The MuSIC perception test: a novel battery for testing music perception of cochlear implant users.

This study was undertaken to evaluate the musical sounds in cochlear implants (MuSIC) perception test, created to assess the music-listening abilities of cochlear implant (CI) users. Thirty-one unilateral MED-EL COMBI 40+/PULSARCI(100) users and a control group of 67 adults with normal hearing (NH) participated. The MuSIC test comprises six objective and two subjective modules employing approximately 2800 musical files recorded from non-synthesized instruments. A subset was used for comparing CI and NH participants' results. CI and NH participants performed significantly differently on: pitch discrimination, melody discrimination, chord discrimination, instrument detection, and instrument identification. No significant difference in performance was seen on the subtests of rhythm discrimination or dissonance rating and emotion rating. The MuSIC test was found to be a valuable tool for assessing music perception in CI users and NH participants, whether investigating one aspect of music perception in depth or conducting a broad survey of music perception.

Music perception in electric acoustic stimulation users as assessed by the Mu.S.I.C. test.

AIMS: This study compared the music perception abilities of 13 electric acoustic stimulation (EAS) users with two control groups: unilateral cochlear implant (CI) users and normal-hearing (NH) listeners. METHODS: Groups were matched according to age and musical experience before hearing loss (HL) and tested using the Musical Sounds in Cochlear Implants (Mu.S.I.C.) test. RESULTS: No difference was found on rhythm perception, chord discrimination, dissonance rating, and emotion rating subtest performance between groups. Mean frequency discrimination scores were significantly better in EAS participants than in CI participants and not significantly worse than in NH participants. However, the EAS and CI groups scored similarly (significantly worse than NH participants) on both instrument detection and identification. Results for EAS participants were not significantly worse when the hearing aid component was removed. Frequency of listening to music before HL was negatively correlated with EAS participants' frequency discrimination scores, though singing and playing an instrument appeared to have no effect. EAS participants who indicated many reasons for listening to music and who listen to many genres after implantation scored higher on instrument detection and instrument identification. Better results on these two subtests were correlated with EAS participants' better postoperative auditory thresholds at 250 and 500 Hz. CONCLUSIONS: Though EAS participants performed better on music perception testing (though not timbre-based tasks) than CI participants, their scores did not reach the level of NH participants. This indicates that acoustic hearing in the low frequencies is helpful for music perception, though not the only important factor.

Comparison of music perception in bilateral and unilateral cochlear implant users and normal-hearing subjects.

Music plays an important role in the daily life of cochlear implant (CI) users, but electrical hearing and speech processing pose challenges for enjoying music. Studies of unilateral CI (UCI) users' music perception have found that these subjects have little difficulty recognizing tempo and rhythm but great difficulty with pitch, interval and melody. The present study is an initial step towards understanding music perception in bilateral CI (BCI) users. The Munich Music Questionnaire was used to investigate music listening habits and enjoyment in 23 BCI users compared to 2 control groups: 23 UCI users and 23 normal-hearing (NH) listeners. Bilateral users appeared to have a number of advantages over unilateral users, though their enjoyment of music did not reach the level of NH listeners.

In vivo intrauterine sound pressure and temperature measurements during magnetic resonance imaging (1.5 T) in pregnant ewes.

OBJECTIVE: To investigate the influence of several magnetic resonance imaging (MRI) sequences on amniotic fluid temperature and intrauterine sound pressure. MATERIAL AND METHODS: Temperature and sound pressure measurements during MRI (1.5 T) in pregnant ewes were done. Linear levels and third octave band spectra were compared. RESULTS: No significant changes in the temperature of amniotic fluid were observed. Intrauterine summation levels reached peak levels up to 103.0 dB(A) before starting the MRI sequence and levels up to 116.0 dB(A) during a real-time sequence. Evaluating the octave band spectra, peak levels did not exceed 100.0 dB(L). CONCLUSIONS: Our delimited data revealed no harm for the fetus by an increase in amniotic fluid temperature or hazards for the fetal auditory system by different MRI sequences.

[Is the use of factor XIII for delayed wound healing in patients with head-neck tumors of value?]. / Ist der Einsatz von Faktor XIII bei Wundheilungsstörungen von Patienten mit Kopf-Hals-Tumoren sinnvoll?

BACKGROUND: Factor XIII is known to play an important role in wound healing. In patients with head and neck carcinomas there is an accumulation of risk factors for factor XIII deficiency such as chronic liver disease, extensive tissue lesions, and high intraoperative blood loss. METHOD: Serum levels of factor XIII in 22 patients who had undergone tumor surgery for head and neck carcinoma were measured preoperatively and daily up to 1 week following surgery. Factor XIII was measured with the Berichrome assay as part of our routine laboratory studies. The results were correlated with preoperative pseudocholinesterase (PChe). Factor XIII was substituted for 3 days in 8 patients with persistent wound healing problems that did not improve after two weeks of conservative treatment. RESULTS: We found that PChe levels are a predictor for the development of factor XIII levels during this period. In patients (n = 14) with normal PChe, factor XIII levels reached 86% of the preoperative values 1 week after operation (group 1). In patients (n = 8) with low PChe, the levels reached only 65% (group 2). The rate of wound healing problems was higher in group 2 (6/8) than in group 1 (2/14). In 6 patients treated with factor XIII, the wounds healed within 3 to 7 days. In two cases revision operation was necessary. CONCLUSION: We conclude that the therapy with factor XIII may be successful in patients with wound healing problems. Further studies will be necessary to find out whether prophylactic substitution of factor XIII in patients with low preoperative pseudocholinesterase levels is useful.

