgH and exhibited a deficiency in Notch signaling in B cells upon poly (I:C injection. We observed that MZ B cell numbers were severely reduced, but still detectable in 3B4/Cre/RBP-J(f/f mice, in contrast to increased numbers of MZ B cells in TgV(H3B4 mice and almost no MZ B cells in Cre/RBP-J(f/f mice. The majority of the MZ B cells in the 3B4/Cre/RBP-J(f/f mice had the same antigen specificity with that of 3B4 antibody, indicating that a particular BCR specificity might direct MZ B cell development in the absence of Notch signaling. The number of MZ B precursor (MZP cells was reduced sharply in 3B4/Cre/RBP-J(f/f mice, and the number of transitional stage 1 and transitional stage 2 cells did not change that much, indicating that the interaction between BCR and Notch signaling likely occurred during the T2-MZP stage. Based on the transgenic mouse model, our data indicate that MZ B cells with certain BCR specificity can develop in a Notch-RBP-J independent manner.

  1. Is All Human Hearing Cochlear?

    Directory of Open Access Journals (Sweden)

    Seyede Faranak Emami

    2013-01-01

    Full Text Available The objective of this cross-sectional study was to investigate the possibility that the saccule may contribute to human hearing. The forty participants included twenty healthy people and twenty other subjects selected from patients who presented with benign paroxysmal positional vertigo to Audiology Department of Hazrat Rasoul Akram hospital (Tehran, Iran. Assessments comprised of audiological evaluations, cervical vestibular evoked myogenic potentials (cVEMPs, recognition of spoken phonemes in white noise (Rsp in wn, and auditory brainstem response to 500 Hz tone burst (ABR500 HZ. Twenty affected ears with decreased vestibular excitability as detected by abnormal cVEMPs revealed decreased scores of Rsp in wn and abnormal findings of ABR500 HZ. Both unaffected and normal ears had normal results. Multiple comparisons of mean values of cVEMPs and ABR500 HZ between three groups were significant (P<0.05, ANOVA. The correlation between RSP in wn and p13 latencies was significant. The peak-to-peak amplitudes showed significant correlation to RSP in wn. The correlation between RSP in wn and the latencies of n23 was significant. In high-level of noisy competing situations, healthy human saccular sensation can mediate the detection of low frequencies and possibly help in cochlear hearing for frequency and intensity discrimination. So, all human hearing is not cochlear.

  2. Optical characterization of lesions and identification of surgical margins in pancreatic metastasis from renal cell carcinoma by using two-photon excited fluorescence microscopy

    Science.gov (United States)

    Chen, Jing; Hong, Zhipeng; Chen, Hong; Chen, Youting; Xu, Yahao; Zhu, Xiaoqin; Zhuo, Shuangmu; Shi, Zheng; Chen, Jianxin

    2014-11-01

    Two-photon excited fluorescence (TPEF) microscopy has become a powerful instrument for imaging unstained tissue samples in biomedical research. The purpose of this study was to determine whether TPEF imaging of histological sections without hematoxylin-eosin (H-E) stain can be used to characterize lesions and identify surgical margins in pancreatic metastasis from renal cell carcinoma (RCC). The specimens of a pancreatic metastasis from RCC, as well as a primary RCC from a patient, were examined by TPEF microscopy and compared with their corresponding H-E stained histopathological results. The results showed that high-resolution TPEF imaging of unstained histological sections of pancreatic metastasis from RCC can reveal that the typical morphology of the tissue and cells in cancer tissues is different from the normal pancreas. It also clearly presented histopathological features of the collagenous capsule, which is an important boundary symbol to identify normal and cancerous tissue and to instruct surgical operation. It indicated the feasibility of using TPEF microscopy to make an optical diagnosis of lesions and identify the surgical margins in pancreatic metastasis from RCC.

  3. Evaluation of Rigid Cochlear Models for Measuring Cochlear Implant Electrode Position.

    Science.gov (United States)

    Cakir, Ahmet; Labadie, Robert F; Zuniga, M Geraldine; Dawant, Benoit M; Noble, Jack H

    2016-12-01

    To investigate the accuracy of rigid cochlear models in measuring intra-cochlear positions of cochlear implant (CI) electrodes. Ninety three adults who had undergone CI and pre- and postoperative computed tomographic (CT) imaging. Seven rigid models of cochlear anatomy were constructed using micro-CTs of cochlear specimens. Using each of the seven models, the position of each electrode in each of the 98 ears in our dataset was measured as its depth along the length of the cochlea, its distance to the basilar membrane, and its distance to the modiolus. Cochlear duct length was also measured using each model. Standard deviation (SD) across rigid cochlear models in measures of electrode depth, distance to basilar membrane, distance to modiolus, and length of the cochlear duct at two turns were 0.68, 0.11, 0.15, and 1.54 mm. Comparing the estimated position of the electrodes with respect to the basilar membrane, i.e., deciding whether an electrode was located within the scala tympani (ST) or the scala vestibuli (SV), there was not a unanimous agreement between the models for 19% of all the electrodes. With respect to the modiolus, each electrode was classified into one of the three groups depending on its modiolar distance: close, medium, and far. Rigid models did not unanimously agree on modiolar distance for approximately 50% of the electrodes tested. Inter-model variance of rigid cochlear models exists, demonstrating that measurements made using rigid cochlear models are limited in terms of accuracy because of non-rigid inter-subject variations in cochlear anatomy.

  4. Cochlear implant: what the radiologist should know

    Directory of Open Access Journals (Sweden)

    Natalia Delage Gomes

    2013-06-01

    Full Text Available Cochlear implant is the method of choice in the treatment of deep sensorineural hypoacusis, particularly in patients where conventional amplification devices do not imply noticeable clinical improvement. Imaging findings are crucial in the indication or contraindication for such surgical procedure. In the assessment of the temporal bone, radiologists should be familiar with relative or absolute contraindication factors, as well as with factors that might significantly complicate the implantation. Some criteria such as cochlear nerve aplasia, labyrinthine and/or cochlear aplasia are still considered as absolute contraindications, in spite of studies bringing such criteria into question. Cochlear dysplasias constitute relative contraindications, among them labyrinthitis ossificans is highlighted. Other alterations may be mentioned as complicating agents in the temporal bone assessment, namely, hypoplasia of the mastoid process, aberrant facial nerve, otomastoiditis, otosclerosis, dehiscent jugular bulb, enlarged endolymphatic duct and sac. The experienced radiologist assumes an important role in the evaluation of this condition.

  5. [Is cochlear processing involved in language disorders?].

    Science.gov (United States)

    Durand-Rivera, J A; Manzano-Martínez, E; González-Piña, R

    Otoacoustic emissions are evidence of the existence of an active process in the cochlea, and the motility of the outer hair cells means that they can change the cochlear mechanical response. We believe that incorrect processing of the sounds of language in the cochlea can result in impaired language processes. Data were collected from the patient record; neurological, visual and auditory examination; Weschler intelligence scale; initial language test (ILT); brainstem auditory evoked potentials (BAEPs) and transient otoacoustic emissions. The results of the ILT were used to form three groups: controls, pathological and pathological with normal ILT. All the children presented a response at 20 dB by means of the BAEPs. In the transient otoacoustic emissions, Student's t test was conducted between the right and the left ear for total reproducibility and reproducibility at different band frequencies within each group. No significant differences were observed. The same test was carried out between groups (controls versus pathological, controls versus pathological with normal ILT, and pathological versus pathological with normal ILT) in the right and left ears; no significant differences were found in the total reproducibility for the two ears. No significant differences were found in the reproducibility at different frequency bands for the left ear, but some were found in the case of the right ear. Laterality from the periphery exists for language processing and if this process fails to perform correctly, due to malfunctioning of the outer hair cells, language may be affected.

  6. [Cochlear implantation through the middle fossa approach].

    Science.gov (United States)

    Szyfter, W; Colletti, V; Pruszewicz, A; Kopeć, T; Szymiec, E; Kawczyński, M; Karlik, M

    2001-01-01

    The inner part of cochlear implant is inserted into inner ear during surgery through mastoid and middle ear. It is a classical method, used in the majority cochlear centers in the world. This is not a suitable method in case of chronic otitis media and middle ear malformation. In these cases Colletti proposed the middle fossa approach and cochlear implant insertion omitting middle ear structures. In patient with bilateral chronic otitis media underwent a few ears operations without obtaining dry postoperative cavity. Cochlear implantation through the middle fossa approach was performed in this patient. The bone fenster was cut, temporal lobe was bent and petrosus pyramid upper surface was exposed. When the superficial petrosal greater nerve, facial nerve and arcuate eminence were localised, the cochlear was open in the basal turn and electrode were inserted. The patient achieves good results in the postoperative speech rehabilitation. It confirmed Colletti tesis that deeper electrode insertion in the cochlear implantation through the middle fossa approach enable use of low and middle frequencies, which are very important in speech understanding.

  7. Characterisation of cochlear inflammation in mice following acute and chronic noise exposure.

    Science.gov (United States)

    Tan, Winston J T; Thorne, Peter R; Vlajkovic, Srdjan M

    2016-08-01

    Oxidative stress has been established as the key mechanism of the cochlear damage underlying noise-induced hearing loss, however, emerging evidence suggests that cochlear inflammation may also be a major contributor. This study aimed to improve our understanding of the cochlear inflammatory response associated with acute and chronic noise exposure. C57BL/6 mice were exposed to acute traumatic noise (100 dBSPL, 8-16 kHz for 24 h) and their cochleae collected at various intervals thereafter, up to 7 days. Using quantitative RT-PCR and immunohistochemistry, changes in expression levels of proinflammatory cytokines (TNF-α, IL-1β), chemokines (CCL2) and cell adhesion molecules (ICAM-1) were studied. All gene transcripts displayed similar dynamics of expression, with an early upregulation at 6 h post-exposure, followed by a second peak at 7 days. ICAM-1 immunoexpression increased significantly in the inferior region of the spiral ligament, peaking 24 h post-exposure. The early expression of proinflammatory mediators likely mediates the recruitment and extravasation of inflammatory cells into the noise-exposed cochlea. The occurrence of the latter expression peak is not clear, but it may be associated with reparative processes initiated in response to cochlear damage. Chronic exposure to moderate noise (90 dBSPL, 8-16 kHz, 2 h/day, up to 4 weeks) also elicited an inflammatory response, reaching a maximum after 2 weeks, suggesting that cochlear damage and hearing loss associated with chronic environmental noise exposure may be linked to inflammatory processes in the cochlea. This study thus provides further insight into the dynamics of the cochlear inflammatory response induced by exposure to acute and chronic noise.

  8. Marginalization and health geomatics.

    Science.gov (United States)

    Alexander, Gregory L; Kinman, Edward L; Miller, Louise C; Patrick, Timothy B

    2003-01-01

    Marginalized groups have been defined as groups that have been peripheralized from the center of society. Increasing nursing knowledge of marginalized groups and the dynamics of population diversity will enable nurses to better recognize shifting health patterns, plan for utilization of health services, and determine ethnic and cultural differences that exist in marginalized populations. The authors of this article review theoretical models responsible for defining the concept marginalization, describe geographical information systems as a recommended tool to evaluate marginalized groups, and provide a case study utilizing tools and maps as a means of assessing marginal situations.

  9. Comparison of the effects of four different cochlear implant electrodes on intra-cochlear pressure in a model.

    Science.gov (United States)

    Todt, Ingo; Mittmann, Marlene; Ernst, Arneborg; Mittmann, Philipp

    2017-03-01

    Based on this model experiment, a small tip and low volume electrode show lowest intra-cochlear pressure values. Insertional support by a tool minimizes fast pressure changes. Higher electrodes volumes affect slow and fast pressure changes as well. Insertion causing low intra-cochlear pressure is assumed to be important for atraumatic cochlear implant surgery to preserve residual hearing. Cochlear implant electrodes differ in terms of parameters like tip size, length, volume, and technique of insertion. The aim of this study was to observe the effect of different cochlear implant electrodes on insertional intra-cochlear pressure in a cochlear model. Cochlear implant electrode insertions were performed in an artificial cochlear model and intra-cochlear pressure changes were recorded in parallel with a micro-pressure sensor positioned in the apical region of the cochlear model to follow the maximum values, temporal changes, maximum amplitude, and frequency of changes in intra-cochlear pressure. Insertions were performed with four different electrodes (Advanced Bionics 1j, Helix, HFMS, and LW23). This study found statistically significant differences in the occurrence of initial maximum pressure values correlating with the electrode tip size. The different electrodes and the technique of insertion significantly affected the occurrence of maximum value, amplitude, and frequency of intra-cochlear pressure occurrence.

  10. Cochlear Implants Keep Twin Sisters Learning, Discovering Together

    Science.gov (United States)

    ... Issue Past Issues Special Section: Focus on Communication Cochlear Implants Past Issues / Fall 2008 Table of Contents For ... Mia, right, and Isabelle Jeppsen meet with Mia's cochlear implant surgeon, John Niparko, M.D., of Johns Hopkins ...

  11. Auditory cortical maturation in children with sequential bilateral cochlear implants.

    NARCIS (Netherlands)

    Sparreboom, M.; Beynon, A.J.; Snik, A.F.M.; Mylanus, E.A.M.

    2014-01-01

    OBJECTIVE: To assess the effect of sequential bilateral cochlear implantation on auditory, cortical maturation after various periods of unilateral cochlear implant use. STUDY DESIGN: Prospective cohort study. SETTING: Tertiary academic referral center. PATIENTS: Thirty prelingually deaf children,

  12. [Cochlear implant operation to summarize and postoperative outcome].

    Science.gov (United States)

    Lu, Yuan; Cao, Keli

    2014-11-01

    The aim of this study was to evaluate the clinical features of cochlear reimplantation. To review our experience of cochlear reimplant surgery. Retrospective analysis of all 25 cochlear reimplant surgeries between 2002 and 2012. Causes of revision operations, number of electrode channels inserted, surgical findings and postoperative speech performances were analyzed. Causes of reimplantation were eight hard failures; eight poor implanted electrodes position, four poor outcome, three skin flap infection lead to implant device exposure, one postoperative symptoms of facial nerve stimulation, one postoperative temporal bone lesions. All cochlear reimplantations were successfully performed in our hospital, audiologic performances were stable or improved following reimplantation in most of cases. Cochlear implant surgeons should have a good knowledge of how to diagnose cochlear implant failures and how to deal with medical complications related to cochlear implantation. Medical and audiologic outcomes are generally excellent. Cochlear reimplantation appears to be a safe and effective.

  13. Splenic Marginal Zone Granulocytes Acquire an Accentuated Neutrophil B-Cell Helper Phenotype in Chronic Lymphocytic Leukemia.

    Science.gov (United States)

    Gätjen, Marcel; Brand, Franziska; Grau, Michael; Gerlach, Kerstin; Kettritz, Ralph; Westermann, Jörg; Anagnostopoulos, Ioannis; Lenz, Peter; Lenz, Georg; Höpken, Uta E; Rehm, Armin

    2016-09-15

    Recruitment of tumor-associated macrophages and neutrophils (TAM and TAN) to solid tumors contributes to immunosuppression in the tumor microenvironment; however, their contributions to lymphoid neoplasms are less clear. In human chronic lymphocytic leukemia (CLL), tumor B cells lodge in lymph nodes where interactions with the microenvironment occur. Tumor cell homing stimulates proliferation, such that engagement of the B-cell receptor is important for malignant progression. In the Eμ-Tcl1 murine model of CLL, we identified gene expression signatures indicative of a skewed polarization in the phenotype of monocytes and neutrophils. Selective ablation of either of these cell populations in mice delayed leukemia growth. Despite tumor infiltration of these immune cells, a systemic inflammation was not detected. Notably, in progressive CLL, splenic neutrophils were observed to differentiate toward a B-cell helper phenotype, a process promoted by the induction of leukemia-associated IL10 and TGFβ. Our results suggest that targeting aberrant neutrophil differentiation and restoring myeloid cell homeostasis could limit the formation of survival niches for CLL cells. Cancer Res; 76(18); 5253-65. ©2016 AACR. ©2016 American Association for Cancer Research.

  14. Transduction without Tip Links in Cochlear Hair Cells Is Mediated by Ion Channels with Permeation Properties Distinct from Those of the Mechano-Electrical Transducer Channel

    NARCIS (Netherlands)

    Marcotti, Walter; Corns, Laura F.; Desmonds, Terri; Kirkwood, Nerissa K.; Richardson, Guy P.; Kros, Corne J.

    2014-01-01

    Tip links between adjacent stereocilia are believed to gate mechano-electrical transducer (MET) channels and mediate the electrical responses of sensory hair cells. We found that mouse auditory hair cells that lack tip links due to genetic mutations or exposure to the Ca2+ chelator BAPTA can,

  15. Eradication of basal cell carcinoma of the head and neck using the Surgical Excision with a new Stained Margin Technique: a preliminary study.

    Science.gov (United States)

    Celasco, Melissa; Zavattaro, Elisa; Veronese, Federica; Boggio, Paolo; Bonvini, Daniele; Leigheb, Giorgio; Valente, Guido; Colombo, Enrico

    2017-05-16

    Basal Cell Carcinomas (BCCs) are common cutaneous neoplasms that mainly affect fair-skinned subjects, in sun-exposed areas of the body. The treatment of choice of BCCs is represented by surgical excision and different techniques are available, in order to allow the complete eradication of the tumour with the best cosmetic results. In this paper we describe the Surgical Excision with Stained Margin Technique (SMET) and we report its efficacy for the treatment of BCCs of the head and neck region. We retrospectively studied 177 BCCs of the head and neck region treated by SMET: a surgical technique in which each specimen is cut vertically like a bread-loaf in multiple sections of 1 mm thickness, after marking peripheral margins. We observed an overall recurrence rate of 4.5% after SMET (mean follow-up=26 months), with higher rate in aggressive subtypes (p=0.04). BCCs located in high-risk sites and those previously undergone to other non-radical therapies required 2 or more procedures (p=0.008 and 0.002, respectively), while no correlation was observed between the number of SMET procedures and recurrence rate. In our experience, since low recurrence rate was obtained by SMET, we suggest that it may be taken into consideration as surgical option for BCCs of the head and neck region.

  16. Histologic and systemic prognosticators for local control and survival in margin-negative transoral laser microsurgery treated oral cavity squamous cell carcinoma.

    Science.gov (United States)

    Sinha, Parul; Mehrad, Mitra; Chernock, Rebecca D; Lewis, James S; El-Mofty, Samir K; Wu, Ningying; Nussenbaum, Brian; Haughey, Bruce H

    2015-01-01

    Appreciable local recurrence rates observed in patients with margin-negative, transoral laser microsurgery (TLM)-treated oral cavity squamous cell carcinoma (SCC) necessitate identification of new prognosticators for local control and survival. A histopathologic index (Brandwein-Gensler score [BGS]) and intrinsic/iatrogenic/chronic conditions causing immune compromise are investigated. From a prospectively assembled database of TLM-treated oral cavity SCC, specimens for 60 patients with a minimum of 2-years follow-up could undergo BGS assignment. Local control, disease-specific survival (DSS), and overall survival (OS) were study endpoints. "Low-BGS" was recorded in 28 patients (47%) and "high-BGS" in 32 patients (53%), whereas immune compromise was observed in 18%. In multivariate analyses, immune compromise was the only predictor for local control. T classification and immune compromise were prognostic for DSS and OS. "High-BGS" was prognostic only for OS. "High-BGS" was associated with recurrences but immune compromise was the most significant predictor of local control and survival in margin-negative, TLM-treated oral cavity SCC. Strategies that maintain/restore tumor-specific immune responses in immune compromised oral cavity SCC hosts need to be developed. © 2014 Wiley Periodicals, Inc.

  17. Cochlear microphonic potentials: a new recording technique.

    Science.gov (United States)

    Carricondo, F; Gil-Loyzaga, P; Sanjuán-Juaristi, J; Poch-Broto, J

    2001-06-01

    A new instrumentation and a particular method for detecting and recording cochlear microphonic potentials (CMPs) are described here. The CMPs were recorded in rats by means of pure tones (4,000, 2,000, 1,000, 500, and 250 Hz) and intraepidermic electrodes; the electrocochleography technique was avoided. An experimental design that included the use of a glutamatergic agonist (kainic acid [KA]) and an aminoglycoside antibiotic (kanamycin [KANA]) was carried out to demonstrate the origin of the recorded potential. Morphological studies showed that KA selectively eliminated the afferent type I dendrites of the spiral ganglion, while the administration of KANA resulted in the absence of outer hair cells. When CMPs were recorded after KA administration, no alterations were detected. In contrast, KANA administration resulted in the absence of any selective electrophysiological activity corresponding to CMPs. All these results were compared with the recording of the compound action potential of the eighth nerve obtained by electrocochleography. These findings and the great specificity of the reproduction of the sound stimulus confirm that the CMPs can be recorded by the new equipment.

  18. A biophysical modelling platform of the cochlear nucleus and other auditory circuits: From channels to networks.

    Science.gov (United States)

    Manis, Paul B; Campagnola, Luke

    2017-12-28

    Models of the auditory brainstem have been an invaluable tool for testing hypotheses about auditory information processing and for highlighting the most important gaps in the experimental literature. Due to the complexity of the auditory brainstem, and indeed most brain circuits, the dynamic behavior of the system may be difficult to predict without a detailed, biologically realistic computational model. Despite the sensitivity of models to their exact construction and parameters, most prior models of the cochlear nucleus have incorporated only a small subset of the known biological properties. This confounds the interpretation of modelling results and also limits the potential future uses of these models, which require a large effort to develop. To address these issues, we have developed a general purpose, biophysically detailed model of the cochlear nucleus for use both in testing hypotheses about cochlear nucleus function and also as an input to models of downstream auditory nuclei. The model implements conductance-based Hodgkin-Huxley representations of cells using a Python-based interface to the NEURON simulator. Our model incorporates most of the quantitatively characterized intrinsic cell properties, synaptic properties, and connectivity available in the literature, and also aims to reproduce the known response properties of the canonical cochlear nucleus cell types. Although we currently lack the empirical data to completely constrain this model, our intent is for the model to continue to incorporate new experimental results as they become available. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  19. Rapidly induced, T-cell independent xenoantibody production is mediated by marginal zone B cells and requires help from NK cells

    OpenAIRE

    Li, Shengqiao; Yan, Yehong; Lin, Yuan; Bullens, Dominique; Rutgeerts, Omer; Goebels, Jozef; Segers, Constant; Boon, Louis; Kasran, Ahmad; Vos, Rita; Dewolf-Peeters, Christiane; Waer, Mark; Billiau, An

    2007-01-01

    Xenoantibody production directed at a wide variety of T lymphocyte-dependent and T lymphocyte-independent xenoantigens remains the major immunologic obstacle for successful xenotransplantation. The B lymphocyte subpopulations and their helper factors, involved in T-cellindependent xenoantibody production are only partially understood, and their identi-ication will contribute to the clinical applicability of xenotransplantation. Here we show, using models involving T-cell-deficient athymic rec...

  20. Marginal zone lymphoma-derived interfollicular diffuse large B-cell lymphoma harboring 20q12 chromosomal deletion and missense mutation of BIRC3 gene: a case report.

    Science.gov (United States)

    Hatem, Joseph; Schrank-Hacker, April M; Watt, Christopher D; Morrissette, Jennifer J D; Rubin, Adam I; Kim, Ellen J; Nasta, Sunita D; Wasik, Mariusz A; Bogusz, Agata M

    2016-12-19

    Diffuse large B-cell lymphoma (DLBCL) typically leads to effacement of the nodal architecture by an infiltrate of malignant cells. Rarely (DLBCL can present with an interfollicular pattern (DLBCL-IF) preserving the lymphoid follicles. It has been postulated that DLBCL-IF is derived from marginal zone B cells and may represent a large-cell transformation of marginal zone lymphoma (MZL), however no direct evidence has been provided to date. Here we describe a rare case of a diagnostically challenging DLBCL-IF involving a lymph node in a patient with a prior history of lymphadenopathy for several years and MZL involving skin. A 53-year old man presented to our Dermatology Clinic due to a 1-year history of generalized itching, fatigue of 2-3 month's duration, nausea and mid back rash that was biopsied. PET (positron emission tomography)/CT (computed tomography) was performed and revealed inguinal, pelvic, retroperitoneal, axillary, and cervical lymphadenopathy. The patient was referred to surgery for excisional biopsy of a right inguinal lymph node. Diagnostic H&E stained slides and ancillary studies were reviewed for the lymph node and skin specimens. B-cell clonality by PCR and sequencing studies were performed on both specimens. We demonstrate that this patient's MZL and DLBCL-IF are clonally related, strongly suggesting that transformation of MZL to DLBCL had occurred. Furthermore, we identified a novel deletion of the long arm of chromosome 20 (del(20q12)) and a missense mutation in BIRC3 (Baculoviral IAP repeat-containing protein 3) in this patient's DLBCL that are absent from his MZL, suggesting that these genetic alterations contributed to the large cell transformation. To our knowledge, this is the first report providing molecular evidence for a previously suspected link between MZL and DLBCL-IF. In addition, we describe for the first time del(20q12) and a missense mutation in BIRC3 in DLBCL. Our findings also raise awareness of DLBCL-IF and discuss the

  1. Marginal zone lymphoma of mucosa-associated lymphoid tissue with prominent plasma cell differentiation affecting the palatine tonsil: histopathological and immunohistochemical analysis.

    Science.gov (United States)

    Carlos Bregni, Román; Nuyens, Michel; Vassallo, José; Soares, Fernando Augusto; Romañach, Mário José; León, Jorge Esquiche; Almeida, Oslei Paes

    2012-04-01

    Non-Hodgkin lymphomas (NHLs) of the oral cavity and oropharynx constitute 13% of all primary extranodal NHLs. Marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT lymphoma) in the palatine tonsil is rare, corresponding to 6% of the NHLs of the Waldeyer ring. Some cases of MALT lymphoma can present prominent plasma cell differentiation, and less commonly, monoclonal gammopathy. The differential diagnosis of these cases from other NHLs with plasmacytic differentiation or plasma cell neoplasms is very difficult. In this article, we describe a rare case of MALT lymphoma in a 34-year-old man presenting as a swelling of the palatine tonsil. The tumor mass was diagnosed as MALT lymphoma with prominent plasma cell differentiation. Systemic evaluation was noncontributory. This is the first report of MALT lymphoma showing extensive plasmacytic differentiation of the palatine tonsil, and reinforces a possible relationship between extramedullary plasmacytoma and MALT lymphoma. Copyright © 2012 Elsevier Inc. All rights reserved.

  2. Cochlear Responses and Auditory Brainstem Response Functions in Adults with Auditory Neuropathy/ Dys-Synchrony and Individuals with Normal Hearing

    Directory of Open Access Journals (Sweden)

    Zahra Jafari

    2007-06-01

    Full Text Available Background and Aim: Physiologic measures of cochlear and auditory nerve function may be of assis¬tance in distinguishing between hearing disorders due primarily to auditory nerve impairment from those due primarily to cochlear hair cells dysfunction. The goal of present study was to measure of co-chlear responses (otoacoustic emissions and cochlear microphonics and auditory brainstem response in some adults with auditory neuropathy/ dys-synchrony and subjects with normal hearing. Materials and Methods: Patients were 16 adults (32 ears in age range of 14-30 years with auditory neu¬ropathy/ dys-synchrony and 16 individuals in age range of 16-30 years from both sexes. The results of transient otoacoustic emissions, cochlear microphonics and auditory brainstem response measures were compared in both groups and the effects of age, sex, ear and degree of hearing loss were studied. Results: The pure-tone average was 48.1 dB HL in auditory neuropathy/dys-synchrony group and the fre¬quency of low tone loss and flat audiograms were higher among other audiogram's shapes. Transient oto¬acoustic emissions were shown in all auditory neuropathy/dys-synchrony people except two cases and its average was near in both studied groups. The latency and amplitude of the biggest reversed co-chlear microphonics response were higher in auditory neuropathy/dys-synchrony patients than control peo¬ple significantly. The correlation between cochlear microphonics amplitude and degree of hearing loss was not significant, and age had significant effect in some cochlear microphonics measures. Audi-tory brainstem response had no response in auditory neuropathy/dys-synchrony patients even with low stim¬uli rates. Conclusion: In adults with speech understanding worsen than predicted from the degree of hearing loss that suspect to auditory neuropathy/ dys-synchrony, the frequency of low tone loss and flat audiograms are higher. Usually auditory brainstem response is absent in

  3. In HepG2 Cells, Coexisting Carnitine Deficiency Masks Important Indicators of Marginal Biotin Deficiency123

    Science.gov (United States)

    Bogusiewicz, Anna; Boysen, Gunnar; Mock, Donald M

    2015-01-01

    Background: A large number of birth defects are related to nutrient deficiencies; concern that biotin deficiency is teratogenic in humans is reasonable. Surprisingly, studies indicate that increased urinary 3-hydroxyisovalerylcarnitine (3HIAc), a previously validated marker of biotin deficiency, is not a valid biomarker in pregnancy. Objective: In this study we hypothesized that coexisting carnitine deficiency can prevent the increase in 3HIAc due to biotin deficiency. Methods: We used a 2-factor nutrient depletion design to induce isolated and combined biotin and carnitine deficiency in HepG2 cells and then repleted cells with carnitine. To elucidate the metabolic pathogenesis, we quantitated intracellular and extracellular free carnitine, acylcarnitines, and acylcarnitine ratios using liquid chromatography–tandem mass spectrometry. Results: Relative to biotin-sufficient, carnitine-sufficient cells, intracellular acetylcarnitine increased by 90%, propionylcarnitine more than doubled, and 3HIAc increased by >10-fold in biotin-deficient, carnitine-sufficient (BDCS) cells, consistent with a defensive mechanism in which biotin-deficient cells transesterify the acyl-coenzyme A (acyl-CoA) substrates of the biotin-dependent carboxylases to the related acylcarnitines. Likewise, in BDCS cells, the ratio of acetylcarnitine to malonylcarnitine and the ratio of propionylcarnitine to methylmalonylcarnitine both more than tripled, and the ratio of 3HIAc to 3-methylglutarylcarnitine (MGc) increased by >10-fold. In biotin-deficient, carnitine-deficient (BDCD) cells, the 3 substrate-derived acylcarnitines changed little, but the substrate:product ratios were masked to a lesser extent. Moreover, carnitine repletion unmasked biotin deficiency in BDCD cells as shown by increases in acetylcarnitine, propionylcarnitine, and 3HIAc (each increased by >50-fold). Likewise, ratios of acetylcarnitine:malonylcarnitine, propionylcarnitine:methylmalonylcarnitine, and 3HIAc:MGc all increased

  4. Retrolabyrinthine approach for cochlear nerve preservation in neurofibromatosis type 2 and simultaneous cochlear implantation

    Directory of Open Access Journals (Sweden)

    Bento, Ricardo Ferreira

    2014-01-01

    Full Text Available Introduction: Few cases of cochlear implantation (CI in neurofibromatosis type 2 (NF2 patients had been reported in the literature. The approaches described were translabyrinthine, retrosigmoid or middle cranial fossa. Objectives: To describe a case of a NF2- deafened-patient who underwent to vestibular schwannoma resection via RLA with cochlear nerve preservation and CI through the round window, at the same surgical time. Resumed Report: A 36-year-old woman with severe bilateral hearing loss due to NF2 was submitted to vestibular schwannoma resection and simultaneous CI. Functional assessment of cochlear nerve was performed by electrical promontory stimulation. Complete tumor removal was accomplishment via RLA with anatomic and functional cochlear and facial nerve preservation. Cochlear electrode array was partially inserted via round window. Sound field hearing threshold improvement was achieved. Mean tonal threshold was 46.2 dB HL. The patient could only detect environmental sounds and human voice but cannot discriminate vowels, words nor do sentences at 2 years of follow-up. Conclusion: Cochlear implantation is a feasible auditory restoration option in NF2 when cochlear anatomic and functional nerve preservation is achieved. The RLA is adequate for this purpose and features as an option for hearing preservation in NF2 patients.

  5. Congenitally deaf children following cochlear implantation.

    Science.gov (United States)

    O'Donoghue, G M; Nikolopoulos, T; Archbold, S M; Tait, M

    1998-01-01

    The aim of this study is to determine the auditory performance of congenitally deaf children following cochlear implantation. A prospective study is undertaken of 71 such children who have been implanted in a dedicated paediatric cochlear implant centre and who have been followed up to 3 years following implantation. All children are aged less than 8 years at the time of implantation and all receive a multichannel cochlear implant system. No child meeting these criteria has been excluded from the study. The average age at implantation is 56.5 months (range 27 to 93 months, standard deviation 15.9 months). Auditory performance is assessed by using the Categories of Auditory Perception (CAP) scale which is developed primarily as a clinical tool for evaluating profoundly deaf young children following cochlear implantation. The median score prior to implantation on this scale is Category 0 (no awareness of environmental sound), at the 1 year interval is Category 4 (discrimination some speech sounds without lip-reading), and at the 2 and 3 year interval, the median score on the CAP scale is Category 5 (understanding of common phrases without lip-reading). These results indicate the ability of cochlear implants to provide significant auditory receptive skills to young congenitally deaf children.

  6. The cochlear implant as a tinnitus treatment.

    Science.gov (United States)

    Vallés-Varela, Héctor; Royo-López, Juan; Carmen-Sampériz, Luis; Sebastián-Cortés, José M; Alfonso-Collado, Ignacio

    2013-01-01

    Tinnitus is a symptom of high prevalence in patients with cochlear pathology. We studied the evolution of tinnitus in patients undergoing unilateral cochlear implantation for treatment of profound hearing loss. This was a longitudinal, retrospective study of patients that underwent unilateral cochlear implantation and who had bilateral tinnitus. Tinnitus was assessed quantitatively and qualitatively before surgery and at 6 and 12 months after surgery. We evaluated 20 patients that underwent unilateral cochlear implantation with a Nucleus(®) CI24RE Contour Advance™ electrode device. During the periods in which the device was in operation, improvement or disappearance of tinnitus was evidenced in the ipsilateral ear in 65% of patients, and in the contralateral ear, in 50%. In periods in which the device was disconnected, improvement or disappearance of tinnitus was found in the ipsilateral ear in 50% of patients, and in the ear contralateral to the implant in 45% of the patients. In 10% of the patients, a new tinnitus appeared in the ipsilateral ear. The patients with profound hearing loss and bilateral tinnitus treated with unilateral cochlear implantation improved in a high percentage of cases, in the ipsilateral ear and in the contralateral ear. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  7. Evolution of otosclerosis to cochlear implantation.

    Science.gov (United States)

    Muñoz-Fernández, Noelia; Morant-Ventura, Antonio; Achiques, María Teresa; Dualde-Beltrán, Delfina; Garcia-Callejo, F Javier; Monrroy-Parada, María Victoria; Pitarch, Ignacia; Latorre, Emilia; Marco-Algarra, Jaime

    2012-01-01

    Otosclerosis is an osteodystrophy of the labyrinthine capsule producing conductive hearing loss. If the process invades the cochlea, a sensorineural hearing loss usually takes place. The cochlear implant is a good alternative in these patients. To ascertain the behaviour of cochlear implantation in otosclerosis. We reviewed a database of 250 patients that underwent cochlear implantation, performing a retrospective study of 13 patients with clinical, audiological and/or imaging findings of bilateral otosclerosis. The 26 ears were studied as to their natural history, previous surgeries, evolution to profound hearing loss, computed tomography images, complications and functional results. Of the cases studied, 46% were female and 54% were men, with a mean age of 26 years at the onset of conductive hearing loss. Stapes surgery was performed in 19 ears (73%), with a mean patient age of 29 years, and 53% of them underwent cochlear implantation. Computed tomography results showed that there were signs of different degrees of radiological affectation in 54% of the ears. A total of 3 complications took place (23%): implant failure, overstimulation of the facial nerve and bilateral tinnitus were found. One year after implantation, the average percentages of correct 2-syllable words were 80% and 85% in open sentences. Patients having profound bilateral sensorineural hearing loss secondary to otosclerosis obtain great benefit from cochlear implantation. Copyright © 2011 Elsevier España, S.L. All rights reserved.

  8. Ipsilateral cochlear implantation after cochlear nerve preserving vestibular schwannoma surgery in patients with neurofibromatosis type 2.

    Science.gov (United States)

    Lloyd, Simon Kingsley Wickham; Glynn, Fergal John; Rutherford, Scott Alexander; King, Andrew Thomas; Mawman, Deborah Jane; O'Driscoll, Martin Paul; Evans, Dafydd Gareth Richard; Ramsden, Richard Thomas; Freeman, Simon Richard Mackenzie

    2014-01-01

    To investigate the outcomes from ipsilateral simultaneous or sequential cochlear implantation in patients with neurofibromatosis type 2 (NF2) after vestibular schwannoma removal with cochlear nerve preservation. Retrospective case series. Single tertiary referral NF2 center. Six patients with NF2. Removal of vestibular schwannoma (VS) with preservation of the cochlear nerve and cochlear implantation. Four patients had their surgery via a translabyrinthine approach. Two patients had a retrosigmoid approach. A cochlear implant was inserted at the same time as tumor removal in 4 cases and sequentially in 2 cases. Surgical and audiometric outcomes using Bamford-Kowal-Bench (BKB) and City of New York University (CUNY) sentence scores. The average age at implantation was 24 years (range, 15-36 yr). Follow-up ranged from 5 to 93 months, with an average of 38 months. All patients had useful hearing in the contralateral ear before surgery. One patient gained no benefit from cochlear implantation and proceeded to have an auditory brainstem implant. Of those that had functional cochlear nerves, the average BKB score in quiet was 64%, BKB score in noise was 42%, and CUNY score with lipreading was 97%. Results varied within the group, but all patients gained significant benefit and continue to use their CI at least intermittantly. The present series demonstrates that in selected cases, cochlear implantation can be successful after a translabyrinthine approach for VS removal and for restoring hearing after failed retrosigmoid hearing preservation surgery. All patients found the cochlear implant offered useful hearing even in the presence of contralateral hearing.

