Hearing Loss - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

HEARING LOSS A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R EFERENCES J AMES N...

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HEARING LOSS A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R EFERENCES

J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS

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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright ©2004 by ICON Group International, Inc. Copyright ©2004 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1

Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Hearing Loss: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-597-83973-5 1. Hearing Loss-Popular works. I. Title.

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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.

Copyright Notice If a physician wishes to copy limited passages from this book for patient use, this right is automatically granted without written permission from ICON Group International, Inc. (ICON Group). However, all of ICON Group publications have copyrights. With exception to the above, copying our publications in whole or in part, for whatever reason, is a violation of copyright laws and can lead to penalties and fines. Should you want to copy tables, graphs, or other materials, please contact us to request permission (E-mail: [email protected]). ICON Group often grants permission for very limited reproduction of our publications for internal use, press releases, and academic research. Such reproduction requires confirmed permission from ICON Group International Inc. The disclaimer above must accompany all reproductions, in whole or in part, of this book.

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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on hearing loss. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support.

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About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications. Philip M. Parker, Ph.D. Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications.

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About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes&Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 4370 La Jolla Village Drive, Fourth Floor San Diego, CA 92122 USA Fax: 858-546-4341 Web site: www.icongrouponline.com/health

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Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON HEARING LOSS.......................................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Hearing Loss ............................................................................... 18 E-Journals: PubMed Central ....................................................................................................... 72 The National Library of Medicine: PubMed ................................................................................ 74 CHAPTER 2. NUTRITION AND HEARING LOSS .............................................................................. 121 Overview.................................................................................................................................... 121 Finding Nutrition Studies on Hearing Loss .............................................................................. 121 Federal Resources on Nutrition ................................................................................................. 127 Additional Web Resources ......................................................................................................... 127 CHAPTER 3. ALTERNATIVE MEDICINE AND HEARING LOSS ....................................................... 129 Overview.................................................................................................................................... 129 National Center for Complementary and Alternative Medicine................................................ 129 Additional Web Resources ......................................................................................................... 139 General References ..................................................................................................................... 140 CHAPTER 4. DISSERTATIONS ON HEARING LOSS ......................................................................... 143 Overview.................................................................................................................................... 143 Dissertations on Hearing Loss................................................................................................... 143 Keeping Current ........................................................................................................................ 147 CHAPTER 5. CLINICAL TRIALS AND HEARING LOSS .................................................................... 149 Overview.................................................................................................................................... 149 Recent Trials on Hearing Loss ................................................................................................... 149 Keeping Current on Clinical Trials ........................................................................................... 153 CHAPTER 6. PATENTS ON HEARING LOSS .................................................................................... 155 Overview.................................................................................................................................... 155 Patents on Hearing Loss ............................................................................................................ 155 Patent Applications on Hearing Loss ........................................................................................ 179 Keeping Current ........................................................................................................................ 201 CHAPTER 7. BOOKS ON HEARING LOSS ........................................................................................ 203 Overview.................................................................................................................................... 203 Book Summaries: Federal Agencies............................................................................................ 203 Book Summaries: Online Booksellers......................................................................................... 217 The National Library of Medicine Book Index ........................................................................... 223 Chapters on Hearing Loss .......................................................................................................... 224 Directories.................................................................................................................................. 234 CHAPTER 8. MULTIMEDIA ON HEARING LOSS ............................................................................. 237 Overview.................................................................................................................................... 237 Video Recordings ....................................................................................................................... 237 Audio Recordings....................................................................................................................... 241 Bibliography: Multimedia on Hearing Loss............................................................................... 243 CHAPTER 9. PERIODICALS AND NEWS ON HEARING LOSS .......................................................... 245 Overview.................................................................................................................................... 245 News Services and Press Releases.............................................................................................. 245 Newsletters on Hearing Loss ..................................................................................................... 250 Newsletter Articles .................................................................................................................... 251 Academic Periodicals covering Hearing Loss ............................................................................ 258 CHAPTER 10. RESEARCHING MEDICATIONS................................................................................. 259 Overview.................................................................................................................................... 259 U.S. Pharmacopeia..................................................................................................................... 259

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Commercial Databases ............................................................................................................... 261 APPENDIX A. PHYSICIAN RESOURCES .......................................................................................... 265 Overview.................................................................................................................................... 265 NIH Guidelines.......................................................................................................................... 265 NIH Databases........................................................................................................................... 267 Other Commercial Databases..................................................................................................... 272 The Genome Project and Hearing Loss ...................................................................................... 272 APPENDIX B. PATIENT RESOURCES ............................................................................................... 283 Overview.................................................................................................................................... 283 Patient Guideline Sources.......................................................................................................... 283 Associations and Hearing Loss .................................................................................................. 314 Finding Associations.................................................................................................................. 314 APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 317 Overview.................................................................................................................................... 317 Preparation................................................................................................................................. 317 Finding a Local Medical Library................................................................................................ 317 Medical Libraries in the U.S. and Canada ................................................................................. 317 ONLINE GLOSSARIES................................................................................................................ 323 Online Dictionary Directories ................................................................................................... 326 HEARING LOSS DICTIONARY................................................................................................ 327 INDEX .............................................................................................................................................. 407

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FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with hearing loss is indexed in search engines, such as www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about hearing loss, using the most advanced research tools available and spending the least amount of time doing so. In addition to offering a structured and comprehensive bibliography, the pages that follow will tell you where and how to find reliable information covering virtually all topics related to hearing loss, from the essentials to the most advanced areas of research. Public, academic, government, and peer-reviewed research studies are emphasized. Various abstracts are reproduced to give you some of the latest official information available to date on hearing loss. Abundant guidance is given on how to obtain free-of-charge primary research results via the Internet. While this book focuses on the field of medicine, when some sources provide access to non-medical information relating to hearing loss, these are noted in the text. E-book and electronic versions of this book are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). If you are using the hard copy version of this book, you can access a cited Web site by typing the provided Web address directly into your Internet browser. You may find it useful to refer to synonyms or related terms when accessing these Internet databases. NOTE: At the time of publication, the Web addresses were functional. However, some links may fail due to URL address changes, which is a common occurrence on the Internet. For readers unfamiliar with the Internet, detailed instructions are offered on how to access electronic resources. For readers unfamiliar with medical terminology, a comprehensive glossary is provided. For readers without access to Internet resources, a directory of medical libraries, that have or can locate references cited here, is given. We hope these resources will prove useful to the widest possible audience seeking information on hearing loss. The Editors

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From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.

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CHAPTER 1. STUDIES ON HEARING LOSS Overview In this chapter, we will show you how to locate peer-reviewed references and studies on hearing loss.

The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and hearing loss, you will need to use the advanced search options. First, go to http://chid.nih.gov/index.html. From there, select the “Detailed Search” option (or go directly to that page with the following hyperlink: http://chid.nih.gov/detail/detail.html). The trick in extracting studies is found in the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Journal Article.” At the top of the search form, select the number of records you would like to see (we recommend 100) and check the box to display “whole records.” We recommend that you type “hearing loss” (or synonyms) into the “For these words:” box. Consider using the option “anywhere in record” to make your search as broad as possible. If you want to limit the search to only a particular field, such as the title of the journal, then select this option in the “Search in these fields” drop box. The following is what you can expect from this type of search: •

The Role of Early Language Experience in the Development of Speech Perception and Language Processing Abilities in Children with Hearing Loss Source: The Volta Review. Alexander Graham Bell Association for the Deaf and Hard of Hearing. 103(1). p. 5-37. Contact: AG Bell. 3417 Volta Place, NW, Washington, DC 20007. Voice (202) 337-5220. TTY (202) 337-5221. Fax (202) 337-8314. E-mail: [email protected]. Web site: www.agbell.org. Summary: A child's ability to perceive speech and process language depends upon his or her early experience with language. Authors of this article sought to determine if speech-perception and language-processing abilities in hearing-impaired children were

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comparable to those of hearing children who experienced setbacks in their early language experience. •

Hearing Loss in Over-65s: Is Routine Questionnaire Screening Worthwhile? Source: Journal of Laryngology and Otology. 114(9): 661-666. September 2000. Contact: Available from Royal Society of Medicine Press Limited. Publications Subscription Department, P.O. Box 9002, London W1A 0ZA, United Kingdom. E-mail: [email protected]. Summary: Although it is quite likely that there is considerable unmet need in respect to hearing loss among the elderly population, no routine screening test is currently used in general practice to identify these patients. This article reports on a study undertaken to determine whether routine questionnaire screening of patients over 65 is a feasible way to identify elderly patients with hearing loss in primary care. The study also attempted to determine whether patients so identified would benefit from hearing aid fitting. A cohort of patients consisting of a sample of 234 individuals aged between 65 and 74, attending a doctor's surgery over a specified period, received a scored questionnaire to complete, based on the Hearing Handicap Inventory for the Elderly Screening test. Hearing aid owners and those with a hearing handicap were identified, and non hearing aid wearers with handicap were offered examination and referral. Those patients who were fitted with hearing aids were assessed after six months, for hearing aid usage and persisting handicap. Twenty-five percent of the patient sample reported a previously undiagnosed hearing handicap. Six months after aid fitting, a reduction in hearing handicap was reported in 79 percent of these cases and overall hearing aid usage in the population sample had increased from 9 percent to 20 percent. The author concludes that routine questionnaire screening in general practice may be worthwhile since it is easy to carry out and the resulting intervention significantly reduces reported hearing handicap. The questionnaire is reprinted in the appendix. 1 appendix. 1 figure. 3 tables. 27 references.

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Death of Deafness? The Choice to Hear: Setting the Baseline Source: Hearing Health. 16(3): 54-57. May-June 2000. Contact: Available from Voice International Publications, Inc. P.O. Drawer V, Ingleside, TX 78362-0500. Voice/TTY (361) 776-7240. Fax (361) 776-3278. Website: www.hearinghealthmag.com. Summary: Anecdotal evidence from the hearing health care field indicates that the vast majority of new parents with deaf babies favor technological intervention which enables their babies to hear. This article, the first in a series on the death of deafness, reviews the statistics that support this apparent trend. The author outlines the problem of defining and quantifying the number of Americans who are deaf, then discusses the sources of his data, the use of probability analysis, the impact of new technology on the Deaf culture, input from other sources, the demographics of deafness, and public policy issues. The author concludes by describing recent programs designed to maximize early identification of hearing loss. The author stresses that the most urgent task is to find all deaf babies at birth and provide them with the hearing aids, cochlear implants, or schooling in sign language they need; identifying infants and children who lose their hearing after birth is also crucial. Further research on the economic effects of deafness is called for. The contact information for two resource organizations (The National Campaign for Hearing Health and Project Hope Center for Health Affairs) is provided. 3 figures.

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DPOAEs Among Normal-Hearing Musicians and Non-Musicians: Diagnostic Measures for the Early Identification and Prevention of Music-Induced Hearing Loss Source: Hearing Review. 8(5): 26-28. May 2001. Contact: Available from Fladmark Publishing Company. P.O. Box 6004, Duluth, MN 55806-9851. (218) 723-9558. Fax (218) 723-9437. Summary: As many as 52 percent of classical musicians and 30 percent of rock or pop musicians have irreversible hearing loss. Typically, audiological measures of music induced hearing loss (MIHL) occurs after the damage has been done. Diagnostic measures for the early identification and prevention of MIHL may help improve musicians' hearing health and lengthen their careers. This article explores the relationship between puretone audiometry and distortion product otoacoustic emissions (DPOAEs) among normal hearing musicians and non musicians. The study of outer hair cell (OHC) function among musicians is a contemporary concept made possible with OAEs. The study described in this article examined 64 ears of musicians (n = 16) and non musicians (n = 16) with normal hearing thresholds (0 to 20 decibels hearing loss) and immittance results. Descriptive analysis of the musician group revealed DPOAE measurements to show 13 of the 16 (81 percent) right ears with poor OHC response. In the non musician group, DPOAE measurements showed five of the 16 (31 percent) right ears with OHC dysfunction. Left ear dysfunction was demonstrated in 75 percent of the musicians and 38 percent of the non musicians. The authors note that, in its early stages, a MIHL is usually gradual and hidden in the sense that one does not feel it, see it, or hear it coming. This type of hearing loss may remain undetected and not perceived by the musician, and may not be diagnosed through conventional puretone measures. The current investigation implies that DPOAE may be able to detect early signs of MIHL before puretone audiometry. Audiological management of the musician early in his or her career may serve to reduce or prevent a hearing disability. 2 figures. 8 references.

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Hearing Loss and Depression in Adults Source: Hearing Review. 8(3): 74-79. March 2001. Contact: Available from Fladmark Publishing Company. P.O. Box 6004, Duluth, MN 55806-9851. (218) 723-9558. Fax (218) 723-9437. Summary: Depression combined with hearing loss and multiple co-occurring medical conditions pose serious risks. Not only is depression an impediment to the remediation of hearing loss, but major depression is a significant predictor of suicide in older adults. This article guides hearing care professionals in the care of clients who may be experiencing depression. The author cautions that hearing care professionals should never assume the role of a clinical therapist. However, hearing care providers can talk with patients and their families about depression when warranted, refer patients when appropriate, and become better educated about depression, its signs, and its treatments. The article includes the criteria for a major depressive episode, the symptoms of depression in older adults, a discussion of special considerations in older adults, and a list of recommended web sites discussing depression in older adults. 2 tables. 40 references.

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Clinical Evaluation of the Hearing Disability and Handicap Scale in Men with Noise Induced Hearing Loss Source: Noise and Health. 6: 67-78. January-March 2000.

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Contact: Available from NRN Publications. Editorial Manager of Noise and Health, Institute of Laryngology and Otology, University College, London, 330 Gray's Inn Road, London WC1X 8EE, United Kingdom. 44 171 915 1575. Fax 44 171 278 8041. E-mail: [email protected]. Summary: During the last 30 years, several hearing disability and handicap questionnaires have been designed and used for clinical purposes. This article reports on a study that includes a review of the most frequently used of these scales. The present study evaluates the reliability and validity of the Hearing Disability and Handicap Scale (HDHS), which is a shortened and modified version of the Hearing Measurement Scale. Correlations between the Hearing Handicap and Support Scale, the Communication Strategy Scale from the Communication Profile of the Hearing Impaired, pure tone audiometry, and speech recognition scores in noise were analyzed. Data from 168 men with noise induced hearing loss of different degrees was obtained; a test retest was also conducted. The disability section of the HDHS seemed accurate but offered no improvement of prediction compared to previous scales. The authors conclude that the reliability of the handicap section was sufficient, however, they discuss its validity and clinical use and offer suggestions about improvements. Since standardized scales are necessary if results are to be compared worldwide, guidelines regarding the clinical use and benefit of hearing disability and handicap scales are required. One appendix reprints the 20 questions from the HDHS. 4 tables. 34 references. •

Genetic Causes of Hearing Loss Source: New England Journal of Medicine. 342(15): 1101-1109. April 13, 2000. Contact: Available from Massachusetts Medical Society. 10 Shattuck Street, Boston, MA 02115-6094. Summary: Hearing loss is the most common sensory defect in humans, affecting normal communication in 10 percent of people aged 65 years or older. This review article focuses on nonsyndromic hearing loss (hearing loss not combined with other abnormalities), since the genes involved in this type of hearing loss have only recently begun to be identified. Topics include the mechanisms of normal hearing, the classification of hearing loss, gene localization studies, and genes implicated in hearing loss. Fifteen genes (13 nuclear genes and 2 mitochondrial genes) involved in nonsyndromic hearing loss have been isolated by positional genetics. The protein products of these genes include ion channels, connexins, transcription factors, structural proteins of the cochlea, and mitochondrial proteins. 3 figures. 2 tables. 82 references.

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Screening and Management of Adult Hearing Loss in Primary Care Source: Journal of the American Medical Association (JAMA). April 16, 2003. 289(15). p. 1976-1985. Contact: Available from Journal of the American Medical Association. P.O. Box 10946, Chicago, IL 60610-0946. (312) 670-7827. Toll-free: (800) 262-2350. E-mail: [email protected]. Web site: http://jama.ama-assn.org/. PRICE: $12.00 for single copy of online version (PDF or full text). Summary: Hearing loss is the third most prevalent chronic condition in older adults. Yet most elder adults are not evaluated and treated for hearing loss. After reviewing 1,595 articles for the most clinically relevant information, the authors of this scientific review contend that fairly simple, yet accurate, methods are available for the screening of

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hearing loss in the primary care setting. These include a self-administered, 10-question survey called the Hearing Handicap Inventory for the Elderly-Screening, and a physiologic test that employs a device called the audioscope, a handheld combination otoscope and audiometer. Primary care physicians can also be instrumental in the treatment of several hearing problems, including impacted cerumen (earwax), chronic otitis media, sudden sensorineural hearing loss, and hearing loss caused by ototoxicity. •

Reflections on Succeeding with a Child with Hearing Loss as a Public School Teacher Source: Volta Voices. 9(5): 23-25. September/October 2002. Summary: In this article, a public school teacher describes how she adapted her teaching strategies to meet the needs of a child with hearing loss, who was placed in her class for one year. The techniques she employed, and the support she received from parents, administrators, and other organizations, helped her gain confidence, while providing a learning experience that benefited the child as well as the child's classmates.

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Maternally Inherited Diabetes and Deafness: A Multicenter Study Source: Annals of Internal Medicine. 134(9 Part 1): 721-728. May 1, 2001. Contact: Available from American College of Physicians-American Society of Internal Medicine. 190 North Independence Mall West, Philadelphia, PA 19106-1572. Summary: Maternally inherited diabetes and deafness (MIDD), which is seen in 0.5 percent to 2.8 percent of patients with type 2 diabetes mellitus, is related to a point mutation at position 3243 of mitochondrial (mt) DNA. The clinical description of MIDD is incomplete. This article reports on a study of the clinical presentation and complications of diabetes in patients with MIDD, undertaken to identify clinical characteristics that may help select patients with diabetes for mtDNA mutation screening. The study included 54 patients with type 2 diabetes mellitus and the mtDNA 3243 mutation, from 16 French departments of internal medicine, diabetes, and metabolic diseases. On average, patients with MIDD were young at diabetes onset and presented with a normal or low body mass index. None were obese; 73 percent of subjects had a maternal family history of diabetes. Diabetes was non insulin dependent at onset in 87 percent of patients; however, 46 percent of patients had non insulin dependent disease at onset but progressed to insulin therapy after a mean duration of approximately 10 years. Neurosensory hearing loss was present in almost all patients. Of the patients who received an ophthalmologic examination, 86 percent had macular pattern dystrophy (a specific retinal lesion). Myopathy (muscle weakness and wasting) was found in 43 percent of patients, 15 percent had cardiomyopathy (wasting and weakness of the heart muscles), and 18 percent (9 of 51 patients) had neuropsychiatric symptoms. The prevalence of diabetic retinopathy (eye disease) was 8 percent among patients who received an ophthalmologic examination, lower than expected after a mean 12 year duration of diabetes; prevalence of kidney disease was 28 percent. This suggests that a specific renal involvement was the result of mitochondrial disease. The authors conclude that MIDD has a specific clinical profile that may help identify patients with diabetes who should undergo mtDNA testing. 2 figures. 1 table. 46 references.

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Connexin26 Mutations Associated with Nonsyndromic Hearing Loss Source: Laryngoscope. 110(9): 1535-1538. September 2000. Contact: Available from Lippincott Williams and Wilkins. 12107 Insurance Way, Hagerstown, MD 21740. (800) 638-3030 or (301) 714-2300. Fax (301) 824-7390.

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Summary: Mutations in the GJB2 gene are a major cause of autosomal recessive and sporadic types of congenital deafness. The 35delG mutation is the most frequent type of mutation in white populations. However, several other forms were reported, such as 167delT among Ashkenazi Jews and R143W in Africans. This article reports on a study that investigated the mutations of connexin26 (Cx26) found in patients with nonsyndromic hearing loss (NSHL, i.e., hearing loss that is not associated with a known genetic syndrome) and newborns in the Korean population. The sequencing data for 147 unrelated patients with congenital NSHL and 100 audiologically screened newborns were included in this prospective study. Genomic DNA samples from all patients and newborns were sequenced in both directions for detection of Cx26 mutations. Thirteen different types of mutations were found in the patients and newborns. V27I and E114G are the popular types of polymorphic mutations in both groups. 35delG was rarely found in both groups. In addition to these noted mutations, several other types of mutations were identified. The family study of the 235delC showed a typical autosomal recessive trait of NSHL in their audiological evaluation of hearing threshold. The frequency of 235delC allele was much higher in the patients (5 percent) than in newborns (0.5 percent). The results suggest that the different types of Cx26 mutations affect autosomal recessive NSHL according to ethnic background. 2 figures. 4 tables. 14 references. •

Effects of Denied Hearing Loss on the Significant Other Source: Hearing Journal. 54(5): 44, 46-47. May 2001. Contact: Available from Lippincott Williams and Wilkins. Customer Service, P.O. Box 1175, Lowell, MA 01853. Summary: People in denial of a hearing loss often create conflicts with their significant others. This article explores the effects of denied hearing loss on the significant other. Significant others are most often spouses, but may also include siblings, children, other family members, and friends. A couple in crisis due to a hearing impairment experiences frustration and anxiety that lead to behavior and coping strategies that are maladaptive. The author briefly reviews the literature in this area, then addresses the different roles that the significant other may plan in the diagnosis and management of the loved one's hearing loss. The author reviews the use of various questionnaires to help determine perceived hearing disability and handicap and then provides preliminary information about an ongoing study of couples in crisis due to a denied hearing impairment. The author stresses that hearing professionals should not depend on amplification alone to resolve the emotional and social consequences of a hearing impairment. Hearing aids are only part of a complete rehabilitation program, which should include the participation of a significant other. The author also notes that the need to refer to mental health experts is infrequent, however, good working relationships with other professionals may prove beneficial. 26 references.

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Six Stages of Grieving a Hearing Loss: How to Assist Clients Through the Stages of the Acceptance Process Source: Hearing Review. 7(5): 28, 31-33. May 2000. Contact: Available from Fladmark Publishing Company. P.O. Box 6004, Duluth,MN 55806-9851. (218) 723-9558. Fax (218) 723-9437. Summary: People who develop a disability often feel a profound sense of loss. A person who has been diagnosed with hearing loss may go through stages that include denial, anger, awareness, depression, acceptance, and bargaining. This article examines each of

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these stages and presents practical information and counseling methods for assisting clients through the acceptance process. The author notes that patients experience some or all of these stages, and the presentation and duration of each stage may vary significantly. The author also comments that even a marginal hearing impairment in an older adult can result in reduced satisfaction with independence, emotional well being, and other limitations that are not seen in normal hearing individuals. People with similar audiometric configurations can display different degrees of communication difficulties and adjustment problems. While it is in the purview of the hearing care professional to counsel patients who develop emotional problems caused by a hearing impairment, it is important for those professionals to be aware of their professional boundaries and to know when to refer a client to other health care workers. 25 references. •

Sudden Sensorineural Hearing Loss Source: The Hearing Journal. July 2003. 56(7). p. 10-15. Contact: Available from Lippincott Williams & Wilkins. 345 Hudson Street, 16th Floor, New York, NY 10014. (212) 886-1244. Fax: (212) 886-1209. E-mail: [email protected]. Web site: www.thehearingjournal.com. Summary: Sudden sensorineural hearing loss affects approximately 4,000 people each year, with the highest incidence occurring in people between 50 and 60 years of age. Through a question-and-answer format, this article explains the characteristics, possible causes, diagnosis, prognosis, and treatment of sudden sensorineural hearing loss.

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Diagnosis and Treatment of Sudden-Onset Sensorineural Hearing Loss: A Study of 51 Patients Source: Otolaryngology-Head and Neck Surgery. 2003;128:92-8. Contact: Send requests to: Ian S. Stroper, MD. Director of Neurotology, Columbia University College of Physicians and Surgeons, Suite 511, 161 Fort Washington Ave., New York, NY 10032. E-mail: [email protected]. Summary: The authors of this article discuss a research study conducted to determine the efficacy of steroid and antiviral therapy in the management of idiopathic sudden sensorineural hearing loss (SSNHL.) Fifty-one patients on the same treatment protocol were evaluated for the study. The reported significance of the study findings is that antiviral therapy and increased length of steroid treatment may play a role in improved recovery rates in patients with sudden-onset sensorineural hearing loss.

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Hearing Loss in Children and Adults: Audiometric Configuration, Asymmetry, and Progression Source: Ear and Hearing. June 2003;24;198-205. Contact: Available from Ear and Hearing. Web site: www.ear-hearing.com. Summary: The authors of this article reports on a study conducted to characterize the sensorineural hearing losses of a group of children and adults along three parameters important to the hearing instrument fitting process: audiometric configuration; asymmetry of loss between ears; and progression of loss over several years. Study devices utilized included audiograms for 248 60-and 61 year old adults and 227 6-yearold children, obtained from the audiological database at Boys Town National Research Hospital, Omaha, Nebraska. 7 figures and references.

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Kids' Connection: Severe Hearing Loss and Cochlear Implants Source: Volta Voices. 7(4): 36-37. July-August 2000. Contact: Available from Alexander Graham Bell Association for the Deaf, Inc. 3417 Volta Place, N.W., Washington, DC 20007-2778. Voice/TTY (202) 337-5220. Fax (202) 337-8314. E-mail: [email protected]. Website: www.agbell.org. Summary: The cochlear implant is an electronic device designed to provide useful hearing and improved communication ability to those who are profoundly hearing impaired and unable to achieve speech understanding with hearing aids. In this newsletter article, the author explores the decisions that a candidate for a cochlear implant must face when considering whether to undergo cochlear implant surgery. Of course, many of the people actually making the decisions are the candidates' parents. The author stresses that improved communication is the goal of any cochlear implant. Beyond learning to hear, one needs to understand the sounds of speech and must learn to produce the sounds of speech in speaking clearly; these skills can be developed as part of the cochlear implant process. The author considers seven questions or issues that must be addressed: how good is the person's hearing while he or she is using two good hearing aids, the causes of the person's hearing loss, problems with the potential patient's general health, why the patient or his or her parents want an implant, how a cochlear implant will fit into the patient's lifestyle, the commitment of family members, and how to find out if a particular person is a candidate.

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Hearing Improvement After Therapy for Hyperlipidemia in Patients with ChronicPhase Sudden Deafness Source: Annals of Otology, Rhinology and Laryngology. 110(2): 105-108. February 2001. Contact: Available from Annals Publishing Company. 4507 Laclede Avenue, St. Louis, MO 63108. Summary: The hearing of patients with chronic phase sudden deafness and associated hyperlipidemia (high levels of fats in the blood) tends to improve with therapy for the hyperlipidemia. This article reports on a study of 12 patients with unilateral sudden deafness and hyperlipidemia in whom more than 1 month had elapsed since the onset of the hearing disturbance. The disturbance was considered to be irreversible without therapy. The 4 men and 8 women ranged in age from 32 to 73 years, with a mean age of 54.3 years. Hyperlipidemia was diagnosed when the total blood cholesterol level was 230 mg per dL or greater. The therapy for hyperlipidemia consisted of diet therapy and the administration of antilipemic drugs. The hearing level was measured both before therapy and when the total blood cholesterol level had decreased to less than 230 mg per dL. After therapy, the mean hearing level had improved significantly at each of 125, 250, 500, and 2,000 Hertz (Hz), but the changes in the level were not significant at 1,000, 4,000, or 8,000 Hz. The authors conclude that with therapy for hyperlipidemia, hearing tends to improve in patients with chronic phase sudden deafness and associated hyperlipidemia, even when more than 1 month has elapsed since the onset of the presumably otherwise irreversible hearing loss. 3 figures. 1 table. 8 references.

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Newborn with Hearing Loss Source: Journal of the Medical Association of Georgia. 90(1): 32-36. February 2001. Contact: Available from Medical Association of Georgia. 1330 West Peachtree Street, Suite 500, Atlanta, GA 30309. (800) 282-0224 or (404) 876-7535. Fax (404) 881-5021. Website: www.mag.org.

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Summary: The identification and habilitation (i.e., amplification with hearing aids) of congenital hearing loss in the initial six months is important to the child's future as a listening speaking communicator. This article reviews the medical management of the newborn with newly identified hearing loss, a topic of considerable controversy. The authors provide a comprehensive yet practical approach that is workable in the managed care environment and that is based on the literature and practical experiences with hearing impaired children. The authors provide a checklist to use as a framework for care, based on the acronym of the word vaticinate: Verify the hearing loss, amplify with hearing aids, typify the hearing loss (conductive, cochlear, or neural), consult appropriately with other health care providers, initiate discussion of the psychological aspects of raising a child with hearing impairment, no harm (prevent problems), assure communication, test repeatedly, and educate. 1 figure. 1 table. 20 references. •

Semi-Implantable Electromagnetic Middle Ear Hearing Device for Moderate to Severe Sensorineural Hearing Loss Source: Otolaryngologic Clinics of North America. 34(2): 401-416. April 2001. Contact: Available from W.B. Saunders Company. 6277 Sea Harbor Drive, Orlando, FL 32887-4800. (800) 654-2452. Website: www.wbsaunders.com. Summary: The largest group of people with hearing impairment, those with moderate to severe sensorineural hearing loss (SNHL), are often disappointed to find that amplification with external hearing aids is the only treatment option available. This article, one in a series on implantable electronic otologic devices, reports on the advances in semi-implantable electromagnetic middle ear hearing devices for people with moderate to severe sensorineural hearing loss. The authors report the results on the five people enrolled in a feasibility study of the SOUNDTEC Direct Drive Hearing System (DDHS). The SOUNDTEC DDHS operates on the basic principle that sound can be conveyed to the middle ear through nonacoustic transmission using electromagnetic permanent magnet coupling. Acoustic signals are received by the microphone of the sound processor and transformer into electrical signals. These signals are then amplified, programmed, and sent to the coil in the ear canal. Interaction between the alternative electromagnetic field of the coil and the implant magnet results in vibratory attractive and repulsive forces which drive the ossicles directly from the stapes to the cochlea, producing amplified sound perception. The authors review the surgical technique used, postoperative fitting, objective and subjective measures, risk factors, and performance factors in implantable hearing devices. 15 references.

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Vertigo and Dysequilibrium with Associated Hearing Loss Source: Otolaryngologic Clinics of North America. 33(3): 535-562. June 2000. Contact: Available from W.B. Saunders Company. 6277 Sea Harbor Drive, Orlando, FL 32887-4800. Summary: There are numerous disorders that can present with hearing loss and vertigo (a spinning sensation) or dysequilibrium (loss of balance), some common, some rare. This article provides a practical brief review of each of these disorders to provide the clinician with a framework for the management of patients manifesting these complaints. The author discusses congenital conditions, acquired conditions, trauma to the temporal bone, barotrauma (trauma attributed to changes in the barometric pressure, including from airplane flights and diving), perilymph fistula, metabolic conditions, otosclerosis (a genetic disease of the ear bones), neoplasm (benign and cancerous tissue changes), infectious conditions, labyrinthitis, syphilis, ototoxicity

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(chemicals that damage the ear), immunologic conditions, autoimmune ear disease, Cogan's syndrome, and Meniere's disease. For each condition, the author discusses the etiology, epidemiology, the clinical presentation, diagnostic tests, treatment options, and prognosis. 2 tables. 113 references. •

Is Hearing Loss Increasing at Younger Ages?: Many Think So, But It's Hard to Prove Source: Hearing Journal. 53(5): 23-24, 26-29. May 2000. Contact: Available from Lippincott Williams and Wilkins. Customer Service, P.O. Box 1175, Lowell, MA 01853. Summary: This article addresses recent concerns that hearing loss in children and adolescents in the United States is increasing. The author begins by reminding readers that changes in hearing sensitivity and hearing levels in groups are inherently hard to determine. The author then describes the hearing loss measured by the National Health Interview Survey (NHIS), including the drawbacks of this survey method and some of the results obtained. Other topics include information on hearing loss in people who are late middle-aged; noise related risk factors for all age groups, including sources of high risk noise such as fitness clubs, movie theaters, concerts, school band practice, and children's toys; research studies that focus on hearing risks and hearing loss for children and youth; how to interpret study results; and studies on the impact of amplified music, including personal listening devices. The author concludes that it is difficult to prove that hearing loss is increasing at younger ages, but time, resources, and research may eventually provide this proof. Meanwhile, the environmental, social, and occupational risks to hearing are well known, widespread, and unlikely to subside. 1 table. 7 references.

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Developmental Consequences of Mild Hearing Loss Source: Current Opinion in Otolaryngology and Head and Neck Surgery. 8(5): 431-435. October 2000. Contact: Available from Lippincott Williams and Wilkins. 12107 Insurance Way, Hagerstown, MD 21740. (800) 637-3030. Fax (301) 824-7390. Website: www.lww.com. Summary: This article considers the possible occurrence of developmental effects associated with mild hearing loss in children. The authors review recent findings in three broad areas: behavioral auditory evidence pertaining to early, mild, conductive hearing loss; speech and language evidence pertaining to children having histories of otitis media with effusion (OME, middle ear infection with fluid drainage); and speech, language, and educational evidence pertaining to children with sensorineural hearing loss (unilateral or bilateral). Recent psychoacoustic results in animals and humans suggest that mild conductive hearing loss can have negative consequences for binaural hearing in young listeners. These results appear to have physiological analogues in animal studies of auditory deprivation. Findings in the area of speech and language remain more controversial, probably due to the larger role of complex intervening variables in this domain. Recent findings on educational achievement in cases of minimal sensorineural hearing loss continue to suggest the existence of negative practical consequences. The authors conclude that the available results suggest that more aggressive treatment of children with minimal sensorineural hearing loss may be desirable. 3 figures. 22 references (4 annotated).

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Hypokalemic Salt-Losing Tubulopathy with Chronic Renal Failure and Sensorineural Deafness Source: Pediatrics. 108(1): [9 p.]. July 2001. Contact: Available from American Academy of Pediatrics. 141 Northwest Point Boulevard, Elk Grove Village, IL 60007-1098. (888) 227-1773. Fax (847) 434-8000. E-mail: [email protected]. Website: www.pediatrics.org. Full text of this article is available at www.pediatrics.org/cgi/content/full/108/1/e5. Summary: This article describes a rare inherited hypokalemic (low levels of potassium) salt losing tubulopathy (kidney disease) with linkage to chromosome 1p31. The authors conducted a retrospective analysis of the clinical data for 7 patients in whom cosegregation of the disease with chromosome 1p31 had been demonstrated. In addition, in 1 kindred, prenatal diagnosis in the second child was established, allowing a prospective clinical evaluation. Clinical presentation (symptoms) of the patients was similar and included premature birth attributable to polyhydramnios, severe renal (kidney) salt loss, normotensive hyperreninemia, hypokalemic alkalosis, and excessive hyperprostaglandin E urea, which suggested the diagnosis of hyperprostaglandin E syndrome and antenatal Bartter syndrome. However, the response to indomethacin was only poor, accounting for a more severe variant of the disease. The patients invariably developed chronic renal failure. The majority had extreme growth retardation, and motor development was markedly delayed. In addition, all patients turned out to be deaf. The authors conclude that this hypokalemic salt losing tubulopathy with chronic kidney failure and sensorineural deafness represents not only genetically but also clinically a disease entity distinct from hyperprostaglandin E syndrome and antenatal Bartter syndrome. A pleiotropic (causing multiple, seemingly unrelated symptoms) effect of a single gene defect is most likely causative for syndromic hearing loss. 6 figures. 1 table. 41 references.

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Hearing Loss in a Memory Disorders Clinic: A Specially Vulnerable Population Source: Archives of Neurology. 53: 922-928. September 1996. Summary: This article describes a study of the prevalence and characteristics of hearing loss in patients undergoing examination because of a memory disorder. It also assesses whether screening tools are adequate for use in this population, and investigates whether people with Alzheimer's disease (AD) report hearing problems reliably. Thirty people who met the criteria for probable AD and 22 people with other forms of cognitive impairment underwent a hearing screening and completed a questionnaire intended to assess hearing impairment and perceived disability. Of the 52 patients, 49 had significant hearing loss. No difference was found in the test failure rate between the two groups, but a significant discrepancy was found between the patient's self-reports and reports of their caregivers for people with probable AD. However, self-reports were reliable for people with other forms of cognitive impairment. The authors note that the prevalence of hearing loss among cognitively impaired participants greatly exceeds that found in healthy older people. They note that the high prevalence of hearing loss in this selected population suggests that a hearing evaluation may need to become a part of any assessment of cognitive function. 3 tables, 5 figures, 47 references.

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Communicating with Patients Who Have Hearing Loss Source: New Jersey Medicine. 97(2): 45-49. February 2000.

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Contact: Available from Medical Society of New Jersey (MSNJ). Two Princess Road, Lawrenceville, NJ 08648. (609) 896-1766. Fax (609) 896-1368. E-mail: [email protected]. Website: www.msnj.org. Summary: This article reminds physicians of their legal and ethical obligations in working with patients who have hearing loss. The authors note that for many deaf persons, accessing medical care is so frustrating that they simply give up; many delay appointments or avoid going to the doctor at all because of communication problems. The authors describe Title III of the Americans with Disabilities Act (ADA) and how it applies to communication between deaf Americans and medical services. Other topics covered include doctor patient communications, the definition of a qualified interpreter, so-called reasonable efforts, financial considerations (including paying an interpreter), and hiring alternatives. One sidebar summarizes the services and information available from two resource organizations: the New Jersey Department of Human Services (Division of the Deaf and Hard of Hearing) and the Registry of Interpreters for the Deaf. A brief biography of each author concludes the article. •

Structures Underpinning Pretend Play and Word Production in Young Hearing Children and Children with Hearing Loss Source: Journal of Deaf Studies and Deaf Education. 6(1): 15-31. Winter 2001. Contact: Available from Oxford University Press, Journals Customer Service, 2001 Evans Road, Cary, NC 27513. (800) 852-7323 or (919) 677-0977. Fax (919) 677-1714. E-mail: [email protected]. Summary: This article reports on a study in which relationships between pretend play and word production were investigated in 10 hearing (H) and 10 toddlers with hearing loss (D) who attended an auditory oral early intervention program. All children were videotaped interacting in free play with their hearing primary caregiver at 28, 29, and 30 months of age. Group comparisons were made of the scores for highest and mean levels of pretend play and for the underlying structures of decontextualization, decentration, sequencing, and planning. Relationships with word production were then explored for the two groups separately. Results showed significantly higher levels of pretend play for all dimensions for the hearing children and an association between level of pretend play and word production for the children with hearing loss. Associations between word production and sequencing and planning were found for both groups of children. Word production was associated with decontextualization for the hearing children and with decentration for the children with hearing loss. The authors discuss the theoretical implications of the findings together with implications for intervention with toddlers who have hearing loss. 1 figure. 5 tables. 75 references.

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Hearing Loss in Progressive Systemic Sclerosis Patients: A Comparative Study Source: Otolaryngology-Head and Neck Surgery. 124(5): 522-525. May 2001. Contact: Available from Harcourt Health Sciences, Subscription Customer Service, 6277 Sea Harbor Drive, Orlando, FL 32887-4800. (800) 654-2452. Fax (407) 363-9661. Website: www.harcourthealth.com. Summary: This article reports on a study that investigated the middle and inner ear involvement in patients with progressive systemic sclerosis (PSS). The authors prospectively evaluated 34 PSS patients. All patients underwent a complete ear nose throat physical examination and audiological evaluation with pure tone, impedance, and speech audiometry. In addition, systemic manifestations of the disease and drug

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therapy were recorded. Finally, all patients were tested for the presence of autoantibodies. The results were compared with those of 45 age matched healthy subjects. The authors found a sensorineural health loss (SNHL) in 20 percent and mixed type hearing loss in 3.3 percent of the patients. There was no correlation of hearing loss with age, systemic manifestations of the disease, presence of autoantibodies, and drug therapy. Ten percent of the patients had patulous (open) Eustachian tubes. The authors concluded that one fourth of the PSS patients had a hearing loss affecting the middle and mainly the high frequencies. This is a lower percentage than that reported by previous investigations. A significant percentage of bilateral (both sides) patulous Eustachian tubes was noticed as well. The authors call for further study to obtain a better understanding of the mechanism of ear damage in PSS patients. 1 figure. 2 tables. 19 references. •

Cost and Cost-Effectiveness of Universal Screening for Hearing Loss in Newborns Source: Otolaryngology-Head and Neck Surgery. 124(4): 359-367. April 2001. Contact: Available from Harcourt Health Sciences, Subscription Customer Service, 6277 Sea Harbor Drive, Orlando, FL 32887-4800. (800) 654-2452. Fax (407) 363-9661. Website: www.harcourthealth.com. Summary: This article reports on a study undertaken to estimate the cost and cost effectiveness of universal newborn hearing screening. The study used a decision analysis model utilizing the hospital perspective; outcome measures were the cost of screening and the number of infants with hearing loss identified through universal screening. Otoacoustic emissions (OAE) testing at birth followed by repeat testing at follow up demonstrated the lowest cost ($13 per infant) and had the lowest cost effectiveness ration ($5100 per infant with hearing loss identified). Screening auditory brainstem evoked response (ABR) testing at birth with no screening test at follow up was the only protocol with greater effectiveness, but it also demonstrated the highest cost ($25 per infant) and highest cost effectiveness ratio ($9500 per infant with hearing loss identified). These findings stood up to sensitivity analysis, including best case and worst case estimation. The prevalence of hearing loss and the fraction of infants returned for follow up testing had a large impact on the absolute level, but not relative level of protocol cost and cost effectiveness. The authors conclude that the otoacoustic emissions testing protocol should be selected by screening programs concerned with cost and cost effectiveness, although there are certain caveats to consider. 4 figures. 5 tables. 20 references.

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Screening for Hearing Loss and Middle-Ear Disorders in Children Using TEOAEs Source: American Journal of Audiology. 9(1): 50-55. June 2000. Contact: Available from American Speech-Language-Hearing Association (ASHA). Product Sales, 10801 Rockville Pike, Rockville, MD 20852. (888) 498-6699. TTY (301) 8970157. Website: www.asha.org. Summary: This article reports on research undertaken to obtain the sensitivity and specificity of transient evoked otoacoustic emission (TEOAE) screening procedures compared with conventional audiometric pure tone screening and tympanometry. Pass or refer values were obtained from a group of 297 ears of 152 preschool and school aged children (ages 3 to 8 years). The sensitivity and specificity of the TEOAE screenings compared with the pure tone screenings were 81 percent and 95 percent, respectively. The sensitivity and specificity of TEOAE screenings compared with tympanometric screenings were 60 percent and 91 percent, respectively. When the data from all

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screening procedures are examined together, there appears to be more argument for considering TEOAEs as a single initial screening procedure. The authors call for additional research with larger numbers of children with hearing loss or middle ear disorders in order to confirm the usefulness of TEOAEs as an alternative method of screening. 2 figures. 1 table. 35 references. •

Essential Competencies for Teaching Students with Hearing Loss and Additional Disabilities Source: American Annals of the Deaf. 146(1): 7-15. March 2001. Contact: Available from American Annals of the Deaf. Fowler Hall 409, 800 Florida Avenue, NE, Washington, DC 20002-3695. Summary: This article reports on the results of a national study undertaken to establish an initial database of the essential competencies needed for working with students who are deaf or hard of hearing with additional disabilities. Surveys were sent to program supervisors across the United States; each supervisor was asked to give the survey to a professional on his or her staff who worked with students who were deaf or hard of hearing with additional disabilities. Respondents indicated that there were 67 specific competencies needed for working with this diverse population of students. This article provides a list of the specific competencies and a rationale for providing more in-depth training for teachers. Competencies are grouped in categories: general, consultation and collaboration, behavior management, learning difficulties, cognitive development, physical and health, vision, deaf blindness, transition, and gifted and talented. 3 tables. 22 references.

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Sudden Deafness: An Auditory Mystery Source: Hearing Health. 16(2): 16-18. March-April 2000. Contact: Available from Voice International Publications, Inc. P.O. Drawer V, Ingleside, TX 78362-0500. Voice/TTY (361) 776-7240. Fax (361) 776-3278. Website: www.hearinghealthmag.com. Summary: This article reviews the diagnosis and etiologies of sudden deafness, characterized as an 'auditory mystery.' The authors begin with a brief case report of a woman who realized that she was suddenly deaf in her left ear. The authors encourage readers to obtain a diagnosis, even for mild cases of hearing loss, because not only does the loss of hearing disrupt quality of life, but its occurrence could also signify a serious condition. Topics include diagnostic tests and the use of a detailed patient history in determining why sudden deafness has occurred; the audiological evaluation; sudden deafness in children; possible causes of sudden deafness; the role of trauma (which can interrupt blood flow to the inner ear); recommended actions when sudden deafness strikes; treatment options, including drug therapy and surgery; and spontaneous recovery from sudden deafness. 1 table.

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Further Support for the Benefits of Early Identification and Intervention for Children with Hearing Loss Source: Volta Review. 100(5): 53-84. 2000. Contact: Available from Alexander Graham Bell Association for the Deaf and Hard of Hearing. Subscription Department, 3417 Volta Place, NW, Washington, DC 20007-2778. Voice/TTY (202) 337-5220. Website: www.agbell.org.

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Summary: This chapter is from a text that provides information on the language, speech, and social emotional development of very young children who are deaf or hard of hearing. In this chapter, the authors present data from two studies that investigated short and long term outcomes of early identification and intervention. All participants in both studies were involved in the same early intervention program for children with hearing loss. Both studies examine the age at entry into intervention as the principal variable of interest. The first study examines the children's speech, language, and auditory skills at the time of exit from the program. The second study investigates language development when the children are between 9 and 52 months postgraduation. Results from these two studies provide further support for the immediate and longer term benefits of early entry into intervention for language, academic, and social emotional development even after controlling for degree of hearing loss and pretest performance. 7 tables. 52 references. •

Progressive Hearing Loss in Hearing Impaired Children: Immediate Results of Antiphlogistic-Rheologic Infusion Therapy Source: International Journal of Pediatric Otorhinolaryngology. 57(2): 129-136. February 2001. Contact: Available from Elsevier Science. P.O. Box 945, New York, NY 10159-0945. (888) 437-4636. Fax (212) 633-3680. E-mail: [email protected]. Summary: This study was undertaken to determine whether an infusion therapy, developed for the treatment of sudden hearing loss in the elderly, can induce recovery after progression in sensorineural hearing loss (SNHL) during childhood. Out of 20 children suffering from acute progression in SNHL, 7 children were treated with an infusion therapy (prednisolone, pentoxifylline, and a plasma expander, Group I) and 13 children were not treated (Group II). All children were advised not to use hearing aids for 6 weeks. In Group I, the authors observed partial to complete restoration of hearing threshold towards the original hearing threshold given by previous routine controls in 6 out of 7 children. In Group II, only 3 children recovered, with the state of the hearing loss in 10 children remaining unchanged. The long term follow up, however, showed no distinct difference in either group. The authors conclude that infusion therapy can be helpful when treating acutely progressing SNHL during childhood. The benefit for communication competence has yet to be determined. 4 tables. 36 references.

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Sudden Sensorineural Hearing Loss: Does Application of Glucocorticoids Make Sense? Source: Archives of Otolaryngology-Head and Neck Surgery. 127(3): 253-258. March 2001. Contact: Available from American Medical Association. Subscriber Services, P.O. 10946, Chicago, IL 60610-0946. (800) 262-3250 or (312) 670-7827. Fax (312) 464-5831. E-mail: [email protected]. Website: www.ama-assn.org/oto. Summary: Treatment of sudden sensorineural hearing loss (SSNHL) consists of administration of blood flow promoting drugs with or without the addition of glucocorticoids. General guidelines for this drug therapy, based on scientific data, do not exist. This article reports on a retrospective analysis of the audiograms of 603 patients with SSNHL: 301 patients received intravenous blood flow promoting drugs without glucocorticoids, and 302 patients received intravenous blood flow promoting drugs with oral glucocorticoids. The age distribution of patients with SSNHL in lower, middle, and higher frequencies was similar in both groups. Patients with SSNHL in

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lower and middle frequencies (250 to 2000 Hz) who received glucocorticoids showed significantly better recovery of hearing levels compared with those who did not receive glucocorticoids. There was no significant difference at higher frequencies between the 2 groups. Patients with SSNHL throughout all frequencies (pancochlear hearing loss) who received glucocorticoids also had significantly better recovery of hearing levels compared with those who received blood flow promoting drugs alone. Also, patients with elevated blood sedimentation rates had better improvement of their hearing levels after receiving glucocorticoids. 5 figures. 1 table. 32 references.

Federally Funded Research on Hearing Loss The U.S. Government supports a variety of research studies relating to hearing loss. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to hearing loss. For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore hearing loss. The following is typical of the type of information found when searching the CRISP database for hearing loss: •

Project Title: ACQUIRED HEARING LOSS Principal Investigator & Institution: Salvi, Richard J.; Professor; Communicative Disorders & Scis; State University of New York at Buffalo Suite 211 Ub Commons Amherst, Ny 14228 Timing: Fiscal Year 2001; Project Start 01-JAN-1999; Project End 31-DEC-2003 Summary: This Program Project consists of four integrated projects that explore the mechanisms, functional consequences, and prevention of cochlear damage/hearing loss induced by ototoxic drugs and acoustic over- stimulation. In addition to its basic scientific merit, the project has clinical implications with regard to acquired hearing loss (HL) in humans. The clinical motivations for Projects 1 and 2 are (a) a growing awareness that inner hair cell (IHC) loss may underlie many of the perceptual difficulties experienced by people with acquired HL, and (b) a lack of clinical tools for assessing IHC loss. Clinical motivations for Projects 3 and 4 include observations that (a) susceptibility to HL varies tremendously among individuals, and (b) identification of the factors that contribute to susceptibility may be crucial for preventing acquired HL in the future. All four projects utilize the chinchilla, a mammal whose hearing capabilities are similar to humans. Project 1 examines anatomical, physiological, and behavioral changes associated with selected IHC lesions produced by carboplatin, an anti-cancer drug. Project 2 uses auditory evoked potentials to examine functional changes along the

2 Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).

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auditory neuroaxis associated with permanent IHC loss from carboplatin and transient cochlear deafferentation by kainic acid, a glutamate analog. Project 3 explores acoustic and biochemical methods of protecting the cochlea from hearing loss induced by acoustic over-stimulation and carboplatin. Project 4 focuses on potential protective effects on lateral and medial olivocochlear efferent fibers on hair cell loss and hearing loss induced by carboplatin, aminoglycosides, kainic acid and acoustic over-stimulation. Overlapping themes among the projects include consequences of IHC loss, central nervous system reorganization, mechanisms of ototoxic damage, and strategies for protecting the inner ear from damage. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: ADAPTATION TO CONTROLLED VESTIBULAR STIMULATION Principal Investigator & Institution: Merfeld, Daniel M.; Director; Massachusetts Eye and Ear Infirmary 243 Charles St Boston, Ma 02114 Timing: Fiscal Year 2001; Project Start 01-SEP-1996; Project End 31-AUG-2006 Summary: Over 90 million Americans (greater than 40 percent) will seek medical attention for dizziness or some other balance disorder sometime in their life. A NIH working committee recently reported that at least 2 million Americans experience chronic impairment due to dizziness or other balance disorders, causing medical expenses in excess of 1 billion dollars per year. Many of these chronically impaired patients could benefit from vestibular rehabilitation, and some of these patients could benefit from a vestibular prosthesis (similar to the cochlear implant for profound sensorineural hearing loss). This proposal directly addresses both of these health care needs. Specifically, the proposed studies develop and test a prototype neural prosthesis. Furthermore, to enhance our understanding of vestibular adaptation, the proposed studies use this prototype device to investigate adaptation to changes in peripheral vestibular stimulation. This study will be the first to comprehensively investigate adaptation to changes in chronic, peripheral stimulation of the vestibular system. A better understanding of vestibular adaptation will lead to improved vestibular rehabilitation. These general scientific goals will be achieved by investigating the following specific aims: 1. Study the importance of bilateral versus unilateral cues. 2. Study how the nervous system adapts to changes in peripheral stimulation of the branch of the vestibular (VIIIth) nerve that innervates the lateral semicircular canal. 3. Study how the nervous system combines sensory information from the otolith organs and semicircular canals when the rotational cues are provided via electrical stimulation. 4. Study how the nervous system adapts to yaw rotational cues delivered to a nerve branch innervating one of the vertical canals that does not normally include yaw rotational information. 5. Study how the nervous system adapts to constant-rate electrical stimulation while stationary, with and without visual cues. All of these proposed specific aims will be investigated by measuring changes in the vestibuloocular responses induced by changes in chronic, patterned, electrical stimulation of the peripheral vestibular system. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: ADENOIDECTOMY FOR OTITIS MEDIA IN 2/3 YEAR OLD CHILDREN Principal Investigator & Institution: Casselbrant, Margaretha L.; Professor; Children's Hosp Pittsburgh/Upmc Hlth Sys of Upmc Health Systems Pittsburgh, Pa 15213 Timing: Fiscal Year 2001; Project Start 01-FEB-1997; Project End 31-JAN-2004

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Summary: Efficacy of adenoidectomy for the treatment and prevention of otitis media with effusion has been shown for children four years and older. In their "Clinical Practice Guidelines, Otitis Media with Effusion in Young Children", the Agency for Health Care Policy and Research of the U.S. Department of Health and Human Services concluded that "Adenoidectomy is not recommended for treatment of OME in a child age 1 through 3 years in the absence of specific adenoid pathology". This conclusion was based on the Panel's finding no clinical trials to support any judgement as to the efficacy of adenoidectomy in the primary management of otitis media with effusion in very young children, coupled with the risk of postoperative bleeding. By means of a well designed large-scale randomized controlled trial, the efficacy of adenoidectomy and myringotomy with and without tympanotomy tube insertion will be compared with that of myringotomy and tympanotomy alone in reducing the morbidity of bilateral otitis media with effusion of at least 3 months's duration associated with hearing loss (>20 dB) in children ages 2 and 3 years. The primary outcome measure will be percentage of time with middle ear effusion. Rates of episodes of acute otitis media, otorrhea, and otitis media with effusion, time to first recurrence, number of surgical procedures, treatment failures, hearing status, and other sequelae and complications will be recorded and compared among the three treatment groups. We estimate that 63 evaluable subjects need to be entered in each treatment arm to have a 90 percent power of detecting a benefit of at least 0.30 in percentage of time with middle ear effusion. The outcome of this trial should resolve the question of efficacy of adenoidectomy for otitis media with effusion in this age group. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: AFFERENT INNERVATION IN THE MOUSE COCHLEA Principal Investigator & Institution: Francis, Howard W.; Assistant Professor; Otolaryn & Head & Neck Surgery; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2003; Project Start 01-JAN-2003; Project End 31-DEC-2005 Summary: (provided by applicant): The long-term goal of my research is to understand fundamental structure-function relationships in the cochlea of terrestrial mammals. Hair cell loss and stereocilia pathology can be found in cochlear regions where hearing is impaired, but not always. Afferent terminals on inner hair cells (IHC), however, undergo acute structural changes in response to noise, but the long-term effects on innervation density and synaptic morphology, and their implications for hearing are unknown. This study will first establish a frequency-place map for the C57BL/6J mouse cochlea, which will enable us to make structure-function correlations in the subsequent experiments. At present there is no conclusive map for any mouse strain. Using retrograde tracer injections into defined frequency regions of the cochlear nucleus, we will plot auditory nerve afferent projections into the organ of Corti. Once a frequency map is available, we will characterize the morphology, density, and organization of nerve terminals on IHCs at specific frequency locations (e.g. 16kHz) using electron microscopic analyses of serial sections. We will combine this analysis with an unbiased stereological protocol developed to use only a fraction of the sections for accurate and efficient study of synaptic morphology in several animals. Lastly, we will test the hypothesis that noise damage has a detrimental long term effect on the structure of afferent terminals and their synapses with IHCs, and that these changes are associated with permanent hearing loss. This aim will study the effects of noise on structure of the IHC-afferent interface at frequency locations corresponding to permanent threshold shift, using stereological techniques developed in the 2nd aim. The mouse is a useful

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model for auditory neuroanatomy because its small size makes for efficient microscopic analysis, and its genome is indispensable for transgenic and mutant creations. A better understanding of normal and abnormal synaptic structure at IHCs may provide new insights into the mechanisms of hearing loss and will increase opportunities for discovery and for the development of new therapies. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: AGED MIDDLE EAR Principal Investigator & Institution: Gratton, Michael A.; Otorhinolaryngology Head & Neck Surgery; University of Pennsylvania 3451 Walnut Street Philadelphia, Pa 19104 Timing: Fiscal Year 2002; Project Start 15-SEP-2002; Project End 31-AUG-2004 Summary: Loss of hearing with aging is a well known phenomenon called presbycusis. Presbycusis, historically and correctly, is largely attributed to hair cell and primary neurons degeneration from unknown, though probably genetic, causes. This proposal argues that hearing loss in the elderly may also arise from age-related changes in the conductive apparatus of the middle ear. The evidence for age-related changes in the human middle-ear function is equivocal. This is most likely due to limitations in the way conductive hearing loss is assessed rather than anything else. Nevertheless, clear evidence can be found for structural changes in the conductive apparatus of both the human and animal middle ear. The aim of the present research is to develop an animal model that demonstrates the effects of aging on the structural and functional aspects of the middle ear. Such a model would then be employed to detail the consequences of these middle-ear changes on hearing. This aim is realized in a series of experiments hat evaluate structure and function in the young adult and aged middle-ear of the rat. The comparison begins with i careful morphological assessment of the tympanic membrane using light and transmission electron microscopy in these two age groups. Next, immunohistochemistry is employed to identify extracellular matrix proteins associated with the tympanic membrane and differences are sought between the two age groups. Then, laser interferometry is used to measure the tympanic membrane velocity transfer function in the two age groups. This function describes the frequency dependent transmission of sound vibration. Finally, Auditory Bralnstem Reponse techniques are used to ascertain the conductive component to the presbycusis seen in the aged rat. Hypotheses specific to each of these studies predict changes in the older rats reflecting a general deterioration in sound conduction. These experiments may reveal a heretofore unrecognized component of the hearing loss seen in the elderly population. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: AGING AND SUSCEPTIBILITY TO HEARING LOSS IN ZEBRAFISH Principal Investigator & Institution: Smith, Michael E.; Biology; University of Maryland College Pk Campus College Park, Md 20742 Timing: Fiscal Year 2002; Project Start 01-FEB-2003; Project End 31-DEC-2004 Summary: (provided by applicant): How aging and noise exposure interact to produce hearing loss is an important issue for understanding its etiology. The relationship between age-related hearing loss (AHL) and noise-induced hearing loss (NIHL) is not always additive. Studies using mammalian models suggest that sensitivity to acoustic trauma may be greatest during the extremes of ontogeny - that is, in developing animals and in senescent animals. Zebrafish (Danio redo) have become a popular vertebrate model for examining embryogenesis and genetic defects because there is considerable synteny between zebrafish and human genes. Thus zebrafish mutations that affect ear

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development, or interact with age to affect hearing, may shed light on similar pathologies in humans. Although age-related shifts in hearing has been examined in developing fishes, the effects of degeneration due to senescence have not been examined in zebrafish or any other teleost. In order to fully understand the effects of inner ear genetic mutations and NIHL in the zebrafish model, baseline data of age-related shifts in hearing capabilities in wild type zebrafish are needed. The purposes of the proposed research will be to 1) examine shifts in hearing capabilities with age and 2) determine how aging (AHL) and noise exposure (NIHL) interact to cause hearing loss in zebrafish. To fulfill these goals, zebrafish will be exposed to specific sound exposures at various ages, and then pathology of the inner ear (via SEM) and hearing thresholds (via auditory brainstem response) will be examined. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: ANTIGENIC HEARING LOSS

TARGETS

AUTOIMMUNE

SENSORINEURAL

Principal Investigator & Institution: Carey, Thomas E.; Professor; Otolaryngology; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, Mi 481091274 Timing: Fiscal Year 2001; Project Start 01-AUG-1999; Project End 31-JUL-2004 Summary: (Adapted from applicant's description) Autoimmune sensorineural hearing loss (AISNHL) in man may be the result of antibodies to inner ear antigens. A monoclonal antibody KHRI-3 that binds to supporting cells in the organ of Corti and a 68 kD protein in guinea pig inner ear extracts causes hearing loss and loss of outer hair cells in the guinea pig. In sera from 50-60% of patients with AISNHL we found antibodies with similarities to KHRI-3. We will test the hypothesis that patients with AISNHL have antibody to a 68 kD inner ear antigen, that this antigen is expressed on supporting cells in the organ of Corti, and that the same antigen is also expressed in human inner ear. We will test a second hypothesis that human autoantibodies and KHRI-3 bind to the same inner ear protein, that this protein is distinct from heat shock protein 70 (HSP-70), that the inner protein can be affinity purified on a KHRI-3 column, sequenced, and that the gene for this protein can be cloned, sequenced, expressed in vitro and used as an antigenic substrate for detecting antibodies in patients with AISNHL. Preliminary results show that human sera with antibodies to a 68 kD guinea pig inner ear antigen also bind to supporting cells in the guinea pig inner ear. Human inner ear tissue can specifically absorb this antibody reactivity. A 68 kD protein immunoprecipitated from guinea pig inner ear extracts by KHRI-3 is stained by AISNHL sera, but not by normal donors' sera and not by antibodies to HSP-70. These preliminary data support our hypotheses and suggest that an immunoaffinity column prepared with KHRI-3 antibodies will isolate a protein of sufficient purity for amino acid sequencing. Based on the sequence we will screen inner ear libraries, isolate and clone the gene for the inner protein, express the full length cDNA in an in vitro translation system, and test whether this material can be used as a substrate for detecting AISNHL antibodies. If we are successful this could lead to a rational, accurate test for AISNHL and a better understanding of the mechanism of autoimmune damage to the inner ear. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: AUDIOLOGY & SIGNAL PROCESSING Principal Investigator & Institution: Tyler, Richards S.; University of Iowa Iowa City, Ia 52242

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Timing: Fiscal Year 2001; Project Start 09-SEP-1985; Project End 31-MAY-2006 Summary: (provided by applicant): This project addresses issues related to cochlear implantation using audiological and speech-perception techniques. We will perform experiments that should expand selection criteria and improve performance. First, we will implant adults with more residual hearing to determine if the current selection criteria can be broadened to benefit more patients. Second, three different experiments will test opportunities to improve speech perception and music by novel speechprocessing approaches. We will use a high-rate conditioning processor to produce more natural nerve-fiber activity. A short electrode will be inserted in patients with good lowfrequency hearing, and then the ear will be stimulated with combined acoustical and electrical signals. Some patients will also receive binaural implants, and studies with independent processors will attempt to improve the binaural advantage for localization and speech perception in noise. The Electrophysiology Project will assist in fitting and the Music Project will assist in the evaluation of these studies. Third, many of our patients are older and can be expected to experience cognitive difficulties. However, hair-cell loss due to aging will not affect these patients, so their performance may not deteriorate as occurs in adults with hearing aids. More children are being identified early with hearing loss, and accurate measures are needed to determine behavioral thresholds in children before 12 months of age. A computer-based visual reinforcement audiometry system will be used to measure a head-turn response, and these same children will be tested later with play audiometry using the exact same equipment. Parallel measures will be made by the Electrophysiology Project. In our effort to further define appropriate selection criteria in children, we will work with the Language Project to determine if the advantage afforded by early implantation extends down to children 12 months of age. To further explore which children should get cochlear implants and which should get hearing aids, we will also measure the speech perception of hearingimpaired school-aged children using well-fit hearing aids. Fifth, we will evaluate children who have been using their implants for many years to document the levels of benefit that can be expected and the factors that contribute to success. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: AUDITORY ANALYSIS AND SPEECH RECOGNITION Principal Investigator & Institution: Dubno, Judy R.; Professor; Otolaryngology-Head & Neck Surgery; Medical University of South Carolina 171 Ashley Ave Charleston, Sc 29425 Timing: Fiscal Year 2001; Project Start 01-DEC-1981; Project End 31-JAN-2006 Summary: (Adapted from applicant's abstract): This research program addresses basic questions related to processing of auditory information and recognition of speech by individuals with normal hearing and cochlear hearing loss. An important consequence of the active cochlear mechanism, revealed by studies of basilar-membrane mechanics, is the nonlinearity (compression) in basilar membrane input-output functions. Among the most prominent psychophysical effects of a loss of compression are changes in growth of masking and suppression, and increased effects of time-varying maskers, each of which may diminish speech recognition in noise. Three aims are proposed to address key question concerning the effects of suppression and the benefits of compression and nonlinearities in the peripheral auditory system to speech recognition in noise. Aim 1 assess growth of masking for tonal and speech signals at moderate and high levels to test the hypothesis that compression and other nonlinearites underlie improvements in speech recognition in noise, and that more linear response resulting from cochlear injury expain diminished speech recognition in noise for persons with cochlear hearing loss.

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Aim 2 test the hypothesis that suppression contributes to normal speech recognition in noise and that a reduction of loss of suppression at high levels or with cochlear hearing loss contributes to declines in speech in noise. Aim 3 measures detection and speech recognition in fluctuating maskers to test the hypothesis that compression and nonlinearities underlie the benefits derived form masker fluctuations and that a loss of compression reduces this benefits for individuals with cochlear hearing loss. A longterm goal is to discover the basis for, and the means for reducing, the detrimental effects of cochlear hearing loss on the perception of speech. A better understanding of these effects is essential if individuals with cochlear hearing loss are to achieve maximum benefit form amplified speech in adverse listening conditions. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: AUDITORY DEVELOPMENT IN EARLY-AMPLIFIED CHILDREN Principal Investigator & Institution: Sininger, Yvonne S.; Professor; House Ear Institute 2100 W 3Rd St Los Angeles, Ca 90057 Timing: Fiscal Year 2001; Project Start 30-SEP-2000; Project End 31-DEC-2001 Summary: (from applicant's abstract): Little information is presently available describing the process of early auditory intervention (fitting of amplification) and resultant auditory-based outcomes in young children. The long-term objective of this project is to investigate speech perception, speech production, and spoken language skills in children with hearing loss who have received early, accurate audiologic assessment and appropriate fitting of amplification. This project will also provide information on the process of accurate hearing loss estimation in infants as well as developmental changes in audition and ear structures and how these may relate to the amplification fitting process. A large group of infants identified with hearing loss in a neonatal hearing screening program will have hearing thresholds predicted by frequency-specific auditory brainstem response (ABR). These thresholds will be used with infantappropriate prescriptive techniques for fitting and validation of amplification. Infants will be enrolled in parent-infant education and followed for up to four years. Young children not screened for hearing loss in the newborn period who are identified with hearing loss up to 2 years of age will also be fit with amplification and followed as subjects. Speech perception and speech production as well as spoken language will be assessed with age- appropriate measures at regular intervals. Important information that may influence the relationship between amplification and auditory outcomes, such as type and timing of educational intervention, cognitive status, parental involvement, socio-economic status and other medical conditions will be documented and used in data analysis. Primary aims of this study are to 1) determine the relationship(s) between age at time of optimized amplification fitting and degree of hearing loss with speech perception, speech production, and spoken language in children with hearing loss; and, 2) determine the time course of this development. Secondary aims are to establish the accuracy of audiometric threshold prediction in newborns using ABIR against standard behavioral audiometric thresholds obtained after 6 months of age, and to determine the extent of developmentally related changes in ear canal volume and resonance on hearing aid prescriptive targets. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: AUDITORY PROCESSING AND SENSORINEURAL HEARING LOSS Principal Investigator & Institution: Summers, W V.; Research Scientist; U.S. Walter Reed Army Med Center 6900 Georgia Ave Nw Washington, Dc 20307

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Timing: Fiscal Year 2001; Project Start 01-JAN-1998; Project End 31-DEC-2002 Summary: (From applicant's abstract): Listeners with sensorineural hearing impairment frequently show deficits in speech understanding, particularly in difficult listening situations involving competing sounds. There may be especially large deficits relative to normal-hearing listeners in the context of dynamically-varied maskers such as speech from a single additional talker or reverberation - the types of maskers commonly found in the real world. These perceptual deficits do not reflect simply the absolute sensitivity loss and reduced audibility of the target speech. The research proposed here focuses on influences of cochlear damage on auditory processing of signals that are audible to listeners with sensorineural hearing loss. In normal-hearing listeners, outer hair cells within the cochlea actively influence cochlear mechanics through a process referred to as the cochlear amplifier or active mechanism. Reduced influence of the active mechanism on internal processing may contribute significantly to the deficits that hearing-impaired listeners experience in identifying complex sounds like speech in competing sound environments. The proposed studies are directed studying the influence of the active mechanism on the processing of audible signals and a means of assessing active mechanism status in individual hearing-impaired listeners. The first set of experiments evaluate a possible psychoacoustic means of assessing active mechanism status in normal-hearing and hearing-impaired listeners. Later studies apply these findings to tasks involving speech-like material and to running speech in order to clarify the role of the active mechanism in the processing of speech in competing sound. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: AUDITORY-VISUAL INTEGRATION AND AGE Principal Investigator & Institution: Tye-Murray, Nancy T.; Senior Research Scientist; Central Institute for the Deaf 4560 Clayton Ave St. Louis, Mo 63110 Timing: Fiscal Year 2001; Project Start 30-SEP-2000; Project End 31-AUG-2005 Summary: This project will be the first large-scale investigation to evaluate changes in visual enhancement across the adult life span. Visual enhancement is the advantage afforded by seeing as well as hearing the talker, as compared to listening alone, and is an issue of critical significance to the audiological rehabilitation of older persons. The unique contributions of the present proposal are threefold. First, we will assess how vision-only speech recognition and auditory-visual integration skills contribute to changes in visual enhancement, and determine if changes relate to more global declines in older persons' abilities to integrate two sensory signals, be they speech or non-speech. Performance will be related to perceived communication handicap. Second, two quantitative models of auditory- visual integration, one developed by Blamey, Alcantara, Whitford, & Clark (1989) and the other by Braida (1991), will allow us to determine whether age affects how individuals integrate specific features of the speech signal, and also, how it affects their ability to achieve optimum integration of the auditory and visual signals. Third, we will determine whether or not the presence of hearing loss may affect integration performance for both older and younger adults, and whether the type of speech material interacts with one's ability to integrate. The results may affect several stages of the geriatric audiological rehabilitation plan, including how we assess speech recognition skills and the kinds of follow-up, support, and counseling we provide to clients and their families after an individual receives appropriate amplification. In addition, the results may have important theoretical implications for models of aging and auditory-visual speech recognition, and may elucidate variables that contribute to the communication handicap experienced by persons who have hearing loss. Over a five-year period 200 subjects, selected on the basis of age and

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Hearing Loss

hearing status, will be enrolled in a set of cross-sectional experiments. The experimental methodologies have been developed and tested through a series of extensive pilot studies. The experiments are designed to assess subjects' levels of visual enhancement, vision-only speech recognition, auditory-visual integration, auditory-auditory speech integration, and auditory-auditory non- speech integration. It is hypothesized that visual enhancement will be shown to decline with age, and that this decline will be associated with a global decline in the ability to integrate sensory information, not to a change in vision-only speech recognition abilities. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: BALANCING SURVIVAL AND OTOTOXICITY IN CISPLATIN THERAPY Principal Investigator & Institution: Li, Yuelin; Children's Hospital of Philadelphia 34Th St and Civic Ctr Blvd Philadelphia, Pa 19104 Timing: Fiscal Year 2001; Project Start 15-FEB-2001; Project End 31-JAN-2004 Summary: (from applicant's abstract): Evaluating the tradeoffs between patient survival and treatment toxicity has been, and always will be, a major challenge to clinicians. Treatment options that improve the Disease Free Survival (DFS) rate are often accompanied by increased side effects whereas options with lower DFS rates are usually less toxic. The administration of Cisplatin to pediatric germ cell tumor patients entails a tradeoff between mortality and ototoxicity. Increasing the dose of Cisplatin from 100mg to 200mg raises the DFS rate from 82% to 92%, yet also results in an increased incidence of permanent hearing loss, from 20% to 76%. The primary goal of this project is to evaluate whether the increase in cancer survival is worth the increased risk of suffering the functional impacts of Cisplatin ototoxicity. The project will proceed in four sequential aims: (1) To understand the hearing impairments due to alternative Cisplatin dosages. Data available from a recent (unpublished) CCG protocol will be used for finding a probability distribution of hearing deficits as a function of dosage. (2) To study the Quality of Life (QOL) consequences and construct health vignettes for decision analysis. Specific hearing deficits will be mapped onto their corresponding patient functional states. This summarizes the real-life difficulties as a result of hearing loss from Cisplatin treatment. Functional status of the child will be assessed by validated inventories from parental ratings and child self-assessments (N = 60). (3) To elicit parental utilities on hearing vignettes constructed from functional results. Using the Standard Gamble and an analog rating scale, five groups of parents will be asked to assign utilities to various hearing vignettes constructed from aim 2 (N = 20 per group). Group differences will be compared. (4) Finally, to perform decision and sensitivity analyses to determine the normative Cisplatin dosage. Preliminary recommendations will be made involving the use of high dose Cisplatin in pediatric germ cell patients. A Markov model is proposed, which extends the time horizon of the analysis and considers hearing deterioration, cancer relapse, second cancer, pediatric cancer, late effects in other organ systems, and additional functional deficits due to salvage regimes. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: BEHAVIORAL ASSESSMENTS OF HEARING LOSS Principal Investigator & Institution: Prosen, Cynthia A.; Psychology; Northern Michigan University Marquette, Mi 49855 Timing: Fiscal Year 2000; Project Start 01-APR-2000; Project End 31-MAR-2004

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Summary: (Adapted from the Investigator's Abstract) The long-term objective of this research project is to investigate perceptual, anatomical, and physiological consequences of sensorineural hearing loss (SNHL). The first specific aim will examine auditory deficits in C57BL/6J mice which serve as an animal model of presbycusis, the progressive loss of high-frequency hearing that afflicts most adult humans. When outer hair cells are lost in the progression of SNHL, the resulting disturbance of active cochlear mechanics is presumed to decrease auditory sensitivity and frequency tuning. This interpretation will be tested in detail by correlating behavioral measures of absolute threshold and frequency resolution at various stages of hearing loss with structural changes in the cochlea, auditory nerve, and cochlear nucleus. It is hypothesized that the onset of behaviorally-assessed perceptual deficits will be correlated with ultrastructural changes of the peripheral innervation before gross cochlear degeneration leads to significant hair cell loss. These findings may lead to a better understanding of the importance of early clinical interventions for the treatment of profound SNHL. Olivocochlear efferent fibers that project from the auditory brainstem to the cochlea terminate upon outer hair cells; for this reason, the most common patterns of SNHL disrupt both afferent and efferent processes in the auditory periphery. The second specific aim will isolate the discrete functional consequences of a compromised efferent feedback system by measuring the hearing thresholds of alpha-9 knockout mice in quiet and in continuo9us background noise. Recent physiological studies have shown that these mutant mice exhibit normal afferent responses but no obvious cochlear efferent activity because cholinergic olivocochlear projections cannot function in the absence of alpha-9 acetylchol9ne receptors. Based on the results of previous olivocochlear lesioning experiments in other species, it is hypothesized that genetically de-efferented mice will be more sensitive to noise masking effects than normal controls. These studies may explain why current hearing aid designs fail to function effectively in the presence of environmental noise. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: BUILDING A COMPREHENSIVE HEARING LOSS SITE IN CYBERSPACE Principal Investigator & Institution: Steinberg, Annie; Children's Hospital of Philadelphia 34Th St and Civic Ctr Blvd Philadelphia, Pa 19104 Timing: Fiscal Year 2001; Project Start 01-SEP-2001; Project End 31-AUG-2004 Summary: (provided by applicant): This project will develop, implement, and evaluate a comprehensive, interdisciplinary, accessible, interactive, and unbiased website to provide information for parents of children with hearing loss, health-care professionals, educators, and other individuals and institutions in order to facilitate informed decision making in regard to treatment choice. This web site will apply the knowledge gained in previous studies of parental decision making about the specific needs of parents, the barriers they faced, and the resources that have proved useful. Content on the site will conform to standards established to assure health information quality, credibility, and currency and will be constructed in a manner which will make it accessible to a wide audience, including underserved minorities and individuals with hearing loss. Parents and professionals will be incorporated into the development process through a series of focus groups, surveys, and evaluations of the site throughout project development and through participation on an advisory board. When fully operational the site will provide users with 1) access to information on a wide range of topics, including links to other sites with valuable information; 2) a computer-interactive decision aid, with privacy ensured, through which parents can explore and clarify their own personal objectives,

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Hearing Loss

decision making style, and the options that are most appropriate for their individual family. Parents who use this tool will be directed to other areas of the website selected specifically to match their individual needs, goals, and values. 3) answers to individual questions from a multidisciplinary group of experts; 4) first-person accounts of the experiences of other families facing similar circumstances; 5) materials on topics such as how to communicate with a deaf baby regardless of communication modality and how to include a deaf toddler in a hearing day care setting; and 6) first-person narratives from adults and children with hearing loss. Narrative accounts will be available as text or video and will be interpreted, captioned, or translated into ASL as appropriate. An outreach campaign will accompany development of this site in order to make all information available to people with limited access to computers and the Internet. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CELL DEATH MECHANISMS OF NOISE-INDUCED HEARING LOSS Principal Investigator & Institution: Nicotera, Thomas M.; Roswell Park Cancer Institute Corp Buffalo, Ny 14263 Timing: Fiscal Year 2001; Project Start 01-AUG-2001; Project End 31-JUL-2003 Summary: (provided by applicant): This project is focused on the temporal and spatial pattern of noise-induced hair cell loss, as well as, the molecular "triggers" for the hair cell loss. Previous work has shown that the size of the cochlea lesion continues to "grow" after the exposure, that the increased hair cells is related to apoptosis and that the apoptotic cells have Caspase-3 expressed. This project extends our preliminary work with noise exposures that are likely to cause metabolic damage in the cochlea (4 kHz OB @ 105 dB SPL for 4h) or noise exposures that will cause both metabolic and mechanical damage (150dB pe SPL impulse). The experiments are designed to elucidate the progression of hair cell loss after noise exposures, the prevalence of apoptosis as reflected in nuclear shrinking, as well as, the expression of Caspase-3. A second set of experiments, with the same noise exposures, examines the relevance of Caspase-8 or 9 as precursors to Caspase-3. Lastly, the third set of experiments will distinguish the temporal sequence of ROS response with respect to caspase activation (i.e. which takes place first). Collectively, these experiments will help better understand the molecular pathways involved in cell death and the results will serve as a rationale for future therapeutic intervention. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: CENTRAL AUDITORY FUNCTION IN ADULTS WITH HEARING LOSS Principal Investigator & Institution: Firszt, Jill B.; Otolaryngology and Commun Scis; Medical College of Wisconsin Po Box26509 Milwaukee, Wi 532264801 Timing: Fiscal Year 2002; Project Start 22-APR-2002; Project End 31-MAR-2007 Summary: (provided by applicant) The long-term objective of our research is to understand the wide variation in speech perception of individuals with hearing loss who are candidates for hearing aids or cochlear implants, an important challenge that confronts clinicians. We know that speech perception is reflected in auditory pathway physiology. In the auditory cortex, timing, intensity and frequency cues are represented by cortical neural activity and ultimately linked to perceptual performance. Although we can assess the perception of sounds, much less is known about the underlying neurophysiology of the central auditory system. Specifically, the experiments in this study are designed to test the hypotheses that there are differences in the tonotopic

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organization and the asymmetric activation patterns of the central auditory system in good and poor perceivers of speech. To accomplish our research, we will use a multidisciplinary approach that combines outcome, neurophysiology and functional magnetic resonance imaging (fMRI) in normal listeners and individuals with hearing loss. Measures such as evoked potentials, which are inherently dependent upon neural synchrony, allow us to evaluate the critical components of neural encoding. Neuroimaging techniques such as fMRI, can produce distinct localized images corresponding to auditory cortex activation. Finally, using fMRI, we will investigate whether tonotopic organizational patterns can be identified and relate to speech perception for cochlear implant recipients with a magnetless cochlear implant system. Overall, this research will not only result in a better understanding of the physiology of the auditory cortex, but also a better understanding of the functional significance of tonotopic organization and hemispheric differences in both normal hearing listeners and those with hearing loss. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CENTRAL DEPRIVATION

AUDITORY

SYSTEM

EFFECTS

OF

AUDITORY

Principal Investigator & Institution: Tucci, Debara L.; Associate Professor of Surgery; Surgery; Duke University Durham, Nc 27706 Timing: Fiscal Year 2002; Project Start 01-APR-2002; Project End 31-MAR-2007 Summary: (provided by applicant):The long-term goal of this work is to understand the structural and functional changes imposed on the central auditory system by conductive hearing impairment. A secondary goal is to determine the factors that govern the potential for reversibility of these changes. The clinical implications of this work are that many children experience conductive hearing loss during early development, in a time period that coincides with that of rapid acquisition of speech and language skills. Childhood conductive hearing loss is known to be associated with deficits in auditory processing skills, some of which persist even after the return of normal hearing. The nature of the functional and neuroanatomical changes in the central auditory system that underlie these deficits is unknown. The hypothesis underlying this proposal is that chronic conductive hearing impairment in early life results in structural changes in the central auditory systems, which are related to functional deficits in central auditory processing. These effects are age-dependent, and more severe in the developing animal. The severity of the structural change will affect the potential for reversibility when normal hearing is reinstated. Experiments are proposed to achieve three specific aims designed to address this hypothesis: 1) to define the effects of conductive hearing loss on activity in the auditory nerve and central auditory system, and assess the agedependent interactions; 2) to define the metabolic and structural changes that occur following unilateral conductive hearing loss in the developing and mature animal; and 3) to investigate factors that govern the reversibility of the above changes. We hypothesize that the potential for reversibility will depend upon the type and severity of the structural modification induced by conductive impairment, and the developmental stage of the animal at the time of the insult. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CLONING OF NON-SYNDROMIC DEAFNESS GENES DFNA29 & DFNA32 Principal Investigator & Institution: Li, Xiaoyan C.; House Ear Institute 2100 W 3Rd St Los Angeles, Ca 90057

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Timing: Fiscal Year 2001; Project Start 09-FEB-2001; Project End 31-JAN-2004 Summary: (from applicant's abstract): The long-term goal of this study is to understand the function and dysfunction of hearing at the molecular level. Hearing impairment is the most common human sensory disorder. Approximately 70 million people worldwide suffer from hearing loss over 55 dB. Genetic factors are one of the most important causes for hearing impairment. Approximately one in every 2,000 children is born with severe to profound hearing loss due to a genetic cause. Non-syndromic hearing loss occurs in isolation, and it accounts for approximately 80% of hereditary deafness. Studies on the molecular basis of non-syndromic hearing loss, especially the late onset forms, are not only important for improving our understanding of the molecular mechanisms of auditory development and function, but also for developing more precise genetic counseling and therapeutics for both genetic and environmentrelated hearing impairment. We have mapped two new deafness loci, DFNA29 and DFNA32, using linkage analysis on two large US families with non-syndromic autosomal dominant progressive hearing loss. The PI proposes to identify the responsible genes, and to explore their function in the hearing process. The following specific aims are proposed: (1) Refine the critical region of DFNA29 and DFNA32 using recombinational mapping and linkage disequilibrium strategies. (2) Establish permanent cell lines from both affected and unaffected individuals by Epstein-Barr virus transformation. (3) Identify the molecular basis of these loci using a positional candidate gene approach. (4) Establish expression patterns of the genes responsible for DFNA29 and DFNA32 in the developing auditory and vestibular systems using PCR, RT-PCR, and RNA in situ hybridization. This specific aim represents a long-term direction of the study. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CMV LABYRINTHITIS INDUCED IN IMMUNODEFICIENT SCID MICE Principal Investigator & Institution: Woolf, Nigel K.; Adjunct Professor; Surgery; University of California San Diego 9500 Gilman Dr, Dept. 0934 La Jolla, Ca 92093 Timing: Fiscal Year 2002; Project Start 01-MAY-1995; Project End 31-MAR-2005 Summary: (provided by applicant):Experimental cytomegalovirus (CMV) labyrinthitis and encephalitis in SCID (severe combined immunodeficiency) mutant mice provides a useful model for the auditory system pathologies and hearing loss observed in immunodeficient patients, like those with acquired immune deficiency syndrome (AIDS). Auditory and vestibular system neuropathologies are common clinical signs in AIDS patients. Sensory system disorders in these immunocompromised patients arise primarily from opportunistic coinfections, and not from the direct effects of human immunodeficiency virus (HIV) infection. By far the most common opportunistic coinfection in AIDS is CMV. While CMV retinitis remains the most frequently recognized sensory system pathology in AIDS, up to 60 percent of AIDS patients reportedly experience CMV induced auditory and vestibular system neuro-otological disorders. CMV exhibits strict species-specificity, and therefore it is not possible to develop an animal model using human virus. However, while inimunocompetent mice are resistant to munne CMV (MCMV) infection, we have demonstrated that intrathecal (i.e., CSF) inoculation of SCID mice with 68 PFU of MCMV induces labyrinthitis, encephalitis and sensorineural hearing losses which closely resemble human disease. We propose to utilize a new recombinant MCMV expressing an enhanced green fluorescent protein reporter gene (rMCMV) in our SCID) mouse model to investigate the following basic questions: 1) How do cellular tropisms influence rMCMV

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neuropathogenesis in the peripheral and central auditory nervous system? 2) By what mechanism is rMCMV propagated between cells in neural circuits within the auditory nervous system? 3) What are the roles of cellular calcium-binding protein expression, apoptosis, and DNA repair mechanisms in the evolution of rMCM labyrinthitis and encephalitis? 4) How does cytokine- and chemokine-specific immunity influence rMCMV clearance and neuropathogenesis in the auditory system? 5) How closely do the clinical signs of rMCMV infections in SCID mice resemble AIDS-associated neuropathologies in the auditory system of humans? An interdisciplinary approach will be used to investigate the clinical symptoms, immunologic, virologic, histopathologic, molecular biologic and electrophysiologic aspects of MCMV infections within the peripheral and central auditory system of immunodeficient SCID mice. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: COCHLEAR HOMEOSTASIS Principal Investigator & Institution: Adams, Joe C.; Professor; Massachusetts Eye and Ear Infirmary 243 Charles St Boston, Ma 02114 Timing: Fiscal Year 2001; Project Start 01-JAN-1999; Project End 31-DEC-2003 Summary: The goal of the proposed work is to explore mechanisms of hearing loss induced by inflammatory cytokines in the cochlea. The work focused on the spiral ligament, because our recent work suggests that it 1) plays a critical role in cochlear fluid and ion homeostasis and 2) may be particularly susceptible to inflammatory processes. Type 1 fibrocytes are the most common cell type within the spiral ligament. They are part of a syncytium of cochlear supporting cells joined by intercellular connections called gap junctions. We have hypothesized that this gap junctional that this gap junctional system is essential for potassium ion recirculation from the organ of Corti to the stria vascularis and ultimately into endolymph, where a high potassium level is critical for normal high cell function. We have also found that type 1 fibrocytes contain high levels of the transcription factor NFkappaB, a protein that plays a key role in the acute phase inflammatory response of tissue to trauma or infections. In other tissues, inflammatory cytokines induced by NFkappaB can disrupt gap functional conductivity. Our working hypotheses is that inflammatory processes in the cochlea, arising from a wide array of disease states, induce cytokines in the spiral ligament, thereby blocking gap junctions between type 1 fibrocytes, depriving the stria vascularis of its potassium supply and producing profound sensorineural hearing loss. We will test this hypothesis by characterizing physiological and cytochemical responses of the cochlea following administration or induction of cytokines. We will measure changes in cochlear function by measuring evoke potentials and the endolymphatic potential and will use immunocytochemistry to document changes in cytochemical constituents of cochlear cells following the pharmacological experiments in order to determine the mechanisms underlying the cytokines' effects. The results may shed considerable light on the bases for sensorineural hearing loss in a variety of common, but poorly understood, otological disorders such as labyrinthitis, otosclerosis, genetic hearing losses involving gap junction proteins, and immune-mediated hearing loss. The proposed characterization of cytochemical substrates of inflammatory processes within the cochlea may help devise treatments or means of preventing hearing loss associated with these disorders. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: COCHLEAR VULNERABILITY/REACTIVE OXYGEN SPECIES Principal Investigator & Institution: Ohlemiller, Kevin K.; Associate Research Scientist; Central Institute for the Deaf 4560 Clayton Ave St. Louis, Mo 63110

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Timing: Fiscal Year 2001; Project Start 01-AUG-1999; Project End 31-JUL-2004 Summary: Acquired hearing loss represents a complex interplay of genes and environment. Although there is much support for the existence of genes that influence the vulnerability of the cochlea to noise and ototoxins, few candidate genes or processes have been identified. One candidate process involves the generation and regulation of reactive oxygen species (ROS). Both chronic neurodegenerative disease and acute CNS injury involve elevated ROS, and deficiency of antioxidant enzymes promotes vulnerability to injury. We hypothesize that some genetic defects that predispose people to acquired hearing loss involve impairment of ROS regulatory mechanisms, rendering the cochlea more vulnerable to injury. We will apply hearing loss-prone and -resistant mouse models (C57BL/6, BALB/c, CBA/Ca), and 'knockout' mice deficient in antioxidant enzymes (superoxide dismutase and glutathione peroxidase), of carefully considered ages to the following Specific Aims: (1) Correlating the dynamics of cochlear ROS production following noise exposure with specific cochlear injury. We will establish the relation between the magnitude and time course of cochlear ROS production following acute noise exposure and cochlear injury, as measured by auditory brainstem responses, light and electron microscopy, and hair cell counts. (2) Identifying genetic influences on the relation between ROS production and noiseinduced cochlear injury. We will determine the impact of genetic defects of hearing and ROS regulation on the relation between cochlear ROS production and noise-induced cochlear injury. (3) Uncovering the basis of genetic and age influences on the efficacy of antioxidants. We will determine the impact of age and genetic defects of hearing on the ability of exogenous antioxidants to attenuate both ROS production and noise-induced cochlear injury. Our experiments will establish how well the dynamics of ROS production predict cochlear injury, and whether progressive deafness genes may impair cochlear ROS regulation. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: COMBINATIONS OF MASKING AND SENSORINEURAL HEARING LOSS Principal Investigator & Institution: Jesteadt, Walt; Director of Research; Father Flanagan's Boys' Home Boys Town, Ne 68010 Timing: Fiscal Year 2001; Project Start 01-JUL-1978; Project End 31-MAR-2003 Summary: The primary evidence of reduced frequency selectivity in listeners with sensorineural hearing loss comes from masking studies where these listeners are found to have abnormally high thresholds and abnormally poor speech perception. This proposal outlines a series of studies designed to test the hypothesis that the effect of hearing loss combines with the effect of an external masker in the same way that the effect of one external masker combines with the effect of another. Recent research suggests that most combinations of external maskers produce more masking in listeners with normal hearing than would be predicted from the effects of the individual maskers and that the rules governing effects of combined maskers differ for different types of maskers. Recent models of additivity of masking provide a framework for integrating these diverse results which could be expanded to include effects of sensorineural hearing loss. The proposed work includes further development of models of additivity, further studies of additivity in both normal and impaired listeners, and studies to extend this approach to encompass loudness growth and speech perception. Hearing loss and masking are clearly not equivalent. Learning more about precisely how they differ will lead to a better understanding of both processes and of how they interact with one another.

