The Cost of Meniere's Disease: A Novel Multisource Approach.

Objectives: To estimate the annual cost of Meniere's disease and the cost per person in the UK population and to investigate the direct and indirect costs of the condition. Design: The authors utilized a multidata approach to provide the first estimate of the cost of Meniere's. Data from the UK Biobank (a study of 500,000 individuals collected between 2007 and 2012), the Hospital Episode Statistics (data on all hospital admissions in England from 2008 to 2012) and the UK Meniere's Society (2014) were used to estimate the cost of Meniere's. Cases were self-reported in the UK Biobank and UK Meniere's Society, within the Hospital Episode Statistics cases were clinician diagnosed. The authors estimated the direct and indirect costs of the condition, using count data to represent numbers of individuals reporting specific treatments, operations etc. and basic statistical analyses ([chi]2 tests, linear and logistic regression) to compare cases and controls in the UK Biobank. Results: Meniere's was estimated to cost between [pounds]541.30 million and [pounds]608.70 million annually (equivalent to US $829.9 to $934.2 million), equating to [pounds]3,341 to [pounds]3,757 ($5112 to $5748) per person per annum. The indirect costs were substantial, with loss of earnings contributing to over [pounds]400 million per annum. Conclusions: For the first time, the authors were able to estimate the economic burden of Meniere's disease. In the UK, the annual cost of this condition is substantial. Further research is required to develop cost-effective treatments and management strategies for Meniere's to reduce the economic burden of the disease. These findings should be interpreted with caution due to the uncertainties inherent in the analysis. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.

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The Cost of Meniere's Disease: A Novel Multisource Approach.

Objectives: To estimate the annual cost of Meniere's disease and the cost per person in the UK population and to investigate the direct and indirect costs of the condition. Design: The authors utilized a multidata approach to provide the first estimate of the cost of Meniere's. Data from the UK Biobank (a study of 500,000 individuals collected between 2007 and 2012), the Hospital Episode Statistics (data on all hospital admissions in England from 2008 to 2012) and the UK Meniere's Society (2014) were used to estimate the cost of Meniere's. Cases were self-reported in the UK Biobank and UK Meniere's Society, within the Hospital Episode Statistics cases were clinician diagnosed. The authors estimated the direct and indirect costs of the condition, using count data to represent numbers of individuals reporting specific treatments, operations etc. and basic statistical analyses ([chi]2 tests, linear and logistic regression) to compare cases and controls in the UK Biobank. Results: Meniere's was estimated to cost between [pounds]541.30 million and [pounds]608.70 million annually (equivalent to US $829.9 to $934.2 million), equating to [pounds]3,341 to [pounds]3,757 ($5112 to $5748) per person per annum. The indirect costs were substantial, with loss of earnings contributing to over [pounds]400 million per annum. Conclusions: For the first time, the authors were able to estimate the economic burden of Meniere's disease. In the UK, the annual cost of this condition is substantial. Further research is required to develop cost-effective treatments and management strategies for Meniere's to reduce the economic burden of the disease. These findings should be interpreted with caution due to the uncertainties inherent in the analysis. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.

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Development of Insertion Models Predicting Cochlear Implant Electrode Position.

Objectives: To assess the possibility to define a preferable range for electrode array insertion depth and surgical insertion distance for which frequency mismatch is minimalized. To develop a surgical insertion guidance tool by which a preferred target angle can be attained using preoperative available anatomical data and surgically controllable insertion distance. Design: Multiplanar reconstructions of pre- and post-operative CT scans were evaluated in a population of 336 patients implanted with the CII HiFocus1 or HiFocus1J implant (26 bilaterally implantees included). Cochlear radial distances were measured on four measurement axes on the preoperative CT scan. Electrode contact positions were obtained in angular depth, distance from the round window and to the modiolus center. Frequency mismatch was calculated based on the yielded frequency as a function of the angular position per contact. Cochlear diameters were clustered into three cochlear size groups with K-sample clustering. Using spiral fitting and general linear regression modeling, the feasibility of different insertion models with cochlear size measures and surgical insertion as input parameters was analyzed. The final developed model was internally validated with bootstrapping to calculate the optimism-corrected R2. Results: Frequency mismatch was minimalized for surgical insertion of 6.7 mm and insertion depth of 484[degrees]. Cochlear size clusters were derived consisting of a "small" (N = 117), "medium" (N = 171), and "large" (N = 74) cluster with mean insertion depths of 506[degrees], 480[degrees], and 441[degrees], respectively. The relation between surgical insertion (LE16) and insertion depth ([theta]E1) differed significantly between the three clusters (p

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The Cost of Meniere's Disease: A Novel Multisource Approach.

Objectives: To estimate the annual cost of Meniere's disease and the cost per person in the UK population and to investigate the direct and indirect costs of the condition. Design: The authors utilized a multidata approach to provide the first estimate of the cost of Meniere's. Data from the UK Biobank (a study of 500,000 individuals collected between 2007 and 2012), the Hospital Episode Statistics (data on all hospital admissions in England from 2008 to 2012) and the UK Meniere's Society (2014) were used to estimate the cost of Meniere's. Cases were self-reported in the UK Biobank and UK Meniere's Society, within the Hospital Episode Statistics cases were clinician diagnosed. The authors estimated the direct and indirect costs of the condition, using count data to represent numbers of individuals reporting specific treatments, operations etc. and basic statistical analyses ([chi]2 tests, linear and logistic regression) to compare cases and controls in the UK Biobank. Results: Meniere's was estimated to cost between [pounds]541.30 million and [pounds]608.70 million annually (equivalent to US $829.9 to $934.2 million), equating to [pounds]3,341 to [pounds]3,757 ($5112 to $5748) per person per annum. The indirect costs were substantial, with loss of earnings contributing to over [pounds]400 million per annum. Conclusions: For the first time, the authors were able to estimate the economic burden of Meniere's disease. In the UK, the annual cost of this condition is substantial. Further research is required to develop cost-effective treatments and management strategies for Meniere's to reduce the economic burden of the disease. These findings should be interpreted with caution due to the uncertainties inherent in the analysis. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.

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Development of Insertion Models Predicting Cochlear Implant Electrode Position.