  9. A Case of Contiguous Primary Hepatic Marginal Zone B-Cell Lymphoma and Hemangioma Ultimately Diagnosed Using Contrast-Enhanced Ultrasonography

    Directory of Open Access Journals (Sweden)

    Kazue Shiozawa

    2015-02-01

    Full Text Available Primary hepatic marginal zone B-cell malignant lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma is extremely rare. We present a case in which a lesion was diagnosed as 2 contiguous tumors (MALT lymphoma and hemangioma using contrast-enhanced ultrasonography (US with sonazoid. There has been no previous case of contiguous hepatic MALT lymphoma and hemangioma. The present case was a female with no medical history. We detected a snowman-like appearance, which was a tumor of 15 mm in diameter with hypo- and hyper-echogenicities in the lateral and medial parts, respectively, in the Couinaud's segment (S6 of the liver on US. The tumor appeared as a single lesion with a low-density area in the unenhanced phase and prolonged enhancement in the equilibrium phases on dynamic CT. On MRI, the whole lesion showed a low-intensity signal on T1-weighted imaging, but isointensity in the lateral part and high intensity in the medial part were seen on T2-weighted imaging. On contrast-enhanced US, the lateral hypoechoic region was homogenously hyperenhanced in the early vascular phase, and the contrast medium was washed out after about 30 s; in contrast, the medial hyperechoic region was gradually stained from the margin toward the central region. The tumor showed a defect in both hypo- and hyperechoic regions in the postvascular phase. Hemangioma was suspected for the medial part based on the typical image findings, but the lateral part was not given a diagnosis. Thus, surgical resection was performed. The medial part was a hemangioma, and the lateral part was a MALT lymphoma by histopathological findings.

  10. Consensus panel on a cochlear coordinate system applicable in histologic, physiologic, and radiologic studies of the human cochlea.

    NARCIS (Netherlands)

    Verbist, B.M.; Skinner, M.W.; Cohen, L.T.; Leake, P.A.; James, C.; Boex, C.; Holden, T.A.; Finley, C.C.; Roland, P.S.; Roland, J.T.; Haller, M.; Patrick, J.F.; Jolly, C.N.; Faltys, M.A.; Briaire, J.J.; Frijns, J.H.

    2010-01-01

    HYPOTHESIS: An objective cochlear framework, for evaluation of the cochlear anatomy and description of the position of an implanted cochlear implant electrode, would allow the direct comparison of measures performed within the various subdisciplines involved in cochlear implant research. BACKGROUND:

  11. [Auditory performance analyses of cochlear implanted patients].

    Science.gov (United States)

    Ozdemir, Süleyman; Kıroğlu, Mete; Tuncer, Ulkü; Sahin, Rasim; Tarkan, Ozgür; Sürmelioğlu, Ozgür

    2011-01-01

    The aim of this study was to analyze the auditory performance development of cochlear implanted patients. The effects of age at implantation, gender, implanted ear and model of the cochlear implant on the patients' auditory performance were investigated. Twenty-eight patients (12 boys, 16 girls) with congenital prelingual hearing loss who underwent cochlear implant surgery at our clinic and a follow-up of at least 18 months were selected for the study. Listening Progress Profile (LiP), Monosyllable-Trochee-Polysyllable (MTP) and Meaningful Auditory Integration Scale (MAIS) tests were performed to analyze the auditory performances of the patients. To determine the effect of the age at implantation on the auditory performance, patients were assigned into two groups: group 1 (implantation age = or <60 months, mean 44.8 months) and group 2 (implantation age = or <60 months, mean 100.6 months). Group 2 had higher preoperative test scores than group 1 but after cochlear implant use, the auditory performance levels of the patients in group 1 improved faster and equalized to those of the patients in group 2 after 12-18 months. Our data showed that variables such as sex, implanted ear or model of the cochlear implant did not have any statistically significant effect on the auditory performance of the patients after cochlear implantation. We found a negative correlation between the implantation age and the auditory performance improvement in our study. We observed that children implanted at young age had a quicker language development and have had more success in reading, writing and other educational skills in the future.

  12. Continued expression of GATA3 is necessary for cochlear neurosensory development.

    Directory of Open Access Journals (Sweden)

    Jeremy S Duncan

    Full Text Available Hair cells of the developing mammalian inner ear are progressively defined through cell fate restriction. This process culminates in the expression of the bHLH transcription factor Atoh1, which is necessary for differentiation of hair cells, but not for their specification. Loss of several genes will disrupt ear morphogenesis or arrest of neurosensory epithelia development. We previously showed in null mutants that the loss of the transcription factor, Gata3, results specifically in the loss of all cochlear neurosensory development. Temporal expression of Gata3 is broad from the otic placode stage through the postnatal ear. It therefore remains unclear at which stage in development Gata3 exerts its effect. To better understand the stage specific effects of Gata3, we investigated the role of Gata3 in cochlear neurosensory specification and differentiation utilizing a LoxP targeted Gata3 line and two Cre lines. Foxg1(Cre∶Gata3(f/f mice show recombination of Gata3 around E8.5 but continue to develop a cochlear duct without differentiated hair cells and spiral ganglion neurons. qRT-PCR data show that Atoh1 was down-regulated but not absent in the duct whereas other hair cell specific genes such as Pou4f3 were completely absent. In addition, while Sox2 levels were lower in the Foxg1(Cre:Gata3(f/f cochlea, Eya1 levels remained normal. We conclude that Eya1 is unable to fully upregulate Atoh1 or Pou4f3, and drive differentiation of hair cells without Gata3. Pax2-Cre∶Gata3(f/f mice show a delayed recombination of Gata3 in the ear relative to Foxg1(Cre:Gata3(f/f . These mice exhibited a cochlear duct containing patches of partially differentiated hair cells and developed only few and incorrectly projecting spiral ganglion neurons. Our conditional deletion studies reveal a major role of Gata3 in the signaling of prosensory genes and in the differentiation of cochlear neurosenory cells. We suggest that Gata3 may act in combination with Eya1, Six1, and

  13. Cortical Plasticity after Cochlear Implantation

    Directory of Open Access Journals (Sweden)

    B. Petersen

    2013-01-01

    tomography at three time points: within 14 days, three months, and six months after switch-on. Fifteen recently implanted adult implant recipients listened to running speech or speech-like noise in four sequential PET sessions at each milestone. CI listeners with postlingual hearing loss showed differential activation of left superior temporal gyrus during speech and speech-like stimuli, unlike CI listeners with prelingual hearing loss. Furthermore, Broca’s area was activated as an effect of time, but only in CI listeners with postlingual hearing loss. The study demonstrates that adaptation to the cochlear implant is highly related to the history of hearing loss. Speech processing in patients whose hearing loss occurred after the acquisition of language involves brain areas associated with speech comprehension, which is not the case for patients whose hearing loss occurred before the acquisition of language. Finally, the findings confirm the key role of Broca’s area in restoration of speech perception, but only in individuals in whom Broca’s area has been active prior to the loss of hearing.

  14. On the Horizon: Cochlear Implant Technology.

    Science.gov (United States)

    Roche, Joseph P; Hansen, Marlan R

    2015-12-01

    Cochlear implantation and cochlear implants (CIs) have a long history filled with innovations that have resulted in the high-performing device's currently available. Several promising technologies have been reviewed in this article, which hold the promise to drive performance even higher. Remote CI programming, totally implanted devices, improved neural health and survival through targeted drug therapy and delivery, intraneural electrode placement, electroacoustical stimulation and hybrid CIs, and methods to enhance the neural-prosthesis interface are evolving areas of innovation reviewed in this article. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. A minute focus of extranodal marginal zone B-cell lymphoma arising in Hashimoto thyroiditis diagnosed with PCR after laser capture microdissection: a case report

    Directory of Open Access Journals (Sweden)

    D'Antonio Antonio

    2009-09-01

    Full Text Available Abstract Background Primary thyroid gland lymphomas are uncommon tumours that occur in the setting of lymphocytic thyroiditis or Hashimoto's disease in almost all cases. In this condition a distinction between an inflammatory lymphoid infiltrate and a low grade lymphoma may be extremely difficult and precise criteria are necessary for a correct diagnosis. Patient and methods We report a case of a minute focus of primary extranodal marginal zone B-cell lymphoma (EMZBCL, incidentally discovered in a 63-year-old man with Hashimoto thyroiditis (HT and diagnosed by means of polymerase chain reaction (PCR after laser capture microdissection. The histological examination of surgical specimen confirmed the diagnosis of HT and showed a minute focus of dense lymphoid infiltrate (less than 4 mm in diameter, composed by centrocyte-like cells forming MALT balls. Immunoistochemistry was not useful. A microscopic focus of EMZBCL was suspected on the basis of morphological features. PCR assays revealed the rearrangement of the heavy chain of immunoglobulins only in the microdissected suspicious area, confirming the diagnosis of EMZBCL. Conclusion Our finding suggests that in cases of autoimmune thyroiditis a careful examination of the thyroid specimen is warranted, in order to disclose areas or small foci of lymphomatous transformation. Furthermore, in difficult cases with doubtful immunohistological findings, ancillary techniques, such as molecular studies, are necessary for a conclusive diagnosis.

  16. [Marginalization and health. Introduction].

    Science.gov (United States)

    Yunes, J

    1992-06-01

    The relationship between marginalization and health is clear. In Mexico, for example, life expectancy is 53 years for the poorest population sectors and 20 years more for the wealthiest. Infant mortality in poor Colombian families is twice that of wealthier families, and one-third of developing countries the rural population is only half as likely as the urban to have access to health services. Women in the Southern hemisphere are 12 times likelier than those in the Northern to die of maternal causes. The most important step in arriving at a solution to the inequity may be to analyze in depth the relationship between marginality and health. Marginality may be defined as the lack of participation of individuals or groups in certain key phases of societal life, such as production, consumption, or political decision making. Marginality came to be viewed as a social problem only with recognition of the rights of all individuals to participate in available social goods. Marginality is always relative, and marginal groups exist because central groups determine the criteria for inclusion in the marginal and central groups. Marginality thus always refers to a concrete society at a specific historical moment. Marginal groups may be of various types. At present, marginal groups include women, rural populations, people with AIDS or mental illness or certain other health conditions, refugees, ethnic or religious groups, homosexuals, and the poor, who are the largest group of marginal persons in the world. Even in developed countries, 100-200 million persons live below the poverty line. Latin America is struggling to emerge from its marginal status in the world. The economic crisis of the 1980s increased poverty in the region, and 40% are not considered impoverished. Latin America is a clear example of the relationship between marginality and health. Its epidemiologic profile is intimately related to nutrition, availability of potable water, housing, and environmental

  17. Marginalization of the Youth

    DEFF Research Database (Denmark)

    Jensen, Niels Rosendal

    2009-01-01

    The article is based on a key note speach in Bielefeld on the subject "welfare state and marginalized youth", focusing upon the high ambition of expanding schooling in Denmark from 9 to 12 years. The unintended effect may be a new kind of marginalization.......The article is based on a key note speach in Bielefeld on the subject "welfare state and marginalized youth", focusing upon the high ambition of expanding schooling in Denmark from 9 to 12 years. The unintended effect may be a new kind of marginalization....

  18. Clinical evaluation of cochlear hearing status in dogs using evoked otoacoustic emissions.

    Science.gov (United States)

    Gonçalves, R; McBrearty, A; Pratola, L; Calvo, G; Anderson, T J; Penderis, J

    2012-06-01

    Evoked otoacoustic emission testing is the preferred test in human patients for sensorineural deafness screening in neonates and cochlear outer hair cell function monitoring in adults. This study evaluated evoked otoacoustic emission testing for cochlear function assessment in dogs within a clinical setting. Two populations of anaesthetised dogs were included. In group 1 the evoked otoacoustic emission response was compared to the brainstem auditory evoked response in 10 dogs having hearing assessment. Group 2 comprised 43 presumed normal dogs, in which the suitability of two types of evoked otoacoustic emissions, transient-evoked and distortion product otoacoustic emissions, were evaluated (brainstem auditory evoked response was not performed in this group). Valid transient-evoked otoacoustic emission and distortion-product otoacoustic emission responses were successfully recorded within the clinical setting and correctly identified deaf and hearing ears. Within presumed healthy dogs, normal otoacoustic emission response was demonstrated in more than 80% of dogs using a single, short distortion-product otoacoustic emission run and in 78% of dogs with valid transient-evoked otoacoustic emission responses using a series of three repeated transient-evoked otoacoustic emission short runs. Transient-evoked otoacoustic emission and distortion-product otoacoustic emission testing provided a rapid, non-invasive frequency-specific assessment of cochlear function. Transient-evoked otoacoustic emission and distortion product otoacoustic emission testing is suitable as a screening procedure to detect loss of cochlear function in dogs, although further investigation is needed. © 2012 British Small Animal Veterinary Association.

  19. Cochlear frequency-place map in adult chickens: intracellular biocytin labeling.

    Science.gov (United States)

    Chen, L; Salvi, R; Shero, M

    1994-12-01

    A cochlear frequency-place map was developed for adult chickens by labeling cochlear ganglion neurons with biocytin and correlating the location of each labeled fiber along the basilar papilla with the characteristic frequency of the unit's tuning curve. Labeled fibers showed little or no branching within the sensory epithelium and most fibers appeared to terminate on a single hair cell along the neural side of the basilar papilla. The CFs of the labeled neurons ranged from 353 Hz to 3145 Hz and the location of the labeled neurons ranged from 30.1% to 74.4% of the total distance from the apex of the papilla. CFs increased in an orderly manner from the apex towards the base of the papilla. The cochlear frequency map for adult chickens was similar to that estimated from previous cochlear lesion studies carried out on 30 day old chicks, although the predicted frequencies in the adults were slightly higher in some regions of the basilar papilla than in 30 day old animals. However, previous maps developed in young animals (< or = 21 days) using lesion or labeling data predict significantly lower frequencies for a given location than in adult animals particularly in the basal half of the cochlea.

  20. Combined effects of noise and neomycin. Cochlear changes in the guinea pig.

    Science.gov (United States)

    Brown, J J; Brummett, R E; Meikle, M B; Vernon, J

    1978-01-01

    Cochlear damage resulting from the combination of neomycin with acoustic overstimulation was investigated in guinea pigs. Four groups of animals received subcutaneous injections and exposure to broad band noise daily for 7 days, as follows: I. Neomycin (200 mg/kg) followed by 10 hours of noise at 115 dB SPL; II. Saline followed by 115 dB noise: III. Neomycin followed by low intensity noise (45 dB as an acoustic control); or IV. Saline followed by 45 dB noise. After a 30 day stabilization period, each ear was examined electrophysiologically and histologically. Measures of cochlear integrity included AC cochlear potentials from 100 Hz through 20 kHz as well as outer hair cell (OHC) counts. A marked interaction leading to augmentation of damage was found when neomycin was combined with 115 dB noise (Group I). Losses in cochlear sensitivity, averaged across all frequencies, amounted to 62 dB in Group I, whereas the averaged losses for Groups II and III were only 16 dB and 17 dB respectively. Loss of OHC's was close to 100% in Group I, while OHC losses were only 17% in Group II and 26% in Group III.

  1. Commissural neurons in the rat ventral cochlear nucleus.

    Science.gov (United States)

    Doucet, John R; Lenihan, Nicole M; May, Bradford J

    2009-06-01

    Commissural neurons connect the cochlear nucleus complexes of both ears. Previous studies have suggested that the neurons may be separated into two anatomical subtypes on the basis of percent apposition (PA); that is, the percentage of the soma apposed by synaptic terminals. The present study combined tract tracing with synaptic immunolabeling to compare the soma area, relative number, and location of Type I (low PA) and Type II (high PA) commissural neurons in the ventral cochlear nucleus (VCN) of rats. Confocal microscopic analysis revealed that 261 of 377 (69%) commissural neurons have medium-sized somata with Type I axosomatic innervation. The commissural neurons also showed distinct topographical distributions. The majority of Type I neurons were located in the small cell cap of the VCN, which serves as a nexus for regulatory pathways within the auditory brainstem. Most Type II neurons were found in the magnocellular core. This anatomical dichotomy should broaden current views on the function of the commissural pathway that stress the fast inhibitory interactions generated by Type II neurons. The more prevalent Type I neurons may underlie slow regulatory influences that enhance binaural processing or the recovery of function after injury.

  2. Adjuvant Radiation Therapy for Margin-Positive Vulvar Squamous Cell Carcinoma: Defining the Ideal Dose-Response Using the National Cancer Data Base

    Energy Technology Data Exchange (ETDEWEB)

    Chapman, Bhavana V.; Gill, Beant S. [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania (United States); Viswanathan, Akila N. [Department of Radiation Oncology Molecular Radiation Sciences, Johns Hopkins University, Baltimore, MD (United States); Balasubramani, Goundappa K. [Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania (United States); Sukumvanich, Paniti [Department of Gynecologic Oncology, Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (United States); Beriwal, Sushil, E-mail: beriwals@upmc.edu [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania (United States)

    2017-01-01

    Purpose: Positive surgical margins after radical vulvectomy for vulvar cancer portend a high risk for local relapse, which may be challenging to salvage. We assessed the impact of adjuvant radiation therapy (aRT) on overall survival (OS) and the dose-response relationship using the National Cancer Data Base. Methods and Materials: Patients with vulvar squamous cell carcinoma who underwent initial extirpative surgery with positive margins from 1998 to 2012 were included. Factors associated with aRT and specific dose levels were analyzed using logistic regression. Log-rank and multivariable Cox proportional hazards modeling were used for OS analysis. Results: We identified 3075 patients with a median age of 66 years (range, 22-90 years); the median follow-up time was 36.4 months (interquartile range [IQR] 15.4-71.0 months). Stage IA/B disease represented 41.2% of the cohort. Sixty-three percent underwent lymph node assessment, with a 45% positivity rate. In total, 1035 patients (35.3%) received aRT, with a median dose of 54.0 Gy (IQR 48.6-60.0 Gy). The 3-year OS improved from 58.5% to 67.4% with aRT (P<.001). On multivariable analysis, age, Charlson-Deyo score ≥1, stage ≥II, tumors ≥4 cm, no aRT, and adverse nodal characteristics led to inferior survival. Dose of aRT was positively associated with OS as a continuous variable on univariate analysis (P<.001). The unadjusted 3-year OS for dose subsets 30.0 to 45.0 Gy, 45.1 to 53.9 Gy, 54.0 to 59.9 Gy, and ≥60 Gy was 54.3%, 55.7%, 70.1%, and 65.3%, respectively (P<.001). Multivariable analysis using a 4-month conditional landmark revealed that the greatest mortality reduction occurred in cumulative doses ≥54 Gy: 45.1 to 53.9 Gy (hazard ratio [HR] 0.94, P=.373), 54.0 to 59.9 Gy (HR 0.75, P=.024), ≥60 Gy (HR 0.71, P=.015). No survival benefit was seen with ≥60 Gy compared with 54.0 to 59.9 Gy (HR 0.95, P=.779). Conclusions: Patients with vulvar squamous cell carcinoma and positive surgical

  3. Listening Effort With Cochlear Implant Simulations

    NARCIS (Netherlands)

    Pals, Carina; Sarampalis, Anastasios; Başkent, Deniz

    2013-01-01

    Purpose: Fitting a cochlear implant (CI) for optimal speech perception does not necessarily optimize listening effort. This study aimed to show that listening effort may change between CI processing conditions for which speech intelligibility remains constant. Method: Nineteen normal-hearing

  4. Benefits and Risks of Cochlear Implants

    Science.gov (United States)

    ... of this rare, but serious complication. For more information on the risk of meningitis in cochlear recipients, see the nearby ... detection systems set off metal detectors or other security systems be ... ways with other computer systems Will have to be careful of static ...

  5. Cochlear implants: our experience and literature review

    Directory of Open Access Journals (Sweden)

    Martins, Mariane Barreto Brandão

    2012-01-01

    Full Text Available Introduction: Cochlear Implants are important for individuals with severe to profound bilateral sensorineural hearing loss. Objective: Evaluate the experience of cochlear implant center of Otorhinolaryngology through the analysis of records of 9 patients who underwent cochlear implant surgery. Methods: This is a retrospective study performed with the patients records. Number 0191.0.107.000-11 ethics committee approval. We evaluated gender, etiology, age at surgery, duration of deafness, classification of deafness, unilateral or bilateral surgery, intraoperative and postoperative neural response and impedance of the electrodes in intraoperative and preoperative tests and found those that counter-indicated surgery. Results: There were 6 pediatric and 3 adult patients. Four male and 5 female. Etiologies: maternal rubella, cytomegalovirus, ototoxicity, meningitis, and sudden deafness. The age at surgery and duration of deafness ranged from 2 - 46 years and 2 - 18 years, respectively. Seven patients were pre-lingual. All had profound bilateral PA. There were 7 bilateral implants. Intraoperative complications: hemorrhage. Complications after surgery: vertigo and internal device failure. In 7 patients the electrodes were implanted through. Telemetry showed satisfactory neural response and impedance. CT and MRI was performed in all patients. We found enlargement of the vestibular aqueduct in a patient and incudomalleolar malformation. Conclusion: The cochlear implant as a form of auditory rehabilitation is well established and spreading to different centers specialized in otoaudiology. Thus, the need for structured services and trained professionals in this type of procedure is clear.

  6. Auditory Learning in Children with Cochlear Implants

    Science.gov (United States)

    Mishra, Srikanta K.; Boddupally, Shiva P.; Rayapati, Deeksha

    2015-01-01

    Purpose: The purpose of this study was to examine and characterize the training-induced changes in speech-in-noise perception in children with congenital deafness who have cochlear implants (CIs). Method: Twenty-seven children with congenital deafness who have CIs were studied. Eleven children with CIs were trained on a speech-in-noise task,…

  7. Gender Categorization in Cochlear Implant Users

    Science.gov (United States)

    Massida, Zoe; Marx, Mathieu; Belin, Pascal; James, Christopher; Fraysse, Bernard; Barone, Pascal; Deguine, Olivier

    2013-01-01

    Purpose: In this study, the authors examined the ability of subjects with cochlear implants (CIs) to discriminate voice gender and how this ability evolved as a function of CI experience. Method: The authors presented a continuum of voice samples created by voice morphing, with 9 intermediate acoustic parameter steps between a typical male and a…

  8. [Cost Analysis of Cochlear Implantation in Adults].

    Science.gov (United States)

    Raths, S; Lenarz, T; Lesinski-Schiedat, A; Flessa, S

    2016-04-01

    The number of implantation of cochlear implants has steadily risen in recent years. Reasons for this are an extension of indication criteria, demographic change, increased quality of life needs and greater acceptance. The consequences are rising expenditure for statutory health insurance (SHI) for cochlear implantation. A detailed calculation of lifetime costs from SHI's perspective for postlingually deafened adolescents and adults is essential in estimating future cost developments. Calculations are based on accounting data from the Hannover Medical School. With regard to further life expectancy, average costs of preoperative diagnosis, surgery, rehabilitation, follow-ups, processor upgrades and electrical maintenance were discounted to their present value at age of implantation. There is an inverse relation between cost of unilateral cochlear implantation and age of initial implantation. From SHI's perspective, the intervention costs between 36,001 and 68,970 € ($ 42,504-$ 81,429). The largest cost components are initial implantation and processor upgrades. Compared to the UK the cost of cochlear implantation in Germany seems to be significantly lower. In particular the costs of, rehabilitation and maintenance in Germany cause only a small percentage of total costs. Also, the costs during the first year of treatment seem comparatively low. With regard to future spending of SHI due to implant innovations and associated extension of indication, increasing cost may be suspected. © Georg Thieme Verlag KG Stuttgart · New York.

  9. Environmental Sound Training in Cochlear Implant Users

    Science.gov (United States)

    Shafiro, Valeriy; Sheft, Stanley; Kuvadia, Sejal; Gygi, Brian

    2015-01-01

    Purpose: The study investigated the effect of a short computer-based environmental sound training regimen on the perception of environmental sounds and speech in experienced cochlear implant (CI) patients. Method: Fourteen CI patients with the average of 5 years of CI experience participated. The protocol consisted of 2 pretests, 1 week apart,…

  10. Practical Marginalized Multilevel Models

    Science.gov (United States)

    Griswold, Michael E.; Swihart, Bruce J.; Caffo, Brian S.; Zeger, Scott L.

    2013-01-01

    Clustered data analysis is characterized by the need to describe both systematic variation in a mean model and cluster-dependent random variation in an association model. Marginalized multilevel models embrace the robustness and interpretations of a marginal mean model, while retaining the likelihood inference capabilities and flexible dependence structures of a conditional association model. Although there has been increasing recognition of the attractiveness of marginalized multilevel models, there has been a gap in their practical application arising from a lack of readily available estimation procedures. We extend the marginalized multilevel model to allow for nonlinear functions in both the mean and association aspects. We then formulate marginal models through conditional specifications to facilitate estimation with mixed model computational solutions already in place. We illustrate the MMM and approximate MMM approaches on a cerebrovascular deficiency crossover trial using SAS and an epidemiological study on race and visual impairment using R. Datasets, SAS and R code are included as supplemental materials. PMID:24357884

  11. Survival of Cochlear Spiral Ganglion Neurons Improved In vivo by Anti-miR204 via TMPRSS3.

    Science.gov (United States)

    Peng, A; Li, Y; Pan, X; Ge, S; Wang, Q; Li, S; Zhu, G; Liu, J

    2015-05-08

    Sensorineural hearing loss (SNHL) is caused by damage to hair cells followed by degeneration of the spiral ganglion neurons (SGNs), and cochlear implanting is an effective treatment. Unfortunately, the progressive hearing loss is still found due to ongoing degeneration of cochlear SGNs. The aim of this study was to investigate the neuroprotective effect of anti-miR204 on SGNs in vivo. Our recent in vitro work suggested that anti-miR204 could be a potential therapeutic strategy in SNHL via rescue cochlear SGNs. In order to further our knowledge of miR204 on SGNs in vivo, we made a kanamycin ototoxicity model and then virus containing the anti-miR204 gene (AAV1-anti-miR204) was microinjected into the cochlear of the model to monitor the effect. The SGNs were rescued by anti-miR204 in the kanamycin ototoxicity mouse group compared to the sham group. Moreover, expression of TMPRSS3 in SGNs was saved by anti-miR204 treatment. Anti-miR204 might be an alternate way to alleviate the degeneration of cochlear SGNs of kanamycin ototoxicity mice.

  12. Motion tracking to enable pre-surgical margin mapping in basal cell carcinoma using optical imaging modalities: initial feasibility study using optical coherence tomography

    Science.gov (United States)

    Duffy, M.; Richardson, T. J.; Craythorne, E.; Mallipeddi, R.; Coleman, A. J.

    2014-02-01

    A system has been developed to assess the feasibility of using motion tracking to enable pre-surgical margin mapping of basal cell carcinoma (BCC) in the clinic using optical coherence tomography (OCT). This system consists of a commercial OCT imaging system (the VivoSight 1500, MDL Ltd., Orpington, UK), which has been adapted to incorporate a webcam and a single-sensor electromagnetic positional tracking module (the Flock of Birds, Ascension Technology Corp, Vermont, USA). A supporting software interface has also been developed which allows positional data to be captured and projected onto a 2D dermoscopic image in real-time. Initial results using a stationary test phantom are encouraging, with maximum errors in the projected map in the order of 1-2mm. Initial clinical results were poor due to motion artefact, despite attempts to stabilise the patient. However, the authors present several suggested modifications that are expected to reduce the effects of motion artefact and improve the overall accuracy and clinical usability of the system.

  13. The prognostic significance of the positive circumferential resection margin in pathologic T3 squamous cell carcinoma of the esophagus with or without neoadjuvant chemotherapy.

    Science.gov (United States)

    Okada, Naoya; Fujii, Satoshi; Fujita, Takeo; Kanamori, Jun; Kojima, Takashi; Hayashi, Ryuichi; Daiko, Hiroyuki

    2016-02-01

    To improve the therapeutic strategy for esophageal squamous cell carcinoma (ESCC), combined neoadjuvant chemotherapy (NAC) followed by operative surgical resection has been applied recently to patients at clinical stages II/III. Our study aimed to elucidate the impact of the circumferential resection margin (CRM) status of surgically resected specimens on the prognosis of patients undergoing neoadjuvant therapy. We enrolled 160 consecutive ESCC patients who underwent esophagectomy. The CRM status of specimens obtained was examined pathologically according to both the College of American Pathologists (CAP) and the Royal College of Pathologists (RCP) criteria. We examined the relationship between CRM status and several clinicopathologic factors among ESCC patients with or without NAC. The local recurrence rate was significantly higher in patients with R1 compared with that of patients with R0 according to CAP criteria (12.5% vs 0.7%; P = .02; Chi-square test). Regarding the prognosis of all patients, Kaplan-Meier analyses showed that there were significant differences between R0 and R1 groups by CAP or RCP criteria (CAP, P CRM according to CAP criteria after multimodality treatment significantly affects the overall and relapse-free survival of ESCC patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. AL Amyloidoma of the Skin/Subcutis: Cutaneous Amyloidosis, Plasma Cell Dyscrasia or a Manifestation of Primary Cutaneous Marginal Zone Lymphoma?

    Science.gov (United States)

    Walsh, Noreen M; Lano, Ian Marie; Green, Peter; Gallant, Christopher; Pasternak, Sylvia; Ly, Thai Yen; Requena, Luis; Kutzner, Heinz; Chott, Andreas; Cerroni, Lorenzo

    2017-08-01

    It is unclear whether AL amyloidoma of the skin/subcutis represents a distinct entity, an indolent precursor of systemic amyloidosis, or a manifestation of cutaneous marginal zone lymphoma (cMZL). We collected 10 cases of cutaneous AL amyloidoma in order to better characterize the clinicopathologic features of this elusive entity (M:F=4:6; median age: 62.5 y, range: 31 to 82 y). Nine patients had a solitary nodule or plaque on the lower extremity (n=7), upper extremity (n=1), or chin (n=1). One patient had an AL amyloidoma on the right thigh and a second lesion on the right arm showing histopathologic features of cMZL without amyloid deposits. Clinical investigations excluded relevant systemic disease in all cases. Microscopically, dermal/subcutaneous deposits of amyloid were associated with sparse to moderate perivascular infiltrates of lymphocytes and monotypic plasma cells (7 with kappa and 3 with lambda light chain restriction). The plasma cells expressed CD56 in one of 9 studied cases. One case was characterized by a t(14;18)(q32;q21)/IGH-MALT1 translocation. Follow-up was available in 8 cases. All remain systemically well after a median time of 86.5 months (range: 40 to 144 mo). Local recurrence of disease was observed in 3 patients. A fourth patient presented with a cMZL without amyloid deposits 8 years after excision of the cutaneous AL amyloidoma. Although our series is small, careful categorization and follow-up of the cases, together with updated information in the literature, show clinical and biological links between AL amyloidomas of the skin/subcutis and cMZL, suggesting that at least a subset of cutaneous AL amyloidoma may represent an unusual manifestation of cMZL (cutaneous mucosa-associated lymphoid tissue lymphomas).

  15. [Morphologic feature and cochlear implant surgical approach for cochlear modiolus deficiency].

    Science.gov (United States)

    Zhang, Daoxing

    2014-09-01

    To review the classification of cochlear modiolus deficiency and decision on surgical approach for above case,in order to provide mastery for cochlear implant (CI) indication. Basing on temporal bone HRCT pre-operation, CI subjects with modiolus deficiency were defined as following groups: (1) deficiency caused by cochlear dysplasia (Mondini malformation); (2) deficiency caused by dysplasia of cochlear and vestibule (Common cavity malformation); (3) deficiency caused by absence of internal acoustic meatus fundus (IP-III malformation). Three types of surgical approach were utilized: type I, electrode array was introduced through facial recess, enlarged the round window, type II, opened the surface of chchlea, electrode array was introduced through facial recess, fenestration on posterior promontory and then inserted around lateral wall of inner-cochlear cavity. type III, electrode array was introduce through fenestration of lateral semicircular canal and then placed close to the bony wall of common cavity. One hundred and sixty-six cochlear modiolus deficiency cases were identified into 3 groups as following: 135 Mondini malformation cases into group a, 18 common cavity malformation cases into group b, and 13 IP-III malformation cases into group c. Surgical approach: type I were used in 136 cases (123 Mondini cases and 13 IP-III cases), while approach type II in 12 cases (12 Mondini cases), and approach type III in 18 cases (18 common cavity cases). Income post-operation of CI: For group a (Mondini malformation), post-activation mean hearing threshold in sound field was 65 dB, speech recognition score is 95% (single finals test) and 25% (signal initials test), while it was 80 dB, 60% and 0 for group b (Conmon cavity malformation), and it was 55 dB, 100% and 45% for group c (IP-III malformation). The income of speech recognition score for cochlear modiolus deficiency was relatively poor, group b was worst and group c was best, while group a moderate.

  16. "We call ourselves marginalized"

    DEFF Research Database (Denmark)

    Jørgensen, Nanna Jordt

    2014-01-01

    In recent decades, indigenous knowledge has been added to the environmental education agenda in an attempt to address the marginalization of non-western perspectives. While these efforts are necessary, the debate is often framed in terms of a discourse of victimization that overlooks the agency...... argue that researchers not only need to pay attention to how certain voices are marginalized in Environmental Education research and practice, but also to how learners as agents respond to, use and negotiate the marginalization of their perspectives....

  17. What Does Music Sound Like for a Cochlear Implant User?

    Science.gov (United States)

    Jiam, Nicole T; Caldwell, Meredith T; Limb, Charles J

    2017-09-01

    Cochlear implant research and product development over the past 40 years have been heavily focused on speech comprehension with little emphasis on music listening and enjoyment. The relatively little understanding of how music sounds in a cochlear implant user stands in stark contrast to the overall degree of importance the public places on music and quality of life. The purpose of this article is to describe what music sounds like to cochlear implant users, using a combination of existing research studies and listener descriptions. We examined the published literature on music perception in cochlear implant users, particularly postlingual cochlear implant users, with an emphasis on the primary elements of music and recorded music. Additionally, we administered an informal survey to cochlear implant users to gather first-hand descriptions of music listening experience and satisfaction from the cochlear implant population. Limitations in cochlear implant technology lead to a music listening experience that is significantly distorted compared with that of normal hearing listeners. On the basis of many studies and sources, we describe how music is frequently perceived as out-of-tune, dissonant, indistinct, emotionless, and weak in bass frequencies, especially for postlingual cochlear implant users-which may in part explain why music enjoyment and participation levels are lower after implantation. Additionally, cochlear implant users report difficulty in specific musical contexts based on factors including but not limited to genre, presence of lyrics, timbres (woodwinds, brass, instrument families), and complexity of the perceived music. Future research and cochlear implant development should target these areas as parameters for improvement in cochlear implant-mediated music perception.

  18. Detection of pulse trains in the electrically stimulated cochlea: effects of cochlear health.

    Science.gov (United States)

    Pfingst, Bryan E; Colesa, Deborah J; Hembrador, Sheena; Kang, Stephen Y; Middlebrooks, John C; Raphael, Yehoash; Su, Gina L

    2011-12-01

    Perception of electrical stimuli varies widely across users of cochlear implants and across stimulation sites in individual users. It is commonly assumed that the ability of subjects to detect and discriminate electrical signals is dependent, in part, on conditions in the implanted cochlea, but evidence supporting that hypothesis is sparse. The objective of this study was to define specific relationships between the survival of tissues near the implanted electrodes and the functional responses to electrical stimulation of those electrodes. Psychophysical and neurophysiological procedures were used to assess stimulus detection as a function of pulse rate under the various degrees of cochlear pathology. Cochlear morphology, assessed post-mortem, ranged from near-normal numbers of hair cells, peripheral processes and spiral ganglion cells, to complete absence of hair cells and peripheral processes and small numbers of surviving spiral ganglion cells. The psychophysical and neurophysiological studies indicated that slopes and levels of the threshold versus pulse rate functions reflected multipulse integration throughout the 200 ms pulse train with an additional contribution of interactions between adjacent pulses at high pulse rates. The amount of multipulse integration was correlated with the health of the implanted cochlea with implications for perception of more complex prosthetic stimuli. © 2011 Acoustical Society of America

  19. Validation of Minimally-Invasive, Image-guided Cochlear Implantation Using Advanced Bionics, Cochlear, and Medel Electrodes in a Cadaver Model

    Science.gov (United States)

    McRackan, Theodore R; Balachandran, Ramya; Blachon, Grégoire S; Mitchell, Jason E; Noble, Jack H; Wright, Charles G; Fitzpatrick, J. Michael; Dawant, Benoit M; Labadie, Robert F

    2015-01-01

    Purpose Validation of a novel minimally-invasive, image-guided approach to implant electrodes from three FDA-approved manufacturers—Medel, Cochlear, and Advanced Bionics—in the cochlea via a linear tunnel from the lateral cranium through the facial recess to the cochlea. Methods Custom microstereotactic frames that mount on bone-implanted fiducial markers and constrain the drill along the desired path were utilized on seven cadaver specimens. A linear tunnel was drilled from the lateral skull to the cochlea followed by a marginal, round-window cochleostomy and insertion of the electrode array into the cochlea through the drilled tunnel. Post-insertion CT scan and histological analysis were used to analyze the results. Results All specimens (N=7) were successfully implanted without visible injury to the facial nerve. The Medel electrodes (N=3) had minimal intracochlear trauma with 8, 8, and 10 (out of 12) electrodes intracochlear. The Cochlear lateral wall electrodes (straight research arrays) (N=2) had minimal trauma with 20 and 21 of 22 electrodes intracochlear. The Advanced Bionics electrodes (N=2) were inserted using their insertion tool; one had minimal insertion trauma and 14 of 16 electrodes intracochlear while the other had violation of the basilar membrane just deep to the cochleostomy following which it remained in scala vestibuli with 13 of 16 electrodes intracochlear. Conclusions Minimally invasive, image-guided cochlear implantation is possible using electrodes from the three FDA-approved manufacturers. Lateral wall electrodes were associated with less intracochlear trauma suggesting that they may be better suited for this surgical technique. PMID:23633113

  20. Predicting effects of impaired cochlear processing on consonant discrimination in stationary noise

    DEFF Research Database (Denmark)

    Jepsen, Morten Løve; Dau, Torsten; Ghitza, Oded

    Cochlear hearing loss is typically associated with reduced sensitivity due to inner hair-cell (IHC) and outer hair-cell (OHC) dysfunction. OHC dysfunction also leads to supra-threshold deficits, such as reduced basilar-membrane (BM) compression as well as reduced frequency selectivity and temporal...... patterns from a Diagnostic Rhyme Test (DRT) were measured and analyzed in terms of acoustic-phonetic features. This was done for three listeners with cochlear hearing loss and at two signal-to-noise ratios. It is shown that the predicted errors patterns matched the measured patterns in most conditions......, such as the evaluation of hearing-instrument signal processing, where the effects of specific processing strategies can be simulated for individual hearing losses....

