Oxana Selivanova

Akt and c-Jun N-Terminal Kinase Are Regulated in Response to Moderate Noise Exposure in the Cochlea of Guinea Pigs

The molecular mechanisms induced in the inner ear after noise exposure are not well understood. Akt and c-Jun N-terminal kinase (JNK) are key factors of signaling pathways balancing cellular survival and apoptosis. Therefore, we analyzed the spatial distribution of Akt, JNK, their respective activated (i.e. phosphorylated) forms, p-Akt and p-JNK, as well as NFĸB by immunohistochemistry after 70- and 90-dB noise exposure in an animal model. Alterations of the expression patterns compared to unexposed animals were quantified by a computer-based image analysis method. In unexposed specimens, Akt, p-Akt, JNK, p-JNK were found to be commonly expressed in different regions of the cochlea, whereas NFĸB was exclusively restricted to the lateral wall. After noise stimulation, the expression of the different molecules was downregulated with the exception of JNK. JNK remained largely unchanged or increased JNK levels were identified in ganglion cells and Schwann cells after 70 dB as well as in the unstained nerve fibers. The stable or increasing levels of JNK might be indicative of a preapoptotic state. The downregulation of Akt in the cochlea might support these activities. p-Akt was not reduced in the spiral ganglion cells after 90-dB exposure and was upregulated in the unstained nerve fibers, probably indicating a counteracting prosurvival cellular reaction in these tissues. In conclusion, we suggest that the observed alterations in both the Akt and JNK pathways are part of a noise distress-induced response indicating pro- and antiapoptotic activities in the different tissues of the cochlea.

Spontaneous Cerebrospinal Fluid Rhinorrhea: A clinical and anatomical study

Spontaneous nasal cerebrospinal fluid (CSF) fistula represents a rare clinical entity. The possible etiology and the localization of the rhinorrhea remain an ongoing clinical challenge. The purpose of this study was to evaluate the localization of spontaneous CSF fistula and to correlate it with anatomical studies.

Noise exposure alters cyclooxygenase 1 (COX-1) and 5-lipoxygenase (5-LO) expression in the guinea pig cochlea.

CONCLUSION Changes in the metabolism of arachidonic acid (AA) might be part of a noise-induced compensatory mechanism with regional specificity. OBJECTIVES The released imbalance of prostaglandins and leukotrienes, both AA metabolites, might result in altered blood flow regulation in the inner ear and probably contributes to noise-induced hearing loss. The aim of this study was to gain further information about noise-dependent changes in AA metabolism in the mammalian cochlea. METHODS In this prospective animal study, 10 male guinea pigs were exposed to tone bursts for 1 h at 70 dB sound pressure level (SPL) (n = 5) or 90 dB SPL (n = 5). Five animals were used as controls. Alterations in cyclooxygenase 1 (COX-1) and 5-lipoxygenase (5-LO) expression were determined by quantitative immunohistochemical analysis in 11 cochlear regions. RESULTS COX-1 expression was decreased after both 70 dB SPL and 90 dB SPL exposure in most cell types of the organ of Corti and increased in the nerve fibers of the osseous spiral lamina. 5-LO was lowered after 90 dB SPL exposure, preferentially in the third cochlear turn in the organ of Corti, in the first and second turn in spiral ganglion cells, and in all turns in the stria vascularis.

Polysomnography and ApneaGraph® in Patients with Sleep-Related Breathing Disorders

Purpose: To evaluate whether ApneaGraph (AG) and polysomnography (PSG) deliver comparable results in patients with sleep-related breathing disorders. Procedures: A prospective study was performed, which included 14 patients with obstructive sleep apnea syndrome. Apnea-hypopnea index (AHI), hypopnea index (HI), apnea index (AI), obstructive, central and mixed apnea, oxygen saturation (SaO2), pulse and body position were simultaneously assessed by PSG and AG in each individual. Results: There was a good correlation between measurements of AG and PSG for AHI, pulse, SaO2, body position and central apnea. However, our study showed differences between PSG and AG for AI (p = 0.002), HI (p = 0.013), mixed apnea (p = 0.003) and obstructive apnea (p = 0.013). AG indicated that 2/14 patients had a pure upper airway obstruction, 6/14 patients had a predominance of lower obstruction and 6/14 patients had a predominance of upper obstruction. Conclusion: AG provides comparable results for AHI, pulse, SaO2, body position and central apnea when compared to PSG, but not for the rest of the measurements. Using AG, the distribution of sites of obstructive events could be identified in this study in all of the patients.