Objectives: To assess the possibility to define a preferable range for electrode array insertion depth and surgical insertion distance for which frequency mismatch is minimalized. To develop a surgical insertion guidance tool by which a preferred target angle can be attained using preoperative available anatomical data and surgically controllable insertion distance. Design: Multiplanar reconstructions of pre- and post-operative CT scans were evaluated in a population of 336 patients implanted with the CII HiFocus1 or HiFocus1J implant (26 bilaterally implantees included). Cochlear radial distances were measured on four measurement axes on the preoperative CT scan. Electrode contact positions were obtained in angular depth, distance from the round window and to the modiolus center. Frequency mismatch was calculated based on the yielded frequency as a function of the angular position per contact. Cochlear diameters were clustered into three cochlear size groups with K-sample clustering. Using spiral fitting and general linear regression modeling, the feasibility of different insertion models with cochlear size measures and surgical insertion as input parameters was analyzed. The final developed model was internally validated with bootstrapping to calculate the optimism-corrected R2. Results: Frequency mismatch was minimalized for surgical insertion of 6.7 mm and insertion depth of 484[degrees]. Cochlear size clusters were derived consisting of a "small" (N = 117), "medium" (N = 171), and "large" (N = 74) cluster with mean insertion depths of 506[degrees], 480[degrees], and 441[degrees], respectively. The relation between surgical insertion (LE16) and insertion depth ([theta]E1) differed significantly between the three clusters (p

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Development of Insertion Models Predicting Cochlear Implant Electrode Position.

Objectives: To assess the possibility to define a preferable range for electrode array insertion depth and surgical insertion distance for which frequency mismatch is minimalized. To develop a surgical insertion guidance tool by which a preferred target angle can be attained using preoperative available anatomical data and surgically controllable insertion distance. Design: Multiplanar reconstructions of pre- and post-operative CT scans were evaluated in a population of 336 patients implanted with the CII HiFocus1 or HiFocus1J implant (26 bilaterally implantees included). Cochlear radial distances were measured on four measurement axes on the preoperative CT scan. Electrode contact positions were obtained in angular depth, distance from the round window and to the modiolus center. Frequency mismatch was calculated based on the yielded frequency as a function of the angular position per contact. Cochlear diameters were clustered into three cochlear size groups with K-sample clustering. Using spiral fitting and general linear regression modeling, the feasibility of different insertion models with cochlear size measures and surgical insertion as input parameters was analyzed. The final developed model was internally validated with bootstrapping to calculate the optimism-corrected R2. Results: Frequency mismatch was minimalized for surgical insertion of 6.7 mm and insertion depth of 484[degrees]. Cochlear size clusters were derived consisting of a "small" (N = 117), "medium" (N = 171), and "large" (N = 74) cluster with mean insertion depths of 506[degrees], 480[degrees], and 441[degrees], respectively. The relation between surgical insertion (LE16) and insertion depth ([theta]E1) differed significantly between the three clusters (p

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On the acoustic analysis and optimization of ducted ventilation systems using a sub-structuring approach

This paper presents a general sub-structuring approach to predict the acoustic performance of ducted ventilation systems. The modeling principle is to determine the subsystem characteristics by calculating the transfer functions at their coupling interfaces, and the assembly is enabled by using a patch-based interface matching technique. For a particular example of a bended ventilation duct connecting an inlet and an outlet acoustic domain, a numerical model is developed to predict its sound attenuation performance. The prediction accuracy is thoroughly validated against finite element models. Through numerical examples, the rigid-walled duct is shown to provide relatively weak transmission loss (TL) across the frequency range of interest, and exhibit only the reactive behavior for sound reflection. By integrating sound absorbing treatment such as micro-perforated absorbers into the system, the TL can be significantly improved, and the system is seen to exhibit hybrid mechanisms for sound attenuation. The dissipative effect dominates at frequencies where the absorber is designed to be effective, and the reactive effect provides compensations at the absorption valleys attributed to the resonant behavior of the absorber. This ultimately maintains the system TL at a relatively high level across the entire frequency of interest. The TL of the system can be tuned or optimized in a very efficient way using the proposed approach due to its modular nature. It is shown that a balance of the hybrid mechanism is important to achieve an overall broadband attenuation performance in the design frequency range.

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Varying irrelevant phonetic features hinders learning of the feature being trained

Learning to distinguish nonnative words that differ in a critical phonetic feature can be difficult. Speech training studies typically employ methods that explicitly direct the learner's attention to the relevant nonnative feature to be learned. However, studies on vision have demonstrated that perceptual learning may occur implicitly, by exposing learners to stimulus features, even if they are irrelevant to the task, and it has recently been suggested that this task-irrelevant perceptual learning framework also applies to speech. In this study, subjects took part in a seven-day training regimen to learn to distinguish one of two nonnative features, namely, voice onset time or lexical tone, using explicit training methods consistent with most speech training studies. Critically, half of the subjects were exposed to stimuli that varied not only in the relevant feature, but in the irrelevant feature as well. The results showed that subjects who were trained with stimuli that varied in the relevant feature and held the irrelevant feature constant achieved the best learning outcomes. Varying both features hindered learning and generalization to new stimuli.

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Leading-order cross term correction of three-dimensional parabolic equation models

The issue of handling a leading-order cross-multiplied term in three-dimensional(3D) parabolic equation (PE) based models is addressed. In particular, numerical results obtained incorporating a leading-order cross-term correction in an existing 3D PE model, written in cylindrical coordinates, based on higher-order Padé approximations in both depth and azimuth, and a splitting operator technique are reported. Note that the numerical algorithm proposed in this paper could be used in the future to update any 3D PE codes that neglect cross terms and use a splitting numerical technique. The 3D penetrable wedge benchmark problem is chosen to illustrate the accuracy of the now-fully wide-angle enhanced 3D PE model. The comparisons with a 3D reference solution based on the image source clearly show that handling the leading-order cross term in the 3D PE computation is sufficient to remove the phase errors inherent to any 3D PE models that neglect cross terms in their formulations.

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Localization-in-noise and binaural medial olivocochlear functioning in children and young adults

Children as young as 5 yr old localize sounds as accurately as adults in quiet in the frontal hemifield. However, children's ability to localize in noise and in the front/back (F/B) dimension are scantily studied. To address this, the first part of this study investigated localization-in-noise ability of children vs young adults in two maskers: broadband noise (BBN) and speech-babble (SB) at three signal-to-noise ratios: −12, −6, and 0 dB. In the second part, relationship between binaural medial olivocochlear system (MOC) function and localization-in-noise was investigated. In both studies, 21 children and 21 young adults participated. Results indicate, while children are able to differentiate sounds arriving in the F/B dimension on par with adults in quiet and in BBN, larger differences were found for SB. Accuracy of children's localization in noise (for both maskers) in the lateral plane was also poorer than adults'. Significant differences in binaural MOC interaction (mBIC; the difference between the sum of two monaural- and binaural-MOC strength) between adults and children were also found. For reasons which are not clear, adult F/B localization in BBN correlates better with mBIC while children's F/B localization in SB correlated better with binaural MOC strength.

