Especificidade nacional-cultural da semântica de unidades fraseológicas, relativas ao campo semântico "ociosidade" nas línguas inglesa e russa

National-cultural specificity of semantics of phraseological units (PU), characterizing the labor activity, in the English and Russian languages, has its special and actual significance in perceiving the depths of national consciousness. This research is devoted to the identification and comparative description of the semantic field of the PU type being investigated and the image-motivational aspects of the PU meaning. The universal and unique traits in the semantics of the PU of both languages are studied, the cultural connotation is defined and described through the cultural interpretation mechanism of all the content components of the studied PU.Cultural connotation, being an interpretation of the components of the PU meaning in the categories of culture, is layered into the connotation as a linguistic concept. Each component of the PU connotation is able to provide additional information of a national cultural character. First of all, such components of the connotation are the emotive and evaluative macrocomponents of the PU semantics.La especificidad nacional-cultural de la semántica de unidades fraseológicas (PU), que caracteriza la actividad laboral, en los idiomas inglés y ruso, tiene su significado especial y real para percibir las profundidades de la conciencia nacional. Esta investigación está dedicada a la identificación y descripción comparativa del campo semántico del tipo de PU que se está investigando y los aspectos de imagen-motivación del significado de la PU. Se estudian los rasgos universales y únicos en la semántica de la PU de ambas lenguas, la connotación cultural se define y describe a través del mecanismo de interpretación cultural de todos los componentes de contenido de la PU estudiada.La connotación cultural, al ser una interpretación de los componentes del significado de la PU en las categorías de la cultura, se superpone a la connotación como un concepto lingüístico. Cada componente de la connotación PU puede proporcionar información adicional de un personaje cultural nacional. En primer lugar, tales componentes de la connotación son los macrocomponentes emotivos y evaluativos de la semántica de la PU.Especificidade nacional-cultural de semântica de unidades fraseológicos (PU), o que caracteriza o local de trabalho, em Inglês e Russo, tem seu especial real e perceber as profundezas da consciência nacional significado. Esta pesquisa dedica-se à identificação e descrição comparativa do campo semântico do tipo de UP que está sendo investigado e dos aspectos de motivação da imagem do significado de UP. As características únicas e universais na semântica da UP de ambas as línguas são estudadas, a conotação cultural é definida e descrita através do mecanismo de interpretação cultural de todos os componentes do conteúdo da UP estudada.A conotação cultural, sendo uma interpretação dos componentes do significado de UP nas categorias de cultura, é sobreposta à conotação como conceito linguístico. Cada componente da conotação PU pode fornecer informações adicionais de caráter cultural nacional. Em primeiro lugar, tais componentes da conotação são os macrocomponentes emotivos e avaliativos da semântica da PU

Intratympanic gentamicin treatment for Ménière's disease: A randomized, double-blind, placebo-controlled trial on dose efficacy - results of a prematurely ended study

Background: Gentamicin is used as a therapeutic agent for Ménière's disease because of its vestibulotoxicity causing chemo-ablation of the vestibular sensory epithelia. Its use has increased in recent years. However, there is still no consensus about the dose regimen of gentamicin in the treatment of Ménière's disease. In this study two different dose regimen treatment protocols are compared in a placebo controlled study design. The primary objective is to quantify the treatment effect on dizziness, the secondary objective is hearing evaluation.Methods: We performed a randomized, double-blind, placebo-controlled study in adults with unilateral Ménière's disease according to the AAO-HNS guidelines resistant to conservative medication. Three groups received four injections, administered weekly (four intratympanic injections with 40 mg/mL gentamicin solution, two injections gentamicin solution and two injections of placebo in random order, or four injections with placebo). Outcome measures were the score on the Dizziness Handicap Inventory and pure tone audiometry (PTA). Intended follow-up was 2 years.Results: During follow-up one patient exceeded the accepted amount of hearing loss. Further, enrollment was very slow (until 12 months between two patients) and new insights showed an apparent benefit of intratympanic gentamicin treatment (ITG). Therefore we performed an unscheduled interim analysis which showed that PTA threshold shifts reached the stopping criteria in two more patients. Because of this, this study was ended. Of the three patients with the significant PTA threshold shift two were enrolled in the gentamicin group.Conclusion: No conclusions can be drawn concerning doses regimens. Now that new publications have shown that ITG treatment can be an effective and safe treatment, a placebo-controlled randomized controlled trial may not pass the ethical committee because of these recent reports in literature. Still, a dose regimen study (without placebo) on ITG treatment needs to be performed.Trial registration: This trial was registered in The University Medical Center Utrecht/ Gelre hospital Apeldoorn. Protocol ID: 07/343, EudraCT number 2006-005913-37