  1. Migration of the ball electrode after cochlear implantation.

    Science.gov (United States)

    Tange, Rinze A; Grolman, Wilko; Carelsen, Bart

    2007-02-01

    To review the postoperative radiographic investigations of patients implanted with a cochlear implant. Retrospective case series. Thirty-nine patients (22-77 yrs old) implanted for sensorineural deafness in the cochlear implants program of the Academic Medical Center of Amsterdam. Cochlear implantation with Cochlear Nucleus 24 Contour and Cochlear Nucleus Freedom (Cochlear Corp., Lane Cove, New South Wales, Australia) implant. This retrospective analysis of the postoperative computed tomographic scans showed that, in a large number of the implantations, the external ball electrode of the cochlear implant migrated from the insertion place toward the magnet of the receiver/stimulator unit of the implant. It seems that this migration of the external ball electrode does not influence the function of the cochlear implant and the result of the hearing rehabilitation in the short term. Because of the magnetic field of the receiver/stimulator unit of the cochlear implant and the magnet of the external transmitting coil of the speech processor, it seems to be possible that the extracochlear ball electrode can migrate in the space between the temporal bone and the temporal muscle during the postoperative healing phase. The importance of our observation is still not clear.

  2. Cochlear response telemetry: intracochlear electrocochleography via cochlear implant neural response telemetry pilot study results.

    Science.gov (United States)

    Campbell, Luke; Kaicer, Arielle; Briggs, Robert; O'Leary, Stephen

    2015-03-01

    To record cochlear responses to acoustic stimulation (electrocochleography) directly from a cochlear implant (CI) in awake recipients with residual hearing, using an adaptation of Neural Response Telemetry (NRT) that achieves a 10-ms recording window. Modern cochlear implants contain circuitry for recording neural responses to electrical stimulation, which is known in Cochlear Ltd systems as NRT. We adapted NRT to achieve an extended recording window long enough to record an acoustic electrocochleogram. This paper reports recordings made with this system in recipients with residual hearing. Subjects were adults with CI422 CIs who retained audiometric thresholds between 75 and 90 dB HL at 500 Hz in their implanted ear. The CI was interfaced to a laptop via a Freedom speech processor connected by USB. Calibrated acoustic stimuli (clicks and tone bursts between 500 and 1,500 Hz) were presented via insert tube phones to the implanted ear. Responses were acquired through the adapted NRT system. Recordings were made from apical, mid-array, and basal electrodes. Electrocochleography responses were compared with audiometric thresholds. Electrocochleography could be recorded from all five subjects. The compound action potential, cochlear microphonic, and summating potentials were identified. Good quality recordings were most reliably attained from apical electrodes using 40 to 100 repetitions. Audiometric thresholds were similar to compound action potential thresholds. Intracochlear responses to acoustic stimulation can be recorded directly from the CI in awake recipients with residual hearing. This may prove useful for monitoring postoperative hearing and for device fitting.

  3. Indian Ocean margins

    Digital Repository Service at National Institute of Oceanography (India)

    Naqvi, S.W.A.

    The most important biogeochemical transformations and boundary exchanges in the Indian Ocean seem to occur in the northern region, where the processes originating at the land-ocean boundary extend far beyond the continental margins. Exchanges across...

  4. Perception of Sung Speech in Bimodal Cochlear Implant Users

    Directory of Open Access Journals (Sweden)

    Joseph D. Crew

    2016-11-01

    Full Text Available Combined use of a hearing aid (HA and cochlear implant (CI has been shown to improve CI users’ speech and music performance. However, different hearing devices, test stimuli, and listening tasks may interact and obscure bimodal benefits. In this study, speech and music perception were measured in bimodal listeners for CI-only, HA-only, and CI + HA conditions, using the Sung Speech Corpus, a database of monosyllabic words produced at different fundamental frequencies. Sentence recognition was measured using sung speech in which pitch was held constant or varied across words, as well as for spoken speech. Melodic contour identification (MCI was measured using sung speech in which the words were held constant or varied across notes. Results showed that sentence recognition was poorer with sung speech relative to spoken, with little difference between sung speech with a constant or variable pitch; mean performance was better with CI-only relative to HA-only, and best with CI + HA. MCI performance was better with constant words versus variable words; mean performance was better with HA-only than with CI-only and was best with CI + HA. Relative to CI-only, a strong bimodal benefit was observed for speech and music perception. Relative to the better ear, bimodal benefits remained strong for sentence recognition but were marginal for MCI. While variations in pitch and timbre may negatively affect CI users’ speech and music perception, bimodal listening may partially compensate for these deficits.

  5. Marginal AMP chain graphs

    OpenAIRE

    Pena, Jose M.

    2014-01-01

    We present a new family of models that is based on graphs that may have undirected, directed and bidirected edges. We name these new models marginal AMP (MAMP) chain graphs because each of them is Markov equivalent to some AMP chain graph under marginalization of some of its nodes. However, MAMP chain graphs do not only subsume AMP chain graphs but also multivariate regression chain graphs. We describe global and pairwise Markov properties for MAMP chain graphs and prove their equivalence for...

  6. SOCIAL MARGINALIZATION AND HEALTH

    Directory of Open Access Journals (Sweden)

    Marjana Bogdanović

    2007-04-01

    Full Text Available The 20th century was characterized by special improvement in health. The aim of WHO’s policy EQUITY IN HEALTH is to enable equal accessibility and equal high quality of health care for all citizens. More or less some social groups have stayed out of many social systems even out of health care system in the condition of social marginalization. Phenomenon of social marginalization is characterized by dynamics. Marginalized persons have lack of control over their life and available resources. Social marginalization stands for a stroke on health and makes the health status worse. Low socio-economic level dramatically influences people’s health status, therefore, poverty and illness work together. Characteristic marginalized groups are: Roma people, people with AIDS, prisoners, persons with development disorders, persons with mental health disorders, refugees, homosexual people, delinquents, prostitutes, drug consumers, homeless…There is a mutual responsibility of community and marginalized individuals in trying to resolve the problem. Health and other problems could be solved only by multisector approach to well-designed programs.

  7. Energy flow in passive and active 3D cochlear model

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Yanli; Steele, Charles [Department of Mechanical Engineering, Stanford University, Stanford, California (United States); Puria, Sunil [Department of Mechanical Engineering, Stanford University, Stanford, California (United States); Department of Otolaryngology, Head and Neck Surgery, Stanford University, Stanford, California (United States)

    2015-12-31

    Energy flow in the cochlea is an important characteristic of the cochlear traveling wave, and many investigators, such as von Békésy and Lighthill, have discussed this phenomenon. Particularly after the discovery of the motility of the outer hair cells (OHCs), the nature of the power gain of the cochlea has been a fundamental research question. In the present work, direct three-dimensional (3D) calculations of the power on cross sections of the cochlea and on the basilar membrane are performed based on a box model of the mouse cochlea. The distributions of the fluid pressure and fluid velocity in the scala vestibuli are presented. The power output from the OHCs and the power loss due to fluid viscous damping are calculated along the length of the cochlea. This work provides a basis for theoretical calculations of the power gain of the OHCs from mechanical considerations.

  8. Intracochlear Pressure Transients During Cochlear Implant Electrode Insertion.

    Science.gov (United States)

    Greene, Nathaniel T; Mattingly, Jameson K; Banakis Hartl, Renee M; Tollin, Daniel J; Cass, Stephen P

    2016-12-01

    Cochlear implant (CI) electrode insertion into the round window induces pressure transients in the cochlear fluid comparable to high-intensity sound transients. Many patients receiving a CI have some remaining functional hearing at low frequencies; thus, devices and surgical techniques have been developed to use this residual hearing. To maintain functional acoustic hearing, it is important to retain function of any hair cells and auditory nerve fibers innervating the basilar membrane; however, in a subset of patients, residual low-frequency hearing is lost after CI insertion. Here, we test the hypothesis that transient intracochlear pressure spikes are generated during CI electrode insertion, which could cause damage and compromise residual hearing. Human cadaveric temporal bones were prepared with an extended facial recess. Pressures in the scala vestibuli and tympani were measured with fiber-optic pressure sensors inserted into the cochlea near the oval and round windows, whereas CI electrodes (five styles from two manufacturers) were inserted into the cochlea via a round window approach. Pressures in the scala tympani tended to be larger in magnitude than pressures in the scala vestibuli, consistent with electrode insertion into the scala tympani. CI electrode insertion produced a range of pressure transients in the cochlea that could occur alone or as part of a train of spikes with equivalent peak sound pressure levels in excess of 170 dB sound pressure level. Instances of pressure transients varied with electrode styles. Results suggest electrode design, insertion mechanism, and surgical technique affect the magnitude and rate of intracochlear pressure transients during CI electrode insertion. Pressure transients showed intensities similar to those elicited by high-level sounds and thus could cause damage to the basilar membrane and/or hair cells.

  9. [Bioethical issues in pediatric cochlear implants].

    Science.gov (United States)

    Santos Santos, S

    2002-10-01

    The use of cochlear implants can modify significantly the way in which deaf children relate with the outside world through psychological, linguistic and cognitive changes. The main question about this subject is the ethical controversy with regards to who has the right to make such a decision for a young child. We present the children evaluated at our hospital in order to assess the cochlear implant option. That population was of 37 implanted children, 10 children waiting for surgery and 21 rejected children. We describe and analyze from the bioethical bases and methodology the problems found: decision of no implant in children of hearing parents, the deaf culture point of view, the mature minor doctrine, teenagers, social and cultural problems, multihandicapped children and responsibility of the implants team.

  10. Acute Disruption of Bone Marrow B Lymphopoiesis and Apoptosis of Transitional and Marginal Zone B Cells in the Spleen following a Blood-Stage Plasmodium chabaudi Infection in Mice

    Directory of Open Access Journals (Sweden)

    Viki Bockstal

    2011-01-01

    Full Text Available B cells and antibodies are essential for the protective immune response against a blood-stage Plasmodium infection. Although extensive research has focused on memory as well as plasma B-cell responses during infection, little is known about how malaria affects B-cell development and splenic maturation into marginal zone B (MZB and follicular B (FoB cells. In this study, we show that acute Plasmodium chabaudi AS infection in C57Bl/6 mice causes severe disruption of B lymphopoiesis in the bone marrow, affecting in particular pro-, pre-, and immature B cells as well as the expression of the bone marrow B-cell retention chemokine CXCL12. In addition, elevated apoptosis of transitional T2 and marginal zone (MZ B cells was observed during and subsequent to the control of the first wave of parasitemia. In contrast, Folllicular (Fo B cells levels were retained in the spleen throughout the infection, suggesting that these are essential for parasite clearance and proper infection control.

  11. Characterizing Electrocochleography in Cochlear Implant Recipients with Residual Low-Frequency Hearing.

    Science.gov (United States)

    Bester, Christofer W; Campbell, Luke; Dragovic, Adrian; Collins, Aaron; O'Leary, Stephen J

    2017-01-01

    Objective: Lay the groundwork for using electrocochleography (ECochG) as a measure of cochlear health, by characterizing typical patterns of the ECochG response observed across the electrode array in cochlear implant recipients with residual hearing. Methods: ECochG was measured immediately after electrode insertion in 45 cochlear implant recipients with residual hearing. The Cochlear Response Telemetry system was used to record ECochG across the electrode array, in response to 100- or 110-dB SPL pure tones at 0.5-kHz, presented at 14 per second and with alternating polarities. Hair cell activity, as the cochlear microphonic (CM), was estimated by taking the difference (DIF) of the two polarities. Neural activity, as the auditory nerve neurophonic (ANN), was estimated by taking the sum (SUM) of the two polarities. Prior work in humans and animal studies suggested that the expected ECochG pattern in response to a 0.5-kHz pure tone is an apical-peak in CM amplitude and latency. Results: The most prevalent pattern was a peak in the DIF amplitude near the most apical electrode, with a prolongation of latency toward the electrode tip; this was found in 21/39 individuals with successful ECochG recordings. The 21 apical-peak recipients had the best low-frequency hearing. A low amplitude, long-latency DIF response that remained relatively constant across the electrode array was found in 10/39 individuals, in a group with the poorest low- and high-frequency hearing. A third, previously undescribed, pattern occurred in 8/39 participants, with mid-electrode peaks in DIF amplitude. These recipients had the best high-frequency hearing and a progressive prolongation of DIF latency around the mid-electrode peaks consistent with the presence of discrete populations of hair cells. Conclusions: The presence of distinct patterns of the ECochG response with relationships to pre-operative hearing levels supports the notion that ECochG across the electrode array functions as a measure

  12. Simplifying cochlear implant speech processor fitting

    OpenAIRE

    Willeboer, C.

    2008-01-01

    Conventional fittings of the speech processor of a cochlear implant (CI) rely to a large extent on the implant recipient's subjective responses. For each of the 22 intracochlear electrodes the recipient has to indicate the threshold level (T-level) and comfortable loudness level (C-level) while stimulated with pulse trains. Obtaining these behavioral measurements is a time-consuming task. It requires cooperation and considerable effort of the CI recipient. Especially in adults that have been ...

  13. Sox10 expressing cells in the lateral wall of the aged mouse and human cochlea.

    Directory of Open Access Journals (Sweden)

    Xinping Hao

    Full Text Available Age-related hearing loss (presbycusis is a common human disorder, affecting one in three Americans aged 60 and over. Previous studies have shown that presbyacusis is associated with a loss of non-sensory cells in the cochlear lateral wall. Sox10 is a transcription factor crucial to the development and maintenance of neural crest-derived cells including some non-sensory cell types in the cochlea. Mutations of the Sox10 gene are known to cause various combinations of hearing loss and pigmentation defects in humans. This study investigated the potential relationship between Sox10 gene expression and pathological changes in the cochlear lateral wall of aged CBA/CaJ mice and human temporal bones from older donors. Cochlear tissues prepared from young adult (1-3 month-old and aged (2-2.5 year-old mice, and human temporal bone donors were examined using quantitative immunohistochemical analysis and transmission electron microscopy. Cells expressing Sox10 were present in the stria vascularis, outer sulcus and spiral prominence in mouse and human cochleas. The Sox10(+ cell types included marginal and intermediate cells and outer sulcus cells, including those that border the scala media and those extending into root processes (root cells in the spiral ligament. Quantitative analysis of immunostaining revealed a significant decrease in the number of Sox10(+ marginal cells and outer sulcus cells in aged mice. Electron microscopic evaluation revealed degenerative alterations in the surviving Sox10(+ cells in aged mice. Strial marginal cells in human cochleas from donors aged 87 and older showed only weak immunostaining for Sox10. Decreases in Sox10 expression levels and a loss of Sox10(+ cells in both mouse and human aged ears suggests an important role of Sox10 in the maintenance of structural and functional integrity of the lateral wall. A loss of Sox10(+ cells may also be associated with a decline in the repair capabilities of non-sensory cells in the

  14. Theoretical Evaluation and Experimental Validation of Localized Therapeutic Hypothermia Application to Preserve Residual Hearing After Cochlear Implantation.

    Science.gov (United States)

    Tamames, Ilmar; King, Curtis; Huang, Chin-Yuh; Telischi, Fred F; Hoffer, Michael E; Rajguru, Suhrud M

    2017-12-13

    Cochlear implantation surgery has been shown to result in trauma to inner ear sensory structures, resulting in loss of residual hearing. Localized therapeutic hypothermia has been shown in clinical care to be a neuroprotective intervention. Previously, we have shown in an experimental model that localized hypothermia protects cochlear hair cells and residual hearing function against surgical and cochlear implantation trauma. Using experimental temperature measurements carried out in human cadaver temporal bones and a finite element model of the inner ear, the present study examined the temperature distribution of a custom-designed hypothermia delivery system in the human inner ear organs. The efficacy of the hypothermia probe and resulting heat distribution across human cochlea and surrounding tissues were modeled in three-dimensional in COMSOL. The geometry and dimensions of inner ear and temporal bones were derived from computed tomographic and magnetic resonance imaging images. Model predictions were compared with experimental observations from five human temporal bones. In both the modeling and experimental studies, the cochlear temperature was lowered by 4 to 6 °C on the round window from a baseline of 37 °C within 16 to 18 minutes. The model simulations showed uniformly distributed cooling across the cochlea. This study provides insight for design, operation, and protocols for efficacious delivery of mild therapeutic hypothermia to the human cochlea that may significantly benefit patients undergoing surgical cochlear implantation by preserving residual hearing. There was a close correlation between the results of the numerical simulations and experimental observations in this study. Our custom-designed system is capable of effectively providing mild therapeutic hypothermia locally to the human cochlea. When combined with results from in vivo animal experiments, the present study suggests that the application of localized therapeutic hypothermia may hold

  15. Automated insertion of preformed cochlear implant electrodes: evaluation of curling behaviour and insertion forces on an artificial cochlear model.

    Science.gov (United States)

    Rau, Thomas S; Hussong, Andreas; Leinung, Martin; Lenarz, Thomas; Majdani, Omid

    2010-03-01

    As a substantial part of our concept of a minimally invasive cochlear implant (CI) surgery, we developed an automated insertion tool. Studies on an artificial scala tympani model were performed in order to evaluate force application when using the insertion tool. Contour electrodes were automatically inserted into a transparent cochlea model in Advance Off-Stylet technique. Occurring forces were measured by the use of a load cell and correlated with observed intracochlear movement of the electrode carriers. Mean insertion forces were measured up to 20 mN comparable to previous studies on temporal bones. The most influencing factor is the implant's 2D curling behaviour in comparison to the 3D helical shape of the cochlea. The study confirms the functionality and reliability of the automated insertion tool for insertion of preformed CI. Improved insertion strategies considering patient-specific anatomy become possible.

  16. Audiometric evaluation short and medium term in cochlear implants.

    Science.gov (United States)

    Alonso-Luján, Laura R; Gutiérrez-Farfán, Ileana; Luna-Reyes, Francisco A; Chamlati-Aguirre, Laura E; Durand Rivera, Alfredo

    2014-01-01

    Our purpose is report the results of cochlear implant program in this Institute, since our first surgery from November 2007, until December 2012. A cross-sectional study, observational, descriptive, analyzing the information about thresholds before and after implantation, using patients files (diagnosis, onset of hearing loss, brainstem auditory evoked potential (BAEP), computed tomography (CT), magnetic resonance imaging (MRI), implanted ear, brand and model of cochlear implants (CI) and audiometric studies before and after the CI. We report the evolution of 68 patients, age ranged 1 year 8 months to 39 years 3 months old. 94% patients (n = 64) had pre-lingual hearing loss being hereditary non-syndromic hearing loss the most common etiology (29.4%). 100% patients had auditory brainstem responses showing bilateral profound hearing loss, in the 77.9% type A tympanograms were obtained (Jerger's classification), and 100% had absence of stapedial reflexes and otoacoustic emissions with low reproducibility. CT reported as normal in 85.2% of patients, the findings: 5.8% had chronic mastoiditis changes, other findings reported in 1.4% of patients were: digastric right facial nerve, facial nerve canal dehiscence, enlarged vestibular aqueduct, occupation and poor pneumatization of mastoid air cells, lateral semicircular canals agenesis, incomplete partition of the cochlea with wide vestibular and vestibular aqueduct dilatation. Most frequent MR findings of skull with cerebellopontine angle approach were vascular loops of internal auditory canals unilaterally. In 10.2%, 55.8% of patients (n = 38) were implanted in the right ear, 56 (82.3%) with a CI from Advanced Bionics, HiRes 90K model, the remaining with Cochlear, Freedom and Nucleus 5 models. Developments in CI results by audiometric tests: prior to placement was 106.2 dB averages at frequencies assessed, one month later 62.4 dB, at 6 months 44 dB, and with satisfactory threshold 32.9 dB. 55.8% of patients (n = 38) with

  17. Improved imaging of cochlear nerve hypoplasia using a 3-Tesla variable flip-angle turbo spin-echo sequence and a 7-cm surface coil.

    Science.gov (United States)

    Giesemann, Anja M; Raab, Peter; Lyutenski, Stefan; Dettmer, Sabine; Bültmann, Eva; Frömke, Cornelia; Lenarz, Thomas; Lanfermann, Heinrich; Goetz, Friedrich

    2014-03-01

    Magnetic resonance imaging of the temporal bone has an important role in decision making with regard to cochlea implantation, especially in children with cochlear nerve deficiency. The purpose of this study was to evaluate the usefulness of the combination of an advanced high-resolution T2-weighted sequence with a surface coil in a 3-Tesla magnetic resonance imaging scanner in cases of suspected cochlear nerve aplasia. Prospective study. Seven patients with cochlear nerve hypoplasia or aplasia were prospectively examined using a high-resolution three-dimensional variable flip-angle turbo spin-echo sequence using a surface coil, and the images were compared with the same sequence in standard resolution using a standard head coil. Three neuroradiologists evaluated the magnetic resonance images independently, rating the visibility of the nerves in diagnosing hypoplasia or aplasia. Eight ears in seven patients with hypoplasia or aplasia of the cochlear nerve were examined. The average age was 2.7 years (range, 9 months-5 years). Seven ears had accompanying malformations. The inter-rater reliability in diagnosing hypoplasia or aplasia was greater using the high-resolution three-dimensional variable flip-angle turbo spin-echo sequence (fixed-marginal kappa: 0.64) than with the same sequence in lower resolution (fixed-marginal kappa: 0.06). Examining cases of suspected cochlear nerve aplasia using the high-resolution three-dimensional variable flip-angle turbo spin-echo sequence in combination with a surface coil shows significant improvement over standard methods. © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

  18. Early Vocabulary Development in Children with Bilateral Cochlear Implants

    Science.gov (United States)

    Välimaa, Taina; Kunnari, Sari; Laukkanen-Nevala, Päivi; Lonka, Eila

    2018-01-01

    Background: Children with unilateral cochlear implants (CIs) may have delayed vocabulary development for an extended period after implantation. Bilateral cochlear implantation is reported to be associated with improved sound localization and enhanced speech perception in noise. This study proposed that bilateral implantation might also promote…

  19. Speech Intelligibility and Prosody Production in Children with Cochlear Implants

    Science.gov (United States)

    Chin, Steven B.; Bergeson, Tonya R.; Phan, Jennifer

    2012-01-01

    Objectives: The purpose of the current study was to examine the relation between speech intelligibility and prosody production in children who use cochlear implants. Methods: The Beginner's Intelligibility Test (BIT) and Prosodic Utterance Production (PUP) task were administered to 15 children who use cochlear implants and 10 children with normal…

  20. Parents' Views on Changing Communication after Cochlear Implantation

    Science.gov (United States)

    Watson, Linda M.; Hardie, Tim; Archbold, Sue M.; Wheeler, Alexandra

    2008-01-01

    We sent questionnaires to families of all 288 children who had received cochlear implants at one center in the United Kingdom at least 5 years previously. Thus, it was a large, unselected group. We received 142 replies and 119 indicated that the child and family had changed their communication approach following cochlear implantation. In 113 cases…

  1. Evaluating the Feasibility of Using Remote Technology for Cochlear Implants

    Science.gov (United States)

    Goehring, Jenny L.; Hughes, Michelle L.; Baudhuin, Jacquelyn L.

    2012-01-01

    The use of remote technology to provide cochlear implant services has gained popularity in recent years. This article contains a review of research evaluating the feasibility of remote service delivery for recipients of cochlear implants. To date, published studies have determined that speech-processor programming levels and other objective tests…

  2. Emotion Understanding in Deaf Children with a Cochlear Implant

    Science.gov (United States)

    Wiefferink, Carin H.; Rieffe, Carolien; Ketelaar, Lizet; De Raeve, Leo; Frijns, Johan H. M.

    2013-01-01

    It is still largely unknown how receiving a cochlear implant affects the emotion understanding in deaf children. We examined indices for emotion understanding and their associations with communication skills in children aged 2.5-5 years, both hearing children (n = 52) and deaf children with a cochlear implant (n = 57). 2 aspects of emotion…

  3. Verbal Working Memory in Children with Cochlear Implants

    Science.gov (United States)

    Nittrouer, Susan; Caldwell-Tarr, Amanda; Low, Keri E.; Lowenstein, Joanna H.

    2017-01-01

    Purpose: Verbal working memory in children with cochlear implants and children with normal hearing was examined. Participants: Ninety-three fourth graders (47 with normal hearing, 46 with cochlear implants) participated, all of whom were in a longitudinal study and had working memory assessed 2 years earlier. Method: A dual-component model of…

  4. Are parents of children with cochlear implants coping?: research ...

    African Journals Online (AJOL)

    Many variables must be considered during the evaluation and rehabilitation of children for cochlear implantation, one of which is parental influence (for the duration of this report the parents, caregivers and guardians of children with cochlear implants and / or hearing impairments will be referred to as 'parents'). The aim of ...

  5. Remote programming of cochlear implants: a telecommunications model.

    Science.gov (United States)

    McElveen, John T; Blackburn, Erin L; Green, J Douglas; McLear, Patrick W; Thimsen, Donald J; Wilson, Blake S

    2010-09-01

    Evaluate the effectiveness of remote programming for cochlear implants. Retrospective review of the cochlear implant performance for patients who had undergone mapping and programming of their cochlear implant via remote connection through the Internet. Postoperative Hearing in Noise Test and Consonant/Nucleus/Consonant word scores for 7 patients who had undergone remote mapping and programming of their cochlear implant were compared with the mean scores of 7 patients who had been programmed by the same audiologist over a 12-month period. Times required for remote and direct programming were also compared. The quality of the Internet connection was assessed using standardized measures. Remote programming was performed via a virtual private network with a separate software program used for video and audio linkage. All 7 patients were programmed successfully via remote connectivity. No untoward patient experiences were encountered. No statistically significant differences could be found in comparing postoperative Hearing in Noise Test and Consonant/Nucleus/Consonant word scores for patients who had undergone remote programming versus a similar group of patients who had their cochlear implant programmed directly. Remote programming did not require a significantly longer programming time for the audiologist with these 7 patients. Remote programming of a cochlear implant can be performed safely without any deterioration in the quality of the programming. This ability to remotely program cochlear implant patients gives the potential to extend cochlear implantation to underserved areas in the United States and elsewhere.

  6. A case report: the first successful cochlear implant in Uganda ...

    African Journals Online (AJOL)

    Pure tone audiometry revealed profound sensorineural hearing loss in both ears( see attached PTA results), CT scan of the temporal bone showed normal inner ear anatomy bilaterally and mild sclerotic changes in both mastoid bones. He then had surgery on his right ear which included cochlear implantation. The cochlear ...

  7. Marginal kidney donor

    Directory of Open Access Journals (Sweden)

    Ganesh Gopalakrishnan

    2007-01-01

    Full Text Available Renal transplantation is the treatment of choice for a medically eligible patient with end stage renal disease. The number of renal transplants has increased rapidly over the last two decades. However, the demand for organs has increased even more. This disparity between the availability of organs and waitlisted patients for transplants has forced many transplant centers across the world to use marginal kidneys and donors. We performed a Medline search to establish the current status of marginal kidney donors in the world. Transplant programs using marginal deceased renal grafts is well established. The focus is now on efforts to improve their results. Utilization of non-heart-beating donors is still in a plateau phase and comprises a minor percentage of deceased donations. The main concern is primary non-function of the renal graft apart from legal and ethical issues. Transplants with living donors outnumbered cadaveric transplants at many centers in the last decade. There has been an increased use of marginal living kidney donors with some acceptable medical risks. Our primary concern is the safety of the living donor. There is not enough scientific data available to quantify the risks involved for such donation. The definition of marginal living donor is still not clear and there are no uniform recommendations. The decision must be tailored to each donor who in turn should be actively involved at all levels of the decision-making process. In the current circumstances, our responsibility is very crucial in making decisions for either accepting or rejecting a marginal living donor.

  8. Tumor Necrosis Factor-α-Induced Ototoxicity in Mouse Cochlear Organotypic Culture.

    Directory of Open Access Journals (Sweden)

    Qian Wu

    Full Text Available Tumor necrosis factor (TNF-α is a cytokine involved in acute inflammatory phase reactions, and is the primary upstream mediator in the cochlear inflammatory response. Treatment of the organ of Corti with TNF-α can induce hair cell damage. However, the resulting morphological changes have not been systematically examined. In the present study, cochlear organotypic cultures from neonatal mice were treated with various concentrations and durations of TNF-α to induce inflammatory responses. Confocal microscopy was used to evaluate the condition of hair cells and supporting cells following immunohistochemical staining. In addition, the ultrastructure of the stereocilia bundle, hair cells, and supporting cells were examined by scanning and transmission electron microscopy. TNF-α treatment resulted in a fusion and loss of stereocilia bundles in hair cells, swelling of mitochondria, and vacuolation and degranulation of the endoplasmic reticulum. Disruption of tight junctions between hair cells and supporting cells was also observed at high concentrations. Hair cell loss was preceded by apoptosis of Deiters' and pillar cells. Taken together, these findings detail the morphological changes in the organ of Corti after TNF-α treatment, and provide an in vitro model of inflammatory-induced ototoxicity.

  9. Surgical excision margins for primary cutaneous melanoma.

    Science.gov (United States)

    Sladden, Michael J; Balch, Charles; Barzilai, David A; Berg, Daniel; Freiman, Anatoli; Handiside, Teenah; Hollis, Sally; Lens, Marko B; Thompson, John F

    2009-10-07

    Cutaneous melanoma accounts for 75% of skin cancer deaths. Standard treatment is surgical excision with a safety margin some distance from the borders of the primary tumour. The purpose of the safety margin is to remove both the complete primary tumour and any melanoma cells that might have spread into the surrounding skin.Excision margins are important because there could be trade-off between a better cosmetic result but poorer long-term survival if margins become too narrow. The optimal width of excision margins remains unclear. This uncertainty warrants systematic review. To assess the effects of different excision margins for primary cutaneous melanoma. In August 2009 we searched for relevant randomised trials in the Cochrane Skin Group Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library (Issue 3, 2009), MEDLINE, EMBASE, LILACS, and other databases including Ongoing Trials Registers. We considered all randomised controlled trials (RCTs) of surgical excision of melanoma comparing different width excision margins. We assessed trial quality, and extracted and analysed data on survival and recurrence. We collected adverse effects information from included trials. We identified five trials. There were 1633 participants in the narrow excision margin group and 1664 in the wide excision margin group. Narrow margin definition ranged from 1 to 2 cm; wide margins ranged from 3 to 5 cm. Median follow-up ranged from 5 to 16 years. This systematic review summarises the evidence regarding width of excision margins for primary cutaneous melanoma. None of the five published trials, nor our meta-analysis, showed a statistically significant difference in overall survival between narrow or wide excision.The summary estimate for overall survival favoured wide excision by a small degree [Hazard Ratio 1.04; 95% confidence interval 0.95 to 1.15; P = 0.40], but the result was not significantly different. This result is compatible

  10. From Borders to Margins

    DEFF Research Database (Denmark)

    Parker, Noel

    2009-01-01

    upon Deleuze's philosophy to set out an ontology in which the continual reformulation of entities in play in ‘post-international' society can be grasped.  This entails a strategic shift from speaking about the ‘borders' between sovereign states to referring instead to the ‘margins' between a plethora...... of entities that are ever open to identity shifts.  The concept of the margin possesses a much wider reach than borders, and focuses continual attention on the meetings and interactions between a range of indeterminate entities whose interactions may determine both themselves and the types of entity...

  11. The Hearing Outcomes of Cochlear Implantation in Waardenburg Syndrome

    Directory of Open Access Journals (Sweden)

    Hajime Koyama

    2016-01-01

    Full Text Available Objectives. This study aimed to determine the feasibility of cochlear implantation for sensorineural hearing loss in patients with Waardenburg syndrome. Method. A retrospective chart review was performed on patients who underwent cochlear implantation at the University of Tokyo Hospital. Clinical classification, genetic mutation, clinical course, preoperative hearing threshold, high-resolution computed tomography of the temporal bone, and postoperative hearing outcome were assessed. Result. Five children with Waardenburg syndrome underwent cochlear implantation. The average age at implantation was 2 years 11 months (ranging from 1 year 9 months to 6 years 3 months. Four patients had congenital profound hearing loss and one patient had progressive hearing loss. Two patients had an inner ear malformation of cochlear incomplete partition type 2. No surgical complication or difficulty was seen in any patient. All patients showed good hearing outcome postoperatively. Conclusion. Cochlear implantation could be a good treatment option for Waardenburg syndrome.

  12. Comparison of Dizziness, Depression, Anxiety and Mental Health of Postlingually Deaf Adults Between Cochlear Implant Recipients and Cochlear Implant Candidates

    Directory of Open Access Journals (Sweden)

    Reza Hossein-Abadi

    2008-07-01

    Full Text Available Objective: Hearing loss can affect on physical, mental and social health of deaf adults and lead to depression, anxiety, isolation, suspicion and stress of them. Cochlear implantation has positive effects on behavioral and emotional status of postlingually hearing impaired adults. This study is aimed to compare dizziness, depression, anxiety and mental health in adult cochlear implant recipients and candidates. Materials & Methods: This case- control and comparative study was conducted on 49 patients, 24 cochlear implant recipients (as case group and 25 severe-profound hearing impaired adults (as control groups whom were selected by simple and convenient sampling. Beck Depression Inventory, Dizziness Handicap Inventory, Beck Anxiety Inventory and General Health Questionnaire were completed to determine and compare cochlear implant effects. Data were analyzed by MANOVA. Results: Mean depression and anxiety scores in cochlear implant candidates were more than cochlear implant recipients. This difference was significant in depression (P=0.001. There was no significant difference between two groups in general health (P=0.415. The results of this study also showed that dizziness is more in cochlear implanted group (P=0.004. Conclusion: It seems that cochlear implant use leads to decrease of depression and anxiety. It leads to increase of dizziness.

  13. Cochlear Histopathology as Observed in Two Patients With a Cochlear Implant Electrode With Positioner.

    Science.gov (United States)

    Kamakura, Takefumi; Nadol, Joseph B

    2016-07-01

    This study reports the cochlear histopathology of two patients who during life underwent cochlear implantation with a positioner. A silastic positioner introduced by the Advanced Bionics Corporation in 1999 was designed to position the electrode of the cochlear implant close to the modiolus. The positioner was recalled in the United States in July 2002 because of an apparent higher incidence of bacterial meningitis in patients in whom the positioner had been placed. Four celloidin-embedded temporal bones from two patients with cochlear implants with a positioner from the temporal bone collection of the Massachusetts Eye and Ear Infirmary were included in the study. In a previous study, we reported histopathologic findings in Patient 1, and in this report, we present the findings in a second case in a 94-year-old woman (Patient 2), and the similarities and differences between the two patients. All four specimens were prepared for histologic study by conventional techniques and 2-D reconstruction. Evidence of insertion trauma was observed in all three implanted specimens. More significant trauma was found in Patient 2 than in Patient 1 including disruption of the osseous spiral lamina and the basilar membrane. In addition, there was more new fibrous tissue and bone in Patient 2 than in Patient 1. There was a large fluid space in all three implanted temporal bones around the electrode and positioner. The findings observed in the two patients may help to explain the increased risk of meningitis in patients implanted with a positioner.

  14. Simultaneous versus sequential bilateral cochlear implants in adults: Cost analysis in a US setting.

    Science.gov (United States)

    Trinidade, Aaron; Page, Joshua C; Kennett, Sarah W; Cox, Matthew D; Dornhoffer, John L

    2017-11-01

    From a purely surgical efficiency point of view, simultaneous cochlear implantation (SimCI) is more cost-effective than sequential cochlear implantation (SeqCI) when total direct costs are considered (implant and hospital costs). However, in a setting where only SeqCI is practiced and a proportion of initially unilaterally implanted patients do not progress to a second implant, this may not be the case, especially when audiological costs are factored in. We present a cost analysis of such a scenario as would occur in our institution. Retrospective review and cost analysis. Between 2005 and 2015, 370 patients fulfilled the audiological criteria for bilateral implantation. Of those, 267 (72.1%) underwent unilateral cochlear implantation only, 101 (27.3%) progressed to SeqCI, and two underwent SimCI. The total hospital, surgical, and implant costs, and initial implant stimulation series audiological costs between August 2015 and August 2016 (29 adult patients) were used in this analysis. The total hospital, surgical, and implant costs for this period was $2,731,360.42. Based on previous local trends, if a projected eight (27.3%) of these patients decide to progress to SeqCI, this will cost an additional $750,811.04, resulting in an overall total of $3,482,171.46 for these 29 patients. Had all 29 undergone SimCI, the total projected cost would have been $3,332,991.75, representing a total potential saving of $149,179.67 (4.3%). In institutions where only SeqCI is allowed in adults, overall patient management may cost marginally more than if SimCI were practiced. This will be of interest to CI programs and health insurance companies. 4. Laryngoscope, 127:2615-2618, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  15. Variational Algorithms for Marginal MAP

    OpenAIRE

    Liu, Q; Ihler, A

    2013-01-01

    The marginal maximum a posteriori probability (MAP) estimation problem, which calculates the mode of the marginal posterior distribution of a subset of variables with the remaining variables marginalized, is an important inference problem in many models, such as those with hidden variables or uncertain parameters. Unfortunately, marginal MAP can be NP-hard even on trees, and has attracted less attention in the literature compared to the joint MAP (maximization) and marginalization problems. W...