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Influence of non-spatial working memory demands on reach-grasp responses to loss of balance: Effects of age and fall risk

Publication date: Available online 12 January 2016
Source:Gait & Posture
Author(s): Kelly P. Westlake, Brian P. Johnson, Robert A. Creath, Rachel M. Neff, Mark W. Rogers
Reactive balance recovery strategies following an unexpected loss of balance are crucial to the prevention of falls, head trauma and other major injuries in older adults. While a longstanding focus has been on understanding lower limb recovery responses, the upper limbs also play a critical role. However, when a fall occurs, little is known about the role of memory and attention shifting on the reach to grasp recovery strategy and what factors determine the speed and precision of this response beyond simple reaction time. The objective of this study was to compare response time and accuracy of a stabilizing grasp following a balance perturbation in older adult fallers compared to non-fallers and younger adults while loading the processing demands of non-spatial, verbal working memory. Working memory was engaged with a progressively challenging verb-generation task that was interrupted by an unexpected sideways platform perturbation and a pre-instructed reach to grasp response. Results revealed that the older adults, particularly those at high fall risk, demonstrated significantly increased movement time to handrail contact and grasping errors during conditions in which non-spatial memory was actively engaged. These findings provide preliminary evidence of the cognitive deficit in attention shifting away from an ongoing working memory task that underlies delayed and inaccurate protective reach to grasp responses in older adult fallers.



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Variability of gait, bilateral coordination, and asymmetry in women with fibromyalgia

Publication date: Available online 12 January 2016
Source:Gait & Posture
Author(s): J. Heredia-Jimenez, E. Orantes-Gonzalez, V.M. Soto-Hermoso
PurposeTo analyze how fibromyalgia affected the variability, asymmetry, and bilateral coordination of gait walking at comfortable and fast speeds.Methods65 fibromyalgia (FM) patients and 50 healthy women were analyzed. Gait analysis was performed using an instrumented walkway (GAITRite system). Average walking speed, coefficient of variation (CV) of stride length, swing time, and step width data were obtained and bilateral coordination and gait asymmetry were analyzed.ResultsFM patients presented significantly lower speeds than the healthy group. FM patients obtained significantly higher values of CV_StrideLength (p=0.04; p<0.001), CV_SwingTime (p<0.001; p<0.001), CV_StepWidth (p=0.004; p<0.001), phase coordination index (p=0.01; p=0.03), and p_CV (p<0.001; p=0.001) than the control group, walking at comfortable or fast speeds. Gait asymmetry only showed significant differences in the fast condition.ConclusionFM patients walked more slowly and presented a greater variability of gait and worse bilateral coordination than healthy subjects. Gait asymmetry only showed differences in the fast condition. The variability and the bilateral coordination were particularly affected by FM in women. Therefore, variability and bilateral coordination of gait could be analyzed to complement the gait evaluation of FM patients.



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Ankle muscle coactivation during gait is decreased immediately after anterior weight shift practice in adults after stroke

Publication date: Available online 12 January 2016
Source:Gait & Posture
Author(s): Ryosuke Kitatani, Koji Ohata, Kaoru Sakuma, Yumi Aga, Natsuki Yamakami, Yu Hashiguchi, Shigehito Yamada
Increased ankle muscle coactivation during gait has frequently been observed as an adaptation strategy to compensate for postural instability in adults after stroke. However, it remains unclear whether the muscle coactivation pattern increases or decreases after balance training. The aim of this study was to investigate the immediate effects of balance practice on ankle muscle coactivation during gait in adults after stroke. Standing balance practice performed to shift as much weight anteriorly as possible in 24 participants after stroke. The forward movement distance of the center of pressure (COP) during anterior weight shifting, gait speed, and ankle muscle activities during 10-m walking tests were measured immediately before and after balance practice. Forward movement of the COP during anterior weight shifting and gait speed significantly increased after balance practice. On the paretic side, tibialis anterior muscle activity significantly decreased during the single support and second double support phases, and the coactivation index at the ankle joint during the first double support and single support phases significantly decreased after balance practice. However, there were no significant relationships between the changes in gait speed, forward movement of the COP during anterior weight shifting, and ankle muscle coactivation during the stance phase. These results suggested that ankle muscle coactivation on the paretic side during the stance phase was decreased immediately after short-term anterior weight shift practice, which was not associated with improved gait speed or forward movement of the COP during anterior weight shifting in adults after stroke.



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Understanding the psychosocial experiences of adults with mild-moderate hearing loss: An application of Leventhal's self-regulatory model.

Understanding the psychosocial experiences of adults with mild-moderate hearing loss: An application of Leventhal's self-regulatory model.

Int J Audiol. 2016 Jan 12;:1-10

Authors: Heffernan E, Coulson NS, Henshaw H, Barry JG, Ferguson MA

Abstract
OBJECTIVE: This study explored the psychosocial experiences of adults with hearing loss using the self-regulatory model as a theoretical framework. The primary components of the model, namely cognitive representations, emotional representations, and coping responses, were examined.
DESIGN: Individual semi-structured interviews were conducted. The data were analysed using an established thematic analysis procedure.
STUDY SAMPLE: Twenty-five adults with mild-moderate hearing loss from the UK and nine hearing healthcare professionals from the UK, USA, and Canada were recruited via maximum variation sampling.
RESULTS: Cognitive representations: Most participants described their hearing loss as having negative connotations and consequences, although they were not particularly concerned about the progression or controllability/curability of the condition. Opinions differed regarding the benefits of understanding the causes of one's hearing loss in detail. Emotional representations: negative emotions dominated, although some experienced positive emotions or muted emotions. Coping responses: engaged coping (e.g. hearing aids, communication tactics) and disengaged coping (e.g. withdrawal from situations, withdrawal within situations): both had perceived advantages and disadvantages.
CONCLUSIONS: This novel application of the self-regulatory model demonstrates that it can be used to capture the key psychosocial experiences (i.e. perceptions, emotions, and coping responses) of adults with mild-moderate hearing loss within a single, unifying framework.

PMID: 26754550 [PubMed - as supplied by publisher]

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A demonstrated positive effect of a hearing conservation program in the Swedish armed forces.

A demonstrated positive effect of a hearing conservation program in the Swedish armed forces.