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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 implantation (UCI) in adults with postlingual deafness. DESIGN, SETTING, AND PARTICIPANTS A multicenter randomized clinical trial was performed. The study took place in 5 Dutch tertiary referral centers: the University Medical Centers of Utrecht, Maastricht, Groningen, Leiden, and Nijmegen. Forty patients eligible for cochlear implantation met the study criteria and were included from January 12, 2010, through November 2, 2012. The main inclusion criteria were postlingual onset of hearing loss, age of 18 to 70 years, duration of hearing loss of less than 20 years, and a marginal hearing aid benefit. Two participants withdrew from the study before implantation. Nineteen participants were randomized to undergo UCI and 19 to undergo BCI. INTERVENTIONS The BCI group received 2 cochlear implants during 1 surgery. The UCI group received 1 cochlear implant. MAIN OUTCOMES AND MEASURES The primary outcome was the Utrecht Sentence Test with Adaptive Randomized Roving levels (speech in noise, both presented from straight ahead). Secondary outcomes were consonant-vowel-consonant words in silence, speech-intelligibility test with spatially separated sources (speech in noise from different directions), sound localization, and quality of hearing questionnaires. Before any data were collected, the hypothesis was that the BCI group would perform better on the objective and subjective tests that concerned speech intelligibility in noise and spatial hearing. RESULTS Thirty-eight patients were included in the study. Fifteen patients in the BCI group used hearing aids before implantation compared with 19 in the UCI group. Otherwise, there were no significant differences between the groups' baseline characteristics. At 1-year follow-up, there were no significant differences between groups on the Utrecht Sentence Test with Adaptive Randomized Roving levels (9.1 dB, UCI group; 8.2 dB, BCI group; P = .39) or the consonant-vowel-consonant test (median percentage correct score 85.0% in the UCI group and 86.8% in the BCI group; P = .21). The BCI group performed significantly better than the UCI group when noise came from different directions (median speech reception threshold in noise, 14.4 dB, BCI group; 5.6 dB, BCI group; P <.001). The BCI group was better able to localize sounds (median correct score of 50.0% at 60 degrees, UCI group; 96.7%, BCI group; P CONCLUSIONS AND RELEVANCE This randomized clinical trial demonstrates a significant benefit of simultaneous BCI above UCI in daily listening situations for adults with postlingual deafness

Temporary Neurotrophin Treatment Prevents Deafness-Induced Auditory Nerve Degeneration and Preserves Function

After substantial loss of cochlear hair cells, exogenous neurotrophins prevent degeneration of the auditory nerve. Because cochlear implantation, the current therapy for profound sensorineural hearing loss, depends on a functional nerve, application of neurotrophins is being investigated. We addressed two questions important for fundamental insight into the effects of exogenous neurotrophins on a degenerating neural system, and for translation to the clinic. First, does temporary treatment with brain-derived neurotrophic factor (BDNF) prevent nerve degeneration on the long term? Second, how does a BDNF-treated nerve respond to electrical stimulation? Deafened guinea pigs received a cochlear implant, and their cochleas were infused with BDNF for 4 weeks. Up to 8 weeks after treatment, their cochleas were analyzed histologically. Electrically evoked compound action potentials (eCAPs) were recorded using stimulation paradigms that are informative of neural survival. Spiral ganglion cell (SGC) degeneration was prevented during BDNF treatment, resulting in 1.9 times more SGCs than in deafened untreated cochleas. Importantly, SGC survival was almost complete 8 weeks after treatment cessation, when 2.6 times more SGCs were observed. In four eCAP characteristics (three involving alteration of the interphase gap of the biphasic current pulse and one involving pulse trains), we found large and statistically significant differences between normal-hearing and deaf controls. Importantly, for BDNF-treated animals, these eCAP characteristics were near normal, suggesting healthy responsiveness of BDNF-treated SGCs. In conclusion, clinically practicable short-term neurotrophin treatment is sufficient for long-term survival of SGCs, and it can restore or preserve SGC function well beyond the treatment period

Recovery characteristics of the electrically stimulated auditory nerve in deafened guinea pigs : Relation to neuronal status