  16. Masculinity at the margins

    DEFF Research Database (Denmark)

    Jensen, Sune Qvotrup

    2010-01-01

    This article analyses how young marginalized ethnic minority men in Denmark react to the othering they are subject to in the media as well as in the social arenas of every day life. The article is based on theoretically informed ethnographic fieldwork among such young men as well as interviews an...

  17. Marginally Deformed Starobinsky Gravity

    DEFF Research Database (Denmark)

    Codello, A.; Joergensen, J.; Sannino, Francesco

    2015-01-01

    We show that quantum-induced marginal deformations of the Starobinsky gravitational action of the form $R^{2(1 -\\alpha)}$, with $R$ the Ricci scalar and $\\alpha$ a positive parameter, smaller than one half, can account for the recent experimental observations by BICEP2 of primordial tensor modes....

  18. Oceanography of marginal seas

    Digital Repository Service at National Institute of Oceanography (India)

    DileepKumar, M.

    The North Indian Ocean consists of three marginal seas; The Persian Gulf and the Red Sea in the west and the Andaman Sea in the east. Oceanographic features of these semi-enclosed basins have been discussed in this article. While circulation...

  19. Marginalization and School Nursing

    Science.gov (United States)

    Smith, Julia Ann

    2004-01-01

    The concept of marginalization was first analyzed by nursing researchers Hall, Stevens, and Meleis. Although nursing literature frequently refers to this concept when addressing "at risk" groups such as the homeless, gays and lesbians, and those infected with HIV/AIDS, the concept can also be applied to nursing. Analysis of current school nursing…

  20. Outcomes of cochlear implantation in children with isolated auditory neuropathy versus cochlear hearing loss.

    Science.gov (United States)

    Budenz, Cameron L; Telian, Steven A; Arnedt, Caroline; Starr, Kelly; Arts, Henry Alexander; El-Kashlan, Hussam K; Zwolan, Terry A

    2013-04-01

    Auditory neuropathy (AN) is a heterogeneous clinical entity for which the optimal method of auditory rehabilitation has been a matter of some debate. Such patients often do not receive sufficient benefit from hearing aids. Previous studies have shown that select AN patients may benefit from cochlear implantation (CI), but reported outcomes are variable and likely are a reflection of the heterogeneous patient population included under the umbrella diagnosis of AN. This study compares CI outcomes in a subset of the pediatric AN population who do not have a confounding cognitive disorder with their cochlear hearing loss peers. Additionally, it examines the impact of a confounding cognitive or developmental disorder on CI outcomes within the AN population. Retrospective chart review. Tertiary referral center. Twenty-six pediatric patients with AN who received a CI were the subjects of this study. Seventeen of these children had a diagnosis of AN alone, and their CI outcomes were compared with those of a similar group of children with cochlear hearing loss. The remaining 9 children had a diagnosis of AN in association with a confounding cognitive or developmental disorder, and their CI outcomes were compared with those of children with isolated AN. Cochlear implantation. All subjects were evaluated preoperatively and postoperatively with age-appropriate speech perception testing. Children with a diagnosis of AN alone performed comparably to their peers with cochlear hearing loss. The presence of a confounding cognitive or developmental disorder within the AN population was correlated with significantly poorer CI outcomes as compared with those of children with isolated AN. Children with a diagnosis of AN without associated cognitive or developmental disorders perform at a level comparable to other children requiring a CI. Children with a diagnosis of AN associated with other developmental anomalies derive some benefit from CI but are significantly more likely to

  1. Sound emission from cochlear filters and foveae--does the auditory sense organ make sense?

    Science.gov (United States)

    Kössl, M

    1997-01-01

    Sense organs filter relevant information from a broad background of physical interactions and discard possible perceptual input that has not proven useful during the course of biological evolution. Sense organs not only limit the access to physical reality, under certain conditions they have a life of their own and produce responses even in the absence of physical stimulation. As a perfect example, the inner ear, the cochlea, in addition to detecting incoming sound waves, it also is capable of producing sound energy. Such "active" processes, however, seem to be necessary to push detection thresholds close to physical limits. The price that has to be paid are "cochlear artifacts" like otoacoustic emissions. In the following, measurement of sound that is emitted by the ear will be introduced as a noninvasive means to assess cochlear function and to help to unravel the mechanical interaction between sensory cells and supporting structures that ultimately leads to sensitive and sharply tuned auditory perception. One focus will be on the cochlea of echo-locating bats that use audition as the main window of perception to their environment and therefore have highest demands on cochlear performance.

  2. Sound Emission from Cochlear Filters and Foveae - Does the Auditory Sense Organ Make Sense?

    Science.gov (United States)

    Kössl, Manfred

    Sense organs filter relevant information from a broad background of physical interactions and discard possible perceptual input that has not proven useful during the course of biological evolution. Sense organs not only limit the access to physical reality, under certain conditions they have a life of their own and produce responses even in the absence of physical stimulation. As a perfect example, the inner ear, the cochlea, in addition to detecting incoming sound waves, it also is capable of producing sound energy. Such ``active'' processes, however, seem to be necessary to push detection thresholds close to physical limits. The price that has to be paid are ``cochlear artifacts'' like otoacoustic emissions. In the following, measurement of sound that is emitted by the ear will be introduced as a noninvasive means to assess cochlear function and to help to unravel the mechanical interaction between sensory cells and supporting structures that ultimately leads to sensitive and sharply tuned auditory perception. One focus will be on the cochlea of echo-locating bats that use audition as the main window of perception to their environment and therefore have highest demands on cochlear performance.

  3. Evolution of impedance field telemetry after one day of activation in cochlear implant recipients.

    Directory of Open Access Journals (Sweden)

    Hao-Chun Hu

    Full Text Available Changes in impedance between 24 hours and one month after cochlear implantation have never been explored due to the inability to switch on within one day. This study examined the effect of early activation (within 24 hours on the evolution of electrode impedance with the aim of providing information on the tissue-to-electrode interface when electrical stimulation was commenced one day post implantation.We performed a retrospective review at a single institution. Patients who received a Nucleus 24RECA implant system (Cochlear, Sydney, Australia and underwent initial switch-on within 24 hours postoperatively were included. Impedance measurements were obtained intraoperatively and postoperatively at 1 day, 1 week, 4 weeks, and 8 weeks.A significant drop in impedance was noted 1 day after an initial activation within 24 hours followed by a significant rise in impedance in all channels until 1 week, after which the impedance behaved differently in different segments. Basal and mid-portion electrodes revealed a slight increase while apical electrodes showed a slight decrease in impedance from 1 week to 8 weeks postoperatively. Impedance was relatively stable 4 weeks after surgery.This is the first study to report the evolution of impedance in all channels between initial mapping 1 day and 1 month after cochlear implantation. The underlying mechanism for the differences in behavior between different segments of the electrode may be associated with the combined effect of dynamics among the interplay of cell cover formation, electrical stimulation, and fibrotic reaction.

  4. The group delay and suppression pattern of the cochlear microphonic potential recorded at the round window.

    Directory of Open Access Journals (Sweden)

    Wenxuan He

    Full Text Available BACKGROUND: It is commonly assumed that the cochlear microphonic potential (CM recorded from the round window (RW is generated at the cochlear base. Based on this assumption, the low-frequency RW CM has been measured for evaluating the integrity of mechanoelectrical transduction of outer hair cells at the cochlear base and for studying sound propagation inside the cochlea. However, the group delay and the origin of the low-frequency RW CM have not been demonstrated experimentally. METHODOLOGY/PRINCIPAL FINDINGS: This study quantified the intra-cochlear group delay of the RW CM by measuring RW CM and vibrations at the stapes and basilar membrane in gerbils. At low sound levels, the RW CM showed a significant group delay and a nonlinear growth at frequencies below 2 kHz. However, at high sound levels or at frequencies above 2 kHz, the RW CM magnitude increased proportionally with sound pressure, and the CM phase in respect to the stapes showed no significant group delay. After the local application of tetrodotoxin the RW CM below 2 kHz became linear and showed a negligible group delay. In contrast to RW CM phase, the BM vibration measured at location ∼2.5 mm from the base showed high sensitivity, sharp tuning, and nonlinearity with a frequency-dependent group delay. At low or intermediate sound levels, low-frequency RW CMs were suppressed by an additional tone near the probe-tone frequency while, at high sound levels, they were partially suppressed only at high frequencies. CONCLUSIONS/SIGNIFICANCE: We conclude that the group delay of the RW CM provides no temporal information on the wave propagation inside the cochlea, and that significant group delay of low-frequency CMs results from the auditory nerve neurophonic potential. Suppression data demonstrate that the generation site of the low-frequency RW CM shifts from apex to base as the probe-tone level increases.

  5. Hearing Preservation Among Patients Undergoing Cochlear Implantation

    Science.gov (United States)

    Van Abel, Kathryn M.; Dunn, Camille C.; Sladen, Douglas P.; Oleson, Jacob J.; Beatty, Charles W.; Neff, Brian A.; Hansen, Marlan; Gantz, Bruce J.; Driscoll, Colin L. W.

    2015-01-01

    Introduction Despite successful preservation of low-frequency hearing in patients undergoing cochlear implantation (CI) with shorter electrode lengths, there is still controversy regarding which electrodes maximize hearing preservation (HP). The thin straight electrode array (TSEA) has been suggested as a full cochlear coverage option for HP. However, very little is known regarding its HP potential. Methods A retrospective review was performed at two tertiary academic medical centers, reviewing the electronic records for 52 patients (mean, 58.2 yr; range, 11–85 yr) implanted with the Cochlear Nucleus CI422 Slim Straight (Centennial, CO, USA) electrode array, referred to herein as the thin straight electrode array or TSEA. All patients had a preoperative low-frequency pure-tone average (LFPTA) of 85 dB HL or less. Hearing thresholds were measured at initial activation (t1) and 6 months after activation (t2). HP was assessed by evaluating functional HP using a cutoff level of 85 dB HL PTA. Results At t1, 54% of the subjects had functional hearing; 33% of these subjects had an LFPTA between 71 and 85 dB HL, and 17% had an LFPTA between 56 and 70 dB HL. At t2, 47% of the patients had functional hearing, with 31% having an LFPTA between 71 and 85 dB HL. Discussion Preliminary research suggests that the TSEA has the potential to preserve functional hearing in 54% of patients at t1. However, 22% (n = 6) of the patients who had functional hearing at t1 (n = 28) lost their hearing between t1 and t2. Further studies are needed to evaluate factors that influence HP with the TSEA electrode and determine the speech perception benefits using electric and acoustic hearing over electric alone. PMID:25575373

  6. Membrane properties of type II spiral ganglion neurones identified in a neonatal rat cochlear slice

    Science.gov (United States)

    Jagger, Daniel J; Housley, Gary D

    2003-01-01

    Neuro-anatomical studies in the mammalian cochlea have previously identified a subpopulation of approximately 5% of primary auditory neurones, designated type II spiral ganglion neurones (sgnII). These neurones project to outer hair cells and their supporting cells, within the ‘cochlear amplifier’ region. Physiological characterization of sgnII has proven elusive. Whole-cell patch clamp of spiral ganglion neurones in P7-P10 rat cochlear slices provided functional characterization of sgnII, identified by biocytin or Lucifer yellow labelling of their peripheral neurite projections (outer spiral fibres) subsequent to electrophysiological characterisation. SgnII terminal fields comprised multiple outer hair cells and supporting cells, located up to 370 μm basal to their soma. SgnII firing properties were defined by rapidly inactivating A-type-like potassium currents that suppress burst firing of action potentials. Type I spiral ganglion neurones (sgnI), had shorter radial projections to single inner hair cells and exhibited larger potassium currents with faster activation and slower inactivation kinetics, compatible with the high temporal firing fidelity seen in auditory nerve coding. Based on these findings, sgnII may be identified in future by the A-type current. Glutamate-gated somatic currents in sgnII were more potentiated by cyclothiazide than those in sgnI, suggesting differential AMPA receptor expression. ATP-activated desensitising inward currents were comparable in sgn II and sgnI. These data support a role for sgnII in providing integrated afferent feedback from the cochlear amplifier. PMID:14561834

  7. Usher syndrome: characteristics and outcomes of pediatric cochlear implant recipients.

    Science.gov (United States)

    Jatana, Kris R; Thomas, Denise; Weber, Lisa; Mets, Marilyn B; Silverman, Josh B; Young, Nancy M

    2013-04-01

    To evaluate the characteristics and outcomes of pediatric cochlear implant recipients diagnosed with Usher syndrome (US). Retrospective study of consecutive pediatric cochlear implant recipients (1991-2010). Tertiary care children's hospital. Children who received a cochlear implant who were diagnosed with US either before or after implantation. Electroretinography and ophthalmologic findings, cochlear anatomy based on preoperative imaging, age of independent ambulation, age at implantation, speech perception level, and communication method. Approximately 26 (3.7%) of 712 cochlear implant recipients were diagnosed with US based on the results of electroretinography and/or genetic testing. Preoperative imaging revealed no evidence of cochlear malformations. Average age of independent ambulation was 21.9 months (range, 12-30). Average age at implantation was 3.3 years (range, 6 mo to 11.6 yr). Mean follow-up after implantation was 7.8 years (range, 10 mo to 15.6 yr). Open-set speech perception was present in 92% of children, with use of a primarily oral communication mode in 69.2%. In this large series of patients with the diagnosis of US who have undergone cochlear implantation, CT and MRI imaging were normal. Significant delay in independent ambulation was present in this population secondary to abnormal vestibular function associated with US Type I. A majority of children developed significant open-set speech perception and oral communication skills. Implantation of US children provides them with the opportunity to develop useful hearing and oral communication.

  8. Music mixing preferences of cochlear implant recipients: a pilot study.

    Science.gov (United States)

    Buyens, Wim; van Dijk, Bas; Moonen, Marc; Wouters, Jan

    2014-05-01

    Music perception and appraisal are generally poor in cochlear implant recipients. Simple musical structures, lyrics that are easy to follow, and clear rhythm/beat have been reported among the top factors to enhance music enjoyment. The present study investigated the preference for modified relative instrument levels in music with normal-hearing and cochlear implant subjects. In experiment 1, test subjects were given a mixing console and multi-track recordings to determine their most enjoyable audio mix. In experiment 2, a preference rating experiment based on the preferred relative level settings in experiment 1 was performed. Experiment 1 was performed with four postlingually deafened cochlear implant subjects, experiment 2 with ten normal-hearing and ten cochlear implant subjects. A significant difference in preference rating was found between normal-hearing and cochlear implant subjects. The latter preferred an audio mix with larger vocals-to-instruments ratio. In addition, given an audio mix with clear vocals and attenuated instruments, cochlear implant subjects preferred the bass/drum track to be louder than the other instrument tracks. The original audio mix in real-world music might not be suitable for cochlear implant recipients. Modifying the relative instrument level settings potentially improves music enjoyment.

  9. The relevance of dosimetry in animal models of cochlear irradiation.

    Science.gov (United States)

    Mujica-Mota, Mario A; Devic, Slobodan; Daniel, Sam J

    2014-04-01

    To compare dose measurements of three different irradiation setups for an animal model of unilateral cochlear irradiation using radiochromic films positioned at the cochlear plane. A method of dosimetry is proposed. Radiation field simulation was performed to locate the cochlear plane for irradiation experiments using CT scan images. Fifteen film pieces were irradiated at the cochlear plane with 3 different irradiation field sizes. A 12-mm diameter field (n = 5), 5.7 mm diameter field (n = 5), and a 6.5 × 7.2 mm field (n = 5). After obtaining an ideal irradiation field size, 15 film pieces were used to compare dosimetry between tissue substitute materials (PVC n = 5 and PVC + Teflon, 5 each) and real tissue (frozen animal, n = 5). Auditory brainstem responses at 3 frequencies (8, 16, 20, and 25 kHz) were performed on 7 guinea pigs after a cycle of fractionated unilateral irradiation. Dosimetry in real tissue demonstrated an asymmetric dose distribution at the cochlear plane and ultimately a lower dose deposition (30%) when compared with tissue substitute materials. Auditory brainstem responses of ears subjected to radiotherapy demonstrated progressive hearing loss in long-term assessment. Asymmetric dose deposition at the cochlear plane highlights the need of comprehensive real tissue dosimetry in animal studies of cochlear irradiation. To avoid misleading discrepancies in dose-deposition between different studies using the same animal model, appropriate planning and confirmatory dosimetry systems are highly desirable.

  10. Cochlear function in patients with chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Samantha Marlanie Govender

    2013-11-01

    Results: Significant differences (p<0.05 were found between pure tone audiometry and DPOAEs in detecting early cochlear dysfunction in the high-frequency range in stages 3 (6 000/5 000 Hz; p=0.00, 4 (6 000/5 000 Hz; p<0.03 and 5 (4 000/3 333 Hz; p<0.01, 8 000/6 667 Hz:p<0.05 with DPOAEs being more sensitive in identifying early cochlear dysfunction. Patients in stages 1 and 2 presented with normal puretone thresholds and DPOAEs, suggesting that cochlear functioning in these patients was normal. Early cochlear dysfunction, thereby indicating a subclinical hearing loss, was identified in stages 3, 4 and 5 by DPOAE testing. In addition, blood test results, drug intake and concomitant conditions were recorded and analysed which suggested a relationship between reduced cochlear functioning and increased electrolyte levels, treatment regimens and concomitant conditions. Conclusion: Participants in the later stages of CKD presented with early cochlear dysfunction, presenting with subclinical hearing loss. It was postulated that this subclinical hearing loss resulted from a combination of electrolytic, urea and creatinine imbalances, together with concomitant medical conditions and ototoxic drug intake. It was concluded that audiological monitoring be included in the management of patients with CKD and that DPOAEs be introduced as part of the test battery to monitor cochlear function in patients with varying degrees of CKD.

  11. Microminiature molding techniques for cochlear electrode arrays.

    Science.gov (United States)

    Loeb, G E; Peck, R A; Smith, D W

    1995-12-01

    We provide a general method for producing a variety of small, complex electrode arrays based on injection molds produced using computer-aided drafting and machining (CAD-CAM) procedures and a novel method for connecting to the very fine electrical leads associated with the individual contacts of such arrays. Cat-sized cochlear electrode arrays with up to eight contacts were built according to these methods and their electrical contacts were characterized in vitro by impedance spectroscopy and in vivo by monitoring impedance for over 1 year of intermittent stimulation in chronically instrumented animals.

  12. Estimation of stimulus attenuation in cochlear implants

    CSIR Research Space (South Africa)

    Smit, Jacoba E

    2009-03-01

    Full Text Available B/mm) in scalar fluids, while the Organ of Corti current length constants are 1.00 – 1.15 mm (7.55 – 8.69 dB/mm). Kral et al. (1998) and Hartmann and Klinke (1990) have reported attenuation slopes of around 3 dB/mm (length constant of about 3 mm) for monopolar... in cochlear stimulation. Ann N Y Acad Sci, 1983; 405: 137-45. 30 Blight AR. Computer simulation of action potentials and afterpotentials in mammalian myelinated axons: The case for a lower resistance myelin sheath. Neuroscience, 1985; 15: 13- 31...

  13. Marginal deformations & rotating horizons

    Science.gov (United States)

    Anninos, Dionysios; Anous, Tarek; D'Agnolo, Raffaele Tito

    2017-12-01

    Motivated by the near-horizon geometry of four-dimensional extremal black holes, we study a disordered quantum mechanical system invariant under a global SU(2) symmetry. As in the Sachdev-Ye-Kitaev model, this system exhibits an approximate SL(2, ℝ) symmetry at low energies, but also allows for a continuous family of SU(2) breaking marginal deformations. Beyond a certain critical value for the marginal coupling, the model exhibits a quantum phase transition from the gapless phase to a gapped one and we calculate the critical exponents of this transition. We also show that charged, rotating extremal black holes exhibit a transition when the angular velocity of the horizon is tuned to a certain critical value. Where possible we draw parallels between the disordered quantum mechanics and charged, rotating black holes.

  14. Cochlear implants in children implanted in Jordan: A parental overview.

    Science.gov (United States)

    Alkhamra, Rana A

    2015-07-01

    Exploring the perspective of parents on the cochlear implant process in Jordan. Sixty parents of deaf children were surveyed on the information gathering process prior to cochlear implant surgery, and their implant outcome expectations post-surgery. Whether child or parent characteristics may impact parents' post-surgical expectations was explored. Although parents used a variety of information sources when considering a cochlear implant, the ear, nose and throat doctor comprised their major source of information (60%). Parents received a range of information prior to cochlear implant but agreed (93.3%) on the need for a multidisciplinary team approach. Post-surgically, parents' expected major developments in the areas of spoken language (97%), and auditory skills (100%). Receiving education in mainstream schools (92%) was expected too. Parents perceived the cochlear implant decision as the best decision they can make for their child (98.3%). A significant correlation was found between parents contentment with the cochlear implant decision and expecting developments in the area of reading and writing (r=0.7). Child's age at implantation and age at hearing loss diagnosis significantly affected parents' post-implant outcome expectations (pparents agree on the need for a comprehensive multidisciplinary team approach during the different stages of the cochlear implant process. Parents' education about cochlear implants prior to the surgery can affect their post-surgical outcome expectations. The parental perspective presented in this study can help professionals develop better understanding of parents' needs and expectations and henceforth improve their services and support during the different stages of the cochlear implant process. Copyright © 2015. Published by Elsevier Ireland Ltd.

  15. Cochlear Nerve Action Potential Monitoring for Preserving Function of an Unseen Cochlear Nerve in Vestibular Schwannoma Surgery.

    Science.gov (United States)

    Ishikawa, Mami; Kojima, Atsuhiro; Terao, Satoshi; Nagai, Mutsumi; Kusaka, Gen; Naritaka, Heiji

    2017-10-01

    Intraoperative monitoring of cochlear nerve action potential (CNAP) has been used in patients with small vestibular schwannoma (<15 mm) to preserve cochlear nerve function. We performed surgery for a larger vestibular schwannoma under CNAP monitoring with the aim of preserving cochlear nerve function, and compared the data with findings from 10 patients with hemifacial spasm who underwent microvascular decompression surgery. We report the case of a patient with a 26-mm vestibular schwannoma and normal hearing function who underwent neurosurgery under electrophysiological monitoring of the facial and cochlear nerves. Amplitudes of evoked facial muscle responses were maintained at approximately 70% during the operation. The latency of wave V on brainstem auditory evoked potential (BAEP) increased by 0.5 ms, and amplitude was maintained at approximately 70% of the value at the beginning of the operation. Latencies of P1, N1, and P2 on CNAP did not change intraoperatively. These latencies were comparable to those of 10 normal patients with hemifacial spasm. CNAP monitoring proved very useful in confirming the location of the cochlear nerve in the operative field and preserving cochlear nerve function. Both facial nerve function and hearing acuity were completely preserved after tumor removal, and wave V latency on BAEP returned to normal and was maintained in the normal range for at least 2 years. CNAP monitoring is extremely useful for preserving the function of the unseen cochlear nerve during vestibular schwannoma surgery. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Sensitivity of cochlear nucleus neurons to spatio-temporal changes in auditory nerve activity.

    Science.gov (United States)

    Wang, Grace I; Delgutte, Bertrand

    2012-12-01

    The spatio-temporal pattern of auditory nerve (AN) activity, representing the relative timing of spikes across the tonotopic axis, contains cues to perceptual features of sounds such as pitch, loudness, timbre, and spatial location. These spatio-temporal cues may be extracted by neurons in the cochlear nucleus (CN) that are sensitive to relative timing of inputs from AN fibers innervating different cochlear regions. One possible mechanism for this extraction is "cross-frequency" coincidence detection (CD), in which a central neuron converts the degree of coincidence across the tonotopic axis into a rate code by preferentially firing when its AN inputs discharge in synchrony. We used Huffman stimuli (Carney LH. J Neurophysiol 64: 437-456, 1990), which have a flat power spectrum but differ in their phase spectra, to systematically manipulate relative timing of spikes across tonotopically neighboring AN fibers without changing overall firing rates. We compared responses of CN units to Huffman stimuli with responses of model CD cells operating on spatio-temporal patterns of AN activity derived from measured responses of AN fibers with the principle of cochlear scaling invariance. We used the maximum likelihood method to determine the CD model cell parameters most likely to produce the measured CN unit responses, and thereby could distinguish units behaving like cross-frequency CD cells from those consistent with same-frequency CD (in which all inputs would originate from the same tonotopic location). We find that certain CN unit types, especially those associated with globular bushy cells, have responses consistent with cross-frequency CD cells. A possible functional role of a cross-frequency CD mechanism in these CN units is to increase the dynamic range of binaural neurons that process cues for sound localization.

  17. [Discrimination of musical pitch with cochlear implants].

    Science.gov (United States)

    Haumann, S; Mühler, R; Ziese, M; von Specht, H

    2007-08-01

    Numerous people with cochlear implants (CI) report difficulties in listening to music even though they understand speech quite well. One reason for this is a limited perception of pitch and timbre. In this study ability of adult CI subjects to discriminate musical pitch is investigated. In two psychoacoustic experiments, each conducted in 10 adult CI subjects provided with MED-EL Combi 40+ cochlear implant devices and a control group of subjects with normal hearing, individual discrimination abilities for musical pitch perception were determined. To investigate the influence of the group of instruments on discrimination ability, stimuli representing four different groups of instruments were used: woodwind (clarinet), brass (trumpet), strings (violin) and keyboard instruments (piano). The discrimination thresholds determined varied between individual CI subjects, and on average they were significantly higher for the piano than for the other three instruments. The results show that in subjects with CI pitch perception differs from instrument to instrument and is in general worse than in persons with normal hearing.

  18. Profile of patients assessed for cochlear implants.

    Science.gov (United States)

    Barbosa, Maria Helena de Magalhães; Felix, Felippe; Ribeiro, Marcia Gonçalves; Tomita, Shiro; Pinheiro, Cintia; Baptista, Monica Machado

    2014-01-01

    Knowledge of the characteristics related to profound hearing loss is a matter of great importance, as it allows for the etiological and prognostic identification and strategic planning for public health interventions. To assess the different etiologies of hearing loss, age at diagnosis of the hearing loss, its relation to language acquisition, and the age at the first consultation in this service for cochlear implant assessment. This was a historical cohort, cross-sectional study, using retrospective analysis of the records of 115 patients with confirmed sensorineural hearing loss, who were followed in a university hospital, based on gender, age of hearing loss, age at the first consultation, language, and hearing loss etiology. The majority of patients assessed for cochlear implants attend the first consultation when they are older than one year (an alarming mean of 3.8 years in the prelingual group) in spite of the early diagnosis of hearing loss. This reflects an already deficient health care system, in terms of referral. The idiopathic cause remains the most frequently identified. Among the known causes, the most prevalent are perinatal causes and meningitis. Copyright © 2014 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  19. Cochlear implant simulator for surgical technique analysis

    Science.gov (United States)

    Turok, Rebecca L.; Labadie, Robert F.; Wanna, George B.; Dawant, Benoit M.; Noble, Jack H.

    2014-03-01

    Cochlear Implant (CI) surgery is a procedure in which an electrode array is inserted into the cochlea. The electrode array is used to stimulate auditory nerve fibers and restore hearing for people with severe to profound hearing loss. The primary goals when placing the electrode array are to fully insert the array into the cochlea while minimizing trauma to the cochlea. Studying the relationship between surgical outcome and various surgical techniques has been difficult since trauma and electrode placement are generally unknown without histology. Our group has created a CI placement simulator that combines an interactive 3D visualization environment with a haptic-feedback-enabled controller. Surgical techniques and patient anatomy can be varied between simulations so that outcomes can be studied under varied conditions. With this system, we envision that through numerous trials we will be able to statistically analyze how outcomes relate to surgical techniques. As a first test of this system, in this work, we have designed an experiment in which we compare the spatial distribution of forces imparted to the cochlea in the array insertion procedure when using two different but commonly used surgical techniques for cochlear access, called round window and cochleostomy access. Our results suggest that CIs implanted using round window access may cause less trauma to deeper intracochlear structures than cochleostomy techniques. This result is of interest because it challenges traditional thinking in the otological community but might offer an explanation for recent anecdotal evidence that suggests that round window access techniques lead to better outcomes.

  20. Decomposition Bounds for Marginal MAP

    OpenAIRE

    PING, WEI; Liu,Qiang; Ihler, Alexander

    2015-01-01

    Marginal MAP inference involves making MAP predictions in systems defined with latent variables or missing information. It is significantly more difficult than pure marginalization and MAP tasks, for which a large class of efficient and convergent variational algorithms, such as dual decomposition, exist. In this work, we generalize dual decomposition to a generic power sum inference task, which includes marginal MAP, along with pure marginalization and MAP, as special cases. Our method is ba...

  1. Cochlear implant outcomes in patients with superior canal dehiscence

    NARCIS (Netherlands)

    Puram, Sidharth V.; Roberts, Daniel S.; Niesten, Marlien E F|info:eu-repo/dai/nl/377125202; Dilger, Amanda E.; Lee, Daniel J.

    2015-01-01

    Objective: To determine whether adult cochlear implant (CI) users with superior canal dehiscence syndrome (SCDS) or asymptomatic superior semicircular canal dehiscence (SCD) have different surgical, vestibular, and audiologic outcomes when compared to CI users with normal temporal bone anatomy.

  2. Current status of cochlear implants in Latin America.

    Science.gov (United States)

    Chiossone, E

    1995-03-01

    In recent years there has been sufficient clinical evidence gathered to show that cochlear implants can benefit a large number of postlingually and prelingually profoundly deaf patients who could not be helped with conventional hearing aids. The number of implanted patients is increasing rapidly around the world in spite of the diverse difficulties in diagnostic, surgical, and rehabilitation procedures involved in this new technology and the controversy among some otologists. Cochlear implant programs started in Latin America more than 10 years ago, and lately the number of cochlear implant teams and implanted patients have increased rapidly. It is the aim of this report to present the results of a recently completed survey regarding the current status of cochlear implant surgery and rehabilitation in Latin America.

  3. Suggestions for a Guideline for Cochlear Implantation in CHARGE Syndrome

    NARCIS (Netherlands)

    Vesseur, A.; Free, R.; Langereis, M.; Snels, C.; Snik, A.F.; Ravenswaaij-Arts, C.M.A. van; Mylanus, E.A.M.

    2016-01-01

    OBJECTIVE: Identifying aspects for establishing cochlear implantation guidelines for patients with ocular coloboma, heart defects, atresia of the choanae, retardation (of growth and/or of development), genital anomalies, and ear anomalies (CHARGE) syndrome (CS). STUDY DESIGN: Explorative

  4. Sound localization ability of young children with bilateral cochlear implants.

    NARCIS (Netherlands)

    Beijen, J.W.; Snik, A.F.M.; Mylanus, E.A.M.

    2007-01-01

    OBJECTIVE: To evaluate the benefit of bilateral cochlear implantation in young children. STUDY DESIGN: Clinical trial comparing a group of bilaterally implanted children with a group of unilaterally implanted children. SETTING: Tertiary referral center. PATIENTS: Five bilaterally implanted children

  5. An Introduction to Cochlear Implant Technology, Activation, and Programming.

    Science.gov (United States)

    Moore, Jan A; Teagle, Holly F B

    2002-07-01

    Over the last decade, cochlear implantation has become an increasingly viable alternative for the treatment of profound sensorineural hearing loss in children. Although speech and hearing professionals play an important role in the communicative, social, and academic development of children with cochlear implants, many may be unfamiliar with recent advances in implant technology. This article provides an overview of the components of cochlear implant systems and the speech processing strategies that are currently being used by toddlers, preschoolers, and school-age children. A brief description of cochlear implant surgery and the procedures for programming these devices are also included. Finally, information regarding the use of assistive listening technology in the classroom is presented.

  6. A Politics of Marginability

    DEFF Research Database (Denmark)

    Pallesen, Cecil Marie

    2015-01-01

    hostile towards them. I argue that this migrant group is unique being marginalized and strong at the same time, and I explain this uniqueness by several features in the Indian migrants’ cultural and religious background, in colonial and post-colonial Tanzania, and in the Indians’ role as middlemen between......In the end of the 19th century, Indians began settling in East Africa. Most of them left Gujarat because of drought and famine, and they were in search for business opportunities and a more comfortable life. Within the following decades, many of them went from being small-scale entrepreneurs to big...

  7. Amphetamine margin in sports

    Energy Technology Data Exchange (ETDEWEB)

    Laties, V.G.; Weiss, B.

    1981-10-01

    The amphetamines can enhance athletic performance. That much seem clear from the literature, some of which is reviewed here. Increases in endurance have been demonstrated in both humans and rats. Smith and Beecher, 20 years ago, showed improvement of running, swimming, and weight throwing in highly trained athletes. Laboratory analogs of such performances have also been used and similar enhancement demonstrated. The amount of change induced by the amphetamines is usually small, of the order of a few percent. Nevertheless, since a fraction of a percent improvement can make the difference between fame and oblivion, the margin conferred by these drugs can be quite important.

  8. Delayed loss of hearing after hearing preservation cochlear implantation: Human temporal bone pathology and implications for etiology.

    Science.gov (United States)

    Quesnel, Alicia M; Nakajima, Hideko Heidi; Rosowski, John J; Hansen, Marlan R; Gantz, Bruce J; Nadol, Joseph B

    2016-03-01

    After initially successful preservation of residual hearing with cochlear implantation, some patients experience subsequent delayed hearing loss. The etiology of such delayed hearing loss is unknown. Human temporal bone pathology is critically important in investigating the etiology, and directing future efforts to maximize long term hearing preservation in cochlear implant patients. Here we present the temporal bone pathology from a patient implanted during life with an Iowa/Nucleus Hybrid S8 implant, with initially preserved residual hearing and subsequent hearing loss. Both temporal bones were removed for histologic processing and evaluated. Complete clinical and audiologic records were available. He had bilateral symmetric high frequency severe to profound hearing loss prior to implantation. Since he was implanted unilaterally, the unimplanted ear was presumed to be representative of the pre-implantation pathology related to his hearing loss. The implanted and contralateral unimplanted temporal bones both showed complete degeneration of inner hair cells and outer hair cells in the basal half of the cochleae, and only mild patchy loss of inner hair cells and outer hair cells in the apical half. The total spiral ganglion neuron counts were similar in both ears: 15,138 (56% of normal for age) in the unimplanted right ear and 13,722 (51% of normal for age) in the implanted left ear. In the basal turn of the implanted left cochlea, loose fibrous tissue and new bone formation filled the scala tympani, and part of the scala vestibuli. Delayed loss of initially preserved hearing after cochlear implantation was not explained by additional post-implantation degeneration of hair cells or spiral ganglion neurons in this patient. Decreased compliance at the round window and increased damping in the scala tympani due to intracochlear fibrosis and new bone formation might explain part of the post-implantation hearing loss. Reduction of the inflammatory and immune response to

  9. Glia-related mechanisms in the anteroventral cochlear nucleus of the adult rat in response to unilateral conductive hearing loss

    Science.gov (United States)

    Fuentes-Santamaría, Verónica; Alvarado, Juan C.; López-Muñoz, Diego F.; Melgar-Rojas, Pedro; Gabaldón-Ull, María C.; Juiz, José M.

    2014-01-01

    Conductive hearing loss causes a progressive decline in cochlear activity that may result in functional and structural modifications in auditory neurons. However, whether these activity-dependent changes are accompanied by a glial response involving microglia, astrocytes, or both has not yet been fully elucidated. Accordingly, the present study was designed to determine the involvement of glial related mechanisms in the anteroventral cochlear nucleus (AVCN) of adult rats at 1, 4, 7, and 15 d after removing middle ear ossicles. Quantitative immunohistochemistry analyses at light microscopy with specific markers of microglia or astroglia along with immunocytochemistry at the electron microscopy level were used. Also, in order to test whether trophic support by neurotrophins is modulated in glial cells by auditory activity, the expression and distribution of neurotrophin-3 (NT-3) and its colocalization with microglial or astroglial markers was investigated. Diminished cochlear activity after middle ear ossicle removal leads to a significant ipsilateral increase in the mean gray levels and stained area of microglial cells but not astrocytes in the AVCN at 1 and 4 d post-lesion as compared to the contralateral side and control animals. These results suggest that microglial cells but not astrocytes may act as dynamic modulators of synaptic transmission in the cochlear nucleus immediately following unilateral hearing loss. On the other hand, NT-3 immunostaining was localized mainly in neuronal cell bodies and axons and was upregulated at 1, 4 and 7 d post-lesion. Very few glial cells expressed this neurotrophin in both control and experimental rats, suggesting that NT-3 is primarily activated in neurons and not as much in glia after limiting auditory activity in the AVCN by conductive hearing loss. PMID:25352772

  10. Language understanding and vocabulary of early cochlear implanted children

    DEFF Research Database (Denmark)

    Percy-Smith, L; Busch, GW; Sandahl, M

    2013-01-01

    The aim of the study was to identify factors associated with the level of language understanding, the level of receptive and active vocabulary, and to estimate effect-related odds ratios for cochlear implanted children's language level.......The aim of the study was to identify factors associated with the level of language understanding, the level of receptive and active vocabulary, and to estimate effect-related odds ratios for cochlear implanted children's language level....