Int J Audiol. 2016 Jan 12;:1-5

Authors: Muhr P, Johnson AC, Skoog B, Rosenhall U

Abstract
OBJECTIVE: A revised hearing conservation program (HCP) was implemented in the Swedish Armed Forces in 2002. The aim of this study was to evaluate the incidence of significant threshold shifts (STS) in male conscripts heavily exposed to noise after the implementation of the new HCP, comparing the results to those of an earlier study from 1999/2000.
DESIGN: The study was prospective and longitudinal, covering the period from reporting to military service to discharge. The outcome measure was the incidence of STS. Statistics from the military insurance system was analysed.
STUDY SAMPLE: A total of 395 conscripts were included in the study (mean age 19 years). The control group (n: 839) consisted of men of the same age.
RESULTS: In 2004/2005 the incidence rate of STS was 2.3% compared to 7.9% in 1999/2000 and compared to 3.7% among the controls. The number of cases of auditory complications reported from conscripts to the insurance system has decreased, from 16 to 5/100 000 days of military training, during the last decade.
CONCLUSIONS: The new HCP apparently reduced the incidence rate of STS to one third compared to before the program was introduced and leveled it to the incidence rate in the control-group not exposed to military noise.

PMID: 26754548 [PubMed - as supplied by publisher]

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Influence of non-spatial working memory demands on reach-grasp responses to loss of balance: Effects of age and fall risk

Publication date: Available online 12 January 2016
Source:Gait & Posture
Author(s): Kelly P. Westlake, Brian P. Johnson, Robert A. Creath, Rachel M. Neff, Mark W. Rogers
Reactive balance recovery strategies following an unexpected loss of balance are crucial to the prevention of falls, head trauma and other major injuries in older adults. While a longstanding focus has been on understanding lower limb recovery responses, the upper limbs also play a critical role. However, when a fall occurs, little is known about the role of memory and attention shifting on the reach to grasp recovery strategy and what factors determine the speed and precision of this response beyond simple reaction time. The objective of this study was to compare response time and accuracy of a stabilizing grasp following a balance perturbation in older adult fallers compared to non-fallers and younger adults while loading the processing demands of non-spatial, verbal working memory. Working memory was engaged with a progressively challenging verb-generation task that was interrupted by an unexpected sideways platform perturbation and a pre-instructed reach to grasp response. Results revealed that the older adults, particularly those at high fall risk, demonstrated significantly increased movement time to handrail contact and grasping errors during conditions in which non-spatial memory was actively engaged. These findings provide preliminary evidence of the cognitive deficit in attention shifting away from an ongoing working memory task that underlies delayed and inaccurate protective reach to grasp responses in older adult fallers.



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Variability of gait, bilateral coordination, and asymmetry in women with fibromyalgia

Publication date: Available online 12 January 2016
Source:Gait & Posture
Author(s): J. Heredia-Jimenez, E. Orantes-Gonzalez, V.M. Soto-Hermoso
PurposeTo analyze how fibromyalgia affected the variability, asymmetry, and bilateral coordination of gait walking at comfortable and fast speeds.Methods65 fibromyalgia (FM) patients and 50 healthy women were analyzed. Gait analysis was performed using an instrumented walkway (GAITRite system). Average walking speed, coefficient of variation (CV) of stride length, swing time, and step width data were obtained and bilateral coordination and gait asymmetry were analyzed.ResultsFM patients presented significantly lower speeds than the healthy group. FM patients obtained significantly higher values of CV_StrideLength (p=0.04; p<0.001), CV_SwingTime (p<0.001; p<0.001), CV_StepWidth (p=0.004; p<0.001), phase coordination index (p=0.01; p=0.03), and p_CV (p<0.001; p=0.001) than the control group, walking at comfortable or fast speeds. Gait asymmetry only showed significant differences in the fast condition.ConclusionFM patients walked more slowly and presented a greater variability of gait and worse bilateral coordination than healthy subjects. Gait asymmetry only showed differences in the fast condition. The variability and the bilateral coordination were particularly affected by FM in women. Therefore, variability and bilateral coordination of gait could be analyzed to complement the gait evaluation of FM patients.



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Ankle muscle coactivation during gait is decreased immediately after anterior weight shift practice in adults after stroke

Publication date: Available online 12 January 2016
Source:Gait & Posture
Author(s): Ryosuke Kitatani, Koji Ohata, Kaoru Sakuma, Yumi Aga, Natsuki Yamakami, Yu Hashiguchi, Shigehito Yamada
Increased ankle muscle coactivation during gait has frequently been observed as an adaptation strategy to compensate for postural instability in adults after stroke. However, it remains unclear whether the muscle coactivation pattern increases or decreases after balance training. The aim of this study was to investigate the immediate effects of balance practice on ankle muscle coactivation during gait in adults after stroke. Standing balance practice performed to shift as much weight anteriorly as possible in 24 participants after stroke. The forward movement distance of the center of pressure (COP) during anterior weight shifting, gait speed, and ankle muscle activities during 10-m walking tests were measured immediately before and after balance practice. Forward movement of the COP during anterior weight shifting and gait speed significantly increased after balance practice. On the paretic side, tibialis anterior muscle activity significantly decreased during the single support and second double support phases, and the coactivation index at the ankle joint during the first double support and single support phases significantly decreased after balance practice. However, there were no significant relationships between the changes in gait speed, forward movement of the COP during anterior weight shifting, and ankle muscle coactivation during the stance phase. These results suggested that ankle muscle coactivation on the paretic side during the stance phase was decreased immediately after short-term anterior weight shift practice, which was not associated with improved gait speed or forward movement of the COP during anterior weight shifting in adults after stroke.



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Understanding the psychosocial experiences of adults with mild-moderate hearing loss: An application of Leventhal's self-regulatory model.

Understanding the psychosocial experiences of adults with mild-moderate hearing loss: An application of Leventhal's self-regulatory model.