Medical, surgical, and technical complications with the COMBI-40.

We present the first report on complications of cochlear implantation with the COMBI-40 (Med-el, Innsbruck, Austria). Between January 1995 and May 1996 325 devices had been implanted by 58 different surgeons. Complications were reported with the help of standardized complication report form. The overall rate of complications was 4.6%. Most common problems were flap necrosis and incorrect positioning of the electrode. No technical failures occurred. The incidence of complications was lower than those reported by other authors.

Octreotide exerts different effects in vivo and in vitro in Cushing's disease.

The effect of the long-acting somatostatin analog octreotide (SMS 201-995) on adrenocorticotropin (ACTH) secretion was studied in five patients with untreated Cushing's disease in vivo and in six human corticotropic adenoma cell cultures in vitro. For the in vivo study, 100 micrograms of octreotide sc was given 30 and 180 min after cannulation of the cubital vein and 100 micrograms of corticotropin-releasing hormone (CRH) was injected iv at 210 min. Serum ACTH and cortisol levels were measured for 390 min. In vivo, octreotide had no significant effect either on basal or CRH-stimulated ACTH levels and did not influence cortisol levels. The in vitro studies were conducted with corticotropic adenoma cell cultures derived from adenoma tissue obtained from six patients with Cushing's disease. In four of six cell cultures, octreotide (1 nmol/l-1 mumol/l) inhibited basal ACTH secretion in a dose-dependent manner. The inhibition ranged from 70 to 92% for 1 nmol/l octreotide to 14-46% for 1 mumol/l octreotide as compared to controls (100%). In three of three octreotide-responsive adenoma cell cultures investigated. CRH-stimulated ACTH secretion was suppressed by octreotide. Hydrocortisone pretreatment in vitro abolished the inhibitory effect of octreotide on ACTH secretion in one octreotide-responsive corticotropic adenoma cell culture. In conclusion, we showed that octreotide in most cases could inhibit the ACTH release from human corticotropic adenoma cells in vitro but had no suppressive effect on ACTH levels of patients with Cushing's disease in vivo. This discrepancy could be due to a somatostatin receptor down-regulation by cortisol at the hypercortisolemic state in vivo.

TRH/GnRH test in acromegaly. Long-term follow-up experience with successfully treated patients.

We investigated the rate of recurrence in acromegaly in 20 patients who were found to have a TRH and GnRH induced GH response postoperatively after primarily successful transsphenoidal selective adenomectomy in a retrospective study. All operations had been carried out by the same neurosurgeon (R.F.). Successful therapy was defined as basal GH-levels < or = 2 ng/ml and no evidence of residual tumour in the postoperative neuroradiological examination. The follow-up period ranged from 5 to 14 years (mean 7.7 years). At the last follow-up visit an OGTT was performed and SmC measured. In spite of the long-follow-up period we did not find patients with recurrent acromegaly in this investigation. We conclude that, in contrast to previous studies, a stimulation of GH in the TRH/GnRH test does not necessarily predict likely recurrence of acromegaly in patients with an adequate suppression of GH during an OGTT following operative microsurgical treatment.

Acromegaly with 'normal' serum growth hormone levels. Clinical features, diagnosis and results of transsphenoidal microsurgery.

Among 216 consecutive patients with growth hormone secreting pituitary adenomas who underwent primary neurosurgical treatment at the University of Erlangen-Nürnberg, 8 cases of acromegaly with 'normal' basal growth hormone levels (less than or equal to 5 ng/ml) were seen. They all had the typical clinical features of acromegaly, exhibited an abnormal growth hormone secretion following an oral glucose load, and had markedly elevated somatomedin C levels. The GRH- and TRH/GnRH-tests were not found helpful in establishing the diagnosis. Neuroradiology could demonstrate a pituitary adenoma in all of the patients. Following transsphenoidal microsurgical resection of the tumours, growth hormone secretion during oral glucose tolerance testing was normalised in 7 of the 8 patients. Immunohistology and explant culture studies documented growth hormone secreting pituitary adenomas in all cases. The authors conclude that even the finding of repetitive 'normal' (less than or equal to 5 ng/ml) serum GH levels does not exclude active acromegaly and when the clinical diagnosis of acromegaly is suspected, dynamic endocrine testing may reveal abnormal secretion patterns of GH in these cases. Transsphenoidal microsurgical resection of a pituitary adenoma offers a good chance of clinical and endocrinological remission in these cases.