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Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: COMPANION MICROPHONES: INCREASED SNR FOR 3+ TALKERS Principal Investigator & Institution: Killion, Mead C.; Etymotic Research 61 Martin Ln Elk Grove Village, Il 60007 Timing: Fiscal Year 2003; Project Start 18-SEP-2003; Project End 31-AUG-2004 Summary: (provided by applicant): The long-term goal of this project is to help provide relief to persons whose hearing loss is so severe that they isolate themselves from normal social interactions, particularly in high-noise environments such as restaurants, it has long been recognized that such isolation may bring on mental and even physical deteriorations, but practical solutions to the problem have been limited. Hearing aids with directional microphones or high-directivity array microphones can provide 4-8 dB effective noise reduction. But it is estimated that 10% of hearing-impaired persons have a loss in the ability to understand speech in noise (signal-to-noise-ratio loss) great enough that they find it virtually impossible to carry on a conversation at a noisy dinner table or restaurant, even with a directional microphone. A well-known solution to this problem is the use of an RF microphone close to the talker's mouth, much as is used in classrooms for hearing-impaired children. This is highly effective, but permits only oneon-one conversations. On a few occasions, multiple-microphone systems (similar to that in U.S. Patent 5,966,639) have been assembled, but they have not achieved the convenience and small size required to make them attractive, and they have generally been expensive. It should now be possible to produce a multiple-microphone system with small RF microphones that clip onto the collars or blouses of three companions of the hearing impaired person (for example at a restaurant table). The hearing-impaired person will wear a small RF receiver that receives all three microphone signals and conveys the combined signal to a hearing-aid telecoil or, for those who have rejected hearing aids, directly to an insert earphone. While past development work has failed to produce a practical and inexpensive system such as described above, current integratedcircuit technology provides excellent chances of success. A crucial part of the development process will be the audiological evaluation of prototypes in real-world situations. This will be accomplished using real-world and simulated-real-world intelligibility-in-noise measures developed in the past. In addition, a subjective value rating will provide a practical check on the utility of these developments. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: CONTROL OF INNER EAR MICROCIRCULATION Principal Investigator & Institution: Nuttall, Alfred L.; Professor; Otolaryngology Head & Neck Surgery; Oregon Health & Science University Portland, or 972393098 Timing: Fiscal Year 2002; Project Start 01-MAY-1977; Project End 31-AUG-2007 Summary: (provided by applicant): Nitric oxide (NO) is a major signaling molecule in biological systems. It serves in normal physiology as a vasodilator and a regulator of cellular processes including energy metabolism. It is also involved in tissue pathology through the damage caused by nitrogen related reactive oxygen species (ROS). The abundant NO synthase (NOS) found in the organ of Corti suggests a role for NO in the mechanical or electrical function of the organ. The NOS found in the stria vascularis and endothelial cells of blood vessels could be important to blood vessel permeability as well as vasodilation. The state of the cochlear blood flow (CBF) and the microcirculation in the cochlea is of critical importance to hearing. It is known that age, drugs and loud sound cause changes in cochlear circulation but it is not know whether these changes

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are a cause of hearing loss or perhaps accelerate declining hearing. This proposal is designed to evaluate the normal physiology of NO generation in the cochlea and the pathological consequences of ROS formation. Aim 1 has the goal of evaluating whether NO produced in the organ of Corti affects the sensitivity and mechanical responses of the organ. Electrophysiological and mechanical measurements of organ of Corti responses to sound while blocking or enhancing NO levels in the cochlea accomplish this. Aim 2 has the goals of determining: whether NO caused vasodilation of CBF reduces the damaging effects of loud sound exposure; whether NO prevents abnormal vascular permeability of the CBF; and how hypoxia alters the cellular biology of cochlear vascular smooth muscle. Mutant mice, deficient in endothelial cell NOS, will be used in part of this work. In Aim 3 it will be determined if an inducible form of NOS (iNOS) is responsible for loss of sensitivity and of sensory cells as a result of noise exposure. These studies will use the mutant mouse lacking iNOS as well as the experimental approach of pharmacological inhibition of iNOS. The work will also determine the amount and cellular locations of nitrogen related ROS. By correlation of the cellular ROS levels with the early expression of stress proteins and subsequent cell death, it will be possible learn the importance of NO in the pathological process of noise-induced hearing loss. The long term goals of this work are to learn how cochlear microcirculation and the NO biochemistry can be treated to prevent noise induced and age-related hearing loss. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CREB-MEDIATED SURVIVAL OF DEAFFERENTED AUDITORY NEURONS Principal Investigator & Institution: Zirpel, Lance; Neurobiology and Anatomy; University of Utah 200 S University St Salt Lake City, Ut 84112 Timing: Fiscal Year 2001; Project Start 01-AUG-2001; Project End 31-JUL-2006 Summary: The proposed experiments are directed at elucidating the mechanism of survival in activity-deprived auditory neurons. As with central neurons in all other sensory systems, brainstem auditory neurons require afferent input for maintenance and survival. Elimination of this input results in the death of 30- 60 percent of cochlear nucleus neurons in neonatal chicks and mice. Thus, the proposed studies concern the role of phosphorylation and activation of the transcription factor calcium/cAMP response element binding protein (CREB) in the subpopulation of cochlear nucleus neurons that survive activity deprivation. The experiments will address two groups of questions about the interactions among activity deprivation, intracellular calcium changes, CREB phosphorylation and activation, and neuronal survival. The hypothesis driving these experiments posits that following activity deprivation cochlear nucleus neurons show increased phophorylation/activation of CREB in the response to increased intracellular calcium. This phosphorylation is mediated by calcium-dependent activation of calcium/calmodulin dependent kinases and protein kinase A. Once phosphorylated, CREB results in the transcription of genes containing the calcium/cAMP response element within their promoter region, and the protein products of some of these genes allow the neurons to survive activity deprivation. The proposed experiments, grouped into two specific aims, will characterize the mechanisms of CREB phosphorylation and the role of this phosphorylation in neuronal survival. Neuronal survival is a critical issue in patients with sensory deficits. A significant fraction of the U.S. population suffers from profound hearing loss of early onset. There is agreement that early intervention is the most effective strategy for successful treatment. Understanding the mechanisms of neuronal survival following

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early sensorineural hearing loss may influence the success of restorative therapies for the congenitally hearing-impaired. During neural development, critical periods occur in which central structures are more sensitive or receptive to changes in afferent input. One potential benefit to understanding how central neurons survive activity deprivation will be to prolong these critical periods, thus improving success rates of early intervention therapy on patients with congenital hearing deficits. The proposed experiments would contribute information about how central auditory neurons survive in the absence of afferent input. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DANGEROUS DECIBELS--PARTNERSHIPS IN PUBLIC HEALTH Principal Investigator & Institution: Holloway, Susan I.; Oregon Museum of Sciences and Industry and Industry Portland, or 97214 Timing: Fiscal Year 2001; Project Start 30-SEP-2000; Project End 31-AUG-2005 Summary: (Adapted from the applicants abstract): A consortium of innovative basic science researchers, museum educators, civic leaders and volunteers propose a unique partnership to reduce the incidence and prevalence of Noise Induced Hearing Loss (NIHL), a growing problem among children and adults. To address this critical public health concern, a unique public/private partnership, including the Oregon Museum of Science and Industry (OMSI), the Oregon Hearing Research Center at the Oregon Health Sciences University (OHSU), the Portland Veterans Administration Medical Center National Center for Rehabilitative Auditory Research (NCRAR), the American Tinnitus Association (ATA), and Oregon and Southwest Washington elementary and secondary schools, propose a regional campaign to significantly reduce the prevalence of preventable hearing loss and tinnitus. The project is comprised of three freestanding, but interlocking components that create a strong public health campaign against Noise Induced Hearing Loss. These components are: (1) exhibitry; (2) curriculum; and (3) research. We propose a three phase, five-year program, directly targeting school-age youth, using established volunteer and volunteer training programs among each of the participating institutions: Phase 1: Prototype exhibit development and full production of one exhibit incorporating education, entertainment and pre-post knowledge evaluation; test-ready curriculum; draft evaluation tools and hearing screening capabilities for data acquisition. Phase 11: Classroom presentations with exhibitry and data acquisition in six Oregon and Southwest Washington for pilot testing. Phase III: Regional model program and implementation strategy for hearing science education and hearing loss prevention. Program evaluation analysis will include research results regarding subject factors and noise induced hearing loss in children. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: DEAFNESS AND OSSIFICATION IN LABYRINTHITIS OSSIFICANS Principal Investigator & Institution: Brodie, Hilary A.; Otolaryngology; University of California Davis Sponsored Programs, 118 Everson Hall Davis, Ca 95616 Timing: Fiscal Year 2001; Project Start 01-JAN-2000; Project End 31-DEC-2004 Summary: (Adapted from the Investigator's Abstract) Labyrinthitis ossificans (LO) is the growth of pathologic new bone within the lumen of the cochlea. It is multifactorial in origin and may result in deafness. Profound hearing loss and LO in children are most commonly associated with meningogenic labyrinthitis. The relationship of LO to meningogenic cochlear pathology and its mechanism of induction have not been clearly defined. Cochlear implants are a significant treatment option for improving hearing and

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quality of life in these patients. However, LO can reduce the efficacy of cochlear implantation. The long-term objective of this research program is to understand the mechanisms which lead to the development, progression, and destructive aspects of LO. Such an understanding may lead to new strategies to prevent the devastating effects of hearing loss associated with this disease. The specific aims of this application are: (1) to correlate hearing loss with the temporal and spatial progression of bacterial meningitis from the subarachnoid space to the cochlea; (2) to correlate hearing loss with the temporal and spatial sequence for both labyrinthine fibrosis and ossification and the histopathology of cochlear tissues: spiral ganglion, organ of Corti, Reissner's membrane, stria vascularis, and spiral ligament; (3) to determine the relationship of bone lining cells to osteoblast formation and recruitment during labyrinthine neo-ossification; and (4) to determine the effects of decomplementation, non-steroidal anti-inflammatory compounds, and bacteriostatic vs. bactericidal antibiotics on neo-ossification and hearing loss. There are four hypotheses/specific aims outlined and they are as follows: Bacterial invasion of the cochlear labyrinth from the subarachnoid space correlates with hearing loss and occurs principally via the cochlear aqueduct and not the internal auditory canal; The destruction of cochlear tissue occurs subsequent to the arrival of inflammatory cells and not with the appearance of bacteria within the cochlea. Hearing loss may occur prior to observable pathology and reflect central auditory damage related to meningitis; Bone lining cells of the endosteum are activated and become mature osteoblasts and are the principal source of neo-ossification in labyrinthitis ossificans; and The inflammatory response to suppurative labyrinthitis includes fibrosis and neo-ossification formation and causes cochlear tissue destruction. Inhibition of this process will result in a reduction in both hearing loss and bone deposition. Methods used: The investigators propose to use an experimental gerbilline model of LO, histomorphometry, fluorescent bone histomorphometry, transmission and scanning electron microscopy, autoradiography, and auditory brainstem evoked response. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DEVELOPMENT AND PLASTICITY IN NORMAL AND IMPAIRED EARS Principal Investigator & Institution: Hall, Joseph W.; Professor; Otolaryngology/Head & Neck Surgery; University of North Carolina Chapel Hill Office of Sponsored Research Chapel Hill, Nc 27599 Timing: Fiscal Year 2001; Project Start 01-SEP-1986; Project End 31-AUG-2004 Summary: The long-term aim of this project is an understanding of auditory development in normal children and in specific clinical popultions of children. One major Study Area is the effect of otitis media on auditory development. The specific aim in this area is assessment of the hypothesis that children with a history of otitis media have particular impairment for the processing of speech under particular conditions: when binaural cues are available for masking release, and when the task is designed such that it is difficult to perceptually segregate the speech from masking interference. The second major Study Area assesses the nature of auditory processing deficiencies in children diagnosed with specific language impairment. One specific aim will be to evaluate the hypothesis that such listeners have explicit deficits in coding the temporal aspect of the signal. The competing hypothesis will be assessed that such children have a more general deficit in auditory processing based upon relatively subtle/difficult cues. A related aim will be to control for possible effects of hearing loss history among the children with specific language disorder. The third major Study Area will investigate developmental and basic mechanisms of binaural masking release. Basic experiments on

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adult listeners will address the question of whether binaural masking release depends upon selective temporal weighting of temporal epochs that are favorable for detection. A related developmental study in this area will investigate the finding that children have reduced MLDs for narrowband noise maskers even though their MLDs are adultlike for relatively wideband maskers. We will examine the hypothesis that children do not take advantage of the narrowband masker valley epochs containing the best signalto-noise ratios. In all Study Areas, most psychophysical or speech recognition methods will use three-alternative or four- alternative forced-choice testing with sound presentation over earphones. All phases of the project will include age-matched control listeners. Data will be analyzed using analysis of variance and correlation procedures. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DEVELOPMENT OF INHIBITATION IN THE AUDITORY SYSTEM Principal Investigator & Institution: Sanes, Dan H.; Professor; Center for Neural Science; New York University 15 Washington Place New York, Ny 10003 Timing: Fiscal Year 2001; Project Start 01-AUG-1989; Project End 31-MAR-2005 Summary: The long-term objective of this proposal is to identify the cellular mechanisms that regulate inhibitory synapse function during development and following hearing loss. The research plan is divided into three areas: (1) The regulation of inhibitory synapse strength will be studied in the developing gerbil lateral superior olivary nucleus (LSO), using a brain slice preparation. The activity-dependent depression of inhibitory synapses from the medial nucleus of the trapezoid body (MNTB) to the LSO will be examined with whole-cell voltage-clamp recordings. The relationship between depression and inhibitory synapse refinement will be tested with paired recordings from dye-filled MNTB and LSO neurons. The cellular basis for depression will be examined by direct activation or blockade of GABA and glycine receptors, and the use of transgenic receptor deletions in mice. The postsynaptic signalling pathway that induces depression will be tested by intracellular application of kinase and phosphatase antagonists. (2) The affect of deafness on inhibitory synapse function will be examined in the gerbil inferior colliculus. Using a brain slice preparation, gramicidin perforated-patch recordings will be obtained from IC neurons, and the evoked synaptic currents will be monitored in response to lemnisal or commissural stimulation. To determine why inhibitor synapse reversal potential depolarizes in deafened animals, postsynaptic chloride homeostasis will be examined in normal and deafened animals using chloride pump and voltage-gated chloride channel antagonists. The ability of synaptic activity to regulate chloride homeostasis will be assessed by monitoring inhibitory reversal potential before and after a prolonged period of excitatory or inhibitory activity. (3) The in vivo occurrence of inhibitory synaptic plasticity will be examined wit extracellular recordings from juvenile gerbils during sound stimulation. The strength of sound evoked inhibition in the LSO will be assessed before and after coactivation of excitatory and inhibitory pathways, using stimulus patterns that induce inhibitory depression in the LSO brain slice. To determine whether inhibitory synaptic strength declines in LSO following deafferentation, the inhibitory pathway will be stimulated electrically following cochlear ablation. The proposed experiments will demonstrate how inhibitory synapse physiology can be modified in the central auditory system, and suggest how inhibitory dysfunction could affect acoustic processing following profound deafness. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: EARLY DEVELOPMENT OF CHILDREN WITH HEARING LOSS Principal Investigator & Institution: Nittrouer, Susan; Staff Scientist; None; Utah State University Logan, Ut 84322 Timing: Fiscal Year 2003; Project Start 01-SEP-2003; Project End 31-AUG-2008 Summary: (provided by applicant): The long-term goal of this project is to understand how age of identification (before 6 mo, between 12 & 18 mo, or between 24 & 30 mo) and communication mode (spoken-only or sign-supplemented) affect spoken language, cognitive, and psychosocial development in young children (under 5 years) with hearing loss (HL). The coincidental advent of effective procedures for diagnosing HL in newborns and of cochlear implants has spurred the general perspective that virtually all children with HL can develop good spoken language, but we don't yet agree on how best to facilitate that development, nor do we know whether there is a "cost" to cognitive and/or psychosocial development imposed by early diagnosis or intervention. To advance our knowledge concerning these issues 25 children in each of 6 cells (crossing 3 ages of identification and 2 communication modes) as well as 50 children with normal hearing (NH) would participate in 5 to 8 test sessions, depending on age of identification. Materials collected would include samples of parent-child interactions, standardized language and cognitive measures, and responses to parental questionnaires. The kinds of data derived from these materials would be new to the study of HL but would reflect current methods used in the study of children with NH, and would include measures of speech acoustics, vocabulary, syntax, discourse, nonverbal cognitive abilities, psychosocial development, and parental stress. Results will help the community of professionals serving children with HL in designing intervention programs and in selecting tools to evaluate progress. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: ELECTRODES AND STIMULATORS FOR STRIAL PRESBYCUSIS Principal Investigator & Institution: Spelman, Francis A.; Prof. & Associate Director; Advanced Cochlear Systems, Inc. 34935 Se Douglas St, Ste 200 Snoqualmie, Wa 98065 Timing: Fiscal Year 2002; Project Start 01-MAR-2002; Project End 31-MAR-2003 Summary: (provided by applicant):In this project, a system for reversing strial hearing loss by increasing endocochlear potential will be constructed and evaluated in vitro. Strial presbycusis is estimated to affect as many as 7 million people in the US. Recent research has shown that when positive current is injected into the scalae media of quietaged gerbils, the endocochlear potential is increased and the hearing thresholds approach normal values of less than 15 dB across all frequencies. The proposed system will increase the endocochlear potential by applying direct current to the scala media, while managing electrode polarization and plating effects. The system will consist of a micro-fluidic electrode, electrode driver, and feedback mechanism to control the endocochlear potential over time. Advanced multi-layer circuit fabrication techniques and UV laser micro-machining will be used to construct various microelectromechanical (MEM) prototypes. Plating effects will be determined by investigating changes in charge capacity using cyclic voltammetry. Successful completion of the Phase I research will allow in vivo characterization of the electrode system in Phase II. A commercial implant system based on this research could ultimately treat strial-based hearing loss in millions of individuals. PROPOSED COMMERCIAL APPLICATION: NOT AVAILABLE Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: ENHANCED DISABILITIES

MULTIMEDIA

TELEHEALTH

FOR

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Principal Investigator & Institution: Zhao, Yunxin; Computer Engr & Computer Sci; University of Missouri Columbia 310 Jesse Hall Columbia, Mo 65211 Timing: Fiscal Year 2001; Project Start 01-AUG-2001; Project End 31-JUL-2006 Summary: (Provided by Applicant): Telemedicine or telehealth has opened a world of specialty health services to persons who may otherwise be unable to access appropriate care. Despite enormous public investment in telehealth initiatives, people who are deaf or hard of hearing encounter serious barriers in accessing current systems because of limited audio quality and limited sign language and lip reading capability. In addition, current videoconferencing systems are hardware-dependent, rendering this technology costly to initiate and upgrade. This project proposes a software driven array of adaptations to current telehealth systems that will facilitate speech and sign language comprehension. The project will achieve three aims: 1) It will enhance language comprehension by developing a real-time voice driven captioning system that automatically transcribes the speech of health care providers for display at both patient and health care provider telehealth sites, 2) It wilI facilitate lip reading and sign language reading by developing a high quality low delay software-only video coding system that can deliver clear motion scenes of lips and hands in synchrony with both speech and captions, and 3) It will evaluate the effectiveness of these technological innovations in facilitating acceptable language comprehension levels in telehealth interactions among persons across the hearing spectrum. While the proposed aims focus on persons with hearing loss, it is expected that the multimedia enhancements to telehealth will significantly benefit persons with intact hearing as well. The effects of the proposed innovations are far-reaching. Medical specialty services including: emergency services, cardiology, psychiatry, which currently use telehealth network systems will become more accessible to deaf and hard of hearing patients, including many elderly persons with hearing loss. The proposed adaptations also will allow for telehealth to support additional services such as speech/language therapy, and cognitive rehabilitation; thus, broadening the array of services available to rural and other underserved populations. Improved access to timely care for deaf and hard of hearing persons will likely improve the health of these populations. In addition, it will reduce the dual isolation of deafness in rural America. The proposed innovations will have notional and worldwide applicability and will spur health-related research in telehealth applications as well as the need of traditionally undeserved populations including deaf, hard of hearing and elderly persons. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: FMRI OF PEDIATRIC COCHLEAR IMPLANT CANDIDATES Principal Investigator & Institution: Holland, Scott K.; Professor; Children's Hospital Med Ctr (Cincinnati) 3333 Burnet Ave Cincinnati, Oh 45229 Timing: Fiscal Year 2001; Project Start 01-AUG-2001; Project End 31-JUL-2003 Summary: (Provided by Applicant): This R21 proposal describes a feasibility study targeted for funding under the Neurosciences Technology Development program (PA98-050) through NICHD. The proposal outlines three aims necessary to develop functional magnetic resonance imaging (fMRI) technology as a tool for evaluation of pediatric candidates for cochlear implantation. FMRI is a relatively new and highly sophisticated technology, which can provide a window into the functional human brain. Cochlear implantation is also a cutting edge technology in approximately the same

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development phase as fMRI. The integration of these technologies presents a challenge. Successful integration of these technologies in very young children is a formidable proposition but offers the opportunity for new understanding of human deafness, cortical plasticity, brain development and connectivity. The proposal has three simple aims, which constitute the necessary preliminary steps toward development of fMRI technology for use in pediatric cochlear implant candidates. We aim to: 1) Determine whether auditory cortical activity can be observed with fMRI with sound stimulation in sedated toddlers and young children with normal hearing; 2) Demonstrate that auditory cortical activity can be observed with fMRI using sound stimulation in compliant older children with severe to profound, sensorineutral hearling loss; and 3) Perform fMRI of auditory stimulation in severely to profoundly hearing impaired toddlers and young children under sedation. These aims define a logical course toward establishing that fMRI can be used successfully in pediatric cochlear implant candidates, many of whom are very young. If this feasibility study is successful, it will provide essential data needed to develop the neuroscience technology required to apply functional neuroimaging in severely to profoundly hearing impared toddlers and young children. This project will also more clearly define the potential role of fMRI in the selection and management of cochlear implant patients. The most optimistic outcome of this project would be that fMRI could be used to predict future benefit from a cochlear implant in a child. Short of achieving this high goal, this project will certainly accomplish the stated purpose of the Neurosciences Technology Development program (PA-98-050) of supporting "research that will develop significant enhancements to existing technologies important to neuroscience and research that will translate a scientific concept into the basis for a future technology that may advance understanding of important neuroscience research problems." Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: FUNCTIONAL AND MOLECULAR CHARACTERIZATION OF PENDRIN Principal Investigator & Institution: Karniski, Lawrence P.; Associate Professor; Internal Medicine; University of Iowa Iowa City, Ia 52242 Timing: Fiscal Year 2001; Project Start 01-FEB-2001; Project End 31-JAN-2005 Summary: (Adapted from applicant's abstract): Pendred syndrome, manifested by sensorineural hearing loss and goiter is the result of mutations in the PDS gene. PDS encodes a protein labeled pendrin that functions as a chloride, formate and iodide transporter and is expressed in the thyroid, inner ear and kidney. Pendrin's function is similar to a previously described chloride/formate exchanger that plays an important role in NaCl transport across epithelial cells, suggesting that pendrin might perform a similar role in the inner ear. Recent evidence suggests that some individuals with mutations in the PDS gene do not develop thyroid abnormalities but instead have nonsyndromic deafness with dilated vestibular aqueducts (DFNB4). The aims of this proposal are to characterize pendrin in terms of its function, location and regulation and determine how different PDS mutations affect pendrin. The following approach will be taken to achieve these aims: Polyclonal anti-pendrin antibodies (already generated by the Principal Investigator) will be used to identify the cell types in which pendrin is expressed. Pendrin function will be analyzed by determining substrate specificity, inhibitor profile, kinetics of transport and regulation, and chloride/bicarbonate exchange. The effect of different mutations in PDS on protein production, processing, regulation and transport properties will be examined. A knock out mouse model will be used to study the mechanisms of ion transport in cells where pendrin is normally

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expressed but rendered inactive. This work is a first step towards understanding the physiologic role of pendrin and determining how defects in pendrin lead to the clinical manifestations of Pendred syndrome. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: FUNCTIONAL IMAGING OF TINNITUS AND HEARING LOSS Principal Investigator & Institution: Lockwood, Alan H.; Professor of Neurology and Nuclear Medic; Neurology; State University of New York at Buffalo Suite 211 Ub Commons Amherst, Ny 14228 Timing: Fiscal Year 2001; Project Start 01-JAN-1998; Project End 31-DEC-2002 Summary: The overall goal of this project is to develop a better understanding of the functional neuroanatomy of the auditory system and how this is affected by tinnitus, sensorineural hearing loss (SNHL) and phenomena associated with SNHL such as loudness recruitment. In preliminary studies, using positron emission tomography (PET) to measure cerebral blood flow (CBF), we have identified spontaneous neural activity in the central auditory system associated with tinnitus, evidence for plastic reorganization of central auditory systems, and links between sensory-motor systems and limbic and frontal brain regions that may mediate the emotional disability associated with tinnitus. We will broaden our successful preliminary approach by using statistical parametric mapping (SPM) to map CBF to focus on 5 specific aims: 1) What is the relationship between the intensity of an external tone and the degree of activation in the auditory cortex for subjects who have: (A) normal hearing, (B) loudness recruitment and (C) loudness recruitment plus tinnitus? 2) What effects do tinnitus and SNHL have on resting neural activity and what are the effects of high-frequency SNHL and tinnitus on the cortical frequency-place map? 3) What regions of the cerebral cortex are activated in patients who can modulate the loudness or pitch of their tinnitus with an oral-facial movement or eye movements? 4) Do lidocaine and residual inhibition reduce activity in regions of the brain activated by tinnitus? 5) What is the anatomical link between tinnitus and depression? This application of advanced imaging technology to study patients with communication disorders to investigate perception, and plasticity in the central auditory system should elucidate normal sensory processing of auditory information and how this is disturbed by tinnitus and SNHL. We expect to identify neural systems mediating tinnitus and related phenomena that will lead to the development of rational therapy targeted at affected neural areas. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: GENERATION OF MODELS FOR GENETIC HEARING LOSS Principal Investigator & Institution: Orten, Dana J.; Father Flanagan's Boys' Home Boys Town, Ne 68010 Timing: Fiscal Year 2002; Project Start 01-APR-2002; Project End 31-MAR-2004 Summary: (provided by applicant): The ultimate objective of this proposal is to create macaque models for the most prevalent types of hearing loss. Mutations in the gene for connexin 26 (GJB2) are the most common cause of hearing loss (DFNB1) in American and European populations, accounting for about 10% of all childhood hearing loss. An animal model is not available to study connexin 26 function in the ear because the mouse knockout is embryonic lethal. The expected outcome of this project, a macaque connexin 26 hearing loss model, will provide a foundation for important new clinical and basic studies of the most common type of inherited hearing loss. Our hypothesis, based on the carrier rate for the average recessive gene of about 1/100 in humans, is that

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generating a model for a recessive human disease by screening outbred primates will be easier than by targeted deletion of the gene in mice. Because mutations in GJB2 gene are the most common genetic cause of hearing loss, we have chosen this gene for our initial screen. The sequence is conserved between human and macaque with 18 base changes and 4 amino acid changes observed. We will test our hypothesis in a stepwise fashion by accomplishing the following Specific Aims. 1) Screen a large population of macaques for mutations in the GJB2 gene. Screening will be prioritized and putative mutation function will be evaluated based on our experience with human mutations. 2) Test the putative GJB2 homozygotes for phenotypic relevance. Once putative pathologic mutations are found, mating or in vitro fertilization at Regional Primate Centers will be arranged to produce homozygous offspring, and proposals will be submitted to study the phenotype and establish GJB2 macaque colonies. 3) Generate macaque models for additional hearing loss genes. Anatomical and physiological similarities between primates and humans have increased the importance of primate models. Responses of macaques to therapies will be similar to humans, increasing relevance of clinical studies. Basic hearing loss research in the macaque model will provide insights into pathologic mechanisms leading to hearing loss in humans. Understanding disease processes will be the basis for designing and testing new treatments that could reduce or prevent human inherited hearing loss. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: GENETICS AND PEDIATRIC NONSYNDROMIC HEARING LOSS Principal Investigator & Institution: Kenna, Margaret A.; Children's Hospital (Boston) Boston, Ma 021155737 Timing: Fiscal Year 2002; Project Start 16-AUG-2002; Project End 31-JUL-2006 Summary: (provided by applicant): Sensorineural hearing loss (SNHL) occurs in 4/1000 newborns. Until recently the work-up used a "shotgun" approach; many tests were ordered but the etiology remained unknown in 50% of cases. However, the recent use of genetic testing and high-resolution imaging has increased the yield of the SNHL evaluation. Mutations in the connexin 26 gene (Cx26) are responsible for approximately 50% of all recessive nonsyndromic SNHL allowing Cx26 gene testing to greatly expand the ability to provide an etiology for SNHL. This information can provide diagnostic as well as prognostic information to the patients, their families, and their physicians. The current proposal seeks to address several areas that have not been addressed by our studies or those of others. First, the audiologic phenotype of infants and children with SNHL and Cx26 mutations, both at the time of presentation and longitudinally, needs further definition. Second, it is not clear whether the audiologic phenotype varies with specific mutations or combination of mutations. Third, it is not clear whether CT scans of the temporal bones are ever routinely indicated in a patient with biallelic Cx26 mutations. Finally, in families of children with SNHL, it is not clear how well patients and families are being counseled to understand the benefits, drawbacks, and limitations of genetic testing or the results and implications of their genetic tests. It is also unclear why parents choose or decline genetic testing, and whether proper consent is obtained for such testing. We propose a clinical study to evaluate infants and children with Cx26related nonsyndromic SNHL. To accomplish these aims we will use 2 large patient populations from Children's Hospital Boston (CHB) including 1.Newborns referred after failing a newborn hearing screen; 2.Non-newborns with newly identified SNHL. There are four areas of concentration: 1.) Identification of Cx26 positive infants and children using genetic testing as part of the initial evaluation for newly-identified SNHL. 2.) The phenotype of the Cx26 related hearing loss will be studied, both at the time of diagnosis

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and prospectively over time. The rate and percentage of progression of Cx26 related hearing loss will also be evaluated. 3.) The diagnostic evaluation of the hearing loss will include temporal bone imaging studies, as the presence of anatomic temporal bone abnormalities is frequently associated with progression of the hearing loss and thus would affect the prognosis if present. Although temporal bone abnormalities have not been sought in large numbers of Cx26 positive patients, they are thought to be uncommon, at least for the two most frequently identified mutations, 35deIG and 67delT. However, recent studies suggest that temporal bone abnormalities may be present in some patients with Cx26 mutations. If this were so, the prognosis of the hearing loss would be affected. 4.) For families of children with SNHL, we will utilize a questionnaire to determine why parents choose to have/not have genetic testing and to ascertain parents understanding of genetic testing. This information will be used to evaluate the effectiveness of genetic counseling associated with gene testing for deafness. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: GENETICS OF MILD HEARING LOSS IN CHILDREN AGED 6-12 YRS Principal Investigator & Institution: Wake, Melissa; Murdoch Children's Research Institute Flemington Rd Melbourne, Timing: Fiscal Year 2002; Project Start 25-SEP-2002; Project End 31-AUG-2005 Summary: (provided by applicant): The Problem: Slight/mild sensorineural hearing impairment (HI) affects at least 180,000 US school-aged children. Although rapid advances have been made in the genetics of moderate-profound HI, little is known about the contributions of single gene mutations to slight/mild nonsyndromic Hl, or of the impacts of such HI on child outcomes. BROAD, LONG-TERM OBJECTIVES: This large-scale project, to be carried out in Victoria, Australia, will be the most comprehensive study yet to address the impacts and genetics of mild childhood hearing impairment. AIMS: In a large community sample of elementary school-aged children, we aim to (1) Describe relationships between slight/mild HI and Connexin 26 (the two most common "deafness genes") and Pendrin mutations, and impacts of slight/mild HI; (2) Develop and trial informed consent procedures on the use of DNA specimens for genetic testing for elementary school children with slight/mild HI; (3) Describe the impact of genetic testing on elementary school children with slight/mild HI and their families; and (4) Develop and evaluate education and counseling approaches when providing genetic information. RESEARCH DESIGN & METHODS: To establish prevalence, we will screen the hearing of approximately 6,000 elementary school-aged children (Years 1 and 5). From this base cohort approximately 180 children with slight/mild HI ("cases") and a further 360 children with normal hearing ("controls") will undergo assessment to address Aim 1. This will include testing the two "deafness genes" of interest, assessing language, academic, cognitive and social/quality of life outcomes, and self-reporting any problems with hearing. In a small preceding qualitative study, issues related to genetic testing in families of children with and without HI will be explored. We will then develop, trial and evaluate information and informed consent procedures, feedback, and counseling procedures (Aims 3 & 4). SIGNIFICANCE: If Cx26 and/or Pendrin is found to contribute to slight/mild HI, then this might profoundly alter (a) the advice and counseling we currently provide to families identified through a child with homozygous Cx26 or Pendrin deafness and (b) approaches to future population screening. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: GENETICS OF NOISE RESISTANCE Principal Investigator & Institution: Tempel, Bruce L.; Professor of Otolaryngology-Hns and Pha; Otolaryn & Head & Neck Surgery; University of Washington Seattle, Wa 98195 Timing: Fiscal Year 2003; Project Start 01-AUG-2003; Project End 31-JUL-2006 Summary: (provided by applicant): Noise-induced hearing loss (NIHL) and age-related hearing loss (AHL or presbycusis) are major health problems. They are common, their consequences are permanent, and their impacts on human communication and quality of life are significant. Although important advances have been made in characterizing the structural changes in the ear that are associated with NIHL or AHL, the mechanisms underlying these changes are poorly understood. In humans, hearing loss secondary to noise exposure is highly variable between individuals: some people have "tough" ears, while others have "tender" ears. In contrast to humans, laboratory mice show significantly less variability in NIHL among individuals within an inbred strain while there are striking differences in NIHL sensitivity between different inbred strains. Our long-term goal is to exploit these strain differences in mouse models to study the genetic factors influencing resistance and susceptibility to NIHL Here we propose to focus on the remarkable NIHL resistance observed in the inbred mouse strain 12986/SvEvTac (129S6). We will address the following Specific Aims: SA 1. Refine and confirm our preliminary Quantitative Trait Locus (QTL) map for NIHL resistance in 129S6. Develop a second NIHL-resistance QTL map in a different mouse strain, MOLF/Ei for comparison. SA 2: Generate congenic strains using both phenotype-driven selection for NIHL resistance and genotype-driven, marker-assisted selection for QTL regions. Isolated QTL regions will be tested for epistatic interactions. SA 3. Identify candidate NIHL resistance genes using DNA microarrays to study changes in gene expression after noise exposure. Genes differentially regulated between strains and mapping within QTL regions will be sequenced in both strains and compared for variations. SA 4. Strong candidate genes will be tested in genetic crosses to determine whether they interact functionally with the NIHL-resistant QTL. Nucleotide differences in genes suspected to account for the QTL will be tested using gene targeting knock-in techniques to see if they are sufficient to transfer NIHL resistance to another strain. The characterization of genes influencing NIHL resistance will provide fundamental insight into the cellular and molecular processes underlying noise-induced cochlear damage. In turn, these insights will be key to devising effective strategies to preserve hearing in human populations. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: GENETICS OF NOISE RESISTANCE IN THE AGING EAR Principal Investigator & Institution: Kujawa, Sharon G.; Massachusetts Eye and Ear Infirmary 243 Charles St Boston, Ma 02114 Timing: Fiscal Year 2001; Project Start 01-AUG-2001; Project End 31-JUL-2003 Summary: (provided by applicant): Hearing losses that accumulate with chronic exposure to high-level sound (noise-induced hearing loss; NIHL) and with age (agerelated hearing loss; AHL or presbycusis) are major health problems. They are common, their consequences are permanent, and their impact on human communication and quality of life is significant. Important advances have been made in characterizing the structural changes in the ear that underlie both NIHL and AHL, however, the mechanisms underlying these changes are still poorly understood. In human populations, hearing losses secondary to noise exposure and those attributed to aging are highly variable between individuals: some have 'tough' ears, while others have

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'tender' ears. In contrast, work with laboratory mice has shown significantly less variability in NIHL and/or AHL within one inbred strain, while there are striking differences between strains. Our long-term goal is to exploit these strain differences in mouse models to study the genetic factors influencing susceptibility to NIHL and AHL, and interactions between them. Our immediate goals focus on the remarkable resistance to NIHL in the inbred mouse strain l29S6/SvEvTac (129S6), recently reported by the Liberman laboratory. Whereas NIHL typically grows rapidly once a critical exposure level is reached, NIHL in 129S6 grows 10 times more slowly over a wide range of exposure energy. Preliminary results from the Kujawa laboratory suggest that 129S6 also shows a type of AHL, demonstrating that AHL vulnerability need not be linked to NIHL vulnerability, as they appear to be in C57BL/6 mice. Further preliminary results from a Kujawa/Tempel collaboration suggest that both the AHL and the NIHL resistance in 129S6 are heritable as recessive traits. With this foundation, we propose to 1) better characterize the AHL and the influence of AHL on NIHL resistance in 129S6 using a number of physiological and histopathological measures, 2) provide a chromosomal localization for the major gene(s) influencing noise resistance in 129S6 using well-established techniques for genetic mapping, and 3) using the same genetic techniques, establish whether the AHL in 129S6 is mediated by the same gene locus associated with AHL in the C57BL/6 strain. The ultimate characterization of the genes influencing susceptibility to AHL and NIHL will provide fundamental insight into the cellular and molecular processes underlying cochlear degeneration, which, in turn, will be key to devising effective strategies to preserve hearing in human populations. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: HAIR CELL REGENERATION--FUNCTIONAL SIGNFICANCE Principal Investigator & Institution: Dooling, Robert J.; Professor; Psychology; University of Maryland College Pk Campus College Park, Md 20742 Timing: Fiscal Year 2001; Project Start 01-JAN-1994; Project End 31-MAR-2003 Summary: The loss of hearing, and all that entails, has devastating consequences for human speech and language both in children and adults. The discovery of hair cell regeneration in birds has provided new hope of eventually restoring hearing in humans through hair cell regeneration. For this reason, it is important to know whether hearing is fully restored following hair cell regeneration in birds and, if not, what are the permanent, enduring effects on hearing and vocal production. Progress in this area has been challenging because, until recently, there is a complete absence of animal models for studying the effect of hearing loss on vocal output and vocal learning. The present research plan continues effort to understand the recovery of function following hear cell regeneration. Now we focus specifically on two species that provide quite different but unique opportunities for understanding the recovery of function. This new, more focused effort is the result of new and exciting findings from the last project period. First, we focus on understanding the relation between hearing recovery in budgerigars and the recovery in vocal precision and vocal learning. A new method for controlling vocal production and learning in an animal opens a whole new window on the study of hearing loss and vocal production. The second new focus is on the Belgian Waterslager canary. Our previous work confirmed that this specifies has an inherited hearing disorder due to missing or damaged hair cells on the basilar papilla, that they are constantly regenerating new hair cells, and that increasing the rate of regeneration can cure some of the inherited threshold shift in BWS canaries. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: HEALTH IMPACT OF CONGENITAL CYTOMEGALOVIRUS INFECTION Principal Investigator & Institution: Dekker, Cornelia L.; Pediatrics; Stanford University Stanford, Ca 94305 Timing: Fiscal Year 2003; Project Start 01-JUL-2003; Project End 31-DEC-2007 Summary: (provided by applicant) Human HCMV infection is the leading infectious cause of congenital birth defects and causes important morbidity and mortality in immunocompromised patients of all ages. Humans are the only reservoir for this infection and many unique strains circulate in the general population throughout the world. Rates of congenital HCMV infection in the U.S. range from 0.2 percent to 2.2 percent of all live births, affecting approximately 10,000 to 80,000 infants born each year. The Institute of Medicine study of vaccine objectives has therefore identified congenital HCMV prevention by vaccines as a Level I priority. The overall objective of this application is to define the epidemiology and disease burden of congenital infection caused by HCMV in a diverse, Northern California population by virologically screening 20,000 newborns from three area hospitals over a two-year period. In Specific Aim 1, screening will be done using a direct early antigen detection of fluorescent foci (DEAFF) method to identify HCMV in saliva samples of newborns. We hypothesize that incidence in white infants will be different than that for Hispanic and Asian/Pacific Islander infants born in this area. Virus isolates obtained from infected infants will be tested to determine genetic relatedness and whether specific subtypes are associated with the occurrence of symptomatic vs. asymptomatic infection of the infant. To assess disease burden, we will describe clinical features in infected infants and determine the distribution of symptomatic vs. asymptomatic presentation among demographic groups. In Specific Aim 2, we will describe the incidence, severity and timing of sensorineurat hearing loss (SNHL) over three years in infected infants, and determine whether universal newborn hearing screening identifies SNHL caused by congenital HCMV. The pattern of hearing loss will be described for the cohort, and affected infants will be offered remedial treatment. In Specific Aim 3, we will describe the HCMVspecific CD4 and CD8 T cell responses of the infected cohort over three years and determine whether there are differences in immune response pattern between symptomatically and asymptomatically infected infants, and between infants and adults. Data from this study will help to define target populations for immunization and clinically relevant immune responses for vaccine researchers. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: HEARING ACUITY, COGNITIVE AGING, AND MEMORY FOR SPEECH Principal Investigator & Institution: Wingfield, Arthur; Professor; Psychology; Brandeis University 415 South Street Waltham, Ma 024549110 Timing: Fiscal Year 2002; Project Start 15-SEP-2002; Project End 31-AUG-2007 Summary: (provided by applicant): Although many adults maintain good hearing into older adulthood, large numbers of older adults manifest age-related hearing declines that significantly interfere with comprehension and memory for speech. Few issues are as important to the quality of life of older adults as the ability to recall heard information, whether it is instructions from medical care providers, verbal instructions on how to complete forms, or the latest news of family and friends. Natural speech is rapid, ranging from 90 words per minute (wpm) for thoughtful conversation, to rates far in excess of 200 wpm. Added to this high input rate is the fact that speech is very often

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accompanied by background distraction. Both factors are known to be especially disruptive to older adults. This application centers on an interdisciplinary approach combining expertise from cognitive psychology and audiology to the understanding of how age-related cognitive factors interact with agerelated hearing loss (presbycusis) in memory for speech. In order to separate the effects of cognitive aging and hearing acuity, four groups of adults will be tested: older adults with age-related hearing loss, older adults with good hearing in the speech range, young adults with hearing loss in the speech range similar to that of the older adults, and a young adult group with good hearing. The research will focus on (1) the effects of rapid speech and auditory distraction on memory for spoken messages, (2) how the features of the spoken messages interact with age and hearing loss, and (3) the extent to which the use of context can be flexibly employed by older adults with poor hearing as distinct from reflecting an enduring perceptual "style" that may not always be appropriate. On the theoretical level one of the goals will be to test the hypothesis that the extra effort expended on lower level perception of speech can draw resources that would ordinarily be available for "down-stream" processes such as memory encoding for later recall. On the applied level, the data obtained will be valuable for developing guidelines for tests of hearing that are sensitive to the special needs of older adults. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: HEARING LOSS AND THE PERCEPTION OF COMPLEX SOUND Principal Investigator & Institution: Leek, Marjorie R.; Senior Research Audiologist; Henry M. Jackson Fdn for the Adv Mil/Med Rockville, Md 20852 Timing: Fiscal Year 2003; Project Start 01-APR-1989; Project End 31-AUG-2008 Summary: (provided by applicant): People with sensorineural hearing loss experience difficulties understanding speech in noisy environments and often complain that music sounds distorted or unpleasant. Both of these deficits may be attributed to the functional effects of damage to cochlear structures, which include a loss of auditory sensitivity, alterations in loudness perception, and impairments of spectral and temporal processing in the auditory system. In this program of research, behavioral psychoacoustic methodologies are used to study the deficits associated with frequency and time analysis in the impaired cochlea, and the impact of those deficits on the clear understanding of speech and the ability to enjoy music. For the next grant period, the focus of this research will be the study of fine temporal processing of complex sounds in the damaged cochlea. Included are studies of complex pitch produced by harmonic and inharmonic complexes and aperiodic rippled noises, studies of the judged consonance and dissonance of pairs of tones and pairs of harmonic complexes, and studies of the ability to perceive the fine structure in temporal waveforms. The studies have as their goal the evaluation of the representation of temporal interval information in the higher auditory centers within the brain, when the inputs to those centers comes from an impaired peripheral auditory system. It is hoped that an understanding of the manner in which the temporal information is distorted or lost, as determined by these studies, will help in understanding the functional deficits experienced by hearing-impaired people in their everyday lives. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: HEARING ENHANCEMENT

LOSS,

SPECTRAL

DEFICITS

AND

FORMANT

Principal Investigator & Institution: Nelson, Peggy B.; Communication Disorders; University of Minnesota Twin Cities 200 Oak Street Se Minneapolis, Mn 554552070

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Timing: Fiscal Year 2001; Project Start 01-AUG-1999; Project End 31-JUL-2003 Summary: The overall goal of this project is to evaluate promising signal processing techniques to enhance speech spectral characteristics for improved speech understanding by hard-of-hearing (HoH) listeners. These spectral enhancements include: 1) deepening of between-formant spectral valleys, 2) frequency scaling of speech, and 3) combinations of both deepening and scaling. Many hard-of- hearing (HoH) listeners can resolve low-frequency spectral cues normally but they are often less able to resolve frequency information in higher-frequency signals. In speech, higherfrequency second formants (F2), which provide important information for phoneme distinctions, are not easily resolved by these HoH listeners. Sinusoidal modeling techniques will be used to detect spectral peaks in rapidly changing syllables, and to deepen spectral valleys between peaks. Sound design software will be used to accomplish modest frequency scaling (up to 30 percent reduction) while retaining good sound quality. It is anticipated that these combined schemes will produce good-quality speech signals with formants that are more easily resolved by HoH listeners. Two groups of listeners with moderate to severe hearing loss will be identified as having better or poorer spectral resolution abilities based on frequency discrimination and spectral peak detection tasks. These listeners will then identify unmodified stimuli and stimuli that have been enhanced by the proposed processing chemes. Results will demonstrate the benefits of each scheme individually, and of the combined schemes. Early results using pilot processed stimulil show promise toward the goal of improving speech perception abilities of listeners with moderate to severe hearing loss. Results from the proposed investigation will provide important additional pilot data that will serve as a basis for future investigations of speech enhancements. A long-term goal of this research is the development of real-time enhancement algorithms that can be implemented into wearable amplification devices. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: INFLUENCES OF HYPOXIA ON NOISE INDUCED HEARING LOSS Principal Investigator & Institution: Chen, Guang-Di; Pharmaceutical Sciences; University of Oklahoma Hlth Sciences Ctr Health Sciences Center Oklahoma City, Ok 73126 Timing: Fiscal Year 2001; Project Start 15-AUG-2001; Project End 31-JUL-2004 Summary: (provided by applicant): Noise-induced hearing loss (NIHL) is the most common occupational disease in the United States, yet it's mechanisms are not fully understood. The goal of this application is to determine whether and how hypoxia can interrupt auditory function transiently. People may suffer from insufficient blood oxygen supply due to pulmonary or cardiovascular disease, altitude, and environmental pollution by chemical asphyxiates. The risk of environmental noise may be tremendously increased when the noise is under hypoxic conditions. As indirect evidence, carbon monoxide (CO) exposure, which among other effects reduces oxygen supply to tissues, potentiates permanent NIHL at a level that alone does not cause a permanent threshold loss. The investigation of effect of hypoxic inhalation on NIHL will provide a direct test of the susceptibility of the cochlea to reduced oxygen tension. In this application, noise intensity will be varied from lower than the current permissible exposure level (PEL) to 120 dB SPL. Noise intensity higher than 120 dB SPL may cause some mechanical damage to the cochlea. Oxygen level in the exposure chamber will be varied from the normal level (21%) to 6%. Hypoxic inhalation alone with oxygen level lower than 6% may cause a temporary auditory function loss. The designed experiments will measure: (1) noise-induced and noise+hypoxia-induced hearing loss and hair cell

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loss 4 weeks after the exposure; (2) free radical generation, succinate dehydrogenase (SDH) activity reduction and apoptotic cell death in the cochlea immediately after the exposure; and (3) time course of these biochemical alterations and the protective effect of a free radical scavenger against SDH-activity reduction and apoptosis. We hypothesize that the noise under hypoxic conditions will generate more free radicals than noise alone, which then impair mitochondria, causing a reduction in SDH activity and also release of cytochrome c that may cause apoptosis. We further hypothesize that free radical scavenging will protect against SDH activity reduction and apoptosis. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: INNER EAR IMMUNE RESPONSES Principal Investigator & Institution: Keithley, Elizabeth M.; Professor; Surgery; University of California San Diego 9500 Gilman Dr, Dept. 0934 La Jolla, Ca 92093 Timing: Fiscal Year 2001; Project Start 01-JAN-2000; Project End 31-DEC-2002 Summary: (Adapted from the Investigator's Abstract) The abrupt loss of the sense of hearing is both frightening and alienating, but in some cases is reversible. The last ten years have seen the beginning of clinical treatment of hearing loss with systemic administration of immunosuppressive agents such as dexamethasone and prednisone. This course of treatment was tried because of the introduction of the idea that the inner ear is vulnerable to immune reactions and more importantly, that these immune reactions cause hearing losses. The fact that patients derive relief from their symptoms provides the motivation to both identify patients who may be helped by this treatment and to obtain the maximum understanding of immune mechanisms within the inner ear tissues. The development of an inner ear immune response involves the endolymphatic sac, an extension of the membraneous labyrinth within the temporal bone projecting into the dura adjacent to the sigmoid sinus of the posterior cranial fossa. The experimental, surgical destruction of the endolymphatic sac results in an attenuated immune response within the inner ear in response to an immunologic challenge. In normally housed laboratory animals and in the human endolymphatic sac reside the only immunocompetent cells found within the inner ear. Antigens introduced in the cochlear fluids very rapidly diffuse into the perisaccular connective tissue and subsequently are found within macrophages in the luminal space of the sac. For these reasons it is hypothesized that the endolymphatic sac is instrumental in connecting the inner ear to the systemic immune system and that signals generated here are used to initiate, modulate and resolve immune responses in the inner ear. The intent of the proposed experiments is to test this hypothesis and thereby gain an understanding of the initial events in the immune response. Such knowledge will enable clinicians to improve the treatments administered to patients who experience the unfortunate and potentially devastating trauma of rapidly progressing sensorineural hearing loss. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: INTERACTION OF AGE RELATED & NOISE INDUCED HEARING LOSS Principal Investigator & Institution: Boettcher, Flint A.; Assistant Professor; Otolaryngology-Head & Neck Surgery; Medical University of South Carolina 171 Ashley Ave Charleston, Sc 29425 Timing: Fiscal Year 2001; Project Start 01-JUN-1999; Project End 31-MAY-2004 Summary: (Adapted from Abstract): Dr. Boettcher will conduct a series of experiments to investigate the additivity of age-related and noise-induced hearing loss in the gerbil.

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Animals will be raised in a sound-isolating environment, and hearing testing will be performed on each ear before and after exposure of a single ear to noise at a level intended to produce a mild hearing loss. Dr. Boettcher will investigate whether susceptibility to noise-induced hearing loss varies as a function of age, and whether a non- traumatic conditioning sound can reduce the magnitude of age- related hearing loss. Dr. Boettcher will measure auditory threshold using auditory brainstem responses, and will also, in a subset of animals, obtain measures of histopathology of the stria vacularis, hair cells and eighth nerve fibers. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MAPPING DEAFNESS GENES USING GENOMIC MISMATCH SCANNING Principal Investigator & Institution: Cheung, Vivian G.; Assistant Professor; Children's Hospital of Philadelphia 34Th St and Civic Ctr Blvd Philadelphia, Pa 19104 Timing: Fiscal Year 2001; Project Start 01-FEB-1998; Project End 31-JAN-2003 Summary: Hearing loss affects over 40 million people in the United States. It is the most common form of sensory defect in humans. The mechanism of hearing is still largely unknown despite recent advances in molecular medicine. The goal of this proposal is to apply two molecular biology techniques, genomic mismatch scanning and DNA microarray, to gain a better understanding of the genetic basis of hearing loss. This will eventually affect the prevention, treatment and care of hearing disorders. Genomic mismatch scanning (GMS) is a high-throughput genetic linkage technique that allows physical isolation of the identical-by-descent DNA fragments shared between two related individuals. In this proposal, we plan to apply GMS to confirm the localization for DFNBI, the gene for non-syndromic autosomal recessive deafness that has been mapped by linkage to chromosome 13q. Then, we will narrow the DFNBI candidate region using linkage disequilibrium mapping. This has been difficult with traditional mapping strategies due to the need for a very dense set of polymorphic markers. However, in GMS, a dense set of completely informative markers is scanned simultaneously on a whole genome level. In addition, during the grant period, we will develop a DNA microarray that will allow mapping of the identical-by-descent DNA fragments isolated by GMS on a whole genome level in one hybridization step. This DNA microarray will allow mapping of other deafness loci with unknown genomic locations. Finally, we will develop a linkage analysis model for the identity-by-descent maps generated by GMS. Upon achieving the goals delineated in this proposal, we hope to have contributed to the understanding of the genetic control of hearing and have provided a robust method that is a promising tool for the next generation of gene mapping. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: MIDDLE-EAR MECHANICS IN NORMAL AND PATHOLOGICAL EARS Principal Investigator & Institution: Merchant, Saumil N.; Associate Professor of Otology & Laryngo; Massachusetts Eye and Ear Infirmary 243 Charles St Boston, Ma 02114 Timing: Fiscal Year 2001; Project Start 01-APR-2001; Project End 31-MAR-2006 Summary: The goal of this work is to understand sound transmission through normal, diseased and reconstructed middle ears so that better diagnostic tests and surgical procedures can be offered to patients with middle-ear disease. Middle-ear diseases such

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as chronic otitis media and otosclerosis, which affect over 10 million people in the US, are common causes of significant conductive hearing loss. The current battery of diagnostic tests (otoscopy, audiometry, tympanometry) cannot reliably differentiate ossicular pathology, especially when the tympanic membrane is intact or if there has been prior middle-ear surgery. Additionally, it is commonly acknowledged that postoperative hearing results after tympanoplasty procedures for chronic otitis media are often unsatisfactory. Factors contributing to the modest nature of surgical results include lack of clear understanding of the critical structure-function relationships in the reconstructed ear, and failure of current diagnostic tests to determine such relationships. Laser Doppler vibrometry has been demonstrated to be more sensitive than audiometry and tympanometry in assessing middle- ear function, because the laser spot (only 100 micrometers diameter) can be focused at various points on the tympanic membrane and malleus, and because vibrometry is unaffected by the ear canal (unlike tympanometry). We propose to use vibrometry, other acoustical measurements (admittance and reflectance), audiometry and tympanometry to investigate structure-function relationships in (a) normal ears, (b) diseased ears with ossicular pathologies, and (c) reconstructed ears that have undergone surgery for chronic otitis media or otosclerosis. Similar vibrometry and acoustical measurements will also be made in a surgicallymodified human temporal bone preparation that mimics diseased and reconstructed ears. Our approach should lead to a better understanding of the structure-function relationships in normal and pathological middle ears, improved differential diagnosis of middle-ear lesions, better pre-operative patient counseling and surgical planning, optimization of surgical techniques and hearing results, and reduction in the number of failed surgeries. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MITOCHONDRIAL TRANSLATION AND HEARING IMPAIRMENT Principal Investigator & Institution: Fischel-Ghodsian, Nathan; Professor of Pediatrics; Cedars-Sinai Medical Center Box 48750, 8700 Beverly Blvd Los Angeles, Ca 90048 Timing: Fiscal Year 2001; Project Start 01-APR-1999; Project End 31-MAR-2003 Summary: The broad, long-term objectives of this proposal are: (1) Identify nuclear genes which can shed light on the tissue specificity and penetrance of mitochondrial related hearing loss; (2) identify candidate nuclear genes which may be responsible for autosomal recessive, autosomal dominant and/or x-linked inherited hearing loss; and (3) provide the basis for understanding the cellular machinery involved in mitochondrial RNA processing and translation. The specific aims are: (1) Identify nuclear genes whose products have a role in mitochondrial RNA processing and translation; (2) characterize the identified genes by (a) mapping their chromosomal location and comparing it to the known deafness loci, and (b) checking each one for isoforms or differential splicing in the cochlea; and (3) screen genes, which by chromosomal position overlap known deafness loci or have cochlea specific isoforms/splice variants, for mutations in appropriate patients. The health-relatedness of the project is in its ability to identify genes which lead to inherited hearing loss and influence the clinical expression of the hearing impairment. The experimental design and methodology will include the use of homology cloning, the yeast dihybrid method, and mitochondrial ribosomal protein extraction and microsequencing for the identification of genes involved in mitochondrial RNA processing and translation. These genes will be characterized for chromosomal location by testing radiation hybrid cell lines with gene specific amplification. Cochlea specific splicing and isoforms will be searched for by screening databases and cochlear cDNA libraries, Southern blotting, and

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direct protein comparisons. Mutational analysis of candidate genes will be done in the appropriate patient populations with standard molecular techniques and for nucleic acid analysis, the precise choice dependent on the tissue available for analysis and the presumed molecular defect. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MODULATION OF COCHLEAR MECHANICS Principal Investigator & Institution: Oghalai, John S.; Otolaryngology; University of California San Francisco 500 Parnassus Ave San Francisco, Ca 94122 Timing: Fiscal Year 2001; Project Start 01-AUG-2001; Project End 31-MAY-2004 Summary: (provided by applicant): The long-term goal of these studies is to understand how drugs modulate the cochlear amplifier. The mammalian cochlea is a mechanical structure that is tuned along its length tonotopically. Outer hair cells (OHCs) within the cochlea undergo high-speed length changes in sync with sound vibrations, adding energy via a positive feedback loop. This is called the cochlear amplifier and provides exquisite hearing sensitivity and frequency selectivity. OHC motility is based upon the highly organized biomechanical structure of the cell's lateral wall, which contains a plasma membrane, a cytoskeleton, and motor proteins. The specific objective of this project is to determine whether drugs that change OHC lateral wall biomechanics in vitro will modulate cochlear mechanics in vivo. There are three categories of drugs that will be tested: amphipathic drugs which change membrane tension by causing cell membranes to bend, drugs that affect the actin-spectrin cytoskeleton and change cell stiffness, and drugs that directly block the electromotility motor. The compound action potential (CAP), distortion product otoacoustic emissions (DPOAEs), and the medial olivocochlear (MOC) reflex will be monitored to assess cochlear function in anesthetized guinea pigs before and during the administration of these drugs. Because OHCs are the most sensitive cell in the cochlea to noise exposure, drugs that change OHC biomechanics may also modulate noise-induced hearing loss. This will be tested in the guinea pig model. Finally, the effect of these drugs on sound conditioning will be assessed. This is a protective process whereby long-term exposure to moderate-level sound can reduce permanent threshold shifts from subsequent high-level noise exposure. Overall, these studies are designed to understand how OHCs transmit forces within the cochlea and the mechanisms behind sound conditioning. Clinically, they will improve our comprehension of the generation of otoacoustic emissions, as well as the role of the efferent nerves on the cochlear amplifier in health and disease. Additionally, these studies may lead to therapeutic interventions for noise-induced hearing loss and tinnitus. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: MODELS

MOLECULAR

GENETICS

OF

MUSCULAR/NEUROSENSORY

Principal Investigator & Institution: Nishina, Patsy M.; Staff Scientist; Jackson Laboratory 600 Main St Bar Harbor, Me 04609 Timing: Fiscal Year 2002; Project Start 15-APR-2002; Project End 31-MAR-2006 Summary: (provided by applicant): We have recently identified a spontaneous mouse mutant, veils (vis), that has retinal vasculopathy, hearing loss and progressive muscle wasting, phenotypes reported for many human diseases, such as Coat's disease, syndromic and non-syndromic congenital hearing loss, and muscular dystrophy, respectively. We have mapped veils to a 0.19+/-0.13 cM interval on mouse Chr. 8 in a

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1,072 meiotic recombinant cross and established the physical contig of the critical region. Portions of human Chrs. 2, 4q, 8, 13, 17, 18, l9p and 22 map to this region, the breakpoints of which have yet to be refined. Interestingly, veils has many, if not all of the phenotypes reported for the disease fascioscapulohumeral muscular dystrophy la (FSHD), the third most prevalent muscular dystrophy that affects 1/20,000 and maps to human Chr. 4q35. Also, a neuromyopathy associated with a highly variable age-of-onset maps to Chr. l9pl3. Veils is a potential genetic and/or phenotypic model for these diseases. The veils mouse is also unique in that it shows retinal lamination abnormalities, a phenotype that has not previously been reported in the literature. In order to understand the biological mechanisms that underlie the disease processes and identify the biochemical pathways that are affected in different tissues, we will: (a) positionally clone the veils gene and identify the mutation in the second allele myd and test the hypothesis that the phenotypic differences between v/s and myd are explained by allelic heterogeneity; (b) begin to identify genes in the genetic background that can significantly alter the disease phenotypes of vis/vis mice; and (c) test the hypothesis that the observed phenotypes are the result of developmental defects rather than degenerative processes. Identification of disease causing genes and animal models is extremely important. Many diseases in humans, especially those involving the eye, if identified early enough, can be treated to attenuate the disease process. If no treatment is currently available, knowing the molecular basis of the disease may provide insights to new treatment regimens and the models can then be used to test those therapeutics. Finally, knowledge of the disease causing genes may lead to an understanding of pathways that are critical in maintaining normal function and physiology of the organism and perhaps, may identify therapeutic targets for prevention of muscle wasting, and vision or hearing loss. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MOLECULAR INTERVENTION PREVENT NOISE INDUCED HEARING LOS Principal Investigator & Institution: Miller, Josef M.; Professor & Director of Research; Otolaryngology; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, Mi 481091274 Timing: Fiscal Year 2001; Project Start 01-AUG-2000; Project End 31-JUL-2003 Summary: The goal of this research project is to assess the role of oxidative stress as a factor in noise-induced hearing loss (NIHL), the primary cause of hearing loss in the industrialized world. Noise induced metabolic activity of inner ear as well as direct mechanical trauma may result in the formation of reactive oxygen species (ROS). We propose a model in which ROS represent a major causal factor in NIHL leading to downstream cascades that result in cell death. The model proposes that noise induces the formation of ROS, and that ROS and their byproducts directly cause pathology of the inner ear tissues, as well as indirectly cause a reduction in inner ear blood flow that exacerbates tissue damage. The model also proposes interventions that can block the formation and direct effects of ROS (antioxidants) or their downstream cascades (neurotrophic factors, NTF), and thus may protect the inner ear from noise damage. The studies proposed will test the hypotheses that: 1) noise induces ROS and inner ear pathology, and that antioxidant treatment prior to noise exposure will reduce ROS (lipid peroxidation) and NAIL (measured electrophysiologically and by sensory cell damage in guinea pigs); 2) cochlear blood flow is reduced by isoprostanes, products of lipid peroxidation, further contributing to NIHL; 3) NTF will significantly reduce NIHL while minimally reducing ROS; 3) post noise-exposure treatment will afford reduced, but

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significant, protection (compared to pretreatment). These studies are geared towards identifying the specific ROS formed and the time course of their formation. They will allow us to specifically assess the relative effectiveness of antioxidants and NTFs to reduce ROS-induced cell destruction. These studies will provide a critical test of this model of NIHL and may lead to interventions that are effective in preventing NIHL. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MOUSE DEAFNESS AND STUDY OF A MOUSE DEAFNESS GENE Principal Investigator & Institution: Kohrman, David C.; Assistant Professor; Otolaryngology; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, Mi 481091274 Timing: Fiscal Year 2001; Project Start 01-APR-2001; Project End 31-MAR-2006 Summary: (Adapted from applicant's abstract): The primary objective of this proposal is the identification and characterization of the gene responsible for inherited deafness in the mouse mutant known as 'spinner'. Mutation of this gene results in sensorineural hearing loss similar to that found in many human nonsyndromic deafness disorders. The approaches described will attempt to correlate effects at the single gene level with those occurring at the cellular level and the level of the intact cochlea. A positional cloning strategy will be used to identify the affected gene. Gene localization information will be derived from an existing high resolution genetic cross and a set of genomic DNA clones that span the candidate region. Positional candidate genes mapped to this region in mouse, and to the region of conserved linkage in humans, will be evaluated for mutation in spinner mice. To further narrow the candidate region, genomic DNA clones from the candidate region will be microinjected into sr/sr zygotes. DNA clones that contain a functional version of the normal gene are expected to produce phenotypic correction in the resulting transgenic progeny. This DNA will be directly screened for the presence of the affected gene. The biological role of the spinner gene in the cochlea will be examined using several approaches. High resolution phenotypic analysis of affected mice will be performed to identify early defects in the cochlea that result from mutation of the spinner gene. Sensory cell function in the cochlea will be assessed by measurement of evoked responses in spinner mice. Ultrastructural and immunocytochemical analyses will be performed to detail the degenerative process in the mutant cochlea. Database analysis of the gene's primary sequence will be used to identify related genes and protein motifs that may provide insight into gene function. The expression pattern of the spinner gene, and the subcellular localization of its encoded protein, will be determined. Based upon comparative genetic data, the human version of the spinner gene is a positional candidate for the gene affected in a nonsyndromic deafness disorder, DFNB6. The human gene will be directly evaluated for mutations in individuals with inherited defects at the DFNB6 locus. This project will result in the identification of a critical gene in the mammalian inner ear, provide the basis for a model of this gene's role in the cochlea, and investigate the involvement of the gene in human nonsyndromic hearing loss. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: MOUSE MODELS OF THE HUMAN HEARING DISORDER DFNA15 Principal Investigator & Institution: Zuo, Jian; St. Jude Children's Research Hospital Memphis, Tn 381052794 Timing: Fiscal Year 2001; Project Start 01-JAN-2001; Project End 31-DEC-2003

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Summary: (from applicant's abstract): Although there have been dramatic successes in recent years in identifying multiple genes that can cause deafness in humans, very little is known about how mutations in these genes cause disease. We have recently succeeded in expressing a reporter gene specifically in hair cells in transgenic mice using a modified bacterial artificial chromosome (BAC). We found that in our transgenic mice the expression of the reporter gene recapitulates the pattern of the endogenous gene expression. Thus, this BAC transgenic technology can be widely used for making mouse models of dominant hearing disorders in which the disease genes display complex expression patterns, or in which the mutations are gain-of-function mutations. This application focuses on making mouse models of DFNA15, a progressive, nonsyndromic, autosomal dominant hearing loss in humans. Recently, an 8-bp deletion has been found in the POU4F3 gene in a family with DFNA15. In the inner ear, Pou4f3 is expressed specifically in hair cells from the earliest onset of development through adulthood. Targeted deletion of the Pou4f3 gene in mice suggested that the 8-bp deletion in POU4F3 does not represent a loss-of function allele, but rather a gain-of function allele of the POU4F3 gene. In this application we plan to test this hypothesis by: 1. generating transgenic mice that overexpress the mutant Pou4f3 gene in a pattern that recapitulates the pattern of endogenous Pou4f3 expression; 2. generating transgenic mice that overexpress the wild-type Pou4f3 gene in a pattern that recapitulates the pattern of endogenous Pou4f3 expression. The creation and characterization of mouse models of DFNA15 will facilitate the prevention and treatment of the disease in humans and will also lead to a better understanding of the normal function of the POU4F3 gene during hair cell development. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: NEURAL REPRESENTATION OF SPEECH WITH SENSORINEURAL LOSS Principal Investigator & Institution: Sachs, Murray B.; Professor; Biomedical Engineering; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2001; Project Start 01-JAN-1975; Project End 31-MAR-2003 Summary: The long-term goal of the proposed work is to improve our understanding of the neural representation of speech in the presence of sensorineural hearing loss. Single neuron recordings will be made in cats exposed to intense noise, which produces a hearing loss comparable to moderate high frequency loss (greater than or equal to 1 kHz). The first aim is designed to test and further develop a way of compensating for the loss of sharp cochlear tuning and nonlinear suppression in damaged cochleas. The aim is to develop a method of specifying the optimum spectral shape for presenting a particular speech sound to an ear with a particular hearing loss, where optimum means designed to produce patterns of auditory nerve activity that are as normal as possible. The second aim will characterize neural responses to running speech, instead of the isolated phonemes that are usually used in auditory experiments. The representation of sentence-level speech will be characterized in both the spectral and temporal domains, for both normal and damaged ears. The compensation methods developed in the first aim will be tested using these stimuli. The effects of background noise will also be examined. In the third aim, an accurate computational model of auditory nerve activity in a damaged ear will be developed. Development and testing of the model will be closely coordinated with the experimental studies of the first two aims. The goal is to produce a model which is accurate enough to be used as a test bed for developing hearing-aid signal- processing. The final aim will study how cats with a hearing loss discriminate variants of the vowel /epsilon/ with different second formant frequencies.

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These behavioral experiments are designed to differentiate between two models of information representation in the auditory nerve, the so-called rate-place, and temporalplace models. The experiments take advantage of the fact that cats with a moderate hearing loss do not have rate-place information which would allow them to discriminate these vowels. This aim will provide evidence, for the first time, on the relative importance of the two information representation codes in the auditory nerve and will be important in interpreting the results of the experiments in the other three aims. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: NEWBORN SCREENING FOR HEARING IMPAIRMENT Principal Investigator & Institution: Naylor, Edwin W.; Neo Gen Screening, Inc. Box 219, Abele Business Park Bridgeville, Pa 15017 Timing: Fiscal Year 2001; Project Start 01-JUL-2001; Project End 31-DEC-2001 Summary: (Adapted from applicant's abstract): The feasibility of screening borns for hearing impairmflent in an assay paralleling routine metabolic screening will be demonstrated. Hearing loss owing to heredity factors and cytomegalovirus are analyzed. DNA from the universally collected newborn filter paper blood card serves as the source of nucleic acids to perform the assay. Several target sequences in the cytomegalovirus genome will be evaluated for their utility to identify viral DNA in the newborn specimen. The following mutations in connexin 26, Pendrin, and connexin 31 genes serve as model systems for hereditary hearing loss: (1) connexin 26 35 del G, 167 del T,.Usher2A 23l4delG; (2) Pendrin L236S, T416P; Mitochondrial A1555G. Amplicons that are diagnostic for CMV DNA and the described mutations are analyzed using a low-density oligonucleotide inicroarray in a multiplex format. The microarray vjfl clearly distinguish homozygous wild type, heterozygotes, and homozygous mutants for the described mutations. Screening for hearing impairment in a laboratory-based program, parallel to auditory screening, will provide an overall superior screening service. The lab assay will identify many newborns that would be missed where auditory screening is not available. PROPOSED COMMERCIAL APPLICATION: NOT AVAILABLE Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: NICOTINIC RECEPTORS IN COCHLEAR HAIR CELL PHYSIOLOGY Principal Investigator & Institution: Fuchs, Paul A.; Professor; Otolaryn & Head & Neck Surgery; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2003; Project Start 01-APR-2003; Project End 31-MAR-2006 Summary: (provided by applicant) Recent years have seen important developments in the study of hearing, especially the emergence of molecular genetics to probe the underlying mechanisms of hearing loss. It is estimated that 1 in every 1,000 newborns is profoundly deaf, while nearly 1 in 20 has a significant hearing impairment. In more than half of these cases, the cause is genetic. As of February 2002, twenty-nine specific genes have been associated with different forms of nonsyndromic human deafness. In addition, many other gene products involved in normal cochlear function have been identified. The foreign collaborator (Elgoyhen) cloned and characterized two novel nicotinic receptor genes (alpha 9 and alpha 10) that are expressed in cochlear hair cells. Alpha 9 and 10 encode receptor proteins that mediate the effect of acetylcholine (ACh) released by efferent neurons onto cochlear hair cells. The Principal Investigator (Fuchs) showed that calcium entry through the ACh receptor leads to hair cell

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hyperpolarization, reducing transmitter release to cause a loss of tuning and sensitivity in the auditory nerve fibers. This FIRCA proposal brings together the expertise of the Fuchs and Elgoyhen laboratories to conduct a series of electrophysiological and molecular genetic experiments to elucidate the properties and function of these cholinergic receptors in hair cell physiology. The long-term goal of this proposal is to define the physiological role of the hair cell's cholinergic receptor. In addition, it is expected that the results obtained will contribute to our understanding of the role of efferent cholinergic input in the genesis and potential treatment of hearing impairment produced by loud sound or ototoxic drugs. The immediate aims of this application are three-fold: first, the pharmacological and physiological comparison of recombinant alpha9/alpha10 receptors expressed in Xenopus laevis oocytes with native cholinergic receptors of inner and outer hair cells in acute cochlear explants; second, the characterization of the ontogeny of cholinergic responses in inner hair cells and third, the physiological analysis of synaptic contacts onto inner and outer hair cells in mice with genetic modifications in the Acra9 gene, namely the alpha9 null mutant mouse and a knock-in mouse bearing a gain of function mutation. This research will be done primarily in Argentina at INGEBI (National Research Council) in collaboration with Ana Belen Elgoyhen as an extension of NIH grant #R01 DC01508. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: OPTIMIZING AMPLIFICATION FOR INFANTS AND YOUNG CHILDREN Principal Investigator & Institution: Stelmachowicz, Patricia G.; Director of Audiology; Father Flanagan's Boys' Home Boys Town, Ne 68010 Timing: Fiscal Year 2001; Project Start 30-SEP-1999; Project End 31-AUG-2004 Summary: The overall goal of this project is to gain information that will improve current techniques for fitting hearing aids to infants and young children. The development of universal hearing- screening programs has created an urgent need for a well-defined scientifically-based approach for the selection and fitting of hearing aids with this population. Current hearing-aid technology is complex, requiring a large number of decisions during the fitting process. Studies with adults have shown large individual differences in hearing-aid benefit across listeners and subjective test techniques used to optimize the fit are not applicable with children. Furthermore, it has been argued that young hearing-impaired children may require different amplification characteristics than adults with similar hearing losses because children do not have the language structure or world knowledge to supplement communication. To date, no studies addressing the specific amplification needs of pre-lingually hearing-impaired children with mild to moderately-severe hearing loss have been conducted. The first aim of this project is to test the hypothesis that the acoustic needs of young hearingimpaired children change developmentally and differ from adults with hearing loss. The results of these studies should provide guidelines for age-appropriate hearing-aid fitting algorithms as well as basic information on the development of speech perception abilities in this population. The second aim is to test the hypothesis that hearingimpaired children can utilize multiple acoustic cues provided that the relevant aspects of the speech signal are sufficiently audible. These studies should enhance our understanding of auditory learning and acclimatization in relation to the hearing-aid fitting process. The final aim is to explore the role of auditory experience in early phonological, lexical, and morphological development. The goal is to identify early markers that would signal the need to modify amplification, alter intervention strategies, and/or explore the existence of additional disorders.