Int J Audiol. 2016 Jan 12;:1-10

Authors: Heffernan E, Coulson NS, Henshaw H, Barry JG, Ferguson MA

Abstract
OBJECTIVE: This study explored the psychosocial experiences of adults with hearing loss using the self-regulatory model as a theoretical framework. The primary components of the model, namely cognitive representations, emotional representations, and coping responses, were examined.
DESIGN: Individual semi-structured interviews were conducted. The data were analysed using an established thematic analysis procedure.
STUDY SAMPLE: Twenty-five adults with mild-moderate hearing loss from the UK and nine hearing healthcare professionals from the UK, USA, and Canada were recruited via maximum variation sampling.
RESULTS: Cognitive representations: Most participants described their hearing loss as having negative connotations and consequences, although they were not particularly concerned about the progression or controllability/curability of the condition. Opinions differed regarding the benefits of understanding the causes of one's hearing loss in detail. Emotional representations: negative emotions dominated, although some experienced positive emotions or muted emotions. Coping responses: engaged coping (e.g. hearing aids, communication tactics) and disengaged coping (e.g. withdrawal from situations, withdrawal within situations): both had perceived advantages and disadvantages.
CONCLUSIONS: This novel application of the self-regulatory model demonstrates that it can be used to capture the key psychosocial experiences (i.e. perceptions, emotions, and coping responses) of adults with mild-moderate hearing loss within a single, unifying framework.

PMID: 26754550 [PubMed - as supplied by publisher]

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A demonstrated positive effect of a hearing conservation program in the Swedish armed forces.

A demonstrated positive effect of a hearing conservation program in the Swedish armed forces.

Int J Audiol. 2016 Jan 12;:1-5

Authors: Muhr P, Johnson AC, Skoog B, Rosenhall U

Abstract
OBJECTIVE: A revised hearing conservation program (HCP) was implemented in the Swedish Armed Forces in 2002. The aim of this study was to evaluate the incidence of significant threshold shifts (STS) in male conscripts heavily exposed to noise after the implementation of the new HCP, comparing the results to those of an earlier study from 1999/2000.
DESIGN: The study was prospective and longitudinal, covering the period from reporting to military service to discharge. The outcome measure was the incidence of STS. Statistics from the military insurance system was analysed.
STUDY SAMPLE: A total of 395 conscripts were included in the study (mean age 19 years). The control group (n: 839) consisted of men of the same age.
RESULTS: In 2004/2005 the incidence rate of STS was 2.3% compared to 7.9% in 1999/2000 and compared to 3.7% among the controls. The number of cases of auditory complications reported from conscripts to the insurance system has decreased, from 16 to 5/100 000 days of military training, during the last decade.
CONCLUSIONS: The new HCP apparently reduced the incidence rate of STS to one third compared to before the program was introduced and leveled it to the incidence rate in the control-group not exposed to military noise.

PMID: 26754548 [PubMed - as supplied by publisher]

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Influence of non-spatial working memory demands on reach-grasp responses to loss of balance: Effects of age and fall risk

Publication date: Available online 12 January 2016
Source:Gait & Posture
Author(s): Kelly P. Westlake, Brian P. Johnson, Robert A. Creath, Rachel M. Neff, Mark W. Rogers
Reactive balance recovery strategies following an unexpected loss of balance are crucial to the prevention of falls, head trauma and other major injuries in older adults. While a longstanding focus has been on understanding lower limb recovery responses, the upper limbs also play a critical role. However, when a fall occurs, little is known about the role of memory and attention shifting on the reach to grasp recovery strategy and what factors determine the speed and precision of this response beyond simple reaction time. The objective of this study was to compare response time and accuracy of a stabilizing grasp following a balance perturbation in older adult fallers compared to non-fallers and younger adults while loading the processing demands of non-spatial, verbal working memory. Working memory was engaged with a progressively challenging verb-generation task that was interrupted by an unexpected sideways platform perturbation and a pre-instructed reach to grasp response. Results revealed that the older adults, particularly those at high fall risk, demonstrated significantly increased movement time to handrail contact and grasping errors during conditions in which non-spatial memory was actively engaged. These findings provide preliminary evidence of the cognitive deficit in attention shifting away from an ongoing working memory task that underlies delayed and inaccurate protective reach to grasp responses in older adult fallers.



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Variability of gait, bilateral coordination, and asymmetry in women with fibromyalgia

Publication date: Available online 12 January 2016
Source:Gait & Posture
Author(s): J. Heredia-Jimenez, E. Orantes-Gonzalez, V.M. Soto-Hermoso
PurposeTo analyze how fibromyalgia affected the variability, asymmetry, and bilateral coordination of gait walking at comfortable and fast speeds.Methods65 fibromyalgia (FM) patients and 50 healthy women were analyzed. Gait analysis was performed using an instrumented walkway (GAITRite system). Average walking speed, coefficient of variation (CV) of stride length, swing time, and step width data were obtained and bilateral coordination and gait asymmetry were analyzed.ResultsFM patients presented significantly lower speeds than the healthy group. FM patients obtained significantly higher values of CV_StrideLength (p=0.04; p<0.001), CV_SwingTime (p<0.001; p<0.001), CV_StepWidth (p=0.004; p<0.001), phase coordination index (p=0.01; p=0.03), and p_CV (p<0.001; p=0.001) than the control group, walking at comfortable or fast speeds. Gait asymmetry only showed significant differences in the fast condition.ConclusionFM patients walked more slowly and presented a greater variability of gait and worse bilateral coordination than healthy subjects. Gait asymmetry only showed differences in the fast condition. The variability and the bilateral coordination were particularly affected by FM in women. Therefore, variability and bilateral coordination of gait could be analyzed to complement the gait evaluation of FM patients.



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Ankle muscle coactivation during gait is decreased immediately after anterior weight shift practice in adults after stroke

Publication date: Available online 12 January 2016
Source:Gait & Posture
Author(s): Ryosuke Kitatani, Koji Ohata, Kaoru Sakuma, Yumi Aga, Natsuki Yamakami, Yu Hashiguchi, Shigehito Yamada
Increased ankle muscle coactivation during gait has frequently been observed as an adaptation strategy to compensate for postural instability in adults after stroke. However, it remains unclear whether the muscle coactivation pattern increases or decreases after balance training. The aim of this study was to investigate the immediate effects of balance practice on ankle muscle coactivation during gait in adults after stroke. Standing balance practice performed to shift as much weight anteriorly as possible in 24 participants after stroke. The forward movement distance of the center of pressure (COP) during anterior weight shifting, gait speed, and ankle muscle activities during 10-m walking tests were measured immediately before and after balance practice. Forward movement of the COP during anterior weight shifting and gait speed significantly increased after balance practice. On the paretic side, tibialis anterior muscle activity significantly decreased during the single support and second double support phases, and the coactivation index at the ankle joint during the first double support and single support phases significantly decreased after balance practice. However, there were no significant relationships between the changes in gait speed, forward movement of the COP during anterior weight shifting, and ankle muscle coactivation during the stance phase. These results suggested that ankle muscle coactivation on the paretic side during the stance phase was decreased immediately after short-term anterior weight shift practice, which was not associated with improved gait speed or forward movement of the COP during anterior weight shifting in adults after stroke.