  11. Cochlear function in patients with chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Samantha Marlanie Govender

    2013-12-01

    Full Text Available Objective: To evaluate cochlear functioning in patients (18 - 45 years old with varying stages of chronic kidney disease (CKD. Using purposive sampling, 50 participants, 10 in each of the 5 stages of CKD, were selected and underwent pure tone audiometric testing and distortion product otoacoustic emissions (DPOAEs.Results: Significant differences (p<0.05 were found between pure tone audiometry and DPOAEs in detecting early cochlear dysfunction in the high-frequency range in stages 3 (6 000/5 000 Hz; p=0.00, 4 (6 000/5 000 Hz; p<0.03 and 5 (4 000/3 333 Hz; p<0.01, 8 000/6 667 Hz:p<0.05 with DPOAEs being more sensitive in identifying early cochlear dysfunction. Patients in stages 1 and 2 presented with normal puretone thresholds and DPOAEs, suggesting that cochlear functioning in these patients was normal. Early cochlear dysfunction, thereby indicating a subclinical hearing loss, was identified in stages 3, 4 and 5 by DPOAE testing. In addition, blood test results, drug intake and concomitant conditions were recorded and analysed which suggested a relationship between reduced cochlear functioning and increased electrolyte levels, treatment regimens and concomitant conditions.Conclusion: Participants in the later stages of CKD presented with early cochlear dysfunction, presenting with subclinical hearing loss. It was postulated that this subclinical hearing loss resulted from a combination of electrolytic, urea and creatinine imbalances, together with concomitant medical conditions and ototoxic drug intake. It was concluded that audiological monitoring be included in the management of patients with CKD and that DPOAEs be introduced as part of the test battery to monitor cochlear function in patients with varying degrees of CKD.

  12. Evaluating the Feasibility of Using Remote Technology for Cochlear Implants

    OpenAIRE

    Goehring, Jenny L.; Hughes, Michelle L.; Baudhuin, Jacquelyn L.

    2012-01-01

    The use of remote technology to provide cochlear implant services has gained popularity in recent years. This article contains a review of research evaluating the feasibility of remote service delivery for recipients of cochlear implants. To date, published studies have determined that speech-processor programming levels and other objective tests (electrode impedance and electrically evoked compound action potentials) are equivalent to those obtained in the face-to-face condition. Despite the...

  13. Ipsilateral single stage conversion from BAHA to cochlear implant.

    Science.gov (United States)

    Li, Shawn; Hrisomalos, Emily N; Semaan, Maroun T; Megerian, Cliff A

    2015-01-01

    Profound unilateral sensorineural hearing loss is an indication for the placement of a bone anchored hearing aid. In a few unfortunate patients who later develop contralateral hearing loss, a cochlear implant becomes a good option. We present our experience in these cases and discuss our technique for single stage conversion from a bone anchored hearing aid to a cochlear implant. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Characterization of Cochlear, Vestibular and Cochlear-Vestibular Electrically Evoked Compound Action Potentials in Patients with a Vestibulo-Cochlear Implant

    Directory of Open Access Journals (Sweden)

    T. A. K. Nguyen

    2017-11-01

    Full Text Available The peripheral vestibular system is critical for the execution of activities of daily life as it provides movement and orientation information to motor and sensory systems. Patients with bilateral vestibular hypofunction experience a significant decrease in quality of life and have currently no viable treatment option. Vestibular implants could eventually restore vestibular function. Most vestibular implant prototypes to date are modified cochlear implants to fast-track development. These use various objective measurements, such as the electrically evoked compound action potential (eCAP, to supplement behavioral information. We investigated whether eCAPs could be recorded in patients with a vestibulo-cochlear implant. Specifically, eCAPs were successfully recorded for cochlear and vestibular setups, as well as for mixed cochlear-vestibular setups. Similarities and slight differences were found for the recordings of the three setups. These findings demonstrated the feasibility of eCAP recording with a vestibulo-cochlear implant. They could be used in the short term to reduce current spread and avoid activation of non-targeted neurons. More research is warranted to better understand the neural origin of vestibular eCAPs and to utilize them for clinical applications.

  15. POLA KEBERAGAMAAN MASYARAKAT MARGINAL

    Directory of Open Access Journals (Sweden)

    Ahmad Muttaqin

    2016-11-01

    Full Text Available This is a research on sociology of religion, focusing on the issue of religious practices in a local community. Kampung Laut was chosen as the setting of this research for two reasons. First, the rituals of religion practices in the region are different from mainstream practices, which result in label and justification that their religiosity is not a part of or only a fragment of the mainstream religion and tend to be the target of correction. Second, this region raises conflicts among government institutions in relation to the rights of natural resources possession and utilization. The bad image built through this marginalization has formed Kampung Laut community as the one that is resistant and latent. This research used descriptive qualitative method with sociological approach. Rituals of religious practices that are different from the mainstream are explained on the basis of Weber’s theory of behavior categorized into value-oriented rationality. This kind of practices is considered to be more beneficial in the context of struggling for identity among the practices of marginalization experienced by Kampung Laut community. This condition gives a description to public that Kampung Laut community receives unfair treatments for their natural resources. Religious issues is made an entry for its massive, communal, and related to transcendental values.

  16. Production of verb tenses in children with cochlear implants

    Directory of Open Access Journals (Sweden)

    Sokolovac Ivana

    2016-01-01

    Full Text Available The production of verb tenses leads to better language development of children with cochlear implants. The aim of this study was to assess the acquisition of verb tenses in children with cochlear implants. The sample included 60 children, aged from 9 to 15, with average intellectual abilities. The study group consisted of 30 patients with cochlear implants, with no additional disabilities. The control group consisted of 30 subjects with typical speech - language development and preserved hearing. The acquisition of basic tenses was assessed by 'Corpus for the Assessment of the Use of Tenses' (Dimić, 2003. Significant statistical differences were found in the use of the present tense in children with cochlear implants and hearing children (t=-4.385; p<0.001 as well as in the use of the past tense (t=-4.650; p<0.001, and the future tense (t=-4.269; p<0.001. There was also a significant difference in the use of irregular verb 'go' (t=-3.958; p<0.001, as well as in the combination of the present and the past tense (t=-5.806; p<0.001. The present tense was used correctly by most children with cochlear implants (70%, followed by the past tense (53%, and finally the future tense (23%. Children with cochlear implants, even after several years of re/habilitation, do not reach the grammatical development of children with normal hearing.

  17. Quantitative polarized light microscopy of unstained mammalian cochlear sections

    Science.gov (United States)

    Kalwani, Neil M.; Ong, Cheng Ai; Lysaght, Andrew C.; Haward, Simon J.; McKinley, Gareth H.; Stankovic, Konstantina M.

    2013-02-01

    Hearing loss is the most common sensory deficit in the world, and most frequently it originates in the inner ear. Yet, the inner ear has been difficult to access for diagnosis because of its small size, delicate nature, complex three-dimensional anatomy, and encasement in the densest bone in the body. Evolving optical methods are promising to afford cellular diagnosis of pathologic changes in the inner ear. To appropriately interpret results from these emerging technologies, it is important to characterize optical properties of cochlear tissues. Here, we focus on that characterization using quantitative polarized light microscopy (qPLM) applied to unstained cochlear sections of the mouse, a common animal model of human hearing loss. We find that the most birefringent cochlear materials are collagen fibrils and myelin. Retardance of the otic capsule, the spiral ligament, and the basilar membrane are substantially higher than that of other cochlear structures. Retardance of the spiral ligament and the basilar membrane decrease from the cochlear base to the apex, compared with the more uniform retardance of other structures. The intricate structural details revealed by qPLM of unstained cochlear sections ex vivo strongly motivate future application of polarization-sensitive optical coherence tomography to human cochlea in vivo.

  18. Cochlear implantation for single-sided deafness and tinnitus suppression.

    Science.gov (United States)

    Holder, Jourdan T; O'Connell, Brendan; Hedley-Williams, Andrea; Wanna, George

    To quantify the potential effectiveness of cochlear implantation for tinnitus suppression in patients with single-sided deafness using the Tinnitus Handicap Inventory. The study included 12 patients with unilateral tinnitus who were undergoing cochlear implantation for single-sided deafness. The Tinnitus Handicap Inventory was administered at the patient's cochlear implant candidacy evaluation appointment prior to implantation and every cochlear implant follow-up appointment, except activation, following implantation. Patient demographics and speech recognition scores were also retrospectively recorded using the electronic medical record. A significant reduction was found when comparing Tinnitus Handicap Inventory score preoperatively (61.2±27.5) to the Tinnitus Handicap Inventory score after three months of cochlear implant use (24.6±28.2, p=0.004) and the Tinnitus Handicap Inventory score beyond 6months of CI use (13.3±18.9, p=0.008). Further, 45% of patients reported total tinnitus suppression. Mean CNC word recognition score improved from 2.9% (SD 9.4) pre-operatively to 40.8% (SD 31.7) by 6months post-activation, which was significantly improved from pre-operative scores (p=0.008). The present data is in agreement with previously published studies that have shown an improvement in tinnitus following cochlear implantation for the large majority of patients with single-sided deafness. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Establishing the standard method of cochlear implant in Rongchang pig.

    Science.gov (United States)

    Chen, Wei; Yi, Haijin; Zhang, Liang; Ji, Fei; Yuan, Shuolong; Zhang, Yue; Ren, Lili; Li, Jianan; Chen, Lei; Guo, Weiwei; Yang, Shiming

    2017-05-01

    In this investigation, a large mammal, Rongchang pigs were used to successfully establish a research platform for cochlear implant study on the routine use of it in clinic. The aim of this study was to establish a standard method of cochlear implant in a large mammal-pig. Rongchang pigs were selected, then divided into two groups: normal-hearing group (Mitf +/+) and mutation group with hearing loss (Mitf -/-). Cochlear implants were used and ABR and EABR were recorded. The implanted electrodes were observed by X-ray and HE stains. The success with cochlear implant and the best electrode position could be defined in all animals, the coiling of the cochlea reached 1.5-1.75 turns. Immediately after the operation of cochlear implants, the ABR threshold of the operated ear (right) could not be derived for each frequency at 120 dB SPL. Moreover, 7 days after surgery, the low-frequency ABR threshold of the operated ear (right) could be derived partly at 100 dB SPL, but the high-frequency ABR threshold could not be derived at 120 dB SPL. Immediately or 1 week after cochlear implants, the EABR threshold was 90 CL in the Mitf +/+ group. This was obviously lower than the 190 CL in the Mitf -/- group.

  20. Analysis of Intraoperative Radiographic Electrode Placement During Cochlear Implantation.

    Science.gov (United States)

    Gnagi, Sharon H; Baker, Trenton R; Pollei, Taylor R; Barrs, David M

    2015-07-01

    To investigate the clinical value of intraoperative plain radiographs in determining correct placement of cochlear implants. All cochlear implant insertions over a 10-year period by a single surgeon. Cochlear implantation with intraoperative imaging. Whether intraoperative imaging affects clinical/surgical management. A consecutive retrospective review of 207 cochlear implantations performed in 187 patients was performed. All implants performed had intraoperative plain film imaging. Etiology of hearing loss, surgical variations, gender, age, and implant type did not affect intraoperative imaging. Four cases were identified where variations in intraoperative imaging interpreted by the surgeon warranted further discussion. In one patient, the intraoperative x-ray interpretation missed an incorrectly placed electrode. Postoperative CT scan confirmed implant electrode within the superior semicircular canal. In three patients, intraoperative x-ray results aided management by confirming surgical findings; however, no subsequent clinical or surgical alterations were made based on imaging. One of these three patients experienced a noticeable function decline postoperatively that correlated with altered positioning of the cochlear implant on intraoperative radiographs. In all surgeries, no changes were made to the electrode placement based on the intraoperative radiographs. Intraoperative plain film imaging during cochlear implantation, although commonly employed, does not typically affect clinical management. For select cases, imaging may continue to be useful based on the surgeon's discretion and intraoperative findings for confirmatory purposes.

  1. Age-related neurochemical changes in the rhesus macaque cochlear nucleus.

    Science.gov (United States)

    Gray, Daniel T; Engle, James R; Recanzone, Gregg H

    2014-05-01

    Neurochemical changes in the expression of various proteins within the central auditory system have been associated with natural aging. These changes may compensate in part for the loss of auditory sensitivity arising from two phenomena of the aging auditory system: cochlear histopathologies and increased excitability of central auditory neurons. Recent studies in the macaque monkey have revealed age-related changes in the density of nicotinamide adenine dinucleotide phosphate (NADPH)-diaphorase (NADPHd) and parvalbumin (PV)-positive cells within the inferior colliculus and superior olivary complex. The cochlear nucleus (CN), which is the first central auditory nucleus, remains unstudied. Since the CN participates in the generation of the auditory brainstem response (ABR) and receives direct innervation from the cochlea, it serves as an ideal nucleus to compare the relationship between these neurochemical changes and the physiological and peripheral changes of the aging auditory system. We used stereological sampling to calculate the densities of NADPHd and PV reactive neurons within the three subdivisions of the CN in middle-aged and aged rhesus macaques. Regression analyses of these values with ABR properties and cochlear histopathologies revealed relationships between these cell types and the changing characteristics of the aging auditory system. Our results indicate that NADPHd expression does change with age in a specific subdivision of the CN, but PV does not. Conversely, PV expression correlated with ABR amplitudes and outer hair cell loss in the cochlea, but NADPHd did not. These results indicate that NADPHd and PV may take part in distinct compensatory efforts of the aging auditory system. Copyright © 2013 Wiley Periodicals, Inc.

  2. Responses of Auditory Nerve and Anteroventral Cochlear Nucleus Fibers to Broadband and Narrowband Noise: Implications for the Sensitivity to Interaural Delays

    NARCIS (Netherlands)

    M. van der Heijden (Marcel); D.H.G. Louage (Dries H.G.); P.X. Joris (Philip)

    2011-01-01

    textabstractThe quality of temporal coding of sound waveforms in the monaural afferents that converge on binaural neurons in the brainstem limits the sensitivity to temporal differences at the two ears. The anteroventral cochlear nucleus (AVCN) houses the cells that project to the binaural nuclei,

  3. [Variations of Picea crassifolia tree-ring cell structure and their implications to past climate in eastern margin of Qaidam Basin, Northwest China].

    Science.gov (United States)

    Li, Yan; Liang, Er-Yuan; Shao, Xue-mei

    2008-03-01

    Tree-ring samples of Picea crassifolia were collected from the upper tree-line in the eastern mountainous area of Qaidam Basin in Qinghai Province. The tree-ring width and the cell number and size of the tree-ring were measured, and the standard chronologies for the early-wood cell number, late-wood cell number, total cell number of tree-rings, maximum cell size, and minimum cell size were constructed. By using correlation analysis and the response functions between cell characteristic indices and 1970-2000 climate factors at Chaka meteorological station which was close to the sampling site, the relationships between P. crassifolia growth at cell scale and climate factors were discussed. The results showed that the early-wood cell number was positively correlated to the wintertime temperature from previous October to current March, while the late-wood cell number was positively correlated to the minimum temperature in previous November and December and to the mean temperature in current July and August. Both the early-wood and the late-wood cell numbers were negatively correlated to the precipitation in July, and the early-wood cell number was positively correlated to the precipitation in May. The chronology of maximum cell size of early-wood was positively related to the precipitation in February, while that of minimum cell size of late-wood was positivelyrelated to the precipitation in August. It was concluded that the cell number and cell size could not only reveal the information of temperature change, which was recorded by tree ring width as well, but also provide additional information of precipitation. Since different types of tree-ring indices contained different climate information, multiple aspects of climate change information could be extracted from different tree-ring indices of the same species at the same site, and the cell level tree ring characteristics had great potential to supply the information regarding past climate.

  4. Strategy towards independent electrical stimulation from cochlear implants : Guided auditory neuron growth on topographically modified nanocrystalline diamond

    OpenAIRE

    Cai, Yixiao; Edin, Fredrik; Jin, Zhe; Alexsson, Andrei; Gudjonsson, Olafur; Liu, Wei; Rask-Andersen, Helge; Karlsson, Mikael; Li, Hao

    2016-01-01

    Cochlear implants (CI) have been used for several decades to treat patients with profound hearing loss. Nevertheless, results vary between individuals, and fine hearing is generally poor due to the lack of discrete neural stimulation from the individual receptor hair cells. A major problem is the deliverance of independent stimulation signals to individual auditory neurons. Fine hearing requires significantly more stimulation contacts with intimate neuron/electrode interphases from ordered ax...

  5. Cochlear Implant Outcomes and Genetic Mutations in Children with Ear and Brain Anomalies

    National Research Council Canada - National Science Library

    Busi, Micol; Rosignoli, Monica; Castiglione, Alessandro; Minazzi, Federica; Trevisi, Patrizia; Aimoni, Claudia; Calzolari, Ferdinando; Granieri, Enrico; Martini, Alessandro

    2015-01-01

    ...) and magnetic resonance imaging (MRI) in children with sensorineural hearing loss who were candidates for cochlear implants and to analyse the anatomic abnormalities of the ear and brain in patients who underwent cochlear implantation...

  6. School failure in students who are normal-hearing or deaf: with or without cochlear implants

    National Research Council Canada - National Science Library

    Duarte, Ivone; Santos, Cristina Costa; Rego, Guilhermina; Nunes, Rui

    2016-01-01

    To evaluate the impact of cochlear implants on the school failure of deaf who attend mainstream classes by comparing them to their normal-hearing peers as well as deaf without cochlear implants. This case...

  7. Effect of unilateral and simultaneous bilateral cochlear implantation on tinnitus : A Prospective Study

    NARCIS (Netherlands)

    van Zon, Alice; Smulders, Yvette E.; Ramakers, Geerte G. J.; Stegeman, Inge; Smit, Adriana L.; Van Zanten, Gijsbert A.; Stokroos, Robert J.; Hendrice, Nadia; Free, Rolien H.; Maat, Bert; Frijns, Johan H. M.; Mylanus, Emmanuel A. M.; Huinck, Wendy J.; Topsakal, Vedat; Tange, Rinze A.; Grolman, Wilko

    Objectives/HypothesisTo determine the effect of cochlear implantation on tinnitus perception in patients with severe bilateral postlingual sensorineural hearing loss and to demonstrate possible differences between unilateral and bilateral cochlear implantation. Study DesignProspective study.

  8. Effect of unilateral and simultaneous bilateral cochlear implantation on tinnitus: A Prospective Study

    NARCIS (Netherlands)

    van Zon, Alice; Smulders, Yvette E.; Ramakers, Geerte G. J.; Stegeman, Inge; Smit, Adriana L.; Van Zanten, Gijsbert A.; Stokroos, Robert J.; Hendrice, Nadia; Free, Rolien H.; Maat, Bert; Frijns, Johan H. M.; Mylanus, Emmanuel A. M.; Huinck, Wendy J.; Topsakal, Vedat; Tange, Rinze A.; Grolman, Wilko

    OBJECTIVES/HYPOTHESIS: To determine the effect of cochlear implantation on tinnitus perception in patients with severe bilateral postlingual sensorineural hearing loss and to demonstrate possible differences between unilateral and bilateral cochlear implantation.\

  9. Cost-Utility of Bilateral Versus Unilateral Cochlear Implantation in Adults: A Randomized Controlled Trial

    NARCIS (Netherlands)

    Smulders, Y.E.; Zon, A. van; Stegeman, I.; Zanten, G.A.; Rinia, A.B.; Stokroos, R.J.; Free, R.H.; Maat, B.; Frijns, J.H.; Mylanus, E.A.M.; Huinck, W.J.; Topsakal, V.; Grolman, W.

    2016-01-01

    OBJECTIVE: To study the cost-utility of simultaneous bilateral cochlear implantation (CI) versus unilateral CI. STUDY DESIGN: Randomized controlled trial (RCT). SETTING: Five tertiary referral centers. PATIENTS: Thirty-eight postlingually deafened adults eligible for cochlear implantation.

  10. Cost-Utility of Bilateral Versus Unilateral Cochlear Implantation in Adults : A Randomized Controlled Trial

    NARCIS (Netherlands)

    Smulders, Yvette E; van Zon, Alice; Stegeman, Inge; van Zanten, Gijsbert A; Rinia, Albert B; Stokroos, Robert J; Free, Rolien H; Maat, Bert; Frijns, Johan H M; Mylanus, Emmanuel A M; Huinck, Wendy J; Topsakal, Vedat; Grolman, Wilko

    OBJECTIVE: To study the cost-utility of simultaneous bilateral cochlear implantation (CI) versus unilateral CI. STUDY DESIGN: Randomized controlled trial (RCT). SETTING: Five tertiary referral centers. PATIENTS: Thirty-eight postlingually deafened adults eligible for cochlear implantation.

  11. The cochlear nerve canal and internal auditory canal in children with normal cochlea but cochlear nerve deficiency

    Energy Technology Data Exchange (ETDEWEB)

    Yan, Fei; Li, Jianhong; Xian, Junfang; Wang, Zhenchang [Dept. of Radiology, Beijing Tongren Hospital, Capital Medical Univ., Beijing (China)], e-mail: cjr.wzhch@vip.163.com; Mo, Lingyan [Dept. of Otorhinolaryngology, Beijing Tongren Hospital, Capital Medical Univ., Beijing (China)

    2013-04-15

    Background: There is an increasing frequency of requests for cochlear implantation (CI) in deaf children and more detailed image information is necessary for selecting appropriate candidates. Cochlear nerve deficiency (CND) is a contraindication to CI. Magnetic resonance imaging (MRI) has been used to evaluate the integrity of the cochlear nerve. The abnormalities of the cochlear nerve canal (CNC) and internal auditory canal (IAC) have been reported to be associated with CND. Purpose: To correlate CNC manifestation, size, and IAC diameter on high-resolution CT (HRCT) with CND diagnosed by MRI in children. Material and Methods: HRCT images from 35 sensorineurally deaf children who had normal cochlea but bilateral or unilateral CND diagnosed by MRI were studied retrospectively. The CNC and IAC manifestation and size were assessed and correlated with CND. Results: CND was diagnosed by MRI in 54/70 ears (77.1%). Thirty-two ears had an absent cochlear nerve (59.3%), while 22 ears had a small cochlear nerve (40.7%). The CNC diameter was <1.5 mm in 36 ears (66.7%). The CNC diameter ranged between 1.5 and 2.0 mm in seven ears (13.0%) and was >2.0 mm in 11 ears (20.4%). The IAC diameter was <3.0 mm in 25 ears (46.3%) and >3.0 mm in 29 ears (53.7%). Conclusion: The hypoplastic CNC might be more highly indicative of CND than that of a narrow IAC.

  12. Evoked cochlear potentials in the barn owl.

    Science.gov (United States)

    Köppl, Christine; Gleich, Otto

    2007-06-01

    Gross electrical responses to tone bursts were measured in adult barn owls, using a single-ended wire electrode placed onto the round window. Cochlear microphonic (CM) and compound action potential (CAP) responses were evaluated separately. Both potentials were physiologically vulnerable. Selective abolishment of neural responses at high frequencies confirmed that the CAP was of neural origin, while the CM remained unaffected. CAP latencies decreased with increasing stimulus frequency and CAP amplitudes were correlated with known variations in afferent fibre numbers from the different papillar regions. This suggests a local origin of the CAP along the tonotopic gradient within the basilar papilla. The audiograms derived from CAP and CM threshold responses both showed a broad frequency region of optimal sensitivity, very similar to behavioural and single-unit data, but shifted upward in absolute sensitivity. CAP thresholds rose above 8 kHz, while CM responses showed unchanged sensitivity up to 10 kHz.

  13. Binaural enhancement for bilateral cochlear implant users.

    Science.gov (United States)

    Brown, Christopher A

    2014-01-01

    Bilateral cochlear implant (BCI) users receive limited binaural cues and, thus, show little improvement to speech intelligibility from spatial cues. The feasibility of a method for enhancing the binaural cues available to BCI users is investigated. This involved extending interaural differences of levels, which typically are restricted to high frequencies, into the low-frequency region. Speech intelligibility was measured in BCI users listening over headphones and with direct stimulation, with a target talker presented to one side of the head in the presence of a masker talker on the other side. Spatial separation was achieved by applying either naturally occurring binaural cues or enhanced cues. In this listening configuration, BCI patients showed greater speech intelligibility with the enhanced binaural cues than with naturally occurring binaural cues. In some situations, it is possible for BCI users to achieve greater speech intelligibility when binaural cues are enhanced by applying interaural differences of levels in the low-frequency region.

  14. Ultra-Wideband Transceivers for Cochlear Implants

    Directory of Open Access Journals (Sweden)

    Reisenzahn Alexander

    2005-01-01

    Full Text Available Ultra-wideband (UWB radio offers low power consumption, low power spectral density, high immunity against interference, and other benefits, not only for consumer electronics, but also for medical devices. A cochlear implant (CI is an electronic hearing apparatus, requiring a wireless link through human tissue. In this paper we propose an UWB link for a data rate of Mbps and a propagation distance up to 500 mm. Transmitters with step recovery diode and transistor pulse generators are proposed. Two types of antennas and their filter characteristics in the UWB spectrum will be discussed. An ultra-low-power back tunnel diode receiver prototype is described and compared with conventional detector receivers.

  15. Effects of NSAIDs on the Inner Ear: Possible Involvement in Cochlear Protection

    Directory of Open Access Journals (Sweden)

    Akira Hara

    2010-04-01

    Full Text Available Cyclooxygenase and lipoxygenase, two important enzymes involved in arachidonic acid metabolism, are major targets of non-steroidal anti-inflammatory drugs (NSAIDs. Recent investigations suggest that arachidonic cascades and their metabolites may be involved in maintaining inner ear functions. The excessive use of aspirin may cause tinnitus in humans and impairment of the outer hair cell functions in experimental animals. On the other hand, NSAIDs reportedly exhibit protective effects against various kinds of inner ear disorder. The present review summarizes the effects of NSAIDs on cochlear pathophysiology. NSAIDs are a useful ameliorative adjunct in the management of inner ear disorders.

  16. Cochlearoids F-K: Phenolic meroterpenoids from the fungus Ganoderma cochlear and their renoprotective activity.

    Science.gov (United States)

    Wang, Xin-Long; Zhou, Feng-Jiao; Dou, Man; Yan, Yong-Ming; Wang, Shu-Mei; Di, Lei; Cheng, Yong-Xian

    2016-11-15

    Ganoderma mushrooms are of great nutritious and medicinal values. This study was designed to characterize compounds from the fruiting bodies of Ganoderma cochlear and investigate their protective effects against kidney disorders. Six novel meroterpenoids cochlearoids F-K (1-6) were isolated by utilizing phytochemical approaches. Their structures were identified on the basis of extensive spectroscopic data and calculation methods. Biological evaluation shows that compounds 1-4 and 6 exhibit potent inhibitory activity on fibronectin overproduction in TGF-β1-induced HKC-8 cells. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Eμ-BCL10 mice exhibit constitutive activation of both canonical and noncanonical NF-κB pathways generating marginal zone (MZ) B-cell expansion as a precursor to splenic MZ lymphoma

    Science.gov (United States)

    Li, Zhaoyang; Wang, Hongsheng; Xue, Liquan; Shin, Dong-Mi; Roopenian, Derry; Xu, Wu; Qi, Chen-Feng; Sangster, Mark Y.; Orihuela, Carlos J.; Tuomanen, Elaine; Rehg, Jerold E.; Cui, Xiaoli

    2009-01-01

    BCL10, required for nuclear factor κB (NF-κB) activation during antigen-driven lymphocyte responses, is aberrantly expressed in mucosa-associated lymphoid tissue-type marginal zone (MZ) lymphomas because of chromosomal translocations. Eμ-driven human BCL10 transgenic (Tg) mice, which we created and characterize here, had expanded populations of MZ B cells and reduced follicular and B1a cells. Splenic B cells from Tg mice exhibited constitutive activation of both canonical and noncanonical NF-κB signaling pathways is associated with increased expression of NF-κB target genes. These genes included Tnfsf13b, which encodes the B-cell activating factor (BAFF). In addition, levels of BAFF were significantly increased in sera from Tg mice. MZ B cells of Tg mice exhibited reduced turnover in vivo and enhanced survival in vitro, indicative of lymphoaccumulation rather than lymphoproliferation as the cause of MZ expansion. In vivo antibody responses to both T-independent, and especially T-dependent, antigens were significantly reduced in Tg mice. Mortality was accelerated in Tg animals, and some mice older than 8 months had histologic and molecular findings indicative of clonal splenic MZ lymphoma. These results suggest that, in addition to constitutive activation of BCL10 in MZ B cells, other genetic factors or environmental influences are required for short latency oncogenic transformation. PMID:19696203

  18. CT and MR imaging for pediatric cochlear implantation: emphasis on the relationship between the cochlear nerve canal and the cochlear nerve

    Energy Technology Data Exchange (ETDEWEB)

    Miyasaka, Mikiko; Nosaka, Shunsuke; Masaki, Hidekazu [National Center for Child Health and Development, Department of Radiology, Tokyo (Japan); Morimoto, Noriko; Taiji, Hidenobu [National Center for Child Health and Development, Department of Otolaryngology, Tokyo (Japan)

    2010-09-15

    Cochlear implantation has become an accepted treatment for deafness. As the frequency of cochlear implantation has increased, requests for images have also increased in the work-up for candidates. An absent cochlear nerve (CN) is a contraindication to cochlear implantation. Therefore, MRI is performed to evaluate the CN in patients with sensorineural hearing loss. Recently, some authors have reported the relationship between cochlear nerve canal (CNC) stenosis and CN hypoplasia. To review the relationship between CNC and CN. During a period of 78 months, 21 children (42 ears) with unilateral or bilateral sensorineural hearing loss underwent both HRCT and MRI of the cochlear nerve. We retrospectively reviewed two factors: the evaluation of inner ear malformations and the relationship between CNC stenosis and CN hypoplasia. Inner ear malformations were recognized in ten ears. The mean CNC diameter was approximately 2 mm (ranging from 0.6 to 2.7 mm). CN hypoplasia was seen in eight of the 42 ears; all eight were associated with CNC stenosis ({<=}1.5 mm). Of the 34 ears with normal CN, 32 had CNC >1.5 mm in diameter and the remaining two ears, with incomplete partition type I, had CNC stenosis. Children with CNC stenosis had a high incidence of CN hypoplasia. CNC stenosis ({<=}1.5 mm) suggests CN hypoplasia. On the other hand, CN hypoplasia was not seen in children with CNC diameter >1.5 mm. Therefore, we conclude that children with CNC stenosis or malformations on HRCT should receive MR imaging of the CN. (orig.)

  19. Intraoperative Electrocochleographic Characteristics of Auditory Neuropathy Spectrum Disorder in Cochlear Implant Subjects

    Directory of Open Access Journals (Sweden)

    William J. Riggs

    2017-07-01

    Full Text Available Auditory neuropathy spectrum disorder (ANSD is characterized by an apparent discrepancy between measures of cochlear and neural function based on auditory brainstem response (ABR testing. Clinical indicators of ANSD are a present cochlear microphonic (CM with small or absent wave V. Many identified ANSD patients have speech impairment severe enough that cochlear implantation (CI is indicated. To better understand the cochleae identified with ANSD that lead to a CI, we performed intraoperative round window electrocochleography (ECochG to tone bursts in children (n = 167 and adults (n = 163. Magnitudes of the responses to tones of different frequencies were summed to measure the “total response” (ECochG-TR, a metric often dominated by hair cell activity, and auditory nerve activity was estimated visually from the compound action potential (CAP and auditory nerve neurophonic (ANN as a ranked “Nerve Score”. Subjects identified as ANSD (45 ears in children, 3 in adults had higher values of ECochG-TR than adult and pediatric subjects also receiving CIs not identified as ANSD. However, nerve scores of the ANSD group were similar to the other cohorts, although dominated by the ANN to low frequencies more than in the non-ANSD groups. To high frequencies, the common morphology of ANSD cases was a large CM and summating potential, and small or absent CAP. Common morphologies in other groups were either only a CM, or a combination of CM and CAP. These results indicate that responses to high frequencies, derived primarily from hair cells, are the main source of the CM used to evaluate ANSD in the clinical setting. However, the clinical tests do not capture the wide range of neural activity seen to low frequency sounds.

  20. Comparison of Bilateral and Unilateral Cochlear Implantation in Adults A Randomized Clinical Trial

    NARCIS (Netherlands)

    Smulders, Yvette E.; van Zon, Alice; Stegeman, Inge; Rinia, Albert B.; van Zanten, Gijsbert A.; Stokroos, Robert J.; Hendrice, Nadia; Free, Rolien H.; Maat, Bert; Frijns, Johan H. M.; Briaire, Jeroen J.; Mylanus, Emmanuel A. M.; Huinck, Wendy J.; Smit, Adriana L.; Topsakal, Vedat; Tange, Rinze A.; Grolman, Wilko

    IMPORTANCE The cost of bilateral cochlear implantation (BCI) is usually not reimbursed by insurance companies because of a lack of well-designed studies reporting the benefits of a second cochlear implant. OBJECTIVE To determine the benefits of simultaneous BCI compared with unilateral cochlear

  1. Comparison of Bilateral and Unilateral Cochlear Implantation in Adults: A Randomized Clinical Trial

    NARCIS (Netherlands)

    Smulders, Y.E.; Zon, A. van; Stegeman, I.; Rinia, A.B.; Zanten, G.A.; Stokroos, R.J.; Hendrice, N.; Free, R.H.; Maat, B.; Frijns, J.H.; Briaire, J.J.; Mylanus, E.A.M.; Huinck, W.J.; Smit, A.L.; Topsakal, V.; Tange, R.A.; Grolman, W.

    2016-01-01

    IMPORTANCE: The cost of bilateral cochlear implantation (BCI) is usually not reimbursed by insurance companies because of a lack of well-designed studies reporting the benefits of a second cochlear implant. OBJECTIVE: To determine the benefits of simultaneous BCI compared with unilateral cochlear

  2. Stable benefits of bilateral over unilateral cochlear implantation after two years : A randomized controlled trial

    NARCIS (Netherlands)

    van Zon, Alice; Smulders, Yvette E; Stegeman, Inge; Ramakers, Geerte G J; Kraaijenga, Veronique J C; Koenraads, Simone P C; van Zanten, Gijsbert A; Rinia, Albert B; Stokroos, Robert J; Free, Rolien H; Frijns, Johan H M; Huinck, Wendy J; Mylanus, Emmanuel A M; Tange, Rinze A; Smit, Adriana L; Thomeer, Hans G X M; Topsakal, Vedat; Grolman, Wilko

    OBJECTIVES/HYPOTHESIS: To investigate hearing capabilities and self-reported benefits of simultaneous bilateral cochlear implantation (BiCI) compared with unilateral cochlear implantation (UCI) after a 2-year follow-up and to evaluate the learning effect of cochlear implantees over time. STUDY

  3. Stable benefits of bilateral over unilateral cochlear implantation after two years: A randomized controlled trial

    NARCIS (Netherlands)

    Zon, A. van; Smulders, Y.E.; Stegeman, I.; Ramakers, G.G.; Kraaijenga, V.J.; Koenraads, S.P.; Zanten, G.A.; Rinia, A.B.; Stokroos, R.J.; Free, R.H.; Frijns, J.H.; Huinck, W.J.; Mylanus, E.A.M.; Tange, R.A.; Smit, A.L.; Thomeer, H.G.; Topsakal, V.; Grolman, W.

    2017-01-01

    OBJECTIVES/HYPOTHESIS: To investigate hearing capabilities and self-reported benefits of simultaneous bilateral cochlear implantation (BiCI) compared with unilateral cochlear implantation (UCI) after a 2-year follow-up and to evaluate the learning effect of cochlear implantees over time. STUDY

  4. Comparison of Bilateral and Unilateral Cochlear Implantation in Adults : A Randomized Clinical Trial

    NARCIS (Netherlands)

    Smulders, Yvette E; van Zon, Alice; Stegeman, Inge; Rinia, Albert B; Van Zanten, Gijsbert A; Stokroos, Robert J; Hendrice, Nadia; Free, Rolien H; Maat, Bert; Frijns, Johan H M; Briaire, Jeroen J; Mylanus, Emmanuel A M; Huinck, Wendy J; Smit, Adriana L; Topsakal, Vedat; Tange, Rinze A; Grolman, Wilko

    2016-01-01

    Importance: The cost of bilateral cochlear implantation (BCI) is usually not reimbursed by insurance companies because of a lack of well-designed studies reporting the benefits of a second cochlear implant. Objective: To determine the benefits of simultaneous BCI compared with unilateral cochlear

  5. Stable benefits of bilateral over unilateral cochlear implantation after two years : A randomized controlled trial

    NARCIS (Netherlands)

    van Zon, Alice; Smulders, Yvette E.; Stegeman, Inge; Ramakers, Geerte G. J.; Kraaijenga, Veronique J. C.; Koenraads, Simone P. C.; Van Zanten, Gijsbert A.; Rinia, Albert B.; Stokroos, Robert J.; Free, Rolien H.; Frijns, Johan H. M.; Huinck, Wendy J.; Mylanus, Emmanuel A. M.; Tange, Rinze A.; Smit, Adriana L.; Thomeer, Hans G. X. M.; Topsakal, Vedat; Grolman, Wilko

    Objectives/HypothesisTo investigate hearing capabilities and self-reported benefits of simultaneous bilateral cochlear implantation (BiCI) compared with unilateral cochlear implantation (UCI) after a 2-year follow-up and to evaluate the learning effect of cochlear implantees over time. Study

  6. Migration of cochlear implant magnets after head trauma in an adult and a child

    NARCIS (Netherlands)

    Stokroos, Robert J.; van Dijk, Pim

    2007-01-01

    Cochlear implantation is considered to be a safe and effective treatment for severe to profound sensorineural hearing loss. Device failures are rare. We report the cases of 2 patients-a 44-year-old woman and a 3-year-old boy-with cochlear implants who were referred to our tertiary cochlear implant

  7. Correlation of Electrophysiological Properties and Hearing Preservation in Cochlear Implant Patients.

    Science.gov (United States)

    Dalbert, Adrian; Sim, Jae Hoon; Gerig, Rahel; Pfiffner, Flurin; Roosli, Christof; Huber, Alexander

    2015-08-01

    To monitor changes in cochlear function during cochlear implantation using electrocochleography (ECoG) and to correlate changes to postoperative hearing preservation. ECoG responses to acoustic stimuli of 250, 500, and 1000 Hz were recorded during cochlear implantation. The recording electrode was placed on the promontory and stabilized to fix the position during cochlear implantation. Baseline recordings were obtained after completion of the posterior tympanotomy. Changes of the ongoing ECoG response at suprathreshold intensities were analyzed after full insertion of the cochlear implant electrode array. Audiometric tests were conducted before and 4 weeks after surgery and correlated with electrophysiological findings. Ninety-five percent (18/19) of cochlear implant subjects had measurable ECoG responses. Under unchanged conditions, recordings showed a high repeatability without significant differences between 2 recordings (p ≤ 0.01). Ninety-four percent (17/18) of subjects showed no relevant changes in ECoG recordings after insertion of the cochlear implant electrode array. One subject showed decreases in responses at all frequencies indicative of cochlear trauma. This was associated with a complete hearing loss 4 weeks after surgery compared with mean presurgical low-frequency hearing of 78 dB HL. Extracochlear ECoG is a reliable tool to assess cochlear function during cochlear implantation. Moderate threshold shifts could be caused by postoperative mechanisms or minor cochlear trauma. Detectable changes in extracochlear ECoG recordings, indicating gross cochlear trauma, are probably predictive of complete loss of residual acoustic hearing.