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Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: OPTIMIZING HEARING AID FITTING FOR OLDER ADULTS Principal Investigator & Institution: Cox, Robyn M.; Professor; None; University of Memphis Memphis, Tn 38152 Timing: Fiscal Year 2003; Project Start 17-SEP-2003; Project End 31-AUG-2005 Summary: GRANT=R556222-01 This research is directed towards improving hearing aid fitting for older adults. Despite substantial improvements in hearing aid technology, the hearing aid take-up rate, and the satisfaction with fitted hearing aids has not improved in the last decade. This is partly due to a failure by the research community to produce and disseminate updated fitting methods that facilitate the ability of practitioners to capitalize on the potential of existing new technologies. The two experiments in this proposal will produce guidelines to assist clinicians to make scientifically based decisions about amplification needs, based on the results of tests conducted before the fitting. The first experiment bridges the gap between laboratory research and clinical in selection of high frequency gain characteristic. Recent studies have demonstrated that, for some individuals with high-frequency hearing loss, high frequency amplification is actually detrimental rather than helpful. There is a pressing need for a clinically practical method that would validly identify patients for whom high-frequency gain is contraindicated. The study assesses the prevalence of such patients, and evaluates two new clinical procedures that have been developed to identify these individuals. The two procedures are used to identify experimental and control groups comprising 20 pairs of subjects. Each subject is fitted with a hearing aid that allows comparison of two amounts of high-frequency gain. Subjects undergo laboratory testing and a field trial to determine which high-frequency gain setting is better. Results show whether the two new clinical procedures yield accurate prediction of optimal high-frequency gain. The second experiment explores the indications for bilateral (binaural) hearing aid fittings for older adults with bilateral hearing loss. About 20 to 30% of bilaterally fitted individuals actually elect to wear only one hearing aid. For these individuals, resources allocated to hearing aid purchase would have been more effectively used for alternate rehabilitation methods. It is not clear why some patients prefer one hearing aid over two, or which patients will fall into this category. This study evaluates outcomes of 100 bilateral hearing aid fittings over a three-month period. Logistic regression is used to develop a model in which binaural summation, binaural integration, binaural interference, and attitudes towards hearing aids and hearing loss are combined to predict which individuals will ultimately prefer to use one hearing aid rather than two. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: OUTCOMES OF GENETIC TESTING FOR HEARING IMPAIRMENT Principal Investigator & Institution: Krantz, Ian D.; Children's Hospital of Philadelphia 34Th St and Civic Ctr Blvd Philadelphia, Pa 19104 Timing: Fiscal Year 2002; Project Start 26-SEP-2002; Project End 31-AUG-2006 Summary: (provided by applicant): Sensorineural hearing loss (SNHL) is a heterogeneous group of disorders that collectively represent the most common congenital deficit in humans. More than 100 genes have been implicated in SNHL. Our ability to identify the molecular etiologies of hearing loss is rapidly increasing, and coupled with the institution of universal newborn hearing screening programs, both diagnosis and molecular testing are being offered at an earlier age. While these technical advances are being incorporated into clinical management of infants and children with

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hearing loss little work has been initiated to understand the decision making processes and attitudes of parents who opt for or against genetic testing. Further work is also needed to understand the outcomes of genetic testing in families with hearing loss both to establish genotype-phenotype correlations to improve clinical management and to identify and address issues of concern to affected families. There is little data to guide this intervention and it is not yet clear how the results of the testing and counseling sessions impact the family, subsequent interventions, or the child's eventual outcome. This proposal takes a multidisciplinary approach to study a large cohort of children and their families ascertained with hearing loss on a molecular and clinical level and to evaluate outcomes, parental attitudes towards, and the psychosocial aspects of, genetic testing with the overall goal of improving clinical practice and providing parents with the information and tools they need to make informed decisions. We hypothesize that 1) by identifying the etiology of hearing loss, through genetic evaluation and molecular testing, genotype-phenotype correlations will be established that will lead to improved clinical management of patients and families with hearing loss; 2) assessment of parental understanding, attitudes, beliefs and concerns about genetic testing throughout the testing process (beginning with the time of referral by the audiologist or otolaryngologist and continuing through specific gene testing) will increase our understanding of the needs and concerns of parents of children with hearing loss thus promoting informed and collaborative decision making resulting in improved clinical management; and 3) assessment of parental understanding, beliefs, attitudes, and concerns about genetic testing will lead to the development of educational materials and decision aids to assist families, both hearing and deaf, with their hearing impaired children. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: OXIDATIVE STRESS PATHWAYS IN NOISE INDUCED HEARING LOSS Principal Investigator & Institution: Schacht, Jochen H.; Professor & Director, Khri; Otolaryngology; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, Mi 481091274 Timing: Fiscal Year 2003; Project Start 01-APR-2003; Project End 31-MAR-2006 Summary: Cellular responses to a traumatic insult include the activation of multiple pathways that lead either to survival (homeostatic pathways) or cell death (apoptotic or necrotic pathways). The control of these pathways requires the concerted efforts of second messengers, protein kinases, and transcription factors that will ultimately change the patterns of gene expression in the cell. Depending on the intensity of the stress, different genes will be activated, eventually shifting the balance from homeostatic pathways (at low stress) to cell death pathways (at high stress). This project intends to unravel some of these pathways and their contributions to noise-induced hearing loss. It is the underlying hypothesis - based on solid preliminary evidence - that an initial event in noise trauma is the formation of reactive oxygen species leading to the activation of transcription factors and upregulation of oxidant stress response genes. Specifically, the following aims will be addressed in a mouse model of noise-induced hearing loss: (1) the formation and distribution of reactive oxygen species and the activation of the transcription factors AP-1 and NF-kappaB; (2) the hypothesis that the phosphoinositide pathway (phosphoinositide-3-OH kinase; PI 3-kinase) and NF-kappaB integrate noise-induced signaling by mediating the effects of ROS and neurotrophic factor; (3) the expression of specific antioxidant genes and the localization of their protein products. The project is coordinated with the other projects and core facilities in

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this application both by the common theme and by shared coordinated design and shared animals. The joint analysis of the data will yield a wide-ranging and integrated model of cochlear stress responses which, in turn, will provide a rational basis for designing pharmacological interventions to prevent noise-induced hearing loss. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PERIPHERAL PROCESSING

INTERACTIONS

IN

AUDITORY

TEMPORAL

Principal Investigator & Institution: Oxenham, Andrew J.; Center for Cancer Research; Massachusetts Institute of Technology Cambridge, Ma 02139 Timing: Fiscal Year 2001; Project Start 01-FEB-1999; Project End 31-JAN-2004 Summary: The purpose of this research is to investigate monaural auditory temporal processing new psychophysical data with quantitative model predictions. The project has three main aims: (i) To investigate the influence of peripheral (cochlear) nonlinearities on psychophysical measures of temporal resolution; (ii) to examine the consequences of a loss of non-linearity due to sensorineural hearing loss; and (iii) to functionally characterize higher stages of temporal processing. Two experiments will examine the magnitude and the time course of psychophysical suppression to discover the extent of which physiological and psychophysical suppression are reflections of the same underlying process. The results will clarify the role of suppression in certain measures of temporal resolution. Further experiments will test the hypothesis that the non-linear growth of forward masking is a reflection of peripheral non-linearities and that more central processes can be treated as quasi linear. Results from normal-hearing listeners will be compared with those from listeners with moderate-to severe cochlear hearing loss to test whether the differences can be accounted for solely by the expected changes in peripheral compression. The hypothesis, if supported, will have important consequences for the modeling and understanding of temporal resolution in hearingimpaired listeners. The penultimate experiments will seek to elucidate the underlying mechanisms of forward masking comparing predictions of the two most popular theories, namely adaptation of response and persistence (or integration) of response, with experimental data designed to distinguish between the two. The final experiment will examine how information is combined across frequency in a forward-masking situation. An understanding of the changes in temporal resolution due to hearing impairment may ultimately assist in selecting appropriate parameters for the design of digital hearing aids. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PHOTORECEPTOR PROTECTION IN A MOUSE MODEL FOR USHER SYNDROME Principal Investigator & Institution: Cao, Wei; University of Oklahoma Hlth Sciences Ctr Health Sciences Center Oklahoma City, Ok 73126 Timing: Fiscal Year 2002; Project Start 16-SEP-2002; Project End 31-AUG-2007 Summary: In post-mitotic photoreceptor cells, there is a significant increase in cell death when metabolic activity in the retina increases. This, together with the high focal concentrations of mitochondria in photoreceptors and the very high blood supply to the choriocapillaris, suggests that there may be very little reserve in the energy supply to photoreceptor cells. The complex inter-relationships between photoreceptors, Muller cells and retinal pigment epithelium add to the vulnerability in that failure of other cell types readily leads to secondary photoreceptor cell loss. It seems possible that

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photoreceptor cells live on a knife's edge, and that relatively mild insults can significantly increase the probability of cell death. On the other hand, a relatively modest benefit to the cell may reduce the chances of cell death sufficiently to have an important clinical impact on vision. Usher syndrome is a group of diseases with autosomal recessive inheritance, congenital hearing loss, and the development of retinitis pigmentosa, a hereditary disease that affects photoreceptor cells and causes blindness. The rd5/rd5 mouse has been identified as an animal model for Usher syndrome and linkage mapping suggests homology to Usher type I located on human chromosome 11 at p15. Growth factors such as pigment epithelium-derived factor (PEDF) and basic fibroblast growth factor (bFGF) and small molecules such as phenyIN-tert-butylnitrone (PBN) have been shown to protect photoreceptors from degeneration in rat model and in culture. However, the mechanism(s) by which PEDF and PBN protect photoreceptors remains unknown. Because little is known about Usher Type I disease and currently, no treatment exists for such disease, it would be important to know whether photoreceptor degeneration in rd5/rd5 mouse can also be delayed or prevented by growth factors or small molecules. The overall goal of this proposal is to explore the role of growth factors and small molecules in photoreceptor protection in rd5/rd5 mice. The protection will be evaluated histologically by measuring the thickness of the outer nuclear layer and functionally by electroretinography. Proteomics and DNA-microarrays will be used to identify genes and proteins differentially expressed between homozygous (rd5/rd5) and normal heterozygous (rd5/+) mice with and without treatments. Western and Northern blot analysis will be used to quantitate the expression, and immunohistochemistry and in situ hybridization will be used to localize the expression. Any of our experimental regimes, which prevent the loss of photoreceptors in this mouse, would be extremely relevant to the therapeutic treatment of humans with Ushers and possibly other types of inherited retinal disorders. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PHYSIOLOGICAL BASES OF OTOTRAUMATIC INSULT Principal Investigator & Institution: Lonsbury-Martin, Brenda L.; Professor; Otolaryngology; University of Colorado Hlth Sciences Ctr P.O. Box 6508, Grants and Contracts Aurora, Co 800450508 Timing: Fiscal Year 2001; Project Start 01-MAR-1996; Project End 31-AUG-2006 Summary: The proposed studies focus on the contribution of the cochlear-efferent system in the susceptibility to noise and the phenomenon of "sound conditioning." Several hypotheses are proposed to determine whether the susceptibility of the ear can be experimentally manipulated through sound conditioning, if the cochlear-efferent system is involved in sound conditioning and whether auditory or systemic factors are involved in the process. In addition, the molecular bases of protection from soundoverexposure will be explored. The functional measure employed in the experiment is the 2f1-f2 DPOAE and its alteration by presentation of a pure tone presented to the opposite ear. The change in DPOAE with binaural stimulation is proposed as a measure of "efferent strength," which appears to vary among individual animals and humans. Three hypotheses are proposed. In the first, awake rabbits will be used as subjects to determine if the efferent system plays a role in 'sound conditioning', whether the effect is ear-specific and whether other systemic factors are involved. The second hypothesis tests the extent to which "sound conditioning" is apparent in mice that have varying susceptibility to noise-induced hearing loss. The third hypothesis tests whether susceptibility to hearing loss or the prevention from it is associated with specific molecules in the cochlea.

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Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PHYSIOLOGICAL STUDIES OF AGE-RELATED HEARING LOSS Principal Investigator & Institution: Schmiedt, Richard A.; Professor; OtolaryngologyHead & Neck Surgery; Medical University of South Carolina 171 Ashley Ave Charleston, Sc 29425 Timing: Fiscal Year 2003; Project Start 01-SEP-1997; Project End 31-MAR-2008 Summary: (provided by applicant): A major factor in human and animal presbyacusis is the degeneration of the cochlear lateral wall tissues and stria vascularis. These tissues supply energy to the organ of Corti in the form of the endocochlear potential (EP). In young animals, this 90 mV potential has been shown to be of fundamental importance in the operation of the cochlear amplifier and subsequent determination of auditory thresholds. Gerbils aged in quiet show an age-related decline of EP, the basis of metabolic presbyacusis. Over the last grant cycle we have developed a model of the aged ear in young gerbils using the chronic application of furosemide to the cochlea to block the generation of the EP. Here we further explore the effects of acute and chronic EP manipulation on cochlear transduction and the encoding of sound in auditory-nerve fibers. Moreover, we explore cell replication as a possible mechanism fundamental to the EP decline with age. There are three specific aims. Specific Aim 1 examines the effects of EP modulation by direct current injection into the scala media of normal, EPimpaired, and aged cochleas. This aim will test the hypothesis that EP is the primary factor controlling neural thresholds and otoacoustic emissions. Moreover, it tests whether direct current injection can serve to ameliorate metabolic presbyacusis. Specific Aim 2 focuses on how populations of auditory-nerve fibers respond to EP decline, with specific regard to the thresholds of low- and high-spontaneous rate (SR) fibers. This aim tests the hypothesis that the thresholds of low-SR fibers located in the cochlear base are more sensitive to EP decline than corresponding high-SR fibers. It will also examine the characteristics of these fibers with acoustic stimuli in EP-impaired cochleas. Specific Aim 3 investigates the role of lateral wall fibrocytes in the production and maintenance of the EP. The hypothesis is that fibrocyte proliferation is essential for EP homeostasis, and a reduced rate of replication is the basis for the decline in EP observed in aged animals. These experiments will involve the infusion of mitotic inhibitors and gap junction uncouplers into the cochlea. Taken together, the three aims explore the major causes and effects of metabolic presbyacusis and have direct application to future interventions to help restore age-related hearing loss. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: PRESBYCUSIS--BIOMEDICAL RISK FACTORS Principal Investigator & Institution: Gates, George A.; Professor; Otolaryn & Head & Neck Surgery; University of Washington Seattle, Wa 98195 Timing: Fiscal Year 2001; Project Start 01-JUL-1993; Project End 31-MAR-2003 Summary: Presbycusis - age-related hearing loss - is an increasingly common communication disorder due to the aging and noisiness of our society.The prevalence and severity of presbycusis vary substantially in people of the same age and gender but the source(s) of this variability are incompletely understood. A major putative factor for this variability is heredity. The proposed research will continue our study of presbycusis using comprehensive examination methods to determine the inheritability of presbycusis in relation to its epidemiology and biomedical risk factors. We propose to: a) finish the auditory testing of the targeted members of the Framingham Offspring

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Group to determine the prevalence of presbycusis (as for their parents; b) delineate clinical presbycusis phenotypes in both groups; c) perform quantitative linkage analysis using the existing Genescan data base for the families with presbycusis pedigrees, d) perform complex segregation analysis of presbycusic families to assess the Mendelian inheritance patterns; and e) identity risk factors in families with genetic transmission. This is the first modern human study to assess the heritability of presbycusis. State-ofthe-art methodology for auditory testing and genetic epidemiology are used. This research can only be done in a large parent-offspring group such as the Framingham Heart Study. Because the parents' hearing testing is done, and about 2/3 of the target Offspring will have been tested under the current funding, completion of this project will require testing of the remaining target Offspring during the first part of Offspring Study 7. Auditory tests are unchanged: pure-tone thresholds, immittance audiometry, acoustic impedance and reflectance, otoacoustic emissions, word recognition in quiet, Dichotic Digits test and the Synthetic Sentence Identification with Ipsilateral Competing Message. Presbycusis will be coded by: a) age-adjusted severity of loss; b) clinical pattern and phenotype, and c) whether it is of an early-onset type or not. Quantitative linkage analysis in the Genescan data base will examine the DNA of large families with presbycusis. Segregation analysis will be done for different phenotypes defined as: a) severity of presbycusis, b) presbycusis pattern, c) early-onset presbycusis, and d) covariate adjusted models that will include known risk factors (gender, noise exposure, and cardiovascular diseases). Characterizing presbycusis by severity, age of onset, and clinical subtype will help to identify specific risk factors associated with hereditary presbycusis among genetically predisposed individuals. Identification of families with inherited presbycusis will facilitate future molecular genetic studies to identify genes for inherited defects. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PSYCHOLOGICAL NONLINEARITIES IN MASKING Principal Investigator & Institution: Hicks, Michelle L.; Hearing and Speech Sciences; University of Maryland College Pk Campus College Park, Md 20742 Timing: Fiscal Year 2001; Project Start 01-AUG-1999; Project End 31-JUL-2003 Summary: The long-term objective of the proposed research is to further our understanding of the mechanisms underlying psychophysical masking. In particular, this project seeks to clarify the role of basilar membrane compressive nonlinearity on growth of masking by altering the nonlinearity through the ingestion of aspirin, an ototoxic drug known to adversely affect outer hair cell function, and hence basilar membrane compression. The goals of this research are to (1) gain insight into the role of basilar membane compressive nonlinearity on growth of masking in forward masking for on-frequency (masker and signal equal in frequency) and off-frequency (masker well below the signal in frequency) maskers, (2) gain a better understanding of the differences in the processing underlying growth of masking in simultaneous and forward masking for off-frequency maskers, and (3) evaluate the legitimacy of using temporary aspirin-induced hearing loss as a model for permanent sensorineural hearing loss. Results from the proposed study will resolve issues fundamental to our understanding of the role of cochlear nonlinearity in psychophysical masking. Moreover, the ability to use aspirin-induced hearing loss as a model for sensorineural hearing loss will be a valuable tool for future research on the processing abilities of hearing-impaired individuals. The proposed experiments will examine growth of masking in forward and simultaneous masking in normal-hearing individuals prior to, and during four days of moderate aspirin use. The aspirin will likely induce a

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temporary, mild-to-moderate cochlear hearing loss, and changes to the growth-ofmasking functions with aspirin will provide insight into the influence of basilar membrane nonlinearity on the functions. The results from individuals with temporary aspirin-induced hearing loss will be compared with those from individuals with permanent sensorineural hearing loss of similar degree and configuration. This comparison will test the hypothesis that sensorineural and aspirin-induced hearing losses affect growth of masking similarly, supporting the aspirin-induced hearing loss as a model for sensorineural hearing loss. All testing will be completed using standard psychoacoustic forced-choice adaptive procedures. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: ROLE OF NATRIURETIC PEPTIDES IN THE COCHLEA Principal Investigator & Institution: Trachte, George J.; Professor; Pharmacology; University of Minnesota Twin Cities 200 Oak Street Se Minneapolis, Mn 554552070 Timing: Fiscal Year 2003; Project Start 15-AUG-2003; Project End 31-JUL-2005 Summary: (provided by applicant): Cyclic guanosine monophosphate (cGMP) is a second messenger that has been implicated in cochlear function. In the cardiovascular system, cGMP can be generated by natriuretic peptide (NP) stimulation of guanylyl cyclase. The proposed experiments will investigate the role of two NP receptors in cochlear homeostasis and pathology: NPR-A, a particulate guanylyl cyclase, and NPR-C, a clearance receptor that removes NPs from the circulation, resulting in decreased activation of NPR-A. In the inner ear, components of the NP system have been localized to the stria vascularis and spiral ganglion, but there are few functional studies of NPs. NPs are primary regulators of fluid transport in other tissues; therefore, our overarching hypothesis is that aberrations in the NP system alter endolymph composition, resulting in hearing loss. Preliminary studies have shown that only NPR-A stimulates cGMP production in the mouse cochlea, and that mutation of NPR-C results in a high frequency hearing loss. The proposed study has two specific aims. First, the effect of NPR-A ablation (i.e., a deficient guanylyl cyclase system) on inner ear function will be assessed in transgenic mice lacking NPR-A. Second, the effects of increased NPR-A activation (i.e., an overactive guanylyl cyclase stem) will be determined using mice deficient in NPR-C. In these experiments, endolymph potassium ion concentrations, endocochlear potentials and auditory brainstem responses will be used to assess cochlear function. In addition to the physiological measurements, guanylyl cyclase responses to NPs will be measured in vitro to ensure that the NP system is either attenuated or stimulated by the mutations. This study will provide critical information regarding the influence of this essential fluid regulating system on auditory function, potentially facilitating the development of novel treatments for disorders such as Meniere's disease and age-related hearing loss. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: ROLES OF ACETYLCHOLINE IN AGE RELATED HEARING DISORDERS Principal Investigator & Institution: Chen, Kejian; Otolaryngology; Medical College of Ohio at Toledo Research & Grants Admin. Toledo, Oh 436145804 Timing: Fiscal Year 2001; Project Start 01-JAN-2001; Project End 31-DEC-2002 Summary: Age-related hearing disorders include decreased pure tone perception and poor speech comprehension during background noise. There is some evidence suggesting that cholinergic pathways to the cochlear nucleus, the first brain center of the

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auditory system, may play a role in the recognition of signals in a noisy background. Studies of other central nervous disorders such as Alzheimer's disease have indicated age-related loss of cholinergic neurons in the brain. In the auditory system, however, the influence of aging on the function of cholinergic pathways is poorly understood. This study aims to explore the possible involvement of cholinergic pathways to the cochlear nucleus in age-related hearing disorders. The CBA mouse has a slowly progressive hearing loss with a similar tone with a similar tone course as that in humans, after correction of life span. We hypothesize that this mouse model has progressive loss of cholinergic neurons in auditory centers, expressed as decreased activities of the enzyme for acetylcholine. Two experiments are proposed in this study: 1) comparison in young and aged animals of the activity of the enzyme for acetylcholine synthesis, choline acetyltransferase (ChAT), in the superior olivary complex, where many somata of cholinergic neurons in auditory centers, expressed as decreased activities of the enzyme for acetylcholine synthesis and changed sensitivities of neurons in the auditory pathway to acetylcholine. To acetylcholine synthesis, choline acetyltransferase (ChAT), in the major target of these cholinergic neurons; 2) comparison in young and aged animals of the sensitivities of cochlear nucleus neurons to acetylcholine-related drugs. Correlation of the results from this study and those from previous studies on hearing function of this mouse model may increase understanding of age-related hearing disorders and suggest new treatment directions. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: POTENTIALS

SCREENING

VESTIBULAR

FUNCTION

USING

EVOKED

Principal Investigator & Institution: Jones, Sherri M.; Surgery; University of Missouri Columbia 310 Jesse Hall Columbia, Mo 65211 Timing: Fiscal Year 2001; Project Start 27-SEP-1999; Project End 31-MAY-2003 Summary: There are no direct, noninvasive, physiological measures of vestibular function. This is in clear contrast to the wide variety of physiological measures available to directly assess function of the auditory system at all levels from the end organ to the cortex. Many of these auditory measures, most notably, auditory brainstem responses, have been used to screen for, or identify and characterize hearing loss in a large number of genetic mutants. These studies have provided important information about the genetics of hearing impairment. The proposed research will develop the techniques to assess the functional status of the vestibular end organs and eighth nerve. Meaurements will be direct, noninvasive and implemented by adapting established techniques for recording linear vestibular evoked potentials. Protocols will be suitable for screening and detailed functional assessment. Two specific aims will be addressed. First, stimulation and recording hardware and software will be developed. Peripheral vestibular and brainstem neural activity will be recorded using far-field evoked potential techniques. Adequate stimuli for activation of macular or ampullar neurons will be used to elicit responses. Stimuli will be applied to the cranium via a mechanical shaker/head mount system. Normal mice and genetic mutants with specific inner ear or central anomalies will be used to demonstrate test validity. Second, the effectiveness and efficiency of the measurement technique will be evaluated. Vestibular function will be surveyed based on two selection strategies. One strategy will measure mice that display behavioral signs of imbalance or vestibular dysfunction or have measurable hearing loss. The second strategy will measure random samples drawn from multiple genetic strains where vestibular dysfunction may be obscure or hidden. This research will produce a tool for the direct, noninvasive assessment of vestibular function and will

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generate a database quantifying vestibular function in relation to genetics. The knowledge gained will serve as a basis for future research ultimately leading to a better understanding of vestibular ontogeny, genetics of vestibular impairment and better diagnosis and treatment of dizziness in humans. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: SINGLE NEURON MARKING IN THE STUDY OF ABNORMAL COCHLEAS Principal Investigator & Institution: Liberman, M. Charles.; Director; Massachusetts Eye and Ear Infirmary 243 Charles St Boston, Ma 02114 Timing: Fiscal Year 2001; Project Start 01-APR-1982; Project End 31-MAR-2003 Summary: The mammalian ear is connected to the brain via four types of nerve fibers: two afferent types carry sensory input to the brain, while two efferent types carry feedback control from the brain. The overall goal of our research effort is to understand the role(s) of each fiber type in audition: our current understanding of these roles is rudimentary in many areas. The present application includes one aim directed at each of the four fiber types. 1) Type-I afferents are subdivided into spontaneous-rate (SR) groups, which differ in threshold sensitivity. We will use intracellular labeling to study the central projections of these fibers, testing the hypothesis that an SR-based spatial organization within the cochlear nucleus (CN) is superimposed on its frequency-based organization, thereby allowing CN cell-types (and the higher centers to which they project) to sample activity from different SR groups according to the nature of the decoding operations performed. 2) Response properties of type-11 afferents from outer hair cells (OHCS) have never been studied, both because their axons are small and because they are few in number. We will use a drug (carboplatin) to selectively eliminate the large type-I population and then apply electrode technology for recording from unmyelinated fibers. The resultant type-II recordings will allow a test of the hypothesis that type-11's mediate the sensation of auditory pain. 3) Olivocochlear (OC) efferent fibers to OHCs comprise a sound-evoked reflex, and chronic de-efferentation greatly increases vulnerability to permanent noise-induced hearing loss (NIHL). Interestingly, the strength of the OC reflex varies among normal individuals, and so does the vulnerability to NIHL. We will test the hypothesis that "tough" ears are those with the most active OC reflex and that "toughening" of the ear seen with long-term, moderate-level acoustic exposure arises via an amplification of the OC reflex. Since OC reflex strength can be measured non-invasively, a NIHL vulnerability screen for humans could be devised based on our findings. 4) The OC fibers to the inner hair cell area are unmyelinated, and their response properties and functional effects are completely unknown, largely because their axons are difficult to excite electrically. Our preliminary results suggest that this part of the OC pathway may be excitable via electric activation of the inferior colliculus. We will pursue this approach to elucidate the peripheral effects these OC efferents. Such information is fundamental to an understanding of the functional role of the entire OC system. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: SOCIETAL IMPACT OF ADVANCES IN GENETIC DEAFNESS Principal Investigator & Institution: Pandya, Arti; Human Genetics; Virginia Commonwealth University Richmond, Va 232980568 Timing: Fiscal Year 2003; Project Start 01-SEP-2003; Project End 31-AUG-2007

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Summary: (provided by applicant): Progress in understanding the genetic basis of hearing loss is occurring at a rapid pace, with more than 100 genes for deafness already mapped and cloned. These advances in genetic deafness are providing us with information on the basic architecture and functioning of this intricate organ of hearing. It is also leading to the development of molecular diagnostic tests which are used in clinical practice for the evaluation of individuals with hearing loss of unknown etiology. In parallel, advances in technology for audiologic evaluation and the recognition that early identification of hearing loss and initiation of language training can influence the linguistic potential have led to the nationwide implementation of the Early Hearing Detection and Intervention (EHDI) program. However, the pace of communicating these revolutionary advances and their relevance to the consumer have lagged behind. This gap in knowledge of the consumer, and the existence of a Deaf culture, pose unique social and ethical issues for the Deaf and hearing communities. One of the key goals of the ELSI program is to identify, analyze and address the ethical and social implications arising as a result of advances due to the Human Genome Project. Thus we propose to seek and understand the attitudes and concerns of deaf adults and hearing parents of deaf children towards several issues related to genetic testing and technological advances in management of the deaf. We will achieve this by conducting focus group interviews, and using this qualitative information to revise and expand the survey instrument, followed by a nationwide survey of the two groups to seek their knowledge, attitudes and concerns. We will also assess the impact of genetic testing and counseling by measuring its influence on selection of a marriage partner. In order to do this we will test the marriage pattern in 100 deaf probands with Cx26 mutations married before and after the discovery of Cx deafness. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: STUDY OF A GENETIC NETWORK INVOLVED IN EAR DEVELOPMENT Principal Investigator & Institution: Friedman, Rick A.; Chief, Section on Hereditary Disorders o; House Ear Institute 2100 W 3Rd St Los Angeles, Ca 90057 Timing: Fiscal Year 2001; Project Start 28-SEP-2001; Project End 31-AUG-2006 Summary: (provided by applicant): Tremendous progress has been made during the last five years in the mapping and cloning of genes responsible for syndromic and nonsyndromic hereditary hearing loss. The mouse is an excellent animal model for the study of these human conditions because the anatomy, function and hereditary abnormalities of the ear have been shown to be similar in both humans and mice. We have recently described one such model resulting from a spontaneous mutation in a C3HIHeJ colony of mice at the Jackson Laboratory. The insertion of a retrotransposon (intracisternal A particle) into an intron of Eyal was associated with reduced expression of the normal Eya] message and inner ear and kidney abnormalities. We have designated this mutation Eya1 bor The human homologue of this gene, EYAJ, has been shown to underlie Branchio-Oto-Renal (B OR) syndrome, an autosomal dominant disorder characterized by hearing loss with associated branchial and renal anomalies. The function of this new class of nuclear protein is poorly understood. Our preliminary data, and that of our collaborators, suggests a critical role for this gene, and other members of this gene family (Eyal-4), in inner ear morphogenesis and postnatal function. In this proposal we intend to explore the hypothesis that Eyal participates in a regulatory network, as Jescribed in the Drosophila eye (eya), that is conserved and critical, in a dose dependent manner, to the early inductive events in mammalian ear development and maintenance of the mature auditory phenotype. We will examine the

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dose dependent effects on the ear and related structures, in viva, anatomically, functionally and molecularly. This will be accomplished by studying the Fl mice resulting from a cross between C3H/HeJ Eyalb0r/+ and BALB/cJ Eya1+/- and Eyal over-expression transgenic mutants. Additionally, we will identify the regions of the Eya homologous region (EyaHR) that are critical to the protein-protein interactions with other members of this conserved transcriptional regulatory complex. These and future experiments represent the natural progression from my Mentored Clinical Scientist Development Award (K08). Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: TEMPORAL PROPERTIES OF AUDITORY MASKING Principal Investigator & Institution: Bacon, Sid P.; Professor; Speech and Hearing Science; Arizona State University P.O. Box 873503 Tempe, Az 852873503 Timing: Fiscal Year 2001; Project Start 01-JUL-1992; Project End 31-MAY-2006 Summary: The long-range goals of the proposed research are to further our understanding of the mechanisms underlying the auditory processing of time-varying stimuli, and to determine how those mechanisms are affected by sensorineural hearing loss. There are three separate but related lines of research, and all focus to some extent on the potential role of peripheral compression in temporal processing. The influence of compression is evaluated by studying the effects of temporary, aspirin- induced hearing loss, permanent hearing loss, and model simulations. The first line of research focuses on the detection of brief signals as a function of prior masker stimulation. The underlying mechanisms could play an important role in enhancing newly arriving or intermittent signals, especially those in an on-going background. The general goal of this line of research is to test the hypothesis that the mechanisms underlying the temporal effect with off frequency tonal maskers differ from those underlying the effect with broadband noise maskers. The second line of research concentrates on phase effects in simultaneous masking, particularly on how the resulting temporal fluctuations influence the amount of masking. The general goal of this research is to gain a better understanding of the within- and across-channel mechanisms underlying these phase effects. This research should enhance our understanding of how the auditory system processes the temporal fluctuations inherent in many complex sounds, including speech, and could ultimately provide insight into why individuals with a sensorineural hearing loss have particular difficulties understanding speech in temporally complex backgrounds. The third line of research focuses on a recently described change in response growth from compressive to linear at high levels. This change, inferred from growth-of-masking functions, is responsible for a measured decline in temporal processing at high stimulus levels. The primary goal of this line of research is to gain a better understanding of the processing underlying this change in response growth. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: THE EFFECTS OF RESVERATROL ON PRESBYACUSIS Principal Investigator & Institution: Seidman, Michael D.; Director; Otolaryngology; Case Western Reserve Univ-Henry Ford Hsc Research Administraion Cfp-046 Detroit, Mi 48202 Timing: Fiscal Year 2003; Project Start 01-JUL-2003; Project End 31-MAR-2005 Summary: (provided by applicant): The primary purpose of this project is to study the long-term effect of resveratrol, the antioxidant compound found in red wine, on agerelated hearing loss. Presbyacusis is a progressive deterioration of hearing loss

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associated with aging and is the most common cause of adult auditory deficiency in the United States. 23% of the population between ages 65 and 75 years and 40% of the population older than 75 years are affected. Compelling evidence suggests that agingrelated diseases progress due to the accumulation of reactive oxygen species (ROS). ROS are primarily produced in vivo during mitochondrial respiration, the process that provides energy to cells. ROS cause damage to mitochondrial DNA (mtDNA), resulting in the production of specific mtDNA deletions and mutations; these produce bioenergetically deficient cells. Ultimately, this persistent attack of ROS on mitochondrial and cellular structures results in cell death, tissue damage and hearing loss. Isolated grape constituents such as resveratrol, catechins and flavanols are noted for their antioxidant and anti-inflammatory properties and their potential for preventing cancer and heart disease. Resveratrol is 20 times more potent than Vitamin C and has been found to be more effective at preventing oxidative DNA damage than any other antioxidant. By decreasing the activity of Complex 3 of mitochondrial oxidative phosphorylation chain, it opposes the production of ROS and scavenges them. This protects against age-related nerve changes. Preliminary studies conducted in our laboratory have shown that resveratrol protects against noise-induced hearing loss as well. This project will study the effects of resveratrol on mitochondrial and auditory functions. We hypothesize that aged animals that have been treated with resveratrol will have improved auditory sensitivity and mitochondrial function and reduced inner ear hair cell loss compared to control animals. The differences in auditory sensitivity will be studied by auditory brainstem response measurements. The differences in mitochondrial function will be studied by measuring the mitochondrial membrane potentials, mitochondrial respiratory enzyme level (complex 1) and mtDNA deletions. We will also study the expression of 5-lipoxygenase, cyclooxygenase 1 and 2 as indirect measures of ROS generation. These studies will provide the foundation for developing clinical studies to investigate the use of antioxidants and mitochondrial-function enhancing nutritional supplements to attenuate auditory deterioration in patients with presbyacusis. Furthermore, these data will provide novel strategies to impart greater wellness in the elderly population and perhaps have a positive effect on health care expenses. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: THE EFFICACY OF GROUP AURAL REHABILITATION PROGRAM Principal Investigator & Institution: Preminger, Jill E.; Surgery; University of Louisville University of Louisville Louisville, Ky 40292 Timing: Fiscal Year 2003; Project Start 01-JUN-2003; Project End 31-MAY-2006 Summary: (provided by applicant): The proposed research will examine the efficacy of adult group aural rehabilitation training, for adults with hearing loss, offered in a classroom environment. Group aural rehabilitation classes may include training in speech reading, auditory perception, and communication strategies. Group classes offer an opportunity to teach general information about hearing loss and provide a forum in which adults with hearing loss can share information and emotional support. It is not known if group training in speech reading, auditory perception, and/or communication strategies will lead to improved performance. It is not clear what component or components of the group aural rehabilitation class specifically lead to reduced hearing handicap. In Experiment 1, 48 adults with hearing loss will participate in a 6-week group aural rehabilitation class in which the content is limited to speech reading and auditory perception exercises. Half of the subjects will attend classes that encourage group interaction; the other half will attend classes that provide no opportunity for

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interaction. The results of Experiment 1 will determine: 1) whether listeners with hearing loss who receive speech reading and auditory perception training over a 6week period actually improve these abilities as measured by tests of visual and auditory speech perception; and 2) whether group interaction within an aural rehabilitation class effects hearing handicap. In Experiment 2, 48 new subjects will participate in 3 types of group classes: 1) training in communication strategies with limited group interaction; 2) training in communication strategies with time devoted to group interaction; and 3) no training, lectures only class with time devoted to group interaction. This data will be analyzed with the data from Experiment 1. The results of Experiment 2 will determine which aspect(s) of group aural rehabilitation classes provide benefit. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: THE ROLE OF THE BRAIN IN HEARING Principal Investigator & Institution: Battat, Brenda; Self Help for Hard of Hearing People Hearing People, Inc. Bethesda, Md 20814 Timing: Fiscal Year 2001; Project Start 01-JAN-2001; Project End 31-DEC-2001 Summary: Hard of hearing consumers, even members of consumer organizations like SHHH, have little opportunity to interact with scientists conducting contemporary research. A conference grant award was made by NIH to support the 1996 and 1999 SHHH research symposia on hearing loss. The first such conference grant award to a consumer organization was to Johns Hopkins Center for Hearing and Balance in 1994 with a research topic of "New Discoveries, New Solutions" presented at the SHHH Orlando Convention and Symposium. This has proven to be a unique opportunity for both consumers and participating scientists to better understand the others' interests. Such interactions help shape future research in positive ways and assist consumers in better understanding how recent and ongoing science research has, or will, benefit them. The latest NIH conference grant award is for the 2000 SHHH Convention in St. Paul, Minnesota for a planned symposium on "Interventions for the Treatment of Acquired Hearing Loss." This proposal seeks funding to conduct a one-day symposium for consumers on another topic of critical concern to hard of hearing consumers, that of the brain and hearing. The symposium will be convened at the time of the 16th Interventional convention of Self Help for Hard of Hearing People, Inc. (SHHH), on June 25, 20001 in Cherry Hill, New Jersey. Key topics to be addressed include the role of the auditory central nervous system in hearing, basic organization of the auditory system, sound representation in the auditory nerve, neural mechanisms of sound localization, auditory plasticity and functional imaging and auditory disorders. Products will include a brochure announcing the symposium for dissemination beyond SHHH members, open captioned videos, a proceedings document, and summary articles in hearing Loss: The Journal of Self Help for Hard of Hearing People. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: TRANSDUCTION MECHANISM OF HAIR CELLS Principal Investigator & Institution: Hudspeth, Albert J.; Professor; Lab/Sensory Neuroscience; Rockefeller University New York, Ny 100216399 Timing: Fiscal Year 2002; Project Start 01-JUL-1983; Project End 31-MAR-2007 Summary: Hair cells are the sensory receptors of the internal ear, where they underlie the responsiveness of both the auditory and the vestibular systems. Each hair cell is a mechanoreceptor that responds when a sound or an acceleration applies a force to its hair bundle, a cluster of a few dozen to a few hundred mechanically sensitive filaments

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protruding from the cell's top surface. Because most hearing loss and many forms of dysequilibrium result from damage to hair cells, the proposed experiments are meant to reveal more about how these cells perform their essential functions. First, a combination of electron-microscopic and biophysical experiments will be used to determine whether a hair cell adapts to a prolonged stimulus by physically resetting the molecular apparatus in its hair bundle. The proposed experiments should show whether the myosin molecules thought to mediate adaptation occur at the appropriate sites and whether these molecules actually move as the hair cell adapts. A second set of experiments is meant to determine whether the hair bundle helps amplify the ear's mechanical inputs, thus augmenting the sensitivity of hearing and sharpening its frequency discrimination. In addition to providing information about the nature of the ear's amplificatory process, this investigation may indicate why hearing is vulnerable to overstimulation and whether the ear's amplifier can be protected from or regenerated after injury. In a final set of studies, genetic and molecular- biological techniques will be used to identify proteins essential to hearing and balance. More than a hundred genes are involved in heritable forms of deafness and vertigo, which affect one child in a thousand at birth and a similar proportion later in life. The zebrafish, a tractable model organism suitable for large-scale genetic analysis, will be used to identify novel genes and to determine the functions of recently discovered genes in the inner ear. After the corresponding human genes have been found, their roles in the ear and their possible involvement in human hearing loss and dysequilibrium will be examined. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: USHERIN: STRUCTURAL AND FUNCTIONAL ANALYSIS Principal Investigator & Institution: Cosgrove, Dominic E.; Staff Scientist Iii & Associate Professo; Father Flanagan's Boys' Home Boys Town, Ne 68010 Timing: Fiscal Year 2002; Project Start 01-SEP-2002; Project End 31-AUG-2007 Summary: (provided by applicant): Usher syndrome is the leading hereditary cause of combined deafness and blindness, accounting for over half of the 20,000 deaf and blind people in the United States. Of the 10 known genetic loci associated with Usher syndrome, Usher type Ha (USH2A) is the most common. People with USH2A have congenital high frequency sensorineural hearing loss associated with progressive retinitis pigmentosa. The gene responsible for USH2A has recently been identified, and shown to encode a novel protein. Conceptual translation of the USH2A gene predicted either an extracellular matrix protein or cell surface receptor. In the preliminary results section of this proposal we show that the USH2A protein, which we call usherin, is an abundant basement membrane protein with widespread, but not ubiquitous, tissue distribution. Usherin is very abundant in both cochlear and retinal basement membranes. Understanding how the usherin protein contributes to the structural architecture and the functional dynamics of the basement membranes where it is found will help us decipher the mechanism of pathogenesis in people who lack this protein. The aims of this proposal are designed to identify the structural and functional properties of the usherin protein. Fusion peptides comprising the functional domains of the protein as well as an expressed full-length recombinant protein will be employed to identify what basement membrane proteins interact with usherin, and what domain(s) of the usherin molecule they interact with. We present data illustrating a type IV collagen/usherin interaction defined using this approach. We will employ immortomouse-derived strial marginal cells, retinal pigment epithelial (RPE) cells, and endothelial cells to define usherin/cell surface receptor interactions, and identify the specific receptors involved. Using this approach, we demonstrate domain-specific

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usherin receptor binding on RPE cells. Fusion peptides will be engineered that harbor amino acid substitutions resulting from missense mutations found in families with Usher syndrome type ila. These peptides will be employed in established competitive binding assays to determine the consequence of these mutations on usherin function. Combined, these studies will provide a basic understanding of how this new class of basement membrane protein contributes to the structural and functional properties of the basement membranes where it is found. Furthermore, these studies will provide a molecular basis for understanding the specific changes associated with USH2A pathology. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: VESTIBULAR EFFECTS OF INTRATYMPANIC GENTAMICIN Principal Investigator & Institution: Carey, John P.; Professor & Chief; Otolaryn & Head & Neck Surgery; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2001; Project Start 29-JAN-2001; Project End 31-DEC-2005 Summary: The goals of this project are: (1) to determine the minimum dose of intratympanic gentamicin necessary to control vertigo in unilateral Meniere's disease, and (2) to determine what effects this dose has on the structure and function of the vestibular organs of the inner ear. Multiple intratympanic injections, if spaced 1 week apart and halted at the first signs of loss of vestibular function, can control vertigo in >90% of patients with no greater hearing loss than the disease itself causes. We will conduct a clinical trial in which gentamicin will be given every 2 weeks until vertigo is controlled. We wish to determine if lower total doses can control vertigo yet preserve some vestibular function as measured by 3-dimensional vestibulo-ocular reflexes, vestibular-evoked myogenic potentials, subjective visual vertical, and caloric tests. By following patients for one year we can also determine if some vestibular function returns over time. We also want to know what these doses of gentamicin do to the vestibular part of the inner ear and the vestibular nerve afferents. Are all or most of the hair cells destroyed? Do the vestibular nerve afferents stop responding? Is there some return of some function over time? If so, why? Do hair cells recover, do afferents become more sensitive, or does the brain adjust its responses to make up for the peripheral loss. These questions will be answered in an animal model. The candidate has a background in vestibular physiology and now seeks a long-term career in academic otolaryngology, focusing physiologic principles on clinical vestibular problems. The short-term goals are to master the fundamentals of clinical trial design and analysis, 3D eye movements, and afferent neurophysiology. Johns Hopkins is uniquely suited to this training because it has a core group devoted to vestibular research, and the mentor's laboratory has successfully used all of the techniques required. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

E-Journals: PubMed Central3 PubMed Central (PMC) is a digital archive of life sciences journal literature developed and managed by the National Center for Biotechnology Information (NCBI) at the U.S. National

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Adapted from the National Library of Medicine: http://www.pubmedcentral.nih.gov/about/intro.html.

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Library of Medicine (NLM).4 Access to this growing archive of e-journals is free and unrestricted.5 To search, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Pmc, and type “hearing loss” (or synonyms) into the search box. This search gives you access to full-text articles. The following is a sample of items found for hearing loss in the PubMed Central database: •

A Human Mitochondrial GTP Binding Protein Related to tRNA Modification May Modulate Phenotypic Expression of the Deafness-Associated Mitochondrial 12S rRNA Mutation. by Li X, Guan MX.; 2002 Nov; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=135671

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A role for pneumolysin but not neuraminidase in the hearing loss and cochlear damage induced by experimental pneumococcal meningitis in guinea pigs. by Winter AJ, Comis SD, Osborne MP, Tarlow MJ, Stephen J, Andrew PW, Hill J, Mitchell TJ.; 1997 Nov; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=175634

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Bacterial Cytolysin Perturbs Round Window Membrane Permeability Barrier In Vivo: Possible Cause of Sensorineural Hearing Loss in Acute Otitis Media. by Engel F, Blatz R, Schliebs R, Palmer M, Bhakdi S.; 1998 Jan; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=107896

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Breakdown of the round window membrane permeability barrier evoked by streptolysin O: possible etiologic role in development of sensorineural hearing loss in acute otitis media. by Engel F, Blatz R, Kellner J, Palmer M, Weller U, Bhadki S.; 1995 Apr; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=173151

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Enteroviruses and sudden deafness. by Schattner A, Halperin D, Wolf D, Zimhony O.; 2003 May 27; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=155958

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From flies' eyes to our ears: Mutations in a human class III myosin cause progressive nonsyndromic hearing loss DFNB30. by Walsh T, Walsh V, Vreugde S, Hertzano R, Shahin H, Haika S, Lee MK, Kanaan M, King MC, Avraham KB.; 2002 May 28; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=124268

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Human deafness dystonia syndrome is a mitochondrial disease. by Koehler CM, Leuenberger D, Merchant S, Renold A, Junne T, Schatz G.; 1999 Mar 2; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=26750

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Identifying the genes of hearing, deafness, and dysequilibrium. by Corwin JT.; 1998 Oct 13; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=33905

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In vitro 3[prime prime or minute]-end endonucleolytic processing defect in a human mitochondrial tRNASer(UCN) precursor with the U7445C substitution, which causes non-syndromic deafness. by Levinger L, Jacobs O, James M.; 2001 Nov 1; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=60182

4 With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age. 5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse sources stored in a common format in a single repository. Many journals already have online publishing operations, and there is a growing tendency to publish material online only, to the exclusion of print.

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KCNQ4, a K + channel mutated in a form of dominant deafness, is expressed in the inner ear and the central auditory pathway. by Kharkovets T, Hardelin JP, Safieddine S, Schweizer M, El-Amraoui A, Petit C, Jentsch TJ.; 2000 Apr 11; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=18242

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Light eye colour linked to deafness after meningitis. by Cullington HE.; 2001 Mar 10; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=26552

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Mutant ion channel in cochlear hair cells causes deafness. by Trussell L.; 2000 Apr 11; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=33974

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Mutations in Mcoln3 associated with deafness and pigmentation defects in varitintwaddler (Va) mice. by Di Palma F, Belyantseva IA, Kim HJ, Vogt TF, Kachar B, NobenTrauth K.; 2002 Nov 12; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=137533

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NMR structure of the LCCL domain and implications for DFNA9 deafness disorder. by Liepinsh E, Trexler M, Kaikkonen A, Weigelt J, Banyai L, Patthy L, Otting G.; 2001 Oct 1; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=125649

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No Evidence of Measles Virus in Stapes Samples from Patients with Otosclerosis. by Grayeli AB, Palmer P, Tran Ba Huy P, Soudant J, Sterkers O, Lebon P, Ferrary E.; 2000 Jul; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=86990

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Patients affected with Fabry disease have an increased incidence of progressive hearing loss and sudden deafness: an investigation of twenty-two hemizygous male patients. by Germain DP, Avan P, Chassaing A, Bonfils P.; 2002; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=134464

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The Deafness-Associated Mitochondrial DNA Mutation at Position 7445, Which Affects tRNASer(UCN) Precursor Processing, Has Long-Range Effects on NADH Dehydrogenase Subunit ND6 Gene Expression. by Guan MX, Enriquez JA, FischelGhodsian N, Puranam RS, Lin CP, Maw MA, Attardi G.; 1998 Oct; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=109173

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The Gene for an Inherited Form of Deafness Maps to Chromosome 5q31. by Leon PE, Raventos H, Lynch E, Morrow J, King M.; 1992 Jun 1; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=49253

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Weather conditions and sudden sensorineural hearing loss. by Danielides V, Nousia CS, Bartzokas A, Lolis CJ, Kateri M, Skevas A.; 2002; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=117786

The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.6 6 PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.

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The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with hearing loss, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “hearing loss” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for hearing loss (hyperlinks lead to article summaries): •

A longitudinal study of the association between tooth loss and age-related hearing loss. Author(s): Lawrence HP, Garcia RI, Essick GK, Hawkins R, Krall EA, Spiro A 3rd, Vokonas PS, Kong L, King T, Koch GG. Source: Spec Care Dentist. 2001 July-August; 21(4): 129-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11669061&dopt=Abstract

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A major gene affecting age-related hearing loss in C57BL/6J mice. Author(s): Johnson KR, Erway LC, Cook SA, Willott JF, Zheng QY. Source: Hearing Research. 1997 December; 114(1-2): 83-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9447922&dopt=Abstract

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A new locus for non-syndromal, autosomal recessive, sensorineural hearing loss (DFNB16) maps to human chromosome 15q21-q22. Author(s): Campbell DA, McHale DP, Brown KA, Moynihan LM, Houseman M, Karbani G, Parry G, Janjua AH, Newton V, al-Gazali L, Markham AF, Lench NJ, Mueller RF. Source: Journal of Medical Genetics. 1997 December; 34(12): 1015-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9429146&dopt=Abstract

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A novel locus for autosomal dominant nonsyndromic hearing loss (DFNA44) maps to chromosome 3q28-29. Author(s): Modamio-Hoybjor S, Moreno-Pelayo MA, Mencia A, del Castillo I, Chardenoux S, Armenta D, Lathrop M, Petit C, Moreno F. Source: Human Genetics. 2003 January; 112(1): 24-8. Epub 2002 October 16. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12483295&dopt=Abstract

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A prospective case-controlled study of 197 men, 50-60 years old, selected at random from a population at risk from hyperlipidaemia to examine the relationship between hyperlipidaemia and sensorineural hearing loss. Author(s): Jones NS, Davis A. Source: Clinical Otolaryngology and Allied Sciences. 1999 September; 24(5): 449-56. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10542930&dopt=Abstract

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A review of cochlear implantation in mitochondrial sensorineural hearing loss. Author(s): Sinnathuray AR, Raut V, Awa A, Magee A, Toner JG. Source: Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 2003 May; 24(3): 418-26. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12806294&dopt=Abstract

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AAP issues screening recommendations to identify hearing loss in children. Author(s): Bush JS; AAP. Source: American Family Physician. 2003 June 1; 67(11): 2409-10, 2413. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12800974&dopt=Abstract

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Abnormal white matter lesions with sensorineural hearing loss caused by congenital cytomegalovirus infection: retrospective diagnosis by PCR using Guthrie cards. Author(s): Haginoya K, Ohura T, Kon K, Yagi T, Sawaishi Y, Ishii KK, Funato T, Higano S, Takahashi S, Iinuma K. Source: Brain & Development. 2002 October; 24(7): 710-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12427519&dopt=Abstract

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ACOEM evidence-based statement: noise-induced hearing loss. Author(s): ACOEM Noise and Hearing Conservation Committee. Source: Journal of Occupational and Environmental Medicine / American College of Occupational and Environmental Medicine. 2003 June; 45(6): 579-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12802210&dopt=Abstract

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Acoustic analysis of monophthong and diphthong production in acquired severe to profound hearing loss. Author(s): Palethorpe S, Watson CI, Barker R. Source: The Journal of the Acoustical Society of America. 2003 August; 114(2): 1055-68. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12942984&dopt=Abstract

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Acoustic neuroma in patients with completely resolved sudden hearing loss. Author(s): Nageris BI, Popovtzer A. Source: The Annals of Otology, Rhinology, and Laryngology. 2003 May; 112(5): 395-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12784975&dopt=Abstract

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Acyclovir in the treatment of idiopathic sudden sensorineural hearing loss. Author(s): Uri N, Doweck I, Cohen-Kerem R, Greenberg E. Source: Otolaryngology and Head and Neck Surgery. 2003 April; 128(4): 544-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12707659&dopt=Abstract

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Age-related hearing loss: a case for nursing intervention. Author(s): Tolson D. Source: Journal of Advanced Nursing. 1997 December; 26(6): 1150-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9429965&dopt=Abstract

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An anti-mumps IgM antibody level in the serum of idiopathic sudden sensorineural hearing loss. Author(s): Fukuda S, Chida E, Kuroda T, Kashiwamura M, Inuyama Y. Source: Auris, Nasus, Larynx. 2001 May; 28 Suppl: S3-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11683339&dopt=Abstract

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An unusual case of hearing loss and cerebellar pathology. Author(s): Joossens K, Demaerel P, Legius B. Source: Jbr-Btr. 2002 October-November; 85(5): 252-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12463501&dopt=Abstract

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Antibodies to HSP-70 in normal donors and autoimmune hearing loss patients. Author(s): Yeom K, Gray J, Nair TS, Arts HA, Telian SA, Disher MJ, El-Kashlan H, Sataloff RT, Fisher SG, Carey TE. Source: The Laryngoscope. 2003 October; 113(10): 1770-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14520104&dopt=Abstract

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Antioxidants in treatment of idiopathic sudden hearing loss. Author(s): Joachims HZ, Segal J, Golz A, Netzer A, Goldenberg D. Source: Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 2003 July; 24(4): 572-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12851547&dopt=Abstract

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Apparently new syndrome of sensorineural hearing loss, retinal pigment epithelium lesions, and discolored teeth. Author(s): Innis JW, Sieving PA, McMillan P, Weatherly RA. Source: American Journal of Medical Genetics. 1998 January 6; 75(1): 13-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9450850&dopt=Abstract

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Audiologic assessment of children with suspected hearing loss. Author(s): Johnson KC. Source: Otolaryngologic Clinics of North America. 2002 August; 35(4): 711-32. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12487077&dopt=Abstract

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Autoimmune sensorineural hearing loss: an immunologic perspective. Author(s): Solares CA, Hughes GB, Tuohy VK. Source: Journal of Neuroimmunology. 2003 May; 138(1-2): 1-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12742646&dopt=Abstract

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Beethoven, a mouse model for dominant, progressive hearing loss DFNA36. Author(s): Vreugde S, Erven A, Kros CJ, Marcotti W, Fuchs H, Kurima K, Wilcox ER, Friedman TB, Griffith AJ, Balling R, Hrabe De Angelis M, Avraham KB, Steel KP. Source: Nature Genetics. 2002 March; 30(3): 257-8. Epub 2002 February 19. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11850623&dopt=Abstract

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Benefits of early intervention for children with hearing loss. Author(s): Yoshinaga-Itano C. Source: Otolaryngologic Clinics of North America. 1999 December; 32(6): 1089-102. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10523454&dopt=Abstract

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Beyond hearing loss. Author(s): Madigan J. Source: Occup Health Saf. 1998 October; 67(10): 84-9. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9772755&dopt=Abstract

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Bilateral acoustic neurofibromatosis camouflaged by corticosteroid treatment of sudden sensorineural hearing loss. Author(s): Gaffney RJ, McShane DP. Source: Ir J Med Sci. 1996 July-September; 165(3): 151-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8824013&dopt=Abstract

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Bilateral evoked otoacoustic emissions in a child with bilateral profound hearing loss. Author(s): Laccourreye L, Francois M, Tran Ba Huy E, Narcy P. Source: The Annals of Otology, Rhinology, and Laryngology. 1996 April; 105(4): 286-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8604890&dopt=Abstract

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Bilateral hearing loss due to viral infection. Author(s): Fuse T, Inamura H, Nakamura T, Suzuki T, Aoyagi M. Source: Orl; Journal for Oto-Rhino-Laryngology and Its Related Specialties. 1996 MayJune; 58(3): 175-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8797224&dopt=Abstract

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Bilateral hearing loss during vincristine therapy: a case report. Author(s): Kalcioglu MT, Kuku I, Kaya E, Oncel S, Aydogdu I. Source: Journal of Chemotherapy (Florence, Italy). 2003 June; 15(3): 290-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12868558&dopt=Abstract

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Bilateral otoacoustic emissions pass in a baby with Mondini deformity and subsequently confirmed profound bilateral hearing loss. Author(s): Cullington HE, Brown EJ. Source: British Journal of Audiology. 1998 August; 32(4): 249-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9923986&dopt=Abstract

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Bilateral petrous internal carotid artery pseudoaneurysms presenting with sensorineural hearing loss. Author(s): Hwang CJ, Moonis G, Hurst RW, Hockstein N, Bigelow D. Source: Ajnr. American Journal of Neuroradiology. 2003 June-July; 24(6): 1139-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12812941&dopt=Abstract

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Bilateral sensorineural hearing loss and spastic paraparesis in Lyme disease. Author(s): Bertholon P, Damon G, Antoine J, Richard O, Aubert G, Icunnoamlak Z, Martin C. Source: Otolaryngology and Head and Neck Surgery. 2000 March; 122(3): 458-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10699828&dopt=Abstract

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Bilateral sensorineural hearing loss complicating basal skull fracture. Author(s): Atkin G, Watkins L, Rich P. Source: British Journal of Neurosurgery. 2002 December; 16(6): 597-600. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12617244&dopt=Abstract

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Bilateral sudden sensorineural hearing loss caused by Charcot-Marie-Tooth disease. Author(s): Papadakis CE, Hajiioannou JK, Kyrmizakis DE, Bizakis JG. Source: The Journal of Laryngology and Otology. 2003 May; 117(5): 399-401. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12803792&dopt=Abstract

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Bilateral sudden sensorineural hearing loss following non-otologic surgery. Author(s): Gordon AG. Source: The Journal of Laryngology and Otology. 1999 June; 113(6): 610-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10605599&dopt=Abstract

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Bilateral sudden sensorineural hearing loss following non-otologic surgery. Author(s): de la Cruz M, Bance M. Source: The Journal of Laryngology and Otology. 1998 August; 112(8): 769-71. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9850320&dopt=Abstract

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Bilateral transient hearing loss associated with vincristine therapy: case report. Author(s): Aydogdu I, Ozturan O, Kuku I, Kaya E, Sevinc A, Yildiz R. Source: Journal of Chemotherapy (Florence, Italy). 2000 December; 12(6): 530-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11154039&dopt=Abstract

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Bilaterally preserved otoacoustic emissions in four children with profound idiopathic unilateral sensorineural hearing loss. Author(s): Konradsson KS. Source: Audiology : Official Organ of the International Society of Audiology. 1996 JulyAugust; 35(4): 217-27. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8879449&dopt=Abstract

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Biochemistry and pharmacology of aminoglycoside-induced hearing loss. Author(s): Schacht J. Source: Acta Physiol Pharmacol Ther Latinoam. 1999; 49(4): 251-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10797868&dopt=Abstract

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Bioelectronic options for a totally implantable hearing device for partial and total hearing loss. Author(s): Maniglia AJ, Murray G, Arnold JE, Ko WH. Source: Otolaryngologic Clinics of North America. 2001 April; 34(2): 469-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11382582&dopt=Abstract

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Box and whisker plots for graphic presentation of audiometric results of conductive hearing loss treatment. Author(s): Govaerts PJ, Somers T, Offeciers FE. Source: Otolaryngology and Head and Neck Surgery. 1998 June; 118(6): 892-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9627261&dopt=Abstract

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British-Polish symposium on noise induced hearing loss. November 20-22 1997, Slok n/Lodz, Poland. Author(s): Prasher D, Sulkowski W. Source: International Journal of Occupational Medicine and Environmental Health. 1997; 10(4): 467-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9575671&dopt=Abstract

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Can permanent sensorineural hearing loss be caused by sleeping with an ear against a train window? Author(s): Robertson A, Bingham B, McIlwraith G. Source: The Journal of Laryngology and Otology. 2002 September; 116(9): 695-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12437803&dopt=Abstract

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Capability of serum to convert streptomycin to cytotoxin in patients with aminoglycoside-induced hearing loss. Author(s): Wang S, Bian Q, Liu Z, Feng Y, Lian N, Chen H, Hu C, Dong Y, Cai Z. Source: Hearing Research. 1999 November; 137(1-2): 1-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10545628&dopt=Abstract

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Carbon monoxide poisoning and sensorineural hearing loss. Author(s): Shahbaz Hassan M, Ray J, Wilson F. Source: The Journal of Laryngology and Otology. 2003 February; 117(2): 134-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12625889&dopt=Abstract

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Cataract and hearing loss in a population-based study: the Beaver Dam studies. Author(s): Klein BE, Cruickshanks KJ, Nondahl DM, Klein R, Dalton DS. Source: American Journal of Ophthalmology. 2001 October; 132(4): 537-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11589876&dopt=Abstract

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Central hearing loss with a bilateral inferior colliculus lesion. Author(s): Hoistad DL, Hain TC. Source: Audiology & Neuro-Otology. 2003 March-April; 8(2): 111-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12634459&dopt=Abstract

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Cerebellar arteriovenous malformation with facial paralysis, hearing loss, and tinnitus: a case report. Author(s): Kikuchi M, Funabiki K, Hasebe S, Takahashi H. Source: Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 2002 September; 23(5): 723-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12218626&dopt=Abstract

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Cigarette smoking and hearing loss: lessons from the young adult periodic examinations in Israel (YAPEIS) database. Author(s): Sharabi Y, Reshef-Haran I, Burstein M, Eldad A. Source: Isr Med Assoc J. 2002 December; 4(12): 1118-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12516904&dopt=Abstract

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Clinical associations of serum antiendothelial cell antibodies in patients with sudden sensorineural hearing loss. Author(s): Cadoni G, Agostino S, Manna R, De Santis A, Fetoni AR, Vulpiani P, Ottaviani F. Source: The Laryngoscope. 2003 May; 113(5): 797-801. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12792313&dopt=Abstract

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Cochlear implantation for progressive hearing loss. Author(s): Gray RF, Jones SE, Court I. Source: Archives of Disease in Childhood. 2003 August; 88(8): 708-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12876170&dopt=Abstract

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Combined effect of smoking and occupational exposure to noise on hearing loss in steel factory workers. Author(s): Mizoue T, Miyamoto T, Shimizu T. Source: Occupational and Environmental Medicine. 2003 January; 60(1): 56-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12499458&dopt=Abstract

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Comments about the value of vestibular testing in young children with sensorineural hearing loss. Author(s): Telian SA. Source: Archives of Otolaryngology--Head & Neck Surgery. 2003 April; 129(4): 483-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12707201&dopt=Abstract

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Comparison of speech perception performance in children using a cochlear implant with children using conventional hearing aids, based on the concept of “equivalent hearing loss”. Author(s): Vermeulen AM, Snik AF, Brokx JP, van den Broek P, Geelen CP, Beijk CM. Source: Scand Audiol Suppl. 1997; 47: 55-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9428046&dopt=Abstract

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Complete senorineural hearing loss as an initial presentation of leukemia. Author(s): Shaar GS, Singletary EM. Source: The American Journal of Emergency Medicine. 1999 October; 17(6): 625-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10530555&dopt=Abstract

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Conductive hearing loss in osteopathia striata-cranial sclerosis. Author(s): Berenholz L, Lippy W, Harrell M. Source: Otolaryngology and Head and Neck Surgery. 2002 July; 127(1): 124-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12161743&dopt=Abstract

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Conductive hearing loss: investigation of possible inner ear origin in three cases studies. Author(s): Al Muhaimeed H, El Sayed Y, Rabah A, Al-Essa A. Source: The Journal of Laryngology and Otology. 2002 November; 116(11): 942-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12487675&dopt=Abstract

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Condylar osteochondroma with complete hearing loss: report of a case. Author(s): Seki H, Fukuda M, Takahashi T, Iino M. Source: Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons. 2003 January; 61(1): 131-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12524621&dopt=Abstract

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Congenital conductive hearing loss in dyschondrosteosis. Author(s): De Leenheer EM, Oudesluijs GG, Kuijpers-Jagtman AM, Rappold GA, Sengers RC, Cremers CW. Source: The Annals of Otology, Rhinology, and Laryngology. 2003 February; 112(2): 1538. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12597288&dopt=Abstract

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Connexin 26 mutations: the first practical genetic marker of inherited hearing loss. Author(s): Perry CF. Source: The Medical Journal of Australia. 2001 August 20; 175(4): 182-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11587274&dopt=Abstract

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Contribution of connexin26 (GJB2) mutations and founder effect to non-syndromic hearing loss in India. Author(s): RamShankar M, Girirajan S, Dagan O, Ravi Shankar HM, Jalvi R, Rangasayee R, Avraham KB, Anand A. Source: Journal of Medical Genetics. 2003 May; 40(5): E68. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12746422&dopt=Abstract

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Couple dynamics and attributions when one partner has an acquired hearing loss: implications for couple therapy. Author(s): Piercy SK, Piercy FP. Source: J Marital Fam Ther. 2002 July; 28(3): 315-26. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12197154&dopt=Abstract

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Deafness genes for nonsyndromic hearing loss and current studies in China. Author(s): Xiao Z, Xie D. Source: Chinese Medical Journal. 2002 July; 115(7): 1078-81. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12173596&dopt=Abstract

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Defibrinogenation therapy for idiopathic sudden sensorineural hearing loss in comparison with high-dose steroid therapy. Author(s): Suzuki H, Furukawa M, Kumagai M, Takahashi E, Matsuura K, Katori Y, Shimomura A, Kobayashi T. Source: Acta Oto-Laryngologica. 2003 January; 123(1): 46-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12625572&dopt=Abstract

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Deficiency in plasma membrane calcium ATPase isoform 2 increases susceptibility to noise-induced hearing loss in mice. Author(s): Kozel PJ, Davis RR, Krieg EF, Shull GE, Erway LC. Source: Hearing Research. 2002 February; 164(1-2): 231-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11950541&dopt=Abstract

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Dehiscence of bone overlying the superior canal as a cause of apparent conductive hearing loss. Author(s): Minor LB, Carey JP, Cremer PD, Lustig LR, Streubel SO, Ruckenstein MJ. Source: Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 2003 March; 24(2): 270-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12621343&dopt=Abstract

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Detection of human cytomegalovirus DNA in perilymph of patients with sensorineural hearing loss using real-time PCR. Author(s): Sugiura S, Yoshikawa T, Nishiyama Y, Morishita Y, Sato E, Hattori T, Nakashima T. Source: Journal of Medical Virology. 2003 January; 69(1): 72-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12436480&dopt=Abstract

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Development of autoimmune sensorineural hearing loss after endolymphatic sac decompression: two case reports. Author(s): Ochoa VM, Weider DJ. Source: Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 2003 March; 24(2): 279-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12621344&dopt=Abstract

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Developmental outcomes of children with hearing loss born in Colorado hospitals with and without universal newborn hearing screening programs. Author(s): Yoshinaga-Itano C, Coulter D, Thomson V. Source: Seminars in Neonatology : Sn. 2001 December; 6(6): 521-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12014893&dopt=Abstract

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DFNB31, a recessive form of sensorineural hearing loss, maps to chromosome 9q3234. Author(s): Mustapha M, Chouery E, Chardenoux S, Naboulsi M, Paronnaud J, Lemainque A, Megarbane A, Loiselet J, Weil D, Lathrop M, Petit C. Source: European Journal of Human Genetics : Ejhg. 2002 March; 10(3): 210-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11973626&dopt=Abstract

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Diagnosis and treatment of sudden-onset sensorineural hearing loss: a study of 51 patients. Author(s): Zadeh MH, Storper IS, Spitzer JB. Source: Otolaryngology and Head and Neck Surgery. 2003 January; 128(1): 92-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12574765&dopt=Abstract

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Diagnosis of neurofibromatosis type 2 in a patient with long-standing bilateral sensorineural hearing loss. Author(s): Sobol SE, Rappaport JM, Al-Abdulhadi K, Mohr G. Source: The Journal of Otolaryngology. 2001 December; 30(6): 368-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11771012&dopt=Abstract

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Diagnostic utility of laser-Doppler vibrometry in conductive hearing loss with normal tympanic membrane. Author(s): Rosowski JJ, Mehta RP, Merchant SN. Source: Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 2003 March; 24(2): 165-75. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12621328&dopt=Abstract

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Differential diagnosis and treatment of hearing loss. Author(s): Isaacson JE, Vora NM. Source: American Family Physician. 2003 September 15; 68(6): 1125-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14524400&dopt=Abstract

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Differential diagnosis of occupational hearing loss. Author(s): Sataloff RT, Sataloff J. Source: Occup Health Saf. 2001 September; 70(9): 126-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11582684&dopt=Abstract

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Diphtheria and hearing loss. Author(s): Schubert CR, Cruickshanks KJ, Wiley TL, Klein R, Klein BE, Tweed TS. Source: Public Health Reports (Washington, D.C. : 1974). 2001 July-August; 116(4): 362-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12037265&dopt=Abstract

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Distal renal tubular acidosis associated with isolated large vestibular aqueduct and sensorineural hearing loss. Author(s): Berrettini S, Forli F, Franceschini SS, Ravecca F, Massimetti M, Neri E. Source: The Annals of Otology, Rhinology, and Laryngology. 2002 May; 111(5 Pt 1): 38591. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12018321&dopt=Abstract

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Distribution of risk factors for hearing loss: implications for evaluating risk of occupational noise-induced hearing loss. Author(s): Prince MM. Source: The Journal of the Acoustical Society of America. 2002 August; 112(2): 557-67. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12186037&dopt=Abstract

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Do not overlook Pendred's syndrome in children with sensorineural hearing loss. Author(s): Caksen H, Kurtoglu S, Yuksel S, Ciftci A, Kendirci M. Source: Ear, Nose, & Throat Journal. 2001 October; 80(10): 760. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11605577&dopt=Abstract

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Does hearing loss after spinal anesthesia differ between young and elderly patients? Author(s): Gultekin S, Ozcan S. Source: Anesthesia and Analgesia. 2002 May; 94(5): 1318-20, Table of Contents. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11973212&dopt=Abstract

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Does spinal anesthesia cause hearing loss in the obstetric population? Author(s): Finegold H, Mandell G, Vallejo M, Ramanathan S. Source: Anesthesia and Analgesia. 2002 July; 95(1): 198-203, Table of Contents. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12088968&dopt=Abstract

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Dynamics of sensorineural hearing loss after head trauma. Author(s): Segal S, Eviatar E, Berenholz L, Kessler A, Shlamkovitch N. Source: Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 2002 May; 23(3): 312-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11981387&dopt=Abstract

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Ear-canal acoustic admittance and reflectance measurements in human neonates. II. Predictions of middle-ear in dysfunction and sensorineural hearing loss. Author(s): Keefe DH, Gorga MP, Neely ST, Zhao F, Vohr BR. Source: The Journal of the Acoustical Society of America. 2003 January; 113(1): 407-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12558278&dopt=Abstract

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Early childhood hearing loss: a frequently overlooked cause of speech and language delay. Author(s): Holte L. Source: Pediatric Annals. 2003 July; 32(7): 461-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12891763&dopt=Abstract

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Early-onset sensorineural hearing loss in a child with Turner syndrome. Author(s): Roush J, Davenport ML, Carlson-Smith C. Source: Journal of the American Academy of Audiology. 2000 September; 11(8): 446-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11012240&dopt=Abstract

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Effect of carbogen inhalation on peripheral tissue perfusion and oxygenation in patients suffering from sudden hearing loss. Author(s): Kallinen J, Kuttila K, Aitasalo K, Grenman R. Source: The Annals of Otology, Rhinology, and Laryngology. 1999 October; 108(10): 9447. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10526848&dopt=Abstract

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Effect of prostaglandin E1 on idiopathic sudden sensorineural hearing loss: a doubleblinded clinical study. Author(s): Ogawa K, Takei S, Inoue Y, Kanzaki J. Source: Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 2002 September; 23(5): 665-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12218617&dopt=Abstract

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Effect of single-drug treatment on idiopathic sudden sensorineural hearing loss. Author(s): Kanzaki J, Inoue Y, Ogawa K, Fukuda S, Fukushima K, Gyo K, Yanagihara N, Hoshino T, Ishitoya J, Toriyama M, Kitamura K, Murai K, Nakashima T, Niwa H, Nomura Y, Kobayashi H, Oda M, Okamoto M, Shitara T, Sakagami M, Tono T, Usami S. Source: Auris, Nasus, Larynx. 2003 May; 30(2): 123-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12753981&dopt=Abstract

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Effectiveness of treatment for sudden sensorineural hearing loss. Author(s): Eisenman D, Arts HA. Source: Archives of Otolaryngology--Head & Neck Surgery. 2000 September; 126(9): 1161-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10979137&dopt=Abstract

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Effects of age and age-related hearing loss on the neural representation of speech cues. Author(s): Tremblay KL, Piskosz M, Souza P. Source: Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology. 2003 July; 114(7): 1332-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12842732&dopt=Abstract

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Effects of hearing loss on echo thresholds. Author(s): Roberts RA, Besing J, Koehnke J. Source: Ear and Hearing. 2002 August; 23(4): 349-57. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12195177&dopt=Abstract

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Effects of sensorineural hearing loss on cortical event-related potential and behavioral measures of speech-sound processing. Author(s): Oates PA, Kurtzberg D, Stapells DR. Source: Ear and Hearing. 2002 October; 23(5): 399-415. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12411773&dopt=Abstract

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Electric-acoustic stimulation of the auditory system. New technology for severe hearing loss. Author(s): von Ilberg C, Kiefer J, Tillein J, Pfenningdorff T, Hartmann R, Sturzebecher E, Klinke R. Source: Orl; Journal for Oto-Rhino-Laryngology and Its Related Specialties. 1999 November-December; 61(6): 334-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10545807&dopt=Abstract

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Enhanced frequency discrimination near the hearing loss cut-off: a consequence of central auditory plasticity induced by cochlear damage? Author(s): Thai-Van H, Micheyl C, Moore BC, Collet L. Source: Brain; a Journal of Neurology. 2003 October; 126(Pt 10): 2235-45. Epub 2003 July 07. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12847078&dopt=Abstract

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Epidemiology of early hearing loss detection in Hawaii. Author(s): Prince CB, Miyashiro L, Weirather Y, Heu P. Source: Pediatrics. 2003 May; 111(5 Part 2): 1202-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12728139&dopt=Abstract

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Etiology of syndromic and nonsyndromic sensorineural hearing loss. Author(s): Gurtler N, Lalwani AK. Source: Otolaryngologic Clinics of North America. 2002 August; 35(4): 891-908. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12487088&dopt=Abstract

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Evaluation of childhood sensorineural hearing loss in the post-genome world. Author(s): Lalwani AK. Source: Archives of Otolaryngology--Head & Neck Surgery. 2002 January; 128(1): 88-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11784265&dopt=Abstract

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Evaluation of the effect of speech-rate slowing on speech intelligibility in noise using a simulation of cochlear hearing loss. Author(s): Nejime Y, Moore BC. Source: The Journal of the Acoustical Society of America. 1998 January; 103(1): 572-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9440342&dopt=Abstract

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Evaluation of the incidence of sensorineural hearing loss in beta-thalassemia major patients under regular chelation therapy with desferrioxamine. Author(s): Karimi M, Asadi-Pooya AA, Khademi B, Asadi-Pooya K, Yarmohammadi H. Source: Acta Haematologica. 2002; 108(2): 79-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12187025&dopt=Abstract

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Evaluation of the risk of noise-induced hearing loss among unscreened male industrial workers. Author(s): Prince MM, Gilbert SJ, Smith RJ, Stayner LT. Source: The Journal of the Acoustical Society of America. 2003 February; 113(2): 871-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12597181&dopt=Abstract

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Evidence in support of a different model of universal newborn hearing loss identification. Author(s): Kileny PR, Lesperance MM. Source: American Journal of Audiology. 2001 December; 10(2): 65-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11808722&dopt=Abstract

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Evidence of acclimatization in persons with severe-to-profound hearing loss. Author(s): Kuk FK, Potts L, Valente M, Lee L, Picirrillo J. Source: Journal of the American Academy of Audiology. 2003; 14(2): 84-99. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12830844&dopt=Abstract

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Factitious hearing loss and otorrhea in an adolescent boy. Author(s): Kelly RH, Kelly CM, Busis SN. Source: Clinica Chimica Acta; International Journal of Clinical Chemistry. 2000 September; 299(1-2): 205-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10900306&dopt=Abstract

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Factors associated with hearing loss among workers of the airline industry in Korea. Author(s): Hong OS, Kim MJ. Source: Orl Head Neck Nurs. 2001 Winter; 19(1): 7-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12024523&dopt=Abstract

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Familial Axenfeld-Rieger anomaly, atrial septal defect, and sensorineural hearing loss: a possible new genetic syndrome. Author(s): Cunningham ET Jr, Eliott D, Miller NR, Maumenee IH, Green WR. Source: Archives of Ophthalmology. 1998 January; 116(1): 78-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9445211&dopt=Abstract

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Familial Axenfeld-Rieger anomaly, cardiac malformations, and sensorineural hearing loss: a provisionally unique genetic syndrome? Author(s): Grosso S, Farnetani MA, Berardi R, Vivarelli R, Vanni M, Morgese G, Balestri P. Source: American Journal of Medical Genetics. 2002 August 1; 111(2): 182-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12210347&dopt=Abstract

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Family with low-grade neuroendocrine carcinoma of salivary glands, severe sensorineural hearing loss, and enamel hypoplasia. Author(s): Michaels L, Lee K, Manuja SL, Soucek SO. Source: American Journal of Medical Genetics. 1999 March 19; 83(3): 183-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10096593&dopt=Abstract

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Fibrinogen and LDL apheresis in treatment of sudden hearing loss: a randomised multicentre trial. Author(s): Suckfull M; Hearing Loss Study Group. Source: Lancet. 2002 December 7; 360(9348): 1811-7. Erratum In: Lancet. 2003 May 31; 361(9372): 1916. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12480357&dopt=Abstract

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First audiometric results with the Vibrant soundbridge, a semi-implantable hearing device for sensorineural hearing loss. Author(s): Snik AF, Cremers CW. Source: Audiology : Official Organ of the International Society of Audiology. 1999 November-December; 38(6): 335-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10582535&dopt=Abstract

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Fluctuant, progressive hearing loss associated with Meniere like vertigo in three patients with the Pendred syndrome. Author(s): Stinckens C, Huygen PL, Joosten FB, Van Camp G, Otten B, Cremers CW. Source: International Journal of Pediatric Otorhinolaryngology. 2001 December 1; 61(3): 207-15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11700190&dopt=Abstract

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Fluctuating sensorineural hearing loss associated with the menstrual cycle. Author(s): Souaid JP, Rappaport JM. Source: The Journal of Otolaryngology. 2001 August; 30(4): 246-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11771038&dopt=Abstract

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Fluctuating sensorineural hearing loss in children. Author(s): Brookhouser PE. Source: Otolaryngologic Clinics of North America. 2002 August; 35(4): 909-23, Ix. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12487089&dopt=Abstract

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Focus on hearing, head & face protection. The many faces of hearing loss prevention. Author(s): Hager L. Source: Occup Health Saf. 2001 March; 70(3): 80-2, 93. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11268804&dopt=Abstract

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Forward- and simultaneous-masked thresholds in bandlimited maskers in subjects with normal hearing and cochlear hearing loss. Author(s): Dubno JR, Ahlstrom JB. Source: The Journal of the Acoustical Society of America. 2001 August; 110(2): 1049-57. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11519573&dopt=Abstract

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Frequency and clinical features of patients with sensorineural hearing loss associated with the A3243G mutation of the mitochondrial DNA in otorhinolaryngic clinics. Author(s): Nagata H, Kumahara K, Tomemori T, Arimoto Y, Isoyama K, Yoshida K, Konno A. Source: Journal of Human Genetics. 2001; 46(10): 595-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11587074&dopt=Abstract

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Frequency of cochlear enhancement on magnetic resonance imaging in patients with autoimmune sensorineural hearing loss. Author(s): Zavod MB, Sataloff RT, Rao VM. Source: Archives of Otolaryngology--Head & Neck Surgery. 2000 August; 126(8): 969-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10922229&dopt=Abstract

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Frequency-specific information from click evoked otoacoustic emissions in noiseinduced hearing loss. Author(s): Tognola G, Grandori F, Avan P, Ravazzani P, Bonfils P. Source: Audiology : Official Organ of the International Society of Audiology. 1999 September-October; 38(5): 243-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10548370&dopt=Abstract

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Functional differences of the PDS gene product are associated with phenotypic variation in patients with Pendred syndrome and non-syndromic hearing loss (DFNB4). Author(s): Scott DA, Wang R, Kreman TM, Andrews M, McDonald JM, Bishop JR, Smith RJ, Karniski LP, Sheffield VC. Source: Human Molecular Genetics. 2000 July 1; 9(11): 1709-15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10861298&dopt=Abstract

