Faculty Bibliography

The acoustic rearing environment can alter central auditory coding properties, yet altered neural coding is seldom linked with specific deficits to adult perceptual skills. To test whether developmental hearing loss resulted in comparable changes to perception and sensory coding, we examined behavioral and neural detection thresholds for sinusoidally amplitude modulated (sAM) stimuli. Behavioral sAM detection thresholds for slow (5 Hz) modulations were significantly worse for animals reared with bilateral conductive hearing loss (CHL), as compared to controls. This difference could not be attributed to hearing thresholds, proficiency at the task, or proxies for attention. Detection thresholds across the groups did not differ for fast (100 Hz) modulations, a result paralleling that seen in humans. Neural responses to sAM stimuli were recorded in single auditory cortex neurons from separate groups of awake animals. Neurometric analyses indicated equivalent thresholds for the most sensitive neurons, but a significantly poorer detection threshold for slow modulations across the population of CHL neurons as compared to controls. The magnitude of the neural deficit matched that of the behavioral differences, suggesting that a reduction of sensory information can account for limitations to perceptual skills.

The auditory CNS is influenced profoundly by sounds heard during development. Auditory deprivation and augmented sound exposure can each perturb the maturation of neural computations as well as their underlying synaptic properties. However, we have learned little about the emergence of perceptual skills in these same model systems, and especially how perception is influenced by early acoustic experience. Here, we argue that developmental studies must take greater advantage of behavioral benchmarks. We discuss quantitative measures of perceptual development and suggest how they can play a much larger role in guiding experimental design. Most importantly, including behavioral measures will allow us to establish empirical connections among environment, neural development, and perception.

PURPOSE/OBJECTIVE:To evaluate obstetric complications and birth outcome in pregnant women with nephrolithiasis. METHODS:A retrospective population-based study comparing all pregnancies of women with and without nephrolithiasis between 1989 and 2010 was conducted. Clinical characteristics were compared, and the obstetric risk factors and labor complication were analyzed. Multivariable logistic regression models were constructed in order to identify independent risk factors for nephrolithiasis. RESULTS:During the study period, there were 219,656 deliveries, of which 195 women with nephrolithiasis were identified. Nephrolithiasis in pregnant women was significantly associated with recurrent abortions, mild preeclampsia, chronic hypertension, gestational diabetes mellitus, and cesarean deliveries. Nephrolithiasis was also significantly associated with urinary tract infections, pyelonephritis, hydronephrosis, and hydroureter. Nevertheless, no higher rates of premature rupture of membranes, preterm deliveries, or adverse perinatal outcomes (birth weight, Apgar scores or perinatal mortality) were noted in patients with nephrolithisais. Using a multiple logistic regression model, obesity (odds ratio 4.4, 95% confidence interval 2.1-9.0) and hypertensive disorders (odds ratio 2.8, 95% confidence interval 1.9-4.1) were independently associated with nephrolithiasis. CONCLUSION/CONCLUSIONS:Maternal kidney stones are significantly associated with several pregnancy complications, including recurrent abortions, hypertensive disorders, gestational diabetes, and cesarean deliveries. Nevertheless, it is not associated with adverse perinatal outcomes. These findings raise the question regarding the proper management of small asymptomatic kidney stone in a pregnant woman.

PURPOSE: We present a strategy to survey proteolytic processes that occur in human cancer microenvironments. EXPERIMENTAL DESIGN: In situ microdialysis during oral cancer surgery was combined with mass spectrometry-based proteomics to analyze interstitial fluid surrounding tumors and anatomically matched normal sites. Protease activity-based (18)O-profiling was utilized to reveal peptides that were processed by co-collected proteases ex vivo. RESULTS: We demonstrated for the first time the use of microdialysis in humans to collect interstitial fluid from cancer microenvironments. Proteomic profiling identified proteases and inhibitors in the microdialysis samples. A subset of peptides displayed characteristic (18)O-isotope patterns that indicated processing by endogenous proteases. CONCLUSIONS AND CLINICAL RELEVANCE: The presented approach provides unprecedented views of in vivo targets of proteases without disrupting the cancer or surrounding tissue. The methodology can be broadly adapted to other physiological conditions in which proteolytic mediators are involved (e.g. arthritic joints, inflamed muscle, other types of cancer) and where a comparison of normal and pathological tissue is sought.