Successful cochlear implant performance requires adequate responsiveness of the auditory nerve to prolonged pulsatile electrical stimulation. Degeneration of the auditory nerve as a result of severe hair cell loss could considerably compromise this ability. The main objective of this study was to characterize the recovery of the electrically stimulated auditory nerve, as well as to evaluate possible changes caused by deafness-induced degeneration. To this end we studied temporal responsiveness of the auditory nerve in a guinea pig model of sensorineural hearing loss. Using masker-probe and pulse train paradigms we compared electrically evoked compound action potentials (eCAPs) in normal-hearing animals with those in animals with moderate (two weeks after ototoxic treatment) and severe (six weeks after ototoxic treatment) loss of spiral ganglion cells (SGCs). Masker-probe interval and pulse train inter-pulse interval was varied from 0.3 to 16ms. Whereas recovery assessed with masker-probe was roughly similar for normal-hearing and both groups of deafened animals, it was considerably faster for six weeks deaf animals (τ≈1.2ms) than for two weeks deaf or normal-hearing animals (τ≈3-4ms) when 100-ms pulse trains were applied. Latency increased with decreasing inter-pulse intervals, and this was more pronounced with pulse trains than with masker-probe stimulation. With high frequency pulse train stimulation eCAP amplitudes were modulated for deafened animals, meaning that amplitudes for odd pulse numbers were larger than for even pulses. The relative refractory period (τ) and the modulation depth of the eCAP amplitude for pulse trains, as well as the latency increase for both paradigms significantly correlated with quantified measures of auditory nerve degeneration (size and packing density of SGCs). In addition to these findings, separate masker-probe recovery functions for the eCAP N1 and N2 peaks displayed a robust non-monotonic or shoulder-shaped course in all animals. The time interval between the N1 and N2 correlated with neuronal refractoriness, suggesting that the N2 peak reflects a second firing of part of the SGC population. We conclude that - compared to the commonly used masker-probe recovery functions - recovery functions obtained with pulse train stimulation may provide a means to augment differences and, by doing so, to more potently discriminate between auditory nerve conditions

Three-dimensional models of the tracheostoma using stereolithography

The availability of an accurate three-dimensional (3-D) model of the tracheostoma and trachea of the laryngectomy patient would be of great help in prototyping of endotracheal prostheses. Stereolithography has been described for skull and jaw models but never for soft-tissue reconstructions of the trachea. CT was performed on tracheostomas of 8 patients. The CT data were used to make 3-D models by means of stereolithography. Inverted CT data were used to create air contour models of the same tracheostomas. Eight soft-tissue and 8 air contour models were reconstructed from CT data, showing accuracy and great detail. In this paper we present a previously unreported application of the stereolithography technique. Measurements and prosthesis prototyping, which are impossible to perform on tracheostomas in patients, can now be executed safely. We are using the 3-D tracheostoma models in our research project to develop an endotracheal fixation method for tracheostomal valve

Effect of round window reinforcement on hearing : A temporal bone study with clinical implications for surgical reinforcement of the round window

Hypothesis: Round window reinforcement leads to conductive hearing loss. Background: The round window is stiffened surgically as therapy for various conditions, including perilymphatic fistula and superior semicircular canal dehiscence. Round window reinforcement reduces symptoms in these patients. However, it also reduces fluid displacement in the cochlea and might therefore increase conductive hearing loss. Methods: Perichondrium was applied to the round window membrane in nine fresh-frozen, nonpathologic temporal bones. In four temporal bones cartilage was applied subsequently. Acoustic stimuli in the form of frequency sweeps from 250 to 8000Hz were generated at 110 dB sound pressure level. A total of 16 frequencies in a 1/3-octave series were used. Stapes velocities in response to the acoustic stimuli were measured at equally spaced multiple points covering the stapes footplate using a scanning laser Doppler interferometry system. Measurements were made at baseline, after applying perichondrium, and after applying cartilage. Results: At frequencies up to 1000 Hz perichondrium reinforcement decreased stapes velocities by 1.5 to 2.9 dB compared with no reinforcement (p value =0.003). Reinforcement with cartilage led to a further deterioration of stapes velocities by 2.6 to 4.2 dB at frequencies up to 1000 Hz (p value=0.050). The higher frequencies were not affected by perichondrium reinforcement (p value=0.774) or cartilage reinforcement (p value=0.644). Conclusion: Our results seem to suggest a modest, clinically negligible effect of reinforcement with perichondrium. Placing cartilage on the round window resulted in a graded effect on stapes velocities in keeping with the increased stiffness of cartilage compared with perichondrium. Even so, the effect was relatively small

Cochlear implant electrode array insertion monitoring with intra-operative 3D rotational X-ray

During cochlear implantation surgery, we use a mobile C-arm with 3D functionality to acquire per-operative 3D X-ray images. Scanning the multielectrode array is performed once before removal of the stylet and once after full insertion. When dissatisfied with the position of the multielectrode a repositioning is considered which happened occasionally. The major advantage is the extra certainty of the multielectrode array position in the cochlea with low-dose and little extra time. All cochlear implantations are now routinely scanned during surgery