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Functional gain of already implanted hearing devices in patients with sensorineural hearing loss of varied origin and extent: Berlin experience. Author(s): Junker R, Gross M, Todt I, Ernst A. Source: Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 2002 July; 23(4): 452-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12170144&dopt=Abstract

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Functional study of GJB2 in hereditary hearing loss. Author(s): Choung YH, Moon SK, Park HJ. Source: The Laryngoscope. 2002 September; 112(9): 1667-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12352684&dopt=Abstract

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Further evaluation of a model of loudness perception applied to cochlear hearing loss. Author(s): Moore BC, Glasberg BR, Vickers DA. Source: The Journal of the Acoustical Society of America. 1999 August; 106(2): 898-907. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10462795&dopt=Abstract

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Further hearing loss during osteoporosis treatment with etidronate. Author(s): Yasil S, Comlekci A, Guneri A. Source: Postgraduate Medical Journal. 1998 June; 74(872): 363-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9799894&dopt=Abstract

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Gadolinium-enhanced MRI and sudden hearing loss. Author(s): Fitzgerald DC. Source: Archives of Otolaryngology--Head & Neck Surgery. 2001 March; 127(3): 340. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11255488&dopt=Abstract

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Gap duration discrimination in listeners with cochlear hearing loss: effects of gap and marker duration, frequency separation, and mode of presentation. Author(s): Grose JH, Hall JW 3rd, Buss E. Source: Journal of the Association for Research in Otolaryngology : Jaro. 2001 December; 2(4): 388-98. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11833611&dopt=Abstract

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Genes and syndromic hearing loss. Author(s): Keats BJ. Source: Journal of Communication Disorders. 2002 July-August; 35(4): 355-66. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12160354&dopt=Abstract

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Genetic analysis of the connexin-26 M34T variant: identification of genotype M34T/M34T segregating with mild-moderate non-syndromic sensorineural hearing loss. Author(s): Houseman MJ, Ellis LA, Pagnamenta A, Di WL, Rickard S, Osborn AH, Dahl HH, Taylor GR, Bitner-Glindzicz M, Reardon W, Mueller RF, Kelsell DP. Source: Journal of Medical Genetics. 2001 January; 38(1): 20-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11134236&dopt=Abstract

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Genetic causes of hearing loss. Author(s): Willems PJ. Source: The New England Journal of Medicine. 2000 April 13; 342(15): 1101-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10760311&dopt=Abstract

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Genetic features of hearing loss associated with ear anomalies: PDS and EYA1 mutation analysis. Author(s): Namba A, Abe S, Shinkawa H, Kimberling WJ, Usami SI. Source: Journal of Human Genetics. 2001; 46(9): 518-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11558900&dopt=Abstract

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Genetic hearing loss. Author(s): Keogh IJ, Godinho RN. Source: Ir Med J. 2002 January; 95(1): 5-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11928792&dopt=Abstract

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Genetic linkage analysis of a novel syndrome comprising North Carolina-like macular dystrophy and progressive sensorineural hearing loss. Author(s): Francis PJ, Johnson S, Edmunds B, Kelsell RE, Sheridan E, Garrett C, Holder GE, Hunt DM, Moore AT. Source: The British Journal of Ophthalmology. 2003 July; 87(7): 893-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12812894&dopt=Abstract

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Genetic modifiers of hereditary hearing loss. Author(s): Riazuddin S, Ahmed ZM, Friedman TB, Griffith AJ, Riazuddin S, Wilcox ER. Source: Advances in Oto-Rhino-Laryngology. 2002; 61: 224-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12408088&dopt=Abstract

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Genetic predisposition and sensorineural hearing loss following bacterial meningitis: is there a link? Author(s): Jayarajan V, Patton MA, Rajenderkumar D. Source: The Journal of Infection. 2002 April; 44(3): 210. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12099760&dopt=Abstract

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Genetic testing for hearing loss: different motivations for the same outcome. Author(s): Dagan O, Hochner H, Levi H, Raas-Rothschild A, Sagi M. Source: American Journal of Medical Genetics. 2002 November 22; 113(2): 137-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12407703&dopt=Abstract

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Genetics Evaluation Guidelines for the Etiologic Diagnosis of Congenital Hearing Loss. Genetic Evaluation of Congenital Hearing Loss Expert Panel. ACMG statement. Author(s): ACMG. Source: Genetics in Medicine : Official Journal of the American College of Medical Genetics. 2002 May-June; 4(3): 162-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12180152&dopt=Abstract

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Gentamicin perfusion vestibular response and hearing loss. Author(s): Light JP, Silverstein H, Jackson LE. Source: Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 2003 March; 24(2): 294-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12621347&dopt=Abstract

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Geriatric hearing loss. Understanding the causes and providing appropriate treatment. Author(s): Marcincuk MC, Roland PS. Source: Geriatrics. 2002 April; 57(4): 44, 48-50, 55-6 Passim. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11974390&dopt=Abstract

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German registry for hearing loss in children: results after 4 years. Author(s): Finckh-Kramer U, Spormann-Lagodzinski M, Gross M. Source: International Journal of Pediatric Otorhinolaryngology. 2000 December 1; 56(2): 113-27. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11115684&dopt=Abstract

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Girl with accelerated growth, hearing loss, inner ear anomalies, delayed myelination of the brain, and del(22)(q13.1q13.2). Author(s): Fujita Y, Mochizuki D, Mori Y, Nakamoto N, Kobayashi M, Omi K, Kodama H, Yanagawa Y, Abe T, Tsuzuku T, Yamanouchi Y, Takano T. Source: American Journal of Medical Genetics. 2000 May 29; 92(3): 195-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10817654&dopt=Abstract

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GJB2 (connexin 26) variants and nonsyndromic sensorineural hearing loss: a HuGE review. Author(s): Kenneson A, Van Naarden Braun K, Boyle C. Source: Genetics in Medicine : Official Journal of the American College of Medical Genetics. 2002 July-August; 4(4): 258-74. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12172392&dopt=Abstract

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GJB2 mutations in Iranians with autosomal recessive non-syndromic sensorineural hearing loss. Author(s): Najmabadi H, Cucci RA, Sahebjam S, Kouchakian N, Farhadi M, Kahrizi K, Arzhangi S, Daneshmandan N, Javan K, Smith RJ. Source: Human Mutation. 2002 May; 19(5): 572. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11968091&dopt=Abstract

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Global problem of drug-induced hearing loss. Author(s): Arslan E, Orzan E, Santarelli R. Source: Annals of the New York Academy of Sciences. 1999 November 28; 884: 1-14. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10842579&dopt=Abstract

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Guidelines on the diagnosis of noise-induced hearing loss for medicolegal purposes. Author(s): Coles RR, Lutman ME, Buffin JT. Source: Clinical Otolaryngology and Allied Sciences. 2000 August; 25(4): 264-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10971532&dopt=Abstract

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Healthy-side dominance of cortical neuromagnetic responses in sudden hearing loss. Author(s): Po-Hung Li L, Shiao AS, Lin YY, Chen LF, Niddam DM, Chang SY, Lien CF, Chou NS, Ho LT, Hsieh JC. Source: Annals of Neurology. 2003 June; 53(6): 810-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12783431&dopt=Abstract

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Hearing loss after continuous or single-shot spinal anesthesia. Author(s): Lamberg T, Pitkanen MT, Marttila T, Rosenberg PH. Source: Reg Anesth. 1997 November-December; 22(6): 539-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9425970&dopt=Abstract

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Hearing loss among workers at an oil refinery in Taiwan. Author(s): Chen JD, Tsai JY. Source: Archives of Environmental Health. 2003 January; 58(1): 55-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12747520&dopt=Abstract

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Hearing loss among workers exposed to moderate concentrations of solvents. Author(s): Sliwinska-Kowalska M, Zamyslowska-Szmytke E, Szymczak W, Kotylo P, Fiszer M, Dudarewicz A, Wesolowski W, Pawlaczyk-Luszczynska M, Stolarek R. Source: Scand J Work Environ Health. 2001 October; 27(5): 335-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11712614&dopt=Abstract

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Hearing loss and changes in transient evoked otoacoustic emissions after gamma knife radiosurgery for acoustic neurinomas. Author(s): Ottaviani F, Neglia CB, Ventrella L, Giugni E, Motti E. Source: Archives of Otolaryngology--Head & Neck Surgery. 2002 November; 128(11): 1308-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12431177&dopt=Abstract

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Hearing loss and growth rate of acoustic neuromas in follow-up observation policy. Author(s): Sakamoto T, Fukuda S, Inuyama Y. Source: Auris, Nasus, Larynx. 2001 May; 28 Suppl: S23-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11683337&dopt=Abstract

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Hearing loss- and hearing aid-related stigma: perceptions of women with age-normal hearing. Author(s): Erler SF, Garstecki DC. Source: American Journal of Audiology. 2002 December; 11(2): 83-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12691218&dopt=Abstract

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Hearing loss as a presenting symptom of cleidocranial dysplasia. Author(s): Dhooge I, Lantsoght B, Lemmerling M, Vanzieleghem B, Mortier G. Source: Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 2001 November; 22(6): 855-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11698808&dopt=Abstract

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Hearing loss due to mannosidosis and otitis media with effusion. A case report and review of audiological assessments in children with otitis media with effusion. Author(s): Ahmmed AU, O'Halloran SM, Roland NJ, Starkey M, Wraith JE. Source: The Journal of Laryngology and Otology. 2003 April; 117(4): 307-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12816222&dopt=Abstract

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Hearing loss in acoustic neuromas following stereotactic radiotherapy. Author(s): Kaplan DM, Hehar SS, Tator C, Guha A, Laperriere N, Bance M, Rutka JA. Source: The Journal of Otolaryngology. 2003 February; 32(1): 23-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12779258&dopt=Abstract

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Hearing loss in adult Refsum's disease. Author(s): Bamiou DE, Spraggs PR, Gibberd FB, Sidey MC, Luxon LM. Source: Clinical Otolaryngology and Allied Sciences. 2003 June; 28(3): 227-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12755761&dopt=Abstract

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Hearing loss in children and adults: audiometric configuration, asymmetry, and progression. Author(s): Pittman AL, Stelmachowicz PG. Source: Ear and Hearing. 2003 June; 24(3): 198-205. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12799541&dopt=Abstract

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Hearing loss in children with Down syndrome. Author(s): Shott SR, Joseph A, Heithaus D. Source: International Journal of Pediatric Otorhinolaryngology. 2001 December 1; 61(3): 199-205. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11700189&dopt=Abstract

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Hearing loss in children with sickle cell disease. Author(s): Koussi A, Zafeiriou DI, Kontzoglou G, Tsatra I, Noussios G, Athanassiou M. Source: Acta Otorhinolaryngol Belg. 2001; 55(3): 235-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11685961&dopt=Abstract

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Hearing loss in patients with nasopharyngeal carcinoma after chemotherapy and radiation. Author(s): Wang LF, Kuo WR, Ho KY, Lee KW, Lin CS. Source: Kaohsiung J Med Sci. 2003 April; 19(4): 163-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12795345&dopt=Abstract

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Hearing loss, hearing handicap, and functional health status between African American and Caucasian American seniors. Author(s): Pugh KC, Crandell CC. Source: Journal of the American Academy of Audiology. 2002 October; 13(9): 493-502. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12416934&dopt=Abstract

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Hearing preservation in patients with vestibular schwannomas with sudden sensorineural hearing loss. Author(s): Friedman RA, Kesser BW, Slattery WH 3rd, Brackmann DE, Hitselberger WE. Source: Otolaryngology and Head and Neck Surgery. 2001 November; 125(5): 544-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11700458&dopt=Abstract

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Heteroplasmy for the 1555A>G mutation in the mitochondrial 12S rRNA gene in six Spanish families with non-syndromic hearing loss. Author(s): del Castillo FJ, Rodriguez-Ballesteros M, Martin Y, Arellano B, Gallo-Teran J, Morales-Angulo C, Ramirez-Camacho R, Cruz Tapia M, Solanellas J, Martinez-Conde A, Villamar M, Moreno-Pelayo MA, Moreno F, del Castillo I. Source: Journal of Medical Genetics. 2003 August; 40(8): 632-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12920080&dopt=Abstract

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Hypertrophic cranial pachymeningitis presenting as steroid-responsive hearing loss. Author(s): Iwasaki S, Matsui Y, Ito K, Naito R, Abbey K. Source: The Annals of Otology, Rhinology, and Laryngology. 2003 May; 112(5): 476-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12784990&dopt=Abstract

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Hypotonia, congenital hearing loss, and hypoactive labyrinths. Author(s): Bodensteiner JB, Smith SD, Schaefer GB. Source: Journal of Child Neurology. 2003 March; 18(3): 171-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12731641&dopt=Abstract

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Identification of hearing loss in newborns by transient otoacoustic emissions. Author(s): Jakubikova J, Kabatova Z, Zavodna M. Source: International Journal of Pediatric Otorhinolaryngology. 2003 January; 67(1): 15-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12560144&dopt=Abstract

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Immune deficiency and hearing loss in CHARGE Association. Author(s): Theodoropoulos DS, Theodoropoulos GA. Source: Pediatrics. 2003 March; 111(3): 711-2; Author Reply 711-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12612267&dopt=Abstract

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Immune-mediated hearing loss: basic mechanisms and options for therapy. Author(s): Ryan AF, Harris JP, Keithley EM. Source: Acta Otolaryngol Suppl. 2002; (548): 38-43. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12211356&dopt=Abstract

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Immunological responses in acute low-tone sensorineural hearing loss and Meniere's disease. Author(s): Fuse T, Hayashi T, Oota N, Fukase S, Asano S, Kato T, Aoyagi M. Source: Acta Oto-Laryngologica. 2003 January; 123(1): 26-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12625569&dopt=Abstract

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Improvement of chronic hearing loss after shunt revision. A case report. Author(s): Russell SM, Hoffman R, Jafar JJ. Source: Surgical Neurology. 2001 September; 56(3): 185-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11597649&dopt=Abstract

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Increased reporting of occupational hearing loss: workers' compensation in Washington State, 1984-1998. Author(s): Daniell WE, Fulton-Kehoe D, Cohen M, Swan SS, Franklin GM. Source: American Journal of Industrial Medicine. 2002 December; 42(6): 502-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12439873&dopt=Abstract

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Infants tested for hearing loss--United States, 1999-2001. Author(s): Centers for Disease Control and Prevention (CDC). Source: Mmwr. Morbidity and Mortality Weekly Report. 2003 October 17; 52(41): 981-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14561955&dopt=Abstract

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Influence of hearing loss on the perceptual strategies of children and adults. Author(s): Pittman AL, Stelmachowicz PG, Lewis DE, Hoover BM. Source: Journal of Speech, Language, and Hearing Research : Jslhr. 2002 December; 45(6): 1276-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12546493&dopt=Abstract

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Informational masking in listeners with sensorineural hearing loss. Author(s): Kidd G Jr, Arbogast TL, Mason CR, Walsh M. Source: Journal of the Association for Research in Otolaryngology : Jaro. 2002 June; 3(2): 107-19. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12162362&dopt=Abstract

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Inner ear hearing loss modulates ipsilateral temporal lobe activation by monaural speech stimuli. Author(s): Tateya I, Naito Y, Hirano S, Kojima H, Inoue M, Kaneko K, Toyoda H, Ueno M, Ishizu K, Ito J. Source: Neuroreport. 2003 April 15; 14(5): 763-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12692479&dopt=Abstract

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Integrating hearing loss into one's life. Author(s): Herth K. Source: Qualitative Health Research. 1998 March; 8(2): 207-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10558329&dopt=Abstract

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Interferon-gamma production to inner ear antigens by T cells from patients with autoimmune sensorineural hearing loss. Author(s): Lorenz RR, Solares CA, Williams P, Sikora J, Pelfrey CM, Hughes GB, Tuohy VK. Source: Journal of Neuroimmunology. 2002 September; 130(1-2): 173-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12225899&dopt=Abstract

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Interpretation of pure-tone thresholds in sensorineural hearing loss (SNHL): a review of measurement variability and age-specific references. Author(s): Lemkens N, Vermeire K, Brokx JP, Fransen E, Van Camp G, Van De Heyning PH. Source: Acta Otorhinolaryngol Belg. 2002; 56(4): 341-52. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12528251&dopt=Abstract

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Intratympanic therapies for sensorineural hearing loss and vertigo. Author(s): Marzo SJ. Source: Orl Head Neck Nurs. 2003 Summer; 21(3): 9-13. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12961790&dopt=Abstract

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Intravenous infusion of recombinant tissue plasminogen activator for the treatment of patients with sudden and/or chronic hearing loss. Author(s): Mora R, Barbieri M, Mora F, Mora M, Yoo TJ. Source: The Annals of Otology, Rhinology, and Laryngology. 2003 August; 112(8): 66570. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12940661&dopt=Abstract

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Ipsilateral distortion product otoacoustic emission (2f1-f2) suppression in children with sensorineural hearing loss. Author(s): Abdala C, Fitzgerald TS. Source: The Journal of the Acoustical Society of America. 2003 August; 114(2): 919-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12942973&dopt=Abstract

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Is it necessary to screen for hearing loss in the paediatric population with osteogenesis imperfecta? Author(s): Imani P, Vijayasekaran S, Lannigan F. Source: Clinical Otolaryngology and Allied Sciences. 2003 June; 28(3): 199-202. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12755755&dopt=Abstract

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Is sensorineural hearing loss a possible side effect of nasopharyngeal and parotid irradiation? A systematic review of the literature. Author(s): Raaijmakers E, Engelen AM. Source: Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology. 2002 October; 65(1): 1-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12413668&dopt=Abstract

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Is there a relation between acoustic trauma or noise-induced hearing loss and a subsequent appearance of Meniere's Disease? An epidemiologic study of 17245 cases and a review of the literature. Author(s): Segal S, Eviatar E, Berenholz L, Kessler A, Shlamkovitch N. Source: Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 2003 May; 24(3): 387-91. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12806289&dopt=Abstract

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Isolated vestibular ossification after meningitis associated with sensorineural hearing loss. Author(s): Reeck JB, Lalwani AK. Source: Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 2003 July; 24(4): 576-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12851548&dopt=Abstract

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JAMA patient page. Adult hearing loss. Author(s): Parmet S, Lynm C, Glass RM. Source: Jama : the Journal of the American Medical Association. 2003 April 16; 289(15): 2020. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12697805&dopt=Abstract

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Ketorolac induced acute reversible hearing loss in a patient maintained on CAPD. Author(s): Otti T, Weindel M, Bastani B. Source: Clinical Nephrology. 1997 March; 47(3): 208-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9105776&dopt=Abstract

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Langerhans' cell histiocytosis--a rare cause of sudden onset unilateral sensorineural hearing loss. Author(s): Hore I, Mitchell RB, Radcliffe G, Quiney R, Walker T. Source: The Journal of Laryngology and Otology. 1999 December; 113(12): 1098-100. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10767925&dopt=Abstract

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Language development in children with profound and prelingual hearing loss, without cochlear implants. Author(s): Svirsky MA. Source: Ann Otol Rhinol Laryngol Suppl. 2000 December; 185: 99-100. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11141026&dopt=Abstract

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Language of early- and later-identified children with hearing loss. Author(s): Yoshinaga-Itano C, Sedey AL, Coulter DK, Mehl AL. Source: Pediatrics. 1998 November; 102(5): 1161-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9794949&dopt=Abstract

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Late-onset hearing loss in a mouse model of DFN3 non-syndromic deafness: morphologic and immunohistochemical analyses. Author(s): Xia AP, Kikuchi T, Minowa O, Katori Y, Oshima T, Noda T, Ikeda K. Source: Hearing Research. 2002 April; 166(1-2): 150-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12062767&dopt=Abstract

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Late-onset, progressive sensorineural hearing loss after severe neonatal respiratory failure. Author(s): Robertson CM, Tyebkhan JM, Hagler ME, Cheung PY, Peliowski A, Etches PC. Source: Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 2002 May; 23(3): 353-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11981395&dopt=Abstract

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Listening effort and fatigue in school-age children with and without hearing loss. Author(s): Hick CB, Tharpe AM. Source: Journal of Speech, Language, and Hearing Research : Jslhr. 2002 June; 45(3): 57384. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12069009&dopt=Abstract

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Localization of biotinidase in the brain: implications for its role in hearing loss in biotinidase deficiency. Author(s): Heller AJ, Stanley C, Shaia WT, Sismanis A, Spencer RF, Wolf B. Source: Hearing Research. 2002 November; 173(1-2): 62-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12372635&dopt=Abstract

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Longitudinal gradients of KCNQ4 expression in spiral ganglion and cochlear hair cells correlate with progressive hearing loss in DFNA2. Author(s): Beisel KW, Nelson NC, Delimont DC, Fritzsch B. Source: Brain Research. Molecular Brain Research. 2000 October 20; 82(1-2): 137-49. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11042367&dopt=Abstract

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Long-term results and experience with the first-generation semi-implantable electromagnetic hearing aid with ossicular replacement device for mixed hearing loss. Author(s): Caye-Thomasen P, Jensen JH, Bonding P, Tos M. Source: Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 2002 November; 23(6): 904-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12438854&dopt=Abstract

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Loudness discomfort levels in patients with conductive and mixed hearing loss. Author(s): Liu TC, Chen YS. Source: Auris, Nasus, Larynx. 2000 April; 27(2): 101-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10733135&dopt=Abstract

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Loudness perception and frequency discrimination in subjects with steeply sloping hearing loss: possible correlates of neural plasticity. Author(s): McDermott HJ, Lech M, Kornblum MS, Irvine DR. Source: The Journal of the Acoustical Society of America. 1998 October; 104(4): 2314-25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10491696&dopt=Abstract

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Low birth weight as a risk factor of hearing loss. Author(s): Pruszewicz A, Pospiech I. Source: Scand Audiol Suppl. 2001; (52): 194-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11318466&dopt=Abstract

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Lyme borreliosis, an etiological factor in sensorineural hearing loss? Author(s): Peltomaa M, Pyykko I, Sappala I, Viitanen L, Viljanen M. Source: European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (Eufos) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 2000; 257(6): 317-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10993551&dopt=Abstract

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Magnetic resonance imaging in patients with sudden hearing loss, tinnitus and vertigo. Author(s): Schick B, Brors D, Koch O, Schafers M, Kahle G. Source: Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 2001 November; 22(6): 808-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11698800&dopt=Abstract

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Magnetic resonance imaging versus computed tomography in pre-operative evaluation of cochlear implant candidates with congenital hearing loss. Author(s): Sennaroglu L, Saatci I, Aralasmak A, Gursel B, Turan E. Source: The Journal of Laryngology and Otology. 2002 October; 116(10): 804-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12437835&dopt=Abstract

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Mechanism of hearing loss in irradiated ears: a long-term longitudinal study. Author(s): Young YH, Lu YC. Source: The Annals of Otology, Rhinology, and Laryngology. 2001 October; 110(10): 9046. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11642420&dopt=Abstract

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Medical evaluation of pediatric hearing loss. Laboratory, radiographic, and genetic testing. Author(s): Hone SW, Smith RJ. Source: Otolaryngologic Clinics of North America. 2002 August; 35(4): 751-64. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12487079&dopt=Abstract

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Methods for early identification of noise-induced hearing loss. Author(s): Hall AJ, Lutman ME. Source: Audiology : Official Organ of the International Society of Audiology. 1999 September-October; 38(5): 277-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10548376&dopt=Abstract

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Molecular genetics of hearing loss. Author(s): Petit C, Levilliers J, Hardelin JP. Source: Annual Review of Genetics. 2001; 35: 589-646. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11700295&dopt=Abstract

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MRI findings of vestibulocochlear hemorrhage in a leukemic patient with sensorineural hearing loss. Author(s): Choi JH, Nath J, Chang A. Source: Journal of Computer Assisted Tomography. 2002 September-October; 26(5): 699700. Erratum In: J Comput Assist Tomogr. 2003 January-February; 27(1): 103. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12439301&dopt=Abstract

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Multiple mutations of MYO1A, a cochlear-expressed gene, in sensorineural hearing loss. Author(s): Donaudy F, Ferrara A, Esposito L, Hertzano R, Ben-David O, Bell RE, Melchionda S, Zelante L, Avraham KB, Gasparini P. Source: American Journal of Human Genetics. 2003 June; 72(6): 1571-7. Epub 2003 May 06. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12736868&dopt=Abstract

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Mutations in the Wolfram syndrome 1 gene (WFS1) are a common cause of low frequency sensorineural hearing loss. Author(s): Bespalova IN, Van Camp G, Bom SJ, Brown DJ, Cryns K, DeWan AT, Erson AE, Flothmann K, Kunst HP, Kurnool P, Sivakumaran TA, Cremers CW, Leal SM, Burmeister M, Lesperance MM. Source: Human Molecular Genetics. 2001 October 15; 10(22): 2501-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11709537&dopt=Abstract

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Myeloperoxidase-antineutrophil cytoplasmic antibody-associated sensorineural hearing loss. Author(s): Maguchi S, Fukuda S, Chida E, Terayama Y. Source: Auris, Nasus, Larynx. 2001 May; 28 Suppl: S103-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11683326&dopt=Abstract

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Newborn hearing screening: tobramycin and vancomycin are not risk factors for hearing loss. Author(s): de Hoog M, van Zanten BA, Hop WC, Overbosch E, Weisglas-Kuperus N, van den Anker JN. Source: The Journal of Pediatrics. 2003 January; 142(1): 41-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12520253&dopt=Abstract

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Noise exposure and hearing conservation practices in an industry with high incidence of workers' compensation claims for hearing loss. Author(s): Daniell WE, Swan SS, McDaniel MM, Stebbins JG, Seixas NS, Morgan MS. Source: American Journal of Industrial Medicine. 2002 October; 42(4): 309-17. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12271478&dopt=Abstract

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Noise-induced autoimmune sensorineural hearing loss. Author(s): Gupta R, Sataloff RT. Source: The Annals of Otology, Rhinology, and Laryngology. 2003 July; 112(7): 569-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12903675&dopt=Abstract

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Noise-induced hearing loss and symphony orchestra musicians: risk factors, effects, and management. Author(s): Teie PU. Source: Md Med J. 1998 January; 47(1): 13-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9448410&dopt=Abstract

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Nongenetic causes of hearing loss. Author(s): Roizen NJ. Source: Mental Retardation and Developmental Disabilities Research Reviews. 2003; 9(2): 120-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12784230&dopt=Abstract

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Nonsyndromic autosomal dominant progressive sensorineural hearing loss: audiologic analysis of a pedigree linked to DFNA2. Author(s): Kunst H, Marres H, Huygen P, Ensink R, Van Camp G, Van Hauwe P, Coucke P, Willems P, Cremers C. Source: The Laryngoscope. 1998 January; 108(1 Pt 1): 74-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9432071&dopt=Abstract

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Nonsyndromic hearing loss caused by a mitochondrial T7511C mutation. Author(s): Ishikawa K, Tamagawa Y, Takahashi K, Kimura H, Kusakari J, Hara A, Ichimura K. Source: The Laryngoscope. 2002 August; 112(8 Pt 1): 1494-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12172268&dopt=Abstract

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Nonsyndromic hereditary hearing loss. Author(s): Li XC, Friedman RA. Source: Otolaryngologic Clinics of North America. 2002 April; 35(2): 275-85. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12391618&dopt=Abstract

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Non-syndromic progressive hearing loss DFNA38 is caused by heterozygous missense mutation in the Wolfram syndrome gene WFS1. Author(s): Young TL, Ives E, Lynch E, Person R, Snook S, MacLaren L, Cater T, Griffin A, Fernandez B, Lee MK, King MC, Cator T. Source: Human Molecular Genetics. 2001 October 15; 10(22): 2509-14. Erratum In: Hum Mol Genet 2001 December 15; 10(26): 3111. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11709538&dopt=Abstract

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Novel ATP6V1B1 and ATP6V0A4 mutations in autosomal recessive distal renal tubular acidosis with new evidence for hearing loss. Author(s): Stover EH, Borthwick KJ, Bavalia C, Eady N, Fritz DM, Rungroj N, Giersch AB, Morton CC, Axon PR, Akil I, Al-Sabban EA, Baguley DM, Bianca S, Bakkaloglu A, Bircan Z, Chauveau D, Clermont MJ, Guala A, Hulton SA, Kroes H, Li Volti G, Mir S, Mocan H, Nayir A, Ozen S, Rodriguez Soriano J, Sanjad SA, Tasic V, Taylor CM, Topaloglu R, Smith AN, Karet FE. Source: Journal of Medical Genetics. 2002 November; 39(11): 796-803. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12414817&dopt=Abstract

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Objective assessment of auditory thresholds in noise-induced hearing loss using steady-state evoked potentials. Author(s): Hsu WC, Wu HP, Liu TC. Source: Clinical Otolaryngology and Allied Sciences. 2003 June; 28(3): 195-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12755754&dopt=Abstract

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Obscure temporal bone fracture with conductive hearing loss. Author(s): Deguine C, Pulec JL. Source: Ear, Nose, & Throat Journal. 2003 February; 82(2): 89. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12619459&dopt=Abstract

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Occupational hearing loss. Author(s): Al-Otaibi ST. Source: Saudi Med J. 2000 June; 21(6): 523-30. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11500698&dopt=Abstract

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Occupational noise exposure and hearing loss of workers in two plants in eastern Saudi Arabia. Author(s): Ahmed HO, Dennis JH, Badran O, Ismail M, Ballal SG, Ashoor A, Jerwood D. Source: The Annals of Occupational Hygiene. 2001 July; 45(5): 371-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11418087&dopt=Abstract

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Ocular findings in children with congenital sensorineural hearing loss. Author(s): Mafong DD, Pletcher SD, Hoyt C, Lalwani AK. Source: Archives of Otolaryngology--Head & Neck Surgery. 2002 November; 128(11): 1303-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12431176&dopt=Abstract

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Open trial of methotrexate as treatment for autoimmune hearing loss. Author(s): Matteson EL, Fabry DA, Facer GW, Beatty CW, Driscoll CL, Strome SE, McDonald TJ. Source: Arthritis and Rheumatism. 2001 April; 45(2): 146-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11324778&dopt=Abstract

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Oral or topical nasal steroids for hearing loss associated with otitis media with effusion in children. Author(s): Butler CC, Van Der Voort JH. Source: Cochrane Database Syst Rev. 2002; (4): Cd001935. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12519563&dopt=Abstract

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Oral or topical nasal steroids for hearing loss associated with otitis media with effusion in children. Author(s): Butler CC, van Der Voort JH. Source: Cochrane Database Syst Rev. 2000; (4): Cd001935. Review. Update In: http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11034736&dopt=Abstract

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Outcomes and patient-based hearing status in conductive hearing loss. Author(s): Stewart MG. Source: The Laryngoscope. 2001 November; 111(11 Pt 2): 1-21. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11802001&dopt=Abstract

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Overview: Infants and children with hearing loss-part I. Author(s): Vohr B. Source: Mental Retardation and Developmental Disabilities Research Reviews. 2003; 9(2): 62-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12784222&dopt=Abstract

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Paternal uniparental heterodisomy with partial isodisomy of chromosome 1 in a patient with retinitis pigmentosa without hearing loss and a missense mutation in the Usher syndrome type II gene USH2A. Author(s): Rivolta C, Berson EL, Dryja TP. Source: Archives of Ophthalmology. 2002 November; 120(11): 1566-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12427073&dopt=Abstract

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Pathways for protection from noise induced hearing loss. Author(s): Le Prell CG, Dolan DF, Schacht J, Miller JM, Lomax MI, Altschuler RA. Source: Noise & Health. 2003 July-September; 5(20): 1-17. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14558888&dopt=Abstract

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Perceived effects of high frequency hearing loss in a farming population. Author(s): Stewart M, Scherer J, Lehman ME. Source: Journal of the American Academy of Audiology. 2003; 14(2): 100-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12830845&dopt=Abstract

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Picture naming by children with hearing loss: I. Effect of semantically related auditory distractors. Author(s): Jerger S, Lai L, Marchman VA. Source: Journal of the American Academy of Audiology. 2002 October; 13(9): 463-77. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12416932&dopt=Abstract

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Picture naming by children with hearing loss: II. Effect of phonologically related auditory distractors. Author(s): Jerger S, Lai L, Marchman VA. Source: Journal of the American Academy of Audiology. 2002 October; 13(9): 478-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12416933&dopt=Abstract

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Precocious puberty, endometriosis, skeletal anomalies and mild hearing loss: a new autosomal dominant syndrome? Author(s): McGaughran JM, Price DA, Kerr BA. Source: Clinical Dysmorphology. 2001 October; 10(4): 235-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11665996&dopt=Abstract

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Prelingual nonsyndromic hearing loss in Greece. Molecular and clinical findings. Author(s): Iliades T, Eleftheriades N, Iliadou V, Pampanos A, Voyiatzis N, Economides J, Leotsakos P, Neou P, Tsakanikos M, Antoniadi T, Konstantopoulou I, Yannoukakos D, Grigoriadou M, Skevas A, Petersen MB. Source: Orl; Journal for Oto-Rhino-Laryngology and Its Related Specialties. 2002 September-October; 64(5): 321-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12417772&dopt=Abstract

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Presbycusis: a human temporal bone study of individuals with flat audiometric patterns of hearing loss using a new method to quantify stria vascularis volume. Author(s): Nelson EG, Hinojosa R. Source: The Laryngoscope. 2003 October; 113(10): 1672-86. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14520091&dopt=Abstract

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Preserved otoacoustic emission in a child with a profound unilateral sensorineural hearing loss. Author(s): Ohwatari R, Fukuda S, Chida E, Matsumura M, Kuroda T, Kashiwamura M, Inuyama Y. Source: Auris, Nasus, Larynx. 2001 May; 28 Suppl: S117-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11683329&dopt=Abstract

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Prognosis is predicted by early hearing improvement in patients with idiopathic sudden sensorineural hearing loss. Author(s): Ito S, Fuse T, Yokota M, Watanabe T, Inamura K, Gon S, Aoyagi M. Source: Clinical Otolaryngology and Allied Sciences. 2002 December; 27(6): 501-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12472519&dopt=Abstract

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Q829X, a novel mutation in the gene encoding otoferlin (OTOF), is frequently found in Spanish patients with prelingual non-syndromic hearing loss. Author(s): Migliosi V, Modamio-Hoybjor S, Moreno-Pelayo MA, Rodriguez-Ballesteros M, Villamar M, Telleria D, Menendez I, Moreno F, Del Castillo I. Source: Journal of Medical Genetics. 2002 July; 39(7): 502-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12114484&dopt=Abstract

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QT interval in children with sensory neural hearing loss. Author(s): El Habbal MH, Mahoney CO. Source: Pacing and Clinical Electrophysiology : Pace. 2002 April; 25(4 Pt 1): 435-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11991368&dopt=Abstract

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Quality ratings for frequency-shaped peak-clipped speech: results for listeners with hearing loss. Author(s): Kozma-Spytek L, Kates JM, Revoile SG. Source: Journal of Speech and Hearing Research. 1996 December; 39(6): 1115-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8959597&dopt=Abstract

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Quantitative evaluation of myelinated nerve fibres and hair cells in cochleae of humans with age-related high-tone hearing loss. Author(s): Felder E, Schrott-Fischer A. Source: Hearing Research. 1995 November; 91(1-2): 19-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8647720&dopt=Abstract

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Quinine-induced hearing loss in the guinea pig is not affected by the Ca2+ channel antagonist verapamil. Author(s): Jager W, Idrizbegovic E, Karlsson KK, Alvan G. Source: Acta Oto-Laryngologica. 1997 January; 117(1): 46-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9039480&dopt=Abstract

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Radiology quiz case 1. Temporally separated bilateral labrynthitis and sensorineural hearing loss. Author(s): Smith JL 2nd, Goldstein SA, Willcox TO Jr. Source: Archives of Otolaryngology--Head & Neck Surgery. 2002 January; 128(1): 80, 82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11784262&dopt=Abstract

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Rapidly progressive bilateral sensory neural hearing loss as a presentation of mitochondrial neurogastrointestinal encephalomyopathy. Author(s): Kaidar-Person O, Golz A, Netzer A, Goldsher D, Joachims HZ, Goldenberg D. Source: American Journal of Otolaryngology. 2003 March-April; 24(2): 128-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12649829&dopt=Abstract

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Recovery of vestibular-evoked myogenic potential: relationship to other neural disorders in two patients with acute sensorineural hearing loss. Author(s): Ochi K, Ohashi T. Source: Orl; Journal for Oto-Rhino-Laryngology and Its Related Specialties. 2002 September-October; 64(5): 346-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12417778&dopt=Abstract

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Refined mapping of a gene for autosomal dominant progressive sensorineural hearing loss (DFNA5) to a 2-cM region, and exclusion of a candidate gene that is expressed in the cochlea. Author(s): Van Laer L, Van Camp G, van Zuijlen D, Green ED, Verstreken M, Schatteman I, Van de Heyning P, Balemans W, Coucke P, Greinwald JH, Smith RJ, Huizing E, Willems P. Source: European Journal of Human Genetics : Ejhg. 1997 November-December; 5(6): 397-405. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9450185&dopt=Abstract

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Resolved sudden hearing loss as a presenting symptom of retrocochlear lesion. Author(s): Popovtzer A, Nageris BI, Bahar G. Source: J Basic Clin Physiol Pharmacol. 2001; 12(2 Suppl): 101-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11605680&dopt=Abstract

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Restoration of hearing loss with tissue plasminogen activator. Case report. Author(s): Mora R, Mora F, Mora M, Barbieri M, Yoo TJ. Source: The Annals of Otology, Rhinology, and Laryngology. 2003 August; 112(8): 671-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12940662&dopt=Abstract

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Reversible hearing loss associated with a malignant pineal germ cell tumor. Case report. Author(s): Gaspar N, Verschuur A, Mercier G, Couanet D, Sainte-Rose C, Brugieres L. Source: Journal of Neurosurgery. 2003 September; 99(3): 587-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12959450&dopt=Abstract

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Reversible sensorineural hearing loss. Author(s): Lee C, Robinson P, Chelladurai J. Source: International Journal of Pediatric Otorhinolaryngology. 2002 December 2; 66(3): 297-301. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12443820&dopt=Abstract

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Risk factors for hearing loss in neonates: a prospective study. Author(s): Kountakis SE, Skoulas I, Phillips D, Chang CY. Source: American Journal of Otolaryngology. 2002 May-June; 23(3): 133-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12019480&dopt=Abstract

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Role of transtympanic endoscopy of the middle ear in the diagnosis of perilymphatic fistula in patients with sensorineural hearing loss or vertigo. Author(s): Selmani Z, Pyykko I, Ishizaki H, Marttila TI. Source: Orl; Journal for Oto-Rhino-Laryngology and Its Related Specialties. 2002 September-October; 64(5): 301-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12417768&dopt=Abstract

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Screening and prevention of hearing loss in children. Author(s): Elden LM, Potsic WP. Source: Current Opinion in Pediatrics. 2002 December; 14(6): 723-30. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12436045&dopt=Abstract

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Sensorineural hearing loss as the result of cliff jumping. Author(s): Hardin MF, Barker M, Neis PR. Source: J Ark Med Soc. 2003 April; 99(10): 327-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12868136&dopt=Abstract

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Sensorineural hearing loss in linear IgA disease. Author(s): Hari CK, Hanif J, Frosh A. Source: Int J Clin Pract. 2001 October; 55(8): 571-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11695083&dopt=Abstract

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Sensorineural hearing loss induced by radiation as a late effect: five cases followed by audiogram. Author(s): Kashiwamura M, Fukada S, Chida E, Satoh N, Inuyama Y. Source: Auris, Nasus, Larynx. 2001 May; 28 Suppl: S111-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11683328&dopt=Abstract

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Severe hearing loss in Pallister-Killian syndrome. Author(s): Schuster M, Hoppe U, Eysholdt U, Rosanowski F. Source: Orl; Journal for Oto-Rhino-Laryngology and Its Related Specialties. 2002 September-October; 64(5): 343-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12417777&dopt=Abstract

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Short-duration space flight and hearing loss. Author(s): Roller CA, Clark JB. Source: Otolaryngology and Head and Neck Surgery. 2003 July; 129(1): 98-106. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12869924&dopt=Abstract

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Steroid perfusion of the inner ear for sudden sensorineural hearing loss after failure of conventional therapy: a pilot study. Author(s): Lefebvre PP, Staecker H. Source: Acta Oto-Laryngologica. 2002 October; 122(7): 698-702. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12484644&dopt=Abstract

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Sudden sensorineural hearing loss following ovarian stimulation. Author(s): Hajioff D, Brook N, Trew G, Joseph T. Source: Bjog : an International Journal of Obstetrics and Gynaecology. 2003 September; 110(9): 873-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14511974&dopt=Abstract

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Sudden sensorineural hearing loss: supporting the immunologic theory. Author(s): Berrocal JR, Ramirez-Camacho R. Source: The Annals of Otology, Rhinology, and Laryngology. 2002 November; 111(11): 989-97. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12450172&dopt=Abstract

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Surgical management of conductive hearing loss in children. Author(s): Raz Y, Lustig L. Source: Otolaryngologic Clinics of North America. 2002 August; 35(4): 853-75. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12487086&dopt=Abstract

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The effect of diabetes on sensorineural hearing loss. Author(s): Kakarlapudi V, Sawyer R, Staecker H. Source: Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 2003 May; 24(3): 382-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12806288&dopt=Abstract

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The effects of aging and hearing loss on distortion product otoacoustic emissions. Author(s): Cilento BW, Norton SJ, Gates GA. Source: Otolaryngology and Head and Neck Surgery. 2003 October; 129(4): 382-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14574293&dopt=Abstract

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The expanding role of the otolaryngologist in managing infants and children with hearing loss. Author(s): Kim SY, Bothwell NE, Backous DD. Source: Otolaryngologic Clinics of North America. 2002 August; 35(4): 699-710. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12487076&dopt=Abstract

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The influence of ageing on noise-induced hearing loss. Author(s): Rosenhall U. Source: Noise & Health. 2003 July-September; 5(20): 47-53. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14558892&dopt=Abstract

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The latency of evoked otoacoustic emissions: its relation to hearing loss and auditory evoked potentials. Author(s): Hoth S, Weber FN. Source: Scandinavian Audiology. 2001; 30(3): 173-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11683455&dopt=Abstract

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The otolaryngologist's role in management of hearing loss in infancy and childhood. Author(s): Doyle KJ, Ray RM. Source: Mental Retardation and Developmental Disabilities Research Reviews. 2003; 9(2): 94-102. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12784227&dopt=Abstract

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The prothrombin G20210A mutation is a risk factor for sudden hearing loss in young patients. Author(s): Patscheke JH, Arndt J, Dietz K, Zenner HP, Reuner KH. Source: Thrombosis and Haemostasis. 2001 October; 86(4): 1118-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11686335&dopt=Abstract

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Transient hearing loss with labour epidural block. Author(s): Rajasekaran AK, Kirk P, Varshney S. Source: Anaesthesia. 2003 June; 58(6): 613-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12846648&dopt=Abstract

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Transient hearing loss with labour epidural block. Author(s): Hardy PA. Source: Anaesthesia. 2003 October; 58(10): 1041. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12969069&dopt=Abstract

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Treatment of hyperacusis in Williams syndrome with bilateral conductive hearing loss. Author(s): Miani C, Passon P, Bracale AM, Barotti A, Panzolli N. Source: European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (Eufos) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 2001 September; 258(7): 341-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11699823&dopt=Abstract

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Unconventional myosins and the genetics of hearing loss. Author(s): Friedman TB, Sellers JR, Avraham KB. Source: American Journal of Medical Genetics. 1999 September 24; 89(3): 147-57. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10704189&dopt=Abstract

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Understanding barriers to preventive health actions for occupational noise-induced hearing loss. Author(s): Patel DS, Witte K, Zuckerman C, Murray-Johnson L, Orrego V, Maxfield AM, Meadows-Hogan S, Tisdale J, Thimons ED. Source: Journal of Health Communication. 2001 April-June; 6(2): 155-68. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11405079&dopt=Abstract

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Unilateral sensorineural hearing loss and its aetiology in childhood: the contribution of computerised tomography in aetiological diagnosis and management. Author(s): Bamiou DE, Savy L, O'Mahoney C, Phelps P, Sirimanna T. Source: International Journal of Pediatric Otorhinolaryngology. 1999 December 5; 51(2): 91-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10619622&dopt=Abstract

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Universal newborn hearing loss: screening, identification, intervention. Author(s): Jacobson GP. Source: American Journal of Audiology. 2001 December; 10(2): 52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11808719&dopt=Abstract

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Universal screening for congenital hearing loss. Author(s): Garganta C, Seashore MR. Source: Pediatric Annals. 2000 May; 29(5): 302-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10826325&dopt=Abstract

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Unpredictable hearing loss after intratympanic gentamicin treatment for vertigo. A new theory. Author(s): Walsted A. Source: Acta Oto-Laryngologica. 2001 January; 121(1): 42-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11270492&dopt=Abstract

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Unusual regression of a sudden-onset sensorineural hearing loss in a patient with cerebellopontine angle pathology. Author(s): Serbetcioglu MB, Sutay S, Ada E. Source: The Journal of Laryngology and Otology. 2001 September; 115(9): 733-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11564303&dopt=Abstract

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Use of comparison populations for evaluating the effectiveness of hearing loss prevention programs. Author(s): Adera T, Amir C, Anderson L. Source: Aihaj : a Journal for the Science of Occupational and Environmental Health and Safety. 2000 January-February; 61(1): 11-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10772609&dopt=Abstract

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Use of laboratory evaluation and radiologic imaging in the diagnostic evaluation of children with sensorineural hearing loss. Author(s): Mafong DD, Shin EJ, Lalwani AK. Source: The Laryngoscope. 2002 January; 112(1): 1-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11802030&dopt=Abstract

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Use of methotrexate for autoimmune hearing loss. Author(s): Matteson EL, Tirzaman O, Facer GW, Fabry DA, Kasperbauer J, Beatty CW, McDonald TJ. Source: The Annals of Otology, Rhinology, and Laryngology. 2000 August; 109(8 Pt 1): 710-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10961801&dopt=Abstract

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Validation of self-reported hearing loss. The Blue Mountains Hearing Study. Author(s): Sindhusake D, Mitchell P, Smith W, Golding M, Newall P, Hartley D, Rubin G. Source: International Journal of Epidemiology. 2001 December; 30(6): 1371-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11821349&dopt=Abstract

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Value of vestibular testing in young children with sensorineural hearing loss. Author(s): Angeli S. Source: Archives of Otolaryngology--Head & Neck Surgery. 2003 April; 129(4): 478-82. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12707199&dopt=Abstract

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Van der Woude syndrome with sensorineural hearing loss, large craniofacial sinuses, dental pulp stones, and minor limb anomalies: report of a four-generation Thai family. Author(s): Kantaputra PN, Sumitsawan Y, Schutte BC, Tochareontanaphol C. Source: American Journal of Medical Genetics. 2002 April 1; 108(4): 275-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11920830&dopt=Abstract

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Vasodilator and vitamins in therapy of sensorineural hearing loss following warrelated blast injury: retrospective study. Author(s): Sprem N, Branica S, Dawidowsky K. Source: Croatian Medical Journal. 2001 December; 42(6): 646-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11740848&dopt=Abstract

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Vertigo and dysequilibrium with associated hearing loss. Author(s): Ruckenstein MJ. Source: Otolaryngologic Clinics of North America. 2000 June; 33(3): 535-62. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10815036&dopt=Abstract

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Vertigo and hearing loss. American College of Radiology. ACR Appropriateness Criteria. Author(s): Hasso AN, Drayer BP, Anderson RE, Braffman B, Davis PC, Deck MD, Johnson BA, Masaryk T, Pomeranz SJ, Seidenwurm D, Tanenbaum L, Masdeu JC. Source: Radiology. 2000 June; 215 Suppl: 471-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11037458&dopt=Abstract

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Vertigo, hearing loss, and tinnitus. Author(s): Raza SA, Phillipps JJ. Source: Postgraduate Medical Journal. 1998 June; 74(872): 375-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9799900&dopt=Abstract

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Vertigo, tinnitus, and hearing loss in the geriatric patient. Author(s): Kessinger RC, Boneva DV. Source: Journal of Manipulative and Physiological Therapeutics. 2000 June; 23(5): 352-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10863256&dopt=Abstract

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Vestibular diagnosis as prognostic indicator in sudden hearing loss with vertigo. Author(s): Park HM, Jung SW, Rhee CK. Source: Acta Otolaryngol Suppl. 2001; 545: 80-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11677749&dopt=Abstract

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Visualization of inner ear dysplasias in patients with sensorineural hearing loss. Author(s): Klingebiel R, Bockmuhl U, Werbs M, Freigang B, Vorwerk W, Thieme N, Lehmann R. Source: Acta Radiologica (Stockholm, Sweden : 1987). 2001 November; 42(6): 574-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11736704&dopt=Abstract

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Waldenstrom's macroglobulinemia and sensorineural hearing loss. Author(s): Syms MJ, Arcila ME, Holtel MR. Source: American Journal of Otolaryngology. 2001 September-October; 22(5): 349-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11562887&dopt=Abstract

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War experience as a possible cause of pediatric sensorineural hearing loss. Author(s): Ahmadizadeh A. Source: Archives of Otolaryngology--Head & Neck Surgery. 1999 November; 125(11): 1284. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10555709&dopt=Abstract

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Weighted DPOAE input/output-functions: a tool for automatic assessment of hearing loss in clinical application. Author(s): Oswald JA, Janssen T. Source: Z Med Phys. 2003; 13(2): 93-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12868334&dopt=Abstract

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What are the causes, prevention and treatment of hearing loss in the ageing worker? Author(s): Irwin J. Source: Occupational Medicine (Oxford, England). 2000 September; 50(7): 492-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11198673&dopt=Abstract

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What employees with rheumatoid arthritis, diabetes mellitus and hearing loss need to cope at work. Author(s): Detaille SI, Haafkens JA, van Dijk FJ. Source: Scand J Work Environ Health. 2003 April; 29(2): 134-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12718499&dopt=Abstract

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What is the risk of noise-induced hearing loss at 80, 85, 90 dB(A) and above? Author(s): Lutman ME. Source: Occupational Medicine (Oxford, England). 2000 May; 50(4): 274-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10912379&dopt=Abstract

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What you need to know--hearing loss and inner ear diseases--can they be cured? Author(s): Ruan RS, Soh KB, Yeoh KH. Source: Singapore Med J. 1999 January; 40(1): 60-1. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10361491&dopt=Abstract

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Which treatment for sudden sensorineural hearing Loss? Author(s): Hashisaki GT. Source: Archives of Otolaryngology--Head & Neck Surgery. 2000 September; 126(9): 1165-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10979139&dopt=Abstract

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Who prompts patients to consult about hearing loss? Author(s): Mahoney CF, Stephens SD, Cadge BA. Source: British Journal of Audiology. 1996 June; 30(3): 153-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8818244&dopt=Abstract

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Word deafness presenting as a sudden hearing loss. Author(s): Murray A, Fields MJ. Source: Int J Clin Pract. 2001 July-August; 55(6): 420-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11501237&dopt=Abstract

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CHAPTER 2. NUTRITION AND HEARING LOSS Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and hearing loss.

Finding Nutrition Studies on Hearing Loss The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail: [email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.7 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “hearing loss” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.

7 Adapted from http://ods.od.nih.gov. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture.

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The following information is typical of that found when using the “Full IBIDS Database” to search for “hearing loss” (or a synonym): •

A randomized, double-blind, placebo-controlled study of dextran/pentoxifylline medication in acute acoustic trauma and sudden hearing loss. Author(s): Department of Otorhinolaryngology, University of Basel, Kantonsspital, Switzerland. Source: Probst, R Tschopp, K Ludin, E Kellerhals, B Podvinec, M Pfaltz, C R ActaOtolaryngol. 1992; 112(3): 435-43 0001-6489

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Acute hearing loss following fractionated stereotactic radiosurgery for acoustic neuroma. Report of two cases. Author(s): Department of Neurosurgery, Stanford University Medical Center, California 94305, USA. Source: Chang, S D Poen, J Hancock, S L Martin, D P Adler, J R J-Neurosurg. 1998 August; 89(2): 321-5 0022-3085

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Aldosterone (mineralocorticoid) equivalent to prednisolone (glucocorticoid) in reversing hearing loss in MRL/MpJ-Fas1pr autoimmune mice. Author(s): Oregon Hearing Research Center, Department of Otolaryngology--Head and Neck Surgery, Oregon Health Sciences University, Portland 97201-3998, USA. Source: Trune, D R Kempton, J B Kessi, M Laryngoscope. 2000 November; 110(11): 19026 0023-852X

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Bilateral transient hearing loss associated with vincristine therapy: case report. Author(s): Inonu University, School of Medicine, Department of Haematology, Turgut Ozal Medical Center, Malatya, Turkey. [email protected] Source: Aydogdu, I Ozturan, O Kuku, I Kaya, E Sevinc, A Yildiz, R J-Chemother. 2000 December; 12(6): 530-2 1120-009X

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Biologic activity of mitochondrial metabolites on aging and age-related hearing loss. Author(s): Department of Otolaryngology Head & Neck Surgery, Henry Ford Health System, Detroit, Michigan 48323, USA. Source: Seidman, M D Khan, M J Bai, U Shirwany, N Quirk, W S Am-J-Otol. 2000 March; 21(2): 161-7 0192-9763

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Candidate's thesis: enhancing intrinsic cochlear stress defenses to reduce noiseinduced hearing loss. Author(s): Department of Defence Spatial Orientation Center, Naval Medical Center San Diego, California 92134, USA. [email protected] Source: Kopke, R D Coleman, J K Liu, J Campbell, K C Riffenburgh, R H Laryngoscope. 2002 September; 112(9): 1515-32 0023-852X

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Cerebellar arteriovenous malformation with facial paralysis, hearing loss, and tinnitus: a case report. Author(s): Department of Otolaryngology, Kobe City General Hospital, Japan. [email protected] Source: Kikuchi, M Funabiki, K Hasebe, S Takahashi, H Otol-Neurotol. 2002 September; 23(5): 723-6 1531-7129

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Cochlear ischemia induced by circulating iron particles under magnetic control: an animal model for sudden hearing loss. Author(s): Albany Medical College, New York, USA. Source: Schweinfurth, J M Cacace, A T Am-J-Otol. 2000 September; 21(5): 636-40 01929763

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Could antioxidant therapy reduce the incidence of deafness following bacterial meningitis? Author(s): Department of Pathology, Houston Medical Center, Warner Robins, GA 31093, USA. Source: Maurizi, C P Med-Hypotheses. 1999 January; 52(1): 85-7 0306-9877

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Dextran-induced pulmonary edema in patients with sudden deafness. Author(s): Department of Otolaryngology, National Taiwan University Hospital, Taipei. Source: Kuo, S T Hsu, W C Young, Y H Otol-Neurotol. 2002 September; 23(5): 661-4 1531-7129

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Effect of prostaglandin E1 on idiopathic sudden sensorineural hearing loss: a doubleblinded clinical study. Author(s): Department of Otolaryngology, School of Medicine, Keio University, Tokyo, Japan. [email protected] Source: Ogawa, K Takei, S Inoue, Y Kanzaki, J Otol-Neurotol. 2002 September; 23(5): 665-8 1531-7129

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Effect of treatment with Ginkgo biloba extract EGb 761 (oral) on unilateral idiopathic sudden hearing loss in a prospective randomized double-blind study of 106 outpatients. Author(s): Institut fur Medizinische Statistik, Informatik und Epidemiologie der Medizinischen Einrichtungen der Universitat Koln, Germany. Source: Burschka, M A Hassan, H A Reineke, T van Bebber, L Caird, D M Mosges, R Eur-Arch-Otorhinolaryngol. 2001 July; 258(5): 213-9 0937-4477

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Effects of an association of vitamin A and E in the treatment of perceptive hearing loss. Effetti terapeutici della vitamina A associata alla vitamina E nelle ipoacusie percettive. Source: Romeo, G. Giorgetti, M. Acta-Vitaminol-Enzymol. Milano : Acta Vitaminologica et Enzymologica 1985. volume 7 (1/2) page 139-143. 0300-8924

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Effects of prostaglandin E2 on the fluctuating hearing loss in Meniere's disease. Author(s): Universitats-HNO-Klinik, Koln, Germany. Source: Michel, O Matthias, R Auris-Nasus-Larynx. 1992; 19(1): 7-16 0385-8146

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Evaluation of vitamin D metabolism in patients with bilateral sensorineural hearing loss. Author(s): Department of Otolaryngology, Tohoku University School of Medicine, Sendai, Japan. Source: Ikeda, K Kobayashi, T Itoh, Z Kusakari, J Takasaka, T Am-J-Otol. 1989 January; 10(1): 11-3 0192-9763

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Fluoride therapy for cochlear otosclerosis? an audiometric and computerized tomography evaluation. Author(s): Department of Otorhinolaryngology, University Medical Center Utrecht, The Netherlands. Source: Derks, W De Groot, J A Raymakers, J A Veldman, J E Acta-Otolaryngol. 2001 January; 121(2): 174-7 0001-6489

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Functional differences of the PDS gene product are associated with phenotypic variation in patients with Pendred syndrome and non-syndromic hearing loss (DFNB4). Author(s): Howard Hughes Medical Institute and the Department of Pediatrics, University of Iowa Hospitals and Clinics and Iowa City Veterans Affairs, 52242, USA. Source: Scott, D A Wang, R Kreman, T M Andrews, M McDonald, J M Bishop, J R Smith, R J Karniski, L P Sheffield, V C Hum-Mol-Genet. 2000 July 1; 9(11): 1709-15 0964-6906

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Hearing loss related to zinc deficiency in rats. Author(s): ENT Department, Erasmus University, Rotterdam, The Netherlands. Source: Hoeve, L J Wensink, J Mertens zur Borg, I R Eur-Arch-Otorhinolaryngol. 1990; 247(5): 267-70 0937-4477

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Hyperlipidemia in association with childhood sensorineural hearing loss. Author(s): Department of Otology and Laryngology, Harvard Medical School, Boston, MA. Source: Strome, M Topf, P Vernick, D M Laryngoscope. 1988 February; 98(2): 165-9 0023852X

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Idiopathic sudden hearing loss and disturbance of iron metabolism. A clinical survey of 426 cases. Author(s): Department of Otolaryngology, Changhai Hospital, People's Republic of China. Source: Sun, A H Wang, Z M Xiao, S Z Li, Z J Ding, J C Li, J Y Kong, L S ORL-JOtorhinolaryngol-Relat-Spec. 1992; 54(2): 66-70 0301-1569

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Idiopathic sudden sensorineural deafness--an approach to the problem. Source: Khanijow, V K Raman, R Singapore-Med-J. 1988 February; 29(1): 76-7 0037-5675

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Iron deficiency and hearing loss. Experimental study in growing rats. Source: Sun, A H Xiao, S Z Li, B S Li, Z J Wang, T Y Zhang, Y S ORL-J-OtorhinolaryngolRelat-Spec. 1987; 49(3): 118-22 0301-1569

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Japanese and Western diet and risk of idiopathic sudden deafness: a case-control study using pooled controls. Author(s): Department of Hygiene, Hamamatsu University School of Medicine, Japan. [email protected] Source: Nakamura, M Whitlock, G Aoki, N Nakashima, T Hoshino, T Yokoyama, T Morioka, S Kawamura, T Tanaka, H Hashimoto, T Ohno, Y Int-J-Epidemiol. 2001 June; 30(3): 608-15 0300-5771

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Modiolar microexostoses with neural impingement and hearing loss in guinea pigs. Author(s): Department of Surgery, Milton S. Hershey Medical Center, Pennsylvania State University, Hershey 17033. Source: Strauss, M Towfighi, J Am-J-Otolaryngol. 1987 Nov-December; 8(6): 381-6 01960709

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Molecular mechanisms of age-related hearing loss. Author(s): Department of Otolaryngology, Head & Neck Surgery, Department of Otolaryngology, Division Otologic/Neurotologic Surgery, Henry Ford Hospital System, Complementary/Integrative Medicine, 6777 W. Maple Rd, W. Bloomfield, MI 48323, USA. [email protected] Source: Seidman, M D Ahmad, N Bai, U Ageing-Res-Revolume 2002 June; 1(3): 331-43 1568-1637

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Oral or topical nasal steroids for hearing loss associated with otitis media with effusion in children. Author(s): Department of General Practice, University of Wales College of Medicine, Llanedeyrn Health Centre, Llanedeyrn, Cardiff, South Galmorgan, UK, CF3 7PN. [email protected] Source: Butler, C C van Der Voort JH Cochrane-Database-Syst-Revolume 2000; (4): CD001935 1469-493X

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Pharmacokinetics of coenzyme Q10 in recovery of acute sensorineural hearing loss due to hypoxia. Author(s): Department of Otolaryngology, Kanazawa Medical University, Japan. Source: Sato, K Acta-Otolaryngol-Suppl. 1988; 45895-102 0365-5237

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Preventive effect of magnesium supplement on noise-induced hearing loss in the guinea pig. Author(s): Department of Otorhinolaryngology, Charite Hospital, Humboldt University, Schumannstrasse 20-21, 10117 Berlin, Germany. [email protected] Source: Scheibe, F Haupt, H Ising, H Eur-Arch-Otorhinolaryngol. 2000; 257(1): 10-6 09374477

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Preventive magnesium supplement reduces ischemia-induced hearing loss and blood viscosity in the guinea pig. Author(s): Department of Otorhinolaryngology, Charite Hospital, Humboldt University, Berlin, Germany. [email protected] Source: Scheibe, F Haupt, H Vlastos, G A Eur-Arch-Otorhinolaryngol. 2000; 257(7): 35561 0937-4477

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Quinine-induced hearing loss. Author(s): ENT Department, University of Amsterdam, The Netherlands. Source: Nielsen Abbring, F W Perenboom, R M van der Hulst, R J ORL-JOtorhinolaryngol-Relat-Spec. 1990; 52(1): 65-8 0301-1569

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Rapid recovery with oral zinc sulphate in deferoxamine-induced presumed optic neuropathy and hearing loss. Author(s): Institute of Ophthalmology, University of Sassari, Italy. [email protected] Source: Pinna, A Corda, L Carta, F J-Neuroophthalmol. 2001 March; 21(1): 32-3 10708022

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Red cell basic ferritin concentration in sensorineural hearing loss. Author(s): Department of Otolaryngology, Changhai Hospital, China. Source: Sun, A H Wang, Z M Xiao, S Z Li, Z J Li, J Y Kong, L S ORL-J-OtorhinolaryngolRelat-Spec. 1991; 53(5): 270-2 0301-1569

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Rheumatoid arthritis and auto-immune hearing loss. A case study. Author(s): Department of Internal Medicine, University of Paris, Hopital RaymondPoincare, Garches, France. Source: Nores, J M Bonfils, P Clin-Rheumatol. 1988 December; 7(4): 520-1 0770-3198

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Safety of the erbium:yttrium-aluminum-garnet laser in stapes surgery in otosclerosis. Author(s): Department of Otorhinolaryngology, University of Ulm, Ulm, Germany. [email protected] Source: Keck, T Wiebe, M Rettinger, G Riechelmann, H Otol-Neurotol. 2002 January; 23(1): 21-4 1531-7129

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Sensorineural hearing loss associated with hypoparathyroidism. Source: Ikeda, K Kobayashi, T Kusakari, J Takasaka, T Yumita, S Furukawa, Y Laryngoscope. 1987 September; 97(9): 1075-9 0023-852X

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Sudden hearing loss. Determining the specific cause and the most appropriate treatment. Author(s): Division of Head and Neck Surgery, University of California, Los Angeles, UCLA School of Medicine. Source: Bredenkamp, J K Shelton, C Postgrad-Med. 1989 August; 86(2): 125-8, 130, 132 0032-5481

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Sudden hearing loss: an update. Author(s): Department of Otolaryngology-Head and Neck Surgery, University of Texas Medical School, Houston. Source: Cole, R R Jahrsdoerfer, R A Am-J-Otol. 1988 May; 9(3): 211-5 0192-9763

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Sudden sensorineural hearing loss induced by experimental iron deficiency in rats. Author(s): Otolaryngological Laboratory, Changhai Hospital, Shanghai, China. Source: Sun, A H Wang, Z M Xiao, S Z Li, Z J Zheng, Z Li, J Y ORL-J-OtorhinolaryngolRelat-Spec. 1992; 54(5): 246-50 0301-1569

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TCM treatment of diabetic hearing loss--an audiological and rheological observation. Author(s): Guangzong TCM Hospital, Hebei Province. Source: Li, R Wu, L Song, N Li, W J-Tradit-Chin-Med. 2000 September; 20(3): 176-9 02546272

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The efficacy of Lasix-vitamin therapy (L-V therapy) for sudden deafness and other sensorineural hearing loss. Author(s): Department of Otolaryngology, Osaka City University Medical School, Japan. Source: Konishi, K Nakai, Y Yamane, H Acta-Otolaryngol-Suppl. 1991; 48678-91 03655237

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The role of free oxygen radicals in noise induced hearing loss: effects of melatonin and methylprednisolone. Author(s): Department of Otorhinolaryngology, Medical School, Firat University, Tip Fakultesi, KBB Anabilim Dali, 23119, Elazig, Turkey. [email protected] Source: Karlidag, T Yalcin, S Ozturk, A Ustundag, B Gok, U Kaygusuz, I Susaman, N Auris-Nasus-Larynx. 2002 April; 29(2): 147-52 0385-8146

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Treatment of sudden sensorineural hearing loss with systemic steroids and valacyclovir. Author(s): Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA. [email protected] Source: Tucci, Debara L Farmer, Joseph C Jr Kitch, Russell D Witsell, David L OtolNeurotol. 2002 May; 23(3): 301-8 1531-7129

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Vasoactive therapy versus placebo in the treatment of sudden hearing loss: a doubleblind clinical study. Author(s): Departments of Otolaryngology, Sackler School of Medicine, Tel-Aviv University, Israel. Source: Kronenberg, J Almagor, M Bendet, E Kushnir, D Laryngoscope. 1992 January; 102(1): 65-8 0023-852X

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Vasodilator and Vitamins in Therapy of Sensorineural Hearing Loss Following Warrelated Blast Injury: Retrospective Study. Author(s): ENT Department, Zagreb University Hospital Center, Salata 4, HR-10000 Zagreb, Croatia, [email protected] Source: Sprem, N Branica, S Dawidowsky, K Croat-Med-J. 2001 December; 42(6): 646-9 0353-9504

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Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: •

healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0

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The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov

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The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov

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The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/

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The Center for Food Safety and Applied Nutrition has an Internet site sponsored by the Food and Drug Administration and the Department of Health and Human Services: http://vm.cfsan.fda.gov/

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Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/

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Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/

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Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/

Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats

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Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html

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Google: http://directory.google.com/Top/Health/Nutrition/

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Healthnotes: http://www.healthnotes.com/

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Open Directory Project: http://dmoz.org/Health/Nutrition/

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Yahoo.com: http://dir.yahoo.com/Health/Nutrition/

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WebMD®Health: http://my.webmd.com/nutrition

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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

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The following is a specific Web list relating to hearing loss; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •

Vitamins Folic Acid Source: Healthnotes, Inc.; www.healthnotes.com Vitamin B12 Source: Healthnotes, Inc.; www.healthnotes.com Vitamin B12 Source: Prima Communications, Inc.www.personalhealthzone.com Vitamin D Source: Healthnotes, Inc.; www.healthnotes.com

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Minerals Magnesium Source: Integrative Medicine Communications; www.drkoop.com Magnesium Source: Prima Communications, Inc.www.personalhealthzone.com Manganese Source: Integrative Medicine Communications; www.drkoop.com

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Food and Diet Low-Salt Diet Source: Healthnotes, Inc.; www.healthnotes.com

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CHAPTER 3. ALTERNATIVE MEDICINE AND HEARING LOSS Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to hearing loss. At the conclusion of this chapter, we will provide additional sources.

National Center for Complementary and Alternative Medicine The National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (http://nccam.nih.gov/) has created a link to the National Library of Medicine’s databases to facilitate research for articles that specifically relate to hearing loss and complementary medicine. To search the database, go to the following Web site: http://www.nlm.nih.gov/nccam/camonpubmed.html. Select “CAM on PubMed.” Enter “hearing loss” (or synonyms) into the search box. Click “Go.” The following references provide information on particular aspects of complementary and alternative medicine that are related to hearing loss: •

A clinical study on the growth of distortion product otoacoustic emissions and hearing loss at 2 kHz in humans. Author(s): Lind O. Source: Scandinavian Audiology. 1998; 27(4): 207-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9832402&dopt=Abstract

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A peptide inhibitor of c-Jun N-terminal kinase protects against both aminoglycoside and acoustic trauma-induced auditory hair cell death and hearing loss. Author(s): Wang J, Van De Water TR, Bonny C, de Ribaupierre F, Puel JL, Zine A. Source: The Journal of Neuroscience : the Official Journal of the Society for Neuroscience. 2003 September 17; 23(24): 8596-607. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=13679429&dopt=Abstract

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ABR thresholds to tonebursts gated with Blackman and linear windows in adults with high-frequency sensorineural hearing loss. Author(s): Purdy SC, Abbas PJ. Source: Ear and Hearing. 2002 August; 23(4): 358-68. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12195178&dopt=Abstract

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An acoustically evoked short latency negative response in profound hearing loss patients. Author(s): Nong DX, Ura M, Owa T, Noda Y. Source: Acta Oto-Laryngologica. 2000 October; 120(8): 960-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11200592&dopt=Abstract

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Auditory ossicle abnormalities and hearing loss in the toothless (osteopetrotic) mutation in the rat and their improvement after treatment with colony-stimulating factor-1. Author(s): Aharinejad S, Grossschmidt K, Franz P, Streicher J, Nourani F, MacKay CA, Firbas W, Plenk H Jr, Marks SC Jr. Source: Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research. 1999 March; 14(3): 415-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10027906&dopt=Abstract

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Bilateral hearing loss during vincristine therapy: a case report. Author(s): Kalcioglu MT, Kuku I, Kaya E, Oncel S, Aydogdu I. Source: Journal of Chemotherapy (Florence, Italy). 2003 June; 15(3): 290-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12868558&dopt=Abstract

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Bilateral transient hearing loss associated with vincristine therapy: case report. Author(s): Aydogdu I, Ozturan O, Kuku I, Kaya E, Sevinc A, Yildiz R. Source: Journal of Chemotherapy (Florence, Italy). 2000 December; 12(6): 530-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11154039&dopt=Abstract

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Cochlear outer-hair-cell efferents and complex-sound-induced hearing loss: protective and opposing effects. Author(s): Rajan R. Source: Journal of Neurophysiology. 2001 December; 86(6): 3073-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11731564&dopt=Abstract

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Comparison of toluene-induced and styrene-induced hearing losses. Author(s): Loquet G, Campo P, Lataye R. Source: Neurotoxicology and Teratology. 1999 November-December; 21(6): 689-97. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10560776&dopt=Abstract

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Conductive hearing loss produces a reversible binaural hearing impairment. Author(s): Moore DR, Hine JE, Jiang ZD, Matsuda H, Parsons CH, King AJ. Source: The Journal of Neuroscience : the Official Journal of the Society for Neuroscience. 1999 October 1; 19(19): 8704-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10493771&dopt=Abstract

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Contralateral hearing loss as an effect of venous congestion at the ipsilateral inferior colliculus after microvascular decompression: report of a case. Author(s): Strauss C, Naraghi R, Bischoff B, Huk WJ, Romstock J. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 2000 November; 69(5): 679-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11032629&dopt=Abstract

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Cortical reorganization in patients with high frequency cochlear hearing loss. Author(s): Dietrich V, Nieschalk M, Stoll W, Rajan R, Pantev C. Source: Hearing Research. 2001 August; 158(1-2): 95-101. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11506941&dopt=Abstract

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Diversity in noise-induced temporary hearing loss in otophysine fishes. Author(s): Amoser S, Ladich F. Source: The Journal of the Acoustical Society of America. 2003 April; 113(4 Pt 1): 2170-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12703727&dopt=Abstract

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Effect of treatment with Ginkgo biloba extract EGb 761 (oral) on unilateral idiopathic sudden hearing loss in a prospective randomized double-blind study of 106 outpatients. Author(s): Burschka MA, Hassan HA, Reineke T, van Bebber L, Caird DM, Mosges R. Source: European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (Eufos) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 2001 July; 258(5): 213-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11548897&dopt=Abstract

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Effects of age and age-related hearing loss on the neural representation of speech cues. Author(s): Tremblay KL, Piskosz M, Souza P. Source: Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology. 2003 July; 114(7): 1332-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12842732&dopt=Abstract

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Effects of conductive hearing loss on gerbil central auditory system activity in silence. Author(s): Tucci DL, Cant NB, Durham D.

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Source: Hearing Research. 2001 May; 155(1-2): 124-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11335082&dopt=Abstract •

Effects of exposure to an augmented acoustic environment on auditory function in mice: roles of hearing loss and age during treatment. Author(s): Willott JF, Turner JG, Sundin VS. Source: Hearing Research. 2000 April; 142(1-2): 79-88. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10748331&dopt=Abstract

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Effects of sound preconditioning on hearing loss from low or middle-frequency noise exposure. Author(s): Liu YG, He YJ, Li DD, Zheng SX, Niu CM. Source: Space Med Med Eng (Beijing). 2000 October; 13(5): 313-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11894866&dopt=Abstract

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Electric-acoustic stimulation of the auditory system. New technology for severe hearing loss. Author(s): von Ilberg C, Kiefer J, Tillein J, Pfenningdorff T, Hartmann R, Sturzebecher E, Klinke R. Source: Orl; Journal for Oto-Rhino-Laryngology and Its Related Specialties. 1999 November-December; 61(6): 334-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10545807&dopt=Abstract

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Evaluation of the incidence of sensorineural hearing loss in beta-thalassemia major patients under regular chelation therapy with desferrioxamine. Author(s): Karimi M, Asadi-Pooya AA, Khademi B, Asadi-Pooya K, Yarmohammadi H. Source: Acta Haematologica. 2002; 108(2): 79-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12187025&dopt=Abstract

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Frequency-specific information from click evoked otoacoustic emissions in noiseinduced hearing loss. Author(s): Tognola G, Grandori F, Avan P, Ravazzani P, Bonfils P. Source: Audiology : Official Organ of the International Society of Audiology. 1999 September-October; 38(5): 243-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10548370&dopt=Abstract

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Hearing loss and the invention of the phonograph: the story of Thomas Alva Edison. Author(s): Limb CJ, Lustig LR. Source: Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 2002 January; 23(1): 96-101. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11773855&dopt=Abstract

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Hearing loss in children with osteogenesis imperfecta. Author(s): Kuurila K, Grenman R, Johansson R, Kaitila I. Source: European Journal of Pediatrics. 2000 July; 159(7): 515-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10923226&dopt=Abstract

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Hyperbaric oxygen as a method of therapy of sudden sensorineural hearing loss. Author(s): Racic G, Petri NM, Andric D. Source: Int Marit Health. 2001; 52(1-4): 74-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11817844&dopt=Abstract

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Implantable hearing devices for sensorineural hearing loss: a review of the audiometric data. Author(s): Snik AF, Mylanus EA, Cremers CW. Source: Clinical Otolaryngology and Allied Sciences. 1998 October; 23(5): 414-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9800076&dopt=Abstract

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Increased noise severity limits potentiation of noise induced hearing loss by carbon monoxide. Author(s): Rao DB, Fechter LD. Source: Hearing Research. 2000 December; 150(1-2): 206-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11077204&dopt=Abstract

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Influence of lecithin on mitochondrial DNA and age-related hearing loss. Author(s): Seidman MD, Khan MJ, Tang WX, Quirk WS. Source: Otolaryngology and Head and Neck Surgery. 2002 September; 127(3): 138-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12297801&dopt=Abstract

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Informational masking in listeners with sensorineural hearing loss. Author(s): Kidd G Jr, Arbogast TL, Mason CR, Walsh M. Source: Journal of the Association for Research in Otolaryngology : Jaro. 2002 June; 3(2): 107-19. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12162362&dopt=Abstract

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Inner ear hearing loss modulates ipsilateral temporal lobe activation by monaural speech stimuli. Author(s): Tateya I, Naito Y, Hirano S, Kojima H, Inoue M, Kaneko K, Toyoda H, Ueno M, Ishizu K, Ito J. Source: Neuroreport. 2003 April 15; 14(5): 763-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12692479&dopt=Abstract

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Ipsilateral distortion product otoacoustic emission (2f1-f2) suppression in children with sensorineural hearing loss. Author(s): Abdala C, Fitzgerald TS.

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Source: The Journal of the Acoustical Society of America. 2003 August; 114(2): 919-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12942973&dopt=Abstract •

Loudness perception and frequency discrimination in subjects with steeply sloping hearing loss: possible correlates of neural plasticity. Author(s): McDermott HJ, Lech M, Kornblum MS, Irvine DR. Source: The Journal of the Acoustical Society of America. 1998 October; 104(4): 2314-25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10491696&dopt=Abstract

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Methods for early identification of noise-induced hearing loss. Author(s): Hall AJ, Lutman ME. Source: Audiology : Official Organ of the International Society of Audiology. 1999 September-October; 38(5): 277-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10548376&dopt=Abstract

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Multi-microphone technology for severe-to-profound hearing loss. Author(s): Kuhnel V, Margolf-Hackl S, Kiessling J. Source: Scand Audiol Suppl. 2001; (52): 65-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11318486&dopt=Abstract

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Neonatal sensorineural hearing loss affects neurone size in cat auditory midbrain. Author(s): Nishiyama N, Hardie NA, Shepherd RK. Source: Hearing Research. 2000 February; 140(1-2): 18-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10675632&dopt=Abstract

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Neural plasticity in the mouse inferior colliculus: relationship to hearing loss, augmented acoustic stimulation, and prepulse inhibition. Author(s): Willott JF, Turner JG. Source: Hearing Research. 2000 September; 147(1-2): 275-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10962191&dopt=Abstract

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Noise-induced aspartate and glutamate efflux in the guinea pig cochlea and hearing loss. Author(s): Jager W, Goiny M, Herrera-Marschitz M, Brundin L, Fransson A, Canlon B. Source: Experimental Brain Research. Experimentelle Hirnforschung. Experimentation Cerebrale. 2000 October; 134(4): 426-34. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11081824&dopt=Abstract

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On the relationships of high-frequency hearing loss and cochlear pathology to the acoustic startle response (ASR) and prepulse inhibition of the ASR in the BXD recombinant inbred series. Author(s): McCaughran J Jr, Bell J, Hitzemann R.

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Source: Behavior Genetics. 1999 January; 29(1): 21-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10371755&dopt=Abstract •

Otoacoustic emissions in screening cleft lip and/or palate children for hearing loss--a feasibility study. Author(s): Anteunis LJ, Brienesse P, Schrander JJ. Source: International Journal of Pediatric Otorhinolaryngology. 1998 August 1O; 44(3): 259-66. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9780072&dopt=Abstract

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Pathways for protection from noise induced hearing loss. Author(s): Le Prell CG, Dolan DF, Schacht J, Miller JM, Lomax MI, Altschuler RA. Source: Noise & Health. 2003 July-September; 5(20): 1-17. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14558888&dopt=Abstract

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Perceptual consequences of peripheral hearing loss: do edge effects exist for abrupt cochlear lesions? Author(s): Buss E, Hall JW 3rd, Grose JH, Hatch DR. Source: Hearing Research. 1998 November; 125(1-2): 98-108. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9833964&dopt=Abstract

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Performance of custom-fit versus fixed-format hearing aids for precipitously sloping high-frequency hearing loss. Author(s): Walden TC, Walden BE, Cord MT. Source: Journal of the American Academy of Audiology. 2002 July-August; 13(7): 356-66. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12199512&dopt=Abstract

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Postoperative hearing loss due to venous congestion at the inferior colliculus, or cochlear dysfunction? Author(s): Kofler M. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 2001 July; 71(1): 135. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11439971&dopt=Abstract

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Prevention of hearing loss in experimental pneumococcal meningitis by administration of dexamethasone and ketorolac. Author(s): Rappaport JM, Bhatt SM, Burkard RF, Merchant SN, Nadol JB Jr. Source: The Journal of Infectious Diseases. 1999 January; 179(1): 264-8. Erratum In: J Infect Dis 1999 March; 179(3): 753. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9841852&dopt=Abstract

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Preventive effect of magnesium supplement on noise-induced hearing loss in the guinea pig. Author(s): Scheibe F, Haupt H, Ising H.