Certain spectrum characteristics have been identified as important for register equalization around the male passaggio, an effect ascribed to formant tuning although descriptions of formant tuning diverge. Eight professional singers sang scales including their passaggio range on different vowels, applying two formant tuning strategies as found in (1) classical and (2) non-classical singing. Formant frequencies were measured using inverse filtering. Results revealed differences between the two strategies. For the classical formant tuning, systematic changes of formant frequencies with pitch were observed. For the highest note sung on /a/, F1 was below the second partial and F2 in the vicinity of the third. Similar spectrum characteristics were achieved by different F1 and F2 values between singers.

Hematomas, pseudocysts, and seromas are all part of the differential diagnosis of auricular swellings. Seromas are benign collections of serous fluid that have a tendency to recur. The fluid accumulates in the space between the dermis and perichondrium of the ear. We describe what we believe is the first case of spontaneous bilateral auricular seromas to be reported in the literature. One of the seromas resolved in 4 weeks without treatment, and the other resolved with incision and drainage. It is important for physicians to be aware of auricular seromas when considering the differential diagnosis of an auricular swelling, and to understand the various treatment options

OBJECTIVES/HYPOTHESIS/OBJECTIVE:To describe the clinical presentation, pathophysiology, and treatment of spontaneous cerebrospinal fluid (CSF) leaks of the sphenoid bone, with an emphasis on a previously undescribed form in this location, in which CSF is trapped under the mucosa of the sinonasal cavity or in the soft tissue of the skull base. STUDY DESIGN/METHODS:Case series and literature review. METHODS:Analysis of cases through medical records and literature review. RESULTS:Four examples of unusual spontaneous CSF leaks of the skull base are presented. In each case, a CSF collection was contained behind the sinonasal mucosa of the sphenoid sinus, resembling a nasal polyp or mucocele on exam or imaging. In one case, the fluid collection was also associated with significant bone resorption and extravasation into the soft tissue of the infratemporal fossa. In each case, small defects of the ventral skull base (sphenoid bone) were the source of the CSF leaks. Successful treatment was achieved after transnasal endoscopic repair of the skull base defects using a combination of free abdominal fat grafts, free fascial grafts, and pedicled nasoseptal flaps. Postoperatively, a ventriculoperitoneal shunt was placed if the intracranial pressure was elevated. CONCLUSIONS:Spontaneous CSF leaks arising in the sphenoid sinus may not always present with overt CSF rhinorrhea but with a submucosal fluid collection (pseudomeningocele) that may mimic a mucocele or nasal polyp. These bona fide pseudomeningoceles of the skull base may be associated with elevated intracranial pressure and can be managed using endoscopic endonasal surgery.

Approximately 60 cases of tongue abscess have been reported in the English-language literature over the past 30 years. We report what we believe is the first case of a glossal abscess that arose as a complication of tongue-base suspension surgery. The patient was a 31-year-old man who presented with a several-day history of odynophagia, tongue swelling, voice changes, and increased snoring. Two years earlier, he had undergone a tongue-base suspension procedure for the treatment of obstructive sleep apnea. Computed tomography (CT) revealed a tongue abscess. During peroral incision and drainage, a knotted 0 Prolene suture was discovered within the abscess cavity. The suture was removed, the area was thoroughly irrigated, the drain was placed in the abscess cavity, and the incision was loosely closed. On postoperative day 5, repeat CT revealed resolution of the abscess, and the patient was discharged on oral antibiotics. Although glossal abscess is very rare, physicians should consider it in the differential diagnosis of any patient who presents with lingual swelling following tongue-base suspension surgery.