Besteht ein Zusammenhang zwischen der Refluxerkrankung und dem obstruktiven Schlafapnoesyndrom

Reflux of gastric contents can be associated with many ENT disorders. Some authors describe an association with obstructive sleep apnea, but it is not clear whether the reflux causes the apnea or vice versa. Furthermore, authors did not distinguish between gastroesophageal reflux and extraesophageal reflux, which is essential to understand a connection with obstructive sleep apnea. Therefore, we performed polysomnography and two-channel pH testing simultaneously in patients with obstructive sleep apnea syndrome (OSAS) and compared the findings with data of healthy volunteers. After exclusion of a changed sleep architecture due to the pH testing system, the results show that patients with OSAS do not suffer more often from reflux than healthy volunteers. This is true for gastroesophageal as well as for extraesophageal reflux. Furthermore, an increasing number of reflux events during the night is not correlated with the number of apnea events. Thus, in summary our data cannot support the postulation that there is a connection between obstructive sleep apnea syndrome and reflux disease.ZusammenfassungDie Refluxerkrankung wird im internationalen Schrifttum mit zahlreichen anderen Erkrankungen in Verbindung gebracht. Unter anderem wird, oftmals anhand von Einzelbeobachtungen, ein Zusammenhang mit dem Auftreten eines obstruktiven Schlafapnoesyndroms postuliert. Dabei ist unklar, ob der Reflux aufgrund einer Magensäureaspiration zur Apnoe führt, was entscheidenden Einfluss auf die Therapie des OSAS haben könnte, oder ob die Apnoe aufgrund des intrathorakalen Unterdrucks zu einem Reflux führt. Außerdem wird nicht zwischen verschiedenen Arten der Refluxerkrankung unterschieden. In der vorliegenden Arbeit wurde deshalb bei Patienten mit OSAS simultan eine Polysomnographie und eine Zweikanal-pH-Metrie durchgeführt, um zu untersuchen, ob sie gehäuft unter einem ösophagealen oder einem extraösophagealen Reflux leiden. Die Daten wurden mit einer Kontrollpopulation verglichen. Nach Ausschluss einer Beeinträchtigung der Schlafarchitektur durch die Refluxmessung zeigen die Ergebnisse, dass es bei Patienten mit gesichertem OSAS im Vergleich zur Kontrollgruppe nicht zu einem gehäuften Vorkommen eines ösophagealen oder extraösophagealen Refluxes kommt. Auch die Gegenüberstellung von der Zahl der Refluxereignisse und der Zahl der Apnoen/Hypopnoen lässt keine Korrelation erkennen. Aufgrund der gemeinsamen Risikofaktoren kommt es sicherlich in Einzelfällen zum Auftreten beider Erkrankungen bei Patienten. Diese Einzelbeobachtungen lassen sich aber an dem hier untersuchten Kollektiv nicht statistisch sichern.AbstractReflux of gastric contents can be associated with many ENT disorders. Some authors describe an association with obstructive sleep apnea, but it is not clear whether the reflux causes the apnea or vice versa. Furthermore, authors did not distinguish between gastroesophageal reflux and extraesophageal reflux, which is essential to understand a connection with obstructive sleep apnea. Therefore, we performed polysomnography and two-channel pH testing simultaneously in patients with obstructive sleep apnea syndrome (OSAS) and compared the findings with data of healthy volunteers. After exclusion of a changed sleep architecture due to the pH testing system, the results show that patients with OSAS do not suffer more often from reflux than healthy volunteers. This is true for gastroesophageal as well as for extraesophageal reflux. Furthermore, an increasing number of reflux events during the night is not correlated with the number of apnea events. Thus, in summary our data cannot support the postulation that there is a connection between obstructive sleep apnea syndrome and reflux disease.