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Source: European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (Eufos) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 2000; 257(1): 10-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10664038&dopt=Abstract •

Preventive magnesium supplement reduces ischemia-induced hearing loss and blood viscosity in the guinea pig. Author(s): Scheibe F, Haupt H, Vlastos GA. Source: European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (Eufos) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 2000; 257(7): 355-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11052244&dopt=Abstract

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Successful treatment of noise-induced cochlear ischemia, hypoxia, and hearing loss. Author(s): Lamm K, Arnold W. Source: Annals of the New York Academy of Sciences. 1999 November 28; 884: 233-48. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10842597&dopt=Abstract

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Sudden hearing loss associated with ephedra use. Author(s): Schweinfurth J, Pribitkin E. Source: American Journal of Health-System Pharmacy : Ajhp : Official Journal of the American Society of Health-System Pharmacists. 2003 February 15; 60(4): 375-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12625221&dopt=Abstract

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Suggestion audiometry for non-organic hearing loss (pseudohypoacusis) in children. Author(s): Hosoi H, Tsuta Y, Murata K, Levitt H. Source: International Journal of Pediatric Otorhinolaryngology. 1999 January 25; 47(1): 11-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10206390&dopt=Abstract

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Targeted mutation of the gene for cellular glutathione peroxidase (Gpx1) increases noise-induced hearing loss in mice. Author(s): Ohlemiller KK, McFadden SL, Ding DL, Lear PM, Ho YS. Source: Journal of the Association for Research in Otolaryngology : Jaro. 2000 November; 1(3): 243-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11545230&dopt=Abstract

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TCM treatment of diabetic hearing loss--an audiological and rheological observation. Author(s): Li R, Wu L, Song N, Li W. Source: J Tradit Chin Med. 2000 September; 20(3): 176-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11038977&dopt=Abstract

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Technology, expectations, and adjustment to hearing loss: predictors of hearing aid outcome. Author(s): Jerram JC, Purdy SC. Source: Journal of the American Academy of Audiology. 2001 February; 12(2): 64-79. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11261460&dopt=Abstract

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The case for early identification of hearing loss in children. Auditory system development, experimental auditory deprivation, and development of speech perception and hearing. Author(s): Sininger YS, Doyle KJ, Moore JK. Source: Pediatric Clinics of North America. 1999 February; 46(1): 1-14. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10079786&dopt=Abstract

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The effects of sensory hearing loss on cochlear filter times estimated from auditory brainstem response latencies. Author(s): Don M, Ponton CW, Eggermont JJ, Kwong B. Source: The Journal of the Acoustical Society of America. 1998 October; 104(4): 2280-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10491692&dopt=Abstract

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The effects of the amplitude distribution of equal energy exposures on noise-induced hearing loss: the kurtosis metric. Author(s): Hamernik RP, Qiu W, Davis B. Source: The Journal of the Acoustical Society of America. 2003 July; 114(1): 386-95. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12880050&dopt=Abstract

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The latency of evoked otoacoustic emissions: its relation to hearing loss and auditory evoked potentials. Author(s): Hoth S, Weber FN. Source: Scandinavian Audiology. 2001; 30(3): 173-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11683455&dopt=Abstract

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The relationship between noise-induced hearing loss and hair cell loss in rats. Author(s): Chen GD, Fechter LD. Source: Hearing Research. 2003 March; 177(1-2): 81-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12618320&dopt=Abstract

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The role of free oxygen radicals in noise induced hearing loss: effects of melatonin and methylprednisolone. Author(s): Karlidag T, Yalcin S, Ozturk A, Ustundag B, Gok U, Kaygusuz I, Susaman N. Source: Auris, Nasus, Larynx. 2002 April; 29(2): 147-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11893449&dopt=Abstract

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The utility of positron emission tomography in the evaluation of autoimmune hearing loss. Author(s): Mazlumzadeh M, Lowe VJ, Mullan BP, Fabry DA, McDonald TJ, Matteson EL. Source: Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 2003 March; 24(2): 201-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12621332&dopt=Abstract

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Tinnitus suppression by electrical promontory stimulation (EPS) in patients with sensorineural hearing loss. Author(s): Konopka W, Zalewski P, Olszewski J, Olszewska-Ziaber A, Pietkiewicz P. Source: Auris, Nasus, Larynx. 2001 January; 28(1): 35-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11137361&dopt=Abstract

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Topodiagnostic assessment of occupational noise-induced hearing loss using distortion-product otoacoustic emissions compared to the short increment sensitivity index test. Author(s): Oeken J. Source: European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (Eufos) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 1999; 256(3): 115-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10234478&dopt=Abstract

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Transient evoked otoacoustic emissions in patients with normal hearing and in patients with hearing loss. Author(s): Hussain DM, Gorga MP, Neely ST, Keefe DH, Peters J. Source: Ear and Hearing. 1998 December; 19(6): 434-49. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9867292&dopt=Abstract

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Treatment of hyperacusis in Williams syndrome with bilateral conductive hearing loss. Author(s): Miani C, Passon P, Bracale AM, Barotti A, Panzolli N. Source: European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (Eufos) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 2001 September; 258(7): 341-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11699823&dopt=Abstract

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Vertigo, tinnitus, and hearing loss in the geriatric patient. Author(s): Kessinger RC, Boneva DV. Source: Journal of Manipulative and Physiological Therapeutics. 2000 June; 23(5): 352-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10863256&dopt=Abstract

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Vinpocetine protects from aminoglycoside antibiotic-induced hearing loss in guinea pig in vivo. Author(s): Nekrassov V, Sitges M. Source: Brain Research. 2000 June 23; 868(2): 222-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10854574&dopt=Abstract

Additional Web Resources A number of additional Web sites offer encyclopedic information covering CAM and related topics. The following is a representative sample: •

Alternative Medicine Foundation, Inc.: http://www.herbmed.org/

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AOL: http://search.aol.com/cat.adp?id=169&layer=&from=subcats

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Chinese Medicine: http://www.newcenturynutrition.com/

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drkoop.com®: http://www.drkoop.com/InteractiveMedicine/IndexC.html

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Family Village: http://www.familyvillage.wisc.edu/med_altn.htm

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Google: http://directory.google.com/Top/Health/Alternative/

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Healthnotes: http://www.healthnotes.com/

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MedWebPlus: http://medwebplus.com/subject/Alternative_and_Complementary_Medicine

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Open Directory Project: http://dmoz.org/Health/Alternative/

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HealthGate: http://www.tnp.com/

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WebMD®Health: http://my.webmd.com/drugs_and_herbs

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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

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Yahoo.com: http://dir.yahoo.com/Health/Alternative_Medicine/

The following is a specific Web list relating to hearing loss; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •

General Overview Birth Defects Prevention Source: Healthnotes, Inc.; www.healthnotes.com Hearing Loss Source: Integrative Medicine Communications; www.drkoop.com Source: Healthnotes, Inc.; www.healthnotes.com Meningitis Source: Integrative Medicine Communications; www.drkoop.com

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Mumps Source: Integrative Medicine Communications; www.drkoop.com Rubella Source: Integrative Medicine Communications; www.drkoop.com Tinnitus Source: Healthnotes, Inc.; www.healthnotes.com •

Alternative Therapy Chiropractic Source: Integrative Medicine Communications; www.drkoop.com

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Chinese Medicine Bushen Yinao Pian Alternative names: Bushen Yinao Tablets Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China

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Herbs and Supplements Aloe Alternative names: Aloe vera, Aloe barbadensis, Aloe ferox , Aloe Vera Source: Integrative Medicine Communications; www.drkoop.com Aloe Vera Source: Integrative Medicine Communications; www.drkoop.com Elder Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Ginkgo Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Ginkgo Biloba Source: Healthnotes, Inc.; www.healthnotes.com

General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html.

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This Web site provides a general overview of various topics and can lead to a number of general sources.

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CHAPTER 4. DISSERTATIONS ON HEARING LOSS Overview In this chapter, we will give you a bibliography on recent dissertations relating to hearing loss. We will also provide you with information on how to use the Internet to stay current on dissertations. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical dissertations that use the generic term “hearing loss” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on hearing loss, we have not necessarily excluded non-medical dissertations in this bibliography.

Dissertations on Hearing Loss ProQuest Digital Dissertations, the largest archive of academic dissertations available, is located at the following Web address: http://wwwlib.umi.com/dissertations. From this archive, we have compiled the following list covering dissertations devoted to hearing loss. You will see that the information provided includes the dissertation’s title, its author, and the institution with which the author is associated. The following covers recent dissertations found when using this search procedure: •

A Comparative Study of Itinerant Teachers' Perceptions on Pull-out and Collaborative Consultation Service Delivery Models for Students with Hearing Loss by Finley, Molly Ann, EDD from University of Delaware, 1997, 113 pages http://wwwlib.umi.com/dissertations/fullcit/9810857

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A Comparative Study of the Ability of Children with High Frequency Hearing Loss and Normal Children to Discriminate Low-pass Filtered Speech by Larson, Alfred D., EDD from University of Kansas, 1969, 73 pages http://wwwlib.umi.com/dissertations/fullcit/7010985

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A Descriptive Study of Changes in Deafness Etiology from 1985 to 1995: a Comparison of Texas School for the Deaf and Northwest Harris County Cooperative for the Hearing Impaired by Chinn, Kathleen Mary, EDD from Lamar University Beaumont, 1997, 145 pages http://wwwlib.umi.com/dissertations/fullcit/9817000

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A Formalized Microethnographic Single-case Investigation of the Effects of Various Modeling/imitation Paradigms on the Production of English Lexical Targets by a Child with a Severe-profound Hearing Loss (disabilities, Instructional Design) by Radaszewski-Byrne, Mary M., EDD from Columbia University Teachers College, 1994, 287 pages http://wwwlib.umi.com/dissertations/fullcit/9432565

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A Government Binding Map to the Language of Children and Adolescents with Significant Hearing Loss (disabilities) by West, Elizabeth Ann, PhD from University of Georgia, 1994, 348 pages http://wwwlib.umi.com/dissertations/fullcit/9504455

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A Study of the Effects of Mild Hearing Loss on Educational Achievement by Embrey, James Edwin, Edd from The University of Tulsa, 1971, 95 pages http://wwwlib.umi.com/dissertations/fullcit/7201734

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Aging and Hearing Loss: Patterns of Coping with the Effects of Late Onset Hearing Loss among Persons Age 60 and Older and Their Spouses/significant Others (elderly, Spouses, Significant Others) by Pray, Janet Lorraine, PhD from The Union Institute, 1992, 191 pages http://wwwlib.umi.com/dissertations/fullcit/9306019

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An Investigation of Teacher Voice Signal Amplification Treatment for Mediating Speech Communication Interference from Jet Aircraft Noise Intrusion and from Minimal Hearing Loss in First and Second Grade Classrooms (physiological, O'hare Airport, Audiometr by Kaufman, Kenneth L., EDD from Loyola University of Chicago, 1985, 273 pages http://wwwlib.umi.com/dissertations/fullcit/8503374

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Bionic Ears and Genetic Mistakes: the Cultural Construction of Deafness in Clinic Settings by Terstriep, Amy Lynn, PhD from University of Kansas, 1998, 296 pages http://wwwlib.umi.com/dissertations/fullcit/9903075

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Body and Soul: Deafness and Identity in Ruth Schaumann's Autobiographical Novel 'das Arsenal' (germany) by Mullens, Margaret Emily; PhD from University of Maryland College Park, 2001, 342 pages http://wwwlib.umi.com/dissertations/fullcit/3035806

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Challenges and Strategies Associated with Hearing Loss among Dairy Farmers by Hass-slavin, Louise Anne; MSC from Queen's University at Kingston (Canada), 2002, 152 pages http://wwwlib.umi.com/dissertations/fullcit/MQ69304

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Comparison of Language Development of Upper Elementary and Secondary Students with Unilateral Hearing Loss and with Normal Hearing by Byrd, Kathryn Cline, PhD from The University of Alabama, 1997, 159 pages http://wwwlib.umi.com/dissertations/fullcit/9735683

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Diplacusis Associated with Unilateral High Frequency Hearing Loss by Norris, Thomas Wellington, PhD from Wayne State University, 1962, 105 pages http://wwwlib.umi.com/dissertations/fullcit/6802101

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Discourse and Hearing Loss: the Effects of a Text Supplement by Haravon, Anita Beatrice; PhD from City University of New York, 2002, 170 pages http://wwwlib.umi.com/dissertations/fullcit/3047225

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Effects of Response Set on Speech Discrimination As a Function of Age, Task Difficulty and Hearing Loss by Saunders, Steven Jay, PhD from Columbia University, 1987, 181 pages http://wwwlib.umi.com/dissertations/fullcit/8710222

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Evaluation of Genetic Counselors' Knowledge and Comfort Level Counseling for the Genetics of Hearing Loss by Campbell, Colleen-Ann; MS from Sarah Lawrence College, 2003, 40 pages http://wwwlib.umi.com/dissertations/fullcit/1413578

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Hearing Loss among Migrant Farmworkers in the Northern Section of Connecticut by Solimini, Jacqueline; MPH from Southern Connecticut State University, 2002, 56 pages http://wwwlib.umi.com/dissertations/fullcit/1412198

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Hearing Loss and Communication Delay in Children Referred for Early Childhood Special Education by Anderson, Gail Nygaard, PhD from University of Minnesota, 1996, 180 pages http://wwwlib.umi.com/dissertations/fullcit/9700912

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Help-seeking for Advanced Rehabilitation by Adults with Hearing Loss: an Ecological Model by Dillon Edgett, Lisa Michelle; PhD from The University of British Columbia (Canada), 2002, 275 pages http://wwwlib.umi.com/dissertations/fullcit/NQ75009

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Hereditary Deafness and Mast Cell Tumors in Dogs: Sequence Analysis of Candidate Genes from the Melanocyte Development Pathway by Zemke, Daniel; PhD from Michigan State University, 2003, 162 pages http://wwwlib.umi.com/dissertations/fullcit/3092235

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Information Processing and Deafness: an Exploratory Study by Just, Evelyn, PhD from University of Alberta (Canada), 1992, 196 pages http://wwwlib.umi.com/dissertations/fullcit/NN73078

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Mapping a New Autosomal Dominant Hearing Loss Locus, Dfna20, on 17q25 and Searching for the Disease Causing Gene(s) by Wei, Sainan; PhD from Michigan State University, 2002, 164 pages http://wwwlib.umi.com/dissertations/fullcit/3075082

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Medical Home Practice Algorithm for Infants with Sensorineural Hearing Loss by Meier, Mary C.; AUD from Central Michigan University, 2003, 120 pages http://wwwlib.umi.com/dissertations/fullcit/3081412

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Mild to Moderate Hearing Loss in Older Adults: How Normal Hearing Spouses Cope with Their Partners' Acquired Hearing Loss by Goldstein, Richard Marc, PhD from The University of Wisconsin - Madison, 1991, 275 pages http://wwwlib.umi.com/dissertations/fullcit/9128909

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Narrative Differences of Children with Normal Hearing in General Education and Mainstreamed Children with Hearing Loss of Ages Four, Five and Six Years by Greenfield, Mona; PhD from New York University, 2002, 163 pages http://wwwlib.umi.com/dissertations/fullcit/3031303

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Neuro-linguistic Programming As an Interviewing Technique with Prelingually Deaf Adults (deafness, Leisure) by Davis, Gerald Loyd, Jr., EDD from Oklahoma State University, 1984, 91 pages http://wwwlib.umi.com/dissertations/fullcit/8515247

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Non-syndromic Hereditary Hearing Loss by Markowitz, Linda Carol; AUD from Central Michigan University, 2002, 31 pages http://wwwlib.umi.com/dissertations/fullcit/3056196

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Occupational Stereotyping of Professional Groups toward Individuals with Hearing Losses (stereotypes) by Scherich, Dayl Law, PhD from The University of Texas at Austin, 1992, 133 pages http://wwwlib.umi.com/dissertations/fullcit/9225721

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Pathways to Understanding: Children with Hearing Loss Respond to Literature Through Language, Drama and Art by Phillips, Lafon Louise; PhD from The University of Arizona, 1999, 469 pages http://wwwlib.umi.com/dissertations/fullcit/9957976

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Pitch-equality Perception As a Function of Frequency, Reception Channel, and Localized Sensory - Neural Hearing Loss by Taylor, Richard Duane, PhD from Wayne State University, 1962, 99 pages http://wwwlib.umi.com/dissertations/fullcit/6806697

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Pure-tone, Speech and Bekesy Audiometry in Simulated Hearing Loss by Conn, Marjorie Deborah, EDD from Columbia University, 1972, 125 pages http://wwwlib.umi.com/dissertations/fullcit/7219512

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Speech Recognition and Auditory Masking: a Comparative Study of Age and Hearing Loss by Davignon, Donald David, PhD from Arizona State University, 1988, 116 pages http://wwwlib.umi.com/dissertations/fullcit/8907695

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The Effect of Age and Hearing Loss on a Speech Recognition in Noise Task Utilizing the Neighborhood Activation Model by McArdle, Rachel Ann; PhD from University of South Florida, 2002, 75 pages http://wwwlib.umi.com/dissertations/fullcit/3078447

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The Effect of Minimal Hearing Loss on Academic Achievement and Classroom Performance (fifth-grade) by Jania, Henry Lawrence, EDD from Peabody College for Teachers of Vanderbilt University, 1985, 117 pages http://wwwlib.umi.com/dissertations/fullcit/8527846

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The Effects of Hearing Loss on the Importance of High- and Low-frequency Information to Speech Understanding by Hornsby, Benjamin Wade Young; PhD from Vanderbilt University, 2002, 103 pages http://wwwlib.umi.com/dissertations/fullcit/3047493

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The Efficacy of Streptomycin Vestibular Neurectomy to Alleviate Vertigo and Fluctuant Hearing Loss Associated with Meniere's Disease by Grace, Stephanie Lubitz; PhD from University of Cincinnati, 2002, 75 pages http://wwwlib.umi.com/dissertations/fullcit/3053376

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The Identification of Special Competencies of Deafness Specialists in Postsecondary Education Programs by Kolvitz, Marcia Ellen; PhD from The University of Tennessee, 1999, 203 pages http://wwwlib.umi.com/dissertations/fullcit/9959295

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The Impact of Hearing Loss on Long-term Relationship Scale by Peck, Sandy Lynn; AUD from Central Michigan University, 2002, 53 pages http://wwwlib.umi.com/dissertations/fullcit/3040667

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The Impact of Hearing Loss on the Development of Visual Perception: Developmental Trends in Graphic Strategies Used to Copy the Rey-Osterreith

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Complex Figure (Cognitive Development) by Eldredge, Nancy Marie, PhD from Oregon State University, 1984, 107 pages http://wwwlib.umi.com/dissertations/fullcit/8508401 •

The Impact of Mild Conductive Hearing Loss on School Children's Achievement at Grades 4, 5, and 6 (Fourth-grade, Fifth-grade, Sixth-grade, Hearing Loss) by Rupp, Mary Ann Herron, PhD from Kansas State University, 1994, 107 pages http://wwwlib.umi.com/dissertations/fullcit/9502777

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The Impact of Unilateral Hearing Loss on Selected Educational Variables by Skinner, Barbara Kay, EDD from University of Northern Colorado, 1987, 142 pages http://wwwlib.umi.com/dissertations/fullcit/8805788

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The Prevalence of High Frequency Hearing Loss in Eighth Grade Children and Their Attitudes and Knowledge Regarding Noisy Leisure Time Activities by Watkins, Dorie Jane; AUD from Central Michigan University, 2003, 47 pages http://wwwlib.umi.com/dissertations/fullcit/3085623

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The Relationship of Testwiseness, Achievement, and Degree of Hearing Loss for Hearing Impaired Adolescents by Stenning, Peggy Cooper, PhD from Texas A&M University, 1979, 103 pages http://wwwlib.umi.com/dissertations/fullcit/8012001

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The Relationship of Theory of Mind to Language Variables and Age of Identification of Congenital Hearing Loss in Deaf Children by Lundy, Jean Elizabeth Barthel; EDD from University of Northern Colorado, 2000, 173 pages http://wwwlib.umi.com/dissertations/fullcit/9999511

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Time - Order Error in Pitch - Equality Perception in Sensory - Neural Hearing Loss by Skinner, Paul Heeter, PhD from Wayne State University, 1963, 74 pages http://wwwlib.umi.com/dissertations/fullcit/6806689

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Vocational Attribution Styles of Community College Students with and without Hearing Loss: Measures of Self-efficacy by Kessler, Emmett Basil; PhD from Kansas State University, 1999, 82 pages http://wwwlib.umi.com/dissertations/fullcit/9958034

Keeping Current Ask the medical librarian at your library if it has full and unlimited access to the ProQuest Digital Dissertations database. From the library, you should be able to do more complete searches via http://wwwlib.umi.com/dissertations.

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CHAPTER 5. CLINICAL TRIALS AND HEARING LOSS Overview In this chapter, we will show you how to keep informed of the latest clinical trials concerning hearing loss.

Recent Trials on Hearing Loss The following is a list of recent trials dedicated to hearing loss.8 Further information on a trial is available at the Web site indicated. •

An Implant for Hearing Loss Due to Removal of Neurofibromatosis 2 Tumors Condition(s): Neurofibromatosis 2 Study Status: This study is currently recruiting patients. Sponsor(s): FDA Office of Orphan Products Development Purpose - Excerpt: This is a study to gather some information on the safety and efficacy of the penetrating auditory brainstem implant (PABI) in patients with neurofibromatosis type 2. Phase(s): Phase I Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00030043

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Clinical and Genetic Analysis of Inner Ear Malformations Condition(s): Sensorineural Hearing Loss; Cytomegalovirus Infection Study Status: This study is currently recruiting patients. Sponsor(s): National Institute on Deafness and Other Communication Disorders (NIDCD)

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These are listed at www.ClinicalTrials.gov.

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Purpose - Excerpt: This study will try to identify and understand the genetic factors that can lead to inner ear malformations that cause hearing loss. Patients with sensorineural hearing loss with or without inner ear malformations and their parents and siblings may be eligible for this study. Participants and their immediate family members, may undergo some or all of the following tests and procedures: - Medical and family history, including questions about hearing, balance and other ear-related issues, and review of medical records. - Routine physical examination. - Blood draw or buccal swab (brushing inside the cheek to collect cells) - Tissue is collected for DNA analysis to look for changes in genes that may be related to hearing loss. - Hearing tests - The subject listens for tones emitted through a small earphone. - Balance tests to see if balance functions of the inner ear are associated with the hearing loss - In one test the subject wears goggles and watches moving lights while cold or warm air is blown into the ears. A second test involves sitting in a spinning chair in a quiet, dark room. - Photograph - A photograph may be taken as a record of eye shape and color, distance between the eyes, and hair color. - Ultrasound tests - An inner ear malformation called EVA (enlargement of the vestibular aqueduct) indicates that a genetic disorder called Pendred syndrome may be the cause. Because thyroid abnormalities are also associated with Pendred syndrome, an ultrasound examination of the thyroid gland may be done. Also, ultrasound examination of the kidneys can detect malformations that may be inherited along with inner ear malformations associated with another genetic disorder called branchio-otorenal (BOR) syndrome. - Computed tomography (CT) and magnetic resonance imaging (MRI) scans - These tests show the structure of the inner ear. For CT, the subject lies still for a short time while X-ray images are obtained. For MRI, the patient lies on a stretcher that is moved into a cylindrical machine with a strong magnetic field. The magnetic field and radio waves produce images of the inner ear. The radio waves cause loud thumping noises that can be muffled by the use of earplugs. - Perchlorate discharge test - Patients suspected of having Pendred syndrome will have this diagnostic test, which takes about 5 hours to complete. The patient swallows a capsule containing radioactive iodine, followed about 90 minutes later by three or four capsules of perchlorate, a type of salt. A monitor is then held over the neck and over the thigh for a few minutes once every 30 minutes. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00023036 •

Early Diagnosis of Steroid-Responsive & No-Responsive Hearing Loss Condition(s): Hearing Loss Study Status: This study is currently recruiting patients. Sponsor(s): Department of Veterans Affairs Purpose - Excerpt: Tinnitus is a prevalent issue for veterans who are proportionally more hearing-impaired than the civilian population. This study will be conducted as three concurrent projects designed to develop an efficient clinical technique to quantify tinnitus perception: (1)Laboratory development of the automated technique for comprehensive tinnitus quantification;(2)Development of a technique to test for tinnitus "malingering"; and (3)Evaluation of the automated technique in the clinical environment. Phase(s): Phase II Study Type: Observational

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Contact(s): Steven Hefeneider, Ph.D. (503) 220-3428 [email protected] Web Site: http://clinicaltrials.gov/ct/show/NCT00013468 •

Epidemiology of Hearing Loss in Diabetic and Non-Diabetic Veterans Condition(s): Diabetes; Tinnitus; Hearing Loss Study Status: This study is currently recruiting patients. Sponsor(s): Department of Veterans Affairs Medical Research Service Purpose - Excerpt: The purpose of this study is to determine if individuals with diabetes are at increased risk of hearing impairment or tinnitus (the perception of ringing or noises in the ears or head). An important goal of this research is also to obtain a better understanding of possible interactions between hearing disorders and other chronic conditions, such as diabetes. Participation in this research will be for a few hours only, to be scheduled at the participant's convenience and according to the testing schedules of the different clinics involved. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00018486

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Genetic Analysis of Hereditary Disorders of Hearing and Balance Condition(s): Sensorineural Hearing Loss; Hearing Disorder; Vestibular Disease Study Status: This study is currently recruiting patients. Sponsor(s): National Institute on Deafness and Other Communication Disorders (NIDCD) Purpose - Excerpt: This study will try to identify the genetic causes of hereditary hearing loss or balance disorders. People with a hearing or balance disorder that affects more than one family member may be eligible for this study. They and their immediate family members may undergo some or all of the following procedures: - Medical and family history, including questions about hearing, balance and other ear-related issues, and review of medical records. - Routine physical examination. - Blood draw or buccal swab (brushing inside the cheek to collect cells) - Tissue is collected for DNA analysis to look for changes in genes that may be related to hearing loss. - Hearing tests - The subject listens for tones emitted through a small earphone. - Balance tests to see if balance functions of the inner ear are associated with the hearing loss - In one test the subject wears goggles and watches moving lights while cold or warm air is blown into the ears. A second test involves sitting in a spinning chair in a quiet, dark room. Photograph - A photograph may be taken as a record of eye shape and color, distance between the eyes, and hair color. - Computed tomography (CT) and magnetic resonance imaging (MRI) scans - These tests show the structure of the inner ear. For CT, the subject lies still for a short time while X-ray images are obtained. For MRI, the patient lies on a stretcher that is moved into a cylindrical machine with a strong magnetic field. The magnetic field and radio waves produce images of the inner ear. The radio waves cause loud thumping noises that can be muffled by the use of earplugs. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00023049

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Genetic Analysis of Human Hereditary Hearing Impairment Condition(s): Partial Hearing Loss Study Status: This study is currently recruiting patients. Sponsor(s): National Institute on Deafness and Other Communication Disorders (NIDCD) Purpose - Excerpt: This studied is designed to discover the genes that cause hearing impairment. More precisely, this study aims to map and clone genes that are important for the development and maintenance of the anatomy and physiology related to hearing (auditory system). The study will begin by finding large families who have members with hearing impairment. Once families are found, members with and without hearing impairment will be evaluated by an audiologist and a clinician (doctor). An audiologist, is a person trained in evaluating, habilitating, and rehabilitating people with disorders of hearing function. The clinician's responsibility is to examine the patients and check for other signs and symptoms related to hearing. Finding the gene for hearing impairment requires: 1. DNA samples of hearing impaired family members, taken from standard blood samples. 2. DNA samples of members of the family without hearing impairment, taken from standard blood samples. 3. Results of hearing tests conducted by the audiologist for all participants. Once all members of the family are evaluated researchers can create a pedigree. A pedigree is like a family tree that charts members of a family with a genetic disorder, like hearing impairment. Pedigrees are used to determine the mode of inheritance of the gene responsible for a particular condition. Finally, researcher intend on using all the information gathered as well as methods for genetic analysis to map out the location of the gene. Patients participating in this study will not directly benefit from its research, but scientific understanding achieved may help researchers better understand the auditory system and someday prevent deafness. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00001606

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Genetic Studies of Tone Deafness Condition(s): Healthy; Tone Deafness Study Status: This study is currently recruiting patients. Sponsor(s): National Institute on Deafness and Other Communication Disorders (NIDCD) Purpose - Excerpt: This study will examine the hereditary basis of tone deafness by identifying regions of the human genome linked to this condition. Both exceptionally good pitch recognition (perfect pitch) and exceptionally poor pitch recognition (tone deafness) run in families. A better understanding of what causes tone deafness may provide new insights into auditory (hearing) function. Individuals with two or more family members 15 years of age or older who are tone deaf or have trouble recognizing different melodies may be eligible for this study. Candidates will be screened with a short listening test for pitch and a short written test. Those identified with poor pitch recognition will fill out a brief questionnaire about their family tree and family members (without identifying names) who have trouble recognizing melodies or tones. Individuals with poor pitch recognition will be asked to help contact family members who may be interested in participating. Members of families with two or more firstdegree relatives (parents, grandparents, siblings) who are tone deaf may enroll in the

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study. They will provide a blood sample (about 2 tablespoons) for genetic studies and may take a 20-minute hearing test using headphones. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00006076 •

Quantifying Auditory Perceptual Learning Following Hearing Aid Fitting Condition(s): Hearing Loss Study Status: This study is currently recruiting patients. Sponsor(s): Department of Veterans Affairs Purpose - Excerpt: The purpose of this study is to examine and relate physiological, behavioral, and self-perceived changes after a period of hearing aid use and as a function of auditory training. The project will focus on the following questions: 1)Is experience-related behavioral change in hearing aid performance reflected as a neurophysiologic change? 2)Does a neurophysiologic change occur prior to or in conjunction with an experience-related behavioral change? 3) Does behavioral training modify the neurophysiologic representation of speech following the provision of hearing aids? 4)What is the relationship between physiologic, behavioral,and selfperceived change impacted by behavioral training? 5)Are neurophysiologic changes limited to trained stimuli or does auditory training alter neurophysiological responses? Phase(s): Phase II Study Type: Interventional Contact(s): Charles Nelson, M.S. (412) 365-5120 [email protected] Web Site: http://clinicaltrials.gov/ct/show/NCT00013455

Keeping Current on Clinical Trials The U.S. National Institutes of Health, through the National Library of Medicine, has developed ClinicalTrials.gov to provide current information about clinical research across the broadest number of diseases and conditions. The site was launched in February 2000 and currently contains approximately 5,700 clinical studies in over 59,000 locations worldwide, with most studies being conducted in the United States. ClinicalTrials.gov receives about 2 million hits per month and hosts approximately 5,400 visitors daily. To access this database, simply go to the Web site at http://www.clinicaltrials.gov/ and search by “hearing loss” (or synonyms). While ClinicalTrials.gov is the most comprehensive listing of NIH-supported clinical trials available, not all trials are in the database. The database is updated regularly, so clinical trials are continually being added. The following is a list of specialty databases affiliated with the National Institutes of Health that offer additional information on trials: •

For clinical studies at the Warren Grant Magnuson Clinical Center located in Bethesda, Maryland, visit their Web site: http://clinicalstudies.info.nih.gov/

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For clinical studies conducted at the Bayview Campus in Baltimore, Maryland, visit their Web site: http://www.jhbmc.jhu.edu/studies/index.html

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For cancer trials, visit the National Cancer Institute: http://cancertrials.nci.nih.gov/

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For eye-related trials, visit and search the Web page of the National Eye Institute: http://www.nei.nih.gov/neitrials/index.htm

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For heart, lung and blood trials, visit the Web page of the National Heart, Lung and Blood Institute: http://www.nhlbi.nih.gov/studies/index.htm

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For trials on aging, visit and search the Web site of the National Institute on Aging: http://www.grc.nia.nih.gov/studies/index.htm

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For rare diseases, visit and search the Web site sponsored by the Office of Rare Diseases: http://ord.aspensys.com/asp/resources/rsch_trials.asp

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For alcoholism, visit the National Institute on Alcohol Abuse and Alcoholism: http://www.niaaa.nih.gov/intramural/Web_dicbr_hp/particip.htm

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For trials on infectious, immune, and allergic diseases, visit the site of the National Institute of Allergy and Infectious Diseases: http://www.niaid.nih.gov/clintrials/

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For trials on arthritis, musculoskeletal and skin diseases, visit newly revised site of the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health: http://www.niams.nih.gov/hi/studies/index.htm

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For hearing-related trials, visit the National Institute on Deafness and Other Communication Disorders: http://www.nidcd.nih.gov/health/clinical/index.htm

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For trials on diseases of the digestive system and kidneys, and diabetes, visit the National Institute of Diabetes and Digestive and Kidney Diseases: http://www.niddk.nih.gov/patient/patient.htm

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For drug abuse trials, visit and search the Web site sponsored by the National Institute on Drug Abuse: http://www.nida.nih.gov/CTN/Index.htm

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For trials on mental disorders, visit and search the Web site of the National Institute of Mental Health: http://www.nimh.nih.gov/studies/index.cfm

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For trials on neurological disorders and stroke, visit and search the Web site sponsored by the National Institute of Neurological Disorders and Stroke of the NIH: http://www.ninds.nih.gov/funding/funding_opportunities.htm#Clinical_Trials

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CHAPTER 6. PATENTS ON HEARING LOSS Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.9 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “hearing loss” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on hearing loss, we have not necessarily excluded non-medical patents in this bibliography.

Patents on Hearing Loss By performing a patent search focusing on hearing loss, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We will tell you how to obtain this information later in the chapter. The following is an 9Adapted

from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.

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example of the type of information that you can expect to obtain from a patent search on hearing loss: •

2-substituted piperidine analogs and their use as subtype-selective NMDA receptor antagonists Inventor(s): Bigge; Christopher F. (Ann Arbor, MI), Cai; Sui Xiong (Foothill, CA), Guzikowski; Anthony P. (Eugene, OR), Keana; John F. W. (Eugene, OR), Lan; Nancy C. (South Pasadena, CA), Weber; Eckard (Laguna Beach, CA), Woodward; Richard (Aliso Viejo, CA) Assignee(s): Cocensys, Inc. (Irvine, CA), Warner-Lambert Company (Morris Plains, NJ) Patent Number: 6,124,317 Date filed: November 18, 1998 Abstract: Novel 2-substituted piperidine analogs, pharmaceutical compositions containing the same and the method of using 2-substituted piperidine analogs as selectively active antagonists of N-methyl-D-aspartatc (NMDA) receptor subtypes for treating conditions such as stroke, cerebral ischemia, central nervous system trauma, hypoglycemia, anxiety, convulsions, amioglycoside antibiotics-induced hearing loss, migraine headaches, chronic pain, glaucoma, CMV retinitis, psychosis, urinary incontinence, opioid tolerance or withdrawal, or neurodegenerative disorders, such as lathyrism, Alzheimer's Disease, Parkinsonism and Huntington's Disease are described. Excerpt(s): This invention is related to 2-substituted piperidine analogs. The analogs are selectively active as antagonists of N-methyl-D-aspartate (NMDA) receptor subtypes. The invention is also directed to the use of 2-substituted piperidine analogs as neuroprotective agents for treating conditions such as stroke, cerebral ischemia, central nervous system trauma, hypoglycemia, anxiety, convulsions, aminoglycoside antibiotics-induced hearing loss, migraine headaches, chronic pain, glaucoma, CMV retinitis, psychosis, urinary incontinence, opioid tolerance or withdrawal, or neurodegenerative disorders such as lathyrism, Alzheimer's Disease, Parkinsonism and Huntington's Disease. Excessive excitation by neurotransmitters can cause the degeneration and death of neurons. It is believed that this degeneration is in part mediated by the excitotoxic actions of the excitatory amino acids (EAA) glutamate and aspartate at the N-methyl-D-Aspartate (NMDA) receptor. This excitotoxic action is considered responsible for the loss of neurons in cerebrovascular disorders such as cerebral ischemia or cerebral infarction resulting from a range of conditions, such as thromboembolic or hemorrhagic stroke, cerebral vasospasms, hypoglycemia, cardiac arrest, status epilepticus, perinatal asphyxia, anoxia such as from drowning, pulmonary surgery and cerebral trauma, as well as lathyrism, Alzheimer's Disease, Parkinson's Disease and Huntington's Disease. Ar is aryl or heteroaryl, each of which may be optionally substituted. 2-[2-(3,4-Dichlorophenoxy)ethyl]-1-cinnamylpiperidine oxalate hemihydrate and 4-[2-(2-Dibenzofuranyloxy)ethyl]-1-cinnamylpiperidine oxalate are exemplified. The compounds of this reference are said to be useful for treating anoxia, ischaemia, such as stroke, migraine, epilepsy, traumatic head injury, AIDS-related dementia, neurodegenerative diseases and drug addiction withdrawal. This reference does not disclose or suggest NMDA receptor activity, let alone selective NMDA receptor subtype antagonism. Web site: http://www.delphion.com/details?pn=US06124317__

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4-substituted piperidine analogs and their use as subtype selective NMDA receptor antagonists Inventor(s): Bigge; Christopher F. (Ann Arbor, MI), Cai; Sui Xiong (Foothill, CA), Guzikowski; Anthony P. (Eugene, OR), Keana; John F. W. (Eugene, OR), Lan; Nancy C. (South Pasadena, CA), Weber; Eckard (Laguna Beach, CA), Woodward; Richard (Aliso Viejo, CA), Yuen; Po-Wai (Ann Arbor, MI), Zhou; Zhang-Lin (Irvine, CA) Assignee(s): Cocensys, Incorporated (Irvine, CA), Warner-Lambert Company (Morris Plains, NJ) Patent Number: 6,124,323 Date filed: September 16, 1998 Abstract: Novel 4-substituted piperidine analogs, pharmaceutical compositions containing the same and the method of using 4-substituted piperidine analogs are selective active antagonists of N-methyl-D-aspartate (NMDA) receptor subtypes for treating conditions such as stroke, cerebral ischemia, central nervous system trauma, hypoglycemia, psychosis, anxiety, migraine headaches, glaucoma, CMV retinitis, aminoglycoside antibiotics-induced hearing loss, convulsions, chronic pain, opioid tolerance or withdrawal, urinary incontinence or neurodegenerative disorders, such as lathyrism, Alzheimer's Disease, Parkinsonism and Huntington's Disease are described. Excerpt(s): This invention is related to 4-substituted piperidine analogs, including hydroxypiperidine and tetrahydropyridine analogs. The analogs are selectively active as antagonists of N-methyl-D-aspartate (NMDA) receptor subtypes. The invention is also directed to the use of 4-substituted piperidine analogs as neuroprotective agents for treating conditions such as stroke, cerebral ischemia, central nervous system trauma, hypoglycemia, anxiety, psychosis, glaucoma, CMV retinitis, urinary incontinence, aminoglycoside antibiotics-induced hearing loss, convulsions, migraine headache, chronic pain, opioid tolerance or withdrawal, or neuro-degenerative disorders such as lathyrism, Alzheimer's Disease, Parkinsonism and Huntington's Disease. Excessive excitation by neurotransmitters can cause the degeneration and death of neurons. It is believed that this degeneration is in part mediated by the excitotoxic actions of the excitatory amino acids (EAA) glutamate and aspartate at the N-methyl-D-Aspartate (NMDA) receptor. This excitotoxic action is considered responsible for the loss of neurons in cerebrovascular disorders such as cerebral ischemia or cerebral infarction resulting from a range of conditions, such as thromboembolic or hemorrhagic stroke, cerebral vasospasms, hypoglycemia, cardiac arrest, status epilepticus, perinatal asphyxia, anoxia such as from drowning, pulmonary surgery and cerebral trauma, as well as lathyrism, Alzheimer's Disease, Parkinson's Disease and Huntington's Disease. Other piperidine derivatives having aryl alkanol functionality are disclosed by PCT International Publication No. WO 93/11107 (for treating hypoxia and ischaemia), International Publication No. WO 94/10166 (for treating stroke, addiction, pain, epilepsy, psychosis, traumatic brain injury and CNS degenerative diseases), EP 0398578 (for treating stroke or CNS degenerative diseases, Alzheimer's disease, Huntington's disease and Parkinson's disease) and PCT International Publication No. WO 93/02052 (for treating stroke, traumatic injury to the brain and spinal cord, and neuronal degenerative diseases). Similar to EP 0648744, each of these references requires a piperidine derivative having an alkyl hydroxy or keto group alpha to the aryl group of the N-1 substituent. The 4-substituted piperidine analogs of this invention differ in kind from the piperidine derivatives of these references. Web site: http://www.delphion.com/details?pn=US06124323__

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Apparatus for and method of filtering in an digital hearing aid, including an application specific integrated circuit and a programmable digital signal processor Inventor(s): Brennan; Robert (Kitchener, CA), Schneider; Anthony Todd (Waterloo, CA) Assignee(s): dspfactory Ltd. (Waterloo, CA) Patent Number: 6,240,192 Date filed: April 16, 1998 Abstract: An apparatus for a hearing aid provides an application specific integrated circuit (ASIC) for filtering of input signals and a programmable digital signal processor connected to it, for control of filterbank gains. This provides a compromise between the conflicting goals of size, re-programmability and power consumption. The fixed portion of the processing, i.e. filtering is implemented in hardware in the ASIC, and the variable or adjustable portion of the processing is implemented by the programmable digital signal processor. The filterbank has an adjustable number of channels and means for shifting the center frequencies of the bands in unison to one of two discrete sets of center frequencies. A wide range of hearing loss compensation schemes can be implemented. Software programs can be executed on the programmable digital signal processor. Excerpt(s): This invention relates to hearing aids. This invention more particularly relates to an apparatus and method for use in hearing aids that employ digital processing methods to implement hearing loss compensation and other forms of corrective processing. The design of digital hearing aids involves numerous trade-offs between processing capability, flexibility, power consumption and size. Minimizing both chip size and power consumption are important design considerations for integrated circuits used in hearing aids. Fully-programmable implementations of digital hearing aids (i.e., those that use a software-controlled digital signal processor) provide the most flexibility. However, with current technology, a fully-programmable digital signal processor (DSP) chip or core consumes a relatively large amount of power. An application specific processor (typically implemented using an application specific integrated circuit or ASIC) will consume less power and chip-area than a fullyprogrammable, general-purpose DSP core for equivalent processing capabilities, but is less flexible and adaptable. Digital hearing aids typically operate at very low supply voltages (1 volt). If circuits for digital hearing aids are fabricated using conventional high-threshold (0.6 volt or greater) semiconductor technology they are not able to operate at high clock speeds (>1 MHz) because of the small difference between the supply voltage and threshold voltage. Even if a DSP core is capable of executing one instruction per clock cycle this limits the computation speed to less than 1 million instructions per second (1 MIPS). This is not a high enough computation rate to implement advanced processing schemes like adaptive noise reduction or multi-band wide dynamic range compression with 16 or more bands. Because ASIC implementations overcome the sequential nature of a typical DSP core and permit calculations to be made in parallel, they can provide more computational capability, i.e. a higher computation rate, and can be used to implement computationally intensive processing strategies. Web site: http://www.delphion.com/details?pn=US06240192__

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Branched chain amino acid-dependent aminotransferase inhibitors and their use in the treatment of neurodegenerative diseases Inventor(s): Hays; Sheryl Jeanne (Ann Arbor, MI), Hu; Lain-Yen (Ann Arbor, MI), Lei; Huangshu (Ann Arbor, MI), Scholten; Jeffrey David (Ann Arbor, MI), Wustrow; David Juergen (Ann Arbor, MI) Assignee(s): Pfizer Inc. (New York, NY) Patent Number: 6,632,831 Date filed: November 26, 2002 Abstract: The invention relates to BCAT inhibitors and the use thereof for treating or preventing neuronal loss associated with stroke, ischemia, CNS trauma, hypoglycemia and surgery, as well as treating neurodegenerative diseases including Alzheimer's disease, amyotrophic lateral sclerosis, Huntington's disease and Down's syndrome, treating or preventing the adverse consequences of the overstimulation of the excitatory amino acids, treating anxiety, psychosis, convulsions, aminoglycoside antibioticsinduced hearing loss, migraine headache, chronic pain, neuropathic pain, Parkinson's disease, diabetic retinopathy, glaucoma, CMV retinitis, urinary incontinence, opioid tolerance or withdrawal, and inducing anesthesia, as well as for enhancing cognition. Excerpt(s): This invention is related to branched chain amino acid-dependent amino transferase (BCAT) inhibitors. The invention is also directed to the use of BCAT inhibitors as neuro-protective agents for treating conditions such as stroke, cerebral ischemia, central nervous system trauma, hypoglycemia, anxiety, convulsions, aminoglycoside antibiotics-induced hearing loss, migraine headaches, chronic pain, neuropathic pain, glaucoma, CMV retinitis, diabetic retinopathy, psychosis, urinary incontinence, opioid tolerance or withdrawal, or neuro-degenerative disorders such as lathyrism, Alzheimer's disease, Parkinsonism, amyotrophic lateral sclerosis (ALS), and Huntington's Disease. Excessive excitation by neurotransmitters can cause the degeneration and death of neurons. It is believed that this degeneration is in part mediated by the excitotoxic actions of the excitatory amino acids (EAA) glutamate and aspartate at the N-methyl-D-aspartate (NMDA) receptor. This excitotoxic action is considered responsible for the loss of neurons in cerebrovascular disorders such as cerebral ischemia or cerebral infarction resulting from a range of conditions, such as thromboembolic or hemorrhagic stroke, cerebral vasospasms, hypoglycemia, cardiac arrest, status epilepticus, perinatal asphyxia, anoxia such as from drowning, pulmonary surgery and cerebral trauma, as well as lathyrism, Alzheimer's disease, Parkinson's disease, and Huntington's disease. Excitatory amino acid receptor antagonists that block NMDA receptors are recognized for usefulness in the treatment of disorders. NMDA receptors are intimately involved in the phenomenon of excitotoxicity, which may be a critical determinant of outcome of several neurological disorders. Disorders known to be responsive to blockade of the NMDA receptor include acute cerebral ischemia (stroke or cerebral trauma, for example), muscular spasm, convulsive disorders, neuropathic pain and anxiety, and may be a significant causal factor in chronic neurodegenerative disorders such as Parkinson's disease (Klockgether T., Turski L., Ann. Neurol., 1993;34:585-593), human immunodeficiency virus (HIV) related neuronal injury, amyotrophic lateral sclerosis (ALS), Alzheimer's disease (Francis P. T., Sims N. R., Procter A. W., Bowen D. M., J. Neurochem., 1993;60(5):1589-1604, and Huntington's disease (see Lipton S., TINS, 1993;16(12):527-532; Lipton S. A., Rosenberg P. A., New Eng. J. Med., 1994;330(9):613-622; and Bigge C. F., Biochem. Pharmacol., 1993;45:15471561, and referenced cited therein.) NMDA receptor antagonists may also be used to

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prevent tolerance to opiate analgesia or to help control withdrawal symptoms from addictive drugs (Eur. Pat. Appl. 488,959A). Web site: http://www.delphion.com/details?pn=US06632831__ •

Composition to treat ear disorders Inventor(s): Petrus; Edward J. (Austin, TX) Assignee(s): Advanced Medical Instruments (Austin, TX) Patent Number: 6,093,417 Date filed: January 11, 1999 Abstract: A topical ear composition that uses penetration enhancers to diffuse the therapeutic agents through the tympanic membrane into the middle and inner ear for the purpose of reducing the inflammation of ear tissues, providing pain relief, and introducing agents with antimicrobial activity to combat infection. The composition reduces swelling of the lining membranes of the middle and inner ear, prevent the destructive effects of inflamation, inhibit the production of prostaglandins, reduce symptoms of tinnitus and vertigo, improve and prevent paralysis of the facial nerve, relieve labyrinthitis, and prevent hearing loss. Excerpt(s): A therapeutic composition for the relief and prevention of symptoms associated with ear disorders in humans and animals. Most ear disorders are the result of an inflammatory response to infections, allergic reactions, or trauma. The infection may be of bacterial, fungal or viral origin and determination of the precise etiology is not practical since the causative organism is often difficult to isolate and culture. The determination of a viral cause is even more difficult to establish. Trauma, as a cause of ear disorders is made on the basis of a medical history and radiological confirmation. It is important to treat the inflammation as soon as possible to reduce the sequella of hearing loss, tinnitus, facial nerve palsy, mastoiditis, labyrinthitis, vertigo, and possible encephalitis. Otitis is a non-specific term that describes a symptom and indicates an inflammation of the ear. The ear is anatomically divided into the external, middle and inner ear. Web site: http://www.delphion.com/details?pn=US06093417__

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Device and process for generating and measuring the shape of an acoustic reflectance curve of an ear Inventor(s): Busey; Hugh W. (Cheshire, CT), Combs; Jerome T. (Wallingford, CT), Ukraincik; Kresimir (Cromwell, CT) Assignee(s): MDI Instruments, Inc. (Woburn, MA) Patent Number: 5,868,682 Date filed: June 18, 1997 Abstract: A device and a process for analysis of an ear directs into the ear acoustic waves Measurements may be made without pressurizing the ear canal and contact between the device and the ear does not need to be air-tight. The patient experiences essentially no discomfort from use of the device. The device detects the reflected waves to produce what is called an acoustic reflectance curve. The shape of a region of the acoustic reflectance curve is electronically measured in order to obtain an indicator of ear

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condition which is substantially independent of a line of sight between a sound source and the ear. This indicator may be based on a measurement of the resonance characteristic, or freedom of motion, of the tympanic membrane or other ear component being analyzed. One such measurement is the rate of change of the acoustic reflectance with respect to frequency. The rate of change measured around the null may be presented as an angle measurement, a gradient or slope measurement, a width measurement, or other form of measurement of the shape of the null. The steepest slopes on either side of a null may be used to define an angle. Diagnosis of an ear pathology, such as abnormal pressure or presence of fluid in the middle ear or conductive hearing loss, may be based on this measure alone. Excerpt(s): The present invention relates generally to devices and processes which provide information about a condition of an ear for use in diagnosis of ear pathologies. More particularly, the invention relates to devices and processes which involve measuring acoustic reflectance of components of the ear. A wide variety of diseases associated with the human and animal ears have been identified. The more frequently diagnosed pathologies include obstruction of the external ear canal, atresia of the external ear canal, perforation of the tympanic membrane, retraction of the tympanic membrane, otitis in its various forms (adhesive, purulent and non-purulent), otosclerosis, fixation of the stapes, and cholesteatoma, among others. In children, otitis media is one of the most common pathologies. By itself, otitis media is a significant affliction which can lead to serious long-term hearing and learning disabilities if not promptly diagnosed and treated. Further, otitis media is frequently symptomatic of other pathologies, and thus useful in their diagnosis. These ear pathologies are generally diagnosed using common diagnostic techniques, such as tympanometry, pneumatic otoscopy or visual otoscopy. While the usefulness of these techniques is well-recognized and established, these techniques do have some difficulties. For example, with both tympanometry and otoscopy, personnel who conduct tests and interpret results must be highly trained. Since these techniques cannot be performed by non-medical or inexperienced personnel, efficient screening of children or infants at home or in a school is not possible with these techniques. Web site: http://www.delphion.com/details?pn=US05868682__ •

Digital hearing impairment simulation method and hearing aid evaluation method using the same Inventor(s): Kim; Dong-wook (Sungnam, KR), Park; Young-cheol (Seoul, KR) Assignee(s): Samsung Electronics Co., Ltd. (Kyungki-do, KR) Patent Number: 5,944,672 Date filed: April 15, 1998 Abstract: A digital hearing impairment simulation method and a hearing aid evaluation method using the same are disclosed. According to the digital hearing impairment simulation method, a hearing characteristic table of a hearing impaired person is input and the input table is stored in a memory, in order to sample the hearing characteristics of the hearing impaired person (S1). A hearing loss table is calculated and stored in the memory (S2). An audio signal input via an audio input portion is converted to a digital signal and the converted digital signal is stored in the memory (S3). The converted digital signal is converted to the frequency domain signal using a fast Fourier transform algorithm (S4). The average power by critical band is calculated (S5). A hearing loss gain for each critical band is calculated using the hearing loss table and the average

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powers of the critical bands (S6). Coefficients for a digital filter corresponding to the hearing loss gains of the critical bands is calculated (S7). The input signal converted to a digital signal and stored in the memory in the step (S3) is digitally filtered using the digital filter coefficients (S8). The digitally filtered signal is converted to an analog signal and the converted analog signal is output to an audio output portion (S9). Thus, the performance of a hearing aid can be easily evaluated and hearing characteristics of a hearing impaired person can be easily sampled. Excerpt(s): The present invention relates to a digital hearing impairment simulation method and a hearing aid evaluation method, and more particularly, to a digital hearing impairment simulation method and a hearing aid evaluation method using the same according to which a clinical test performed on actual hearing impaired persons can be replaced by one performed on normal persons, and also the performance of a hearing aid can be easily evaluated since the result of the clinical test is predictable. Generally, in a study of hearing impairment, or evaluation and comparison of hearing aids, a hearing test is directly performed on hearing impaired persons and a clinical test of wearing a hearing aid is performed. That is, in the clinical test, impaired persons are allowed to listen to diverse sounds or voice in a soundproof chamber or a hearing test room, and their responses to the sound or voice are checked and evaluated. However, since there are many types of hearing impairment, and the type of hearing impairment and characteristics of the individual vary greatly, experiments on hearing impairment must be performed based on an individual or the type of hearing impairment, which requires enormous time and effort. One method for evaluating the capability of a hearing aid is to evaluate the capability of the hearing aid itself, and another is to evaluate the hearing aid in use by directly applying the hearing aid to impaired persons. The method for evaluating a hearing aid in use has disadvantages in that: 1) a long-term test is not easy since most impaired persons are aged, 2) communication between hearing impaired persons and testers is not easy, 3) due to diverse hearing impairment types and the difference of individual hearing characteristics, it is difficult to group similar hearing impairments, and 4) impaired persons may respond uncertainly to the test due to symptoms of hearing impairment. To solve the above problems, it is an objective of the present invention to provide a digital hearing impairment simulation method by which a clinical test performed on actual hearing impaired persons can be replaced by one performed on normal persons, and which makes it easy to evaluate the capability of a hearing aid since the result of the clinical test is predictable. Web site: http://www.delphion.com/details?pn=US05944672__ •

Disposable audio processor for use with implanted hearing devices Inventor(s): Arthur; Bruce D. (San Jose, CA), Ball; Geoffrey R. (Sunnyvale, CA), Katz; Bob H. (Los Gatos, CA) Assignee(s): Symphonix Devices, Inc. (San Jose, CA) Patent Number: 5,949,895 Date filed: September 7, 1995 Abstract: A disposable audio processor for use with implanted hearing devices is provided. The audio processor may include a microphone, application specific integrated circuit performing both signal processing and signal modulation, a battery, and a coil. The audio processor is designed for specific types of hearing loss. Electronic signals are transmitted to an implanted receiver through the use of electromagnetic fields generated by the coil of the audio processor. The audio processor is a low power

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and inexpensive device that may be disposed of when it becomes inoperable. The audio processor and may include a finger tab for manipulating the device. Excerpt(s): The present invention relates to the field of devices and methods for improving hearing in hearing impaired persons and, more particularly, to external audio processors for use with implanted hearing devices. Traditional hearing aids have generally been devices including a microphone, an amplifier and a speaker placed in a person's external ear canal. The microphone picks up ambient sounds which the amplifier amplifies and delivers to the speaker (also known as the "receiver"). The speaker broadcasts the amplified sound at a much louder level to the hearing impaired person. Recently, hearing aid devices have incorporated advanced integrated circuit designs that shape the amplified sounds to best suit the person's hearing loss. Although there have been numerous advancements in traditional hearing aid devices, inherent problems still remain. Traditional hearing aid devices have the inherent problem of occlusion. The electronic components of the hearing aid are housed in a plastic or acrylic ear plug which is placed in the external ear canal. Placing the hearing aid in the ear canal diminishes the hearing impaired person's natural ability to hear by occluding the ear canal. Thus, traditional hearing aid devices cause the user to rely almost solely upon the hearing aid and the resulting occlusion is thought to be at least partially responsible for complaints of unnatural or poor sounding devices. Web site: http://www.delphion.com/details?pn=US05949895__ •

Earphone without impulse noise and conductive hearing loss Inventor(s): Lin; Chung-Yu (29, Tunnel 152, Kuang Hwa 1 Rd., Kaohsiung, TW) Assignee(s): none reported Patent Number: 6,084,976 Date filed: June 11, 1999 Abstract: An earphone without impulse noise and conductive hearing includes a loudspeaker having a first sound output end for producing a high intensive sound wave and a second sound output end for producing a low intensive sound wave, and an earphone housing which includes a housing body, a sound output hood and a sound collecting hood. The housing body has a first open-end, a second open-end and a receiving chamber therein for mounting the loudspeaker. A sound output hood, which has a plurality of meshes thereon, is positioned in front of the first sound output end of the loudspeaker. The sound collecting hood, which has a plurality of meshes thereon, is positioned in front of the second sound output end of the loudspeaker. In which, the high intensive sound wave produced at the first sound output end emits outside the housing body through the meshes of the sound output hood and returns between the second sound output end of the loudspeaker and the sound collecting hood inside the housing body through a sound inlet provided around the housing body. Thereby the high intensive sound wave and the low intensive sound wave are constructively and destructively interfered between the sound collecting hood and the second sound output end of the loudspeaker to form a combined sound wave with high-clarity sound interval to emit through the meshes of the sound collecting hood. Excerpt(s): The present invention relates to an earphone without impulse noise and conductive hearing loss, wherein the sound waves from the loudspeaker thereof would not directly transmit to the middle ear so as to prevent conductive hearing loss caused by the direct impact of the sound pressure. In 1990, the National Institutes of Health

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Consensus Development Conference State announced: "there are about 28 million American have hearing loss problem, among those people, at least one million people have hearing loss from high impact noise environment." Additionally, in 1993, National Ear Care Plan claimed that approximate 1.7% of American Teen, under 18, have hearing disability. Furthermore, in 1997, UT Southwestern Medical Center stated: "approximate 20% of American Teen, between 13-19, have hearing disability. The major cause of the hearing loss is people exposed to the noise especially the impulse noise from the earphone." People should concern the control of the sound volume while using the traditional earphone (continuous hearing not more than one hour or six hours per day when sound pressure at 105 dB or 95 dB respectively). In fact, this flash impulse noise contains high sound pressure and may damage the eardrum or middle ear hearing loss. It is called Conductive Hearing Loss. America's medical report recently stated that the percentage of people having the Conductive Hearing Loss is gradually increasing since earphones are improperly used to listen hot music such as Rock and Roll. Moreover, earphone receives signal from source such as walkman o communicator devices, and transfers the sound wave to human ear which the perceptible frequency range of human being is about 20 Hz to 20 kHz. In fact, the reproductive resonance of sound interval in above frequency range is not ideal since the source of sound is not come from millions dollars of high-end musical devices but from the walkman or communicator devices. Among these signal from walkman or communicator devices exist lots of feedback or noise, so the noise of `beep` sounds often found at high frequency range and `woo` sounds often found at low frequency range. Web site: http://www.delphion.com/details?pn=US06084976__ •

Filterbank structure and method for filtering and separating an information signal into different bands, particularly for audio signal in hearing aids Inventor(s): Brennan; Robert (Kitchener, CA), Schneider; Anthony Todd (Waterloo, CA) Assignee(s): dspfactory Ltd. (Waterloo, CA) Patent Number: 6,236,731 Date filed: April 16, 1998 Abstract: A filterbank structure is provided which provides a flexible compromise between the conflicting goals of processing delay, filter sharpness, memory usage and band interaction. The filterbank has an adjustable number of bands and a stacking which provides for a selectable shift of band frequencies to one of two discrete sets of center frequencies. The width of the bands and hence the number of the bands is selected depending upon acceptable delay, memory usage, and processing speed required. The flexibility in terms of stacking of the bands provides twice the number of potential band edge placements, which is advantageous for hearing loss fitting, especially at low frequencies. The same filter coefficients can be used for analysis and synthesis, to reduce memory usage. Excerpt(s): This invention relates to a filterbank structure and a method for filtering and separating an information signal into different bands, particularly for such filtering and separation of audio signals in hearing aids. This invention more particularly relates to such a technique carried out using digital signal processing in hearing aids. This invention more particularly relates to a method and architecture for a digital filterbank for hearing aid applications. Hearing loss is generally associated with a loss of hearing sensitivity which is a function of frequency. The most common type of sensitivity loss is an increasing function of frequency. Sensitivity is typically a function of speech level as

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well. Hence, loud sounds should be amplified less than soft sounds. It has been long known that a hearing aid should treat the various frequency components of speech differently to render them intelligible to a hearing impaired person. Known analog hearing aids use relatively simple methods to alter their frequency shaping and dynamic range compression to mitigate the loss in hearing sensitivity for frequency and level. Web site: http://www.delphion.com/details?pn=US06236731__ •

Fully implantable hearing system with telemetric sensor testing Inventor(s): Leysieffer; Hans (Taufkirchen, DE) Assignee(s): Implex Aktiengesellschaft Hearing Technology (Ismaning, DE) Patent Number: 6,334,072 Date filed: August 6, 1999 Abstract: A fully implantable hearing system for rehabilitation of a pure sensorineural hearing loss or combined conduction and inner ear hearing impairment, comprising at least one implantable sensor which generates an electrical audio signal, at least one signal processing and amplification unit in an audio-signal processing electronic hearing system path, at least one implantable electromechanical transducer and a unit for supplying power for the implant system. The hearing system is furthermore provided with an implant-side measurement unit which acquires the electrical sensor signal(s) electronically by measurement engineering and electronically conditions the signal(s). Also, a wireless telemetry unit is provided on the implant side which transfers the electronically conditioned sensor signal(s) to the outside to an external display and/or evaluation unit. Excerpt(s): The present invention relates to implantable hearing systems for rehabilitation of pure sensorineural hearing losses, or combined conduction and inner ear hearing impairments. In particular, the invention relates to such hearing system in which as implantable sensor delivers an electrical audio signal which is processed by an implanted processor and delivered to an to implantable electromechanical transducer which acts on the middle or inner ear. Fully implantable hearing systems for rehabilitation of a pure sensorineural hearing loss, or combined conduction and inner ear hearing impairment, with mechanical stimulation of the damaged ear will soon be available on the market. Examples of these systems are disclosed in the journal HNO 46:844-852, 10-1998, H. P. Zenner et al., "Initial implantations of a completely implantable electronic hearing system in patients with sensorineural hearing loss"; U.S. Pat. Nos. 5,277,694; 5,788,711; 5,814,095; 5,554,096 and U.S. Pat. No. 5,624,376. These hearing systems have basically four function units, specifically a sensor (microphone) which converts the incident airborne sound into an electrical signal, an electronic signal processing and amplification unit, an electromechanical transducer which converts the amplified and preprocessed sensor signals into mechanical vibrations and sends them via suitable coupling mechanisms to the damaged middle and/or inner ear, and an electrical power supply system which supplies these modules. Furthermore, a unit may be provided which supplies electrical recharging energy to the implant, when the implant-side power supply unit contains a rechargeable (secondary) battery, for example as shown in U.S. Pat. No. 5,279,292. A telemetry unit may also be provided with which patient-specific audiological data can be bidirectionally transmitted wirelessly or programmed in the implant and thus permanently stored as disclosed in the journal HNO 46:853-863, 10-1998, H. Leysieffer et al., "A completely implantable hearing system for inner ear hearing handicapped: TICA LZ 3001". Especially in fully

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implantable systems is the visibility of the system not an issue. As a result, in addition to the advantages of high sound quality, the open auditory canal and full suitability for everyday use, high future patient acceptance can be assumed. Basically, in these implantable systems, the output signal is a mechanical vibratory stimulus which directly excites the middle ear or inner ear. The coupling of the mechanical excitation which is produced by an electromechanical transducer takes place by direct mechanical connection of the vibrating transducer element to the ossicle chain or an ossicle of the middle ear or to the inner ear, e.g. commonly owned co-pending U.S. patent application Ser. No. 09/042,805 filed Mar. 17, 1998, or by force coupling via an air gap in electromagnetic transducers, for example. Web site: http://www.delphion.com/details?pn=US06334072__ •

Hearing evaluation device with predictive capabilities Inventor(s): Coppin; Christophe M. (Carlsbad, CA), Smits; Matthijs P. (Woodside, CA) Assignee(s): Natus Medical, Inc. (San Carlos, CA) Patent Number: 6,343,230 Date filed: January 7, 2000 Abstract: An apparatus and method for evaluation of hearing loss is disclosed. The apparatus and method use evoked Auditory Brainstem Responses (ABR) to determine if the subject is able to hear repeatedly administered click stimuli. In order to expedite evaluation, the present invention uses normative data to accurately predict when a subject is likely to fail the test, so that evaluation will not needlessly continue for a subject who is very unlikely to pass. Excerpt(s): This application is related to the co-pending and commonly assigned U.S. Patent Application entitled "Hearing Evaluation Device with Patient Connection Evaluation Capabilities," Ser. No. 09/479,559 filed by Matthijs P. Smits, Vineet Bansal, Abraham J. Totah and Bryan P. Flaherty and the U.S. Patent Application entitled "Hearing Evaluation with Noise Detection and Evaluation Capability," Ser. No. 09/479,548 filed by Matthijs P. Smits and Bryan P. Flaherty, the disclosures of which are hereby incorporated herein by reference. The present invention relates to devices and methods that use electroencephalographic responses to auditory stimuli to evaluate the hearing of a subject, and that are capable of quickly and accurately determining when a subject is unlikely to pass the hearing loss test. In the past, hearing impairment in babies and children was often not detected until after it was observed that the baby or child did not respond normally to sound. Unfortunately, it often took months or even years for the parent to observe the impairment, and by that time the child's language and learning abilities were negatively and often irreversibly impacted. Indeed, recent studies indicate that the vocabulary skills of hearing impaired children markedly increases if their hearing loss is detected early. The optimal time to evaluate hearing loss is thus immediately after birth, both because early detection allows for early treatment, and because parents often fail to bring their infants to later appointments. As a result, a number of states have implemented programs to evaluate newborns for hearing loss. Web site: http://www.delphion.com/details?pn=US06343230__

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Hearing improvement device Inventor(s): Goode; Richard (Los Altos, CA) Assignee(s): ReSound Corporation (Redwood City, CA) Patent Number: 5,797,834 Date filed: May 31, 1996 Abstract: A thin diaphragm for contacting an individual's tympanic membrane is sufficiently stiff and flexible to vibrate in response to audio frequencies so as to augment or over-ride the displacement of the individual's tympanic membrane in order to increase the acoustic efficiency of the tympanic membrane at all frequencies but particularly above 1000 Hz so as to improve mild hearing loss. Excerpt(s): The present invention relates generally to hearing improvement devices, and more particularly to a device which contacts a user's ear drum for improving the user's hearing by augmenting and/or over-riding the vibrational characteristics of the user's ear drum. The types of treatment given to the hearing impaired vary depending upon the type and extent of hearing loss. For example, aging and noise exposure result in hearing loss due primarily to a decrease in the nerve function in the cochlea or a reduction in the number of "hair" cells (very small, specialized cells) located within the inner ear. Hair cells are responsible for producing electrical impulses which are transmitted to the brain by the auditory nerve and perceived as sound. Another type of hearing loss is due to abnormalities in an individual's tympanic membrane, more commonly known as the ear drum. Abnormalities of this type include perforations, scars, stretching, biological variations of the intrinsic visco-elastic properties, and tissue damage due to disease. The most common and often the most impairing of these abnormalities is a perforation of the tympanic membrane. Tympanic membrane perforations are usually corrected by surgery. However, other less impairing abnormalities, such as an intact but scarred or flaccid tympanic membrane, are rarely surgically corrected because the results are not regularly predictable and may not be worth the expense and risks associated with surgery. Web site: http://www.delphion.com/details?pn=US05797834__

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Hearing prosthesis Inventor(s): Merchant; Saumil N. (Acton, MA), Nadol, Jr.; Joseph B. (Needham, MA) Assignee(s): Massachusetts Eye & Ear Infirmary (Boston, MA) Patent Number: 6,251,138 Date filed: July 28, 1999 Abstract: This invention relates to surgical methods and prosthetic devices for ameliorating hearing loss in patients having ailments of the middle ear. The prosthetic device of the invention includes at least a synthetic gas-filled balloon having a pliant membrane of biocompatible material. The surgical method of the invention places the synthetic balloon in the patient's middle ear in contact with the tympanic membrane to restore tympanic membrane motion so as to enhance transfer of sound through the middle ear to the inner ear of the patient. Excerpt(s): The present invention relates to surgical methods and prosthetic devices for ameliorating hearing loss in patients suffering from ailments of the middle ear. Chronic otitis media (COM), a common inflammatory disease of the middle ear and mastoid, can

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affect 0.5 to 30% of the population (a conservative estimate of the number of people suffering from COM is over 5 million in the U.S. and over 120 million worldwide), and results in conductive hearing loss that can range in severity up to 60 dB. The main form of therapy for COM is surgical, i.e., mastoidectomy and tympanoplasty. Although tympanomastoid surgery is typically successful in controlling infection, a post-operative hearing loss of more than 20 dB persists in about 50% of patients. Such hearing loss is often significant, in the range of 40 to 60 dB. Non-aeration of the middle ear due to deposition of fibrous tissue or formation of fluid resulting from eustachian tube dysfunction is understood to be the main cause of such post-operative hearing loss. Serous otitis media (OME) is another common disorder of the middle ear that can lead to conductive hearing loss ranging in severity up to 30-40 dB. A number of patients with OME fail to respond to medical therapy and hence require surgical intervention by way of a tympanostomy (ventilation) tube. In fact, tympanostomy tube placement is the most common operation performed in the United States, with over 1.3 million ears intubated annually. Such tubes, however, have several disadvantages that include the need for water precautions, and the potential for chronic perforations, focal tympanic membrane atrophy, formation of retraction pockets, cholesteatoma and tube extrusion. Web site: http://www.delphion.com/details?pn=US06251138__ •

Internet platform with screening test for hearing loss and for providing related health services Inventor(s): Naidoo; Sharmala (Jupiter Strasse 21-416, Bern, 3015, CH) Assignee(s): none reported Patent Number: 6,319,207 Date filed: March 13, 2000 Abstract: An adaptive screening tool for hearing loss for use over the internet. The test is part of a web-based system which providing hearing related information and health services. The system allows users of the internet located anywhere in the world to perform a screening test in the privacy of their own homes or offices. The test is performed well above the threshold level of the user, and screens users for their ability to detect small changes in intensity within bursts of sound delivered to the user through headphones. Users are given a first or preliminary test to establish a base intensity. Then, after the base intensity is established, a second test for hearing loss is presented. The second test asks the user to identify which of a plurality of similar sounds, or stimuli, is different from the others because it has a short duration deviation embedded in it. The deviation or differentiating characteristic may be: a) an increase or decrease in at least a portion of one in a plurality of similar sounds, and/or b) an increase or decrease in the frequency or pitch of at least a portion of one in a plurality of similar sounds and/or c) an increase or decrease in the duration of one of a plurality of similar sounds. The series of sounds, one of which contains a differentiating characteristic, may be designed so that the differentiating characteristic is detectable only by persons with certain kinds of hearing losses. Alternatively or in combination, such additional groups or series of sounds in which one sound of a plurality of similar sounds in the series is capable of being identified only by persons with normal hearing. Based upon the user's score on the screening tests, the user may be directed to a source for further information on how to deal with partial hearing loss. Excerpt(s): The present invention relates to the providing of health services over the internet. In particular, the present invention relates to an internet platform or portal for

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providing early diagnosis, through screening, of hearing impairment, and for providing information regarding effective treatment, rehabilitation and monitoring of patients. Hearing loss affects people of all ages, and it is conservatively estimated that at least 10% of any population have a hearing disorder. For a young child, early identification of hearing loss facilitates successful integration of that child into society as he or she grows up. The prevelance of hearing loss in the teenage population is steadily rising, due mainly to exposure to dangerous levels of environmental sounds, such as very loud music. Preventative awareness programs play a major role in controlling the number of teenagers affected. In the adult population, good hearing is important to maintaining an active and healthy lifestyle and for purposes of earning a living. As the life expectancy of people increases, and the number of elderly people increases, the negative impact of hearing loss on the quality of life during retirement years has become even more important. Only about one percent of those with hearing loss seek diagnosis and intervention at an appropriate time. The main reason for this shortcoming is the lack of good information regarding options which are available, where to go for hearing tests, and where to purchase devices which will enable one to hear better. Even though many people have hearing aids, nearly all of those require ongong monitoring of the effectiveness of those devices, regular testing of the extent of hearing loss, and advice on how to make the best use of the hearing aid in order to maximize the benefit therof. Web site: http://www.delphion.com/details?pn=US06319207__ •

Method and system for on-line hearing examination and correction Inventor(s): Hou; Zezhang (Cupertino, CA) Assignee(s): Audia Technology, Inc. (Cupertino, CA) Patent Number: 6,322,521 Date filed: March 31, 2000 Abstract: Improved approaches to assist those having hearing loss are disclosed. One approach pertains to providing on-line hearing loss testing. The on-line hearing loss testing can be self-performed without any specialized equipment. Another approach pertains to on-line sound customization. The sound customization can simulate hearing compensation on-line. As an example, the hearing compensation can be used to simulate hearing aid processing. Still another approach pertains to a recommendation and/or referral procedure. Excerpt(s): The present invention relates to hearing loss and, more particularly, to hearing loss evaluation and correction assistance. One out of ten people suffer from some degree of hearing loss. However, due to stigma, cost, and availability only about 25% of those who have hearing loss wear hearing aids. Many people do not want to wear hearing aids because they view hearing aids as a symbol of disability. In many countries (including the United States) hearing specialists, such as audiologists, perform hearing loss diagnosis. The diagnosis and subsequent fitting of a hearing aid device is a costly process. In developing countries, hearing specialists are rare and thus people of developing counties are often unable to get assistance. There are also many people with impaired hearing that are not aware that they have impaired hearing. Many people in this category are reluctant to spend the time and money to have their hearing examined by a hearing specialist. More particularly, in most developed countries, hearing loss is diagnosed using specialized equipment known as an audiometer. Typically, a patient must visit a hearing specialists office or an ear, noise and throat (ENT) doctor's office to have hearing loss testing performed. If hearing loss is diagnosed, the hearing specialist

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or doctor will counsel the patient to consider using a hearing aid. If the patient chooses to purchase a hearing aid, the hearing specialist or doctor has to spend additional time to fit the hearing aid for the patient. All these services are expensive and usually not covered by insurance or the government. Web site: http://www.delphion.com/details?pn=US06322521__ •

Method for evaluating inner ear hearing loss Inventor(s): Nuttall; Alfred L. (Ann Arbor, MI), Ren; Tianying (Ann Arbor, MI) Assignee(s): The University of Michigan (Ann Arbor, MI) Patent Number: 5,776,179 Date filed: October 6, 1995 Abstract: A method for evaluating the electromotility of hair cells within the cochlea of a mammalian ear by providing an electrode in proximate relation with the round window and applying electricity therethrough in order to electrically excite hair cells within the cochlea to produce electrically-evoked otoacoustic emissions therefrom. The electricallyevoked otoacoustic emissions further excite the internal structure of the cochlea which produces vibrations at the oval window that act through the bones of the middle ear to drive the tympanic membrane, producing corresponding acoustic sounds in the ear canal. The resulting acoustic sounds in the ear canal are subsequently detected with a microphone where they are later measured and characterized via readily available signal processing techniques. A hearing aid device is also provided by this invention utilizing the features of the before mentioned analysis technique wherein a traditional hearing aid device acoustically captures a sound adjacent the outer ear and converts it to an electrical signal which is fed to the electrode in order to excite the hair cells within the cochlea and produce electrically-evoked pressure waves therein. The resulting electrically-evoked pressure waves subsequently excite the cochlea and produce perceived hearing in the brain of the test subject through the normal hearing processes of hair cells and conducting neurons. Excerpt(s): There are a number of previously known devices for detecting hearing loss in individuals. Additionally, there are a number of different hearing aids that operate to partially or completely recover hearing loss resulting from one or more physiological changes that can occur within an ear, or to produce acceptable hearing for the first time in cases of congenital defect. Some previously known methods for evaluating hearing loss in an individual have involved the application of electric current to the test subject, typically to impart hearing in the subject by provoking auditory sensations. Under normal acoustical stimulation of the tympanic membrane, the auditory energy drives the inner ear via the normal mechanical features of the middle ear to produce pressure waves within the inner ear, resulting in sensory cell and neural activity therein. Alessandro Volta a 17th Century Italian physicist is thought to be the first to apply current to the human head. In early first attempts, Volta applied electrical current to his own head. Web site: http://www.delphion.com/details?pn=US05776179__

Patents 171

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Method for hearing loss compensation in telephony systems based on telephone number resolution Inventor(s): Knappe; Michael E. (San Jose, CA), Oran; David R. (Acton, MA) Assignee(s): Cisco Technology, Inc. (San Jose, CA) Patent Number: 6,061,431 Date filed: October 9, 1998 Abstract: Different hearing impairment compensation parameters are stored in a searchable attribute database indexed by the telephone numbers of hearing impaired users. Calls made to or from the stored telephone numbers have incoming voice samples redirected to signal processing resources that perform customized hearing compensation. The compensation parameters are downloaded from the attribute database to the chosen signal processing resource at call setup time. The signal processing resource then compensates the audio signals of the telephone call for specific user hearing impairment using the downloaded compensation parameters. Excerpt(s): The invention relates to compensating audio signals for the hearing impaired and more particularly to hearing loss compensation for telephony systems. Persons with hearing impairments have particular trouble understanding conversations conducted over telephones. Some hearing aids include a special magnetic coupling device that magnetically couples audio signals from a telephone handset to the hearing aid. However, not all telephones can be used with magnetic coupling devices. Many public and home telephones have volume controls that compensate for mild hearing loss by simply increasing the volume of the audio signals coming out of the telephone handset. However, volume controls amplify the entire audio signal and do not compensate for the particular frequencies associated with a particular user's dependent hearing impediment. Telephone volume controls generally must be manually adjusted every time someone with a hearing impediment uses the telephone. A person with normal hearing, who wishes to use the same telephone, must then readjust the telephone back to a normal volume level. Increasing local gain in the telephone handset also increases noise reflected back to the telephone receiver from the listener's local. This decreases the ability to distinguish speech from the amplified background noise. Web site: http://www.delphion.com/details?pn=US06061431__

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Method for transforming a speech signal using a pitch manipulator Inventor(s): Fink; Flemming K. (Lundeg.ang.rdsvej 38, DK-9490 Pandrup, DK), Hartmann; Uwe (Solbakken 36, DK-9210 Aalborg S.O slashed., DK), Hermansen; Kjeld (Stammen 67, DK-9260 Gistrup, DK), Rubak; Per (Rosenparken 46, DK-9240 Nibe, DK) Assignee(s): none reported Patent Number: 5,933,801 Date filed: July 2, 1997 Abstract: Transformation of a speech signal comprises separating the speech signal into two signal parts (a, b), where (a) represents the quasistationary part and (b) the transient part of the signal. The signal (b) is filtered inversely and is supplied in parallel to a transient detector and a pitch manipulator, while the signal (a) is subjected to a spectral analysis. The transformation circuit permits well-defined manipulation of any speech signal, which is advantageous partly for hearing-impaired persons, partly for persons

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having normal hearing ability in noisy environments. Finally, the circuit has been found to be extremely expedient for synthesizing well-defined sounds, which is of great importance in the control of hearing aids (hearing loss simulator). Excerpt(s): The invention concerns a method of transforming a speech signal which is separated into two signal parts a, b, where a represents the quasistationary part of the signal with information on the formant frequencies, and b represents a residual signal, the transient part of the signal, containing information on pitch frequency and stop consonants, the signal b being produced by inverse filtration of the speech signal. Such a method is known from U.S. Pat. No. 5,060,258 and from articles by U. Hartmann, K. Hermansen and F. K. Fink: "Feature extraction for profoundly deaf people", D.S.P. Group, Institute for Electronic Systems, Alborg University, September 1993, and by K. Hermansen, P. Rubak, U. Hartman and F. K. Fink: "Spectral sharpening of speech signals using the partran tool", Alborg University. The second signal produced via an LPC analysis (inverse filtration) is a residual signal which in respect of voiced sounds is indicative of the tone or pitch of a speech signal, which is typically in the range from 100 to 300 Hz. For example, a male voice has a low frequency, while a female voice has a somewhat higher value. The above-mentioned tone frequencies or pitch frequencies are defined as the-number of pulses per second which are generated by the vocal chords. Web site: http://www.delphion.com/details?pn=US05933801__ •

Method for treating sensorineural hearing loss using glial cell line-derived neurotrophic factor (GDNF) protein product Inventor(s): Magal; Ella (Thousand Oaks, CA) Assignee(s): Amgen Inc. (Thousand Oaks, CA) Patent Number: 5,837,681 Date filed: February 23, 1996 Abstract: The present invention relates generally to methods for preventing and/or treating injury or degeneration of cochlear hair cells and spiral ganglion neurons by administering glial cell line-derived neurotrophic factor (GDNF). The invention relates more specifically to methods for treating sensorineural hearing loss. Excerpt(s): The present invention relates generally to methods for preventing and/or treating injury or degeneration of inner ear sensory cells, such as hair cells and auditory neurons, by administering glial cell line-derived neurotrophic factor (GDNF) protein product. The invention relates specifically to methods for preventing and/or treating hearing loss due to variety of causes. Neurotrophic factors are natural proteins, found in the nervous system or in non-nerve tissues innervated by the nervous system, that function to promote the survival and maintain the phenotypic differentiation of certain nerve and/or glial cell populations (Varon et al., Ann. Rev. Neuroscience, 1:327, 1979; Thoenen et al., Science, 229:238, 1985). Because of this physiological role, neurotrophic factors are useful in treating the degeneration of such nerve cells and the loss of differentiated function that results from nerve damage. Nerve damage is caused by conditions that compromise the survival and/or proper function of one or more types of nerve cells, including: (1) physical injury, which causes the degeneration of the axonal processes (which in turn causes nerve cell death) and/or nerve cell bodies near the site of injury, (2) temporary or permanent cessation of blood flow (ischemia) to parts of the nervous system, as in stroke, (3) intentional or accidental exposure to neurotoxins, such as the cancer and AIDS chemotherapeutic agents cisplatinum and dideoxycytidine,

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respectively, (4) chronic metabolic diseases, such as diabetes or renal dysfunction, or (5) neurodegenerative diseases such as Parkinson's disease, Alzheimer's disease, and Amyotrophic Lateral Sclerosis, which result from the degeneration of specific neuronal populations. In order for a particular neurotrophic factor to be potentially useful in treating nerve damage, the class or classes of damaged nerve cells must be responsive to the factor. It has been established that all neuron populations are not responsive to or equally affected by all neurotrophic factors. The first neurotrophic factor to be identified was nerve growth factor (NGF). NGF is the first member of a defined family of trophic factors, called the neurotrophins, that currently includes brain-derived neurotrophic factor (BDNF), neurotrophin-3 (NT-3), NT-4/5, and NT-6 (Thoenen, Trends. Neurosci., 14:165-170, 1991; Snider, Cell, 77:627-638, 1994; Bothwell, Ann. Rev. Neurosci., 18:223253, 1995). These neurotrophins are known to act via the family of trk tyrosine kinase receptors, i.e., trkA, trkB, trkC, and the low affinity p75 receptor (Snider, Cell, 77:627 638, 1994; Bothwell, Ann. Rev. Neurosci., 18:223-253, 1995; Chao et al., TINS 18:321-326, 1995). Web site: http://www.delphion.com/details?pn=US05837681__ •

Method of enhancing the survival of retinal neurons and treating ocular diseases using FGF-5 Inventor(s): Kljavin; Ivar J. (Lafayette, CA), La Fleur; Monique (Daly City, CA) Assignee(s): Genentech, Inc. (South San Francisco, CA) Patent Number: 6,331,523 Date filed: January 29, 1999 Abstract: The present invention relates to the use of FGF-5 polypeptides to delay, prevent or rescue retinal neurons, including photoreceptors, other retinal cells or supportive cells (e.g. Muller cells or RPE cells) from injury and degradation. Conditions comprehended by treatment of the present FGF-5 polypeptides (including variants), antibodies, compositions and articles of manufacture include: retinal detachment, agerelated and other maculopathies, photic retinopathies, surgery-induced retinopathies (either mechanically or light-induced), toxic retinopathies including those resulting from foreign bodies in the eye, diabetic retinopathies, retinopathy of prematurity, viral retinopathies such as CMV or HIV retinopathy related to AIDS, uveitis, ischemic retinopathies due to venous or arterial occlusion or other vascular disorder, retinopathies due to trauma or penetrating lesions of the eye, peripheral vitreoretinopathy, and inherited retinal degenerations. Exemplary retinal degenerations include e.g., hereditary spastic paraplegia with retinal degeneration (Kjellin and Barnard-Scholz syndromes), retinitis pigmentosa, Stargardt disease, Usher syndrome (refinitis pigmentosa with congenital hearing loss), and Refsum syndrome (retinitis pigmentosa, hereditary hearing loss, and polyneuropathy). Additional disorders which result in death of retinal neurons include, retinal tears, detachment of the retina and pigment epithelium, degenerative myopia, acute retinal necrosis syndrome (ARN), traumatic chorioretinopathies or contusion (Purtscher's Retinopathy) and edema. Excerpt(s): The present invention relates to a method of promoting retinal neuron survival as well as preventing photoneuron degredation. The retina is the light-sensitive portion of the eye. The retina contains the cones and rods (photoreceptors), the photosensitive cells. The rods contain rhodopsin, the rod photopigment, and the cones contain 3 distinct photopigments, which respond to light and transmit signals through successive neurons to ultimately trigger a neural discharge in the output cells of the

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retina, the ganglion cells. The signal is carried by the optic nerve to the visual cortex where it is registered as a visual stimulus. In the center of the retina is the macula lutea, which is about 1/3 to 1/2 cm in diarneter. The macula provides detailed vision, particularly in the center (the fovea), because the cones are higher in density. Blood vessels, ganglion cells, inner nuclear layer and cells, and the plexiform layers are all displaced to one side (rather than resting above the ones), thereby allowing light a more direct path to the cones. Web site: http://www.delphion.com/details?pn=US06331523__ •

Methods for inducing proliferation in auditory receptor epithelium Inventor(s): Navarathan; Dhasakumar S. (Philadelphia, PA), Oberholtzer; J. Carl (Philadelphia, PA) Assignee(s): The Trustees of the University of Pennsylvania (Philadelphia, PA) Patent Number: 6,268,351 Date filed: May 27, 1998 Abstract: The present invention provides novel methods for stimulating proliferation in auditory receptor epithelium. Administration of agents that activate cAMP production result in demonstrable regeneration of hair cells in the cochlea. These agents may be administered in vivo to restore hearing loss or balance loss in patients in need of such treatment. Excerpt(s): This invention relates to the field of auditory research. Specifically, the invention pertains to methods which promote the regeneration of auditory hair cells following loss due to trauma or disease. Several publications are referenced in this application by numerals in parenthesis in order to more fully describe the state of the art to which this invention pertains. Full citations for these references are found at the end of the specification. The disclosure of each of these publications is incorporated by reference herein. Hair cells are sensory cells that transduce motion into neural signals. In the cochlea, they are used to detect sound waves in the environment and convert them into auditory signals that can be processed in the brain. Loss of receptor hair cells in the cochlea accounts for a significant proportion of hearing impairment in the population (1). This loss can occur as a consequence of viral or bacterial insult, aging, and damage from intense sound or aminoglycoside antibiotics. The generation of replacement hair cells following damage by sound or drugs has been clearly demonstrated in birds (2-4), the chick being the best-studied model for auditory hair cell regeneration (5). New hair cells arise as progeny from an otherwise non-dividing supporting cell population induced to proliferate by the damage (6-12). Functional recovery of hearing accompanies this cellular recovery process (13,14). The signals and pathways responsible for regenerative proliferation are presently unknown. However, evidence in the art indicates that such a regenerative response also occurs in mammals. Web site: http://www.delphion.com/details?pn=US06268351__

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Mutated polynucleotide corresponding to a mutation responsible for prelingual nonsyndromic deafness in the connexin 26 gene and method of detecting this hereditary defect Inventor(s): Denoyelle-Gryson; Francoise (Arcueil, FR), Guesdon; Jean-Luc (Sevres, FR), Marlin-Duvernois; Sandrine (Colombes, FR), Petit; Christine (Le Plessis-Robinson, FR), Weil; Dominique (Paris, FR) Assignee(s): Institut Pasteur (Paris, FR) Patent Number: 5,998,147 Date filed: August 14, 1998 Abstract: A purified polynucleotide having a chain of nucleotides corresponding to a mutated sequence, which in a wild type form encodes a polypeptide implicated in hereditary sensory defect, wherein said mutated purified polynucleotide presents a mutation responsible for prelingual non-syndromic deafness selected from the group consisting of a specific deletion of at least one nucleotide. Excerpt(s): The present invention concerns a mutation responsible for autosomal prelingual non-syndromic deafness and a method for the detection of this hereditary sensory defect for homozygous and heterozygous individuals. The invention concerns more particularly a specific deletion of at least one nucleotide in the connexin 26 (Cx 26) gene and especially in a guanosine rich region, notably between the nucleotides 27 and 32. The invention is also directed to the use of polynucleotide, or fragments thereof, for example as tools useful for the in vitro detection of a mutation of a gene belonging to the Cx26 gene family. Profound or severe prelingual deafness affects one child in a thousand in developed countries (Morton N E. Genetic epidemiology of hearing impairment. In Genetics of hearing impairment. (The New York Acad Sci, New York 1991; 630:16-31). It is a major handicap as it impedes language acquisition. According to studies performed in a U.S. population of children with non-syndromic (isolated) prelingual deafness and in whom an obvious environmental cause has been excluded, it is estimated that up to two-thirds of the cases have a genetic basis (Marazita M L, Ploughman L M, Rawlings B, Remington E, Arnos K S, Nance W E. Genetic epidemiological studies of early-onset deafness in the U.S. school-age population. Am J Med Genet 1993; 46:486-91). These forms are mainly sensorineural and are almost exclusively monogenic. The major mode of inheritance is autosomal recessive (DFNB), involving 72% to 85% of cases, this fraction increasing to 90% when only profound deafness is taken into account. Web site: http://www.delphion.com/details?pn=US05998147__

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Oral administration of immunoglobulins for treating autoimmune hearing loss Inventor(s): Weisbart; Richard H. (Los Angeles, CA) Assignee(s): Research Corporation Technologies, Inc. (Tucson, AZ) Patent Number: 6,200,565 Date filed: May 7, 1999 Abstract: The present invention is directed to methods of treating autoimmune sensorineural hearing loss in a patient by orally administering a human immunoglobulin preparation to the patient.