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Exome sequencing and CRISPR/Cas genome editing identify mutations of ZAK as a cause of limb defects in humans and mice.

Exome sequencing and CRISPR/Cas genome editing identify mutations of ZAK as a cause of limb defects in humans and mice.

Genome Res. 2016 Jan 11;

Authors: Spielmann M, Kakar N, Tayebi N, Leettola C, Nürnberg G, Sowada N, Lupiáñez DG, Harabula I, Flöttmann R, Horn D, Chan WL, Wittler L, Yilmaz R, Altmüller J, Thiele H, van Bokhoven H, Schwartz CE, Nürnberg P, Bowie JU, Ahmad J, Kubisch C, Mundlos S, Borck G

Abstract
The CRISPR/Cas technology enables targeted genome editing and the rapid generation of transgenic animal models for the study of human genetic disorders. Here we describe an autosomal recessive human disease in two unrelated families characterized by a split-foot defect, nail abnormalities of the hands, and hearing loss, due to mutations disrupting the SAM domain of the protein kinase ZAK. ZAK is a member of the MAPKKK family with no known role in limb development. We show that Zak is expressed in the developing limbs and that a CRISPR/Cas-mediated knockout of the two Zak isoforms is embryonically lethal in mice. In contrast, a deletion of the SAM domain induces a complex hindlimb defect associated with down-regulation of Trp63, a known split-hand/split-foot malformation disease gene. Our results identify ZAK as a key player in mammalian limb patterning and demonstrate the rapid utility of CRISPR/Cas genome editing to assign causality to human mutations in the mouse in <10 wk.

PMID: 26755636 [PubMed - as supplied by publisher]

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Understanding the psychosocial experiences of adults with mild-moderate hearing loss: An application of Leventhal's self-regulatory model.

Understanding the psychosocial experiences of adults with mild-moderate hearing loss: An application of Leventhal's self-regulatory model.

Int J Audiol. 2016 Jan 12;:1-10

Authors: Heffernan E, Coulson NS, Henshaw H, Barry JG, Ferguson MA

Abstract
OBJECTIVE: This study explored the psychosocial experiences of adults with hearing loss using the self-regulatory model as a theoretical framework. The primary components of the model, namely cognitive representations, emotional representations, and coping responses, were examined.
DESIGN: Individual semi-structured interviews were conducted. The data were analysed using an established thematic analysis procedure.
STUDY SAMPLE: Twenty-five adults with mild-moderate hearing loss from the UK and nine hearing healthcare professionals from the UK, USA, and Canada were recruited via maximum variation sampling.
RESULTS: Cognitive representations: Most participants described their hearing loss as having negative connotations and consequences, although they were not particularly concerned about the progression or controllability/curability of the condition. Opinions differed regarding the benefits of understanding the causes of one's hearing loss in detail. Emotional representations: negative emotions dominated, although some experienced positive emotions or muted emotions. Coping responses: engaged coping (e.g. hearing aids, communication tactics) and disengaged coping (e.g. withdrawal from situations, withdrawal within situations): both had perceived advantages and disadvantages.
CONCLUSIONS: This novel application of the self-regulatory model demonstrates that it can be used to capture the key psychosocial experiences (i.e. perceptions, emotions, and coping responses) of adults with mild-moderate hearing loss within a single, unifying framework.

PMID: 26754550 [PubMed - as supplied by publisher]

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A demonstrated positive effect of a hearing conservation program in the Swedish armed forces.

A demonstrated positive effect of a hearing conservation program in the Swedish armed forces.

Int J Audiol. 2016 Jan 12;:1-5

Authors: Muhr P, Johnson AC, Skoog B, Rosenhall U

Abstract
OBJECTIVE: A revised hearing conservation program (HCP) was implemented in the Swedish Armed Forces in 2002. The aim of this study was to evaluate the incidence of significant threshold shifts (STS) in male conscripts heavily exposed to noise after the implementation of the new HCP, comparing the results to those of an earlier study from 1999/2000.
DESIGN: The study was prospective and longitudinal, covering the period from reporting to military service to discharge. The outcome measure was the incidence of STS. Statistics from the military insurance system was analysed.
STUDY SAMPLE: A total of 395 conscripts were included in the study (mean age 19 years). The control group (n: 839) consisted of men of the same age.
RESULTS: In 2004/2005 the incidence rate of STS was 2.3% compared to 7.9% in 1999/2000 and compared to 3.7% among the controls. The number of cases of auditory complications reported from conscripts to the insurance system has decreased, from 16 to 5/100 000 days of military training, during the last decade.
CONCLUSIONS: The new HCP apparently reduced the incidence rate of STS to one third compared to before the program was introduced and leveled it to the incidence rate in the control-group not exposed to military noise.

PMID: 26754548 [PubMed - as supplied by publisher]

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Understanding the psychosocial experiences of adults with mild-moderate hearing loss: An application of Leventhal's self-regulatory model.

Understanding the psychosocial experiences of adults with mild-moderate hearing loss: An application of Leventhal's self-regulatory model.

Int J Audiol. 2016 Jan 12;:1-10

Authors: Heffernan E, Coulson NS, Henshaw H, Barry JG, Ferguson MA

Abstract
OBJECTIVE: This study explored the psychosocial experiences of adults with hearing loss using the self-regulatory model as a theoretical framework. The primary components of the model, namely cognitive representations, emotional representations, and coping responses, were examined.
DESIGN: Individual semi-structured interviews were conducted. The data were analysed using an established thematic analysis procedure.
STUDY SAMPLE: Twenty-five adults with mild-moderate hearing loss from the UK and nine hearing healthcare professionals from the UK, USA, and Canada were recruited via maximum variation sampling.
RESULTS: Cognitive representations: Most participants described their hearing loss as having negative connotations and consequences, although they were not particularly concerned about the progression or controllability/curability of the condition. Opinions differed regarding the benefits of understanding the causes of one's hearing loss in detail. Emotional representations: negative emotions dominated, although some experienced positive emotions or muted emotions. Coping responses: engaged coping (e.g. hearing aids, communication tactics) and disengaged coping (e.g. withdrawal from situations, withdrawal within situations): both had perceived advantages and disadvantages.
CONCLUSIONS: This novel application of the self-regulatory model demonstrates that it can be used to capture the key psychosocial experiences (i.e. perceptions, emotions, and coping responses) of adults with mild-moderate hearing loss within a single, unifying framework.