  8. Speech-evoked cortical potentials and speech recognition in cochlear implant users.

    NARCIS (Netherlands)

    Groenen, P.A.P.; Beynon, A.J.; Snik, A.F.M.; Broek, P. van den

    2001-01-01

    Processing in the auditory cortex may play a role in the unexplained variability in cochlear implant benefit. P300 and N1/P2 were elicited in post-lingually deaf cochlear implant users wearing a Nucleus multichannel cochlear implant. Four sound contrasts were presented (500-1,000 Hz, /ba/-/da/,

  9. New Criteria of Indication and Selection of Patients to Cochlear Implant

    Science.gov (United States)

    Sampaio, André L. L.; Araújo, Mercêdes F. S.; Oliveira, Carlos A. C. P.

    2011-01-01

    Numerous changes continue to occur in cochlear implant candidacy. In general, these have been accompanied by concomitant and satisfactory changes in surgical techniques. Together, this has advanced the utility and safety of cochlear implantation. Most devices are now approved for use in patients with severe to profound unilateral hearing loss rather then the prior requirement of a bilateral profound loss. Furthermore, studies have begun utilizing short electrode arrays for shallow insertion in patients with considerable low-frequency residual hearing. This technique will allow the recipient to continue to use acoustically amplified hearing for the low frequencies simultaneously with a cochlear implant for the high frequencies. The advances in design of, and indications for, cochlear implants have been matched by improvements in surgical techniques and decrease in complications. The resulting improvements in safety and efficacy have further encouraged the use of these devices. This paper will review the new concepts in the candidacy of cochlear implant. Medline data base was used to search articles dealing with the following topics: cochlear implant in younger children, cochlear implant and hearing preservation, cochlear implant for unilateral deafness and tinnitus, genetic hearing loss and cochlear implant, bilateral cochlear implant, neuropathy and cochlear implant and neural plasticity, and the selection of patients for cochlear implant. PMID:22013448

  10. Cochlear implantation in autistic children with profound sensorineural hearing loss.

    Science.gov (United States)

    Lachowska, Magdalena; Pastuszka, Agnieszka; Łukaszewicz-Moszyńska, Zuzanna; Mikołajewska, Lidia; Niemczyk, Kazimierz

    2016-11-19

    Cochlear implants have become the method of choice for the treatment of severe-to-profound hearing loss in both children and adults. Its benefits are well documented in the pediatric and adult population. Also deaf children with additional needs, including autism, have been covered by this treatment. The aim of this study was to assess the benefits from cochlear implantation in deafened children with autism as the only additional disability. This study analyzes data of six children. The follow-up time was at least 43 months. The following data were analyzed: medical history, reaction to music and sound, Ling's six sounds test, onomatopoeic word test, reaction to spoken child's name, response to requests, questionnaire given to parents, sound processor fitting sessions and data. After cochlear implantation each child presented other communication skills. In some children, the symptoms of speech understanding were observed. No increased hyperactivity associated with daily use cochlear implant was observed. The study showed that in autistic children the perception is very important for a child's sense of security and makes contact with parents easier. Our study showed that oral communication is not likely to be a realistic goal in children with cochlear implants and autism. The implantation results showed benefits that varied among those children. The traditional methods of evaluating the results of cochlear implantation in children with autism are usually insufficient to fully assess the functional benefits. These benefits should be assessed in a more comprehensive manner taking into account the limitations of communication resulting from the essence of autism. It is important that we share knowledge about these complex children with cochlear implants. Copyright © 2016 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  11. Costs involved in using a cochlear implant in South Africa

    Directory of Open Access Journals (Sweden)

    Gillian Robyn Kerr

    2012-12-01

    Full Text Available Cochlear implantation is an expensive but effective lifelong intervention for individuals with a severe-to-profound hearing loss. The primary aim of this study was to survey the short- and long-term costs of cochlear implantation. Individuals (N=154 using cochlear implants obtained from the University of Stellenbosch-Tygerberg Hospital Cochlear Implant Unit in Cape Town, South Africa were surveyed using a questionnaire and patient record review. The questionnaire used a combination of closed and open-ended questions to gather both quantitative and qualitative information. Costs were categorised as short- and long-term costs. All costs were converted to constant rands (June 2010 using the Consumer Price Index to allow for comparison in real terms over time. In the first 10 years of implantation the average estimated costs incurred by adults totalled R379 626, and by children R455 225. The initial purchase of the implant system was the most substantial cost, followed by upgrading of the processor. Travel and accommodation costs peaked in the first 2 years. On average the participants spent R2 550 per year on batteries and spares. Rehabilitation for children cost an average of R7 200. Insurance costs averaged R4 040 per year, and processor repairs R3 000 each. In addition to the upfront expense of obtaining the cochlear implant system, individuals using a cochlear implant in South Africa should be prepared for the long-term costs of maintenance, accessing the unit, support services and additional costs associated with use. Knowledge of these costs is important to ensure that individuals are successful users of their cochlear implants in the long term.

  12. Hearing loss and cochlear damage in experimental pneumococcal meningitis, with special reference to the role of neutrophil granulytes

    DEFF Research Database (Denmark)

    Brandt, CT; Caye-Thomsen, P; Lund, SP

    2006-01-01

    Hearing loss is a well-known sequelae from meningitis, affecting up to 25% of survivors. However, the principal components of the infectious and inflammatory reaction responsible for the sensorineural hearing loss remain to be identified. The present study aimed to investigate the impact...... of an augmented neutrophil response on the development of hearing loss and cochlear damage in a model of experimental pneumococcal meningitis in rats. Hearing loss and cochlear damage were assessed by distortion product oto-acoustic emissions (DPOAE), auditory brainstem response (ABR) and histopathology in rats...... infection. Pretreatment with G-CSF increased hearing loss 24 h after infection and on day 8 compared to untreated rats (Mann-Whitney, P = 0.012 and P = 0.013 respectively). The increased sensorineural hearing loss at day 8 was associated with significantly decreased spiral ganglion cell counts (P = 0...

  13. Hearing loss and cochlear damage in experimental pneumococcal meningitis, with special reference to the role of neutrophil granulytes

    DEFF Research Database (Denmark)

    Brandt, CT; Caye-Thomsen, P; Lund, SP

    2006-01-01

    of an augmented neutrophil response on the development of hearing loss and cochlear damage in a model of experimental pneumococcal meningitis in rats. Hearing loss and cochlear damage were assessed by distortion product oto-acoustic emissions (DPOAE), auditory brainstem response (ABR) and histopathology in rats...... infection. Pretreatment with G-CSF increased hearing loss 24 h after infection and on day 8 compared to untreated rats (Mann-Whitney, P = 0.012 and P = 0.013 respectively). The increased sensorineural hearing loss at day 8 was associated with significantly decreased spiral ganglion cell counts (P = 0...... pathology compared to controls. In conclusion, the inflammatory host reaction contributes significantly to the development of hearing loss in experimental meningitis....

  14. Automatic Cochlear Duct Length Estimation for Selection of Cochlear Implant Electrode Arrays.

    Science.gov (United States)

    Rivas, Alejandro; Cakir, Ahmet; Hunter, Jacob B; Labadie, Robert F; Zuniga, M Geraldine; Wanna, George B; Dawant, Benoit M; Noble, Jack H

    2017-03-01

    Cochlear duct length (CDL) can be automatically measured for custom selection of cochlear implant (CI) electrode arrays. CI electrode array selection can be influenced by measuring the CDL, which is estimated based on the length of the line that connects the round window and the lateral wall of the cochlea when passing through the modiolus. CDL measurement remains time consuming and inter-observer variability has not been studied. We evaluate an automatic approach to directly measure the two-turn (2T) CDL using existing algorithms for localizing cochlear anatomy in computed tomography (CT). Pre-op CT images of 309 ears were evaluated. Two fellowship-trained neurotologists manually and independently measured CDL. Inter-observer variability between measurements across expert and automatic observers is assessed. Inter-observer differences for choice of electrode type are also investigated. Manual measurement of CDL by experts tends to underestimate cochlea size and has high inter-observer variability, with mean absolute differences between expert CDL estimations of 1.15 mm. Our results show that this can lead to a large number of cochleae for which a different electrode array type would be selected by different observers, depending on the specific threshold value of CDL used to decide between array type. Choosing the best CI electrode array is an important task for optimizing hearing outcomes. Manual cochleae length measurements are user-dependent, and errors impact upon the CI electrode array choice for certain patients. Measuring cochlea length automatically is less time consuming and generates more repeatable results. Our automatic approach could make use of CDL for patient-customized treatment more clinically adoptable.

  15. Cell-cell junctions: a target of acoustic overstimulation in the sensory epithelium of the cochlea

    OpenAIRE

    Zheng Guiliang; Hu Bo

    2012-01-01

    Abstract Background Exposure to intense noise causes the excessive movement of the organ of Corti, stretching the organ and compromising sensory cell functions. We recently revealed changes in the transcriptional expression of multiple adhesion-related genes during the acute phases of cochlear damage, suggesting that the disruption of cell-cell junctions is an early event in the process of cochlear pathogenesis. However, the functional state of cell junctions in the sensory epithelium is not ...

  16. Responding to Marginalization

    Directory of Open Access Journals (Sweden)

    Jie Y. Park

    2017-01-01

    Full Text Available This article offers an analysis of how refugee youths from Africa used and shifted languages and discourses in the United States. Drawing on sociocultural theories of language and utilizing ethnographic discourse and classroom observation data, the author illustrates the varied ways in which three high school–aged refugee youths used languages to make sense of who and where they are; respond to social, religious, and linguistic marginalization in the United States; and challenge narrow perceptions of African Muslims. This article brings to fore a group that, although facing a unique set of challenges in the United States, is rarely included in research on youth language practices and im/migration. Attention to their multilingual practices and the multilayered nature of their identity is central to understanding how refugee youths experience school in their new land, and how they see themselves and others. This understanding can guide school personnel, educational researchers, and community-based youth workers in their respective work with refugee students.

  17. Transcanal labyrinthectomy for intractable vertigo after unilateral cochlear implantation.

    Science.gov (United States)

    Heidenreich, Katherine D; Basura, Gregory J; Zwolan, Teresa A; El-Kashlan, Hussam K; Telian, Steven A

    2011-10-01

    Document the use of transcanal labyrinthectomy to treat disabling attacks of vertigo after unilateral cochlear implantation. A 46-year-old woman with severe-profound bilateral sensorineural hearing loss secondary to enlarged vestibular aqueducts underwent cochlear implantation for her right ear with a Nucleus Freedom device. The surgery was uneventful, and postoperative imaging confirmed that the electrode was positioned properly. She developed episodic vertigo 10 to 14 days after the implant surgery, which failed to improve with aggressive vestibular rehabilitation therapy. Plugging of the round window for possible perilymphatic fistula did not relieve her symptoms. Right transcanal labyrinthectomy supplemented by filling the vestibule with gentamicin-soaked Gelfoam and then a customized vestibular rehabilitation program. Comparison of vestibular symptoms and cochlear implant performance before and after transcanal labyrinthectomy. The patient had immediate relief of symptoms, and the function of the cochlear implant was not adversely affected. Transcanal labyrinthectomy may be an effective method to ablate the vestibular end organ after unilateral cochlear implantation. It can offer relief of disabling vertigo without adversely affecting the performance of the implant.

  18. Exploring the experiences of teenagers with cochlear implants.

    Science.gov (United States)

    Watson, Victoria; Verschuur, Carl; Lathlean, Judith

    2016-11-01

    Teenage cochlear implant users' perceptions of deafness, surgery, fitting of the device and life as a cochlear implant wearer were explored in order to gain a more comprehensive understanding of teenagers' experiences of living with the device. Semi-structured in-depth interviews were undertaken and analysed using thematic analysis. Ten teenagers aged 14-16 years with at least one cochlear implant were interviewed. Seven teenagers experienced great pre-operative anxiety and two reported significant post-operative pain. Four of the teenagers described a mismatch between their expectations and the disappointing reality of adjusting to the device. However, all the teenagers reported an enhanced sense of well-being as a result of being able to interact more easily with their world around them. The teenagers differed in the extent to which they identified with the hearing and deaf world. Despite the early challenges, over time the teenagers experienced many functional and psychosocial benefits. Most felt their lives were now easier as a result of the cochlear implant(s). They described complex, flexible identities. By giving prominence to the teenagers' voices this study has added new knowledge concerning their experience of surgery. The findings also more fully revealed the challenges of adjusting to the device and the impact of having a cochlear implant on the teenagers' identities. Clinical recommendations are made to address the gaps in service highlighted by these findings.

  19. A cochlear implant user with exceptional musical hearing ability.

    Science.gov (United States)

    Maarefvand, Mohammad; Marozeau, Jeremy; Blamey, Peter J

    2013-06-01

    Although the perception of music is generally poor in cochlear implant users, there are a few excellent performers. The aim of this study was the assessment of different aspects of music perception in one exceptional cochlear implant user. The assessments included pitch direction discrimination, melody and timbre recognition, relative and absolute pitch judgment, and consonance rating of musical notes presented through the sound processor(s). An adult cochlear implant user with musical background who lost her hearing postlingually, and five normally-hearing listeners with musical training participated in the study. The CI user discriminated pitch direction for sounds differing by one semitone and recognized melody with nearly 100% accuracy. Her results in timbre recognition were better than average published data for cochlear implant users. Her consonance rating, and relative and absolute pitch perception were comparable to normally-hearing listeners with musical training. The results in this study showed that excellent performance is possible on musical perception tasks including pitch perception using present day cochlear implant technologies. Factors that may explain this user's exceptional performance are short duration of deafness, pre- and post-deafness musical training, and perfect pitch abilities before the onset of deafness.

  20. Verbal Working Memory in Children With Cochlear Implants.

    Science.gov (United States)

    Nittrouer, Susan; Caldwell-Tarr, Amanda; Low, Keri E; Lowenstein, Joanna H

    2017-11-09

    Verbal working memory in children with cochlear implants and children with normal hearing was examined. Ninety-three fourth graders (47 with normal hearing, 46 with cochlear implants) participated, all of whom were in a longitudinal study and had working memory assessed 2 years earlier. A dual-component model of working memory was adopted, and a serial recall task measured storage and processing. Potential predictor variables were phonological awareness, vocabulary knowledge, nonverbal IQ, and several treatment variables. Potential dependent functions were literacy, expressive language, and speech-in-noise recognition. Children with cochlear implants showed deficits in storage and processing, similar in size to those at second grade. Predictors of verbal working memory differed across groups: Phonological awareness explained the most variance in children with normal hearing; vocabulary explained the most variance in children with cochlear implants. Treatment variables explained little of the variance. Where potentially dependent functions were concerned, verbal working memory accounted for little variance once the variance explained by other predictors was removed. The verbal working memory deficits of children with cochlear implants arise due to signal degradation, which limits their abilities to acquire phonological awareness. That hinders their abilities to store items using a phonological code.

  1. Music activities and responses of young cochlear implant recipients.

    Science.gov (United States)

    van Besouw, Rachel M; Grasmeder, Mary L; Hamilton, Mary E; Baumann, Sarah E

    2011-05-01

    The development of auditory receptive skills and spoken language is often delayed in children who use cochlear implants, which may affect their appreciation of and responses to music. This in turn may be interpreted as disinterest in music. A questionnaire was developed to determine whether differences in exposure and responses to music exist between young cochlear implant recipients and their normally hearing peers. The questionnaire was developed by a multidisciplinary team and distributed to parents of preschool children with normal hearing and to parents of preschool children who had been implanted at least one year prior. The cochlear implant group comprised 23 children and was gender and age matched (within ±2 months) to a group of children with normal hearing. Young cochlear implant recipients receive similar exposure to audiovisual music media, parental singing and musical instruments at home. However, the data suggest that they receive less exposure to children's music presented without visual stimuli. Parents also reported less sophisticated responses to music for this group. The findings of this study have important implications concerning the provision of age-appropriate music habilitation materials and activities for young cochlear implant recipients.

  2. Cochlear Implantation, Enhancements, Transhumanism and Posthumanism: Some Human Questions.

    Science.gov (United States)

    Lee, Joseph

    2016-02-01

    Biomedical engineering technologies such as brain-machine interfaces and neuroprosthetics are advancements which assist human beings in varied ways. There are exciting yet speculative visions of how the neurosciences and bioengineering may influence human nature. However, these could be preparing a possible pathway towards an enhanced and even posthuman future. This article seeks to investigate several ethical themes and wider questions of enhancement, transhumanism and posthumanism. Four themes of interest are: autonomy, identity, futures, and community. Three larger questions can be asked: will everyone be enhanced? Will we be "human" if we are not, one day, transhuman? Should we be enhanced or not? The article proceeds by concentrating on a widespread and sometimes controversial application: the cochlear implant, an auditory prosthesis implanted into Deaf patients. Cochlear implantation and its reception in both the deaf and hearing communities have a distinctive moral discourse, which can offer surprising insights. The paper begins with several points about the enhancement of human beings, transhumanism's reach beyond the human, and posthuman aspirations. Next it focuses on cochlear implants on two sides. Firstly, a shorter consideration of what technologies may do to humans in a transhumanist world. Secondly, a deeper analysis of cochlear implantation's unique socio-political movement, its ethical explanations and cultural experiences linked with pediatric cochlear implantation-and how those wary of being thrust towards posthumanism could marshal such ideas by analogy. As transhumanism approaches, the issues and questions merit continuing intense analysis.

  3. Workers' marginal costs of commuting

    DEFF Research Database (Denmark)

    van Ommeren, Jos; Fosgerau, Mogens

    2009-01-01

    This paper applies a dynamic search model to estimate workers' marginal costs of commuting, including monetary and time costs. Using data on workers' job search activity as well as moving behaviour, for the Netherlands, we provide evidence that, on average, workers' marginal costs of one hour of ...

  4. Radiation Therapy Administration and Survival in Stage I/II Extranodal Marginal Zone B-Cell Lymphoma of Mucosa-Associated Lymphoid Tissue

    Energy Technology Data Exchange (ETDEWEB)

    Olszewski, Adam J., E-mail: adam_olszewski@brown.edu; Desai, Amrita

    2014-03-01

    Purpose: To determine the factors associated with the use of radiation therapy and associated survival outcomes in early-stage marginal zone lymphoma of the mucosa-associated lymphoid tissue (MALT). Methods and Materials: We extracted data on adult patients with stage I/II MALT lymphoma diagnoses between 1998 and 2010 recorded in the Surveillance, Epidemiology, and End Results (SEER) database. We studied factors associated with radiation therapy administration in a logistic regression model and described the cumulative incidence of lymphoma-related death (LRD) according to receipt of the treatment. The association of radiation therapy with survival was explored in multivariate models with adjustment for immortal time bias. Results: Of the 7774 identified patients, 36% received radiation therapy as part of the initial course of treatment. Older patients; black or Hispanic men; white, Hispanic, and black women; and socioeconomically disadvantaged and underinsured patients had a significantly lower chance of receiving radiation therapy. Radiation therapy administration was associated with a lower chance of LRD in most sites. In cutaneous, ocular, and salivary MALT lymphomas, the 5-year estimate of LRD after radiation therapy was 0%. The association of radiation therapy with overall survival in different lymphoma sites was heterogeneous, and statistically significant in cutaneous (hazard ratio 0.45, P=.009) and ocular (hazard ratio 0.47, P<.0001) locations after multivariate adjustment. Conclusions: Demographic factors are associated with the use of radiation therapy in MALT lymphoma. Clinicians should be sensitive to those disparities because the administration of radiation therapy may be associated with improved survival, particularly in cutaneous and ocular lymphomas.

  5. Surgical considerations and safety of cochlear implantation in otitis media with effusion.

    Science.gov (United States)

    Cevizci, Rasit; Dilci, Alper; Celenk, Fatih; Karamert, Recep; Bayazit, Yildirim

    2017-07-26

    To evaluate the effects of otitis media with effusion on surgical parameters, patient safety, perioperative and postoperative complications. Total 890 children who underwent cochlear implantation between 2006 and 2015 were included. The ages ranged from 12 months to 63 months (mean: 32 months). The patients were divided into two groups according to the presence or absence of otitis media with effusion; otitis media with effusion group and non-otitis media group. Of 890 children, 105 had otitis media with effusion prior to surgery. In non-otitis media with group, there were 785 children. The average duration of surgery was 60min (ranged from 28 to 75min) in non-otitis media group, and 90min (ranged from 50 to 135min) in otitis media with effusion group (pmedia with effusion during the surgery. There was no significant difference between the complications of groups with or without otitis media with effusion (p>0.05). In 5 of 105 patients, there was a ventilation tube inserted before cochlear implantation, which did not change the outcome of implantation. There is no need for surgical treatment for otitis media with effusion before implantation since otitis media with effusion does not increase the risks associated with cochlear implantation. Operation duration is longer in the presence of otitis media with effusion. However, otitis media with effusion leads to intraoperative difficulties like longer operation duration, bleeding, visualization of the round window membrane, cleansing the middle ear granulations as well as mastoid and petrous air cells. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. Riluzole is a promising pharmacological inhibitor of bilirubin-induced excitotoxicity in the ventral cochlear nucleus.

    Science.gov (United States)

    Han, Guo-Ying; Li, Chun-Yan; Shi, Hai-Bo; Wang, Ji-Ping; Su, Kai-Ming; Yin, Xin-Lu; Yin, Shan-Kai

    2015-03-01

    Bilirubin encephalopathy as a result of hyperbilirubinemia is a devastating neurological disorder that occurs mostly in the neonatal period. To date, no effective drug treatment is available. Glutamate-mediated excitotoxicity is likely an important factor causing bilirubin encephalopathy. Thus, drugs suppressing the overrelease of glutamate may protect the brain against bilirubin excitotoxicity. Riluzole is a prescription drug known for its antiglutamatergic function. This study was conducted in the rat's ventral cochlear nucleus, a structure highly sensitive to bilirubin toxicity, to find whether riluzole can be used to inhibit bilirubin toxicity. Electrophysiology changes were detected by perforated patch clamp technique. Calcium imaging using Rhod-2-AM as an indicator was used to study the intracellular calcium. Cell apoptosis and necrosis were measured by PI/Hoechst staining. In the absence of bilirubin, riluzole effectively decreased the frequency of spontaneous excitatory postsynaptic currents (sEPSCs) and suppressed neuronal firing but did not change the amplitude of sEPSC and glutamate-activated currents (I(Glu)). Moreover, riluzole inhibited bilirubin-induced increases in the frequency of sEPSC and neuronal firing. Riluzole could prevent the bilirubin-induced increase in intracellular calcium, mediated by AMPA and NMDA receptors. Furthermore, riluzole significantly reduced bilirubin-induced cell death. These data suggest that riluzole can protect neurons in the ventral cochlear nucleus from bilirubin-induced hyperexcitation and excitotoxicity through reducing presynaptic glutamate release. © 2014 John Wiley & Sons Ltd.

  7. Effects of chronic furosemide on central neural hyperactivity and cochlear thresholds after cochlear trauma in guinea pig

    Directory of Open Access Journals (Sweden)

    Wilhelmina eMulders

    2014-08-01

    Full Text Available Increased neuronal spontaneous firing rates have been observed throughout the central auditory system after trauma to the cochlea and this hyperactivity is believed to be associated with the phantom perception of tinnitus. Previously we have shown in an animal model of hearing loss, that an acute injection with furosemide can significantly decrease hyperactivity after cochlear trauma and eliminate behavioural evidence of tinnitus of early onset. However, furosemide also has the potential to affect cochlear thresholds. In this paper we measured the effects of a chronic (daily injections for 7 days furosemide treatment on the spontaneous firing rate of inferior colliculus neurons and on cochlear thresholds in order to establish whether a beneficial effect on hyperactivity can be obtained without causing additional hearing loss. Guinea pigs were exposed to a 10 kHz, 124dB, 2 hour acoustic trauma, and after 5 days of recovery, were given daily i.p. injections of 80mg/kg furosemide or an equivalent amount of saline. The activity of single IC neurons was recorded 24 hours following the last injection. The furosemide treatment had no effect on cochlear thresholds compared to saline injections but did result in significant reductions in spontaneous firing rates recorded in inferior colliculus. These results that suggest a long term beneficial effect of furosemide on hyperactivity after cochlear trauma may be achievable without detrimental effects on hearing, which is important when considering therapeutic potential.

  8. Cochlear re-implant rates in children: 20 years experience in a quaternary paediatric cochlear implant centre.

    Science.gov (United States)

    Trozzi, Marilena; Powell, Harry R F; Toma, Shamim; Ahmed, Waseem; Jephson, Christopher G; Rajput, Kaukab; Cochrane, Lesley A

    2015-10-01

    The aim of this study is to determine the incidence and causes for cochlear explantation/re-implantation in children as a retrospective case review in a Quaternary paediatric Cochlear Implant (CI) Centre. The subjects included in the study were Paediatric CI patients requiring cochlear explantation/re-implantation. Outcome measurements were incidence and aetiology of device explantation/re-implantation. Patient age at implantation, aetiology of deafness, CI manufacturer, and timing of explantation/re P implantation were the independent variables. 778 paediatric cochlear implants were performed in 653 children between 1992 and January 2013. There were a total of 40 (5.1%) failed implants in 38 patients. The most common reason for explantation was device failure in 22 (2.8%). Risk factors for device failure were known manufacturing defect/device recall. Medical/surgical issues accounted for 18 (2.3%) implant failures. The mean time to explantation was 3 years 10 months. The incidence of explantation/re-implantation in our paediatric cochlear implant population is comparable to other published studies. The most common reason for explantation was device failure, however, the aetiology of deafness, in particular meningitis, does not appear to increase the risk of explantation as described in previous series.

  9. Pre-, intra- and post-operative imaging of cochlear implants

    Energy Technology Data Exchange (ETDEWEB)

    Vogl, T.J.; Naguib, N.N.N.; Burck, I. [University Hospital Frankfurt (Germany). Inst. of Diagnostic and Interventional Radiology; Tawfik, A. [Mansoura Univ. (Egypt). Dept. of Diagnostic and Interventional Radiology; Emam, A. [University Hospital Alexandria (Egypt). Dept. of Diagnostic and Interventional Radiology; Nour-Eldin, A. [University Hospital Cairo (Egypt). Dept. of Radiology; Stoever, T. [University Hospital of Frankfurt (Germany). Dept. of Otolaryngology

    2015-11-15

    The purpose of this review is to present essential imaging aspects in patients who are candidates for a possible cochlear implant as well as in postsurgical follow-up. Imaging plays a major role in providing information on preinterventional topography, variations and possible infections. Preoperative imaging using DVT, CT, MRI or CT and MRI together is essential for candidate selection, planning of surgical approach and exclusion of contraindications like the complete absence of the cochlea or cochlear nerve, or infection. Relative contraindications are variations of the cochlea and vestibulum. Intraoperative imaging can be performed by fluoroscopy, mobile radiography or DVT. Postoperative imaging is regularly performed by conventional X-ray, DVT, or CT. In summary, radiological imaging has its essential role in the pre- and post-interventional period for patients who are candidates for cochlear implants.

  10. Simultaneous cochlear implantation in children: the Great Ormond Street experience.

    Science.gov (United States)

    Grainger, Joe; Jonas, Nicolaas E; Cochrane, Lesley A

    2012-08-01

    To analyse the surgical aspects and safety of bilateral simultaneous cochlear implantation in children. A retrospective case series at a tertiary paediatric centre in the United Kingdom. Surgical times, analgesia and antiemetic use, and complications were analysed for the first 25 bilateral simultaneous cochlear implants performed at Great Ormond Street Hospital for Children between September 2007 and December 2009. These were compared with a consecutive group of sequentially implanted children whose second implant was performed during the same period. Total time for simultaneous implantation was significantly less than the cumulative time required for sequential implantation (P 0.05). No difference in complication rates was seen between the groups. Bilateral simultaneous cochlear implantation in children is safe and results in a reduction in total theatre time when compared with the cumulative time required for sequential implantation. Simultaneous implantation also reduces total analgesia and antiemetic requirements and length of stay to levels comparable with single-side implantation.

  11. Nijmegen Cochlear Implant Questionnaire (NCIQ): translation, cultural adaptation, and application in adults with cochlear implants.

    Science.gov (United States)

    Santos, Nathália Porfírio Dos; Couto, Maria Inês Vieira; Martinho-Carvalho, Ana Claudia

    2017-12-11

    Cross-cultural adaptation and translation of the Nijmegen Cochlear Implant Questionnaire (NCIQ) into Brazilian Portuguese and analysis of quality of life (QoL) results in adults with cochlear implant (CI). The NCIQ instrument was translated into Brazilian Portuguese and culturally adapted. After that, a cross-sectional and clinical QoL evaluation was conducted with a group of 24 adults with CI. The questionnaire title in Brazilian Portuguese is 'Questionário Nijmegen de Implantes Cocleares' (NCIQ-P). The version of the NCIQ questionnaire translated into Brazilian Portuguese presented good internal consistency (0.78). The social and physical domains presented the highest scores, with the basic and advanced sound perception subdomains achieving the highest scores. No correlation between gender and time of device use was found for the questionnaire domains and subdomains. The cross-cultural adaptation and translation of the NCIQ into Brazilian Portuguese suggests that this instrument is reliable and useful for clinical and research purposes in Brazilian adults with CI.

  12. Cochlear implantation for a child with cochlear nerve deficiency: parental perspectives explored through narrative.

    Science.gov (United States)

    Kotjan, Hannah; Purves, Barbara; Small, Susan A

    2013-11-01

    The objective of this study was to explore, from the parents' perspectives, decision-making regarding a cochlear implant (CI) for their child when a favourable outcome is less likely because of abnormal neurophysiology. The primary research method of this single case study was qualitative interviewing drawing on a narrative approach to elicit the parents' perspectives about their experiences over time. Each parent was interviewed separately, but thematic analyses were undertaken both within and across interviews in order to identify overlaps and differences. Participants included the parents of a five-year old child with severe-profound hearing loss, cochlear nerve deficiency, and bilateral common cavities who had received a CI at the age of 18 months. Four themes were identified across the four narrative stages that emerged from the parents' accounts of their experiences regarding their daughter's CI. Themes included hope and despair, questioning professionals' motivations, does deafness need a cure, and bringing the child into the family. Although these themes emerged from both parents' accounts, each parent expressed different perspectives and insights within them. Findings highlight the central place of parental needs and perspectives in decision-making regarding a CI, particularly in the context of uncertain outcomes.

  13. Factors contributing to communication skills development in cochlear implanted children

    Directory of Open Access Journals (Sweden)

    Ostojić Sanja

    2015-01-01

    Full Text Available Background/Aim. Over the last 10 years more than 300 persons received cochlear implant in Serbia and more than 90% of the recipients were children under 10 years of age. The program of cochlear implantation includes postoperative rehabilitation in which cognitive, integrative and developmental methods are used. The study was conducted to reveal factors affecting communication performance (CP of cochlear implanted (CI children. Special attention was focused on the influence of the duration and intensity of rehabilitation and hearing age on further development of communication skills. Methods. A group of 30 CI children (13 boys and 17 girls aged 2 to 5 years was enrolled in the study. All of the children had average intelligence and no other developmental disorder. They lived in families and attended rehabilitative seances 3 to 5 times a week. Their parents/ caregivers answered structured questionnaire about functioning after pediatric cochlear implantation (FAPCI and the results were the subject of detailed statistical analysis. Results. Analysis of variance did not show any difference between the boys and the girls regarding FAPCI achievements (F (1, 28 = 2.909; p = 0.099 and age aberration in CP score (F (1, 28 = 0.114, p = 0.738. Correlation analysis showed a statistically significant difference in FAPCI scores related to hearing age and duration of rehabilitation. Regression analysis (enter method showed that model consisting of indipendent variables significantly contributed to prediction of overall FAPCI scores and Adjusted R2 value could explain 32% difference in communication skills of participants in this study. Conclusion. Communication skills of CI children evaluated by FAPCI are falling behind normatives for normal hearing children 18.6 months on the average. Hearing age, duration and intensity of rehabilitation have positive predictive value for communication skills development. Later identification of hearing loss and later cochlear

  14. Behavior problems in children with cochlear implants.

    Science.gov (United States)

    Chao, Wei-Chieh; Lee, Li-Ang; Liu, Tien-Chen; Tsou, Yung-Ting; Chan, Kai-Chieh; Wu, Che-Ming

    2015-05-01

    (1) To examine behavior problems in Mandarin-speaking children with cochlear implants (CIs); (2) to investigate the associated factors of problem behaviors; (3) to understand the relationships between behavior problems and parenting stress. Sixty patients (25 boys, 35 girls) aged 6-18 years (mean=12.2±3.2) who used CIs for a mean duration of eight years participated in the study. Behavior problems were assessed by Achenbach's child behavior checklist (CBCL). Categorical auditory performance (CAP) and speech intelligibility rating (SIR) scales were utilized to investigate auditory performance and speech production intelligibility. Parenting stress index (PSI) was filled out by parents to measure parenting stress level. Significantly more CI subjects had problems with 'Withdrawn/Depressed' (p=0.010), 'Social Problems' (pProblems' (pProblems' (pProblems' was the most common problem and could be independently associated with gender, socioeconomic status and CAP (R(2)=0.361). CAP score was also associated with Overall Behaviors (R(2)=0.081). The results of PSI had a significant positive correlation with almost all CBCL subscales (pproblems, which may in turn increase parenting stress. Good family support as well as aural-verbal rehabilitation are of particular importance in determining behavioral outcomes in CI children. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  15. The Value of Optical Coherence Tomography in Determining Surgical Margins in Squamous Cell Carcinoma of the Vulva: A Single-Center Prospective Study

    NARCIS (Netherlands)

    Wessels, R.; Wessels, R.; van Beurden, M.F.B.; de Bruin, D.M.; Faber, D.J.; Vincent, A.D.; Sanders, J.; van Leeuwen, Ton; Ruers, Theo J.M.

    2015-01-01

    Background: Vulvar squamous cell carcinoma (VSCC) is treated with wide local excision. The challenge is to remove as much skin as necessary to prevent recurrence, but meanwhile preserve genital skin to diminish morbidity. Optical coherence tomography (OCT) is a noninvasive imaging tool that produces

  16. Tinnitus after Simultaneous and Sequential Bilateral Cochlear Implantation

    Directory of Open Access Journals (Sweden)

    Geerte G. J. Ramakers

    2017-11-01

    Full Text Available ImportanceThere is an ongoing global discussion on whether or not bilateral cochlear implantation should be standard care for bilateral deafness. Contrary to unilateral cochlear implantation, however, little is known about the effect of bilateral cochlear implantation on tinnitus.ObjectiveTo investigate tinnitus outcomes 1 year after bilateral cochlear implantation. Secondarily, to compare tinnitus outcomes between simultaneous and sequential bilateral cochlear implantation and to investigate long-term follow-up (3 years.Study designThis study is a secondary analysis as part of a multicenter randomized controlled trial.MethodsThirty-eight postlingually deafened adults were included in the original trial, in which the presence of tinnitus was not an inclusion criterion. All participants received cochlear implants (CIs because of profound hearing loss. Nineteen participants received bilateral CIs simultaneously and 19 participants received bilateral CIs sequentially with an inter-implant interval of 2 years. The prevalence and severity of tinnitus before and after simultaneous and sequential bilateral cochlear implantation were measured preoperatively and each year after implantation with the Tinnitus Handicap Inventory (THI and Tinnitus Questionnaire (TQ.ResultsThe prevalence of preoperative tinnitus was 42% (16/38. One year after bilateral implantation, there was a median difference of −8 (inter-quartile range (IQR: −28 to 4 in THI score and −9 (IQR: −17 to −9 in TQ score in the participants with preoperative tinnitus. Induction of tinnitus occurred in five participants, all in the simultaneous group, in the year after bilateral implantation. Although the preoperative and also the postoperative median THI and TQ scores were higher in the simultaneous group, the median difference scores were equal in both groups. In the simultaneous group, tinnitus scores fluctuated in the 3 years after implantation. In the sequential group

  17. Automatic Model Generation Framework for Computational Simulation of Cochlear Implantation

    DEFF Research Database (Denmark)

    Mangado Lopez, Nerea; Ceresa, Mario; Duchateau, Nicolas

    2016-01-01

    Recent developments in computational modeling of cochlear implantation are promising to study in silico the performance of the implant before surgery. However, creating a complete computational model of the patient's anatomy while including an external device geometry remains challenging...... constitutive parameters to all components of the finite element model. This model can then be used to study in silico the effects of the electrical stimulation of the cochlear implant. Results are shown on a total of 25 models of patients. In all cases, a final mesh suitable for finite element simulations...