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Excerpt(s): This invention relates generally to the treatment of hearing loss, and particularly to the treatment of autoimmune sensorineural hearing loss by oral administration of a preparation of human immunoglobulins. Of the 25 million people who are hearing impaired, 85% suffer from sensorineural hearing loss (SNHL), a loss of hearing due to decreased hearing nerve function. There are various forms of inner ear disorders causing SNHL, including Meniere's disease, viral labyrinthitis, perilymph fistula, otosyphilis, and congenial or hereditary deafness. Sensorineural hearing loss is generally accompanied by ear fullness, tinnitus and disturbance of balance. A number of medical, dietary and surgical treatments are available for SNHL. See, e.g., Hicks and Wright III (1991) Indiana Medicine 84(8): 450-544. Autoimmune sensorineural hearing loss (ASNHL) has been considered by some as a separate entity of SNHL and by others as a cause for various forms of SNHL. ASNHL is characterized by progressive unilateral or bilateral deafness that, in its incipient stages, may fluctuate or become sudden and profound. The symptoms of ASNHL are quite similar to other forms of SNHL. ASNHL is believed to occur when the body's immune system attacks and progressively destroys the inner ear. The pathogenesis of ASNHL includes vasculitis of vessels supplying the inner ear, autoantibodies directed against inner ear antigenic epitopes or cross-reacting antibodies. See, e.g., Hicks and Wright III (1991) and U.S. Pat. No. 5,422,282 to Harris. Web site: http://www.delphion.com/details?pn=US06200565__ •

Process for controlling a programmable or program-controlled hearing aid for its insitu fitting adjustment Inventor(s): Topholm; Jan (Holte, DK) Assignee(s): Topholm & Westerman ApS (Vaerloese, DK) Patent Number: 5,991,417 Date filed: October 29, 1997 Abstract: The process for controlling a programmable or program-controllable hearing aid for in-situ adjustment of said hearing aid to an optimum target gain in one or more frequency bands by establishing the hearing threshold level of the wearer for one or more frequency bands, determining the target input/output response for the detected hearing loss and generating a corresponding parameter set for an ideal input/output response for the detected hearing loss under feedback-free conditions, by setting the control parameter set of a signal processor initially to an input/output response with a gain equal to the maximum target gain, operating the hearing aid in-situ in accordance with said initial input/output response while monitoring said hearing aid for the occurence of any acoustic feedback, and if no noticeable feedback is detected setting said initial parameter set for said input/output response into said hearing aid, and if noticeable acoustic feedback is detected reducing the gain over at least one of said frequency bands while leaving unchanged with respect to said initial parameter set the gain in any other frequency band, to thereby obtain an adjusted input/output response for at least said one frequency band. Excerpt(s): The invention relates to a process for controlling a programmable or program-controllable hearing aid for in-situ adjustment of said hearing aid to the optimum gain in one or more frequency bands, with due consideration of any possible acoustical feedback, as per the preamble of claim 1. It is well known that with hearing instruments, be it with BTE hearing aids that are connected to the ear canal by means of a small-diameter plastic tubing and an earmold, or with an ITE hearing aid inserted deeply into the ear canal with its earmold or otoplastic, acoustic feedback is possible

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from the residual cavity between the earmold and the timpanic membrane to the microphone, either by a less than perfect fit of the earmold in the ear canal or by a small venting tubing provided for pressure relief, or both. This has for example been described in "HEARING INSTRUMENTS, Vol. 42, Nr. 9 1991, pages 24, 26". Web site: http://www.delphion.com/details?pn=US05991417__ •

Speaker attenuation for practicing a musical instrument Inventor(s): Pritchard; Eric K. (290 Pritchard La., Berkeley Springs, WV 25411) Assignee(s): none reported Patent Number: 6,631,195 Date filed: October 14, 1998 Abstract: Speaker attenuation for practicing a musical instrument is a filter means connected between an amplifier and a speaker for providing greater treble attenuation than bass attenuation to compensate for bass hearing loss at attenuated sound levels. The reduction of load created by the attenuator is compensated by a load means. Excerpt(s): The speaker attenuation for practicing a musical instrument is an attenuator for reducing the sound pressure level of an amplifier that compensates for the changing hearing capability as described in the Fletcher-Munson curves such as found in the Radiotron Designer's Handbook, Radio Corporation of America, 1953, pg 826. Consequently, this invention is related to loudness attenuators, attenuators connected between amplifiers and speakers, and reactive amplifier loads. There are other attenuators which are connected between an amplifier and a speaker. The most notable is the crossover. The crossover keeps audio signals nominally out of the range of the speaker or driver from going to a speaker and directing those audio signals to another speaker or driver. The filters in these crossovers are low-pass for woofers, band-pass for mid-range drivers; and high-pass for tweeters. Another attenuator which is connected between an amplifier and a speaker is the resistive pad which has no frequency characteristics. These pads are found in public address systems and found in guitar amplifier "power soaks". Some of these power soaks even have reactive networks to emulate the load of a speaker or driver. These reactive networks resonate at typical speaker resonances, about 90 Hertz. Web site: http://www.delphion.com/details?pn=US06631195__

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Technique for determining a compression ratio for use in processing audio signals within a telecommunications system Inventor(s): Allen; Jonathan Brandon (Mountainside, NJ) Assignee(s): AT&T Corp. (Middletown, NJ) Patent Number: 5,737,389 Date filed: December 18, 1995 Abstract: A "loudness balance" procedure is used to determine the amount of dynamic range for syllabic compression loss in an individual's cochlea. In particular, an individual is asked to adjust a set of tone volumes, which are played to them, until the tone volumes sound equally loud. Based on the adjustments performed by the individual, a compression ratio is determined for that individual over at least one

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frequency band. The determined compression ratio is then subsequently used by a telecommunications system to provide an individual-specific sound enhancement in a telephone call. As a result, the individual-specific sound enhancement particularly compensates for an amount of hearing loss unique to that individual. Excerpt(s): Related subject matter is disclosed in the co-pending commonly assigned, U.S. patent applications of Allen et al., entitled "Method For Customer Selection of Telephone Sound Enhancement," Ser. No. 08/311,647, filed on Sep. 23, 1994. The present invention relates to telecommunications systems and, more particularly, to methods and apparatus for the processing of audio signals to enhance the audibility of speech. The co-pending, commonly assigned, United States patent application of Allen et al., entitled "Method for Customer Selection of Telephone Sound Enhancement," Ser. No. 08/311,647, filed on Sep. 23, 1994 describes a way to provide a "sound enhancement" service in a telecommunications system. Generally speaking, the "sound enhancement" service changes the amplitudes of an audio signal transmitted to an individual during a telephone call. As used herein, the term "audio signal" represents an electrical signal, which, upon transduction, becomes an acoustical signal. Web site: http://www.delphion.com/details?pn=US05737389__ •

Totally implantable cochlear implant for improvement of partial and total sensorineural hearing loss Inventor(s): Ko; Wen H. (1356 Forest Hills Blvd., Clevelamd Heights, OH 44118), Maniglia; Anthony J. (1 Bratenahl Pl. Suite 1201, Bratenahl, OH 44108) Assignee(s): none reported Patent Number: 6,161,046 Date filed: February 1, 1999 Abstract: An implantable hearing device for improvement of extreme partial and total hearing loss has a transducer mounted to the malleus of the ossicular chain by METABOND adhesive. The device responds to auditory vibrations of the malleus to establish an electrical signal in response thereto. For total hearing loss restoration, a speech processing unit is mounted inside the mastoid cavity having a intracochlear electrode which is inserted into the cochlea through the oval window to reach the nerve endings thereof and transmit speech signals capable of being understood by the brain. For total hearing loss a totally implantable system with a rechargeable battery, receiving antenna for remote control of on/off switch, volume, speech processor and programing is used with a biologic-electronic microphone activated by the implanted rechargeable battery to interact with implanted electronics for transmission of electrical signals from the transducer directly to the cochlear nerve endings. Excerpt(s): The present invention relates to totally implantable hearing devices generally and particularly to totally implantable cochlear implants which stimulate the ossicular chain of the middle ear for restoring partial hearing loss and for totally implantable devices which stimulate the cochlear nerve endings to restore total hearing loss. Conventional prior art hearing aids are composed of a microphone, an amplifier, a battery as a power source, and a speaker or earphone (commonly referred to as a receiver in the hearing aid industry). Known implantable hearing device have the same basic components, except that the speaker is replaced by a driving vibrating component, such as an electromagnetic coil or a piezoelectric system of biomorph design. Environmental sound energy, as it passes through either device, is converted by the

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microphone into an electrical signal which is routed to an amplifier. In the conventional hearing aid, the speaker converts the amplified electrical signals into acoustic energy, which is then transmitted to the tympanic membrane and ossicular the speaker is eliminated, being replaced by the vibratory component which drives the ossicular chain. Partially implantable middle ear hearing devices are also known. These devices have a small, lightweight high coercivity magnet effectively glued to the ossicular chain by a bio compatible bonding material such as METABOND or SUPERBOND adhesives manufactured in the USA and Japan respectively. The magnet is driven by an air core electromagnetic coil optimally spaced from the target magnet at a distance of approximately 1 mm. There is no contact between the air core coil and the target magnet. Web site: http://www.delphion.com/details?pn=US06161046__

Patent Applications on Hearing Loss As of December 2000, U.S. patent applications are open to public viewing.10 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to hearing loss: •

4-Substituted piperidine analogs and their use as subtype selective NMDA receptor, antagonists Inventor(s): Bigge, Christopher F.; (Ann Arbor, MI), Cai, Sui Xiong; (Foothill, CA), Keana, John F.W.; (Eugene, OR), Lan, Nancy F.; (South Pasadena, CA), Weber, Eckard; (Laguna Beach, CA), Woodward, Richard; (Aliso Viejo, CA), Wright, Jonathan; (Ann Arbor, MI), Zhou, Zhang-Lin; (Irvine, CA) Correspondence: Fitzpatrick Cella Harper & Scinto; 30 Rockefeller Plaza; New York; NY; 10112; US Patent Application Number: 20030105133 Date filed: July 29, 2002 Abstract: Novel 4-substituted piperidine analogs, pharmaceutical compositions containing the same and the method of using 4-substituted piperidine analogs as selectively active antagonists of N-methyl-D-aspartate (NMDA) receptor subtypes for treating conditions such as stroke, cerebral ischemia, central nervous system trauma, hypoglycemia, anxiety, convulsions, aminoglycoside antibiotics-induced hearing loss, migraine headaches, glaucoma, CMV retinitis, chronic pain, opioid tolerance or withdrawals, or neurodegenerative disorders, such as lathyrism, Alzheimer's Disease, Parkinsonism and Huntington's Disease are described. Also described are novel methods for preparing 4-substituted piperidine analogs and novel intermediates of the 4-substituted piperidine analogs. Excerpt(s): This invention is related to 4-substituted piperidine analogs, including hydroxypiperidine and tetrahydropyridine analogs, as well as novel intermediates of the 4-substituted analogs. The analogs are selectively active as antagonists of N-methylD-aspartate (NMDA) receptor subtypes. The invention is also directed to the use of 4substituted piperidine analogs as neuroprotective agents for treating conditions such as

10

This has been a common practice outside the United States prior to December 2000.

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stroke, cerebral ischemia, central nervous system trauma, hypoglycemia, anxiety, convulsions, aminoglycoside antibiotics-induced hearing loss, migraine headache, chronic pain, glaucoma, CMV retinitis, psychosis, urinary incontinence, opioid tolerance or withdrawal, or neuro-degenerative disorders such as lathyrism, Alzheimer's Disease, Parkinsonism and Huntington's Disease. Excessive excitation by neurotransmitters can cause the degeneration and death of neurons. It is believed that this degeneration is in part mediated by the excitotoxic actions of the excitatory amino acids (EAA) glutamate and aspartate at the N-methyl-D-Aspartate (NMDA) receptor. This excitotoxic action is considered responsible for the loss of neurons in cerebrovascular disorders such as cerebral ischemia or cerebral infarction resulting from a range of conditions, such as thromboembolic or hemorrhagic stroke, cerebral vasospasms, hypoglycemia, cardiac arrest, status epilepticus, perinatal asphyxia, anoxia such as from drowning, pulmonary surgery and cerebral trauma, as well as lathyrism, Alzheimer's Disease, Parkinson's Disease and Huntington's Disease. Ar.sup.1 and Ar.sup.2 are each independently substituted or unsubstituted aryl, a heteroaromatic ring, or a heteroaromatic bicylic ring. The tetrahydropyridines and hydroxypiperidines of this reference are indicated to be useful as central nervous system agents, particularly as dopaminergic, antipsychotic and antihypertensive agents, and for treating central nervous system disorders such as Parkinson Disease, Huntington Disease and depression. The particular 4-substituted piperidines, including the 4-hydroxypiperdines and tetrahydropyridines of this invention are not exemplified. In addition, there is no disclosure or suggestion of treating disorders with selective NMDA receptor subtype antagonists and the advantages of such treatment. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Auditory prosthesis, a method and a system for generation of a calibrated sound field Inventor(s): Ludvigsen, Carl; (Valby, DK) Correspondence: Sughrue Mion, Pllc; 2100 Pennsylvania Avenue, NW; Washington; DC; 20037-3213; US Patent Application Number: 20030002698 Date filed: July 24, 2002 Abstract: An auditory prosthesis (14, 14') is adapted for compensation of hearing loss and for sound pressure determination. During calibration of the sound field to be used during fine-tuning of the auditory prosthesis, the auditory prosthesis is positioned at an observation point in the sound field, and the sound pressure at the auditory prosthesis is adjusted based on determinations of sound pressures performed with the auditory prosthesis. Thus, the need for dedicated calibrated sound pressure determining equipment is eliminated. The invention provides an auditory prosthesis, a method and a system for calibration of a sound field. Excerpt(s): The present application is a continuation-in-part of application No. PCT/DK01/00048, filed on Jan. 23, 2001 in Denmark, now abandoned. The present application is based on PA 2000 00113, filed on Jan. 25, 2000 in Denmark, the contents of which are incorporated hereinto by reference. The present invention generally relates to auditory prostheses. The invention more particularly relates to a method and a system for calibration of a sound field. The invention still more specifically relates to a method and a system to be used during fine-tuning of an auditory prosthesis. An auditory prosthesis, such as a hearing aid, is typically fine-tuned to an individual user by placing the user with the auditory prosthesis in an auditory test room in which various sound

Patents 181

fields are generated from a sound source. Each of the sound fields corresponds to a sound field occurring in a real life sound environment, such as in a concert hall, in an environment with party noise, with traffic noise, with no background noise, etc, etc. It is the object of the fine-tuning procedure to adjust the auditory prosthesis in such a way that the user's hearing loss is compensated as well as possible in similar real life sound environments. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Bone conduction hearing aid Inventor(s): Schumaier, Daniel R.; (Johnson City, TN) Correspondence: Luedeka, Neely & Graham, P.C.; P O Box 1871; Knoxville; TN; 37901; US Patent Application Number: 20020122563 Date filed: March 2, 2001 Abstract: A bone conduction hearing aid includes a vibrator carried by the insertion end of the hearing aid. When the hearing aid is inserted into the ear canal of a patient, the vibrator is positioned in the ear canal adjacent the mastoid bone. A microphone receives sound waves and outputs a microphone signal to the hearing aid electronics where the microphone signal is amplified and then sent to the vibrator, causing the vibrator to vibrate. Vibrations produced by the vibrator are transferred to the opposite cochlea by way of the mastoid bone, enabling enhanced hearing perception in patients with hearing loss in one ear. Transfer of vibrations to the bones of the middle ear also assists patients with conductive pathology in one ear. The hearing aid may also function to enhance communication in high noise environments. Feedback from the vibrator to the microphone is eliminated electronically. Various alternate forms of feedback elimination are also contemplated by the invention. Excerpt(s): The present invention relates generally to devices for assisting the hearing impaired. More particularly, the present invention relates to a bone conduction hearing aid having a vibrator which is placed in the ear. Transcranial cross amplification has been used for patients that have a profound sensorineural (permanent) hearing loss in one ear and normal hearing or a mild hearing loss in the other ear. A typical remedial approach used by practitioners has been to employ powerful acoustic speakers which produce an amplified sound so intense to the bad ear that the sound is transferred through bone conduction in the skull to the cochlea of the good ear. The purpose of this approach is to increase hearing sensitivity when the primary signal is coming from the side of the bad ear and also to improve a patient's signal to noise ratio for speech, especially in situations where noise is being introduced to the good ear. Unfortunately, the acoustic speakers provide a poor transfer of sound when used in a transcranial application (i.e., when the amplified sound output by the speakers is to be used to stimulate the bony portion of the ear canal for transfer through the skull to the good cochlea). Because of the power required, feedback often occurs before an optimal intensity level can be achieved for stimulating the bony portion of the ear canal. Thus, the gain of the instrument must be reduced, which in turn reduces the effectiveness of the hearing aid. Another remedial approach used by practitioners has been to employ a body type hearing aid with a bone vibrator. Such bone vibrators are normally worn on the mastoid bone behind the ear and are generally used for individuals with conductive losses (outer or middle ear pathology). The bone vibrator used with body hearing aids are typically held in place with a head band that provides a sufficient force to maintain

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good contact with the mastoid bone. Disadvantages of such hearing aids are that they are aesthetically undesirable and physically uncomfortable. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Cytokine antagonists for the treatment of sensorineural hearing loss Inventor(s): Tobinick, Edward L.; (Los Angeles, CA) Correspondence: Ezra Sutton, P.A.; Plaza 9; 900 Route 9; Woodbridge; NJ; 07095; US Patent Application Number: 20010004456 Date filed: December 27, 2000 Abstract: Specific Cytokine Antagonists, including TNF antagonists and/or Interleukin1 antagonists, are used as novel therapeutic agents for the treatment of hearing loss, including presbycusis and other forms of sensorineural hearing loss. The present invention provides a method for inhibiting the action of TNF and/or IL-1 antagonists for treating hearing loss in a human by administering a TNF antagonist and/or an IL-1 antagonist for reducing the inflammation affecting the auditory apparatus of said human, or for modulating the immune response affecting the auditory apparatus of said human, by administering a therapeutically effective dosage level to said human of a TNF antagonist and/or an IL-1 antagonist. Administration may be systemic, through the subcutaneous, intramuscular, oral, or intravenous routes; or by delivering an anatomically localized application in the region of the head. The TNF antagonist is selected from the group consisting of etanercept, infliximab, D2E7, CDP 571, or thalidomide; and the IL-1 antagonist is either IL-1 RA or IL-1R type II receptor. Antiviral agents may be added for treating certain patients. Excerpt(s): This is a continuation-in-part of application Ser. No. 09/654,996, filed on Sep. 5, 2000, which is a continuation-in-part of application Ser. No. 09/563,651, filed on May 2, 2000, which is a continuation-in-part of application Ser. No. 09/476,643, filed on Dec. 31, 1999, which is a continuation-in-part of application Ser. No. 09/275,070, filed on Mar. 23, 1999, now U.S. Pat. No. 6,015,557, which is a continuation-in-part of application Ser. No. 09/256,388, filed on Feb. 24, 1999, now abandoned. The present invention is directed to specific cytokine antagonists, including TNF antagonists and IL-1 antagonists, for the treatment of hearing loss, including sensorineural hearing loss and presbycusis. The invention also includes methods of administration for these antagonists. Hearing loss occurs in humans in many forms. Hearing is essential to the normal conduct of one's daily activities and people with impaired hearing have many difficulties. Hearing loss can date from birth; it can be acquired later in life; or it can be the result of trauma, accident, disease, or a toxic effect of a medication. It can be genetic, either as a solitary disorder or as part of a complex syndrome. Hearing loss is one of the most common chronic neurological impairments, estimated to affect about 4 percent of those under 45 in the United States, and about 29 percent of those 65 years or older. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Dosage forms useful for modifying conditions and functions associated with hearing loss and/or tinnitus Inventor(s): Pearson, Don C.; (Lakewood, WA), Richardson, Kenneth T.; (Anchorage, AK) Correspondence: M. Henry Heines; Townsend And Townsend And Crew Llp; Two Embarcadero Center, 8th Floor; San Francisco; CA; 94111-3834; US Patent Application Number: 20020061870 Date filed: January 19, 2001 Abstract: The invention defines interdependent biofactors and biomolecules, and clinically useful formulations that are comprised of them. The active agents are demonstrated to be complementary in their physiologic functions especially as these relate to the quenching of free radicals and to the support of endothelial physiology, the reduction of hyperinsulinemia and improvements in vascular health. The active components of the invention are selected for inclusion in precise combinations specifically because they improve these various conditions and physiological functions, and by so doing reduce a variety of risks associated with hearing loss and tinnitus. The resulting enhancement of general systemic vascular health, improvement in local VIII.sup.th nerve vascular health, modulation of conditions surrounding blood fluid dynamics, the consequences of hyperinsulinemia, and improvements in free radical defenses, all reduce the potential for cochlear hair cell death and VIII.sup.th nerve atrophy, and the hearing loss and possible deafness that accompany them. Excerpt(s): This application is related to United States Provisional Patent Application No. 60/178,487, filed Jan. 27, 2000, and claims all benefits legally available therefrom. Provisional Patent Application No. 60/178,487 is hereby incorporated by reference for all purposes capable of being served thereby. This invention is in the field of pharmacology and relates specifically to the improvement of clinical conditions associated with symptomatic or presymptomatic hearing loss and/or tinnitus and the reduction of risks associated with their onset. The ear of humans consists of three parts: the outer, middle and inner ear. The outer ear consists of the external ear and the auditory canal. The external ear modifies sound waves and the air-filled auditory canal conducts the sound waves to the middle ear, which consists of the tympanic membrane, or eardrum; the eustachian tube; and three tiny bones called the hammer, anvil, and stirrup. Membranes and bone surround the middle ear with the eustachian tube connecting it to the pharynx, equalizing the air pressure between the middle ear and the atmosphere. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Earphone without impulse noise and surroundings blockade Inventor(s): Lin, Chung Yu; (Kaohsiung, TW) Correspondence: Raymond Y.C. Chan; 1050 Oakdale Lane; Arcadia; CA; 91006; US Patent Application Number: 20020080990 Date filed: November 5, 2001 Abstract: An earplug type earphone without impulse noise and surroundings blockade includes an earphone housing having a sound chamber inside thereof and a loudspeaker mounted therein, wherein a plurality of sound outlet meshes is provided

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on the front end of the earphone housing. A proper distance is given between the front end of the earphone housing and the loudspeaker mounted therein. A plurality of sound inlet meshes is provided on and encircled the earphone housing within the proper distance. The lower impulse noise output end with respect to two output ends of the loudspeaker is arranged to face to the sound outlet meshes. Therefore, the earphone can prevent not only the impulse noise directly impact to the middle ear but also the damage of the middle ear and the cause of conductive hearing loss. Excerpt(s): This is a Continuation-In-Part application of a non-provisional application having an application number of 09/345,135 and a filing date of Jul. 6, 1999. The present invention relates to an earphone, and more particularly to an earphone without impulse noise surroundings blockade, wherein the sound outside can be caught by the human ear so that any events outside are able to be realized at once without taking off the earphone. Moreover, the present invention can also prevent conductive hearing loss caused by the direct impact of the impulse noise. Furthermore, in 1997, UT Southwestern Medical Center stated: "approximate 20% of American Teenagers, between 13-19 have hearing disability. The major cause of the hearing loss is that people exposed to the noise especially the impulse noise from the earphone." People should concern the control of the sound volume while using the traditional earphone (continuous hearing not more than one hour or six hours per day when sound pressure at 105 dB or 95 dB respectively). In fact, this flash impulse noise contains high sound pressure and may damage the eardrum or middle ear hearing loss. It is called Conductive Hearing Loss. America's medical report recently stated that the percentage of people having the Conductive Hearing Loss is gradually increasing since the earplug type earphones are improperly used listen to the hot music such as Rock and Roll. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Filterbank structure and method for filtering and separating an information signal into different bands, particularly for audio signals in hearing aids Inventor(s): Brennan, Robert; (US), Schneider, Anthony Todd; (US) Correspondence: Bereskin And Parr; Scotia Plaza; 40 King Street West-suite 4000 Box 401; Toronto; ON; M5h 3y2; CA Patent Application Number: 20020122562 Date filed: May 2, 2001 Abstract: A filterbank structure is provided which provides a flexible compromise between the conflicting goals of processing delay, filter sharpness, memory usage and band interaction. The filterbank has an adjustable number of bands and a stacking which provides for a selectable shift of band frequencies to one of two discrete sets of center frequencies. The width of the bands and hence the number of the bands is selected depending upon acceptable delay, memory usage, and processing speed required. The flexibility in terms of stacking of the bands provides twice the number of potential band edge placements, which is advantageous for hearing loss fitting especially at low frequencies. The same filter coefficients can be used for analysis and synthesis, to reduce memory usage. Excerpt(s): This application is a continuation of application Ser. No. 09/060,823 filed on Apr. 16, 1998, which claimed the benefit of provisional application no. 60/041,977 filed on Apr. 16, 1997. This invention relates to a filterbank structure and a method for filtering and separating an information signal into different bands, particularly for such

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filtering and separation of audio signals in hearing aids. This invention more particularly relates to such a technique carried out using digital signal processing in hearing aids. This invention more particularly relates to a method and architecture for a digital filterbank for hearing aid applications. Hearing loss is generally associated with a loss of hearing sensitivity which is a function of frequency. The most common type of sensitivity loss is an increasing function of frequency. Sensitivity is typically a function of speech level as well. Hence, loud sounds should be amplified less than soft sounds. It has been long known that a hearing aid should treat the various frequency components of speech differently to render them intelligible to a hearing impaired person. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Hearing evaluation device with noise-weighting capabilities Inventor(s): Smits, Matthijs P.; (Sherwood, OR), Thornton, Aaron R.; (West Des Moines, IA) Correspondence: Daniel P. Maguire; 423 E Street; Davis; CA; 95616; US Patent Application Number: 20030073920 Date filed: October 17, 2001 Abstract: An apparatus and method for evaluation of hearing loss is disclosed. The apparatus and method use evoked Auditory Brainstem Responses (ABR) to determine if the subject is able to hear repeatedly administered click stimuli. In order to optimize evaluation, the present invention uses normative data to accurately weight the auditory responses, so that evaluation will be possible in different or changing noise conditions. Excerpt(s): This application is related to the co-pending and commonly assigned U.S. Patent Application entitled "Hearing Evaluation Device with Patient Connection Evaluation Capabilities," application Ser. No. 09/479,559, filed by Matthijs P. Smits, Vineet Bansal, Abraham J. Totah and Bryan P. Flaherty and the U.S. Patent Application entitled "Hearing Evaluation with Noise Detection and Evaluation Capability," application Ser. No. 09/479,548 filed by Matthijs P. Smits and Bryan P. Flaherty and the U.S. Patent Application entitled "Hearing Evaluation with Predictive Capabilities," application Ser. No. 09/479,557, filed by Matthijs P. Smits and Christophe M. Coppin, the disclosures of which are hereby incorporated herein by reference. The present invention relates to devices and methods that use electroencephalographic responses to auditory stimuli to evaluate the hearing of a subject, and that are capable of weighting the response to an auditory stimulus based upon an analysis with normative data. In the past, hearing impairment in babies and children was often not detected until after it was observed that the baby or child did not respond normally to sound. Unfortunately, it often took months or even years for the parent to observe the impairment, and by that time the child's language and learning abilities were negatively and often irreversibly impacted. Indeed, recent studies indicate that the vocabulary skills of hearing impaired children markedly increase if their hearing loss is detected early. The optimal time to evaluate hearing loss is thus immediately after birth, both because early detection allows for early treatment, and because parents often fail to bring their infants to later appointments. As a result, a number of states have implemented programs to evaluate newborns for hearing loss. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Hearing-aid assembly using folded flex circuits Inventor(s): Paczkowski, Theodore T.; (Chaska, MN) Correspondence: Schwegman, Lundberg, Woessner & Kluth; P.O. Box 2938; Minneapolis; MN; 55402; US Patent Application Number: 20010038703 Date filed: February 23, 2001 Abstract: Hearing aids improve not only the hearing, but the lives of millions. Unfortunately, far too many sufferers of hearing loss forego the benefits of hearing aids because of size and cost of the devices. To address this need, the present inventor devised hearing-aid circuit modules that use folded flexible circuits. The modules save space and reduce the cost of manufacturing hearing aids. Excerpt(s): This application is a continuation of U.S. Provisional application 60/184,237 which was filed Feb. 23, 2000 and which is incorporated herein by reference. The present invention concerns hearing aids, particularly hearing-aid assemblies and components. For many, it is surprising to learn that one out of every ten Americans suffers from some form of hearing loss, ranking it the third most common disability in the United States, behind arthritis and high-blood pressure. Perhaps even more surprising is that half of those suffering hearing loss are under age 65. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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High fidelity digital hearing aid and methods of programming and operating same Inventor(s): French, John S.; (Arlington, IL), Gudmundsen, Gail; (Elk Grove Village, IL), Killion, Mead C.; (Elk Grove Village, IL), Matzen, Norman; (Campbell, CA), Monroe, Timothy; (Schaumburg, IL), Preves, David; (Chanhassen, MN), Viranyi, Steven; (Palatine, IL) Correspondence: Mcandrews Held & Malloy, Ltd; 500 West Madison Street; Suite 3400; Chicago; IL; 60661 Patent Application Number: 20030086581 Date filed: October 15, 2002 Abstract: A programmable digital hearing aid circuit and method for operating and programming same are disclosed. The device provides a flexible means to compensate for undesirable frequency response distortion normally due to the electro-acoustical characteristics of the microphone, receiver, and sound coupling mechanisms employed in hearing aid design. Parameters of the programmable hearing aid circuit may also be set to tailor the hearing aid response characteristics for the frequency-dependent hearing loss of an individual hearing aid user. The device is intended to make available a significant improvement in audio fidelity to users of hearing aid devices. Excerpt(s): The applicants claim priority based on provisional application No. 60/328,981 filed Oct. 12, 2001, the complete subject matter of which is incorporated herein by reference in its entirety. A practical problem has prevented the widespread use and availability of high fidelity hearing aids. Specifically, dampers, which are used to smooth the frequency response, often needed to be near the tip of the hearing aid outlet at a point where they are easily clogged with ear canal wax. As a result, hearing aid manufacturers stopped using dampers near the eartip, and unpleasant peaks in the frequency response became commonplace. This problem was recognized by Killion et al.

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in U.S. Pat. No. 5,812,679 issued Sep. 22, 1998 entitled "Electronic Damper Circuit for a Hearing Aid and Method of Using the Same" and in U.S. Pat. No. 6,047,075 issued Apr. 4, 2000 entitled "Damper for Hearing Aid." These patents describe the use of electronic filtering to substitute for the acoustic damper. One of the realizations at the time was that by making the filter programmable, it could be adjusted to accommodate the different peak frequencies that are obtained when different lengths of tubing are used with the earphone to accommodate different lengths of ear canals and earmolds. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Hydantoin derivative compounds, pharmace utical compositions, and methods of using same Inventor(s): Hamilton, Gregory S.; (Catonsville, MD) Correspondence: Nath & Associates; 1030 15th Street; 6th Floor; Washington; DC; 20005; US Patent Application Number: 20020058685 Date filed: December 21, 2000 Abstract: The present invention relates generally to novel hydantoin derivative compounds, pharmaceutical compositions containing such compounds, and methods for their use in preventing and/or treating neurological disorders, including physically damaged nerves and neurodegenerative diseases; for treating alopecia and promoting hair growth; for treating vision disorders and/or improving vision; for treating memory impairment and/or enhancing memory performance; and for treating sensorineural hearing loss by administering such compounds. Excerpt(s): This invention relates to novel hydantoin and hydantoin derivative compounds, their inclusion in pharmaceutical compositions, and their preparation and use for preventing and/or treating neurological disorders; for treating alopecia and promoting hair growth; for treating vision disorders and/or improving vision; for treating memory impairment and/or enhancing memory performance; and for preventing and/or treating hearing loss in an animal. It has been found that picomolar concentrations of an immunosuppressant such as FK506 and rapamycin stimulate neurite outgrowth in PC12 cells and sensory nervous, namely dorsal root ganglion cells (DRGs). Lyons et al., Proc. Of Natl. Acad. Sci., 1994 vol. 91, pp. 3191-3195. In whole animal experiments, FK506 has been shown to stimulate nerve regeneration following facial nerve injury and results in functional recovery in animals with sciatic nerve lesions. Several neurotrophic factors effecting specific neuronal populations in the central nervous system have been identified. For example, it has been hypothesized that Alzheimer's disease results from a decrease or loss of nerve growth factor (NGF). It has thus been proposed to treat Alzheimer's patients with exogenous nerve growth factor or other neurotrophic proteins such as brain derived nerve factor (BDNF), glial derived nerve factor, ciliary neurotrophic factor, and neurotropin-3 to increase the survival of degenerating neuronal populations. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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IDENTIFYING THE ANTIGENIC TARGET OF AUTOIMMUNE SENSORINEURAL HEARING LOSS (AISNHL) AND DEVELOPEMENT OF SPECIFIC TESTS FOR DIAGNOSIS AND MANAGEMENT OF AISNHL Inventor(s): CAREY, THOMAS E.; (DEXTER, MI), GRAY, JENNIFER P.; (YPSILAMT, MI), NAIR, THANKUM S.; (ANN ARBOR, MI) Correspondence: Peter G Carroll; Medlen And Carroll; 220 Montgomery Street; Suite 2200; San Francisco; CA; 94104 Patent Application Number: 20010006788 Date filed: December 29, 1998 Abstract: The substantial purification and characterization of the glycoprotein Inner Ear Supporting Cell Antigen (IESCA) is described, along with methods employing IESCA to detect autoimmune sensorineural hearing loss (AISNHL), agonists and antagonists of IESCA binding and anti-IESCA binding, as well as homologs of IESCA. Excerpt(s): This invention generally relates to a novel antigen, Inner Ear Supporting Cell Antigen (IESCA), reactive with an autoantibody associated with autoimmune sensorineural hearing loss (AISNHL) and methods for the detection of AISNHL in a patient. Additionally, a kit containing reagents to assay for an antibody associated with AISNHL in a patient is disclosed and claimed by this invention. Furthermore, drugs screens for compounds that are agonistic or antagonistic to IESCA binding, as well as agonistic or antagonistic to anti-IESCA antibody binding, are claimed by this invention. Also, screens for IESCA homologs are claimed by this invention. The invention represents a major improvement over existing tests for AISNHL which identify antibodies to a universally distributed substance that is not unique to the inner ear and has never been linked to hearing loss. Sensorineural Hearing Loss. Sensorineural hearing loss (SNHL) is a common disorder affecting millions of Americans. SNHL is the result of damage to either the sensory system within the inner ear or the nerves that carry information from the sensory system to the brain. The inner ear is a tiny organ comprised of specialized sensory cells. These specialized cells are called hair cells because they have stereocilia or long stiff projections from their upper surface. The hair cells are arranged in the inner ear or cochlea within the organ of Corti, in order from the high frequency region in the base of the cochlea to the low frequency region in the apex. Sounds are transmitted from the eardrum to the inner ear by small bones called ossicles. These bones vibrate against a membrane in the cochlea transmitting the energy to the fluid inside. The fluid moves the organ of Corti stimulating hair cells at the appropriate frequency. The stimulated hair cells then stimulate nerves that send the information to the brain for processing. If hair cells are damaged or lost then hearing is affected for the frequencies encoded by those sensory cells. Autoimmune Hearing Loss In Humans. Unexplained or idiopathic SNHL is troubling to physicians and patients alike because the etiology is unknown and there are few effective treatments. Autoimmunity is suspected to be a cause of some cases of sudden onset, rapidly progressive or fluctuating hearing loss, particularly when bilateral involvement occurs. Autoimmune sensorineural hearing loss (AISNHL) in humans has been suspected in systemic autoimmune diseases, and there are indications that inner ear organ-specific autoimmunity is involved in rapidly progressive hearing loss (Harris J P, "Immunologic Mechanisms In Disorders Of The Inner Ear," In: 2nd edition Otolaryngology Head and Neck Surgery, Vol IV: Ear and Cranial Base, Cummings C W, Krause C J, Schuller D E, Fredrickson J M, Harker L A (eds), Mosby Yearbook, St. Louis, Mo., pp. 2926-2942, 1993; McCabe B F, "Autoimmune Sensorineural Hearing Loss," Ann. Otol., 88:585-859, 1979; McCabe B F, "Autoimmune Inner Ear Disease: Results Of Therapy," In: Bearing Of Basic

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Research On Clinical Otolaryngology, Adv. Otorhinolaryngol, Pfaltz C R, Arnold W, Kleinsasser O (eds), Karger Publishing, Basel, Switzerland, Vol. 46, pp. 78-81, 1991; Hughes et al. "Clinical Diagnosis Of Immune Inner-Ear Disease," Laryngoscope, 98:251253, 1988; Harris and Ryan "Immunobiology Of The Inner Ear," Am. J Otolaryngol, 5:418-425, 1984; Cruz et al., "Autoimmune Sensorineural Hearing Loss: A Preliminary Experimental Study," Am. J. Otol, 11:342-346, 1990; Harris, "Immunology Of The Inner Ear: Response Of The Inner Ear To Antigen Challenge," Otolaryngol Head Neck Surg., 91:17, 1983; Arnold et al., "Evidence Of Serum Antibodies Against Inner Ear Tissues In The Blood Of Patients With Certain Sensorineural Hearing Disorders," Acta Otolaryngol, 99:437, 1985; Harris and Sharp, "Inner Ear Autoantibodies In Patients With Rapidly Progressive Sensorineural Hearing Loss," Laryngoscope, 100:516-524, 1990; Moscicki et al., "Serum Antibody To Inner Ear Proteins In Patients With Progressive Hearing Loss: Correlation With Disease Activity And Response To Corticosteroid Treatment," JAMA, 272:611-616, 1994; Sismanis et al., "Methotrexate Management Of Immune-Mediated Cochleovestibular Disorders," Otolaryngol Head Neck Surg., 116:146-152, 1997). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Kids ear saver headphone adapter Inventor(s): Metcalfe, Thomas O. III; (Madison, MS) Correspondence: Clinton R. Stuart; P.O. Box 4412; Baton Rouge; LA; 70821-4412; US Patent Application Number: 20030103633 Date filed: November 1, 2002 Abstract: The Kids Ear Saver Headphone Adapter ("KESHA") is a device designed for use with headphones for stereo sound system equipment. The purpose of KESHA is to prevent permanent hearing loss associated with listening to music using headphones at excessive volumes, specifically with regard to children. Parents may use KESHA as a safeguard, in order to help reduce the chances that their children will suffer serious hearing damage due to the use of headphones. KESHA accomplishes this by permanently affixing a sound dampening circuit in place in the transmission line between the sound system equipment and the headphones. The sound dampening circuit acts upon the electronic sound signal from the sound system, effectively reducing the volume to a safer level prior to transmission to the headphones. And by permanently affixing the sound dampening circuit in place, children are unable to simply disengage or disable the protection provided by KESHA. Excerpt(s): Headphones are often used when listening to stereo sound system equipment, so that the listener may use the stereo equipment without disturbing others. Children are often particularly fond of headphones, since headphones allow them to listen to their music without bothering their parents, providing a feeling of privacy and unrestrained freedom that teens seem to crave. Unfortunately, children tend to listen to music on their stereo headphones at volumes far above the recommended safety level, risking permanent hearing damage that can affect them for the rest of their lives. The present invention of the Kids Ear Saver Headphone Adapter ("KESHA") is specifically designed to help parents guard against this problem. Generally, the KESHA invention applies to the field of hearing protection. More specifically, KESHA is designed to assist in reducing the chances of sustaining hearing loss related to listening to music or other sound from electrical sound generating equipment, such as a stereo equipment, using headphones. Since prolonged exposure to high decibel levels is the primary cause for

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concern, KESHA focuses on reducing the chances for hearing loss by reducing the exposure to high end decibel levels transmitted through the headphones. To accomplish its goals, KESHA utilizes two primary elements: a sound dampening circuit and a means for affixing the sound dampening circuit in place, so that it cannot be easily removed. The sound dampening circuit acts to reduce the sound exposure within the headphones, so that the listener will not be exposed to the high decibel levels which would cause permanent hearing loss. The means for affixing the sound dampening circuit in place acts to lock the sound dampening circuit in place, so that children will not circumvent the hearing protection that their parents have provided by removing the sound dampening circuit when their parents are not present. In this way, KESHA provides a simple but effective way for parents to protect their children's hearing from damage caused by improper use of headphones with excessive volume. Stated another way, KESHA provides an effective parental control mechanism for stereo headphones, which may assist parents in protecting their children from inadvertently doing permanent damage to their hearing. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Method for customizing audio systems for hearing impaired Inventor(s): Hou, Zezhang; (Cupertino, CA) Correspondence: Beyer Weaver & Thomas Llp; P.O. Box 778; Berkeley; CA; 94704-0778; US Patent Application Number: 20020183648 Date filed: April 24, 2002 Abstract: Improved approaches to assist those having hearing loss are disclosed. One approach pertains to providing customization of personal audio systems for a hearing impaired individual. Another approach pertains to designing and producing an audio product that includes components or software that can be customized for hearing impaired individuals. The customization provided by either approach can be performed on-line or off-line. Excerpt(s): This application claims priority of U.S. Provisional Application Ser. No. 60/288,130, filed May 3, 2001, and entitled "METHOD FOR CUSTOMIZING AUDIO SYSTEMS FOR HEARING IMPAIRED," the content of which is hereby incorporated by reference. This application is related to U.S. application Ser. No. 09/541,366, filed Mar. 31, 2000, and entitled "METHOD AND SYSTEM FOR ON-LINE HEARING EXAMINATION AND CORRECTION," now U.S. Pat. No. 6,322,521, the content of which is hereby incorporated by reference. This application is also related to U.S. application Ser. No. 09/540,577, filed Mar. 30, 2000, and entitled "METHOD AND SYSTEM FOR ON-LINE HEARING EXAMINATION USING CALIBRATED LOCAL MACHINE," the content of which is hereby incorporated by reference. The present invention relates to audio systems and, more particularly, to customizing personal audio systems for hearing impaired individuals. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Method of treating sensorineural hearing loss Inventor(s): Cotanche, Douglas A.; (Southborough, MA), Parker, Mark A.; (Hull, MA) Correspondence: Nixon Peabody Llp; 101 Federal ST; Boston; MA; 02110; US Patent Application Number: 20030114381 Date filed: October 18, 2002 Abstract: The present invention provides a method for treating and preventing sensorineural hearing loss in a subject in need of such treatment by implanting stem cells into the subject's inner ear. The stem cells of the present invention are preferably derived from a neuronal lineage and are capable of differentiating into cochlear hair cells. In the preferred embodiment of the invention, the subject suffering from the sensorineural hearing loss is a mammal such as a human. Excerpt(s): The present application claims benefit of U.S. Provisional Application No. 60/346,238, filed on Oct. 22, 2001. The present invention generally relates to the treatment of hearing loss disorders, and more particularly to the treatment of sensorineural hearing loss. In the United States, almost thirty million people exhibit some level of deafness or hearing loss. While this disability is rarely life threatening, it impairs more people psychologically and economically than epilepsy, multiple sclerosis, spinal injury, stroke, and Huntington's and Parkinson's diseases combined (Hudspeth, 1997). The vast majority of the cases of hearing impairment are caused by a loss of hair cells, the sensory cells in the inner ear that transduce sounds into neural signals. This type of hearing loss is called "sensorineural hearing loss" and is caused by a number of factors including sound trauma, ototoxic drug exposure, disease, viral infection, and genetic disorders. Severe to profound sensorineural hearing loss affects one in every thousand children born in the United States country, with half of these due to hereditary causes (Rehm & Morton, 1999). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Methods for preventing/treating damage to sensory hair cells and cochlear neurons Inventor(s): Hudkins, Robert L.; (Chester Springs, PA), Pirvola, Ulla; (Kauniainen, FI), Saarma, Mart; (Helsinki, FI), Walton, Kevin M.; (Old Saybrook, CT), Ylikoski, Jukka; (Kauniainen, FI) Correspondence: Woodcock Washburn Llp; One Liberty Place - 46th Floor; Philadelphia; PA; 19103; US Patent Application Number: 20020115706 Date filed: January 8, 2002 Abstract: Methods for preventing or treating damage to sensory hair cells and cochlear neurons are disclosed. The methods comprise the administration of an effective amount of a compound of Formula I or Formula II. The method provides for the prevention/treatment of both hearing loss and loss of the sense of balance. Excerpt(s): This application claims the benefit of U.S. Provisional Application Serial No. 601101,763, filed Sep. 25, 1998, the disclosures of which is hereby incorporated herein by reference, in its entirety. The present invention provides methods for preventing and/or treating hearing loss and loss of the sense of balance. More specifically, the present invention provides methods for preserving sensory hair cells and cochlear neurons in a subject by administering an effective amount of compounds of Formula I and/or

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Formula II. The mammalian ear functions by tnansforming sound waves, or airborne vibrations, into electrical impulses. The brain then recognizes these electrical impulses as sound. The ear has three major parts, the outer, middle, and inner ear. Sound waves enter the outer ear and cause the eardrum to vibrate. The vibrations of the eardrum are transmitted serially through the three ossicles in the middle ear--the malleus, incus and stapes, also called the hammer, anvil and stirrup, respectively. The stirrup transmits the vibrations to the inner ear. The inner ear comprises the cochlea and is connected to the middle ear via the oval and round windows. The inner ear is filled with fluid and vibrations transmitted to the inner ear cause fluid movement in the cochlea of the inner ear. Fluid movement in the cochlea causes movement of sensory hair cells which initiates nerve impulses. These nerve impulses are interpreted in the brain as sound. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Methods for treating hearing loss Inventor(s): Kil, Jonathan; (Seattle, WA), Lynch, Eric D.; (Lake Forest Park, WA) Correspondence: Christensen, O'connor, Johnson, Kindness, Pllc; 1420 Fifth Avenue; Suite 2800; Seattle; WA; 98101-2347; US Patent Application Number: 20030162747 Date filed: January 3, 2003 Abstract: In one aspect, the present invention provides otoprotectant compositions useful for ameliorating hearing loss. In some embodiments, the otoprotective compositions comprise at least one glutathione peroxidase mimic. In some embodiments, the otoprotective compositions comprise at least one glutathione peroxidase mimic and at least one otoprotectant selected from the group consisting of a xanthine oxidase inhibitor and a glutathione or glutathione precursor. In some embodiments, the otoprotective compositions comprise at least one glutathione peroxidase mimic, at least one xanthine oxidase inhibitor, at least one glutathione or glutathione precursor. In another aspect, the present invention provides methods for ameliorating hearing loss by administering to a subject an amount of an otoprotective composition that is effective to ameliorate hearing loss. Excerpt(s): This application claims the benefit of U.S. Provisional Application No. 60/345,813, filed Jan. 4, 2002, under 35 U.S.C.sctn.119. The present invention relates to methods and compositions for treating and preventing hearing loss. A major cause of acquired hearing loss is loud noise. Exposure to harmful noise levels is common in the workplace. The National Institute for Occupational Safety and Health estimates that about 30 million workers in the United States encounter hazardous levels of noise. (Franks et al. (1996) Preventing Occupational Hearing Loss--A Practical Guide, DHHA (NIOSH) Publication No. 96-110, p.1). These levels are encountered in, for example, construction, mining, agriculture, manufacturing and utilities, transportation, and in the military. The incidence of noise associated hearing loss continues to increase in spite of efforts to regulate job related noise exposure, and to improve the use of hearing protective devices such as ear muffs and ear plugs. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Mutation within the connexin 26 gene responsible for prelingual non-syndromic deafness and method of detection Inventor(s): Denoyelle-Gryson, Francoise; (Sceaux, FR), Guesdon, Jean-Luc; (Sevres, FR), Marlin-Duvernois, Sandrine; (Colombes, FR), Petit, Christine; (Le Plessis-Robinson, FR), Weil, Dominique; (Paris, FR) Correspondence: Finnegan, Henderson, Farabow, Garrett & Dunner; Llp; 1300 I Street, NW; Washington; DC; 20005; US Patent Application Number: 20030170676 Date filed: October 23, 2002 Abstract: A purified polynucleotide having a chain of nucleotides corresponding to a mutated sequence, which in a wild form encodes a polypeptide implicated in hereditary sensory defect, wherein said mutated purified polynucleotide presents a mutation responsible for prelingual non-syndromic deafness selected from the group consisting of a specific deletion of at least one nucleotide. Excerpt(s): The present invention concerns a mutation responsible for autosomal prelingual non-syndromic deafness and a method for the detection of this hereditary sensory defect for homozygous and heterozygous individuals. The invention concerns more particularly a specific deletion of at least one nucleotide in the connexin 26 (Cx 26) gene and especially in a guanosine rich region, notably between the nucleotides 27 and 32. The invention is also directed to the use of polynucleotide, or fragments thereof, for example as tools useful for the in vitro detection of a mutation of a gene belonging to the Cx26 gene family. Profound or severe prelingual deafness affects one child in a thousand in developed countries (Morton N E. Genetic epidemiology of hearing impairment. In Genetics of hearing impairment. (The New York Acad Sci, New York 1991; 630:16-31). It is a major handicap as it impedes language acquisition. According to studies performed in a U.S. population of children with non-syndromic (isolated) prelingual deafness and in whom an obvious environmental cause has been excluded, it is estimated that up to two-thirds of the cases have a genetic basis (Marazita M L, Ploughman L M, Rawlings B, Remington E, Arnos K S, Nance W E. Genetic epidemiological studies of early-onset deafness in the U.S. school-age population. Am J Med Genet 1993; 46:486-91). These forms are mainly sensorineural and are almost exclusively monogenic. The major mode of inheritance is autosomal recessive (DFNB), involving 72% to 85% of cases, this fraction increasing to 90% when only profound deafness is taken into account. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Myosin IXa and cyclic nucleotide gated channel-15 (CNGC-15) polynucleotides, polypeptides, compositions, methods, and uses thereof Inventor(s): Adams, Arwen E.; (Oakland, CA), Chin, Choi Ying; (Castro Valley, CA), Duhl, David; (Oakland, CA), Gorman, Susan W.; (Santa Monica, CA), Leng, Song; (Castro Valley, CA), Sheffield, Val; (Iowa City, IA), Welch, Juliet; (Kensington, CA) Correspondence: Chiron Corporation; Intellectual Property R338; P.O. Box 8097; Emeryville; CA; 94662-8097; US Patent Application Number: 20020091248 Date filed: May 8, 2001

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Abstract: The present invention discloses the amino acid and nucleic acid sequences of a new CNGC and Myosin that map to the region of the human chromosome associated with Bardet-Biedl Syndrome. Cyclic nucleotide gated channels (CNGCs) comprise a family of multimeric protein ion channels that open in response to the binding of a cyclic nucleotide to an intracellular domain. The two new proteins, CNGC-15 and Myosin IXa, are useful in the study, diagnosis and treatment of Bardet-Biedl Syndrome and Usher Syndrome. Other indications that can be treated by CNGC-15 and/or Myosin IXa polypeptides, or agonists or antagonists include hearing loss, retinis pigmentosa, obesity, hypogonadism, sterility, polydactyly, brachydactyly, syndactyly, mental retardation, renal abnormalities, hypertension, diabetes and cardiovascular abnormalities.Compositions and methods for expressing cyclic nucleotide gated channel-15 (CNGC-15) and Myosin IXa are provided. The compositions comprise CNGC-15 and Myosin IXa polypeptides and derivatives thereof, nucleotide sequences, expression cassettes, transformed cells and antibodies to these polypeptides. Methods for the expression and detection of CNGC-15 and Myosin IXa nucleotides and polypeptides and compositions for the treatment of these conditions are provided. Excerpt(s): This application claims the benefit of U.S. Provisional Application Serial No. 60/062,858, filed Oct. 15, 1997, U.S. Provisional Application No. 60/062,241, filed Oct. 17, 1997, and U.S. Provisional Application No. 60/068,953, filed Dec. 30, 1997, the contents of which are herein incorporated by reference. This invention relates to the fields of molecular biology and pharmaceutical research. More specifically, this invention relates to the identification and recombinant expression of two new genes, cyclic nucleotide gated channel-15 (CNGC-15) and Myosin IXa. Accordingly, isolation of the human myosin IXa gene will prove useful in the study, diagnosis and treatment of Bardet-Biedl Syndrome, Usher Syndrome and related conditions. Usher Sydrome typel (USH1) is characterized by a profound congenital sensoneural hearing loss, vestibular dysfunction and prepubescent onset retinitis pigmentosa. Family studies indicated that three genes with different chromosomal locations are responsible for USH1; a defect in any one of these genes causes the disease. Of these, the gene USH1B mapped to a region homologous to the murine region containing the mouse deafness mutant shaker-1 which results from mutations in myosin VIIa. Subsequent work confirmed that myosin VIIa is the cause of Usher Sydrome type 1B and localized the myosin VIIa protein to the receptor cells of the inner ear (Hasson et al. (1995) Genomics 36:431-439) and the connecting cilia of photoreceptor cells in the retina (Liu et al. (1997) Cell Motil. Cytoskel. 37:240-252). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

NMDA NR2B antagonists for treatment Inventor(s): Chenard, Bertrand L.; (Waterford, CT), Menniti, Frank S.; (Mystic, CT), Saltarelli, Mario D.; (Mystic, CT) Correspondence: Paul H. Ginsburg; Pfizer INC.; 20th Floor; 235 East 42nd Street; New York; NY; 10017-5755; US Patent Application Number: 20020072538 Date filed: October 2, 2001 Abstract: The invention provides new methods for treating certain disorders resulting from neurodegeneration and for treating depression which comprise administration of NR2B subunit selective NMDA antagonists. The disorders that can be treating by the invention include hearing loss, vision loss, neurodegeneration caused by epileptic

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seizures, neurotoxin poisoning, Restless Leg Syndrome, multi-system atrophy, nonvascular headache, and depression. Excerpt(s): This application claims priority under 35 U.S.C. 119(e) of U.S. Provisional Application No. 60/237,770, filed Oct. 2, 2000. This invention relates to the treatment of neurological disorders. This invention also relates to the treatment of depression. More particularly, this invention relates to treatment of hearing loss, vision loss, neurodegeneration caused by epileptic seizures, neurotoxin poisoning, Restless Leg Syndrome, multi-system atrophy, non-vascular headache, and depression comprising administering an N-methyl-D-aspartate (NMDA) NR2B subtype receptor antagonist. Glutamate and aspartate play dual roles in the central nervous system as essential amino acids and as the principal excitatory neurotransmitters (hereinafter referred to as excitatory amino acids or EAAS). There are at least four classes of EAA receptors: NMDA, AMPA (2-amino-3-(methyl-3-hydroxyisoxazol-4-yl)propanoic acid), kainate and metabotropic receptors. These EAA receptors mediate a wide range of signaling events that impact all physiological brain functions. For example, it has been reported that NMDA receptor antagonists produce an analgesic effect under certain conditions (Wong, C. S., Cherng, C. H. and Ho, S. T., Clinical Applications of Excitatory Amino Acid Antagonists in Pain Management Acta Anaesthesiologica.Sinica; 33, 227-232 (1995)). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Piperidine derivatives as subtype selective N-methyl-D-aspartate antagonists Inventor(s): Kornberg, Brian Edward; (Ann Arbor, MI), Lewthwaite, Russell Andrew; (Cambridge, GB), Manning, David; (Duanesburg, NY), Nikam, Sham Shridhar; (Ann Arbor, MI), Scott, Ian Leslie; (Delanson, NY) Correspondence: David R. Kurlandsky; Warner-lambert Company; 2800 Plymouth Road; Ann Arbor; MI; 48105; US Patent Application Number: 20030018021 Date filed: November 30, 2001 Abstract: Described are piperidines of Formula I 1and pharmaceutically acceptable salts thereof. The compounds of Formula I are antagonists of NMDA receptor channel complexes useful for treating cerebral vascular disorders such as, for example, stroke, cerebral ischemia, central nervous system disorders, depression, trauma, hypoglycemia, neurodegenerative disorders, anxiety, migraine headache, convulsions, Parkinson's disease, aminoglycoside antibiotics-induced hearing loss, psychosis, glaucoma, CMV retinitis, opioid tolerance or withdrawal, pain, especially chronic pain, neuropathic pain, or surgical pain, or urinary incontinence. Excerpt(s): The invention relates to piperidine derivatives as N-Methyl-D-Aspartate (NMDA) antagonists useful in the treatment of diseases and disorders responsive to antagonism of NMDA receptors. Many of the physiological and pathophysiological effects of the endogenous excitatory neurotransmitter glutamate are mediated via actions at N-Methyl-D-Asparate (NMDA) receptors. Over-excitation of the NMDA receptors on postsynaptic cells-mediated by excessive release of glutamate from nerve endings or glial cells-results in a massive calcium ion influx through a calcium ion channel into neuronal cells, leading to neuronal cell death. These events occur under ischemic or hypoxic conditions such as, for example, stroke, hypoglycemia, cardiac arrest, or acute physical trauma. NMDA receptors in vivo form an NMDA receptor

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channel complex in cell walls comprising at least three binding domains, including a glutamic acid (or NMDA) recognition site, a channel blocking binding site, and a strychnine-insensitive glycine binding site. Physiologically, a blockade of at least one of these sites terminates the channel opening of the NMDA receptor, thereby preventing calcium ion influx into cells. Accordingly, an NMDA receptor antagonist is therapeutically useful because it minimizes damage to the central nervous system induced by calcium ion influx under ischemic or hypoxic conditions. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Polymorphisms associated with ion-channel disease Inventor(s): Curran, Mark Edward; (Newark, CA), Guida, Marco; (San Diego, CA), Rienhoff, Hugh Y. JR.; (San Carlos, CA), Sotos, John G.; (Palo Alto, CA) Correspondence: Sheridan Ross PC; 1560 Broadway; Suite 1200; Denver; CO; 80202 Patent Application Number: 20030162192 Date filed: August 20, 2002 Abstract: The present invention provides methods and materials to identify genetic abnormalities that predispose an individual to ion-channel diseases. The invention provides four polymorphic sites in the KCNQ1 gene that cause reduced conductance of the associated potassium ion channel current and a variant form of the KCNE1 gene which causes decreased conductance though the channel. The variant form of KCNE1 also acts synergistically with variants of KCNQ1 to cause further decreased conductance than either variant alone. The invention further provides polymorphisms in ion channel genes showing a higher frequency in populations afflicted with ion channel diseases or within control groups. The detection of these polymorphic sites that produce the potassium ion channel protein variants in either heterozygous or homozygous form in a subject indicates that the subject has, or is susceptible to, ion channel diseases such as congenital or acquired cardiac arrhythmia, LQT syndrome, SIDS, epilepsy, or hearing loss. Excerpt(s): This application claims benefit under 35 USC.sctn.119(e) of U.S. Provisional Application No. 60/314,331, filed Aug. 20, 2001, and U.S. Provisional Application No. 60/378,521, filed May 6, 2002, which are incorporated herein in their entirety by this reference. The invention lies in the field of genetic changes associated with ion channel diseases and methods of identifying and detecting these changes in individuals having or suspected of having an ion channel disease. Electrical functions in complex living organisms depend on a specialized class of molecules called "ion channels." Ion channels are protein molecules that regulate the flow of electrically charged atoms (ions) across membranes. Complex organisms have a plurality of ion channel proteins which allow them to precisely control the timing, direction, and magnitude of ion flux (Hille, B. (1984). Ionic Channels of Excitable Membranes, pp. 99-116, Sinauer. Variations in ion flux and/or ion channel structure have been associated with several disease states, collectively referred to as "ion channel diseases." (Schulze-Bahr, Z Kardiol 89 Suppl 4:IV12-22 (2000); Noebels News Physiol Sci. October; 13:255-256 (1998); Bockenhauer, Curr Opin Pediatr. April 2001; 13(2):142-9.; Schofield, Clin Exp Pharmacol Physiol.28(12):84-8. (2001)). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Prevention of cisplatin induced deafness Inventor(s): Ehrsson, Hans; (Stockholm, SE), Ekborn, Andreas; (Stockholm, SE), Laurell, Goran; (Stockholm, SE), Miller, Josef; (Ann Arbor, MI) Correspondence: Medlen & Carroll, Llp; Suite 350; 101 Howard Street; San Francisco; CA; 94105; US Patent Application Number: 20030180388 Date filed: January 16, 2003 Abstract: The present invention relates to compositions and methods for the protection and restoration of hearing. In particular, the present invention relates to methods and compositions for the prevention of chemical (e.g., cisplatin) induced deafness. The present invention thus provides methods of improving the outcome of subjects treated with cisplatin. Excerpt(s): This application claims priority to U.S. provisional patent application serial No. 60/349,801, filed Jan. 17, 2002 and U.S. provisional patent application serial No. 60/351,662, filed Jan. 25, 2002. The present invention relates to compositions and methods for the protection and restoration of hearing. In particular, the present invention relates to methods and compositions for the prevention of chemical (e.g., cisplatin) induced deafness. Hearing impairment is the United State's number one disability. It has been estimated to compromise the quality of life and communication in more than 30 million Americans, and approximately 1 billion individuals worldwide. With the increase in longevity in life and the association of hearing impairment with aging, this disability is increasing in incidence and prevalence. In children, it severely affects education and future employment opportunities. In a working individual, it compromises the quality of life, job satisfaction, and productivity; and in the elderly, it leads to isolation and increased medical costs. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Prevention or reversal of sensorineural hearing loss (SNHL) through biologic mechanisms Inventor(s): Henderson, Donald; (Clarence, NY), Hoffer, Michael E.; (San Diego, CA), Kopke, Richard D.; (San Diego, CA) Correspondence: Office OF Naval Research, Onr 00cc; 800 N. Quincy ST.; Arlington; VA; 22217; US Patent Application Number: 20010007871 Date filed: January 23, 2001 Abstract: The invention is accomplished by preventing and/or reversing inner ear damage due to noise or toxins. In part, this is accomplished by upregulating antioxidant enzyme activity by applying agents such as R-N6-Phenylisopropyl adenosine (R-PIA) to the round window membrane of the inner ear or systemically, and/or by also applying agents such as 1-2-oxothiazolidine-4-carboxylic acid (Procysteine) to the round window membrane. Also, the invention is accomplished by giving the compounds systemically. Selective auditory hair cell protection in the face of gentamicin exposure by concomitant delivery of an NMDA antagonist or glial dervied neurtrophic factor (GDNF) with the gentamicin. These and additional agents are also accomplished by curtailing activated programmed cell death pathways and/or inducing/enhancing cell repair mechanisms

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in the inner ear. The agent(s) may be applied before, during or after the noise trauma or toxin exposure. Excerpt(s): This application Claims Benefit of Provisional Application Ser. No. 60/069,761 Filed Dec. 16, 1997. This invention relates to a method and composition for preventing and/or reversing sensorineural hearing loss (SNHL) or toxin-induced hearing loss. More specifically, this invention relates to the use of agents which augment inner ear antioxidant defenses such as adenosine agonists or up-regulating agents and/or agents which increase inner ear glutathione levels to prevent and/or reverse hearing loss induced by noise or toxin. In addition, this invention covers agents that curtail activated programmed cell death pathways and induce/enhance cell repair mechanisms in the inner ear. SNHL is a very common problem for service members and civilian government employees. Approximately 450 million dollars is spent annually to compensate service members for hearing loss(1). Despite hearing conservation programs, 20-30% of service members develop compensable hearing loss after 10 years in the service(2). The sense of hearing is critical for combat and operational readiness of soldiers and sailors. Both temporary and permanent hearing threshold impairments decrease the ability to communicate and to detect enemy movements(3). Successful implementation of medical treatment to prevent or reverse SNHL as an augmentation to established hearing conservation programs has the potential to save millions of dollars annually and to significantly improve operational readiness. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Sound enhancement for mobile phones and other products producing personalized audio for users Inventor(s): Edwards, Brent W.; (San Francisco, CA), Johansen, Benny B.; (Sunnyvale, CA), Menzel, Christoph; (Madison, CT), Puria, Sunil; (Mountain View, CA), Rader, R. Scott; (Menlo Park, CA) Correspondence: Haynes Beffel & Wolfeld Llp; P O Box 366; Half Moon Bay; CA; 94019; US Patent Application Number: 20030064746 Date filed: September 20, 2001 Abstract: A mobile phone or other personal communication device includes resources applying measures of an individual's hearing profile, personal choice profile, and induced hearing loss profile, separately or in combination, to build the basis of sound enhancement. A personal communication device thus comprises a transmitter/receiver coupled to a communication medium for transmitted receiving audio signals, control circuitry that controls transmission, reception and processing of call and audio signals, a speaker, and a microphone. The control circuitry includes logic applying one or more of a hearing profile of the user, a user preference related hearing, and environmental noise factors in processing the audio signals. The control circuitry may includes instruction memory and an instruction execution processor such as a digital signal processor. Excerpt(s): The present invention relates the field of sound enhancement for mobile phones and other products which produce audio for users, and more particularly to techniques for enhancing sound based upon an individual's hearing profile, based upon environmental factors like noise-induced hearing impairment, and based on personal choice. Assessing an individual's hearing profile is important in a variety of contexts. For example, individuals with hearing profiles that are outside of a normal range, must

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have their profile recorded for the purposes of prescribing hearing aids which fit the individual profile. Typically hearing profile assessments are made by professional audiologists using calibrated and specialized equipment. Therefore, hearing profile assessments have been relatively difficult to obtain and expensive. The mobile phone is a unique class of personal audio device, which presents difficulties to persons with hearing profiles that do not fall within the normal ranges. The most common approach to enabling use of mobile phones for hearing impaired persons involves the use of hearing aids. However, digital mobile phones can cause electromagnetic and acoustic interference with digital hearing aids, forcing removal of aids during mobile phone usage, leaving the user with no compensatory signal processing. In one innovative example, mobile phones can be coupled to inductive neck-worn loops as phone accessories, which deliver signals to electromagnetic receivers called "Telecoils" within hearing aids. However the inconvenience and small market penetration of Telecoils in hearing aids makes them a limited solution. Simply increasing amplification in cell phones is another approach with obvious drawbacks. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Subtype-selective NMDA receptor ligands and the use thereof Inventor(s): Araldi, Gian Luca; (Washington, DC), Bigge, Christopher F.; (Ann Arbor, MI), Cai, Sui Xiong; (Foothill, CA), Guzikowski, Anthony P.; (Eugene, OR), Keana, John F.W.; (Eugene, OR), Lamunyon, Donald; (Tualatin, OR), Lan, Nancy C.; (South Pasadena, CA), Zhou, Zhang-Lin; (Irvine, CA) Correspondence: Fitzpatrick Cella Harper & Scinto; 30 Rockefeller Plaza; New York; NY; 10112; US Patent Application Number: 20010051633 Date filed: February 7, 2001 Abstract: The invention relates to subtype-selective NMDA receptor ligands and the use thereof for treating or preventing neuronal loss associated with stroke, ischemia, CNS trauma, hypoglycemia and surgery, as well as treating neurodegenerative diseases including Alzheimer's disease, amyotrophic lateral sclerosis, Huntington's disease and Down's syndrome, treating or preventing the adverse consequences of the overstimulation of the excitatory amino acids, treating anxiety, psychosis, convulsions, aminoglycoside antibiotics-induced hearing loss, migraine headache, chronic pain, Parkinson's disease, glaucoma, CMV retinitis, urinary incontinence, opioid tolerance or withdrawal, and inducing anesthesia, as well as for enhancing cognition. Excerpt(s): This invention is related to 2-substituted piperidine analogs. The analogs are selectively active as antagonists of N-methyl-D-aspartate (NMDA) receptor subtypes. The invention is also directed to the use of 2-substituted piperidine analogs as neuroprotective agents for treating conditions such as stroke, cerebral ischemia, central nervous system trauma, hypoglycemia, anxiety, convulsions, aminoglycoside antibiotics-induced hearing loss, migraine headaches, chronic pain, glaucoma, CMV retinitis, psychosis, urinary incontinence, opioid tolerance or withdrawal, or neurodegenerative disorders such as lathyrism, Alzheimer's Disease, Parkinsonism and Huntington's Disease. Excessive excitation by neurotransmitters can cause the degeneration and death of neurons. It is believed that this degeneration is in part mediated by the excitotoxic actions of the excitatory amino acids (EAA) glutamate and aspartate at the N-methyl-D-Aspartate (NMDA) receptor. This excitotoxic action is considered responsible for the loss of neurons in cerebrovascular disorders such as

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cerebral ischemia or cerebral infarction resulting from a range of conditions, such as thromboembolic or hemorrhagic stroke, cerebral vasospasms, hypoglycemia, cardiac arrest, status epilepticus, perinatal asphyxia, anoxia such as from drowning, pulmonary surgery and cerebral trauma, as well as lathyrism, Alzheimer's Disease, Parkinson's Disease and Huntington's Disease. Excitatory amino acid receptor antagonists that block NMDA receptors are recognized for usefulness in the treatment of disorders. NMDA receptors are intimately involved in the phenomenon of excitotoxicity, which may be a critical determinant of outcome of several neurological disorders. Disorders known to be responsive to blockade of the NMDA receptor include acute cerebral ischemia (stroke or cerebral trauma, for example), muscular spasm, convulsive disorders, neuropathic pain and anxiety, and may be a significant causal factor in chronic neurodegenerative disorders such as Parkinson's disease [T. Klockgether, L. Turski, Ann. Neurol. 34, 585593 (1993)], human immunodeficiency virus (HIV) related neuronal injury, amyotrophic lateral sclerosis (ALS), Alzheimer's disease [P.T. Francis, N. R. Sims, A. W. Procter, D. M. Bowen, J. Neurochem. 60 (5), 1589-1604 (1993)] and Huntington's disease. [See S. Lipton, TINS 16 (12), 527-532 (1993); S. A. Lipton, P. A. Rosenberg, New Eng. J. Med. 330 (9), 613-622 (1994); and C. F. Bigge, Biochem. Pharmacol. 45, 1547-1561 (1993) and references cited therein.]. NMDA receptor antagonists may also be used to prevent tolerance to opiate analgesia or to help control withdrawal symptoms from addictive drugs (Eur. Pat. Appl. 488,959A). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Suppression of perceived occlusion Inventor(s): Ludvigsen, Carl; (Valby, DK) Correspondence: Sughrue Mion Zinn Macpeak & Seas, Pllc; 2100 Pennsylvania Avenue, NW; Washington; DC; 20037-3213; US Patent Application Number: 20020150269 Date filed: July 9, 2001 Abstract: A fitting method is provided for a multichannel hearing aid with at least one low frequency channel having an individually adjustable compressor. The method comprises the steps of first adjusting the characteristic of the compressor according to the hearing loss to be compensated by the hearing aid, followed by the step of increasing the compression ratio of the characteristic of the compressor in the at least one low frequency band. The at least one low frequency channel may further comprise an offset amplifier adding an offset gain to the compressor characteristic, and the method may further comprise the step of adjusting the offset gain in the range from -20 dB to 20 dB. After adjustment according to the method, compressors operating at low frequencies enhance low level signals and attenuate high level signals whereby perception of occlusion is suppressed. Excerpt(s): The present invention relates to a hearing aid with means for suppression of perceived occlusion. The occlusion effect denotes the low frequency enhancement in the loudness level of bone conducted signals due to occlusion of the ear canal. Some users having an earmold or a hearing aid in the ear canal blocking the canal complain that they have a perception of being in a barrel. In particular, their own voice sounds as if they speak in a barrel. Sounds produced in a person's throat is transmitted to the person's ear canal by bone conduction. The elastic carilaginous tissue in the ear canal transforms the bone conducted energy to acoustic waves in the ear canal. Speech transmitted to the ear canal in this way is denoted bone conducted speech.

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Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

System and method for remotely calibrating a system for administering interactive hearing tests Inventor(s): Atamaniuk, Andy P.; (Redwood City, CA), Edwards, Brent W.; (San Francisco, CA), Ives, Terri E.; (San Jose, CA), Menzel, Christoph; (Madison, CT), Puria, Sunil; (Mountain View, CA), Winstead, John H.; (Sunnyvale, CA) Correspondence: Haynes Beffel & Wolfeld Llp; P O Box 366; Half Moon Bay; CA; 94019; US Patent Application Number: 20030078515 Date filed: October 12, 2001 Abstract: A technique allows a web site visitor, or other user of a consumer electronic device that is remote from a hearing test server, to calibrate the device in a selfadministered fashion, and to apply the calibration in measuring their hearing loss. The measurements can be applied as a hearing profile having a level of quality which can be used for customizing audio products. Audio resources on consumer electronic device such as a home computer, a hand-held computing platform, a mobile phone, or other device that includes audio resources sufficient to support self-administered hearing tests are calibrated. The method includes prompting a user of the device to make a calibration sound using an item likely to be available to the user, other than audio resources on the device. Next, a calibration test using the audio resources on the device to calibrate the device with reference to the calibration sound is run. Excerpt(s): The present application is related to co-pending and commonly owned U.S. patent application Ser. No. 09/830,480, INTERNET BASED HEARING ASSESSMENT METHODS, invented by Menzel et al.; filed Apr. 26, 2001; and to co-pending and commonly owned U.S. patent application Ser. No. ______, SYSTEM AND METHOD FOR REMOTELY ADMINISTERED, INTERACTIVE HEARING TESTS, invented by Edwards, et. al; filed on the same day as the present application. The present invention relates to methods and systems for remotely administering hearing tests, in which the subjects of the test use consumer electronic equipment coupled to communication media, such as Internet connected personal computers, cell phones, personal digital assistants, personal audio equipment, and the like, for the generation of stimuli during the test. Hearing tests are used to develop hearing profiles of persons, which can be used for fitting hearing aids and for other diagnostic purposes. Professional audiologists are typically required for conducting the tests needed to provide a hearing profile, because of the large number of factors involved in making an assessment necessary for generating a reliable hearing profile. An audiologist is able to set up a controlled environment, and conduct the test according to a testing protocol involving a number of stimuli and response steps that is adapted based on the responses gathered during the test. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

Keeping Current In order to stay informed about patents and patent applications dealing with hearing loss, you can access the U.S. Patent Office archive via the Internet at the following Web address:

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http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “hearing loss” (or synonyms) into the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on hearing loss. You can also use this procedure to view pending patent applications concerning hearing loss. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.

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CHAPTER 7. BOOKS ON HEARING LOSS Overview This chapter provides bibliographic book references relating to hearing loss. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on hearing loss include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

Book Summaries: Federal Agencies The Combined Health Information Database collects various book abstracts from a variety of healthcare institutions and federal agencies. To access these summaries, go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. You will need to use the “Detailed Search” option. To find book summaries, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer. For the format option, select “Monograph/Book.” Now type “hearing loss” (or synonyms) into the “For these words:” box. You should check back periodically with this database which is updated every three months. The following is a typical result when searching for books on hearing loss: •

Listen with the Heart: Relationships and Hearing Loss Source: San Diego, CA: Dawn Sign Press. 2001. 198 p. Contact: Available from Dawn Sign Press. 6130 Nancy Ridge Drive, San Diego, CA 92121-3223. (800) 549-5350. Voice/TTY (858) 625-0600. Fax (858) 625-2336. Website: www.dawnsign.com. PRICE: $19.95 plus shipping and handling. ISBN: 1581210191. Summary: Hearing loss does not just affect a person, but also one's family and friends. Written in a nontechnical, storytelling format, the book shares the counseling experiences of nine people who are late deafened and one who was born with a profound hearing loss. The reader will find much in this book that is also applicable to losses other than of hearing: often there is grieving, impact on self esteem, the challenges of dealing with reactions of significant others, often conflicting professional guidance, and spiritual crises. At the same time, however, the stories chronicle many unique challenges of hearing loss, largely having to do with communication, self identity, and

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interpersonal relationships. The author hopes that these stories chronicle the psychological, social, and spiritual effects of hearing loss on a person and on those surrounding people. Each chapter concludes with brief notes or references, as applicable. •

Quiet World: Living with Hearing Loss Source: New Haven, CT: Yale University Press. 2000. 224 p. Contact: Available from Yale University Press. Order Department, P.O. Box 209040, New Haven, CT 06520. (800) 987-7323. Fax (800) 777-9253. Website: www.yale.edu/yup. PRICE: $18.50 plus shipping and handling. ISBN: 0300083439. Summary: In this book, the author, who has experienced gradual hearing loss, explores the problems faced by people who are hard of hearing. The book discusses issues that may be encountered at home and at work, and provides information on the new technology and surgical procedures that are available. Drawing on both his own experiences and his expertise as a social psychologist, the author recounts how he has coped with hearing loss and how he has incorporated technological aids into his life. The author notes that the family and friends of people with hearing loss also face adjustments. The author addresses this situation and provides advice for families on how best to alert loved ones to a hearing problem, persuade them to seek assistance, and encourage them to adjust to and use hearing aids. Seven chapters cover adaptation, relationships, communication, support, hearing aids and advice, understanding hearing and its loss, and technology and hearing loss. The book includes an international list of resources for the hard of hearing and a subject index.