PMID: 26754550 [PubMed - as supplied by publisher]

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A demonstrated positive effect of a hearing conservation program in the Swedish armed forces.

A demonstrated positive effect of a hearing conservation program in the Swedish armed forces.

Int J Audiol. 2016 Jan 12;:1-5

Authors: Muhr P, Johnson AC, Skoog B, Rosenhall U

Abstract
OBJECTIVE: A revised hearing conservation program (HCP) was implemented in the Swedish Armed Forces in 2002. The aim of this study was to evaluate the incidence of significant threshold shifts (STS) in male conscripts heavily exposed to noise after the implementation of the new HCP, comparing the results to those of an earlier study from 1999/2000.
DESIGN: The study was prospective and longitudinal, covering the period from reporting to military service to discharge. The outcome measure was the incidence of STS. Statistics from the military insurance system was analysed.
STUDY SAMPLE: A total of 395 conscripts were included in the study (mean age 19 years). The control group (n: 839) consisted of men of the same age.
RESULTS: In 2004/2005 the incidence rate of STS was 2.3% compared to 7.9% in 1999/2000 and compared to 3.7% among the controls. The number of cases of auditory complications reported from conscripts to the insurance system has decreased, from 16 to 5/100 000 days of military training, during the last decade.
CONCLUSIONS: The new HCP apparently reduced the incidence rate of STS to one third compared to before the program was introduced and leveled it to the incidence rate in the control-group not exposed to military noise.

PMID: 26754548 [PubMed - as supplied by publisher]

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Differences in Perilymphatic Space Enhancement and Adverse Inflammatory Reaction after Intratympanic Injection of Two Different Gadolinium Agents: A 9.4-Tesla Magnetic Resonance Imaging Study

Publication date: Available online 13 January 2016
Source:Hearing Research
Author(s): Mina Park, Ho Sun Lee, Hyeonjin Kim, Seung Ha Oh, Jun Ho Lee, Myung-Whan Suh
PurposeTo compare the inner ear enhancement after intratympanic injection of two widely used gadolinium (Gd) agents by 9.4 Tesla micro-magnetic resonance imaging (MRI) and to investigate the effects of Gd on the inner ear.MethodsTwelve ears of six rats received intratympanic administration of 1/5 diluted Gd agents: gadoterate meglumine (Gd-DTPA) for the left ear and gadodiamide (Gd-DTPA-BMA) for the right ear. MRI was performed every 30 min from 1 to 4 h after administration. The normalized signal intensity was evaluated by quantitative analysis at each cochlear fluid compartment. Eight, six, and seven ears treated with Gd-DTPA, Gd-DPTA-BMA, and nothing as controls, respectively, were processed for histological evaluation after MRI. After hematoxylin & eosin staining, adverse inflammatory reactions were evaluated for turbid aggregation and lymphocytes.ResultsThe perilymphatic enhancement of Gd-DTPA was superior to that of Gd-DTPA-BMA regardless of cochlear turn, compartment, and time point. Inflammatory reactions were found in 4/8 (50.0%) and 4/6 (66.6%) ears administered Gd-DTPA and Gd-DTPA-BMA, respectively. Regardless of the contrast agent used, inflammatory reactions were most definite in the scala tympani of the basal turn, i.e., near the round window. Slightly greater inflammatory reactions were observed in ears injected with Gd-DTPA-BMA compared to Gd-DTPA although the difference was not statistically significant. No inflammatory reaction was observed in any of the seven controls. The auditory brainstem response threshold was 11.8±2.5 dB SPL before IT Gd injection and it did not change for up to 5 days (15.4±6.6 dB SPL) post-injection.ConclusionsGd-DTPA was superior to Gd-DTPA-BMA for visualization of the inner ear. Administration of diluted Gd agents intratympanically may induce considerable inflammatory reactions in the inner ear.



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Differences in Perilymphatic Space Enhancement and Adverse Inflammatory Reaction after Intratympanic Injection of Two Different Gadolinium Agents: A 9.4-Tesla Magnetic Resonance Imaging Study

Publication date: Available online 13 January 2016
Source:Hearing Research
Author(s): Mina Park, Ho Sun Lee, Hyeonjin Kim, Seung Ha Oh, Jun Ho Lee, Myung-Whan Suh
PurposeTo compare the inner ear enhancement after intratympanic injection of two widely used gadolinium (Gd) agents by 9.4 Tesla micro-magnetic resonance imaging (MRI) and to investigate the effects of Gd on the inner ear.MethodsTwelve ears of six rats received intratympanic administration of 1/5 diluted Gd agents: gadoterate meglumine (Gd-DTPA) for the left ear and gadodiamide (Gd-DTPA-BMA) for the right ear. MRI was performed every 30 min from 1 to 4 h after administration. The normalized signal intensity was evaluated by quantitative analysis at each cochlear fluid compartment. Eight, six, and seven ears treated with Gd-DTPA, Gd-DPTA-BMA, and nothing as controls, respectively, were processed for histological evaluation after MRI. After hematoxylin & eosin staining, adverse inflammatory reactions were evaluated for turbid aggregation and lymphocytes.ResultsThe perilymphatic enhancement of Gd-DTPA was superior to that of Gd-DTPA-BMA regardless of cochlear turn, compartment, and time point. Inflammatory reactions were found in 4/8 (50.0%) and 4/6 (66.6%) ears administered Gd-DTPA and Gd-DTPA-BMA, respectively. Regardless of the contrast agent used, inflammatory reactions were most definite in the scala tympani of the basal turn, i.e., near the round window. Slightly greater inflammatory reactions were observed in ears injected with Gd-DTPA-BMA compared to Gd-DTPA although the difference was not statistically significant. No inflammatory reaction was observed in any of the seven controls. The auditory brainstem response threshold was 11.8±2.5 dB SPL before IT Gd injection and it did not change for up to 5 days (15.4±6.6 dB SPL) post-injection.ConclusionsGd-DTPA was superior to Gd-DTPA-BMA for visualization of the inner ear. Administration of diluted Gd agents intratympanically may induce considerable inflammatory reactions in the inner ear.