  18. Cochlear implantation in pediatric patients with Cockayne Syndrome.

    Science.gov (United States)

    Van Wyhe, Renae D; Emery, Claudia V; Williamson, Robert A

    2018-03-01

    Cockayne Syndrome (CS) is a rare, autosomal recessive disorder characterized by a spectrum of phenotypic abnormalities, including progressive sensorineural hearing loss (SNHL) that involves both peripheral and central components. To date, a single series of CS patients undergoing cochlear implant (CI) placement has been reported; this study reports on additional previously unreported pediatric CI recipients. Subjective benefits were noted early after activation in both patients, and speech perception scores improved over time as well, varying from 42 to 70% (versus 0-12% previously). Thus, we report that cochlear implantation in pediatric patients with CS can be effective in the management of progressive SNHL. Copyright © 2017. Published by Elsevier B.V.

  19. Speech, language, and reading skills after early cochlear implantation.

    Science.gov (United States)

    Geers, Ann E

    2004-05-01

    To examine whether age at cochlear implantation or duration of implant use is associated with speech, language, and reading skills exhibited at age 8 to 9 years in children who underwent implantation by age 5 years. Performance outcomes in speech perception, speech production, language, and reading were examined in terms of the age at which children first received a cochlear implant (2, 3, or 4 years), the age they received an updated (Spectra) processor, and the duration of use of an implant and an updated processor. Data collection was conducted at summer research camps held over 4 consecutive years to maximize the number of children available at a specific age (8-9 years). Children were tested individually by experienced examiners, and their parents and therapists provided background and educational history information. A total of 181 children from 33 different states and 5 Canadian provinces who received a cochlear implant by age 5 years were tested. A subsample of 133 children with performance IQ scores of 80 or greater and onset of deafness at birth were selected for the age-at-implantation analysis. Another subsample of 39 children with deafness acquired by age 3 years was also examined. A battery of tests of speech perception, speech production, language, and reading was administered to each child and reduced to a single factor score for each skill. Correlation coefficients between age at implantation and duration of use did not reach significance for any of the outcome skills measured. Age at which the updated speech processor (Spectra) was fitted was significantly related to speech production outcome (earlier use of an updated processor was associated with greater speech intelligibility) but not to any other skill area. However, more of the children who underwent implantation at age 2 years (43%) achieved combined speech and language skills commensurate with their age-matched peers with normal hearing than did children who underwent implantation at age 4

  20. Staphylococcus lugdunensis: novel organism causing cochlear implant infection

    Directory of Open Access Journals (Sweden)

    Samina Bhumbra

    2014-06-01

    Full Text Available A majority of cochlear implant infections are caused by Staphylococcus aureus or Pseudomonas aeruginosa. Reported here is a pediatric patient with a cochlear implant infection caused by methicillin-resistant Staphylococcus lugdunensis, a coagulase-negative Staphylococcus that has only recently been determined to be clinically relevant (1988. Unlike other coagulase-negative Staphylococcus, it is more aggressive, carrying a greater potential for tissue destruction. In pediatrics, the organism is uncommon, poorly described, and generally pan-susceptible. Described herein is the presentation and management of this unusual organism in a pediatric setting.

  1. REHABILITATION OF PRESCHOOL CHILDREN AFTER A COCHLEAR IMPLANTATION (PEDAGOGICAL ASPECT

    Directory of Open Access Journals (Sweden)

    A. I. Sataeva

    2012-01-01

    Full Text Available The only way for children with an inherent loss of hearing to be able to hear is cochlear implantation. The author covers important problems of medical, psychological and pedagogical rehabilitation of children, which had undergone such surgery. The necessity of cooperation between doctors, psychologists, deaf-and-dumb pedagogues and the child’s family in order to achieve a successful restoration of the lost skills or to form new ones: perception of sound, speaking skills, social adaptation is being stressed. A personal experience of rehabilitating children after cochlear implantation is described.

  2. Aspects of Music with Cochlear Implants – Music Listening Habits and Appreciation in Danish Cochlear Implant Users

    DEFF Research Database (Denmark)

    Petersen, Bjørn; Hansen, Mads; Sørensen, Stine Derdau

    Cochlear implant users differ significantly from their normal hearing peers when it comes to perception of music. Several studies have shown that structural features – such as rhythm, timbre, and pitch – are transmitted less accurately through an implant. However, we cannot predict personal...... enjoyment of music solely as a function of accuracy of perception. But can music be pleasant with a cochlear implant at all? Our aim here was to gather information of both music enjoyment and listening habits before the onset of hearing loss and post-operation from a large, representative sample of Danish...... recipients. A hundred and sixty three adult cochlear implant users (101 females, 62 males) completed a survey containing questions about musical background, listening habits, and music enjoyment. The results indicate a wide range of success with music, but in general, the results show that the CI users enjoy...

  3. Continuous topical drug delivery using osmotic pump in animal cochlear implant model: Continuous steroid delivery is effective for hearing preservation.

    Science.gov (United States)

    Lee, Min Young; Lee, Jun Ho; Lee, Ho Sun; Choi, Jun-Jae; Jang, Jongmoon; Choi, Hongsoo; Oh, Seung-Ha; Jang, Jeong Hun

    2015-08-01

    Continuous topical drug delivery using an osmotic pump is an effective supplementary technique for hearing preservation after cochlear implantation, as demonstrated in a guinea pig model. To evaluate the effect of continuous topical steroid delivery via an osmotic pump in an animal cochlear implant model. Twenty-three guinea pigs were used for the study. The animals were divided into three groups: control group (n = 8), simple topical dexamethasone delivery group (sDEXA group, n = 7) and continuous topical dexamethasone delivery group (cDEXA, n = 8). The hearing thresholds of all animals were measured by pre-operative auditory brain stem responses (ABRs) at 2, 8, 16, 24, and 32 kHz. ABRs were re-evaluated after cochlear implantation, and the animals were sacrificed for hematoxylin and eosin staining. The ABR threshold at 1 week post-operatively was significantly lower in the cDEXA group than in the control and sDEXA groups at most frequencies. Threshold shifts from baseline were statistically smaller in the cDEXA group than in the control and sDEXA groups at all frequencies. Histological analysis revealed decreased numbers of multi-nucleated giant cells and thinner histiocyte layers.

  4. Effects of brain-derived neurotrophic factor (BDNF) on the cochlear nucleus in cats deafened as neonates.

    Science.gov (United States)

    Kandathil, Cherian K; Stakhovskaya, Olga; Leake, Patricia A

    2016-12-01

    Many previous studies have shown significant neurotrophic effects of intracochlear delivery of BDNF in preventing degeneration of cochlear spiral ganglion (SG) neurons after deafness in rodents and our laboratory has shown similar results in developing cats deafened prior to hearing onset. This study examined the morphology of the cochlear nucleus (CN) in a group of neonatally deafened cats from a previous study in which infusion of BDNF elicited a significant improvement in survival of the SG neurons. Five cats were deafened by systemic injections of neomycin sulfate (60 mg/kg, SQ, SID) starting one day after birth, and continuing for 16-18 days until auditory brainstem response (ABR) testing demonstrated profound bilateral hearing loss. The animals were implanted unilaterally at about 1 month of age using custom-designed electrodes with a drug-delivery cannula connected to an osmotic pump. BDNF (94 μg/ml; 0.25 μl/hr) was delivered for 10 weeks. The animals were euthanized and studied at 14-23 weeks of age. Consistent with the neurotrophic effects of BDNF on SG survival, the total CN volume in these animals was significantly larger on the BDNF-treated side than on the contralateral side. However, total CN volume, both ipsi- and contralateral to the implants in these deafened juvenile animals, was markedly smaller than the CN in normal adult animals, reflecting the severe effects of deafness on the central auditory system during development. Data from the individual major CN subdivisions (DCN, Dorsal Cochlear Nucleus; PVCN, Posteroventral Cochlear Nucleus; AVCN, Anteroventral Cochlear Nucleus) also were analyzed. A significant difference was observed between the BDNF-treated and control sides only in the AVCN. Measurements of the cross-sectional areas of spherical cells showed that cells were significantly larger in the AVCN ipsilateral to the implant than on the contralateral side. Further, the numerical density of spherical cells was significantly lower in

  5. [What size of surgical margins for carcinoma of the eyelid?].

    Science.gov (United States)

    Mouriaux, F; Stefan, A; Coffin-Pichonnet, S; Verneuil, L; Rousselot, P

    2015-02-01

    Traditional surgical treatment of non-melanoma skin cancer includes excision with adjacent surgical margins, such "safety" margins theoretically leading to lower recurrence rates. Thus, some authors favor a clinical excision margin of 4mm for basal cell carcinoma and 6mm for squamous cell carcinoma. However, such "safety" margins cannot be applied in all cases of eyelids tumors for anatomic and functional reasons, because such recommendations may lead to severe ocular complications, even loss of the globe. Thus, in order to mitigate these issues in oculoplastic surgery, excision with reduced margins is proposed, either with frozen sections or with traditional pathologic analysis and secondary reconstructive surgery several days later. The purpose of this article is to demonstrate that it is possible to reduce surgical margins while respecting "safety" from tumor recurrence, in order to preserve ocular integrity. The most appealing technique is frozen section of the margins, corresponding to "slow-Mohs" micrographic surgery. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  6. Pseudo-Marginal Slice Sampling

    OpenAIRE

    Murray, Iain; Graham, Matthew

    2015-01-01

    Markov chain Monte Carlo (MCMC) methods asymptotically sample from complex probability distributions. The pseudo-marginal MCMC framework only requires an unbiased estimator of the unnormalized probability distribution function to construct a Markov chain. However, the resulting chains are harder to tune to a target distribution than conventional MCMC, and the types of updates available are limited. We describe a general way to clamp and update the random numbers used in a pseudo-marginal meth...

  7. Standard gross margin for poultry

    OpenAIRE

    Chetroiu, Rodica; Iurchevici, Lidia

    2012-01-01

    The standard gross margin (SGM) is the difference between the gross product (GP) of a product and the direct proportional expenditures (DPE). The standard gross margin shall be calculated on one activity unit: surface (1 ha) or per head: SGM = GP - DPE The standard gross product at poultry is calculated per kg of meat and per 1000 eggs and includes the total output value plus the supplied subsidy. Direct proportional expenditures (DPE) are expenditures that vary directly with the changes in t...

  8. Emergent literacy in kindergartners with cochlear implants.

    Science.gov (United States)

    Nittrouer, Susan; Caldwell, Amanda; Lowenstein, Joanna H; Tarr, Eric; Holloman, Christopher

    2012-01-01

    A key ingredient to academic success is being able to read. Deaf individuals have historically failed to develop literacy skills comparable with those of their normal-hearing (NH) peers, but early identification and cochlear implants (CIs) have improved prospects such that these children can learn to read at the levels of their peers. The goal of this study was to examine early, or emergent, literacy in these children. Twenty-seven deaf children with CIs, who had just completed kindergarten were tested on emergent literacy, and on cognitive and linguistic skills that support emergent literacy, specifically ones involving phonological awareness, executive functioning, and oral language. Seventeen kindergartners with NH and eight with hearing loss, but who used hearing aids served as controls. Outcomes were compared for these three groups of children, regression analyses were performed to see whether predictor variables for emergent literacy differed for children with NH and those with CIs, and factors related to the early treatment of hearing loss and prosthesis configuration were examined for children with CIs. The performance of children with CIs was roughly 1 SD or more below the mean performance of children with NH on all tasks, except for syllable counting, reading fluency, and rapid serial naming. Oral language skills explained more variance in emergent literacy for children with CIs than for children with NH. Age of first implant explained moderate amounts of variance for several measures. Having one or two CIs had no effect, but children who had some amount of bimodal experience outperformed children who had none on several measures. Even deaf children who have benefitted from early identification, intervention, and implantation are still at risk for problems with emergent literacy that could affect their academic success. This finding means that intensive language support needs to continue through at least the early elementary grades. Also, a period of

  9. Multisensory Integration in Cochlear Implant Recipients.

    Science.gov (United States)

    Stevenson, Ryan A; Sheffield, Sterling W; Butera, Iliza M; Gifford, René H; Wallace, Mark T

    Speech perception is inherently a multisensory process involving integration of auditory and visual cues. Multisensory integration in cochlear implant (CI) recipients is a unique circumstance in that the integration occurs after auditory deprivation and the provision of hearing via the CI. Despite the clear importance of multisensory cues for perception, in general, and for speech intelligibility, specifically, the topic of multisensory perceptual benefits in CI users has only recently begun to emerge as an area of inquiry. We review the research that has been conducted on multisensory integration in CI users to date and suggest a number of areas needing further research. The overall pattern of results indicates that many CI recipients show at least some perceptual gain that can be attributable to multisensory integration. The extent of this gain, however, varies based on a number of factors, including age of implantation and specific task being assessed (e.g., stimulus detection, phoneme perception, word recognition). Although both children and adults with CIs obtain audiovisual benefits for phoneme, word, and sentence stimuli, neither group shows demonstrable gain for suprasegmental feature perception. Additionally, only early-implanted children and the highest performing adults obtain audiovisual integration benefits similar to individuals with normal hearing. Increasing age of implantation in children is associated with poorer gains resultant from audiovisual integration, suggesting a sensitive period in development for the brain networks that subserve these integrative functions, as well as length of auditory experience. This finding highlights the need for early detection of and intervention for hearing loss, not only in terms of auditory perception, but also in terms of the behavioral and perceptual benefits of audiovisual processing. Importantly, patterns of auditory, visual, and audiovisual responses suggest that underlying integrative processes may be

  10. TeleCITE: Telehealth--A Cochlear Implant Therapy Exchange

    Science.gov (United States)

    Stith, Joanna; Stredler-Brown, Arlene; Greenway, Pat; Kahn, Gary

    2012-01-01

    What might bring the efforts of a physician, a speech-language pathologist, a teacher of the deaf and hard of hearing, and a nurse together? The answer is the innovative use of telepractice to deliver high quality, family-centered early intervention to infants and toddlers with hearing loss. TeleCITE: Telehealth--A Cochlear Implant Therapy…

  11. Simultaneous communication supports learning in noise by cochlear implant users

    NARCIS (Netherlands)

    Blom, H.C.; Marschark, M.; Machmer, E.

    2017-01-01

    Objectives: This study sought to evaluate the potential of using spoken language and signing together (simultaneous communication, SimCom, sign-supported speech) as a means of improving speech recognition, comprehension, and learning by cochlear implant (CI) users in noisy contexts.Methods: Forty

  12. The influence of cochlear implant electrode position on performance

    NARCIS (Netherlands)

    Marel, K.S. van der; Briaire, J.J.; Verbist, B.M.; Muurling, T.J.; Frijns, J.H.M.

    2015-01-01

    To study the relation between variables related to cochlear implant electrode position and speech perception performance scores in a large patient population.The study sample consisted of 203 patients implanted with a CII or HiRes90K implant with a HiFocus 1 or 1J electrode of Advanced Bionics.

  13. Implants and Ethnocide: Learning from the Cochlear Implant Controversy

    Science.gov (United States)

    Sparrow, Robert

    2010-01-01

    This paper uses the fictional case of the "Babel fish" to explore and illustrate the issues involved in the controversy about the use of cochlear implants in prelinguistically deaf children. Analysis of this controversy suggests that the development of genetic tests for deafness poses a serious threat to the continued flourishing of Deaf…

  14. Paediatric cochlear implantation | MÜLLER | Continuing Medical ...

    African Journals Online (AJOL)

    Continuing Medical Education. Journal Home · ABOUT · Advanced Search · Current Issue · Archives · Journal Home > Vol 21, No 10 (2003) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. Paediatric cochlear implantation. AMU MÜLLER, DJH WAGENFELD ...

  15. Interleaved Processors Improve Cochlear Implant Patients' Spectral Resolution.

    Science.gov (United States)

    Aronoff, Justin M; Stelmach, Julia; Padilla, Monica; Landsberger, David M

    2016-01-01

    Cochlear implant patients have difficulty in noisy environments, in part, because of channel interaction. Interleaving the signal by sending every other channel to the opposite ear has the potential to reduce channel interaction by increasing the space between channels in each ear. Interleaving still potentially provides the same amount of spectral information when the two ears are combined. Although this method has been successful in other populations such as hearing aid users, interleaving with cochlear implant patients has not yielded consistent benefits. This may be because perceptual misalignment between the two ears, and the spacing between stimulation locations must be taken into account before interleaving. Eight bilateral cochlear implant users were tested. After perceptually aligning the two ears, 12-channel maps were made that spanned the entire aligned portions of the array. Interleaved maps were created by removing every other channel from each ear. Participants' spectral resolution and localization abilities were measured with perceptually aligned processing strategies both with and without interleaving. There was a significant improvement in spectral resolution with interleaving. However, there was no significant effect of interleaving on localization abilities. The results indicate that interleaving can improve cochlear implant users' spectral resolution. However, it may be necessary to perceptually align the two ears and/or use relatively large spacing between stimulation locations.

  16. Speech Recognition and Cognitive Skills in Bimodal Cochlear Implant Users

    Science.gov (United States)

    Hua, Håkan; Johansson, Björn; Magnusson, Lennart; Lyxell, Björn; Ellis, Rachel J.

    2017-01-01

    Purpose: To examine the relation between speech recognition and cognitive skills in bimodal cochlear implant (CI) and hearing aid users. Method: Seventeen bimodal CI users (28-74 years) were recruited to the study. Speech recognition tests were carried out in quiet and in noise. The cognitive tests employed included the Reading Span Test and the…

  17. Simultaneous communication and cochlear implants in the classroom?

    NARCIS (Netherlands)

    Blom, H.C.; Marschark, M.

    2015-01-01

    This study was designed to evaluate the potential of simultaneous communication (sign and speech together) to support classroom learning by college students who use cochlear implants (CIs). Metacognitive awareness of learning also was evaluated. A within-subjects design involving 40 implant users

  18. Reading comprehension of deaf children with cochlear implants

    NARCIS (Netherlands)

    Vermeulen, A.M.; Bon, W.H.J. van; Schreuder, R.; Knoors, H.E.T.; Snik, A.F.M.

    2007-01-01

    The reading comprehension and visual word recognition in 50 deaf children and adolescents with at least 3 years of cochlear implant (0) use were evaluated. Their skills were contrasted with reference data of 500 deaf children without CIs. The reading comprehension level in children with CIs was

  19. Implicit Sequence Learning in Deaf Children with Cochlear Implants

    Science.gov (United States)

    Conway, Christopher M.; Pisoni, David B.; Anaya, Esperanza M.; Karpicke, Jennifer; Henning, Shirley C.

    2011-01-01

    Deaf children with cochlear implants (CIs) represent an intriguing opportunity to study neurocognitive plasticity and reorganization when sound is introduced following a period of auditory deprivation early in development. Although it is common to consider deafness as affecting hearing alone, it may be the case that auditory deprivation leads to…

  20. Editorial From sexual orientation to cochlear transplants in a tropical ...

    African Journals Online (AJOL)

    SHS

    Infectious diseases: The infectious disease section begins with ... of health in Africa36. We conclude this discourse with case reports on perma- nent neonatal diabetes37;cochlear implant in Uganda38 ; cardiomyopathy39; and epicardial fat thickness and car- ... weight: the situation in a traditional birth home in Be- nin City ...

  1. Patient Specific Simulation for Planning of Cochlear Implantation Surgery

    DEFF Research Database (Denmark)

    Vera, Sergio; Perez, Frederic; Balust, Clara

    2014-01-01

    Cochlear implantation is a surgical procedure that can restore the hearing capabilities to patients with severe or complete functional loss. However, the level of restoration varies highly between subjects and depends on patient-specific factors. This paper presents a software application for pla...

  2. Mismatch Negativity Based Neurofeedback for Cochlear Implant Users

    NARCIS (Netherlands)

    Luckmann, Annika; Başkent, Deniz; Jolij, Jacob

    2015-01-01

    Cochlear implant (CI) users experience great difficulty when it comes to pitch discrimination. This leads to problems during daily interactions, due to poor speech perception, but also a very low pleasure ratings for music. Improving pitch perception and discrimination in CI users would improve

  3. Identification and Multiplicity of Double Vowels in Cochlear Implant Users

    Science.gov (United States)

    Kwon, Bomjun J.; Perry, Trevor T.

    2014-01-01

    Purpose: The present study examined cochlear implant (CI) users' perception of vowels presented concurrently (i.e., "double vowels") to further our understanding of auditory grouping in electric hearing. Method: Identification of double vowels and single vowels was measured with 10 CI subjects. Fundamental frequencies (F0s) of…

  4. Spelling of Deaf Children Who Use Cochlear Implants

    Science.gov (United States)

    Hayes, Heather; Kessler, Brett; Treiman, Rebecca

    2011-01-01

    The spellings of 39 profoundly deaf users of cochlear implants, aged 6 to 12 years, were compared with those of 39 hearing peers. When controlled for age and reading ability, the error rates of the 2 groups were not significantly different. Both groups evinced phonological spelling strategies, performing better on words with more typical…

  5. The acquisition of personal pronouns in cochlear-implanted children

    NARCIS (Netherlands)

    Verbist, Annemie Josee Jozef

    2010-01-01

    Today, many deaf children can be given access to oral language thanks to a cochlear implant, a surgically implanted electronic device that provides a sense of sound thanks to electric stimulation of the auditory nerve. In this study, the acquisition of personal pronouns is considered to be a measure

  6. Using Flanagan's phase vocoder to improve cochlear implant performance

    Science.gov (United States)

    Zeng, Fan-Gang

    2004-10-01

    The cochlear implant has restored partial hearing to more than 100000 deaf people worldwide, allowing the average user to talk on the telephone in quiet environment. However, significant difficulty still remains for speech recognition in noise, music perception, and tonal language understanding. This difficulty may be related to speech processing strategies in current cochlear implants that emphasized the extraction and encoding of the temporal envelope while ignoring the temporal fine structure in speech sounds. A novel strategy was developed based on Flanagan's phase vocoder [Flanagan and Golden, Bell Syst. Tech. 45, 1493-1509 (1966)], in which frequency modulation was extracted from the temporal fine structure and then added to amplitude modulation in the current cochlear implants. Acoustic simulation results showed that amplitude and frequency modulation contributed complementarily to speech perception with amplitude modulation contributing mainly to intelligibility whereas frequency modulation contributed to speaker identification and auditory grouping. The results also showed that the novel strategy significantly improved cochlear implant performance under realistic listening situations. Overall, the present result demonstrated that Flanagan's classic work on phase vocoder still shed insight on current problems of both theoretical and practical importance. [Work supported by NIH.

  7. Linguistic and Pragmatic Skills in Toddlers with Cochlear Implant

    Science.gov (United States)

    Rinaldi, Pasquale; Baruffaldi, Francesca; Burdo, Sandro; Caselli, Maria Cristina

    2013-01-01

    Background: An increasing number of deaf children received cochlear implants (CI) in the first years of life, but no study has focused on linguistic and pragmatic skills in children with CI younger than 3 years of age. Aims: To estimate the percentage of children who had received a CI before 2 years of age whose linguistic skills were within the…

  8. Spectral loudness summation for electrical stimulation in cochlear implant users

    NARCIS (Netherlands)

    Theelen-van den Hoek, Femke L.; Boymans, Monique; Dreschler, Wouter A.

    2015-01-01

    This study investigates the effect of spectral loudness summation (SLS) in the electrical domain as perceived by cochlear implant (CI) users. Analogous to SLS in the acoustical domain, SLS was defined as the effect of electrode separation at a fixed overall stimulation rate. Categorical loudness

  9. Frequency-dependent loudness balancing in bimodal cochlear implant users

    NARCIS (Netherlands)

    Veugen, L.C.E.; Chalupper, J.; Snik, A.F.M.; Opstal, A.J. van; Mens, L.H.M.

    2016-01-01

    Conclusion In users of a cochlear implant (CI) and a hearing aid (HA) in contralateral ears, frequency-dependent loudness balancing between devices did, on average, not lead to improved speech understanding as compared to broadband balancing. However, nine out of 15 bimodal subjects showed

  10. Age at implantation and auditory memory in cochlear implanted children.

    Science.gov (United States)

    Mikic, B; Miric, D; Nikolic-Mikic, M; Ostojic, S; Asanovic, M

    2014-05-01

    Early cochlear implantation, before the age of 3 years, provides the best outcome regarding listening, speech, cognition an memory due to maximal central nervous system plasticity. Intensive postoperative training improves not only auditory performance and language, but affects auditory memory as well. The aim of this study was to discover if the age at implantation affects auditory memory function in cochlear implanted children. A total of 50 cochlear implanted children aged 4 to 8 years were enrolled in this study: early implanted (1-3y) n = 27 and late implanted (4-6y) n = 23. Two types of memory tests were used: Immediate Verbal Memory Test and Forward and Backward Digit Span Test. Early implanted children performed better on both verbal and numeric tasks of auditory memory. The difference was statistically significant, especially on the complex tasks. Early cochlear implantation, before the age of 3 years, significantly improve auditory memory and contribute to better cognitive and education outcomes.

  11. Temporal processing in postlingual adult users of cochlear implant.

    Science.gov (United States)

    Duarte, Maycon; Gresele, Amanda Dal Piva; Pinheiro, Maria Madalena Canina

    2016-01-01

    Postlingual adults demonstrate impressive performance in speech recognition in silence after cochlear implant (CI) surgery. However, problems in central hearing abilities remain, which complicates understanding in certain situations, such as in competitive listening and in the perception of suprasegmental aspects of speech. To assess the temporal processing abilities in postlingual adult users of CI. Cross-sectional and descriptive study, with a non-probabilistic sample for convenience. The population was divided into two groups. The study group consisted of 12 postlingual adult users of cochlear implants and the control group consisted of 12 adults with normal hearing, matched for age and gender with the control group. The Frequency Pattern Test and the Gaps in Noise test were selected to assess temporal processing. Free-field testing was applied at 50dB SL. Adult users of cochlear implant attained a mean temporal threshold of 16.33ms and scored 47.7% in the pattern frequency test; the difference was statistically significant in comparison with the control group. It was verified that postlingual adult users of cochlear implants have significant alterations in temporal processing abilities in comparison to adults with normal hearing. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  12. Modulation of cochlear tuning by low-frequency sound

    NARCIS (Netherlands)

    Klis, J.F.L.; Prijs, V.F.; Latour, J.B.; Smoorenburg, G.F.

    1988-01-01

    An intense, low-frequency tone (about 30 Hz) modulates the sensitivity of the inner ear to high-frequency stimulation. This modulation is correlated with the displacement of the basilar membrane. The findings suggest that the modulation may also affect cochlear tuning. We have investigated

  13. The long-term concerns post cochlear implantation as experienced ...

    African Journals Online (AJOL)

    The findings of this study highlight a need for continued support for parents and families with children who have been fitted with cochlear implants. This should be through the use of a family systems perspective model that takes into account the impact on the quality of life of families with children who have a hearing loss or ...

  14. Theory of Mind and Language in Children with Cochlear Implants

    Science.gov (United States)

    Remmel, Ethan; Peters, Kimberly

    2009-01-01

    Thirty children with cochlear implants (CI children), age range 3-12 years, and 30 children with normal hearing (NH children), age range 4-6 years, were tested on theory of mind and language measures. The CI children showed little to no delay on either theory of mind, relative to the NH children, or spoken language, relative to hearing norms. The…

  15. Counselling Challenges and Strategies for Cochlear Implant Specialists

    Science.gov (United States)

    English, Kris

    2010-01-01

    Cochlear implant specialists daily observe patients and families grapple with a wide range of emotions. As nonprofessional counsellors, we can help patients address those emotions by providing more opportunities to talk about their thoughts and feelings. This paper will review some familiar counselling challenges, such as the disappointment that…

  16. Interaction of tinnitus suppression and hearing ability after cochlear implantation.

    Science.gov (United States)

    Wang, Qian; Li, Jia-Nan; Lei, Guan-Xiong; Chen, Dai-Shi; Wang, Wei-Ze; Chen, Ai-Ting; Mong, Meng-Di; Li, Sun; Jiao, Qing-Shan; Yang, Shi-Ming

    2017-10-01

    To study the postoperative impact of cochlear implants (CIs) on tinnitus, as well as the impact of tinnitus on speech recognition with CI switched on. Fifty-two postlingual deafened CI recipients (21 males and 31 females) were assessed using an established Tinnitus Characteristics Questionnaire and Tinnitus Handicap Inventory (THI) before and after cochlear implantation. The tinnitus loudness was investigated when CI was switched on and off in CI recipients with persistent tinnitus. The relation between tinnitus loudness and recipients' satisfaction of cochlear implantation was analyzed by the visual analogue scale (VAS) score. With CI 'OFF', 42 CI recipients experienced tinnitus postimplant ipsilaterally and 44 contralaterally. Tinnitus was totally suppressed ipsilateral to the CI with CI 'ON' in 42.9%, partially suppressed in 42.9%, unchanged in 11.9% and aggravated in 2.4%. Tinnitus was totally suppressed contralaterally with CI 'ON' in 31.8% of CI recipients, partially suppressed in 47.7%, unchanged in 20.5%. Pearson correlation analysis showed that tinnitus loudness and the results of cochlear implant patients satisfaction was negatively correlated (r = .674, p tinnitus. The tinnitus loudness may affect patients' satisfaction with the use of CI.

  17. Strategies for Working with Children with Cochlear Implants

    Science.gov (United States)

    Schraer-Joiner, Lyn; Prause-Weber, Manuela

    2009-01-01

    According to the National Institute on Deafness and Other Communication Disorders, 23,000 individuals in the United States, including 10,000 children, have a cochlear implant. This biomedical electronic device has been a breakthrough in the auditory rehabilitation of individuals diagnosed with severe or profound sensorineural hearing losses who…

  18. High School Students with Cochlear Implants: Coming Together for Success

    Science.gov (United States)

    Nussbaum, Debra; Chisholm, Genie; Galloway, Rebecca; Dzime-Assison, Venita; Doyle, Jane

    2017-01-01

    While many people assume that students with cochlear implants have placements in mainstream schools, almost 25 percent of the approximately 175 students at the Model Secondary School for the Deaf (MSSD), the residential high school on the campus of Gallaudet University in Washington, D.C., have an implanted listening device. Working with these…

  19. Growing up with a Cochlear Implant: Education, Vocation, and Affiliation

    Science.gov (United States)

    Spencer, Linda J.; Tomblin, J. Bruce; Gantz, Bruce J.

    2012-01-01

    The long-term educational/vocational, affiliation, and quality-of-life outcomes of the first and second cohorts of children with bilateral, profound hearing loss who received cochlear implants under a large National Institutes of Health-funded study was investigated in 41 of 61 eligible participants. Educational and vocational outcomes were…

  20. Concept Formation Skills in Long-Term Cochlear Implant Users

    Science.gov (United States)

    Castellanos, Irina; Kronenberger, William G.; Beer, Jessica; Colson, Bethany G.; Henning, Shirley C.; Ditmars, Allison; Pisoni, David B.

    2015-01-01

    This study investigated if a period of auditory sensory deprivation followed by degraded auditory input and related language delays affects visual concept formation skills in long-term prelingually deaf cochlear implant (CI) users. We also examined if concept formation skills are mediated or moderated by other neurocognitive domains (i.e.,…

  1. Cochlear Implants in the Inclusive Classroom: A Case Study

    Science.gov (United States)

    Jachova, Zora; Kovacevic, Jasmina

    2010-01-01

    This article presents a case study of a child aged 12 years with a cochlear implant who is attending a mainstream educational setting in Skopje, FYR Macedonia. The study, which uses both qualitative and quantitative data, took place over a period of 12 months. It illustrates the importance of professional development and training of teachers and a…

  2. Reading and Writing Skills of Deaf Pupils with Cochlear Implants

    Science.gov (United States)

    Mayer, Connie; Watson, Linda; Archbold, Sue; Ng, Zheng Yen; Mulla, Imran

    2016-01-01

    Thirty-three young people with cochlear implants, aged between 9 and 16 years, were assessed for use of their implant system, cognitive abilities, vocabulary, reading, and writing skills. The group came from throughout England and included 26 born deaf, six deafened by meningitis, one with auditory neuropathy, and five with additional needs.…

  3. Libyan cochlear implant programme: achievements, difficulties, and future goals

    Directory of Open Access Journals (Sweden)

    Samya El-Ogbi

    2011-05-01

    Full Text Available Cochlear implantation has become established worldwide as a safe and effective method of auditory rehabilitation of selected severely and profound deaf children and adults. Over 100,000 patients have received cochlear implants worldwide with the paediatric population proving to be the main beneficiaries. The Libyan cochlear implant programme was set up in 2004. Data relating to the patients who received cochlear implantation at Tripoli Medical Centre between October 2007 and February 2010 were analysed. Implant operations were performed on 37 patients. All patients received Med-El SONATATI 100 devices. Thirty-four (91.9% of these patients were children, whilst three (8.1% were adults. Combined, congenital hearing loss (56.8% and perinatal/neonatal (29.7% were the two main aetiological factors in children. Seventeen patients (45.9% had a positive family history of deafness. Sixteen patients (43.2% were born to blood-related parents. The overall rate of minor and major complications was 16.2%, which is comparable to previous studies.

  4. Simultaneous Communication and Cochlear Implants in the Classroom?

    NARCIS (Netherlands)

    Blom, H.C.; Marschark, M.

    2015-01-01

    This study was designed to evaluate the potential of simultaneous communication (sign and speech together) to support classroom learning by college students who use cochlear implants (CIs). Metacognitive awareness of learning also was evaluated. A within-subjects design involving 40 implant users

  5. Deaf Teenagers with Cochlear Implants in Conversation with Hearing Peers

    Science.gov (United States)

    Ibertsson, Tina; Hansson, Kristina; Maki-Torkko, Elina; Willstedt-Svensson, Ursula; Sahlen, Birgitta

    2009-01-01

    Background: This study investigates the use of requests for clarification in conversations between teenagers with a cochlear implant (CI) and hearing peers. So far very few studies have focused on conversational abilities in children with CI. Aims: The aim was to explore co-construction of dialogue in a referential communication task and the…

  6. Risk of Bacterial Meningitis in Children with Cochlear Implants

    Science.gov (United States)

    ... al. [ Read article ] Risk of Bacterial Meningitis in Children with Cochlear Implants New England Journal of Medicine; July 31, 2003; Volume 349:435-445 J. Reefhuis, M.A. Honein, C.G. Whitney, et al. [ Read article ] Related Links Birth ... Development Developmental Disabilities Learn the Signs. Act Early. ...

  7. The management of deafness with cochlear implant – our experience

    Directory of Open Access Journals (Sweden)

    Jagoda Vatovec

    2005-11-01

    Full Text Available Background: The hearing impairment has an impact on the person’s capabilities and has an influence on the quality of life. In the early childhood the acoustic information is indispensable for development of speech and language. The cochlear implant is a biomedical device that enables the deaf to hear but it cannot help all the hearing impaired individuals.Patients and methods: In the period from March 1996 to August 2004 there were 110 deaf patients who were operated on for cochlear implantation. We evaluated the ethiologic factors of deafness, the age at onset of deafness and the benefits of cochlear implant use.Results: Most of the implanted patients were congenitally deaf (60.91%. The most frequent cause of deafness was hereditary hearing loss (30.00%. The period of deafness was in majority (52.72% less than five years but a few (10.00% were deaf for more than 15 years. Reimplantation was necessary in four patients. The application and the benefits vary between the individuals but only two gave up the implant all the remainders use it every day. The communication mode in 88 patients is acoustic-oral while in 22 subjects a total method is used.Conclusions: The outcome of management of deafness by cochlear implants is comparable to other centers. Good results in congenitally deaf children support the need for universal neonatal hearing screening.

  8. Challenges in Improving Cochlear Implant Performance and Accessibility.

    Science.gov (United States)

    Zeng, Fan-Gang

    2017-08-01

    Here I identify two gaps in cochlear implants that have been limiting their performance and acceptance. First, cochlear implant performance has remained largely unchanged, despite the number of publications tripling per decade in the last 30 years. Little has been done so far to address a fundamental limitation in the electrode-to-neuron interface, with the electrode size being a thousand times larger than the neuron diameter while the number of electrodes being a thousand times less. Both the small number and the large size of electrodes produce broad spatial activation and poor frequency resolution that limit current cochlear implant performance. Second, a similarly rapid growth in cochlear implant volume has not produced an expected decrease in unit price in the same period. The high cost contributes to low market penetration rate, which is about 20% in developed countries and less than 1% in developing countries. I will discuss changes needed in both research strategy and business practice to close the gap between prosthetic and normal hearing as well as that between haves and have-nots.

  9. Passive margins through earth history

    Science.gov (United States)

    Bradley, Dwight C.