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People with Hearing Loss and the Workplace: A Guide for Employers to Comply with the Americans with Disabilities Act Source: Bethesda, MD: Self Help for Hard of Hearing People, Inc. (SHHH). 1993. 34 p. Contact: Available from Self Help for Hard of Hearing People, Inc. (SHHH). 7910 Woodmont Avenue, Suite 1200, Bethesda, MD 20814. Voice (301) 657-2248; TTY (301) 657-2249; Fax (301) 913-9413. PRICE: $15.00 plus shipping and handling; bulk orders available. Summary: In this guidebook, the principal provisions of Title I (Equal Employment Opportunity for Individuals with Disabilities) of the Americans with Disabilities Act (ADA) are covered as they specifically apply to employees and job applicants who are hearing impaired. The guidebook is designed to assist the employer in understanding what the ADA regulations require in terms of communication access. In addition, essential information is included on how to modify the workplace for employees with hearing impairments, in order to comply with the ADA. Chapters cover reasonable accommodations and undue hardship; employment issues for complying with the ADA, including essential job functions, legal ramifications, job analysis, qualifications and description, recruitment, and interviewing; common signs of hearing loss; options for communication access; assistive devices, including interpreters and hearing ear dogs; and tips for effective communication with employees who have hearing impairments. A resource list includes information centers, videotapes, and sources of communication access products. A glossary concludes the guidebook.

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Confident Living Program: A Community Based Learning Experience for Older Adults with Vision and-or Hearing Losses Source: Sands Point, NY: Helen Keller National Center for Deaf-Blind Youths and Adults (HKNC). 1994. 505 p. Contact: Available from Helen Keller National Center (HKNC). 4455 LBJ Freeway, LB Number 3, Suite 814, Dallas, TX 75244. Voice/TTY (972) 490-9677; Fax (972) 490-6042. PRICE: Single copy free, plus $5.00 for shipping (all formats). Summary: The Confident Living Program (CLP) is based on the belief that acquiring a sensory impairment, at any age, does not have to mean loss of independence. The program includes a facilitator's manual and a participant's manual for CLP. CLP is designed to provide high quality information about vision and hearing losses to older adults experiencing such losses. The facilitator manual includes the program philosophy, program preparation, details about conducting the CLP, program followup, and the curriculum. The curriculum covers the eye and vision, the ear and hearing, coping with vision loss, coping with hearing loss, and coping skills. The participant's manual is provided in master form for facilitators to duplicate and distribute. The participant manual is printed in large, bold type. The program is provided in a looseleaf notebook for ease of use.

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Understanding Deafness and the Rehabilitation Process Source: Needham Heights, MA: Allyn and Bacon. 1994. 320 p. Contact: Available from Allyn and Bacon. 160 Gould Street, Needham Heights, MA 02194-2310. (617) 455-1200. PRICE: $44.95 plus shipping and handling. ISBN: 0205156282. Summary: The purpose of this book is to help vocational rehabilitation counselors and counselors-in-training to better understand deafness, people who are deaf, and the many challenges that they face in preparing themselves for and finding jobs. The book begins with a brief overview of hearing loss and the development of people who are deaf. This is followed by an in-depth look at the effects of deafness on language and communication, cognition, and affective development. Next the authors examine the critical task of helping individuals who are deaf make the transition from school to work. Other chapters cover general assessment; how the outcomes of assessment are applied in vocational guidance for workers who are deaf; personal adjustment issues; therapeutic interventions, including individual and group counseling with cognitive behavior therapy, and family intervention with a systems approach; technological and personal support services; and job placement. Each chapter includes extensive references and a subject index concludes the volume.

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Odyssey of Hearing Loss: Tales of Triumph Source: San Diego, CA: DawnSign Press. 1998. 220 p. Contact: Available from DawnSign Press. 6130 Nancy Ridge Drive, San Diego, CA 92121-3223. (858) 625-0600. Fax: (858) 625-2336. E- mail: [email protected]. Web site: www.dawnsign.com/. ISBN: 1- 58121-006-X. PRICE: $23.95 plus shipping, tax, and handling. Available in hardcover. Summary: The ten case studies presented in this book illustrate the ways that people come to accept and manage their acquired hearing loss. Using a psycho-social-spiritual framework, the stories describe the emotional impact of hearing loss and the resilience

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of the people who are affected. Emphasis is placed on the loss of self-esteem, spiritual difficulties, oppression, and the role of psychotherapy. The individuals overcame the challenges of hearing loss with a wide range of responses, such as integration into deaf culture and extensive investigation into options for treatment. •

Communication Issues Related to Hearing Loss Source: Bethesda, MD: Self Help for Hard of Hearing People, Inc. (SHHH). 1993. 72 p. Contact: Available from Self Help for Hard of Hearing People, Inc. (SHHH). 7910 Woodmont Avenue, Suite 1200, Bethesda, MD 20814. Voice (301) 657-2248; TTY (301) 657-2249; Fax (301) 913-9413. PRICE: $12.00 plus shipping and handling. Summary: This book enumerates and describes the essentials of communication issues related to hearing loss. The author presents an overview of the issues related to communication problems. The book is written for people who are hearing impaired, their hearing family members, their employers and coworkers, their friends, and professionals who provide services to them. Seven chapters cover situations that produce problems; reactions to communication problems; assessing and altering environments; the effective use of assistive devices; identifying faulty speaker behavior; encouraging effective listener behavior; and relationship concerns. The book concludes with an annotated list of manuals and videotapes.

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Hear: Solutions, Skills, and Sources for People with Hearing Loss Source: New York, NY: DK Publishing. 1997. 128 p. Contact: Available from DK Publishing. 95 Madison Avenue, New York, NY 10016. (212) 4800; Fax (212) 213-5240; http://www.dk.com. PRICE: $19.95 plus shipping and handling. ISBN: 0789414589. Summary: This book explains the principles of sound, how the ear works, and what can go wrong. The author gives advice on choosing a hearing aid, as well as information about other assistive listening devices, and skills such as speechreading and auditory training. The author suggests strategies for dealing with everyday situations, and provides information for families and friends. The emotional impact of hearing loss is also covered, along with advice on stress management, legal matters, and the function of self-help groups. The author includes interviews with people who have developed hearing loss; these interviews offer personal insights and varied perspectives. Hints are given throughout the book, and a comprehensive list of resources is also included. The book includes full-color illustrations. A glossary and subject index conclude the book.

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Communication and Adult Hearing Loss Source: Melbourne, Australia: Clavis Publishing. 1993. 136 p. Contact: Available from Interactive Therapeutics, Inc. P.O. Box 1805, Stow, OH 442240805. (800) 253-5111. Fax (330) 923-3030. E-mail: [email protected]. Website: www.interactivetherapy.com. PRICE: $12.95 plus shipping and handling. ISBN: 0646141562. Summary: This book is designed for anyone who wants to communicate more effectively with hard of hearing adults, including friends, relatives, doctors, nurses, and health care workers. In this text, practical samples of everyday conversation are used to illustrate the application of professional methods. Six chapters explain how people typically talk with one another, how adult hearing loss can disrupt conversation, how to

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speak sentences with maximum clarity, how to clarify sentences that are not understood, how to recognize and reduce distractions and how the hard of hearing person can contribute to the communication interchange. The book concludes with a list of clinical and scientific references for readers who want more information; a subject index is also included. •

Coping with Hearing Loss: Plain Talk for Adults About Losing Your Hearing Source: New York, NY: Barricade Books. 2000. 287 p. Contact: Available from Barricade Books, Inc. 185 Bridge Plaza North, Suite 308 A, Ft. Lee, NJ 07024. (800) 592-6657. Website: www.barricadebooks.com. PRICE: $19.95 plus shipping and handling. ISBN: 1569801657. Summary: This book is designed to help adults and their families cope with hearing loss. The book includes 16 chapters on a wide range of topics including the causes of hearing loss; the psychological effects of hearing loss; how hearing loss can ruin a relationship; information for the person with the hearing loss; how to handle the hearing loss of a spouse, parent or friend; hearing aids; the role of the physician; the audiologist and the hearing aid dispenser; other assistive devices; tinnitus; strategies for better communication; hearing rehabilitation and therapy; assertive communication behavior in real world settings; financial concerns; and coping. Written in nontechnical language, the chapters are filled with examples and specific strategies that real people have used in settings from the workplace to home to social and recreational situations. Each type of hearing aid is illustrated with a photograph, a description, and a discussion of advantages and disadvantages. The text includes a detailed glossary, an appendix of related web information sources, and a subject index.

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Understanding Hearing Loss Source: Bristol, PA: Taylor and Francis. 1996. 188 p. Contact: Available from Taylor and Francis. 1900 Frost Road, Suite 101, Bristol, PA 19007-1598. (800) 821-8312; Fax (215) 785-5515. PRICE: $18.95 plus shipping and handling. ISBN: 1853022144. Summary: This book is intended for anyone who is hard of hearing or deafened or for anyone who lives or works with people who have a significant hearing loss, and for anybody who wishes to know something about hearing disability and how it can be helped. The author explains how the ear works; describes the nature and causes of the various kinds of hearing loss and what both the doctor and the person concerned can do to help; considers hearing aids and other devices, focusing on their limitations and the best kinds of hearing aids for different conditions; discusses cochlear implants; explains speechreading, hearing tactics, and auditory training (listening skills); gives examples of audiometric tests and how to interpret them; and examines the implications for employment, hospitalization, and family relationships caused by hearing loss. Subject and author indices are included. The author also includes a chapter on resources; however, these are predominantly for the United Kingdom.

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Coping with Hearing Loss and Hearing Aids Source: San Diego, CA: Singular Publishing Group, Inc. 1992. 224 p. Contact: Available from Singular Publishing Group, Inc. 401 West 'A' Street, Suite 325, San Diego, CA 92101-7904. (800) 521-8545 or (619) 238-6777. Fax (800) 774-8398 or (619)

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238-6789. E-mail: [email protected]. Website: www.singpub.com. PRICE: $18.95 plus shipping and handling. ISBN: 1879105454. Summary: This book on hearing loss and hearing aids is one of a series of books written for men and women coping with the challenges of aging, their families, and caregivers. The author provides a thorough explanation of hearing health care professionals, the ear, hearing loss, and the effect of hearing loss on communication. Thirteen chapters cover recognizing hearing loss; hearing health care professionals; the hearing evaluation; the anatomy and physiology of the ear; the effect of presbycusis and other factors on communication; ways to improve communication; common hearing aid myths; what to know before purchasing a hearing aid; understanding hearing aids; hearing aid batteries; obtaining and maintaining a hearing aid; adjusting to a hearing aid; and hearing aid repairs. The final chapter lists resource organizations through which readers can obtain further information about hearing loss, hearing devices, and hearing help. A subject index concludes the book. (AA-M). •

Hear What You've Been Missing: How to Cope with Hearing Loss Source: Minneapolis, MN: Chronimed Publishing. 1998. 167 p. Contact: Available from John Wiley and Sons, Inc. Distribution Center, 1 Wiley Drive, Somerset, NJ 08875-1272. (800) 225-5945 or (732) 469-4400. Fax (732) 302-2300. Website: www.wiley.com. E-mail: [email protected]. Also available from Hear Again. 1200 Madison Avenue, Austin, TX 78757. (512) 451-6633. Website: www.hearagainpublishing.com. E-mail: [email protected]. PRICE: $14.95. ISBN: 0471347345. Summary: This book outlines the many tools and strategies available to overcome the effects of hearing loss. The author, an audiologist, answers common questions about causes and treatment of hearing loss, hearing aids and other assistive listening devices, medications and surgery, and communication strategies. Specific topics include how hearing loss can affect daily life, the incidence of hearing loss, the signs of hearing loss in adults and children, how hearing is tested, how to read an audiogram, how hearing loss is defined and classified, how the ear works, tinnitus (ringing or other noises in the ears), noise sensitivity, the interplay between dizziness and hearing loss, how hearing loss can affect speech, how to explain hearing loss to others, the causes of hearing loss, hearing loss associated with aging (presbycusis), problems associated with earwax, assistive listening devices and systems, how hearing aids are dispensed, cost considerations, one hearing aid versus two, the care and maintenance of hearing aids, cochlear implants, telephone assistance, alerting devices, television systems (including captioning), FM systems, employment and workplace considerations, classroom listening and communication strategies, speechreading, nonverbal communication, Cued Speech, sign language, the use of interpreters, common emotional reactions to hearing loss, and locating and using support groups. The book includes a glossary of terms, a list of recommended readings, a list of suppliers of assistive listening devices and systems, a listing of SHHH affiliates, and a five minute hearing test. The book concludes with a subject index. 7 appendices. 25 figures. 10 references.

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Deafness. 5th ed Source: London, England: Whurr Publishers Ltd. 1993. 339 p. Contact: Available from Singular Publishing Group, Inc. 401 West 'A' Street, Suite 325, San Diego, CA 92101-7904. (800) 521-8545 or (619) 238-6777. Fax (800) 774-8398 or (619)

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238-6789. E-mail: [email protected]. Website: www.singpub.com. PRICE: $63.50 plus shipping and handling. ISBN: 1565935179. Summary: This collection of readings is written for health professionals and educators whose professional work may bring them into close contact with individuals who are deaf. Chapters cover the normal ear and hearing, the diagnosis of deafness, conductive deafness, deafness in children, acquired sensorineural deafness (hearing loss due to hereditary factors, infections, iatrogenic factors, trauma, and presbycusis), non-organic hearing loss, tinnitus, psychological aspects of hearing loss, hearing aids and other assistive devices, implants (cochlear and bone-conduction), and auditory rehabilitation. The book includes a glossary of abbreviations and acronyms, and a subject index. A list of resource organizations reflects the British perspective of the text. 68 references. (AAM). •

Consumer Handbook on Hearing Loss and Hearing Aids: A Bridge to Healing Source: Sedona, AZ: Auricle Ink Publishers. 1998. 268 p. Contact: Available from Auricle Ink Publishers. P.O. Box 20607, Sedona, AZ 86341. (520) 284-0860; E-mail: [email protected]; http://www.hearingproblems.com. PRICE: $18.95 plus shipping and handling. ISBN: 096618260X. Summary: This consumer handbook offers information about the problems of hearing loss and how they affect families. All chapters are authored by clinical audiologists who work on a daily basis with people who have hearing loss. The text discusses the use of hearing aids as a therapeutic factor in addressing hearing loss. But it emphasizes that efforts to overcome the challenge of living in the mainstream as a hard of hearing person should not end with the hearing aid purchase. Fourteen chapters cover the emotions of losing hearing, aging and its impact on hearing, the process of hearing loss, why some consumers reject hearing aids, how hearing aids work, problem solving for hearing aid users, ways to improve listening and hearing, tinnitus, preventing noise-induced hearing loss or drug-induced hearing damage (ototoxicity), and assistive listening devices. The book includes one chapter of answers to commonly-asked questions about hearing aids and adapting to their use. The book concludes with a chapter of resource organizations which offer information for consumers with hearing impairments; organizations are listed with their addresses, telephone numbers, fax numbers, e-mail addresses, and World Wide Web addresses. Each organization is briefly described. Black and white photographs illustrate the text; a subject index concludes it.

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Gallaudet Encyclopedia of Deaf People and Deafness Source: New York, NY: McGraw-Hill Book Company, 1987, 3 volumes. Contact: Available from TAB/McGraw-Hill, Blue Ridge Summit, PA 17294. (800)2331128. PRICE: $385.00. ISBN 0070792291. Summary: This encyclopedia is written for persons with hearing impairments. The volumes pertain both to an identifiable group of people, those with hearing impairments, and to a physical attribute, deafness. The information has been selected from studies in the sciences, the social sciences, and the humanities. The 273 entries in the encyclopedia are arranged alphabetically in continuous sequence in three volumes. Many of the entries are divided into sections and subsections about particular aspects of the topic. An index is included. Bibliographies and cross-references accompany most entries. Illustrations accompany the text.

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Missing Words: The Family Handbook on Adult Hearing Loss Source: Washington, DC: Gallaudet University Press. 1993. 259 p. Contact: Available from Gallaudet University Press. 800 Florida Avenue, NE, Washington, DC 20002-3695. Voice-TTY (800) 451-1073 or (202) 651-5488. Fax (202) 6515489. PRICE $24.95 plus shipping and handling. ISBN 1563680238. Also available from Self-Help for Hard of Hearing People, Inc. 7910 Woodmont Avenue, Suite 1200, Bethesda, MD 20814. Voice (301) 657-2248. TTY (301) 657-2249. Fax (301) 913-9413. PRICE: $24.95 plus shipping and handling. Summary: This guidebook presents the experiences of an adult dealing with hearing loss and the perspective of a family member who also must adjust to the inevitable changes associated with hearing loss. The authors offer tips and information on making the most of voices, the environment, communicating beyond words, predicting meaning, and rethinking sound. Two chapters summarize the basics of communicating with a person who has a hearing loss and provide techniques for improving communication. The book also includes advice from an otologist on the medical aspects of hearing loss, including the use of assistive devices and the potential benefit of a cochlear implant. The book concludes with an extensive resources chapter and a subject index. 41 references. (AA-M).

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Preventing Occupational Hearing Loss: A Practical Guide Source: Atlanta, GA: National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control (CDC), U.S. Department of Health and Human Services. June 1996. 91 p. Contact: Available from National Institute for Occupational Safety and Health (NIOSH). Publications Dissemination, 4676 Columbia Parkway, Cincinnati, OH 45226-1998. Email: [email protected]. Website: www.cdc.gov/niosh/homepage.html. PRICE: Single copy free. DHHS Publication Number 96-110. Summary: This guidebook sets forth the concepts and techniques for achieving an effective hearing conservation program (HCP). These guidelines were originally established by a group of hearing conservation experts convened in 1988 by the National Institute for Occupational Safety and Health (NIOSH). This updated version of the guidelines increases the emphasis on prevention of noise-induced hearing loss. Concepts and action terms are presented in terms of the responsibilities of three groups of personnel: management, those who implement the HCP, and the affected or noiseexposed employees. The NIOSH hierarchy is summarized in three stages: prevent or contain the escape of the hazardous workplace agent at its source (noise or other agents, such as chemicals); control exposure by relocating the worker to a safe area; and control the exposure with barriers between the worker and the hazard (personnel protective equipment). This hierarchy underscores the principle that the best of all prevention strategies is to have no exposure to agents that can cause or contribute to hearing loss. In the area of hearing loss prevention, protection is a many-faceted process that includes exposure assessment, provision of protective equipment, assessment of hearing with appropriate management and followup actions, worker education and training, and continuous evaluation of program effectiveness. Appendices include an OSHA noise standard compliance checklist, a list of suggested readings, a checklist for evaluating HCPs already in place, a listing of audiovisual materials, a list of resource organizations in both government and the private sector, and a glossary of terms common to hearing loss prevention. 16 figures. 63 references.

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How the Student with Hearing Loss Can Succeed in College: A Handbook for Students, Families and Professionals. 2nd ed Source: Washington, DC: Alexander Graham Bell Association for the Deaf. 1996. 304 p. Contact: Available from Alexander Graham Bell Association for the Deaf. 3417 Volta Place, N.W., Washington, DC 20007-2778. Voice/TTY (202) 337-5220. Fax (202) 337-8270. PRICE: $28.95 plus shipping and handling. ISBN: 0882002074. Summary: This handbook on college education for students with hearing loss is based on the philosophy that with appropriate education, testing, and emotional support, students with hearing loss can become their own best advocates and can participate in their rehabilitation programs. The book includes 17 chapters that cover service delivery to students with hearing impairments, federal laws and program accessibility, understanding and measuring hearing loss, the physiology of hearing, hearing aids and their uses, amplification, hearing aid dispensing, assistive listening devices, strategies for succeeding with a hearing loss, career planning, getting ready for the transition to college, selecting a college, financing one's education, support systems, strategies for classroom listening and amplification, the role of the speech language pathologist, and support groups. The final chapter presents opinions from students with hearing loss who suggest ways to succeed in college. The handbook concludes with a glossary of terms. The handbook is illustrated with black and white photographs and most of the chapters include references.

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Living Well with Hearing Loss Source: New York, NY: John Wiley and Sons, Inc. 1992. 179 p. Contact: Available from John Wiley and Sons, Inc. 605 Third Avenue, New York, NY 10158-0012. (212) 850-6000; (212) 850-6000. PRICE: $12.95 plus shipping and handling. ISBN: 0471545228. Summary: This handbook, designed as a guide for persons with hearing loss and their families, emphasizes the need for everyone to become knowledgeable about hearing loss and how to manage it. Written by an audiologist, the book includes checklists and guides on the warning signs of hearing loss in children and adults; how to achieve effective communication with people who have hearing impairments; sources for obtaining assistive listening devices; and how to support children with hearing loss and start a parents' group. The handbook also includes a guide to the manual alphabet; information on organizations and information sources for people who have hearing impairments; and a glossary of terms. A subject index concludes the book.

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Hereditary Hearing Loss and Its Syndromes Source: New York, NY: Oxford University Press. 1995. 480 p. Contact: Available from Oxford University Press. 200 Madison Avenue, New York, NY 10016. (800) 334-4249 or (212) 679-7300. PRICE: $195.00 plus shipping and handling. ISBN: 0195065522. Summary: This medical text describes types of hereditary hearing loss occurring alone or with associated abnormalities. Within each chapter, the author covers many individual types of hearing loss as described in the literature. Fifteen chapters cover 22 forms of isolated genetic hearing loss, 30 involving the external ear, 40 the eye, 87 the musculoskeletal system, 23 the kidney, 63 the central nervous system, 51 endocrine and metabolic conditions, and 12 chromosomal disorders, 56 the skin, 8 oral and dental, and

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35 miscellaneous disorders. For each condition discussed, the author covers the clinical findings, the auditory system, laboratory findings, pathology, heredity, diagnosis, and prognosis. References are included in each section. A detailed subject index concludes the volume. •

Evaluation of People Reporting Occupational Hearing Loss Source: Alexandria, VA: American Academy of Otolaryngology-Head and Neck Surgery, Inc. (AAOHNS). 1998. 62 p. Contact: Available from American Academy of Otolaryngology-Head and Neck Surgery, Inc. (AAOHNS). One Prince Street, Alexandria, VA 22314-3357. (703) 836-4444. Fax (703) 683-5100. Website: www.entnet.org. PRICE: $12.00 (members); $15.00 (nonmembers). Summary: This monograph addresses the medical and legal aspects of occupational hearing loss with special emphasis on the practical aspects of the otolaryngologist's role. The otolaryngologist is often requested to evaluate people who report occupational hearing loss and to determine the presence and type of hearing loss, to estimate the magnitude of the hearing loss, and to render an opinion about whether the loss was work-related. Topics include the medical history, physical examination, and audiometric assessment of the patient; reporting issues; measurement of noise exposure, including the temporal characteristics of noise, the types of occupational and nonoccupational noise exposure, and relevant standards and regulations; pathophysiology of noise-induced hearing loss, including epidemiology, causative factors, histopathology, sociocusis, genetic susceptibility, smoking, presbycusis, age, cardiovascular disease, diabetes mellitus, hyperlipoproteinemia, gender, and ototoxic drugs; clinical aspects, including symptoms, audiometric considerations, asymmetric hearing loss, and tinnitus; audiologic evaluations; allocation; and pertinent legal standards, including Workers' Compensation, product liability claims, railroad and maritime workers, tinnitus claims, Federal noise regulations in injury litigation, and the role of the expert witness. The monograph includes a list of the abbreviations relevant to this area. Each section offers references. 1 figure. 7 tables. 159 references.

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Otosclerosis (Otospongiosis) Source: Alexandria, VA: American Academy of Otolaryngology-Head and Neck Surgery Foundation, Inc. (AAO-HNS). 1991. 165 p. Contact: American Academy of Otolaryngology-Head and Neck Surgery Foundation, Inc. (AAO-HNS). One Prince Street, Alexandria, VA 22314. (703) 836-4444. Fax (703) 6835100. Website: www.entnet.org. PRICE: $12.00 members; $15.00 non-members. Item Number 5206245. Summary: This monograph provides an overview of otospongiosis of the labyrinthine capsule, commonly referred to as otosclerosis. The condition consists of one or several circumscribed foci of new, softer, and more vascular bone that appear in, and replace, the ivory-hard, avascular endochondral bone of the adult labyrinthine capsule. Twelve chapters cover the historical background, embryology and genetics, pathology, etiopathogenesis, clinical features and epidemiology of otosclerosis, evaluating hearing loss secondary to otosclerosis, radiology, the prognosis of sensorineural deterioration and cochlear otosclerosis, treatment of otosclerosis, special conditions in otosclerosis surgery, and complications in stapes surgery. Each chapter includes references. Full color and black and white photographs illustrate the monograph.

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Medical Aspects of Hearing Loss for the Consumer and the Professional Source: Volta Review. 9(5): 1-203. November 1999. Contact: Available from Alexander Graham Bell Association for the Deaf and Hard of Hearing. Subscription Department, 3417 Volta Place, NW, Washington, DC 20007-2778. Voice/TTY (202) 337-5220. Website: www.agbell.org. Also available as individual copies from Publication Sales Department, 3417 Volta Place, NW, Washington, DC 20007-2778. Voice/TTY (202) 337-5220. Website: www.agbell.org. PRICE: $22.95 plus shipping and handling. Summary: This monograph was written by assembling the leading experts from all over the country to present to both the consumer and the professional the latest information on the diagnosis and management of hearing loss in children and adults. Seventeen articles are included, on how the ear works, research on hearing and balance, screening for hearing loss in infants, hereditary hearing loss, hearing loss and cytomegalovirus, the emotional aspects of hearing loss, genetic counseling for hearing loss, otitis media (middle ear infections) in children, the diagnosis and management of tinnitus (ringing or buzzing in the ears), the evaluation and treatment of the patient with vertigo, immunologic disorders of the inner ear, sudden sensorineural hearing loss (the role of perilymph fistula), hearing loss in adults, otosclerosis, sudden hearing loss, Meniere's disease, and medications and characteristics of drugs causing ototoxicity. Each article includes a brief summary and references.

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KIP, Knowledge is Power: A Program to Help Students Learn About Their Hearing Loss Source: Bettendorf, IA: Mississippi Bend Area Education Agency, Special Education Division. 1994. 238 p. Contact: Available from Audiological and Education, H.I. Services Department. Attention: KIP, Mississippi Bend Area Education Agency, 729-21st Street, Bettendorf, IA 52722-5096. (319) 359-1371 or (319) 263-8476. PRICE: $14.00 plus $4.00 for shipping and handling. Summary: This program is designed to help preschool through high school age students with all degrees of hearing loss to develop coping skills, communication strategies, and healthy levels of self-esteem. A pretest may be used to measure students' understanding of a topic. After the pretest is administered, informal learning sessions are scheduled with an individual student or with small groups. When the discussion of each topic is completed, students participate in follow-up activities. A follow-up activity for each topic is also used with parents. Topics covered include the anatomy of hearing, causes of hearing loss, hearing measurement, hearing aids, assistive listening devices, communication strategies, and national, state, and local resources. KIP services are typically provided by audiologists, teachers of the hearing impaired, or speech language pathologists. The KIP program is provided in a looseleaf notebook format for ease of use.

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Help and hope: A resource guide for parents of children with hearing loss Source: Boise, ID: Idaho State Council for the Deaf and Hard of Hearing. 1999. 40 pp. Contact: Available from Idaho State Council for the Deaf and Hard of Hearing, 1720 Westgate Drive, Boise, ID 83704. Telephone: (800)433- 1323 or (208)334-0879 or (800)4331361 TTY or (208)334--0803 TTY / fax: (208)334-0828 / e-mail: [email protected] / Web site: http://www2.state.id.us/cdhh/cdhh1.htm. Available at no charge.

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Summary: This resource guide was specifically written for parents and caregivers of children with hearing loss to help them locate organizations that provide support and information. This resource can also be used by teachers, speech language pathologists, child development agency personnel and anyone interested in the field. Topics covered in this resource guide include health care needs, child development, education, communication, psychosocial needs, legal resources, financial resources, publications, glossary, references, and local agencies and organizations. •

Language and Deafness. 3rd ed Source: San Diego, CA: Singular Publishing Group. 2001. 692 p. Contact: Available from Thomson Learning Group. P.O. Box 6904, Florence, KY 41022. (800) 842-3636. Fax (606) 647-5963. Website: www.singpub.com. PRICE: $59.95 plus shipping and handling. ISBN: 1565939999. Summary: This text offers an indepth introduction to language development in children and adolescents who are deaf or hard of hearing. In addition to focusing on children with severe to profound hearing impairment, the book also offers some coverage of the language acquisition of individuals with less severe hearing losses, particularly in the chapter on the development of oral English skills. Twelve chapters cover an introduction to language and deafness, language functions and structures, language acquisition, primary language development, orality [speech, audition, and speechreading], signed systems, American Sign Language, the development of reading and writing (script literacy), bilingualism and second language learning, language instruction, language assessment, and language and communication approaches (a concluding chapter). Each chapter includes a summary, a list of comprehension questions for readers, a list of challenge questions, and a list of further readings. The sign language references are illustrated with black and white photographs. The textbook concludes with a reference list and a detailed subject index. 1,063 references.

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Musicians and the Prevention of Hearing Loss Source: San Diego, CA: Singular Publishing Group, Inc. 1996. 184 p. Contact: Available from Singular Publishing Group, Inc. 401 West 'A' Street, Suite 325, San Diego, CA 92101-7904. (800) 521-8545 or (619) 238-6777. Fax (800) 774-8398 or (619) 238-6789. E-mail: [email protected]. Website: www.singpub.com. PRICE: $45.00 plus shipping and handling. ISBN: 1565936264. Summary: This text offers nine chapters on musicians and the prevention of hearing loss. The book includes wide use of case examples and music spectra from a range of musicians and instruments. Chapter 1 is an introduction to hearing and hearing loss that covers topics of special interest to the counseling of musicians. Chapter 2 is a critical analysis of the relevant research on factors that can affect hearing. Chapter 3 covers the development of acoustic principles found in the study of musical instruments, ear protection, and the performing environment. Chapter 4 covers the physics of musical instruments with a focus on aspects important for the assessment of the musician. Chapter 5 covers the development and assessment of ear protection for those in the performing arts. Chapter 6 offers a clinical approach to the assessment of musicians with case studies. Chapter 7 discusses the science of room acoustics and appropriate modifications. Chapter 8 overviews clinical and environmental strategies that can be implemented to reduce the potential of hearing loss among musicians, yet still allow the environment to be musically acceptable. Chapter 9 discusses many of the issues surrounding the general approach to musicians and the need for individual assessments

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in most cases. The two appendices cover information important for the clinical assessment and service development in the performing arts industry. A subject index concludes the text. 184 references. •

Literacy and Deafness: The Development of Reading, Writing, and Literative Thought Source: Needham Heights, MA: Allyn and Bacon. 1998. 367 p. Contact: Available from Allyn and Bacon. 160 Gould Street, Needham Heights, MA 02494. (781) 455-1250. Website: www.abacon.com. PRICE: $55.00 plus shipping and handling. ISBN: 0205175767. Summary: This textbook offers a comprehensive study of the acquisition of English literacy skills in children and adolescents with severe to profound hearing impairment. Topics include an overview of the major aspects of literacy and deafness, including major perspectives on literacy, the role of teaching, and deafness; the research on literacy among hearing students, and literacy and deaf students; the development of writing in both hearing and deaf students; the major tenets of the literary critical perspective, including considerations for bilingualism of ASL (American Sign Language) and English. The textbook's topics also include the theory and research on second language development of English literacy; the teaching of literacy in English; reform in assessment, focusing on alternative measures of achievement; the interrelations of metatheory, theory, research, and practice; the reciprocal relations between word identification and comprehension and between the conversational and written forms of a phonetic language such as English; and the contribution of a well and early developed language to the subsequent development of literate thought. Each chapter offers suggestions for further reading. The text concludes with a section of comprehension questions for each chapter, a lengthy reference list, and a subject index. 541 references.

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Dizziness, Hearing Loss, and Tinnitus Source: Philadelphia, PA: F.A. Davis Company. 1998. 240 p. Contact: Available from Oxford University Press, Inc. Business Office, 2001 Evans Road, Cary, NC 27513. (800) 451-7556 or (919) 677-0977. Fax (919) 677-1303. PRICE: $65.00 plus shipping and handling. Summary: This textbook presents a concise approach to evaluating patients with dizziness, hearing loss, and tinnitus. In the first section, the author briefly reviews clinically relevant anatomy and physiology to provide a framework for understanding the pathophysiology of vestibular and auditory symptoms. The second section outlines the important features in the patient's history and examination that determine the probable site of a lesion. Separate chapters provide a systematic approach to evaluating patients with different types of dizziness and tinnitus. Numerous tables and flowcharts guide the reader through the diagnostic workup. The section on diagnosis and treatment covers the key differential diagnosis points that help the clinician decide the cause of the patient's problem and how to treat it. The description of each disease begins with an outline of symptoms, signs, laboratory findings, and treatment options. Each chapter includes references and a subject index concludes the volume.

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Infants and Toddlers with Hearing Loss: Family Centered Assessment and Intervention Source: Timonium, MD: York Press. 1994. 380 p. Contact: Available from York Press. P.O. Box 504, Timonium, MD 21098. (800) 962-2763; Fax (410) 560-6758. PRICE: $38.00 plus shipping and handling. ISBN: 0912752289. Summary: This textbook provides an overview of family-centered assessment and intervention as it applies to families with infants and toddlers with hearing loss. The text begins with a review of the family-centered movement, discusses its implications for assessment and intervention, and provides numerous examples of how these principles have been integrated into practice in a variety of settings. The editors stress that they have tried not to favor any particular methodology, placement option, or service delivery setting. They note that such decisions should be made by the families themselves. Information regarding identification of hearing loss and the use of hearing aids or other sensory devices is presented at a level appropriate for professionals from a variety of disciplines. A review of federal regulations is also provided, with examples of how these principles may be applied to the development and implementation of an individualized family service plan. The practical application of a family-centered approach is illustrated through descriptions of several programs currently operating in the United States. The textbook concludes with a section reporting results of a mail survey of families with young children with deafness and hearing impairments; the survey asked families to share experiences that were and were not helpful. Each chapter includes references and a subject index concludes the volume. (AA-M).

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Bridges Beyond Sound: An Instructional Workbook on Understanding and Including Students with a Hearing Loss Source: Baltimore, MD: Paul H. Brookes Publishing Company. 1996. 154 p. Contact: Available from Paul H. Brookes Publishing Company. P.O. Box 10624, Baltimore, MD 21285-0624. (800) 638-3775. Fax (410) 337-8539. E-mail: [email protected]. Website: www.brookespublishing.com. PRICE: $33.00 plus shipping and handling. ISBN: 1557662266. Summary: This workbook, designed for use with a separately available videotape, offers teachers an effective way to address their students questions and concerns about understanding students with hearing loss. The workbook includes the videotape script, background information on hearing loss, discussion questions, activities, and reproducible worksheets that give students a chance to apply what they are learning. Topics include how hearing impairments are diagnosed, inclusive education (mainstreaming), speechreading, interpreting, American Sign Language (ASL), famous people who are deaf, and the history of deaf people in the U.S. The manual includes fact sheets about hearing loss and people with hearing impairments, a glossary of terminology related to hearing loss, how to use a TTY, selected readings and videotapes about deafness and people who are deaf, state organizations of and for the deaf, national and international organizations of and for the deaf, tips for including students who have hearing impairments in general classrooms, and tips for evaluating instructional materials. The student instructional materials include fact sheets, a sample audiogram, a diagram of the ear's anatomy and physiology, technology used by people who have hearing impairments, a diagram of the manual alphabet (for fingerspelling), a list of children's books about people who are deaf, and various word puzzles (word jumble, crosswords, word search, connect-the-dots). The manual concludes with a subject index.

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Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in Print®). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “hearing loss” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “hearing loss” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “hearing loss” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •

A Quiet World: Living With Hearing Loss by David G. Myers (2000); ISBN: 0300084390; http://www.amazon.com/exec/obidos/ASIN/0300084390/icongroupinterna

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Acquired Hearing Loss and Elderly People: Papers Arising from a Seminar Arranged by the Department OfAdult Education, University of Keele and the Beth JohnsonFounda at Keele, in March 1982 (Beth Johnson Foundation Publications) by Frank Glendenning, E.F. Evans (1982); ISBN: 0907875041; http://www.amazon.com/exec/obidos/ASIN/0907875041/icongroupinterna

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Acquired Hearing Loss: Psychological and Psychosocial Implications by Alan J. Thomas; ISBN: 0126879206; http://www.amazon.com/exec/obidos/ASIN/0126879206/icongroupinterna

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AIDS and Deafness: Resource Directory (1989); ISBN: 9993039888; http://www.amazon.com/exec/obidos/ASIN/9993039888/icongroupinterna

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As in Every Deafness by Graham Foust (2003); ISBN: 0971005982; http://www.amazon.com/exec/obidos/ASIN/0971005982/icongroupinterna

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At the Crossroads: A Celebration of Diversity (Readings in Deafness Monograph, No 15) by Douglas Watson, Myra Taff-Watson (Editor) (1991); ISBN: 091449418X; http://www.amazon.com/exec/obidos/ASIN/091449418X/icongroupinterna

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Basic and Applied Aspects of Noise-Induced Hearing Loss (NATO Asi Series A, Life Sciences, Vol 111) by Richard J. Salvi (Editor); ISBN: 0306423693; http://www.amazon.com/exec/obidos/ASIN/0306423693/icongroupinterna

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Bibliography on Deafness: The Volta Review, 1899-1976; American Annals of the Deaf, 1847-1976. Rev Ed (272P) by George W. Fellendorf; ISBN: 0882001116; http://www.amazon.com/exec/obidos/ASIN/0882001116/icongroupinterna

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Caring for Someone with a Hearing Loss (Carers Handbook Series) by Marina Lewycka (2000); ISBN: 0862423104; http://www.amazon.com/exec/obidos/ASIN/0862423104/icongroupinterna

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Child With a Hearing Loss in Your Classroom by Mangiard (1993); ISBN: 9994830643; http://www.amazon.com/exec/obidos/ASIN/9994830643/icongroupinterna

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Cochlear Hearing Loss by Brian C. J. Moore; ISBN: 1861560915; http://www.amazon.com/exec/obidos/ASIN/1861560915/icongroupinterna

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Communication Access for Persons With Hearing Loss: Compliance With the Americans With Disabilities Act by Mark Ross (Editor) (1994); ISBN: 0912752351; http://www.amazon.com/exec/obidos/ASIN/0912752351/icongroupinterna

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Communication Disorders Sourcebook: Basic Information About Deafness and Hearing Loss, Speech and Language Disorders, Voice Disorders, Balance and Vestibular Disorders, and Disorders of (Health Reference Series, Vol 11) by Linda M. Ross (Editor) (1996); ISBN: 078080077X; http://www.amazon.com/exec/obidos/ASIN/078080077X/icongroupinterna

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Conceptualization and Measurement of Physiologic Health for Adults: Hearing Loss by S. Beck (Editor) (1981); ISBN: 0833003070; http://www.amazon.com/exec/obidos/ASIN/0833003070/icongroupinterna

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Congenital Deafness: A New Approach to Early Detections of Deafness by F.O. Black (1971); ISBN: 0870810057; http://www.amazon.com/exec/obidos/ASIN/0870810057/icongroupinterna

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Coping With Hearing Loss and Hearing AIDS by Debra A. Shimon (1992); ISBN: 1879105454; http://www.amazon.com/exec/obidos/ASIN/1879105454/icongroupinterna

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Counseling in Audiologic Practice : Helping Patients and Families Adjust to Hearing Loss by John Greer Clark (Author), Kristina M. English (Author); ISBN: 020536697X; http://www.amazon.com/exec/obidos/ASIN/020536697X/icongroupinterna

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Deafness (1992); ISBN: 083897578X; http://www.amazon.com/exec/obidos/ASIN/083897578X/icongroupinterna

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Deafness - The Facts (Replaced by Freeland 2617419) by H. A. Beagley (1984); ISBN: 0192614118; http://www.amazon.com/exec/obidos/ASIN/0192614118/icongroupinterna

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Deafness and Ethnicity: Services, Policy and Politics (1998); ISBN: 1861340885; http://www.amazon.com/exec/obidos/ASIN/1861340885/icongroupinterna

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Deafness and Mental Health--Emerging Responses (Readings in Deafness Monograph, No 12) by Eugene W. Petersen, Eugene W. Peterson (Editor) (1985); ISBN: 0914494139; http://www.amazon.com/exec/obidos/ASIN/0914494139/icongroupinterna

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Deafness in Perspective by David M. Luterman (Editor); ISBN: 0887441947; http://www.amazon.com/exec/obidos/ASIN/0887441947/icongroupinterna

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Deafness in the Adult by Winifred Brinson; ISBN: 0809570777; http://www.amazon.com/exec/obidos/ASIN/0809570777/icongroupinterna

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Deafness, Children and the Family: A Guide to Professional Practice by Jennifer Densham (1995); ISBN: 185742221X; http://www.amazon.com/exec/obidos/ASIN/185742221X/icongroupinterna

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Dizziness, Hearing Loss, and Tinnitus by Robert W., Md. Baloh; ISBN: 0803603304; http://www.amazon.com/exec/obidos/ASIN/0803603304/icongroupinterna

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Early Diagnosis of Hearing Loss by George T. and Sanford E. Gerber Mencher (Editor) (1978); ISBN: 0808911538; http://www.amazon.com/exec/obidos/ASIN/0808911538/icongroupinterna

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Family Communication Folio: A Folio of Articles from Perspectives in Education and Deafness by Shawn N. Mahshie (Editor) (1997); ISBN: 0880952156; http://www.amazon.com/exec/obidos/ASIN/0880952156/icongroupinterna

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Handbook of Congenital and Early Onset Hearing Loss (1991); ISBN: 4260141848; http://www.amazon.com/exec/obidos/ASIN/4260141848/icongroupinterna

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Hear What You've Been Missing: How to Cope with Hearing Loss : Questions, Answers, Options by Donna S. Wayner (Author) (1998); ISBN: 0471347345; http://www.amazon.com/exec/obidos/ASIN/0471347345/icongroupinterna

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Hearing Conservation: A Guide to Preventing Hearing Loss (Injury Prevention Library) (1984); ISBN: 9995607719; http://www.amazon.com/exec/obidos/ASIN/9995607719/icongroupinterna

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Hearing Loss by Carol Baldwin (2002); ISBN: 1403402515; http://www.amazon.com/exec/obidos/ASIN/1403402515/icongroupinterna

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Hearing Loss by Michael Martin (1986); ISBN: 0443028028; http://www.amazon.com/exec/obidos/ASIN/0443028028/icongroupinterna

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Hearing Loss by Robert Thayer Sataloff, Joseph Sataloff; ISBN: 0824790413; http://www.amazon.com/exec/obidos/ASIN/0824790413/icongroupinterna

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Hearing Loss by Peter S. Roland (Editor), et al; ISBN: 0865776237; http://www.amazon.com/exec/obidos/ASIN/0865776237/icongroupinterna

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Hearing Loss and Dizziness by Yasuya Nomura (Editor) (1985); ISBN: 0896401138; http://www.amazon.com/exec/obidos/ASIN/0896401138/icongroupinterna

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Hearing Loss: Questions You Have.Answers You Need by Jennifer Hay (1995); ISBN: 1882606159; http://www.amazon.com/exec/obidos/ASIN/1882606159/icongroupinterna

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Hearing Loss?: A Guide to Self-Help by Rosemary McCall, Evelyn M. Templer (2001); ISBN: 0709043937; http://www.amazon.com/exec/obidos/ASIN/0709043937/icongroupinterna

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Helping the Older Adult With an Acquired Hearing Loss: Suggestions and Techniques for Clinicians, Audiologists, and Others Working With the Adult hea by Joan M. Sayre; ISBN: 0813421209; http://www.amazon.com/exec/obidos/ASIN/0813421209/icongroupinterna

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Hereditary Hearing Loss and Its Syndromes (Oxford Monographs on Medical Genetics, No 28) by Robert J. Gorlin (Editor), et al (1995); ISBN: 0195065522; http://www.amazon.com/exec/obidos/ASIN/0195065522/icongroupinterna

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Heredity and Deafness (1975); ISBN: 9997649494; http://www.amazon.com/exec/obidos/ASIN/9997649494/icongroupinterna

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Hooray for Harold, Dealing With Hearing Loss (Dr. Wellbook, 9) by Tim Peters, Tim Peters and Company (1997); ISBN: 1879874687; http://www.amazon.com/exec/obidos/ASIN/1879874687/icongroupinterna

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How the Student With Hearing Loss Can Succeed in College: A Handbook for Students, Families, and Professionals (Centennial Celebration Series) by Carol Ann Flexer, et al; ISBN: 0882001701; http://www.amazon.com/exec/obidos/ASIN/0882001701/icongroupinterna

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How to Cope With Tinnitus and Hearing Loss [LARGE PRINT] by Robert Youngson; ISBN: 1850895252; http://www.amazon.com/exec/obidos/ASIN/1850895252/icongroupinterna

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Impact 1980: Telecommunications and Deafness (Rs008) by Jerome Schein, Ronald Hamilton (1980); ISBN: 9990073376; http://www.amazon.com/exec/obidos/ASIN/9990073376/icongroupinterna

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Industrial Diseases Series: Deafness (MacDuff Series Practice Guides) by Alistair MacDuff QC (1997); ISBN: 1858111234; http://www.amazon.com/exec/obidos/ASIN/1858111234/icongroupinterna

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Instructor's manual for Education and deafness by Peter V. Paul; ISBN: 0801304873; http://www.amazon.com/exec/obidos/ASIN/0801304873/icongroupinterna

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Integrating Human Resources, Technology and Systems in Deafness (Readings in Deafness Monograph, No 13) by Douglas Watson, et al (1986); ISBN: 0914494147; http://www.amazon.com/exec/obidos/ASIN/0914494147/icongroupinterna

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International Directory of Periodicals Related to Deafness by Steven A. Frank (1985); ISBN: 9998921090; http://www.amazon.com/exec/obidos/ASIN/9998921090/icongroupinterna

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Keys to Living With Hearing Loss (Barron's Keys to Retirement Planning) by Marcia B. Dugan, Marcia P. Dugan; ISBN: 0764100173; http://www.amazon.com/exec/obidos/ASIN/0764100173/icongroupinterna

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Language, Learning, and Deafness: Theory, Applications, and Classroom Management by Alice H. Streng; ISBN: 020510164X; http://www.amazon.com/exec/obidos/ASIN/020510164X/icongroupinterna

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Let's Learn About Deafness by Rachel Harris (1993); ISBN: 999452044X; http://www.amazon.com/exec/obidos/ASIN/999452044X/icongroupinterna

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Listen With the Heart: Relationships and Hearing Loss by Michael A. Harvey (2001); ISBN: 1581210191; http://www.amazon.com/exec/obidos/ASIN/1581210191/icongroupinterna

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Living Well with Hearing Loss : A Guide for the Hearing-Impaired and Their Families by Debbie Huning (Author) (1992); ISBN: 0471545228; http://www.amazon.com/exec/obidos/ASIN/0471545228/icongroupinterna

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Living with Hearing Loss by Marcia B. Dugan (2003); ISBN: 156368134X; http://www.amazon.com/exec/obidos/ASIN/156368134X/icongroupinterna

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Living With Hearing Loss: The Sourcebook for Deafness and Hearing Disorders by Carol Turkington, Allen E. Sussman (2000); ISBN: 0816041407; http://www.amazon.com/exec/obidos/ASIN/0816041407/icongroupinterna

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Mainstreaming of Children With a Hearing Loss: Practical Guidelines and Implications by Verna V. Yater; ISBN: 0398035865; http://www.amazon.com/exec/obidos/ASIN/0398035865/icongroupinterna

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Mayo Clinic on Hearing: Strategies for Managing Hearing Loss, Dizziness and Other Ear Problems by Wayne, Ph.D. Olsen (Editor) (2003); ISBN: 1893005291; http://www.amazon.com/exec/obidos/ASIN/1893005291/icongroupinterna

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Medical-Legal Evaluation of Hearing Loss by Robert A. Dobie (Editor); ISBN: 0769300529; http://www.amazon.com/exec/obidos/ASIN/0769300529/icongroupinterna

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Mental Health and Deafness: Strategic Perspectives (Readings in Deafness Monograph, No 11) by Douglas Watson (Editor), et al (1985); ISBN: 0914494120; http://www.amazon.com/exec/obidos/ASIN/0914494120/icongroupinterna

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Missing Words: The Family Handbook on Adult Hearing Loss by Kay Thomsett, et al (2002); ISBN: 1563680238; http://www.amazon.com/exec/obidos/ASIN/1563680238/icongroupinterna

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Modeling Sensorineural Hearing Loss by Walt Jesteadt (Editor) (1997); ISBN: 0805822305; http://www.amazon.com/exec/obidos/ASIN/0805822305/icongroupinterna

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Musicians and the Prevention of Hearing Loss by Marshall Chasin (1996); ISBN: 1565936264; http://www.amazon.com/exec/obidos/ASIN/1565936264/icongroupinterna

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Neurotransmission and Hearing Loss: Basic Science, Diagnosis and Management by La.)/ Berlin, Charles I., Ph.D. Kresge-Mirmelstein Symposium 1995 New Orleans (Editor), Charles I. Berlin; ISBN: 1565938348; http://www.amazon.com/exec/obidos/ASIN/1565938348/icongroupinterna

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Newcomers Guide to an Old Problem: Hearing Loss by Scott Bally (1989); ISBN: 9994622455; http://www.amazon.com/exec/obidos/ASIN/9994622455/icongroupinterna

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Noise and Hearing: Readings for the Medical Examiner Assessing Cases of Occupational Noise-Induced Hearing Loss by Linda Luxton, et al (2001); ISBN: 1861561547; http://www.amazon.com/exec/obidos/ASIN/1861561547/icongroupinterna

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Noise-Induced Hearing Loss by Armand L. Dancer, et al; ISBN: 1556643217; http://www.amazon.com/exec/obidos/ASIN/1556643217/icongroupinterna

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Now Hear This: A Consumer's Guide to Testing for Hearing Loss, and the Selection and Purchase of a Suitable Hearing Aid by Lindsay L. Pratt; ISBN: 0963076507; http://www.amazon.com/exec/obidos/ASIN/0963076507/icongroupinterna

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Odyssey of Hearing Loss: Tales of Triumph by Michael A. Harvey (2000); ISBN: 158121006X; http://www.amazon.com/exec/obidos/ASIN/158121006X/icongroupinterna

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People With Hearing Loss and Workplace (1993); ISBN: 9994225022; http://www.amazon.com/exec/obidos/ASIN/9994225022/icongroupinterna

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Perspectives on Deafness (A Deaf American Monograph, Vol. 41, Nos. 1-2, 1991) by Mervin D. Garretson (Editor) (1991); ISBN: 9992012048; http://www.amazon.com/exec/obidos/ASIN/9992012048/icongroupinterna

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Perspectives on Deafness in Higher Education: A Look at the University of Tennessee (Readings in Deafness Monograph, No 8) by Sharon H. Carter (1983); ISBN: 0914494090; http://www.amazon.com/exec/obidos/ASIN/0914494090/icongroupinterna

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Positive Solutions to Hearing Loss; ISBN: 0136875904; http://www.amazon.com/exec/obidos/ASIN/0136875904/icongroupinterna

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Positive solutions to hearing loss by Richard Carmen; ISBN: 0136875823; http://www.amazon.com/exec/obidos/ASIN/0136875823/icongroupinterna

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Profound Deafness and Speech Communication by Geoff Plant (Editor), Karl-Erik Spens (Editor); ISBN: 1897635451; http://www.amazon.com/exec/obidos/ASIN/1897635451/icongroupinterna

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Profound Deafness and Speech Communication by Geoff Plant (Editor), et al; ISBN: 156593492X; http://www.amazon.com/exec/obidos/ASIN/156593492X/icongroupinterna

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Reading and Deafness by Cynthia M. King, Stephen P. Quigley; ISBN: 0887441076; http://www.amazon.com/exec/obidos/ASIN/0887441076/icongroupinterna

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Readings on Deafness by Douglas Watson (Editor); ISBN: 0317629913; http://www.amazon.com/exec/obidos/ASIN/0317629913/icongroupinterna

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Reasonable Accommodation for Deaf Employees in White Collar Jobs (Readings in Deafness Monograph, No 10) by Dorothy J. Steffanic (1983); ISBN: 0914494112; http://www.amazon.com/exec/obidos/ASIN/0914494112/icongroupinterna

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Rehabilitation and Human Services: Critical Issues for the Eighties (Readings in Deafness: Monography, No 6) by G. Douglas Tyler (Editor), et al (1983); ISBN: 0914494082; http://www.amazon.com/exec/obidos/ASIN/0914494082/icongroupinterna

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Say That Again, Please!: Insights in Dealing With a Hearing Loss by Thomas H. Bradford, Tom Bradford (1991); ISBN: 0963073842; http://www.amazon.com/exec/obidos/ASIN/0963073842/icongroupinterna

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Scientific Basis of Noise-Induced Hearing Loss by Alf Axelsson (Editor), et al (1996); ISBN: 0865775966; http://www.amazon.com/exec/obidos/ASIN/0865775966/icongroupinterna

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Screening For Hearing Loss and Otitis Media In Children by Jackson Roush (Editor); ISBN: 0769300006; http://www.amazon.com/exec/obidos/ASIN/0769300006/icongroupinterna

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Sensorineural Hearing Loss, Vertigo, and Tinnitus by Meyerhof (1981); ISBN: 0683067508; http://www.amazon.com/exec/obidos/ASIN/0683067508/icongroupinterna

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Social Security Acts 1975 to 1990: Prescribed Disease - Occupational Deafness - Time Limit for Claim - Retrospective Legislation - Relevant Change of Circumstances (Decisions of the Commissioners: R(I) 1994/2) (1997); ISBN: 0117625035; http://www.amazon.com/exec/obidos/ASIN/0117625035/icongroupinterna

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Study Guide for Language and Deafness by Peter V. Paul, Stephen P. Quigley; ISBN: 156593363X; http://www.amazon.com/exec/obidos/ASIN/156593363X/icongroupinterna

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Surgical Solutions for Conductive Hearing Loss by Mirko Tos (2000); ISBN: 0865779104; http://www.amazon.com/exec/obidos/ASIN/0865779104/icongroupinterna

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The Biology of Hearing and Deafness by Robert V. Harrison (1988); ISBN: 0398054320; http://www.amazon.com/exec/obidos/ASIN/0398054320/icongroupinterna

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The causes of profound deafness in childhood : a study of 3,535 individuals with severe hearing loss present at birth or of childhood onset by George Robert Fraser; ISBN: 0801816858; http://www.amazon.com/exec/obidos/ASIN/0801816858/icongroupinterna

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The Employment Situation and Experiences of Deaf and Hard of Hearing People: Research into Deafness and Employment (2002); ISBN: 0900634952; http://www.amazon.com/exec/obidos/ASIN/0900634952/icongroupinterna

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The Experience of Employers: Research into Deafness and Employment (2002); ISBN: 0900634944; http://www.amazon.com/exec/obidos/ASIN/0900634944/icongroupinterna

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The Hearing Healthcare Practitioner's Handbook: A Guide to the Successful Treatment of Hearing Loss with Auditory Prosthetics by Paul O. Popp, Gregg Hackett (2002); ISBN: 0971538506; http://www.amazon.com/exec/obidos/ASIN/0971538506/icongroupinterna

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The Hearing Loss Handbook by Richard Rosenthal; ISBN: 0312365403; http://www.amazon.com/exec/obidos/ASIN/0312365403/icongroupinterna

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The Hearing Loss Sourcebook: A Complete Guide to Coping With Hearing Loss and Where to Get Help by Carol A. Turkington (1997); ISBN: 0452275776; http://www.amazon.com/exec/obidos/ASIN/0452275776/icongroupinterna

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The Madness of Usher's: Coping With Vision and Hearing Loss/Usher Syndrome Type II (Business of Living Series) by Dorothy H. Stiefel, Richard A. Lewis (1991); ISBN: 1879518066; http://www.amazon.com/exec/obidos/ASIN/1879518066/icongroupinterna

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There's a Hearing Impaired Child in My Class: A Learning Packet about Hearing Loss for Public School Teachers by Debra Nussbaum, Shawn Mahshie (Editor) (1998); ISBN: 0880952040; http://www.amazon.com/exec/obidos/ASIN/0880952040/icongroupinterna

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Turn It Down: Effects of Noise on Hearing Loss in Children and Youth: Hearing Before the Select Committee on Children, Youth, and Fa by United States (1991); ISBN: 0160370221; http://www.amazon.com/exec/obidos/ASIN/0160370221/icongroupinterna

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Two Decades of Excellence: A Foundation for the Future (Readings in Deafness Monograph, No 14) by Douglas Watson (Editor), et al (1988); ISBN: 0914494163; http://www.amazon.com/exec/obidos/ASIN/0914494163/icongroupinterna

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Understanding Hearing Loss by Kenneth Lysons (1995); ISBN: 1853022144; http://www.amazon.com/exec/obidos/ASIN/1853022144/icongroupinterna

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Vertigo, Nausea, Tinnitus and Hearing Loss in Cardiovascular Diseases: Proceedings of the Neurootological and Equilibriometric Society: Vertigo in by C.F. Claussen (1988); ISBN: 0444808256; http://www.amazon.com/exec/obidos/ASIN/0444808256/icongroupinterna

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Your Hearing Loss: And How to Cope With It by Kenneth Lysons; ISBN: 0715374729; http://www.amazon.com/exec/obidos/ASIN/0715374729/icongroupinterna

The National Library of Medicine Book Index The National Library of Medicine at the National Institutes of Health has a massive database of books published on healthcare and biomedicine. Go to the following Internet site, http://locatorplus.gov/, and then select “Search LOCATORplus.” Once you are in the search area, simply type “hearing loss” (or synonyms) into the search box, and select “books only.” From there, results can be sorted by publication date, author, or relevance. The following was recently catalogued by the National Library of Medicine:11 11 In addition to LOCATORPlus, in collaboration with authors and publishers, the National Center for Biotechnology Information (NCBI) is currently adapting biomedical books for the Web. The books may be accessed in two ways: (1) by searching directly using any search term or phrase (in the same way as the bibliographic database PubMed), or (2) by following the links to PubMed abstracts. Each PubMed abstract has a "Books" button that displays a facsimile of the abstract in which some phrases are hypertext links. These phrases are also found in the books available at NCBI. Click on hyperlinked results in the list of books in which the phrase is found.

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Genetic and environmental hearing loss: syndromic and nonsyndromic: the second annual Symposium on Craniofacial Dysmorphology held in Chicago, Illinois, June 24, 1979 Author: Greene, Sue Conde.; Year: 1964; New York: Liss, 1980; ISBN: 0845110403 http://www.amazon.com/exec/obidos/ASIN/0845110403/icongroupinterna

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Genetic hearing loss Author: Willems, Patrick J.,; Year: 1963; New York: Marcel Dekker, c2004; ISBN: 0824743091 http://www.amazon.com/exec/obidos/ASIN/0824743091/icongroupinterna

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Industrial noise deafness: its influence on speech hearing Author: Gils, Jurriaan Johan Peter.; Year: 1971; Groningen: Drukkerij van Denderen, 1962

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Mondini's deafness: a review of histopathology Author: Paparella, Michael M.; Year: 2000; St. Louis, Mo.: Annals Pub. Co., 1980

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New perspectives on noise-induced hearing loss Author: Henderson, Donald,; Year: 1972; New York: Raven Press, c1982; ISBN: 0890046018 http://www.amazon.com/exec/obidos/ASIN/0890046018/icongroupinterna

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Occupational hearing loss: conservation and compensation: proceedings of the 1978 Annual Conference of the Australian Acoustical Society Author: Australian Acoustical Society. Annual Conference; Year: 1973; Sydney, N.S.W.: The Society, 1978

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Rehabilitation strategies for sensorineural hearing loss Author: Yanick, Paul.; Year: 1975; New York: Grune; Stratton, c1979; ISBN: 0808912151 http://www.amazon.com/exec/obidos/ASIN/0808912151/icongroupinterna

Chapters on Hearing Loss In order to find chapters that specifically relate to hearing loss, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and hearing loss using the “Detailed Search” option. Go to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find book chapters, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Book Chapter.” Type “hearing loss” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on hearing loss: •

Genetic Intervention and Hearing Loss Source: in Roeser, R.J.; Valente. M.; Hosford-Dunn, H., eds. Audiology: Diagnosis. New York, NY: Thieme. 2000. p. 593-614. Contact: Available from Thieme. 333 Seventh Avenue, New York, NY 10001. (800) 7823488. Fax (212) 947-0108. E-mail: [email protected]. PRICE: $59.00 plus shipping and handling. ISBN: 0865778574. Summary: A genetic cause must be considered for all patients with hearing impairment, and consultation with a clinical geneticist is recommended as standard practice for audiologists. This chapter on genetic intervention and hearing loss is from a textbook that provides a comprehensive overview of the diagnostic options available to identify and diagnose the clinical symptoms seen in an audiology practice. Topics include the

Currently, the majority of the links are between the books and PubMed. In the future, more links will be created between the books and other types of information, such as gene and protein sequences and macromolecular structures. See http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Books.

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human genome; phenotype and genotype, including syndromic (related to a specific syndrome) and nonsyndromic hearing loss; patterns of inheritance, including autosomal dominant, autosomal recessive, X linked, and mitochondrial; methods for identifying hearing loss genes, including linkage analysis, heterogeneity, physical mapping, cDNA libraries, candidate genes, transgenic and knockout mice, and gene therapy; localized and identified genes for hearing impairment; molecular genetic diagnostic tests for hearing loss; genetic counseling; and the future of genetic intervention in hearing loss. Syndromes covered include Treacher Collins, branchio oto renal, Stickler, neurofibromatosis Type 2, Waardenburg's, Usher, Pendred's, Jervell and Lange Nielsen, Alport, Norrie, MELAS and MERRF, and auditory neuropathies. The chapter includes an outline of the topic covered, a list of references, a summary outline of the related preferred practice guidelines, and various 'pearls and pitfalls' offering practical advice to the reader. 7 figures. 130 references. •

Occupational Hearing Loss Prevention Programs Source: in Musiek, F.E. and Rintelmann, W.F., eds. Contemporary Perspectives in Hearing Assessment. Needham Heights, MA: Allyn and Bacon. 1999. p. 465-484. Contact: Available from Allyn and Bacon. 160 Gould Street, Needham Heights, MA 02194. (800) 278-3525. Website: www.abacon.com. PRICE: $65.33. ISBN: 0205274579. Summary: Audiologists are uniquely qualified to assume positions of responsibility in occupational hearing loss prevention programs (HLPPs). Audiologists should also acquire knowledge and skills necessary to interact with professionals from other disciplines commonly associated with occupational health nurses, physicians, industrial hygienists, safety professionals, and noise control engineers. This chapter on occupational hearing loss prevention programs is from a textbook designed to serve as a text for graduate level audiology courses concerned with the assessment of the peripheral and central auditory systems. The textbook includes an auditory compact disc (CD) that provides students with an opportunity to have some experience with acoustic stimuli. This chapter provides a brief overview of current legal requirements and 'best practices' for occupational hearing loss prevention programs. Legal requirements will identify minimum steps necessary to achieve compliance with federal regulations. The author notes that professional supervision by audiologists of audiometric testing programs is necessary to assure reliable and valid data for early identification and intervention. Topics include the basic concepts and terminology of noise induced hearing loss (NIHL), damage risk criteria, federal regulations, noise exposure monitoring, audiometric testing programs, hearing protection programs, training and motivation programs, recordkeeping, program evaluation, noise control, worker compensation, and research needs. 4 figures. 4 tables. 156 references.

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About Late Deafness Source: in Woodcock, K. and Aguayo, M. Deafened People: Adjustment and Support. Toronto, Ontario: University of Toronto Press. 2000. p. 3-33. Contact: Available from University of Toronto Press Inc. 5201 Dufferin Street, North York, Ontario M3H 5T8. (800) 565-9523. Fax (416) 667-7832. E-mail: [email protected]. Website: www.utpress.utoronto.ca. Price: $21.95 plus shipping and handling. ISBN: 0802083730. Summary: Late deafness can be defined as hearing loss in people who could once hear naturally or with amplification but who have become deaf and are now unable to rely on hearing to comprehend speech. This chapter describing late deafness is from a book

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that addresses the process of adjustment to, and acceptance of, deafness as an adult. The authors demonstrate that deafness is not merely a medical condition; it is a social disability that affects the individual, the family, the social circle, and the work group. By describing the psychosocial experience of acquired deafness as a process of adjustment, the authors demonstrate that acceptance of deafness is a process with practical, social, and emotional implications. Written predominantly in a question and answer format, this chapter covers hearing evaluation and measurement of hearing loss, how loss of a few sounds affects speech comprehension, the anatomy and physiology of the ear and hearing, the causes of hearing loss and deafness, medical classifications of deafness, the prevalence of different types of hearing loss, and the practical definitions of hearing loss and its impact on every day living. Comments from the authors' experiences are provided in sidebars throughout the chapter. 3 figures. 1 table. •

Nongenetic Sensorineural Hearing Loss in Children Source: in Canalis, R.F. and Lambert, P.R., eds. Ear: Comprehensive Otology. Philadelphia, PA: Lippincott Williams and Wilkins. 2000. p. 489-510. Contact: Available from Lippincott Williams and Wilkins. P.O. Box 1600, Hagerstown, MD 21741. (800) 638-3030. Fax (301) 223-2300. Website: www.lww.com. PRICE: $179.00 plus shipping and handling. ISBN: 078171558X. Summary: Persistent, bilateral congenital or early onset hearing loss in the moderate to profound range (41 to 100 dB) distorts the speech perception of a developing child. This chapter on nongenetic sensorineural hearing loss in children is from a textbook that offers complete coverage of the field of clinical otology (study of the ear). The book is oriented to serve both the otolaryngology resident as a practical learning tool and the practicing otolaryngologist as an updated reference source of clinical and basic information. Topics include the evaluation of a young child with a hearing loss, including history and physical examination, laboratory testing, and audiometric testing; and specific causes of nongenetic sensorineural hearing loss, including congenital and early onset infections, late onset infections, ototoxic drugs and chemicals, hyperbilirubinemia, prematurity and term low birth weight, ear and head trauma, and noise induced hearing loss. The authors stress that comprehensive evaluation of a child with educationally significant hearing impairment is best accomplished by a team of specialists. Rehabilitative advances such as cochlear implants and improved hearing aid technology have improved the prospects for children with marked sensorineural hearing loss (SNHL). 2 figures. 3 tables. 68 references.

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Education and Communication Choices for Children with Hearing Loss Source: in Canalis, R.F. and Lambert, P.R., eds. Ear: Comprehensive Otology. Philadelphia, PA: Lippincott Williams and Wilkins. 2000. p. 625-632. Contact: Available from Lippincott Williams and Wilkins. P.O. Box 1600, Hagerstown, MD 21741. (800) 638-3030. Fax (301) 223-2300. Website: www.lww.com. PRICE: $179.00 plus shipping and handling. ISBN: 078171558X. Summary: The choice of communication and education methodologies to use with deaf children has long been the subject of controversy within the professional community. This chapter is from a textbook that offers complete coverage of the field of clinical otology (study of the ear). The book is oriented to serve both the otolaryngology resident as a practical learning tool and the practicing otolaryngologist as an updated reference source of clinical and basic information. In this chapter, the authors describe the various methodologies used in deaf education and, where available, they cite studies

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that have documented the performance of children using these methodologies. The three communication methodologies covered are auditory oral approaches, bilingual and bicultural approaches, and total communication approaches. The authors review the three categories of support services that may be provided to families: education, guidance, and counseling. The authors present their recommendations for assisting families in choosing a methodology consistent with their philosophy and their child's abilities. Finally, they outline the role that the otologist may play in assisting families with these decisions. A brief list of contact numbers is provided. 25 references. •

Acoustic Trauma and Noise-Induced Hearing Loss Source: in Canalis, R.F. and Lambert, P.R., eds. Ear: Comprehensive Otology. Philadelphia, PA: Lippincott Williams and Wilkins. 2000. p. 773-783. Contact: Available from Lippincott Williams and Wilkins. P.O. Box 1600, Hagerstown, MD 21741. (800) 638-3030. Fax (301) 223-2300. Website: www.lww.com. PRICE: $179.00 plus shipping and handling. ISBN: 078171558X. Summary: The extraordinary auditory (hearing) capability and sensitivity is vulnerable to the effects of acute acoustic trauma and chronic environmental noise. From an otologic perspective, it is the acoustic energy reaching the ear that is important, not the nature or quality of the sound; beautiful music may inflict as much damage on the ear as a jackhammer if delivered with equal intensity. This chapter on acoustic trauma and noise induced hearing loss (NIHL) is from a textbook that offers complete coverage of the field of clinical otology (study of the ear). The book is oriented to serve both the otolaryngology resident as a practical learning tool and the practicing otolaryngologist as an updated reference source of clinical and basic information. Topics include noise classification; the clinical aspects of noise, including acute acoustic trauma and chronic NIHL; the pathophysiology of both conditions; temporal bone histopathology; industrial noise and workers' compensation; nonoccupational noise; and the constitutional nonauditory effects of noise. The authors conclude that NIHL is a growing health hazard. Noise is the most common preventable cause of irreversible sensorineural hearing loss in the United States. 6 figures. 4 tables. 48 references.

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Hearing Loss in Paget 's Disease Source: in A Patient's Guide to Paget 's Disease of Bone. New York, NY: The Paget 's Disease Foundation, Inc. 1994. p. 29-30. Contact: Paget Foundation For Paget 's Disease of Bone and Related Disorders. 200 Varick Street, Suite 1004, New York, NY 10014-4810. (212) 229-1582 or FAX (212) 2291502. PRICE: Free. Summary: This article indicates that hearing loss in patients with Paget 's disease ( PD ), is the result of the disease's effect on the temporal bone surrounding the inner ear. The type of hearing loss in PD may be conductive, sensorineural, or both. If hearing loss is progressive and PD is the underlying cause, treating PD may slow the progression of the loss. The author recommends that patients with PD should undergo a baseline hearing test and evaluation, which may include an examination of the temporal bone to determine whether PD is present in the ear.

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Hereditary Hearing Loss and Deafness Source: in Massimini, K., ed. Genetic Disorders Sourcebook. 2nd ed. Detroit, MI: Omnigraphics. 2000. p. 605-617.

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Contact: Available from Omnigraphics. 615 Griswold Street, Detroit, MI 48226. (313) 961-1340. Fax (313) 961-1383. Website: www.omnigraphics.com. PRICE: $78.00 plus shipping and handling. ISBN: 0780802411. Summary: This chapter from a Genetic Disorders Sourcebook covers hereditary hearing loss and deafness. Several hundred genes are known to cause hereditary hearing loss and deafness. The genetic forms of hearing loss are diagnosed by otologic, audiologic, and physical examination, family history, ancillary testing (such as computed tomography, or CT, examination of the temporal bone), and DNA based testing. DNA based genetic tests are available for the diagnosis of branchiootorenal (BOR) syndrome, Pendred syndrome, dilated vestibular aqueduct syndrome, DNFB1, and DFNB4; testing for deafness causing mutations in the GHB2 gene (connexin 26) plays a prominent role in diagnosis and genetic counseling. The authors cover definitions, categories of hearing loss, syndrome hearing loss, manners of inheritance, Usher syndrome, Pendred syndrome, Jervell and Lange Nielsen syndrome, Waardenburg syndrome, BOR syndrome, Stickler syndrome, neurofibromatosis, Alport syndrome, genetic counseling, special issues in counseling Deaf persons, and patient care management. The chapter concludes with a listing of resources through which readers can obtain additional information. •

Comparison of Links Between Emotional Availability and Language Gain in Young Children with and Without Hearing Loss Source: Volta Review. 100(5): 251-277. 2000. Contact: Available from Alexander Graham Bell Association for the Deaf and Hard of Hearing. Subscription Department, 3417 Volta Place, NW, Washington, DC 20007-2778. Voice/TTY (202) 337-5220. Website: www.agbell.org. Summary: This chapter is from a text that provides information on the language, speech, and social emotional development of very young children who are deaf or hard of hearing. In this chapter, the authors describe a study that compared the links between emotional availability (EA) and language gain in young children with and without hearing loss. Derived from attachment theory, emotional availability is a construct (theory or model) that describes emotional openness and emotional communication between parent and child. The scales in use include parental sensitivity, parental structuring, parental nonintrusiveness, parental nonhostility, child responsiveness, and child involvement. The authors describe the prospective study that investigated the link between child vocabulary gain and the quality of mother child interaction. All mothers participating in the study were hearing, but half the children were deaf or hard of hearing and half were children with normal hearing. Children in both groups were matched for productive vocabulary at the initial assessment, and language level was reassessed at one year follow up. Dyads (pairs) with children who are deaf or hard of hearing (and their mothers) and dyads with children with normal hearing (and their mothers) showed no differences in EA ratings. In both groups, child emotional availability made significant positive predictions of language gain. Maternal emotional availability, however, made significantly greater positive predictions of child language gain for children who are deaf or hard of hearing than for children with normal hearing. Therefore, the authors conclude that the language of children who are deaf or hard of hearing seems to be more responsive to greater maternal sensitivity. 6 tables. 62 references.

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Acute Suppurative Otitis Media and Mastoiditis Source: in Canalis, R.F. and Lambert, P.R., eds. Ear: Comprehensive Otology. Philadelphia, PA: Lippincott Williams and Wilkins. 2000. p. 397-408. Contact: Available from Lippincott Williams and Wilkins. P.O. Box 1600, Hagerstown, MD 21741. (800) 638-3030. Fax (301) 223-2300. Website: www.lww.com. PRICE: $179.00 plus shipping and handling. ISBN: 078171558X. Summary: This chapter is from a textbook that offers complete coverage of the field of clinical otology (study of the ear). The book is oriented to serve both the otolaryngology resident as a practical learning tool and the practicing otolaryngologist as an updated reference source of clinical and basic information. This chapter focuses on the clinical and pathologic features of acute bacterial infections of the middle ear cleft (acute otitis media) and mastoid process. In the first section, on acute otitis media, the authors discuss a definition, epidemiology, etiology, bacteriology, pathology, symptoms, physical findings, laboratory tests, hearing tests, clinical course, medical treatment, surgery (myringotomy, i.e., drainage tubes), follow up care, and complications. In the section on acute mastoiditis, the authors discuss a definition, incidence, bacteriology, pathology, symptoms, physical findings, laboratory tests, auditory tests, radiographic evaluation, medical management, and surgical management. The authors also discuss acute bullous myringitis (which involves the lateral middle ear boundary), the technique of simple mastoidectomy, and temporal bone fungal infection. 13 figures. 33 references.

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Introduction to Language and Deafness Source: in Paul, P.V. Language and Deafness. 3rd ed. San Diego, CA: Singular Publishing Group. 2001. p. 1-32. Contact: Available from Thomson Learning Group. P.O. Box 6904, Florence, KY 41022. (800) 842-3636. Fax (606) 647-5963. Website: www.singpub.com. PRICE: $59.95 plus shipping and handling. ISBN: 1565939999. Summary: This chapter on language and deafness is from a textbook that offers an indepth introduction to language development in children and adolescents who are deaf or hard of hearing. This introductory chapter provides an overview of language and deafness, including acquisition and instructional issues such as exposure, use, and representation, and acquisition of more than one language; philosophical perspectives on deafness, including those based on clinical descriptions and those based on cultural descriptions; and the use of metatheory, paradigm, and language. The authors give readers a general framework for learning more about these sometimes conflicting approaches to language development in children who are deaf. The chapter includes a list of comprehension questions (to test the reader's understanding of the chapter), a list of challenge questions (which can be answered only with additional thinking and research), and a group of suggested readings for further study. 6 tables. 5 references.

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Nonorganic Hearing Loss Source: in Gelfand, S.A. Essentials of Audiology. 2nd ed. New York, NY: Thieme Medical Publishers, Inc. 2001. p. 421-442. Contact: Available from Thieme Medical Publishers, Inc. 333 Seventh Avenue, New York, NY 10001. (800) 782-3488. Fax (212) 947-0108. E-mail: [email protected]. PRICE: $49.00 plus shipping and handling. ISBN: 1588900177.

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Summary: This chapter on nonorganic hearing loss is from an undergraduate textbook that deals with audiology and related topics in speech language pathology. Nonorganic hearing losses are also known as functional or exaggerated hearing losses, or pseudohypacusis. A functional loss involves questionable test results on hearing evaluation. A nonorganic hearing loss is identified on the basis of observable differences in audiological tests or between the patient's behavior and the test results that are not accounted for by an organic disorder (physical or anatomic abnormalities). Most adults with functional impairments also have at least some degree of underlying organic hearing loss. Topics include the motivating factors in nonorganic hearing loss in adults, nonorganic hearing loss in children, the clinical signs and manifestations of nonorganic hearing loss, tests for nonorganic hearing loss, and counseling in cases of nonorganic hearing loss. 9 figures. 1 table. 83 references. •

Strategies for Facilitating Hearing and Listening in All Children: With or Without Hearing Loss Source: in Flexer, C. Facilitating Hearing and Listening in Young Children. 2nd ed. San Diego, CA: Singular Publishing Group, Inc. 1999. p. 195-247. Contact: Available from Singular Publishing Group, Inc. 401 West 'A' Street, Suite 325, San Diego, CA 92101-7904. (800) 521-8545 or (619) 238-6777. Fax (800) 774-8398 or (619) 238-6789. E-mail: [email protected]. Website: www.singpub.com. PRICE: $45.00 plus shipping and handling. ISBN: 1565939891. Summary: This chapter on strategies for facilitating hearing and listening in children is from a textbook that emphasizes the need to create an auditory world for children, in which their auditory brain centers continue to develop the neurological and experiential foundations for literacy and learning. The authors discuss issues and strategies related to the facilitation of auditory skills for all infants and children, whether or not they have a hearing loss. Topics include: levels of auditory skill development, tests of auditory and speech perception, guidelines for maximizing hearing and facilitating listening in infants and young children, professional and medical prerequisites for the initiation of intervention and therapy, the use of amplification, understanding the role of audition in language development, management of noise in the learning environment, the structure of the learning environment and strategies for facilitating listening skills, linguistic factors, reading to the child, and family interaction. The authors conclude by reiterating that there is no such thing as an insignificant hearing impairment; consequently, hearing sensitivity must be assessed and maximized. Listening strategies must be employed to create an auditory focused world and to teach the child to derive meaning from spoken communication. 2 appendices. 4 figures. 3 tables.

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Assessment of Hearing Loss in Infants and Children Source: in Flexer, C. Facilitating Hearing and Listening in Young Children. 2nd ed. San Diego, CA: Singular Publishing Group, Inc. 1999. p. 73-106. Contact: Available from Singular Publishing Group, Inc. 401 West 'A' Street, Suite 325, San Diego, CA 92101-7904. (800) 521-8545 or (619) 238-6777. Fax (800) 774-8398 or (619) 238-6789. E-mail: [email protected]. Website: www.singpub.com. PRICE: $45.00 plus shipping and handling. ISBN: 1565939891. Summary: This chapter on the assessment of hearing loss in infants and children is from a textbook that emphasizes the need to create an auditory world for children, in which their auditory brain centers continue to develop the neurological and experiential foundations for literacy and learning. The author stresses that the primary purpose of

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assessment is to provide information that can serve as the basis for intervention. Topics include differential diagnosis (the separation of hearing impairment from other problems that have similar effects), basic audiometric considerations, behavioral and objective audiologic tests (Behavioral Observation Audiometry, Visual Reinforcement Audiometry, Conditioned Play Audiometry, otoacoustic emissions, auditory brainstem response, and impedance audiometry), the information contained in the audiogram and how to read it, and the observation of auditory behaviors (behaviors that an infant or child may exhibit in response to speech or environmental sounds). The chapter concludes with two forms that specify the audiologic information that would be most helpful in early intervention programming. The information requested on the forms is designed to assist the audiologist in providing meaningful audiometric data to the intervention team. 11 figures. •

Medical and Surgical Treatment of Neural Hearing Loss Source: in Valente, M.; Hosford-Dunn, H.; Roeser, R.J., eds. Audiology: Treatment. New York, NY: Thieme. 2000. p. 351-375. Contact: Available from Thieme. 333 Seventh Avenue, New York, NY 10001. (800) 7823488. Fax (212) 947-0108. E-mail: [email protected]. PRICE: $69.00 plus shipping and handling. ISBN: 0865778590. Summary: This chapter on the medical and surgical management of neural hearing loss is from a textbook that provides a comprehensive overview of the numerous treatment options available to help patients relieve the clinical symptoms seen in an audiology practice. Neural hearing loss is defined as any audiometric evidence of a lesion referable to the eighth nerve or low brain stem. Professionally skilled medical audiologists are crucial partners with medical specialists, knowledgeable about ear diseases, for the diagnosis and for monitoring the medical and surgical management of the neurotological patient. The authors discuss symptoms that should serve as 'red flags' for neurologic problems; diseases causing neural hearing losses; and the medical and surgical treatment of specific diseases causing neural hearing loss, including lesions detectable by imaging and lesions not detectable by imaging. The authors reiterate that audiological assessments are crucial in the initial evaluation and subsequent therapeutic monitoring of neural hearing losses. Because the primary purpose is to determine which components are changing and to what degree, a full diagnostic audiogram, including impedance audiometry in the ipsilateral and in the contralateral condition and speech audiometry, is mandatory at each evaluative session. The chapter includes an outline of the topic covered, a list of references, a summary outline of the related preferred practice guidelines, and various 'pearls and pitfalls' offering practical advice to the reader. 15 figures. 1 table. 75 references.