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Differences in Perilymphatic Space Enhancement and Adverse Inflammatory Reaction after Intratympanic Injection of Two Different Gadolinium Agents: A 9.4-Tesla Magnetic Resonance Imaging Study

Publication date: Available online 13 January 2016
Source:Hearing Research
Author(s): Mina Park, Ho Sun Lee, Hyeonjin Kim, Seung Ha Oh, Jun Ho Lee, Myung-Whan Suh
PurposeTo compare the inner ear enhancement after intratympanic injection of two widely used gadolinium (Gd) agents by 9.4 Tesla micro-magnetic resonance imaging (MRI) and to investigate the effects of Gd on the inner ear.MethodsTwelve ears of six rats received intratympanic administration of 1/5 diluted Gd agents: gadoterate meglumine (Gd-DTPA) for the left ear and gadodiamide (Gd-DTPA-BMA) for the right ear. MRI was performed every 30 min from 1 to 4 h after administration. The normalized signal intensity was evaluated by quantitative analysis at each cochlear fluid compartment. Eight, six, and seven ears treated with Gd-DTPA, Gd-DPTA-BMA, and nothing as controls, respectively, were processed for histological evaluation after MRI. After hematoxylin & eosin staining, adverse inflammatory reactions were evaluated for turbid aggregation and lymphocytes.ResultsThe perilymphatic enhancement of Gd-DTPA was superior to that of Gd-DTPA-BMA regardless of cochlear turn, compartment, and time point. Inflammatory reactions were found in 4/8 (50.0%) and 4/6 (66.6%) ears administered Gd-DTPA and Gd-DTPA-BMA, respectively. Regardless of the contrast agent used, inflammatory reactions were most definite in the scala tympani of the basal turn, i.e., near the round window. Slightly greater inflammatory reactions were observed in ears injected with Gd-DTPA-BMA compared to Gd-DTPA although the difference was not statistically significant. No inflammatory reaction was observed in any of the seven controls. The auditory brainstem response threshold was 11.8±2.5 dB SPL before IT Gd injection and it did not change for up to 5 days (15.4±6.6 dB SPL) post-injection.ConclusionsGd-DTPA was superior to Gd-DTPA-BMA for visualization of the inner ear. Administration of diluted Gd agents intratympanically may induce considerable inflammatory reactions in the inner ear.



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Differences in Perilymphatic Space Enhancement and Adverse Inflammatory Reaction after Intratympanic Injection of Two Different Gadolinium Agents: A 9.4-Tesla Magnetic Resonance Imaging Study

Publication date: Available online 13 January 2016
Source:Hearing Research
Author(s): Mina Park, Ho Sun Lee, Hyeonjin Kim, Seung Ha Oh, Jun Ho Lee, Myung-Whan Suh
PurposeTo compare the inner ear enhancement after intratympanic injection of two widely used gadolinium (Gd) agents by 9.4 Tesla micro-magnetic resonance imaging (MRI) and to investigate the effects of Gd on the inner ear.MethodsTwelve ears of six rats received intratympanic administration of 1/5 diluted Gd agents: gadoterate meglumine (Gd-DTPA) for the left ear and gadodiamide (Gd-DTPA-BMA) for the right ear. MRI was performed every 30 min from 1 to 4 h after administration. The normalized signal intensity was evaluated by quantitative analysis at each cochlear fluid compartment. Eight, six, and seven ears treated with Gd-DTPA, Gd-DPTA-BMA, and nothing as controls, respectively, were processed for histological evaluation after MRI. After hematoxylin & eosin staining, adverse inflammatory reactions were evaluated for turbid aggregation and lymphocytes.ResultsThe perilymphatic enhancement of Gd-DTPA was superior to that of Gd-DTPA-BMA regardless of cochlear turn, compartment, and time point. Inflammatory reactions were found in 4/8 (50.0%) and 4/6 (66.6%) ears administered Gd-DTPA and Gd-DTPA-BMA, respectively. Regardless of the contrast agent used, inflammatory reactions were most definite in the scala tympani of the basal turn, i.e., near the round window. Slightly greater inflammatory reactions were observed in ears injected with Gd-DTPA-BMA compared to Gd-DTPA although the difference was not statistically significant. No inflammatory reaction was observed in any of the seven controls. The auditory brainstem response threshold was 11.8±2.5 dB SPL before IT Gd injection and it did not change for up to 5 days (15.4±6.6 dB SPL) post-injection.ConclusionsGd-DTPA was superior to Gd-DTPA-BMA for visualization of the inner ear. Administration of diluted Gd agents intratympanically may induce considerable inflammatory reactions in the inner ear.



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Differences in Perilymphatic Space Enhancement and Adverse Inflammatory Reaction after Intratympanic Injection of Two Different Gadolinium Agents: A 9.4-Tesla Magnetic Resonance Imaging Study

Publication date: Available online 13 January 2016
Source:Hearing Research
Author(s): Mina Park, Ho Sun Lee, Hyeonjin Kim, Seung Ha Oh, Jun Ho Lee, Myung-Whan Suh
PurposeTo compare the inner ear enhancement after intratympanic injection of two widely used gadolinium (Gd) agents by 9.4 Tesla micro-magnetic resonance imaging (MRI) and to investigate the effects of Gd on the inner ear.MethodsTwelve ears of six rats received intratympanic administration of 1/5 diluted Gd agents: gadoterate meglumine (Gd-DTPA) for the left ear and gadodiamide (Gd-DTPA-BMA) for the right ear. MRI was performed every 30 min from 1 to 4 h after administration. The normalized signal intensity was evaluated by quantitative analysis at each cochlear fluid compartment. Eight, six, and seven ears treated with Gd-DTPA, Gd-DPTA-BMA, and nothing as controls, respectively, were processed for histological evaluation after MRI. After hematoxylin & eosin staining, adverse inflammatory reactions were evaluated for turbid aggregation and lymphocytes.ResultsThe perilymphatic enhancement of Gd-DTPA was superior to that of Gd-DTPA-BMA regardless of cochlear turn, compartment, and time point. Inflammatory reactions were found in 4/8 (50.0%) and 4/6 (66.6%) ears administered Gd-DTPA and Gd-DTPA-BMA, respectively. Regardless of the contrast agent used, inflammatory reactions were most definite in the scala tympani of the basal turn, i.e., near the round window. Slightly greater inflammatory reactions were observed in ears injected with Gd-DTPA-BMA compared to Gd-DTPA although the difference was not statistically significant. No inflammatory reaction was observed in any of the seven controls. The auditory brainstem response threshold was 11.8±2.5 dB SPL before IT Gd injection and it did not change for up to 5 days (15.4±6.6 dB SPL) post-injection.ConclusionsGd-DTPA was superior to Gd-DTPA-BMA for visualization of the inner ear. Administration of diluted Gd agents intratympanically may induce considerable inflammatory reactions in the inner ear.



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