No correlation between reflux of gastric contents and obstructive sleep apnea

Reflux of gastric contents can be associated with many ENT disorders. Some authors describe an association with obstructive sleep apnea, but it is not clear whether the reflux causes the apnea or vice versa. Furthermore, authors did not distinguish between gastroesophageal reflux and extraesophageal reflux, which is essential to understand a connection with obstructive sleep apnea. Therefore, we performed polysomnography and two-channel pH testing simultaneously in patients with obstructive sleep apnea syndrome (OSAS) and compared the findings with data of healthy volunteers. After exclusion of a changed sleep architecture due to the pH testing system, the results show that patients with OSAS do not suffer more often from reflux than healthy volunteers. This is true for gastroesophageal as well as for extraesophageal reflux. Furthermore, an increasing number of reflux events during the night is not correlated with the number of apnea events. Thus, in summary our data cannot support the postulation that there is a connection between obstructive sleep apnea syndrome and reflux disease.ZusammenfassungDie Refluxerkrankung wird im internationalen Schrifttum mit zahlreichen anderen Erkrankungen in Verbindung gebracht. Unter anderem wird, oftmals anhand von Einzelbeobachtungen, ein Zusammenhang mit dem Auftreten eines obstruktiven Schlafapnoesyndroms postuliert. Dabei ist unklar, ob der Reflux aufgrund einer Magensäureaspiration zur Apnoe führt, was entscheidenden Einfluss auf die Therapie des OSAS haben könnte, oder ob die Apnoe aufgrund des intrathorakalen Unterdrucks zu einem Reflux führt. Außerdem wird nicht zwischen verschiedenen Arten der Refluxerkrankung unterschieden. In der vorliegenden Arbeit wurde deshalb bei Patienten mit OSAS simultan eine Polysomnographie und eine Zweikanal-pH-Metrie durchgeführt, um zu untersuchen, ob sie gehäuft unter einem ösophagealen oder einem extraösophagealen Reflux leiden. Die Daten wurden mit einer Kontrollpopulation verglichen. Nach Ausschluss einer Beeinträchtigung der Schlafarchitektur durch die Refluxmessung zeigen die Ergebnisse, dass es bei Patienten mit gesichertem OSAS im Vergleich zur Kontrollgruppe nicht zu einem gehäuften Vorkommen eines ösophagealen oder extraösophagealen Refluxes kommt. Auch die Gegenüberstellung von der Zahl der Refluxereignisse und der Zahl der Apnoen/Hypopnoen lässt keine Korrelation erkennen. Aufgrund der gemeinsamen Risikofaktoren kommt es sicherlich in Einzelfällen zum Auftreten beider Erkrankungen bei Patienten. Diese Einzelbeobachtungen lassen sich aber an dem hier untersuchten Kollektiv nicht statistisch sichern.AbstractReflux of gastric contents can be associated with many ENT disorders. Some authors describe an association with obstructive sleep apnea, but it is not clear whether the reflux causes the apnea or vice versa. Furthermore, authors did not distinguish between gastroesophageal reflux and extraesophageal reflux, which is essential to understand a connection with obstructive sleep apnea. Therefore, we performed polysomnography and two-channel pH testing simultaneously in patients with obstructive sleep apnea syndrome (OSAS) and compared the findings with data of healthy volunteers. After exclusion of a changed sleep architecture due to the pH testing system, the results show that patients with OSAS do not suffer more often from reflux than healthy volunteers. This is true for gastroesophageal as well as for extraesophageal reflux. Furthermore, an increasing number of reflux events during the night is not correlated with the number of apnea events. Thus, in summary our data cannot support the postulation that there is a connection between obstructive sleep apnea syndrome and reflux disease.

Cochlear implantation after surgery for bilateral jugular foramen paragangliomas: a case report

This paper describes a case of cochlear implantation for deafness due to bilateral glomus jugulare tumors (paragangliomas) as well as an unusual complication after cochlear implantation in a 31-year-old male. A 31-year-old male with profound sensorineural hearing loss on the right side and deafness on the left side, caused by bilateral jugular foramen paragangliomas, was implanted with a multi-channel cochlear implant (Combi 40+, Med-El) on the right side during subtotal petrosectomy for removal of the right-sided glomus jugulare tumor. No postoperative medical complications were observed. The patient responded to acoustic stimuli. Postoperative computed tomography (CT) did not show any misplacement of the electrode. Three years after implantation, an acute, rapidly progressive hearing impairment with pain to acoustic stimuli was observed. A CT scan at that time showed cochlear bone resorption. No radiologic evidence of paraganglioma recurrence was observed. The implant was removed and a biopsy of the cochlea was performed which on histologic examination showed fibrosis without any sign of any tumor recurrence. Cochlear implantation can restore hearing in deafness due to bilateral glomus jugulare tumors. Cochlear resorption may occur as a late complication in the implanted side in the patients.