    2008-12-01

    Passive margins have existed somewhere on Earth almost continually since 2740 Ma. They were abundant at 1900-1890, 610-520, and 150-0 Ma, scarce at ca. 2445-2300, 1600-1000, and 300-275 Ma, and absent before ca. 3000 Ma and at 1740-1600. The fluctuations in abundance of passive margins track the first-order fluctuations of the independently derived seawater 87Sr/ 86Sr secular curve, and the compilation thus appears to be robust. The 76 ancient passive margins for which lifespans could be measured have a mean lifespan of 181 m.y. The world-record holder, with a lifespan of 590 m.y., is the Mesoproterozoic eastern margin of the Siberian craton. Subdivided into natural age groups, mean lifespans are 186 m.y. for the Archean to Paleoproterozoic, 394 m.y. for the Mesoproterozoic, 180 m.y. for the Neoproterozoic, 137 m.y. for the Cambrian to Carboniferous, and 130 m.y. for the Permian to Neogene. The present-day passive margins, which are not yet finished with their lifespans, have a mean age of 104 m.y. and a maximum age of 180 m.y. On average, Precambrian margins thus had longer, not shorter, lifespans than Phanerozoic ones—and this remains the case even discounting all post-300 Ma margins, most of which have time left. Longer lifespans deeper in the past is at odds with the widely held notion that the tempo of plate tectonics was faster in the Precambrian than at present. It is entirely consistent, however, with recent modeling by Korenaga [Korenaga, J., 2004. Archean geodynamics and thermal evolution of Earth. Archean Geodynamics and Environments, AGU Geophysical Monograph Series 164, 7-32], which showed that plate tectonics was more sluggish in the Precambrian. The abundance of passive margins clearly tracks the assembly, tenure, and breakup of Pangea. Earlier parts of the hypothesized supercontinent cycle, however, are only partly consistent with the documented abundance of passive margins. The passive-margin record is not obviously consistent with the proposed

  10. [Do children with cochlear implants read or write differently?: literacy acquisition after cochlear implantation].

    Science.gov (United States)

    Fiori, A; Reichmuth, K; Matulat, P; Schmidt, C-M; Am Zehnhoff-Dinnesen, A

    2010-09-01

    Despite the fact that literacy acquisition in hearing impaired children is frequently hampered, reading and writing competences continue not to be regularly evaluated and documented in children fitted with cochlear implants (CI). In this 2-year longitudinal study literacy acquisition in children fitted with CI was investigated. In total, 18 pre- and primary school children fitted with CI who had suffered prelingual deafness were examined. Subjects' ages at CI fitting ranged from 0.9 to 5.9 years; they were raised orally and monolingual German and showed normal intellectual achievement. Familial risk of developing dyslexia was ruled out. To assess subjects' literacy acquisition precursor and partial abilities in reading and writing according to dual route and developmental models were examined three times within 2 years. Precursor abilities included development of vocabulary and phonological awareness. Partial abilities were mastery in sublexical and lexical word processing in reading and writing as well as auditory and visual working memory. Subjects showed a broad range in performance regarding vocabulary development as well as literacy. Discrepant results in terms of age equivalent visual and underachievement in auditory working memory as well as good achievement in implicit phonological awareness and weakness in explicit demands on phoneme analysis and manipulation of phonemes can be described. Indications were that subjects tended towards lip reading the instructor's item presentation. Performance in the administered writing test reveals a preference for lexical word processing, whereas sublexical word processing seems to make relatively higher demands on subjects. Easier processing of visual information in partial and precursor abilities are consistent with a tendency to prefer a visual-lexical processing strategy. The presented study stresses the importance of generally assessing reading and writing skills when evaluating language development in children

  11. Progression of changes in the sensorial elements of the cochlear and peripheral vestibular systems: The otitis media continuum.

    Science.gov (United States)

    Monsanto, Rafael da Costa; Schachern, Patricia; Paparella, Michael M; Cureoglu, Sebahattin; Penido, Norma de Oliveira

    2017-08-01

    Our study aimed to evaluate pathologic changes in the cochlear (inner and outer hair cells and stria vascularis) and vestibular (vestibular hair cells, dark, and transitional cells) sensorial elements in temporal bones from donors who had otitis media. We studied 40 temporal bones from such donors, which were categorized in serous otitis media (SOM), serous-purulent otitis media (SPOM), mucoid/mucoid-purulent otitis media (MOM/MPOM), and chronic otitis media (COM); control group comprised 10 nondiseased temporal bones. We found significant loss of inner and outer cochlear hair cells in the basal turn of the SPOM, MOM/MPOM and COM groups; significant loss of vestibular hair cells was observed in the MOM/MPOM and COM groups. All otitis media groups had smaller mean area of the stria vascularis in the basal turn of the cochlea when compared to controls. In conclusion, our study demonstrated more severe pathologic changes in the later stages of the continuum of otitis media (MOM/MPOM and COM). Those changes seem to progress from the basal turn of the cochlea (stria vascularis, then inner and outer hair cells) to the middle turn of the cochlea and to the saccule and utricle in the MOM/MPOM and COM stages. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. [Sinaloa: the geography of marginalization].

    Science.gov (United States)

    Aguayo Hernandez, J R

    1993-01-01

    Sinaloa's State Population Program for 1993-98 contains the objective of promoting integration of demographic criteria into the planning process. The action program calls for establishing indicators of economic and social inequality so that conditions of poverty and margination can be identified. To further these goals, the State Population Council used data from the National Population Council project on regional inequality and municipal margination in Mexico to analyze margination at the state level. Nine indicators of educational status, housing conditions, spatial distribution, and income provide information that allows the definition of municipios and regions that should receive priority in economic and social development programs. The index of municipal margination (IMM) is a statistical summary of the nine indicators, which are based on information in the 1990 census. As of March 1990, 9.9% of Sinaloa's population over age 15 was illiterate and 37.4% had incomplete primary education. 91.0% had electricity, but 18.7% lacked indoor toilet facilities and 19.4% had no piped water. 23.7% of houses had dirt floors. 60% of households were crowded, defined as having more than two persons per bedroom. 43.5% of the state population lived in localities with fewer than 5000 inhabitants, where service delivery is difficult and costly. 55.6% of the economically active population was judged to earn less than the amount needed to satisfy essential needs. All except one municipio bordering the Pacific ocean had low or very low indicators of margination, while all those in the sierra had a medium or high degree of margination. Sinaloa's statewide IMM was eighteenth among Mexico's 32 federal entities, with Chiapas showing the highest degree of margination and the Federal District the lowest.

  13. Self-reports about tinnitus and about cochlear implants.

    Science.gov (United States)

    Noble, W

    2000-08-01

    Analyze literature on self-report outcomes in two areas of audiological rehabilitation: 1) tinnitus and 2) cochlear implant hearing aids. 1) Tinnitus: survey of features in the development of self-report approaches and of formal scales used in assessment of tinnitus disability and handicaps. 2) Cochlear implants: summary of the literature using self-report approaches to cochlear implant experience that indicates points of theoretical significance. 1) Major features of tinnitus are: a) disabilities such as interference with and distortion of normal auditory perception; b) handicaps such as emotional distress, interference with sleep, and with personal and social life. Nonauditory factors-chronic depression, high self-focused attention-mediate the degree of experienced tinnitus handicap. 2) People with prelingual loss of hearing report that a cochlear implant primarily enables improved detection and discrimination of environmental sound; those with postlingual loss find that an implant in addition provides improved speech recognition. 1) Coping with tinnitus is influenced by the personal resources that can be brought to bear on the experience, highlighting a general point that any rehabilitation outcome is not only a matter of acoustical solutions. By the same token, tinnitus can be easier to cope with if its "psychoacoustic presence" can be diminished by some form of masking. 2) Cochlear implants fitted in childhood that do not provide meaningful input signals in real-world settings may be rejected in adolescence. 3) "Hearing," as a capacity, does not have a fixed worth. Different circumstances mean it will be taken as desirable or as delivering torment (extreme tinnitus, e.g.). Its value will also vary depending on the extent of a person's access to spoken language (aiding in very early childhood, e.g.).

  14. Utility of MRIs in adult cochlear implant evaluations.

    Science.gov (United States)

    Jiang, Zi Yang; Odiase, Eunice; Isaacson, Brandon; Roland, Peter S; Kutz, J Walter

    2014-10-01

    To determine the prevalence of MRI abnormalities in adults undergoing cochlear implantation and to correlate abnormalities to audiology data. Case series. Academic medical center. Adult patients (>18 yr old) undergoing cochlear implant evaluation from January 2008 to December 2012 were identified based on CPT code search. Demographics, preoperative MRI findings, operative findings, and audiometric data were collected. The study included 188 patients. Seventeen (9%) patients had significant otic capsule or vestibulocochlear nerve pathologies: 5 vestibular schwannomas, 4 enlarged vestibular aqueducts, 2 hypoplastic cochlear nerves, 2 labyrinthitis ossificans, 1 cochlear aplasia, 1 posterior semicircular canal malformation, 1 calcified meningioma, and 1 cholesterol granuloma. MRI results were normal (65%) or with findings not directly related to hearing loss (incidental findings, 25%) in the remaining patients. Mean pure tone average (PTA) differences (between the implanted and contralateral ear) did not significantly vary between normal-incidental and abnormal MRI scans (-6.6 dB versus -6.7 dB, p = 0.99) nor did speech discrimination scores (SDS) scores (8.5% versus 8.4%, p = 0.99). No significant difference was found in HINT scores for patients with a normal versus an abnormal MRI (19% versus 16,%, p = 0.62). Although the majority of precochlear implantation MRIs were normal or demonstrated incidental findings, such as white matter changes, significant MRI findings affecting implantation site and patient counseling were found in almost 10% of patients. Audiogram findings did not correlate with abnormal findings on MRIs. Routine use of MRI in adult cochlear implant candidates may be warranted.

  15. Factors contributing to communication skills development in cochlear implanted children.

    Science.gov (United States)

    Ostojić, Sanja; Djoković, Sanja; Radić-šestić, Marina; Nikolić, Mina; Mikić, Branka; Mirić, Danica

    2015-08-01

    Over the last 10 years more than 300 persons received cochlear implant in Serbia and more than 90% of the recipients were children under 10 years of age. The program of cochlear implantation includes postoperative rehabilitation in which cognitive, integrative and developmental methods are used. The study was conducted to reveal factors affecting communication performance (CP) of cochlear implanted (Cl) children. Special attention was focused on the influence of the duration and intensity of rehabilitation and hearing age on further development of communication skills. A group of 30 CI children (13 boys and 17 girls) aged 2 to 5 years was enrolled in the study. All of the children had average intelligence and no other developmental disorder. They lived in families and attended rehabilitative seances 3 to 5 times a week. Their parents/caregivers answered structured questionnaire about functioning after pediatric cochlear implantation (FAPCI) and the results were the subject of detailed statistical analysis. Analysis of variance did not show any difference between the boys and the girls regarding FAPCI achievements (F(1, 28) = 2.909; p = 0.099) and age aberration in CP score (F(1,28) = 0.114, p = 0.738). Correlation analysis showed a statistically significant difference in FAPCI scores related to hearing age and duration of rehabilitation. Regression analysis (enter method) showed that model consisting of indipendent variables significantly contributed to prediction of overall FAPCI scores and Adjusted R2 value could explain 32% difference in communication skills of participants in this study. Communication skills of CI children evaluated by FAPCI are falling behind normatives for normal hearing children 18.6 months on the average. Hearing age, duration and intensity of rehabilitation have positive predictive value for communication skills development. Later identification of hearing loss and later cochlear implantation lead to delayed development of communication

  16. Electroacoustic verification of frequency modulation systems in cochlear implant users.

    Science.gov (United States)

    Fidêncio, Vanessa Luisa Destro; Jacob, Regina Tangerino de Souza; Tanamati, Liége Franzini; Bucuvic, Érika Cristina; Moret, Adriane Lima Mortari

    2017-12-26

    The frequency modulation system is a device that helps to improve speech perception in noise and is considered the most beneficial approach to improve speech recognition in noise in cochlear implant users. According to guidelines, there is a need to perform a check before fitting the frequency modulation system. Although there are recommendations regarding the behavioral tests that should be performed at the fitting of the frequency modulation system to cochlear implant users, there are no published recommendations regarding the electroacoustic test that should be performed. Perform and determine the validity of an electroacoustic verification test for frequency modulation systems coupled to different cochlear implant speech processors. The sample included 40 participants between 5 and 18 year's users of four different models of speech processors. For the electroacoustic evaluation, we used the Audioscan Verifit device with the HA-1 coupler and the listening check devices corresponding to each speech processor model. In cases where the transparency was not achieved, a modification was made in the frequency modulation gain adjustment and we used the Brazilian version of the "Phrases in Noise Test" to evaluate the speech perception in competitive noise. It was observed that there was transparency between the frequency modulation system and the cochlear implant in 85% of the participants evaluated. After adjusting the gain of the frequency modulation receiver in the other participants, the devices showed transparency when the electroacoustic verification test was repeated. It was also observed that patients demonstrated better performance in speech perception in noise after a new adjustment, that is, in these cases; the electroacoustic transparency caused behavioral transparency. The electroacoustic evaluation protocol suggested was effective in evaluation of transparency between the frequency modulation system and the cochlear implant. Performing the adjustment of

  17. Cochlear coordinates in regard to cochlear implantation: a clinically individually applicable 3 dimensional CT-based method.

    NARCIS (Netherlands)

    Verbist, B.M.; Joemai, R.M.; Briaire, J.J.; Teeuwisse, W.M.; Veldkamp, W.J.H.; Frijns, J.H.

    2010-01-01

    SETTING: Cochlear implant (CI)/tertiary referral center. SUBJECTS: Twenty-five patients implanted with an Advanced Bionics HiRes90K HiFocus1J CI. STUDY DESIGN/MAIN OUTCOME MEASURES: A 3-dimensional cylindrical coordinate system is introduced using the basal turn of the cochlea as the x and y planes

  18. Brazilian adaptation of the Functioning after Pediatric Cochlear Implantation (FAPCI): comparison between normal hearing and cochlear implanted children.

    Science.gov (United States)

    Vassoler, Trissia M F; Cordeiro, Mara L

    2015-01-01

    Enabling development of the ability to communicate effectively is the principal objective of cochlear implantation (CI) in children. However, objective and effective metrics of communication for cochlear-implanted Brazilian children are lacking. The Functioning after Pediatric Cochlear Implantation (FAPCI), a parent/caregiver reporting instrument developed in the United States, is the first communicative performance scale for evaluation of real-world verbal communicative performance of 2-5-year-old children with cochlear implants. The primary aim was to cross-culturally adapt and validate the Brazilian-Portuguese version of the FAPCI. The secondary aim was to conduct a trial of the adapted Brazilian-Portuguese FAPCI (FAPCI-BP) in normal hearing (NH) and CI children. The American-English FAPCI was translated by a rigorous forward-backward process. The FAPCI-BP was then applied to the parents of children with NH (n=131) and CI (n=13), 2-9 years of age. Test-retest reliability was verified. The FAPCI-BP was confirmed to have excellent internal consistency (Cronbach's alpha > 0.90). The CI group had lower FAPCI scores (58.38 ± 22.6) than the NH group (100.38 ± 15.2; pimplanted children. Copyright © 2014 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  19. Speech and language outcomes of cochlear implantation in children with isolated auditory neuropathy versus cochlear hearing loss.

    Science.gov (United States)

    Budenz, Cameron L; Starr, Kelly; Arnedt, Caroline; Telian, Steven A; Arts, Henry Alexander; El-Kashlan, Hussam K; Zwolan, Terry A

    2013-12-01

    Children with auditory neuropathy (AN) have variable hearing on pure tone testing, and the presence of speech and language delays often play a major role in the decision to offer cochlear implantation (CI) in this population. Despite this fact, the speech and language outcomes in this group after CI are not well described. This study compares speech and language outcomes after CI in a subset of the pediatric AN population that does not have a confounding cognitive disorder with those of their peers with cochlear hearing loss (CoHL). Retrospective chart review. Tertiary referral center. Seventeen pediatric patients with AN who received a CI and a group of children with CoHL who received a CI were the subjects of this study. The 2 groups demonstrated similar ages at implant. Children with cognitive delays were excluded from each group. Cochlear implantation. All subjects were evaluated preoperatively and postoperatively with standardized age appropriate speech and language measures, including the Expressive Vocabulary Test (EVT), Peabody Picture Vocabulary Test (PPVT), and Preschool Language Scale (PLS). There was no significant difference between the groups on age of activation of the CI. Children with a diagnosis of AN had a significantly lower unaided pure tone average preoperatively as compared with children with cochlear hearing loss; however, there was no significant difference between the groups on either their preimplantation or postimplantation speech and language scores. Children with a diagnosis of AN without associated cognitive or developmental disorders have speech and language outcomes comparable to other children who received a CI.

  20. Effects of furosemide on cochlear neural activity, central hyperactivity and behavioural tinnitus after cochlear trauma in guinea pig.

    Science.gov (United States)

    Mulders, Wilhelmina H A M; Barry, Kristin M; Robertson, Donald

    2014-01-01

    Cochlear trauma causes increased spontaneous activity (hyperactivity) to develop in central auditory structures, and this has been suggested as a neural substrate for tinnitus. Using a guinea pig model we have previously demonstrated that for some time after cochlear trauma, central hyperactivity is dependent on peripheral afferent drive and only later becomes generated intrinsically within central structures. Furosemide, a loop diuretic, reduces spontaneous firing of auditory afferents. We investigated in our guinea pig model the efficacy of furosemide in reducing 1) spontaneous firing of auditory afferents, using the spectrum of neural noise (SNN) from round window recording, 2) hyperactivity in inferior colliculus, using extracellular single neuron recordings and 3) tinnitus at early time-points after cochlear trauma. Tinnitus was assessed using gap prepulse inhibition of acoustic startle (GPIAS). Intraperitoneal furosemide, but not saline, caused a marked decrease in both SNN and central hyperactivity. Intracochlear perfusion with furosemide similarly reversed central hyperactivity. In animals in which GPIAS measurements suggested the presence of tinnitus (reduced GPIAS), this could be reversed with an intraperitoneal injection with furosemide but not saline. The results are consistent with furosemide reducing central hyperactivity and behavioural signs of tinnitus by acting peripherally to decrease spontaneous firing of auditory afferents. The data support the notion that hyperactivity may be involved in the generation of tinnitus and further suggest that there may be a therapeutic window after cochlear trauma using drug treatments that target peripheral spontaneous activity.

  1. Automatic segmentation of intra-cochlear anatomy in post-implantation CT of unilateral cochlear implant recipients.

    Science.gov (United States)

    Reda, Fitsum A; McRackan, Theodore R; Labadie, Robert F; Dawant, Benoit M; Noble, Jack H

    2014-04-01

    A cochlear implant (CI) is a neural prosthetic device that restores hearing by directly stimulating the auditory nerve using an electrode array that is implanted in the cochlea. In CI surgery, the surgeon accesses the cochlea and makes an opening where he/she inserts the electrode array blind to internal structures of the cochlea. Because of this, the final position of the electrode array relative to intra-cochlear anatomy is generally unknown. We have recently developed an approach for determining electrode array position relative to intra-cochlear anatomy using a pre- and a post-implantation CT. The approach is to segment the intra-cochlear anatomy in the pre-implantation CT, localize the electrodes in the post-implantation CT, and register the two CTs to determine relative electrode array position information. Currently, we are using this approach to develop a CI programming technique that uses patient-specific spatial information to create patient-customized sound processing strategies. However, this technique cannot be used for many CI users because it requires a pre-implantation CT that is not always acquired prior to implantation. In this study, we propose a method for automatic segmentation of intra-cochlear anatomy in post-implantation CT of unilateral recipients, thus eliminating the need for pre-implantation CTs in this population. The method is to segment the intra-cochlear anatomy in the implanted ear using information extracted from the normal contralateral ear and to exploit the intra-subject symmetry in cochlear anatomy across ears. To validate our method, we performed experiments on 30 ears for which both a pre- and a post-implantation CT are available. The mean and the maximum segmentation errors are 0.224 and 0.734mm, respectively. These results indicate that our automatic segmentation method is accurate enough for developing patient-customized CI sound processing strategies for unilateral CI recipients using a post-implantation CT alone

  2. Studies on correlation of positive surgical margin with clinicopathological factors and prognoses in breast conserving surgery

    Energy Technology Data Exchange (ETDEWEB)

    Nishimura, Reiki; Nagao, Kazuharu; Miyayama, Haruhiko [Kumamoto City Hospital (Japan)

    1999-09-01

    Out of 484 cases with breast conserving surgery between April 1989 and March 1999, surgical procedures of 34 cases were changed to total mastectomy due to positive surgical margins. In this study we evaluated a clinical significance of surgical margin in relation to clinicopathological factors and prognoses. Ninety-nine cases (20.5%) had positive margins that were judged when cancer cells existed within 5 mm from margin. In multivariate analysis of factors for surgical margin, EIC-comedo status, ly, located site, proliferative activity, and age were significant and independent factors. Regarding local recurrence, positive margin, age, ER and proliferative activity were significant factors in multivariate analysis, especially in cases not receiving postoperative radiation therapy. Radiation therapy may be beneficial for patients with positive surgical margin. And patients with breast recurrence alone had significantly higher survival rates. Therefore, it is suggested that surgical margin may not reflect survival, although it is a significant factor for local recurrence. (author)

  3. MED-EL Cochlear Implants: State of the Art and a Glimpse Into the Future

    Science.gov (United States)

    Hochmair, Ingeborg; Nopp, Peter; Jolly, Claude; Schmidt, Marcus; Schößer, Hansjörg; Garnham, Carolyn; Anderson, Ilona

    2006-01-01

    Cochlear implantation is an accepted treatment method for adults and children with severe to profound hearing loss. Confidence in technology has led to changes in individuals who can receive a cochlear implant and changes in expected benefit with a cochlear implant. This article describes the research and development activities at MED-EL, which make possible the implementation of new speech-coding strategies as well as the application of acoustic and electric stimulation via a combined speech processor in MED-EL devices. Research on benefits from bilateral cochlear implantation and electric-acoustic stimulation are also reviewed. Finally, the potential of drug delivery systems is considered as a way to improve cochlear implant outcomes, and results from preliminary evaluations of a hybrid cochlear implant system with drug delivery capabilities are reported. PMID:17172548

  4. Brazilian adaptation of the Functioning after Pediatric Cochlear Implantation (FAPCI: comparison between normal hearing and cochlear implanted children

    Directory of Open Access Journals (Sweden)

    Trissia M.F. Vassoler

    2015-04-01

    Full Text Available OBJECTIVE: Enabling development of the ability to communicate effectively is the principal objective of cochlear implantation (CI in children. However, objective and effective metrics of communication for cochlear-implanted Brazilian children are lacking . The Functioning after Pediatric Cochlear Implantation (FAPCI, a parent/caregiver reporting instrument developed in the United States, is the first communicative performance scale for evaluation of real-world verbal communicative performance of 2-5-year-old children with cochlear implants. The primary aim was to cross-culturally adapt and validate the Brazilian-Portuguese version of the FAPCI. The secondary aim was to conduct a trial of the adapted Brazilian-Portuguese FAPCI (FAPCI-BP in normal hearing (NH and CI children. METHODS: The American-English FAPCI was translated by a rigorous forward-backward process. The FAPCI-BP was then applied to the parents of children with NH (n = 131 and CI (n = 13, 2-9 years of age. Test-retest reliability was verified. RESULTS: The FAPCI-BP was confirmed to have excellent internal consistency (Cronbach's alpha > 0.90. The CI group had lower FAPCI scores (58.38 ± 22.6 than the NH group (100.38 ± 15.2; p < 0.001, Wilcoxon test. CONCLUSION: The present results indicate that the FAPCI-BP is a reliable instrument. It can be used to evaluate verbal communicative performance in children with and without CI. The FAPCI is currently the only psychometrically-validated instrument that allows such measures in cochlear-implanted children.

  5. Using channel-specific statistical models to detect reverberation in cochlear implant stimuli

    OpenAIRE

    Desmond, Jill M.; Collins, Leslie M.; Throckmorton, Chandra S.

    2013-01-01

    Reverberation is especially detrimental for cochlear implant listeners; thus, mitigating its effects has the potential to provide significant improvements to cochlear implant communication. Efforts to model and correct for reverberation in acoustic listening scenarios can be quite complex, requiring estimation of the room transfer function and localization of the source and receiver. However, due to the limited resolution associated with cochlear implant stimulation, simpler processing for re...

  6. Study of Phonological Awareness of Preschool and School Aged Children with Cochlear Implant and Normal Hearing

    OpenAIRE

    Rastegarianzadeh, Niloufar; Shahbodaghi, Mohammadrahim; Faghihzadeh, Soghrat

    2014-01-01

    Background and Objectives The primary purpose of this study was to assess whether very early access to speech sounds provided by the cochlear implant enables children to develop age-appropriate phonological awareness abilities in their preschool and school years. A secondary purpose of this study was to examine whether children who had cochlear implantation before 18 months of age will develop better skills in phonological awareness than children who had cochlear implants in 18-36 months of a...

  7. Contralateral cochlear effects of ipsilateral damage: no evidence for interaural coupling

    OpenAIRE

    Larsen, Erik; Liberman, M. Charles

    2009-01-01

    Lesion studies of the olivocochlear efferents have suggested that feedback via this neuronal pathway normally maintains an appropriate binaural balance in excitability of the two cochlear nerves (Darrow et al., 2006). If true, a decrease in cochlear nerve output from one ear, due to conductive or sensorineural hearing loss, should change cochlear nerve response in the opposite ear via modulation in olivocochlear feedback. To investigate this putative efferent-mediated interaural coupling, we ...

  8. Outcomes of cochlear implantation in deaf children of deaf parents: comparative study.

    Science.gov (United States)

    Hassanzadeh, S

    2012-10-01

    This retrospective study compared the cochlear implantation outcomes of first- and second-generation deaf children. The study group consisted of seven deaf, cochlear-implanted children with deaf parents. An equal number of deaf children with normal-hearing parents were selected by matched sampling as a reference group. Participants were matched based on onset and severity of deafness, duration of deafness, age at cochlear implantation, duration of cochlear implantation, gender, and cochlear implant model. We used the Persian Auditory Perception Test for the Hearing Impaired, the Speech Intelligibility Rating scale, and the Sentence Imitation Test, in order to measure participants' speech perception, speech production and language development, respectively. Both groups of children showed auditory and speech development. However, the second-generation deaf children (i.e. deaf children of deaf parents) exceeded the cochlear implantation performance of the deaf children with hearing parents. This study confirms that second-generation deaf children exceed deaf children of hearing parents in terms of cochlear implantation performance. Encouraging deaf children to communicate in sign language from a very early age, before cochlear implantation, appears to improve their ability to learn spoken language after cochlear implantation.

  9. Behavioral estimates of cochlear nonlinearity and its effects on normal and impaired hearing

    Science.gov (United States)

    Oxenham, Andrew J.; Plack, Christopher J.

    2002-05-01

    Recent physiological studies of basilar-membrane motion have clarified many aspects of normal and pathological cochlear processing. The compressive input-output function in response to tones around the characteristic frequency and the sharp tuning at low levels are examples of basilar-membrane properties that are thought to be important for hearing, but that are also highly vulnerable to cochlear damage. Aspects of auditory perception influenced by cochlear nonlinearity include loudness and dynamic range, temporal processing, and frequency selectivity. Functional models have assisted us in understanding the perceptual consequences of peripheral nonlinearity in a wide variety of psychoacoustic tasks. In addition, many effects of cochlear hearing loss can be simulated within such a model simply by reducing or eliminating the nonlinearity within the model. A number of behavioral measures of cochlear nonlinearity in humans have been developed in recent years. These techniques offer insights into human cochlear processing in general, and may also provide diagnostic information about cochlear function on an individual basis. By gaining a better understanding of the changes in cochlear processing associated with hearing loss, it may be possible to design sound-processing algorithms for hearing aids that better compensate for the effects of cochlear damage. [Work supported by NIH Grant R01DC03909.

  10. Silicone allergy: A new cause for cochlear implant extrusion and its management.

    Science.gov (United States)

    Kunda, Larisa D; Stidham, Katrina R; Inserra, Michelle M; Roland, Peter S; Franklin, Daniel; Roberson, Joseph B

    2006-12-01

    We introduce silicone allergy as a rare cause for cochlear implant extrusion and discuss its management. Retrospective case series and literature review. Tertiary referral centers. Primary eligibility criteria included patients who experienced a delayed extrusion of their cochlear implants with negative wound cultures and had a suspected or a test-proven allergy to silicone components of an implant. Silicone allergy testing, explantation of a cochlear implant containing allergenic silicone materials, reimplantation with a custom-made cochlear implant excluding an allergenic silicone component. Uneventful wound healing and extrusion-free long-term follow-up after the reimplantation with a custom-made cochlear implant excluding an allergenic silicone component. Three known cases of cochlear implant extrusion as a result of silicone allergy have been noted from 1991 through 2004 in three cochlear implant programs in the United States. All three devices extruded, resulting in explantation of the old device and reimplantation with a new custom-made device eliminating the allergenic silicone component. Wound cultures were negative in all cases. All three patients experienced a delayed extrusion of their devices. Two of these patients had a test-proven allergy to the implant's silicone components, whereas the third patient was presumed to have a hypersensitivity solely on the basis of a clinical presentation. We propose that silicone allergy is a rare cause of cochlear implant extrusion. Patients experiencing cochlear implant extrusion, particularly with a delayed onset and negative wound culture results, should be tested for silicone allergy.

  11. 17 CFR 41.45 - Required margin.

    Science.gov (United States)

    2010-04-01

    ... 17 Commodity and Securities Exchanges 1 2010-04-01 2010-04-01 false Required margin. 41.45 Section... PRODUCTS Customer Accounts and Margin Requirements § 41.45 Required margin. (a) Applicability. Each security futures intermediary shall determine the required margin for the security futures and related...

  12. 12 CFR 220.4 - Margin account.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 3 2010-01-01 2010-01-01 false Margin account. 220.4 Section 220.4 Banks and... BROKERS AND DEALERS (REGULATION T) § 220.4 Margin account. (a) Margin transactions. (1) All transactions not specifically authorized for inclusion in another account shall be recorded in the margin account...

  13. 17 CFR 242.403 - Required margin.

    Science.gov (United States)

    2010-04-01

    ... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false Required margin. 242.403...) REGULATIONS M, SHO, ATS, AC, AND NMS AND CUSTOMER MARGIN REQUIREMENTS FOR SECURITY FUTURES Customer Margin Requirements for Security Futures § 242.403 Required margin. (a) Applicability. Each security futures...

  14. Localization in reverberation with cochlear implants: predicting performance from basic psychophysical measures.

    Science.gov (United States)

    Kerber, Stefan; Seeber, Bernhard U

    2013-06-01

    Users of bilateral cochlear implants (CIs) experience difficulties localizing sounds in reverberant rooms, even in rooms where normal-hearing listeners would hardly notice the reverberation. We measured the localization ability of seven bilateral CI users listening with their own devices in anechoic space and in a simulated reverberant room. To determine factors affecting performance in reverberant space we measured the sensitivity to interaural time differences (ITDs), interaural level differences (ILDs), and forward masking in the same participants using direct computer control of the electric stimulation in their CIs. Localization performance, quantified by the coefficient of determination r(2) and the root mean squared error, was significantly worse in the reverberant room than in anechoic conditions. Localization performance in the anechoic room, expressed as r(2), was best predicted by subject's sensitivity to ILDs. However, the decrease in localization performance caused by reverberation was better predicted by the sensitivity to envelope ITDs measured on single electrode pairs, with a correlation coefficient of 0.92. The CI users who were highly sensitive to envelope ITDs also better maintained their localization ability in reverberant space. Results in the forward masking task added only marginally to the predictions of localization performance in both environments. The results indicate that envelope ITDs provided by CI processors support localization in reverberant space. Thus, methods that improve perceptual access to envelope ITDs could help improve localization with bilateral CIs in everyday listening situations.

  15. Direct testing of the biasing effect of manipulations of endolymphatic pressure on cochlear mechanical function

    Science.gov (United States)

    LePage, Eric; Avan, Paul

    2015-12-01

    The history of cochlear mechanical investigations has been carried out in two largely separate sets of endeavours; those interested in auditory processing in animal models and those interested in the origin of adverse vestibular symptoms in humans. In respect of the first, mechanical vibratory data is considered pathological and not representative of pristine behaviour if it departs from the reigning model of sharp tuning and high hearing sensitivity. Conversely, when the description of the pathological behaviour is the focus, fluid movements responsible for hearing loss and vestibular symptoms dominate. Yet both extensive sets of data possess a common factor now being reconsidered for its potential to shed light on the mechanisms in general. The common factor is a mechanical bias — the departure of cochlear epithelial membranes from their usual resting position. In both cases the bias modulates hearing sensitivity and distorts tuning characteristics. Indeed several early sets of guinea pig mechanical data were dismissed as "pathological" when in hindsight, the primary effect influencing the data was not loss of outer hair cell function per se, but a mechanical bias unknowingly introduced in process of making the measurement. Such biases in the displacement of the basilar membrane from its position are common, and may be caused by low-frequency sounds (topically including infrasound) or by variations in fluid volume in the chambers particularly applying the case of endolymphatic hydrops. Most biases are quantified in terms of visualisation of fluid volume change, electric potential changes and otoacoustic emissions. Notably many previous studies have also searched for raised pressures with negative results. Yet these repeated findings are contrary to the widespread notion that, at least when homeostasis is lost, it is a rise in endolymphatic pressure which is responsible for membrane rupture and Meniere's attacks. This current investigation in Mongolian gerbils

  16. Selective degeneration of synapses in the dorsal cochlear nucleus of chinchilla following acoustic trauma and effects of antioxidant treatment.

    Science.gov (United States)

    Du, Xiaoping; Chen, Kejian; Choi, Chul-Hee; Li, Wei; Cheng, Weihua; Stewart, Charles; Hu, Ning; Floyd, Robert A; Kopke, Richard D

    2012-01-01

    The purpose of this study was to reveal synaptic plasticity within the dorsal cochlear nucleus (DCN) as a result of noise trauma and to determine whether effective antioxidant protection to the cochlea can also impact plasticity changes in the DCN. Expression of synapse activity markers (synaptophysin and precerebellin) and ultrastructure of synapses were examined in the DCN of chinchilla 10 days after a 105 dB SPL octave-band noise (centered at 4 kHz, 6 h) exposure. One group of chinchilla was treated with a combination of antioxidants (4-hydroxy phenyl N-tert-butylnitrone, N-acetyl-l-cysteine and acetyl-l-carnitine) beginning 4 h after noise exposure. Down-regulated synaptophysin and precerebellin expression, as well as selective degeneration of nerve terminals surrounding cartwheel cells and their primary dendrites were found in the fusiform soma layer in the middle region of the DCN of the noise exposure group. Antioxidant treatment significantly reduced synaptic plasticity changes surrounding cartwheel cells. Results of this study provide further evidence of acoustic trauma-induced neural plasticity in the DCN and suggest that loss of input to cartwheel cells may be an important factor contributing to the emergence of hyperactivity in the DCN after noise exposure. Results further suggest that early antioxidant treatment for acoustic trauma not only rescues cochlear hair cells, but also has impact on central auditory structures. Copyright © 2011 Elsevier B.V. All rights reserved.

  17. Marginality and Variability in Esperanto.

    Science.gov (United States)

    Brent, Edmund

    This paper discusses Esperanto as a planned language and refutes three myths connected to it, namely, that Esperanto is achronical, atopical, and apragmatic. The focus here is on a synchronic analysis. Synchronic variability is studied with reference to the structuralist determination of "marginality" and the dynamic linguistic…

  18. Marginality and the OD Practitioner

    Science.gov (United States)

    Browne, Philip J.; And Others

    1977-01-01

    Marginality can be associated with personal qualities of neutrality, open-mindedness, and flexibility in processing information, all of which can be useful and desirable, both personally and organizationally. Available from: JABS Order Dept., NTL Institute for Applied Behavioral Science, P.O. Box 9155, Rosslyn Station, Arlington, Virginia 22209…

  19. [Deviations of spontaneous firing in the cochlear nucleus of the frog from the renewal point process].

    Science.gov (United States)

    Bibikov, N G; Dymov, A B

    2007-01-01

    The analysis of statistical characteristics of spontaneous activity (distribution of interpulse intervals, hazard function, autocorrelation function, autocorrelation function for a process with shifted intervals, interdependence between adjoining intervals) for 123 units located in the cochlear nucleus of the frog has been performed. In the majority of cells, this activity was distinct from the poissonic process, and in some cases firing periodicity was noticed. Besides, deviations of the spontaneous activity from the renewal process were usually observed. A reliable positive correlation of interpulse intervals was typical for the majority of the units, though in some cases a negative correlation of short adjoining intervals was revealed. The data indicate the occurrence of effects of memory in the activity of single units of the acoustical system.

  20. Determining the Identity of the Cochlear Amplifier:. Electrical Stimulation of the Tecta Mouse Cochlea

    Science.gov (United States)

    Lagarde, Marcia M. Mellado; Drexl, Markus; Lukashkina, Victoria A.; Lukashkin, Andrei N.; Russell, Ian J.

    2009-02-01

    The sensitivity, large dynamic range and narrow frequency tuning of the mammalian cochlea is determined by the passive mechanical properties of the basilar membrane (BM) and active feedback from the outer hair cells (OHCs). Two mechanisms have been proposed to provide amplification: Hair bundle motility, and OHC somatic-motility. Acoustically- and electrically-elicited mechanical responses were measured from the BMs of the cochleae of wild type and genetically modified mice where the hair bundles are freestanding and cannot react against the tectorial membrane (TM) to contribute to amplification. We found the electrically elicited responses in mutant mice, where only somatic motility can provide amplification, to be remarkably similar to acoustical and electrical responses in the wild type animals. We, therefore, conclude that somatic, not stereocilia motility is the basis of the cochlear amplifier.