Besteht ein Zusammenhang zwischen der Refluxerkrankung und dem obstruktiven Schlafapnoesyndrom?@@@No correlation between reflux of gastric contents and obstructive sleep apnea

Reflux of gastric contents can be associated with many ENT disorders. Some authors describe an association with obstructive sleep apnea, but it is not clear whether the reflux causes the apnea or vice versa. Furthermore, authors did not distinguish between gastroesophageal reflux and extraesophageal reflux, which is essential to understand a connection with obstructive sleep apnea. Therefore, we performed polysomnography and two-channel pH testing simultaneously in patients with obstructive sleep apnea syndrome (OSAS) and compared the findings with data of healthy volunteers. After exclusion of a changed sleep architecture due to the pH testing system, the results show that patients with OSAS do not suffer more often from reflux than healthy volunteers. This is true for gastroesophageal as well as for extraesophageal reflux. Furthermore, an increasing number of reflux events during the night is not correlated with the number of apnea events. Thus, in summary our data cannot support the postulation that there is a connection between obstructive sleep apnea syndrome and reflux disease.ZusammenfassungDie Refluxerkrankung wird im internationalen Schrifttum mit zahlreichen anderen Erkrankungen in Verbindung gebracht. Unter anderem wird, oftmals anhand von Einzelbeobachtungen, ein Zusammenhang mit dem Auftreten eines obstruktiven Schlafapnoesyndroms postuliert. Dabei ist unklar, ob der Reflux aufgrund einer Magensäureaspiration zur Apnoe führt, was entscheidenden Einfluss auf die Therapie des OSAS haben könnte, oder ob die Apnoe aufgrund des intrathorakalen Unterdrucks zu einem Reflux führt. Außerdem wird nicht zwischen verschiedenen Arten der Refluxerkrankung unterschieden. In der vorliegenden Arbeit wurde deshalb bei Patienten mit OSAS simultan eine Polysomnographie und eine Zweikanal-pH-Metrie durchgeführt, um zu untersuchen, ob sie gehäuft unter einem ösophagealen oder einem extraösophagealen Reflux leiden. Die Daten wurden mit einer Kontrollpopulation verglichen. Nach Ausschluss einer Beeinträchtigung der Schlafarchitektur durch die Refluxmessung zeigen die Ergebnisse, dass es bei Patienten mit gesichertem OSAS im Vergleich zur Kontrollgruppe nicht zu einem gehäuften Vorkommen eines ösophagealen oder extraösophagealen Refluxes kommt. Auch die Gegenüberstellung von der Zahl der Refluxereignisse und der Zahl der Apnoen/Hypopnoen lässt keine Korrelation erkennen. Aufgrund der gemeinsamen Risikofaktoren kommt es sicherlich in Einzelfällen zum Auftreten beider Erkrankungen bei Patienten. Diese Einzelbeobachtungen lassen sich aber an dem hier untersuchten Kollektiv nicht statistisch sichern.AbstractReflux of gastric contents can be associated with many ENT disorders. Some authors describe an association with obstructive sleep apnea, but it is not clear whether the reflux causes the apnea or vice versa. Furthermore, authors did not distinguish between gastroesophageal reflux and extraesophageal reflux, which is essential to understand a connection with obstructive sleep apnea. Therefore, we performed polysomnography and two-channel pH testing simultaneously in patients with obstructive sleep apnea syndrome (OSAS) and compared the findings with data of healthy volunteers. After exclusion of a changed sleep architecture due to the pH testing system, the results show that patients with OSAS do not suffer more often from reflux than healthy volunteers. This is true for gastroesophageal as well as for extraesophageal reflux. Furthermore, an increasing number of reflux events during the night is not correlated with the number of apnea events. Thus, in summary our data cannot support the postulation that there is a connection between obstructive sleep apnea syndrome and reflux disease.