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Psychological Effects of Hearing Loss Source: in Rezen, S.V. and Hausman, C. Coping with Hearing Loss: Plain Talk for Adults About Losing Your Hearing. New York, NY: Barricade Books. 2000. p. 27-38. Contact: Available from Barricade Books, Inc. 185 Bridge Plaza North, Suite 308 A, Ft. Lee, NJ 07024. (800) 592-6657. Website: www.barricadebooks.com. PRICE: $19.95 plus shipping and handling. ISBN: 1569801657. Summary: This chapter on the psychological effects of hearing loss is from a book designed to help adults and their families cope with hearing loss. Written in nontechnical language, the chapters are filled with examples and specific strategies that real people have used in settings from the workplace to home to social and recreational

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situations. In this chapter, the authors note that many people go through needless emotional suffering simply because they have not been adequately prepared to cope with their hearing disability. Professionals in the hearing field, who may be experts at treating the physical side of a hearing loss, often do not have the time or motivation to explain and help deal with a client's typical anxieties and emotions. The authors describe the stages of denal, projection, anger, depression, and acceptance that may accompany any loss, including loss of one's hearing. For each stage, the authors answer common questions that the patient may have about his or her experiences. The chapter concludes with a list of a number of organizations that offer materials, advice, and guidance, particularly in locating local support groups. •

Technological Management of Hearing and of Hearing Loss Source: in Flexer, C. Facilitating Hearing and Listening in Young Children. 2nd ed. San Diego, CA: Singular Publishing Group, Inc. 1999. p. 107-176. Contact: Available from Singular Publishing Group, Inc. 401 West 'A' Street, Suite 325, San Diego, CA 92101-7904. (800) 521-8545 or (619) 238-6777. Fax (800) 774-8398 or (619) 238-6789. E-mail: [email protected]. Website: www.singpub.com. PRICE: $45.00 plus shipping and handling. ISBN: 1565939891. Summary: This chapter on the technological management of hearing and hearing loss is from a textbook that emphasizes the need to create an auditory world for children, in which their auditory brain centers continue to develop the neurological and experiential foundations for literacy and learning. The chapter details the components of technological management of hearing problems. The focus of all environmental and technological management strategies is to enhance the reception of clear and intact acoustic signals in order to access and strengthen the auditory centers of the brain. The author discusses how to facilitate the reception of clear and intact acoustic events, including: control and management of the listening environment; favorable positioning of parent, teacher, and clinician so that talkers are always within earshot of the baby or child; and consistent use of appropriate forms of amplification (hearing aids, cochlear implants, assistive listening devices). Specific topics include the signal to noise ratio (SNR), the rapid speech transmission index (RASTI), terms used to describe hearing aid features, the use of FM units and FM auditory trainers, the amplification of classroom and home environments, tactile communication devices, cochlear implants, and tips to remember about children's hearing aids. The chapter concludes by offering fact sheets that describe construction, use, responsibilities, and tips about hearing aids, personal FM systems, sound field FM systems, and a mild gain hard wired system. A 'how to' guide for use of a hard wired mild gain amplifier with remote microphone is provided, as is a protocol for pediatric hearing and amplification management. 20 figures. 1 table.

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Types, Degrees, and Causes of Hearing Loss Source: in Flexer, C. Facilitating Hearing and Listening in Young Children. 2nd ed. San Diego, CA: Singular Publishing Group, Inc. 1999. p. 35-72. Contact: Available from Singular Publishing Group, Inc. 401 West 'A' Street, Suite 325, San Diego, CA 92101-7904. (800) 521-8545 or (619) 238-6777. Fax (800) 774-8398 or (619) 238-6789. E-mail: [email protected]. Website: www.singpub.com. PRICE: $45.00 plus shipping and handling. ISBN: 1565939891. Summary: This chapter on the types, degrees, and causes of hearing loss is from a textbook that emphasizes the need to create an auditory world for children, in which their auditory brain centers continue to develop the neurological and experiential

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foundations for literacy and learning. This chapter presents an overview of the general classifications of hearing impairment and then details specific pathologies that can cause hearing impairment in children. Topics include congenital and acquired hearing impairments, distinguishing audiometric and functional definitions for hard of hearing and deaf persons, classification of hearing loss, genetic syndromes and the incidence of hearing loss associated with some syndromes (Treacher Collins, Crouzon, Waardenburg, Alport, Usher, Pendred, Jervell, Lange Nielsen), auditory pathologies, conductive hearing impairments (otitis media, collapsed ear canals, abnormalities of the middle ear ossicles, atresia, stenosis, cerumen impaction, otitis externa, perforated tympanic membrane, objects in the ear canal, cholesteatoma, and mastoiditis), sensorineural hearing impairments (tinnitus, noise induced hearing loss, viral and bacterial infections, anoxia, ototoxicity, large vestibular aqueduct, perilymph fistula, acoustic neuroma, Rh incompatibility), dysplasias (malformations or incomplete development of the inner ear), auditory neuropathy, mixed hearing impairments, progressive hearing impairments, and central and functional hearing impairments. A list of factors that place an infant or child at risk for hearing impairment is included at the end of the chapter. 2 figures. 3 tables. •

Facing the Realities of Deafness Source: in Cornett, R.O. and Daisey, M.E. Cued Speech Resource Book for Parents of Deaf Children. 2nd ed. Cleveland, OH: National Cued Speech Association. 2001. p. 1-16. Contact: Available from National Cued Speech Association. 23970 Hermitage Road, Cleveland, OH 44122-4008. Voice/TTY (800) 459-3529 or (216) 292-6213. E-mail: [email protected]. PRICE: $37.50 for members; $39.50 for nonmembers, plus shipping and handling. ISBN: 0963316419. Summary: This introductory chapter is from a book that offers an overview of cued speech, the use of hand cues with speech that permits the deaf child to learn the English language. The book includes information and advice for parents who have decided to use Cued Speech with a child who is deaf or hard of hearing, or are considering doing so. This chapter is addressed to parents who have just learned that they have a hearing impaired child. The authors feel that such parents should begin by taking a careful look at what typically happens to parents of a deaf child and what typically happens to the child. At the same time, the authors stress that it does not have to be this way. The authors discuss the effects of inadequate communication, the implications of different methods of communication, the emotional stages that parents go through, problems associated with post-lingual (after some language has been achieved) hearing loss, and typical performance of deaf children. The authors conclude that most hearing impaired children have speech and speechreading skills inadequate for effective communication with the general public, and they fall (and remain) far behind their hearing peers in language, reading, and other academic areas. The authors end the chapter by noting that Cued Speech offers a solution to these problems.

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Why Do I Hear But Don't Always Understand?: An Introduction to Hearing Loss and Its Impact on Communication Source: in Self Help for Hard of Hearing People (SHHH). Understanding Genes: Is My Hearing Loss Genetic?. Proceedings from the Sixth Annual Research Symposium Given at the 14th International SHHH Convention, New Orleans, Louisiana, June 30, 1999. Bethesda, MD: Self Help for Hard of Hearing People (SHHH). 1999. p. 4-5.

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Contact: Available from SHHH Publications. 7910 Woodmont Avenue, Suite 1200, Bethesda, MD 20814. (301) 657-2248. Fax (301) 913-9413. TTY (301) 657-2249. E-mail: [email protected]. Website: www.shhh.org. PRICE: Single copy free. Summary: This newsletter article explains why sometimes people with hearing loss can hear speech but cannot understand what is being said. The author offers an introduction to the nature of hearing loss and its impact on communication. Topics covered include three dimensions to sound, i.e., frequency, intensity, and time temporal factors; and understanding the audiogram, particularly the intensity expressed in the vertical axis and labeled dB Hearing Level and the frequency shown on the horizontal axis in Hz. The author explains how shaded zones are used on the audiogram to represent hearing loss; each dot in the shading carries 1 percent of the information that contributes to speech clarity. The number of dots that are audible to the individual predict how well that person will understand quiet speech from a six foot distance. The author notes that this is called the Ling Zone or the Articulation Index zone. The author refers readers to a tour of the auditory system with animations that assist in understanding the anatomy and physiology and how the hair cells work (www.neurophys.wisc.edu). 2 figures. 2 references.

Directories In addition to the references and resources discussed earlier in this chapter, a number of directories relating to hearing loss have been published that consolidate information across various sources. The Combined Health Information Database lists the following, which you may wish to consult in your local medical library:12 •

Organization Resources for Families of Children with Deafness or Hearing Loss Source: Pediatric Clinics of North America. 46(1): 153-162. February 1999. Contact: Available from W.B. Saunders Company. 6277 Sea Harbor Drive, Orlando, FL 32887-4800. (800) 654-2452. Summary: Pediatricians, as part of an interdisciplinary team, can provide families of children with hearing loss or deafness with information about important resources to expedite their child's habilitative process. This article, from a monograph on hearing loss in children, describes the emotional stages that parents and caregivers may experience upon initial diagnosis of hearing loss and the support that pediatricians can offer during this critical time of discovery when families seek guidance. The authors discuss the variety of communication strategies and options available to children and families, based on the child's specific needs, diagnostic findings, educational opportunities, family culture, and preferences. A listing of programs, agencies, and organizations pertinent to persons with deafness or hearing loss is provided to facilitate linkages from diagnosis to intervention. 1 appendix. 15 references.

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All About Deafness: Where to Turn for Answers to Questions About Hearing Loss Source: Rochester, NY: Salavatore J. Parlato. 1995. 76 p.

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You will need to limit your search to “Directory” and “hearing loss” using the "Detailed Search" option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find directories, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Select your preferred language and the format option “Directory.” Type “hearing loss” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months.

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Contact: Available from Dolores Parlato. 248 Seville Drive, Rochester, NY 14617. PRICE: $9.95 each. Also available from Gallaudet University Bookstore. 800 Florida Avenue, NE, Washington, DC 20002. Voice (202) 651-5380; Voice/TTY (800) 451-1073; Fax (202) 651-5489. PRICE: $7.95 plus shipping and handling. Summary: This directory lists organizations committed to serving Americans with hearing loss. Organizations are listed in twenty-two categories: the Americans with Disabilities Act, assistive listening devices, associations, book publishers, captioned media, computers, education, employment, financial assistance, foundations, health (including AIDS), hearing aids and cochlear implants, interpreters, mental health, periodicals, rehabilitation, religion, research, speech and hearing, TTY telecommunications, reference materials, and mega-centers. The entry for each organization includes only the organization name, address, and telephone number.

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CHAPTER 8. MULTIMEDIA ON HEARING LOSS Overview In this chapter, we show you how to keep current on multimedia sources of information on hearing loss. We start with sources that have been summarized by federal agencies, and then show you how to find bibliographic information catalogued by the National Library of Medicine.

Video Recordings An excellent source of multimedia information on hearing loss is the Combined Health Information Database. You will need to limit your search to “Videorecording” and “hearing loss” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find video productions, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Videorecording (videotape, videocassette, etc.).” Type “hearing loss” (or synonyms) into the “For these words:” box. The following is a typical result when searching for video recordings on hearing loss: •

Understanding Hearing and Hearing Loss Source: Baltimore, MD: Advisory Board Foundation and Listening Center at Johns Hopkins University. 1998. (videocassette). Contact: Available from York Press. P.O. Box 504, Timonium, MD 21094. (800) 962-2763. Fax (410) 560-6758. E-mail: [email protected]. PRICE: $35.00 for individual copy, plus shipping and handling. Series is available as a set for $195.00 plus shipping and handling. ISBN: 0912752513. Summary: The world of cochlear implant technology provides a new type of opportunity for children who are deaf. However, hearing sound for the first time can be confusing and overwhelming to a child with a cochlear implant. Without a systematic approach to learning how to listen and understand, the connection between a sound and its meaning has no significance. Designed for audiologists, speech language pathologists, parents, and educators, this videotape program is one in a series of four tapes that guides readers through the world of cochlear implant rehabilitation. This

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program on hearing and hearing loss offers easy to understand descriptions and definitions of an audiogram, speech acoustics, amplification, and related issues. The program then describes the cochlear implant, demonstrates how cochlear implants work, and introduces a young patient, Cecilia (age 3) as she anticipates surgery for a cochlear implant. A separate rehabilitation manual is also available. •

Hearing Loss: You Can Live With It Source: Phoenix, AZ: Interlingual Images. 199x. (videocassette). Contact: Available from Interlingual Images. 4013 North 89th Avenue, Phoenix, AZ 85037. PRICE: $24.95 plus $3.00 shipping and handling. Summary: This open-captioned videotape program is introduced by Norm Crosby, a popular comedian who has a hearing impairment. While giving assurance and hope to the person losing his or her hearing, the video also includes an explanation of today's hearing loss technology, coping strategies, various resource agencies, and self-help groups. In addition, legislative issues including the Americans With Disabilities Act (ADA) are touched upon. (AA-M).

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For Families Video One: Understanding Hearing Loss and Hearing Aids and Helping Your Child Learn to Listen Source: Portland, OR: Infant Hearing Resource-Hearing and Speech Institute. 1998. (videocassette). Contact: Available from Infant Hearing Resource-Hearing and Speech Institute. 3515 SW Veterans Hospital Road, Portland, OR 97201. Voice/TTY (503) 228-6479. Fax (503) 2284248. E-mail: [email protected]. PRICE: $45.00 plus shipping and handling. Summary: This video is the first of two programs included in an informational package that covers the basics that parents and caregivers may need when they learn their young child has a hearing loss. Topics covered in this videotape focus on understanding hearing loss and hearing aids, and helping the child learn to listen. Specific segments cover the parts of the ear, how babies respond to sound, types of hearing loss, effects of hearing loss (particularly on language development), Visual Reinforcement Audiometry and Conditioned Play Audiometry, hearing tests, describing hearing loss (type, degree, and configuration), the audiogram, and defining degree of hearing loss and the loudness of speech sounds. Other topics include parts of the hearing aid, the problem of hearing aid battery ingestion, caring for the child's hearing aids, simulated hearing loss exercise and hearing in noise, amplification systems (cochlear implants and FM systems), managing the child's beginning hearing aid use, the daily check of hearing aid function, helping the child learn to listen, how hearing is used in everyday life, and demonstrations of four steps families can use to help their child learn to listen. The video concludes with the ordering information for the accompanying manual. The manual covers the same topics, and includes many blank forms for recordkeeping and parent instructional strategies. The manual also notes the corresponding segments for each topic covered in the two videotapes.

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Sensorineural Hearing Loss in Adults Source: Timonium, MD: Milner-Fenwick, Inc. 1992. (videocassette). Contact: Available from Milner-Fenwick, Inc. 2125 Greenspring Drive, Timonium, MD 21093. (800) 432-8433. PRICE: $250.00; discounts available. Order Number OT-14.

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Summary: This videotape illustrates the impact that sensorineural hearing loss can have on communication and quality of life. Designed for use in patient education, the program describes the causes and symptoms of sensorineural hearing loss and explains the evaluation that will be performed by both physician and audiologist. The value of a hearing aid in restoring functional hearing is stressed. Types of hearing aids are described and tips are given for adapting to their use. Advice is also given for family and friends of a person using a hearing aid wearer. The program discusses the importance of protecting remaining hearing and offers guidelines for doing so. (AA-M). •

Families With Hard-of-Hearing Children: What If Your Child Has a Hearing Loss? Source: Boys Town, NE: Boys Town Press. 1996. (videocassette). Contact: Available from Boys Town Press. 13603 Flanagan Boulevard, Boys Town, NE 68010. Voice (800) 282-6657; Fax (402) 498-1125; E-mail: [email protected]. PRICE: $19.99 plus shipping and handling. ISBN: 0938510800. Order Number: 76-417. Summary: This videotape is designed to help parents of children who are newly diagnosed with a hearing loss. The video features parents who faced similar diagnoses. The parents describe their experiences and how they learned to cope. The program features professionals discussing similar issues. Topics include diagnostic tests, working with various health care providers, communication methods, educational options, and how to proceed once the diagnosis has been made. The parents depicted each had different feelings and made different choices, but all of them see their children as individuals who can succeed. The program is designed to provide parents and professionals with a starting point for discussion and decision-making.

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Hearing Loss in Young Children Source: Milwaukee, WI: Maxishare. 1993. (videocassette). Contact: Available from Maxishare. P.O. Box 2041, Milwaukee, WI 53201. (800) 444-7747 or (414) 266-3428; Fax (414) 266-3443; E-mail: [email protected]. PRICE: $89.00 each. Item Number 201001. Summary: This videotape program addresses several basic issues that parents of children newly diagnosed with hearing loss may encounter. The program begins with scenes depicting common household sounds and a voice narration discussing how most people take everyday sounds for granted. The program then describes the emotions that parents may go through upon learning that their child has been diagnosed with a hearing loss. Other topics briefly mentioned include how proper evaluation and testing help determine the degree of hearing loss, the use of video reinforcement audiology, the audiogram, how loudness is measured, the four degrees of hearing loss (mild, moderate, severe, profound), the anatomy of the ear, the impact of ear infection on hearing loss, the degree of hearing loss and how it impacts language and speech development, the types of hearing aids used in children, what to expect when a child begins using a hearing aid, problems with hearing aids and otitis externa (outer ear infection), the methods of communication available (manual, oral, total), and the role of the speech pathologist and speech therapy in the child's language and speech development. The video depicts a number of families and children in household settings and in speech therapy. Parents are encouraged to seek support from other parents and health care professionals and to become educated partners in advocating for their child's health care and education.

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Causes of Hearing Loss Source: Princeton, NJ: Films for Humanities and Sciences, Inc. 1995. (videocassette). Contact: Available from Films for Humanities and Sciences, Inc. Box 2053, Princeton, NJ 08543-2053. (800) 257-5126 or (609) 275-1400. PRICE: $149.00 plus shipping and handling. Summary: This videotape program focuses on the millions of Americans who experience hearing loss and examines two important causes of hearing loss: exposure to loud noises and ear infections. Noise exposure is a troubling current trend because so many teenagers and young adults listen to music at high volume. Such loud noise can destroy the thousands of hearing cells in the inner ear. The only remedy once these cells have been destroyed is a hearing aid. Ear infections are another cause of hearing loss. The program examines how ear infections can develop and the variety of treatments available, from antibiotics to the surgical implantation of tubes. (AA-M).

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Audiological Processing in Sensorineural Hearing Loss Source: Bethesda, MD: Self Help for Hard of Hearing People, Inc. (SHHH). 1996. (videocassette). Contact: Available from Self Help for Hard of Hearing People, Inc. (SHHH). 7910 Woodmont Avenue, Suite 1200, Bethesda, MD 20814. Voice (301) 657-2249; TTY (301) 657-2249; Fax (301) 913-9413; http://www.shhh.org. PRICE: $20.00 (members); $25.00 (nonmembers); plus shipping and handling. Summary: This videotape program is a presentation given as part of the 3rd Annual SHHH Research Symposium on Advances in Hearing Aid Technology. The program begins with the introductory remarks for the symposium, which was set up as a scientific conference for consumers. This tape then features Dr. Charles Liberman discussing audiological processing in sensorineural hearing loss (SNHL). Dr. Liberman first considers the physiology of normal hearing, including how the structures of the ear and audiological system turn sound into nerve activity, and how the brain then decodes that nerve activity. The second session discusses SNHL, including how those audiological structures may be damaged, how damage changes the conversion of sound into nerve activity, and why these changes are difficult to rectify with hearing aids, amplification, or implants. The program includes a lengthy question and answer session. The videotape is open-captioned.

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Hearing Development and Hearing Loss: Birth to Three Years Source: Nashville, TN: Bill Wilkerson Center Press. 1995. (videocassette). Contact: Available from Bill Wilkerson Center Press. 1114 19th Avenue South, Nashville, TN 37212-2197. (615) 936-5023. Fax (615) 936-5013. PRICE: $70.00 plus shipping and handling. ISBN: 0963143956. Summary: This videotape program shows the milestones of hearing development in the first 3 years of life. The structures of the ear and their role in hearing are described. The program also discusses risk factors and conditions associated with hearing loss. Conductive hearing loss and sensorineural hearing loss are defined and the consequences of each are outlined. The program concludes with information for caregivers who suspect a child has a hearing loss, including where to seek assistance. The videotape program is closed captioned. (AA-M).

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Listen and Learn: Hearing Loss and What You Can Do About It Source: Birmingham, AL: Terra Nova Films. 1991. (videocassette). Contact: Available from Terra Nova Films, Inc. 9848 South Winchester Avenue, Chicago, IL 60643. (800) 779-8491 or (773) 881-8491. Fax (773) 881-3368; E-mail: [email protected]. PRICE: $45.00 plus $9.00 for shipping and handling. Summary: This videotape program, designed for senior citizens and their families, reviews the problem of hearing loss and what can be done about it. The tape begins with a listing and brief description of the symptoms of hearing loss. The program continues by discussing the incidence of hearing loss, hearing loss as a natural part of the aging process, and the importance of hearing as a way to enjoy life's everyday pleasures. The video describes the causes of hearing loss and the treatment for each, the anatomy and function of the ear, and referral to an otologist or an otorhinolaryngologist. Other topics include the use of assistive listening devices for the telephone or television, the types of hearing aids available and how they are used, how to find a hearing aid dispenser, and consumer information and awareness issues, including cost considerations, warranties, and deposits. The program concludes with a review of the symptoms of hearing loss and the importance of ongoing hearing evaluations. The program depicts a variety of older people in everyday settings, at the physician's office, and undergoing a hearing evaluation with an audiologist.

Audio Recordings The Combined Health Information Database contains abstracts on audio productions. To search CHID, go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find audio productions, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Sound Recordings.” Type “hearing loss” (or synonyms) into the “For these words:” box. The following is a typical result when searching for sound recordings on hearing loss: •

Aided Hearing Loss Simulations Source: Northampton, MA: Mainstream Center: Clarke School for the Deaf-Center for Oral Education. 199x. Contact: Available from Clarke School for the Deaf-Center for Oral Education. 48 Round Hill Road, Northampton, MA 01060-2199. (413) 584-3450. Fax (413) 586-6654. PRICE: $10.00 per tape or $35.00 for four tapes; plus shipping and handling. Summary: These audio tapes illustrate aided hearing losses on various grade levels. Each tape contains a sample of moderate, severe, and profound loss as heard through a hearing aid. The tapes are available for four levels: first grade, fourth grade, eighth grade, and high school. The tapes are designed to help people with normal hearing to understand what a hearing loss is and what a hearing aid can and cannot do. The simulations can help special education directors, administrators, and teachers acquire a better understanding of hearing loss and the effect it can have on a student. The tapes include examples recorded at distances of one foot and 12 feet from the microphone for three levels of hearing loss: moderate, severe, and profound. The samples at the closer distance show that a student will have the best chance of getting the speech signal if the speaker is close to the microphone.

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Genetics of Hearing Loss and Genetic Counseling: What the Practicing Audiologist Needs to Know Source: Rockville, MD: American Speech-Hearing-Language Association (ASHA). 1998. (audiocassettes and study guide). Contact: Available from American Speech-Language-Hearing Association (ASHA). Product Sales, 10801 Rockville Pike, Rockville, MD 20852. (888) 498-6699. TTY (301) 8970157. Website: www.asha.org. PRICE: $58.00 for ASHA members; $66.00 for nonmembers; plus shipping and handling. ISBN: 1580410251. Summary: This audio conference (designed for self study) offers an opportunity for practicing audiologists to increase their understanding of the genetics of hearing loss and genetic counseling. Topics include syndromic and nonsyndromic genetic hearing loss, the medical aspects of genetic hearing loss, and related databases and registries. After studying the audioconference tapes and handbook, the student should be able to identify syndromes associated with hearing loss and other communication disorders; make appropriate referrals to other health care providers; make informed referrals to genetic counseling; and define the purpose of national databases on genetic hearing loss and be able to access or add information as appropriate. The information in the manual is presented in outline format, with plenty of space for participant's notes. The posttest, with which participants can qualify for continuing education units (CEUs), is included in the manual. 13 references.

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Hearing and Hearing Loss Source: Northampton, MA: Mainstream Center, Clarke School for the Deaf. 199x. (sound recording, handout). Contact: Available from Mainstream Center. Center for Oral Education, Clarke School for the Deaf, Round Hill Road, Northampton, MA 01060-2199. (413) 582-1121; Fax (413) 586-6654. PRICE: $4.00 plus shipping and handling. Order Number 9301. Summary: This audiotape program is from a series designed to allow parents and professionals to continue learning about hearing loss and its implications. The tape was recorded during a workshop presentation and comes with relevant handouts. This tape features an audiologist discussing hearing and hearing loss. Topics include the anatomy of the ear, major causes of conductive hearing and sensorineural hearing loss, and noise measurement and the relative intensities of familiar sounds. The audiotape also demonstrates how normal hearing sounds in quiet and noisy setting, high frequency hearing loss in quiet and noisy settings, and flat sensorineural hearing loss or distortion. The tapes are produced by the Mainstream Center at the Clarke School for the Deaf and represent a commitment to the oral approach to educating young people with hearing loss.

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Lend Me Your Ears: Experiencing Noise Induced Hearing Loss Source: Portland, OR: Audiology Research Laboratory, Portland State University. 1999. (audiocassette, instructor's manual). Contact: Available from Audiology Research Laboratory, Portland State University. P.O. Box 751 Portland, OR 97215-0751. (503) 725-3577. E-mail: [email protected]. PRICE: $20.00 plus shipping and handling. Summary: This program features a series of three audio programs aimed at alerting people to the deleterious effects of noise induced hearing loss (NIHL) on

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communication and safety. The three programs demonstrate how a hearing loss affects the comprehension of speech, warning sounds, and environmental sounds. In addition, the series contains simple listening exercises in which the listener evaluates his or her ability to understand speech that is filtered to simulate NIHL. The self scored exercises demonstrate how simple commands and questions can be misunderstood, and how warning signals and environmental sounds can go unheard when a person has a hearing loss. Having a listener 'experience' a hearing loss before it actually occurs is intended to motivate him or her to use hearing protection. The accompanying instructor's manual explains how to administer the listening tests, contains a sample answer sheet, and provides additional educational materials for promoting hearing conservation.

Bibliography: Multimedia on Hearing Loss The National Library of Medicine is a rich source of information on healthcare-related multimedia productions including slides, computer software, and databases. To access the multimedia database, go to the following Web site: http://locatorplus.gov/. Select “Search LOCATORplus.” Once in the search area, simply type in hearing loss (or synonyms). Then, in the option box provided below the search box, select “Audiovisuals and Computer Files.” From there, you can choose to sort results by publication date, author, or relevance. The following multimedia has been indexed on hearing loss: •

[Juvenile hearing loss] [motion picture] Source: produced by Monumental Films & Recordings, Inc.; National Institutes of Health public service message; Format: Juvenile hearing loss; United States: [U.S. Dept. of Health, Education, and Welfare, 197-?]

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Causes of hearing loss [videorecording] Source: a presentation of Films for the Humanities & Sciences; a presentation of KCBD-TV and Medstar Communications, Inc; Year: 1995; Format: Videorecording; Princeton, N.J.: Films for the Humanities and Sciences, c1995

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Genetics and hearing loss Source: edited by Charles I. Berlin and Bronya J. B. Keats; Year: 2000; San Diego, Calif.: Singular Pub. Group/Thomson Learning, c2000

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Health communication and follow-through related to early identification of deafness and hearing loss in newborns [electronic resource]: January 1990 through June 2001: 633 citations Source: prepared by Ronald L. Gordner. [et al.]; Format: Electronic resource; Bethesda, Md. (8600 Rockville Pike): U.S. Dept. of Health and Human Services, Public Health Service, National Institutes of Health, National Library of Medicine, Reference Section, [2001]

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Hearing loss [videorecording] Source: [presented by] American Medical Association; Year: 1982; Format: Videorecording; Chicago, Ill.: The Association, c1982

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Hearing loss [videorecording] Source: with Robert A. Goldenberg; Year: 1986; Format: Videorecording; Secaucus, N.J.: Network for Continuing Medical Education, 1986

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Hearing loss [videorecording] Source: [presented by] Interlingual Images; Year: 1995; Format: Videorecording; Phoenix, Ariz.: Interlingual Images, c1995

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Hearing loss and rehabilitation [slide] Source: Paul R. Lambert; Year: 1985; Format: Slide; [Washington, D.C.]: American Academy of Otolaryngology-Head and Neck Surgery Foundation, c1985

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Hearing loss management [slide]. Year: 1991; Format: Slide; [Columbus, Ohio]: Ohio Medical Education Network, 1991

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How to communicate effectively with someone who has hearing loss [videorecording]. Year: 2000; Format: Videorecording; South Melbourne, Vic.: Educational Media Australia [distributor, 2000]

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Noise and hearing loss [videorecording] Source: American Academy of Ophthalmology and Otolaryngology; Year: 1976; Format: Videorecording; Rochester, Minn.: The Academy, c1976

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Rehabilitation of hearing loss [videorecording] Source: Peter W. Alberti. [et al]; produced by Instructional Media Services, University of Toronto; Year: 1981; Format: Videorecording; Toronto: IMS, 1981

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Sensory deficits in primary care [videorecording]: screening for hearing loss in the elderly and preventing blindness from diabetes Source: Cynthia D. Mulrow, James McGroarty; Year: 1992; Format: Videorecording; Secaucus, N.J.: Network for Continuing Medical Education, 1992

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Understanding hearing loss [videorecording] Source: a presentation of Films for the Humanities & Sciences; produced for Deafness Resources Project, Griffith University [by] QUT Educational TV Facility; Year: 1993; Format: Videorecording; Princeton, N.J.: Films for the Humanities and Sciences, c1993

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CHAPTER 9. PERIODICALS AND NEWS ON HEARING LOSS Overview In this chapter, we suggest a number of news sources and present various periodicals that cover hearing loss.

News Services and Press Releases One of the simplest ways of tracking press releases on hearing loss is to search the news wires. In the following sample of sources, we will briefly describe how to access each service. These services only post recent news intended for public viewing. PR Newswire To access the PR Newswire archive, simply go to http://www.prnewswire.com/. Select your country. Type “hearing loss” (or synonyms) into the search box. You will automatically receive information on relevant news releases posted within the last 30 days. The search results are shown by order of relevance. Reuters Health The Reuters’ Medical News and Health eLine databases can be very useful in exploring news archives relating to hearing loss. While some of the listed articles are free to view, others are available for purchase for a nominal fee. To access this archive, go to http://www.reutershealth.com/en/index.html and search by “hearing loss” (or synonyms). The following was recently listed in this archive for hearing loss: •

Prenatal events may increase risk of later hearing loss Source: Reuters Medical News Date: November 21, 2003

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Hearing loss risk may be set before birth Source: Reuters Health eLine Date: November 21, 2003

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Infants not always screened or treated for hearing loss Source: Reuters Medical News Date: October 16, 2003

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Methotrexate ineffective in slowing autoimmune hearing loss Source: Reuters Medical News Date: October 08, 2003

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Multiple mutations in MYO1A linked to hearing loss Source: Reuters Medical News Date: June 04, 2003

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Evidence of CMV seen in perilymph of patient with hearing loss Source: Reuters Medical News Date: January 07, 2003

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Otitis media-related hearing loss not linked with decrease in academic skills Source: Reuters Medical News Date: October 11, 2002

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Exposure to low levels of styrene may cause hearing loss Source: Reuters Medical News Date: October 04, 2002

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Cochlear implants benefit kids with CMV-related deafness, despite other deficits Source: Reuters Medical News Date: September 24, 2002

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High-decibel jobs to blame for much hearing loss Source: Reuters Health eLine Date: September 04, 2002

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Guidelines set on genetic tests for infant deafness Source: Reuters Health eLine Date: June 06, 2002

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Cochlear implants effective for profound deafness from GJB2 gene mutation Source: Reuters Medical News Date: May 24, 2002

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Estrogen may protect women from hearing loss Source: Reuters Health eLine Date: April 30, 2002

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Hearing loss linked to cardiovascular disease Source: Reuters Health eLine Date: April 29, 2002

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Corticosteroids ineffective for sudden-onset low frequency hearing loss Source: Reuters Industry Breifing Date: April 15, 2002

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Ganciclovir prevents worsening of CMV-related hearing loss in infants Source: Reuters Industry Breifing Date: October 24, 2001

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US task force takes no stand on neonatal screening for hearing loss Source: Reuters Medical News Date: October 23, 2001

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Connexin 26 mutations tied to hearing loss in children Source: Reuters Medical News Date: September 28, 2001

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Childhood hearing loss may be underestimated in UK Source: Reuters Health eLine Date: September 07, 2001

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Many US children may have noise-related hearing loss Source: Reuters Medical News Date: July 03, 2001

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Many US kids may have noise-related hearing loss Source: Reuters Health eLine Date: July 02, 2001

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Sensorineural hearing loss is more prevalent in diabetics than non-diabetics Source: Reuters Medical News Date: May 11, 2001

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Genetically modified sensory cells could restore hearing loss Source: Reuters Industry Breifing Date: March 26, 2001

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High-dose glucocorticoid treatment improves outcome of sudden hearing loss Source: Reuters Medical News Date: March 22, 2001

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FDA clears Bionic Ear System for deafness Source: Reuters Medical News Date: March 22, 2001

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FDA clears Advance Bionics Corporation's Bionic Ear System for deafness Source: Reuters Industry Breifing Date: March 22, 2001

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Light eyes linked to hearing loss from meningitis Source: Reuters Health eLine Date: March 09, 2001

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Researchers discover gene that suppresses recessive deafness Source: Reuters Medical News Date: December 25, 2000

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Smoking may cause hearing loss Source: Reuters Health eLine Date: November 10, 2000

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Cigarette smoking doubles risk of hearing loss Source: Reuters Medical News Date: November 10, 2000

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FDA okays brainstem implant for deafness Source: Reuters Health eLine Date: October 24, 2000

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Cochlear's brain-stem implant cleared to treat deafness in NF2 patients Source: Reuters Industry Breifing Date: October 23, 2000

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Idiopathic hearing loss improves with antiviral/corticosteroid combination Source: Reuters Industry Breifing Date: September 26, 2000

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Hearing loss due to pulmonary hypertension of newborn may have delayed onset Source: Reuters Medical News Date: August 15, 2000

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Lung disorder in newborns linked to hearing loss Source: Reuters Health eLine Date: August 14, 2000

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Deafness, labyrinthitis in AIDS patient may have been due to CMV encephalitis Source: Reuters Medical News Date: August 11, 2000

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Gene therapy for hearing loss may be possible Source: Reuters Health eLine Date: May 16, 2000

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High-frequency hearing loss linked to use of recreational firearms Source: Reuters Medical News Date: April 26, 2000

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Gun users on target for hearing loss Source: Reuters Health eLine Date: April 18, 2000

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Fractionation reduces hearing loss from radiosurgery for vestibular schwannomas Source: Reuters Medical News Date: December 14, 1999

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Mutations in collagen gene COL11A2 cause isolated hearing loss Source: Reuters Medical News Date: December 01, 1999

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Transtympanic steroid therapy an effective alternative in sudden hearing loss Source: Reuters Medical News Date: October 04, 1999

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Steel pan musicians need protection against hearing loss Source: Reuters Medical News Date: October 04, 1999

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Steel pan musicians at risk for hearing loss Source: Reuters Health eLine Date: September 30, 1999

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Gene helps predict risk for deafness in offspring Source: Reuters Health eLine Date: September 29, 1999

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Hearing loss is big problem in workforce Source: Reuters Health eLine Date: September 10, 1999

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Viral infection causes hearing loss in children Source: Reuters Health eLine Date: July 21, 1999

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Aspirin may prevent antibiotic-related hearing loss Source: Reuters Health eLine Date: July 21, 1999

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Much inherited severe deafness in US attributable to GJB2 mutations Source: Reuters Medical News Date: June 21, 1999

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Gene discovery may lead to hearing loss treatments Source: Reuters Health eLine Date: June 10, 1999

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The NIH Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “hearing loss” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “hearing loss” (or synonyms). If you know the name of a company that is relevant to hearing loss, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/.

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BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “hearing loss” (or synonyms).

Newsletters on Hearing Loss Find newsletters on hearing loss using the Combined Health Information Database (CHID). You will need to use the “Detailed Search” option. To access CHID, go to the following hyperlink: http://chid.nih.gov/detail/detail.html. Limit your search to “Newsletter” and “hearing loss.” Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter.” Type “hearing loss” (or synonyms) into the “For these words:” box. The following list was generated using the options described above: •

Advances in the Genetics of Deafness Source: Advances in the Genetics of Deafness: A Bulletin of the HHIRR. 1(1): 1-8. Spring 1994. Contact: Available from National Research Register for Hereditary Hearing Loss, Boys Town National Research Hospital (BTNRH). 555 North 30th Street, Omaha, NE 68131. (800) 320-1171. PRICE: $2.00 for each back issue. Summary: This document is the premier issue of a newsletter on the genetics of deafness, a bulletin of the Hereditary Hearing Impairment Resource Registry (HHIRR). The bulletin is designed to inform researchers in the genetics of the human auditory system about advances and opportunities for research in this area. The main article discusses the HHIRR, focusing on its purpose, information collection activities, data management concerns, and research collaboration activities. The newsletter also includes a literature review, with materials grouped under five major categories: reviews, clinical reports, genetic epidemiology, gene localization, and molecular genetics. Other segments include a calendar of related meetings; a questions, comments, and feedback section; and a call for readers to join the mailing list of the HHIRR.

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Hearing Advocate: The Deafness Research Foundation Source: New York, NY: Deafness Research Foundation (DRF). Spring 1998. 8 p. Contact: Available from Deafness Research Foundation (DRF). 15 West 39th Street, New York, NY 10018. Voice/TTY (800) 535-3323 or (212) 768-1181. Fax (212) 768-1782. E-mail: [email protected]. Website: village.ios.com/~drf1. Summary: This is a sample issue of the Hearing Advocate, the newsletter of the Deafness Research Foundation (DRF). The main article describes the DRF's 40th anniversary celebration and activities. The article reviews the history of the organization, the National Hearing Research Grant Center, the National Hearing Education and Advocacy Support Center, working with the Deaf community, and future research and granting activities. The newsletter also includes a section describing the DRF's campaign for hearing care among musicians and other musical artists, a letter from the new President and CEO, the address of the DRF website, the recipients chosen for the 1998 Otologic Research Grant Awards, and an article that profiles members of

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the otolaryngological professions. The newsletter concludes with a list of longterm donors, and suggestions for contributing to the DRF. •

Noise-Induced Hearing Loss: Common Condition Easily Prevented Source: Facts of Life. 6(5): 1-6. July-August 2001. Contact: Available from Center for the Advancement of Health. 2000 Florida Avenue, NW, Suite 210, Washington, DC 20009-1231. (202) 387-2829. Fax (202) 387-2857. Website: www.cfah.org. Summary: This issue of the Center for Advancement of Health's newsletter focuses on noise-induced hearing loss (NIHL). The issue begins with a brief explanation of NIHL and a bulleted list of NIHL facts. The first article is an interview with Dr. William H. Slattery, III from the House Ear Clinic in Los Angeles. Dr. Slattery answers questions concerning the physical effects of noise on the anatomy of the ear, prevention and causes of NIHL, the effect of modern society on the prevalence of NIHL, detection and diagnosis, treatment options, and future research. An interview with Dr. Peter Rabinowitz, Yale University School of Medicine, discusses how to prevent NIHL, the types of noise that pose the greatest risk, environmental versus occupational noise, headphones, and patient counseling. Two additional articles cover the relationship between decibel levels and hearing loss and noise exposure in urban settings. Research suggests that more people in urban settings are being exposed to damaging levels of noise at a younger age. Some of the causes are night clubs, restaurants, and video arcades. The newsletter concludes with a reference page. 18 references.

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Usher Syndrome: Vision and Hearing Loss Source: HDNA. Hereditary Deafness Newsletter America. 4(1): 1-8. Summer 1994. Contact: Available from National Research Register for Hereditary Hearing Loss, Boys Town National Research Hospital (BTNRH). 555 North 30th Street, Omaha, NE 68131. (800) 320-1171. PRICE: $2.00 for each back issue. Summary: This issue of the Hereditary Deafness Newsletter of America focuses on Usher syndrome, a condition in which both hearing loss and retinitis pigmentosa (RP) are present. In the lead article, the symptoms of RP and the various forms of Usher syndrome are discussed and suggestions are given for sources of further information. Other topics covered include hearing loss in Usher syndrome, balance in Usher syndrome, and gene studies in Usher syndrome. In another article, a 43-year-old man describes his own experiences with Usher syndrome and how it has impacted his life. The issue concludes with a list of feedback instructions and questions for readers to respond to the articles in the newsletter.

Newsletter Articles Use the Combined Health Information Database, and limit your search criteria to “newsletter articles.” Again, you will need to use the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter Article.” Type “hearing loss” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it

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is updated every three months. The following is a typical result when searching for newsletter articles on hearing loss: •

Workplace Noise Can Cause Hearing Loss Source: 3M JobHealth Highlights. Special Edition: 1-4. 1997. Contact: Available from 3M Occupational Health and Environmental Safety Division. 3M Center, Building 275-6W-01, St. Paul, MN 55144-1000. Summary: Noise is probably the most common occupational health problem, especially in the manufacturing industries. Hearing protection can be a satisfactory solution, as long as protectors are properly fitted, worn, and maintained. This article on workplace noise is from a special issue of JobHealth Highlights (a newsletter from the 3M company) that includes six articles on noise, hearing conservation, and hearing protection. The articles are written by Alice Suter, PhD, a consultant in industrial audiology and community noise; Dr. Suter is known as the principal author of OSHA's hearing conservation amendment to the standard for occupational noise exposure. The article discusses the decibel level at which hearing may be at risk, the impact of exposure duration, the progression of noise induced hearing loss (NIHL), communication interference, and the use of noise masking. Voice levels and levels of background noise, the effects of noise on job performance, and the effects of noise on health are also discussed. 1 figure. 2 tables. 3 references.

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Navy Patent Holds Promise for Noise-Induced Hearing Loss Source: ASHA Leader. 6(7): 1, 13. April 17, 2001. Contact: Available from American Speech-Language-Hearing Association (ASHA). Product Sales, 10801 Rockville Pike, Rockville, MD 20852. (888) 498-6699. TTY (301) 8970157. Website: www.asha.org. Summary: The United States Navy recently received a patent for a technique that can prevent or reduce hearing loss after a damaging noise exposure. This brief article describes the technique, which uses a microcatheter (a tiny tube) inserted into the ear to deliver drugs, such as antioxidants, to rescue the cochlear hair cells fundamental to sound detection. This technique is not a cure for cumulative hearing loss, but can be used as an intervention after an exposure to a high level of noise. The article briefly explains how noise exposure damages the cochlear hair cells, and how drug therapy can interrupt that process. The author also reports on animal studies that were used to support this technique. The article concludes with a web site that readers can consult for additional information (www.onr.navy.mil/onr/newsrel/nr980731.htm).

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Welcoming a Student With Hearing Loss Source: CLARKE-School for the Deaf, Center for Oral Education. Clarke Mainstream News, Vol. 22, No. 1. Northampton, MA. 2002. Contact: Mainstream Center. CLARKE-School for the Deaf. 48 Round Hill Road, Northampton, MA 01060-2124. Voice: (413) 582-1121. Fax (413) 586-6645. E-mail: [email protected]. Web site: http://www.clarkeschool.org. PRICE: $3.00 per copy for back issues; Subscriptions: $25.00 for individuals and $75.00 for schools (8 copies per issue). Summary: This article discusses the steps that teachers, school personnel, and parents should take to make a student with hearing loss feel comfortable and welcome in a new

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school environment. The information is especially directed toward educators who have no experience working with deaf or hard-of-hearing students. •

Spotlight On: Mitochondrial Genetics and Hearing Loss Source: New Developments in the Genetics of Hearing Impairment: Bulletin of the National Institute on Deafness and Other Communication Disorders Hereditary Hearing Impairment Resource Registry. 2(2): 1-5. Summer 1996. Contact: Available from National Institute on Deafness and Other Communication Disorders Hereditary Hearing Impairment Resource Registry. 555 North 30th Street, Omaha, NE 68131. Voice-TTY (800) 320-1171; Fax (800) 320-1171; E-mail: [email protected]. Summary: This article gives a short introduction to mitochondrial genetics and outlines the spectrum of clinical presentations of mitochondrially-determined hearing impairments. Topics include normal mitochondrial genetics; mitochondrial DNA mutations and hearing loss, including syndromic and non-syndromic deafness; ototoxic deafness; presbycusis; and the clinical relevance of mitochondrially-induced hearing loss. The article includes contact information for researchers and diagnostic laboratories working in the field of genetic deafness. 27 references.

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Otosclerosis: A Common Cause of Hearing Loss Source: American Hearing Research Foundation Newsletter. 27(2): 1-3. Fall 2000. Contact: Available from American Hearing Research Foundation. 55 East Washington Street, Suite 2022, Chicago, IL 60602. (312) 726-9670. Fax (312) 726-9695. Summary: This article provides an overview of otosclerosis. This disease, which is characterized by the growth of spongy bone around the stapes and oval window, causes the progressive loss of hearing. Conductive hearing loss occurs if this bone tissue grows around the ossicles and keeps them from moving. If the tissue does not interfere with the ossicles, it is termed subclinical. Histologic otosclerosis is the presence of otosclerosis tissue whether or not it is causing hearing loss. Clinical otosclerosis is the term used when hearing loss is detectable. Hearing loss usually occurs in the low frequencies first and is only conductive. High frequencies are generally affected next, followed by hearing loss in the middle frequencies. As the conductive hearing loss develops, a sensorineural hearing loss may also occur. Although middle ear surgery can restore the conductive component of hearing loss in many people, it will not eliminate the sensorineural loss. The frequency of otosclerosis depends on age, race, and gender. Although otosclerosis runs in families, the genetic cause is unclear. The most common theory is that a dominant gene causes otosclerosis. In addition, it appears that the bone rebuilding process is faulty in otosclerosis, which could be caused by genetic defects in the enzymes directing the remodeling process.

•

Recreational Noise Exposure and Hearing Loss Source: Otoscope. 9(4): 1-2. Spring 1994. Contact: Available from Ear Foundation. 2000 Church Street, Box 111, Nashville, TN 37236. (800) 545-HEAR; (615) 329-7809; TTY (615) 329-784. PRICE: Reprints are available for $25.00/200 copies. Summary: This article reviews the problem of nonoccupational and recreational noise exposure and hearing loss. Topics covered include examples of recreational activities

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capable of producing hazardous sound levels; the capability of a sound to cause hearing loss, notably the intensity and duration of the sound; how noise exposure causes hearing loss; hearing protection devices that have been designed for the music industry; and hearing protection devices that have electronic amplification, so that the user is protected from dangerous sounds (in excess of 80-90 dB) but can still hear ambient sound or conversation. The article includes a sidebar providing the answers to common questions about recreational hearing loss. 3 figures. 1 table. •

Implications of Delay in Detection and Management of Deafness Source: Educational Audiology Review. 15(4): 10-15. Fall 1998. Contact: Available from Educational Audiology Association. 4319 Ehrlich Road, Tampa, FL 33624. (800) 460-7322. Website: www.edaud.org. Summary: This article, first published in the early 1990s, reviews the implications of delay in the detection and management of deafness in children. The author notes that, although there may be controversies in the field of education of the hearing impaired, nearly everyone involved with children with hearing loss can agree on the important role of early detection and intervention, regardless of method used. The author reviews the typical progression of parental concern, general physician assessment of the child, dismissal of the concern, then finally referral of the child for intervention, often after the child's abnormal auditory and verbal development becomes more apparent. The end result of this sequence is that the average child with hearing loss still does not receive his or her first hearing aid until age two or older. The author then discusses the possible consequences of this delay, including the devaluation of hearing and attitudes toward hearing impairments in the U.S. Topics include self-acceptance, auditory sensory deprivation, auditory self-monitoring, the effects of delay in intervention on early linguistic development, and psychosocial implications. The author reiterates that children with hearing loss who are enrolled in early management programs demonstrate superior linguistic skills compared to those who are enrolled later.

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Rapidly Progressive Sensorineural Hearing Loss Source: Sarcoidosis Networking. 8(3): 9. May-June 2000. Contact: Available from Sarcoidosis Networking Association. 13925 80th Street East, Puyallup, WA 98372-3614. E-mail: [email protected]. Summary: This brief article, from a newsletter for people with sarcoidosis, describes rapidly progressive sensorineural hearing loss (SNHL). The author first defines three types of hearing loss: conductive, sensorineural, and mixed. The author then notes that sudden SNHL is of great concern and may be caused by various factors. Every patient with SNHL should be evaluated thoroughly to determine the underlying disorder contributing to the hearing loss. Early diagnosis of SNHL is crucial as a significant number of patients with idiopathic (unknown cause) SNHL may have an immunological condition causing their hearing loss. The author reviews the diagnostic tests commonly used to evaluate idiopathic progressive SNHL and stresses the importance of prompt and effective treatment. Patients with autoimmune deafness may benefit from immunosuppressive therapy.

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Hearing Loss: Devices Help When a Hearing Aid Isn't Enough Source: Mayo Clinic Health Letter. 14(4): 7. April 1996.

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Contact: Available from Mayo Foundation for Medical Education and Research. 200 First Street, S.W., Rochester, MN 55905. (800) 633-4567. PRICE: $3.00 for single copy of newsletter plus shipping and handling. Summary: This brief newsletter article outlines assistive listening devices that can be used to supplement the use of hearing aids. Three main categories of devices are described: amplifying devices, alerting devices, and decoding devices. Specific devices discussed include FM systems, telephone amplifiers, doorbell and telephone alerting devices, television decoders, and TTYs. •

Spotlight On: Dominant Progressive Hearing Loss Source: Hereditary Deafness Newsletter of America. 4(2): 1-2. Spring 1995. Contact: Available from NIDCD Hereditary Hearing Impairment Resource Registry. Boys Town National Research Hospital, 555 North 30th Street, Omaha, NE 68131. Voice/TTY (800) 320-1171. Fax (402) 498-6331; E-mail: [email protected]. Summary: This brief newsletter article provides an introduction to dominant progressive hearing loss (DPHL), a form of nonsyndromic genetic deafness. Topics covered include the symptoms of DPHL; its presentation; balance problems associated with DPHL; classifying DPHL; and the genetics of DPHL. The article concludes with the names and contact information for two resource organizations for individuals and families adapting to progressive hearing loss. 2 references.

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Age, Hearing Loss, and Hearing Aids Source: Harvard Health Letter. 26(1): 4-5. November 2000. Contact: Available from Harvard Health Letter. P.O. Box 380, Boston, MA 02117. (800) 829-9045 or (617) 432-1485. Summary: This health newsletter article reminds readers of the relationship between age and hearing loss, focusing on the use of hearing aids. The author reviews presbycusis (hearing loss associated with aging), noting that about 33 percent of all Americans aged 65 to 75 years have some hearing loss, and the percentage climbs to 50 percent among people aged 75 and over. The article discusses the signs and symptoms of hearing loss, including threshold and discrimination, the physiology of hearing loss (including noise induced hearing loss, which often becomes more apparent over time), the indications for hearing aids, cost considerations, and the hearing aid dispensing industry. The article focuses on educating consumers to make wise choices about hearing aids. One illustration explains the parts of the outer, middle, and inner ear. 1 figure.

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Q and A: Otosclerosis Source: House Ear Institute Review. p. 10-11. Summer 1993. Contact: Available from House Ear Institute. 2100 West Third Street, Fifth Floor, Los Angeles, CA 90057. Voice (213) 483-4431; TTY (213) 484-2642; Fax (213) 483-8789. Summary: This newsletter article answers general questions about otosclerosis, a disorder of the middle ear that causes conductive progressive hearing loss. Otosclerosis causes bony deposits to make the stapes footplate (the innermost bone of the inner ear) fixed or immobilized. When this happens, sound vibrations cannot be passed to the inner ear, resulting in conductive hearing loss. The author defines the disorder and then discusses the cause, symptoms, diagnosis, treatment, and current related research being conducted at the House Ear Institute. The author also discusses advances that have been

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made in the surgical management of otosclerosis. The focus is on improving technique in order to reduce the incidence of further hearing loss or dizziness as a result of surgery. 1 figure. (AA-M). •

Cumulative Effect of Hearing Loss Source: Clarke Mainstream News. 18(2): 1-2. September 1998. Contact: Available from Mainstream Center. Clarke School for the Deaf, 48 Round Hill Road, Northampton, MA 01060-2124. (413) 582-1121. Fax (413) 586-6654. E-mail: [email protected]. Website: www.clarkeschool.org. Summary: This newsletter article describes the cumulative effect of hearing loss and how it might impact a child's experiences in the classroom and other aspects of academic learning. Hearing students have acquired a great deal of information simply because they can hear what is going on around them. Even when they are not paying direct attention, they are still picking up a significant amount of information. However, the student with hearing loss has not heard all that is going on unless she or he has been paying direct and close attention. The author discusses the impact of this missed information in the child's foundation of knowledge, sophistication of language, vocabulary base, and use of abstract thinking. The author encourages teachers to be aware of, and sensitive to, the cumulative effect of hearing loss, and to provide help, information, and exposure whenever appropriate. This article is one in a series of articles on the effects of hearing loss on academic learning.

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How Hearing Loss Impacts the Time Necessary for Processing Information Source: Clarke Mainstream News. 18(3): 1-2. October 1998. Contact: Available from Mainstream Center. Clarke School for the Deaf, 48 Round Hill Road, Northampton, MA 01060-2124. (413) 582-1121. Fax (413) 586-6654. E-mail: [email protected]. Website: www.clarkeschool.org. Summary: This newsletter article discusses how hearing loss can impact the time necessary for processing information and how this can affect the academic progress of children with hearing loss. The author first considers the information processing utilized by a student with normal hearing, then compares that to the process used by the student with hearing loss. The author then lists strategies that the classroom teacher can implement to assist the student with hearing loss. These include: providing preteaching of new concepts and vocabulary, adjusting the pace of the class (particularly during discussions), providing regular and natural pauses to allow students to gather their thoughts, summarizing and repeating at frequent intervals, providing supplementary written or visual information, checking the students comprehension periodically, and providing after class help sessions. This article is one in a series of articles on the effects of hearing loss on academic learning.

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Hearing Loss in Singers and Other Performers Source: Voice Foundation Newsletter. 4(1): 7. April 1998. Contact: Available from Voice Foundation. 1721 Pine Street, Philadelphia, PA 19103. (215) 735-7999. Fax (215) 735-9293. E-mail: [email protected]. Summary: This newsletter article explores the incidence of hearing loss in singers and other performers. The author first reviews the mechanism of hearing and notes how delicate it is. The author then describes the problem of noise-induced hearing loss in

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musical and other entertainment settings. While hearing loss resulting from this level of noise may not be severe enough to interfere with speech, it may be bad enough to affect the acute auditory needs of a performing artist. The author stresses that any entertainer who works around loud noise should undergo hearing tests (audiograms) periodically. The remainder of the article describes specific strategies that can be implemented to prevent noise-induced hearing loss in music and theatrical settings. In addition, musicians and performers should be aware of protecting their hearing in environments away from work, i.e., recreational noise. Whenever hearing loss is suspected, medical attention should be obtained promptly to determine whether hearing loss has been caused by noise or by one of the many other important or treatable medical conditions that may produce hearing impairment. •

Mentoring a Student with Hearing Loss Source: Clarke Mainstream News. 19(3): [p. 3]. October 1999. Contact: Available from Mainstream Center at Clarke School for the Deaf/Center for Oral Education. 48 Round Hill Road, Northampton, MA 01060-2124. (413) 582-1121. Website: www.clarkeschool.org. Summary: This newsletter article offers strategies for teachers and other adults who are mentoring students with hearing loss. The author first defines the role of the mentor and notes that, for a student with hearing loss managing in the mainstream setting, having a mentor can be particularly helpful because of the additional stress he or she is apt to be under, and the struggles that must be dealt with on a daily basis. The author then details six strategies that the mentor can use: empathize when the student is feeling frustration with school life; take an interest in how the student adapts to his or her hearing loss; be a role model; help the student explore alternative solutions for problems that the student faces; encourage activities that provide relaxation and fun; and attend events in which the student participates whenever possible. The author concludes by mentioning that there is much good to be had when the mentor is also deaf or hard of hearing and has grown up in mainstream settings.

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Managing and Adjusting to Hearing Loss Source: Clarke Mainstream News. 16(7): 1-3. April 1997. Contact: Available from Mainstream Center. Clarke School for the Deaf, 48 Round Hill Road, Northampton, MA 01060-2199. (413) 582-1121; Fax (413) 586-6654; E-mail: [email protected]. Summary: This newsletter article outlines a structure for writing individual education plans (IEP) for students adjusting to hearing loss. The author provides a series of examples of hypothetical situations in which objectives have been written that would be appropriate for students with hearing loss. These examples are meant to stimulate ideas for creating objectives to suit a particular student at a particular level of development. Situations are provided that discuss maintenance and adjustment issues. The author emphasizes that ensuring the emotional health and growth of a student with hearing loss is no less valid than ensuring equal access to information in classes. (AA-M).

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Unilateral Hearing Loss: Part II, A Loss in One Ear Only Source: Clarke Mainstream News. 14(6): 2-3. March 1995. Contact: Available from Mainstream News. Clarke, Round Hill Road, Northampton, MA 01060-2199. (413) 582-1121.

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Summary: This newsletter article, the second of a two-part series on unilateral hearing loss, discusses how learning and education might be affected in children with a unilateral hearing loss. Topics covered include how a unilateral hearing loss can affect the child's perceptual ability; the use of hearing aids or other assistive devices in this population; determining appropriate classroom seating and placement for the child; and successful classroom strategies. Strategies are suggested for three areas: in the classroom, when teaching or communicating with the student, and to help with social and emotional development. The author cautions teachers to remember that even an 'invisible' disability such as unilateral hearing loss can cause difficulties in the classroom for the child. 4 references. •

Hearing Loss Prevention Programs Are a Good Value Source: Today's Supervisor. 64(2): 4-5. February 2000. Contact: Available from National Safety Council. 1121 Spring Lake Drive, Itasca, IL 60143-3201. (800) 621-7619 or (630) 775-2056. Website: www.nsc.org. Summary: Work related hearing loss continues to be a critical workplace safety and health issue. Noise induced hearing loss (NIHL) is one of the most common occupational diseases and the second most self reported occupational illness or injury. This article is from a special issue of a newsletter written for workplace supervisors that is dedicated to hearing loss prevention. This article explains how an effective hearing loss prevention program will save employers money, even if implementing such a program requires an initial investment. For example, a hearing loss prevention program will help employers minimize compensation claims for hearing loss. In addition, retaining good employees and retraining them as needed is more cost-effective that hiring new employees. Ensuring that employees retain their sense of hearing will increase the likelihood that they remain versatile in their capabilities. Studies have also shown that quieter workplaces are more productive and efficient, especially when the work is complex or requires concentration. Workplaces that are quieter also have lower injury rates. The article concludes that companies that have implemented hearing loss prevention programs often find less absenteeism, greater job satisfaction, and improved morale among their employees. The newsletter is illustrated with black and white line drawings. This issue of the newsletter is a collaboration between the National Safety Council and National Institute for Occupational Safety and Health (NIOSH). 1 figure.

Academic Periodicals covering Hearing Loss Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to hearing loss. In addition to these sources, you can search for articles covering hearing loss that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”

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CHAPTER 10. RESEARCHING MEDICATIONS Overview While a number of hard copy or CD-ROM resources are available for researching medications, a more flexible method is to use Internet-based databases. Broadly speaking, there are two sources of information on approved medications: public sources and private sources. We will emphasize free-to-use public sources.

U.S. Pharmacopeia Because of historical investments by various organizations and the emergence of the Internet, it has become rather simple to learn about the medications recommended for hearing loss. One such source is the United States Pharmacopeia. In 1820, eleven physicians met in Washington, D.C. to establish the first compendium of standard drugs for the United States. They called this compendium the U.S. Pharmacopeia (USP). Today, the USP is a nonprofit organization consisting of 800 volunteer scientists, eleven elected officials, and 400 representatives of state associations and colleges of medicine and pharmacy. The USP is located in Rockville, Maryland, and its home page is located at http://www.usp.org/. The USP currently provides standards for over 3,700 medications. The resulting USP DI® Advice for the Patient® can be accessed through the National Library of Medicine of the National Institutes of Health. The database is partially derived from lists of federally approved medications in the Food and Drug Administration’s (FDA) Drug Approvals database, located at http://www.fda.gov/cder/da/da.htm. While the FDA database is rather large and difficult to navigate, the Phamacopeia is both user-friendly and free to use. It covers more than 9,000 prescription and over-the-counter medications. To access this database, simply type the following hyperlink into your Web browser: http://www.nlm.nih.gov/medlineplus/druginformation.html. To view examples of a given medication (brand names, category, description, preparation, proper use, precautions, side effects, etc.), simply follow the hyperlinks indicated within the United States Pharmacopeia (USP). Below, we have compiled a list of medications associated with hearing loss. If you would like more information on a particular medication, the provided hyperlinks will direct you to ample documentation (e.g. typical dosage, side effects, drug-interaction risks, etc.). The

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following drugs have been mentioned in the Pharmacopeia and other sources as being potentially applicable to hearing loss: Ciprofloxacin •

Ophthalmic - U.S. Brands: Ciloxan http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202655.html

Diphtheria and Tetanus Toxoids and Pertussis Vaccine Adsorbed and Haemophilus B Conjugate Vaccine •

Systemic - U.S. Brands: Tetramune http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202911.html

Erythromycin •

Ophthalmic - U.S. Brands: Ilotycin http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202220.html

Gentamicin •

Ophthalmic - U.S. Brands: http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202604.html

•

Ophthalmic - U.S. Brands: Garamycin; Gentacidin; Gentafair; Gentak; OcuMycin; Spectro-Genta http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202604.html

•

Topical - U.S. Brands: Garamycin; Gentamar; G-Myticin http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202258.html

Guaifenesin •

Systemic - U.S. Brands: Anti-Tuss; Breonesin; Fenesin; Gee-Gee; Genatuss; Glycotuss; Glytuss; Guiatuss; Halotussin; Hytuss; Hytuss-2X; Pneumomist; Robitussin; Sinumist-SR; Uni-tussin http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202270.html

Kanamycin •

Oral - U.S. Brands: Kantrex http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202312.html

Neomycin •

Oral - U.S. Brands: Mycifradin http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202396.html

•

Topical - U.S. Brands: Myciguent http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202397.html

Phenylephrine •

Nasal - U.S. Brands: Doktors; Duration; Rhinall http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202460.html

•

Ophthalmic - U.S. Brands: Ak-Dilate; Ak-Nefrin; Dilatair; I-Phrine; Mydfrin; Neofrin; Neo-Synephrine; Ocugestrin; Phenoptic http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202461.html

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Phenylpropanolamine •

Systemic - U.S. Brands: Note:; Propagest; Thinz-Span http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202462.html

Quinine •

Systemic - U.S. Brands: http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202462.html

Sodium Iodide •

Systemic - U.S. Brands: Iodopen http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202621.html

Commercial Databases In addition to the medications listed in the USP above, a number of commercial sites are available by subscription to physicians and their institutions. Or, you may be able to access these sources from your local medical library.

Mosby’s Drug Consult™ Mosby’s Drug Consult™ database (also available on CD-ROM and book format) covers 45,000 drug products including generics and international brands. It provides prescribing information, drug interactions, and patient information. Subscription information is available at the following hyperlink: http://www.mosbysdrugconsult.com/.

PDRhealth The PDRhealth database is a free-to-use, drug information search engine that has been written for the public in layman’s terms. It contains FDA-approved drug information adapted from the Physicians’ Desk Reference (PDR) database. PDRhealth can be searched by brand name, generic name, or indication. It features multiple drug interactions reports. Search PDRhealth at http://www.pdrhealth.com/drug_info/index.html. Other Web Sites Drugs.com (www.drugs.com) reproduces the information in the Pharmacopeia as well as commercial information. You may also want to consider the Web site of the Medical Letter, Inc. (http://www.medletter.com/) which allows users to download articles on various drugs and therapeutics for a nominal fee. If you have any questions about a medical treatment, the FDA may have an office near you. Look for their number in the blue pages of the phone book. You can also contact the FDA through its toll-free number, 1-888-INFO-FDA (1-888-463-6332), or on the World Wide Web at www.fda.gov.

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APPENDICES

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APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.

NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute13: •

Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm

•

National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/

•

National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html

•

National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25

•

National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm

•

National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm

•

National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375

•

National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/

13

These publications are typically written by one or more of the various NIH Institutes.

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•

National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm

•

National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/

•

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm

•

National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm

•

National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/

•

National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/

•

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm

•

National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html

•

National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm

•

National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm

•

National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm

•

National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html

•

National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm

•

Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp

•

National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/

•

National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp

•

Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html

•

Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm

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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.14 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:15 •

Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html

•

HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html

•

NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html

•

Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/

•

Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html

•

Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html

•

Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/

•

Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html

•

Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html

•

Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html

•

MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html

14

Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 15 See http://www.nlm.nih.gov/databases/databases.html.

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•

Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html

•

Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html The Combined Health Information Database

A comprehensive source of information on clinical guidelines written for professionals is the Combined Health Information Database. You will need to limit your search to one of the following: Brochure/Pamphlet, Fact Sheet, or Information Package, and “hearing loss” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For the publication date, select “All Years.” Select your preferred language and the format option “Fact Sheet.” Type “hearing loss” (or synonyms) into the “For these words:” box. The following is a sample result: •

Early Identification of Hearing Loss: Implementing Universal Newborn Hearing Screening Programs Source: Rockville, MD: Maternal and Child Health Bureau (MCHB), Health Resources and Services Administration (HRSA), U.S. Department of Health and Human Services. 1999. 36 p. Contact: Available from National Maternal and Child Health Clearinghouse (NMCHC). 2070 Chain Bridge Road, Suite 450, Vienna, VA 22182-2536. (703) 356-1964. Fax (703) 821-2098. Website: www.nmchc.org. PRICE: Single copy free. Summary: This booklet offers a checklist of 13 items that need to be addressed in implementing and operating a successful early identification of hearing loss program for newborns. The booklet provides a brief explanation of each activity in the checklist. Items are: enlisting support for newborn hearing screening; determining an appropriate protocol for each individual hospital; dealing with procedural issues; communicating with parents, physicians, and hospital staff; training newborn hearing screeners; keeping referral rates low; managing data and patient information; financing the program; caring for equipment and supplies; reporting; completing audiological diagnosis and follow up; coordinating with state systems; and considering legislative mandates. The material in the booklet is based on the experience of staff and collaborators of the national Center for Hearing Assessment and Management (NCHAM), who have directly or indirectly assisted with the implementation and successful operation of hundreds of hospital based newborn hearing screening programs. The appendices referred to in the booklet and additional information and supporting materials for starting hospital based newborn hearing screening programs are available from NCHAM (www.usu.edu/~ncham). The booklet is illustrated with full color photographs of equipment, patients, and health care staff involved in newborn hearing screening programs. 3 tables. 21 figures.

•

Journey Through Late Deafness: Results of a Focus Group Study Source: San Diego, CA: California School of Professional Psychology. 1997. 21 p.

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Contact: Available from California School of Professional Psychology Rehabilitation Research and Training Center on Mental Health for Persons Who are Hard of Hearing or Late Deafened. 6160 Cornerstone Court East, San Diego, CA 92121. E-mail: [email protected]. PRICE: Single copy free. Summary: This document reports on the results of a series of focus groups with late deafened adults and their family members. Questions posed during these groups attempted to get to the heart of significant issues related to hearing loss that strikes in adulthood. Issues include personal adjustment, employment barriers, communication issues, family dynamics, and social factors. This report outlines the process of the focus group study, provides readers with the significant findings of that process, gives recommendations and suggestions regarding future research, and describes a model service delivery system developed with consumer input. The number one concern reiterated by both individuals who were late deafened and family members was communication difficulty: at home, in the workplace, and with friends and other family members. Other concerns of people the focus groups included: dealing with depression and withdrawal, learning coping skills, finding information about deafness, staying positive, socializing, issues of independence, and intimacy. The report concludes with a recommendation for a proposed Individual and Family Life Center for Late Deafened adults. The center would be research-based and would serve a regional area. The initial center would conduct research and provide training in the area of late deafness, and would support the development of a regional system of Individual and Family Life Centers. 5 appendices. 9 figures. •

Hearing Loss and Hearing Aid Use in the United States: Highlights of the National Center for Health Statistics' Report 'Prevalence and Characteristics of Persons with Hearing Trouble: United States 1990-91' Source: Rockville, MD: American Speech-Language-Hearing Association (ASHA), Science and Research Department. 1995. 2 p. Contact: Available from American Speech-Language-Hearing Association (ASHA). Science and Research Department. 10801 Rockville Pike, Rockville, MD 20852. (301) 8975700. PRICE: Single copy free. Summary: This fact sheet from the American Speech-Language Hearing Association (ASHA) offers information on hearing loss and hearing aid use in the United States. The fact sheet presents highlights of the National Center for Health Statistics' report entitled 'Prevalence and Characteristics of Persons with Hearing Trouble: United States, 1990-91.' After a brief description of the National Health Interview Survey, the fact sheet covers general findings, types and degrees of hearing loss, hearing aid use. and use of other assistive devices. The fact sheet concludes with information on how readers can obtain the full NCHS report. 3 references.

•

Early identification of hearing loss: Implementing universal newborn screening programs Source: [Rockville, MD: Division of Services for Children with Special Health Needs, Maternal and Child Health Bureau, U.S. Department of Health and Human Services]. [1998?]. 2 v. Contact: Available from National Maternal and Child Health Clearinghouse, 2070 Chain Bridge Road, Suite 450, Vienna, VA 22182-2536. Telephone: (703) 356-1964 / fax: (703) 821-2098 / e-mail: [email protected] / Web site: http://www.circsol.com/mch. Available at no charge.

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Summary: This report addresses universal newborn hearing screening (UNHS). The full report is forthcoming. Extensive appendices provide supporting information. [Funded by the Maternal and Child Health Bureau]. •

Hearing Loss: A Guide to Prevention and Treatment Source: Boston, MA: Harvard Health Publications. 2000. 41 p. Contact: Available from Harvard Health Publications. P.O. Box 421073, Palm Coast, FL 32142-1073. Website: www.health.harvard.edu. PRICE: $16.00 plus shipping and handling. Summary: This report from the Harvard Medical School offers an overview of the prevention and treatment of hearing loss. The report begins with a review of the anatomy and physiology of hearing, then describes the diagnostic tests that may be used to evaluate hearing. The next section discusses the use of hearing aids, including the new technology, hearing aid dispensing, choosing hearing aid circuitry, deciding between one hearing aid (monaural) or two (binaural), fitting a hearing aid, and adjusting to a hearing aid. Surgical options for hearing loss, including cochlear implants and other surgeries, are also considered. Additional sections cover current research and technology directions, coping with hearing loss, and preventing hearing loss. The booklet concludes with a list of resources (organizations and publications) and a glossary of related terms. Various sidebars include a do it yourself five minute hearing test, a definition of the roles of hearing professionals, a description of tinnitus (ringing in the ears), assistive listening devices (besides hearing aids), hearing loss and the law, and noise induced hearing loss. The report is illustrated with black and white photographs. 6 figures. Hearing.

The NLM Gateway16 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.17 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “hearing loss” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category.

16 17

Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.

The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH).

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Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total

Items Found 36764 399 939 53 5 38160

HSTAT18 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.19 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.20 Simply search by “hearing loss” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

Coffee Break: Tutorials for Biologists21 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.22 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.23 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.

18

Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html.

19

The HSTAT URL is http://hstat.nlm.nih.gov/.

20

Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations. 21 Adapted from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html. 22 The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 23 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.

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Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •

CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.

•

Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.

The Genome Project and Hearing Loss In the following section, we will discuss databases and references which relate to the Genome Project and hearing loss. Online Mendelian Inheritance in Man (OMIM) The Online Mendelian Inheritance in Man (OMIM) database is a catalog of human genes and genetic disorders authored and edited by Dr. Victor A. McKusick and his colleagues at Johns Hopkins and elsewhere. OMIM was developed for the World Wide Web by the National Center for Biotechnology Information (NCBI).24 The database contains textual information, pictures, and reference information. It also contains copious links to NCBI’s Entrez database of MEDLINE articles and sequence information. To search the database, go to http://www.ncbi.nlm.nih.gov/Omim/searchomim.html. Type “hearing loss” (or synonyms) into the search box, and click “Submit Search.” If too many results appear, you can narrow the search by adding the word “clinical.” Each report will have additional links to related research and databases. In particular, the option “Database Links” will search across technical databases that offer an abundance of information. The following is an example of the results you can obtain from the OMIM for hearing loss: •

Arthrogryposis-like Hand Anomaly and Sensorineural Deafness Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?108200

•

Ataxia, Deafness, and Cardiomyopathy Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?208750

•

Ataxia, Fatal X-linked, with Deafness and Loss of Vision Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?301835

•

Ataxia-deafness-retardation Syndrome Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?208850

•

Atresia of External Auditory Canal and Conduction Deafness Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?108760

24 Adapted from http://www.ncbi.nlm.nih.gov/. Established in 1988 as a national resource for molecular biology information, NCBI creates public databases, conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information--all for the better understanding of molecular processes affecting human health and disease.

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•

Axenfeld-rieger Anomaly with Cardiac Defects and Sensorineural Hearing Loss Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?602482

•

Brachycephaly, Deafness, Cataract, Microstomia, and Mental Retardation Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?601353

•

Brachydactyly, Intraventricular Septal Defect, and Deafness Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?602561

•

Bulbar Palsy, Progressive, with Sensorineural Deafness Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?211530

•

Cataract-ataxia-deafness-retardation Syndrome Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?212710

•

Cerebellar Ataxia and Neurosensory Deafness Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?212850

•

Cerebellar Ataxia, Areflexia, Pes Cavus, Optic Atrophy, and Sensorineural Hearing Loss Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?601338

•

Charcot-Marie-Tooth Disease and Deafness Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?118300

•

Corneal Degeneration, Ribbonlike, with Deafness Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?121450

•

Corneal Dystrophy and Perceptive Deafness Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?217400

•

Corneal Hypesthesia with Retinal Abnormalities, Sensorineural Deafness, Unusual Facies, Persistent Ductus Arteriosus, and Mental Retardation Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?122430

•

Craniofacial-Deafness-Hand Syndrome Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?122880

•

Cutis Verticis Gyrata, Retinitis Pigmentosa, and Sensorineural Deafness Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?605685

•

Deafness and Onychodystrophy, Dominant Form Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?124480

•

Deafness with Anhidrotic Ectodermal Dysplasia Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?125050

•

Deafness with Ear Pits Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?125100

•

Deafness, Autosomal Dominant 16 Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?603964

•

Deafness, Autosomal Dominant 20 Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?604717

•

Deafness, Autosomal Dominant 39, with Dentinogenesis Imperfecta 1 Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?605594

•

Deafness, Autosomal Dominant 52 Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?607683

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Deafness, Autosomal Dominant Nonsyndromic Sensorineural 1 Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?124900

•

Deafness, Autosomal Dominant Nonsyndromic Sensorineural 10 Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?601316

•

Deafness, Autosomal Dominant Nonsyndromic Sensorineural 11 Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?601317

•

Deafness, Autosomal Dominant Nonsyndromic Sensorineural 12 Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?601842

•

Deafness, Autosomal Dominant Nonsyndromic Sensorineural 13 Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?601868

•

Deafness, Autosomal Dominant Nonsyndromic Sensorineural 15 Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?602459

•

Deafness, Autosomal Dominant Nonsyndromic Sensorineural 17 Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?603622

•

Deafness, Autosomal Dominant Nonsyndromic Sensorineural 18 Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?606012

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Deafness, Autosomal Dominant Nonsyndromic Sensorineural 2 Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?600101

•

Deafness, Autosomal Dominant Nonsyndromic Sensorineural 21 Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?607017

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Deafness, Autosomal Dominant Nonsyndromic Sensorineural 22 Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?606346

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Deafness, Autosomal Dominant Nonsyndromic Sensorineural 23 Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?605192

•

Deafness, Autosomal Dominant Nonsyndromic Sensorineural 24 Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?606282

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Deafness, Autosomal Dominant Nonsyndromic Sensorineural 25 Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?605583

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Deafness, Autosomal Dominant Nonsyndromic Sensorineural 3 Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?601544

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Deafness, Autosomal Dominant Nonsyndromic Sensorineural 30 Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?606451

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Deafness, Autosomal Dominant Nonsyndromic Sensorineural 36 Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?606705

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Deafness, Autosomal Dominant Nonsyndromic Sensorineural 4 Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?600652

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Deafness, Autosomal Dominant Nonsyndromic Sensorineural 44 Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?607453

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Deafness, Autosomal Dominant Nonsyndromic Sensorineural 5 Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?600994

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Deafness, Autosomal Dominant Nonsyndromic Sensorineural 6 Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?600965

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Deafness, Autosomal Dominant Nonsyndromic Sensorineural 7 Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?601412

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Deafness, Autosomal Dominant Nonsyndromic Sensorineural 8 Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?601543

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Deafness, Autosomal Dominant Nonsyndromic Sensorineural 9 Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?601369

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Deafness, Autosomal Dominant Nonsyndromic Sensorineural, due to Mutation in Myo1a Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?607841

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Deafness, Autosomal Recessive Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?220700

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Deafness, Autosomal Recessive Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?607197

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Deafness, Autosomal Recessive 13 Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?603098

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Deafness, Autosomal Recessive 15 Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?601869

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Deafness, Autosomal Recessive 16 Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?603720

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Deafness, Autosomal Recessive 20 Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?604060

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Deafness, Autosomal Recessive 21 Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?603629

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Deafness, Autosomal Recessive 27 Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?605818

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Deafness, Autosomal Recessive 30 Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?607101

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Deafness, Autosomal Recessive 31 Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?607084

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Deafness, Autosomal Recessive 33 Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?607239

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Deafness, Autosomal Recessive 9 Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?601071

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Deafness, Cochlear, with Myopia and Intellectual Impairment Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?221200

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Deafness, Conductive, with Malformed External Ear Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?221300

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Deafness, Conductive, with Ptosis and Skeletal Anomalies Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?221320

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Deafness, Conductive, with Stapes Fixation Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?304400

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Deafness, Congenital Neurosensory, Autosomal Recessive 37 Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?607821

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Deafness, Congenital Neurosensory, Autosomal Recessive 40 Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?608264

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Deafness, Congenital, and Familial Myoclonic Epilepsy Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?220300

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Deafness, Congenital, and Onychodystrophy, Recessive Form Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?220500

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Deafness, Congenital, and Split Hands and Feet Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?220600

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Deafness, Congenital, with Keratopachydermia and Constrictions of Fingers and Toes Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?124500

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Deafness, Congenital, with Total Albinism Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?220900

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Deafness, Congenital, with Vitiligo and Achalasia Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?221350

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Deafness, High-frequency Sensorineural, X-linked Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?304590

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Deafness, Low-frequency Hearing Loss, Mixed Conductive-sensorineural Type Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?124910

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Deafness, Mid-tone Neural Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?124700

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Deafness, Nerve Type, with Mesenteric Diverticula of Small Bowel and Progressive Sensory Neuropathy Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?221400

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Deafness, Neural, Congenital Moderate Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?221500

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Deafness, Neural, Early Onset Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?221600

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Deafness, Neural, Progressive Childhood Type Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?221650

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Deafness, Neural, with Atypical Atopic Dermatitis Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?221700

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Deafness, Neurosensory, Autosomal Recessive 1 Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?220290

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Deafness, Neurosensory, Autosomal Recessive 17 Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?603010

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Deafness, Neurosensory, Autosomal Recessive 18 Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?602092

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Deafness, Neurosensory, Autosomal Recessive 4 Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?600791

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Deafness, Neurosensory, Autosomal Recessive 5 Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?600792

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Deafness, Neurosensory, Autosomal Recessive 6 Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?600971

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Deafness, Neurosensory, Autosomal Recessive 7 Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?600974

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Deafness, Progressive High-tone Neural Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?124800

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Deafness, Progressive, with Stapes Fixation Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?601449

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Deafness, Sensorineural, with Peripheral Neuropathy and Arterial Disease Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?124950

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Deafness, Unilateral Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?125000

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Deafness, X-linked 2, Sensorineural Congenital Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?304500

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Deafness, X-linked 4, Congenital Sensorineural Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?300030

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Deafness, X-linked 6, Progressive Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?300066

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Deafness-Craniofacial Syndrome Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?125230

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Deafness-Hypogonadism Syndrome Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?304350

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Deafness-Oligodontia Syndrome Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?221740

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Deafness--Optic Atrophy Syndrome Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?125250

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Diabetes-Deafness Syndrome, Maternally Transmitted Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?520000

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Earlobes, Thickened, with Conductive Deafness from Incudostapedial Abnormalities Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?128980

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Ectodermal Dysplasia and Neurosensory Deafness Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?224800

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Epiphyseal Dysplasia of Femoral Head, Myopia, and Deafness Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?226950

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Facial Dysmorphism, Cleft Palate, Hearing Loss, and Camptodactyly Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?602556

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Fibromatosis, Gingival, with Progressive Deafness Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?135550

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Friedreich Ataxia, So-called, with Optic Atrophy and Sensorineural Deafness Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?136600

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Gonadal Dysgenesis, Xx Type, with Deafness Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?233400

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Growth Retardation, Deafness, Femoral Epiphyseal Dysplasia, and Lacrimal Duct Obstruction Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?601351

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Hearing Loss, Sensorineural, with Enamel Hypoplasia and Nail Defects Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?234580

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Hypoparathyroidism, Sensorineural Deafness, and Renal Dysplasia Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?146255

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Hypospadias, Hypertelorism, Upper Lid Coloboma, and Mixed-type Hearing Loss Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?603463

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Ichthyosis, Hystrix-like, with Deafness Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?602540

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Keratitis-ichthyosis-deafness Syndrome, Autosomal Dominant Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?148210

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Keratoderma, Palmoplantar, with Deafness Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?148350

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Knuckle Pads, Leukonychia, and Sensorineural Deafness Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?149200

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Macrothrombocytopenia and Progressive Sensorineural Deafness Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?600208

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Mastocytosis, Cutaneous, with Short Stature, Conductive Hearing Loss and Microtia Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?248910

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Metaphyseal Dysostosis, Mental Retardation, and Conductive Deafness Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?250420

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Microtia with Meatal Atresia and Conductive Deafness Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?251800

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Mitochondrial Deafness Modifier Gene 1 Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?221745

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Myoclonus, Cerebellar Ataxia, and Deafness Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?159800

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Nephrosis with Deafness and Urinary Tract and Digital Malformations Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?256200

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Neuroendocrine Carcinoma of Salivary Glands, Sensorineural Hearing Loss, and Enamel Hypoplasia Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?603641

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Neuropathy, Axonal Motor-sensory, with Deafness and Mental Retardation Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?310490

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Optic Atrophy, Deafness, Ophthalmoplegia, and Myopathy Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?165490

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Optic Atrophy, Hearing Loss, and Peripheral Neuropathy Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?165199

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Optic Atrophy, Nerve Deafness, and Distal Neurogenic Amyotrophy Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?258650

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Optic Atrophy, Polyneuropathy, and Deafness Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?311070

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Otosclerosis Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?166800

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Phocomelia-ectrodactyly, Ear Malformation, Deafness, and Sinus Arrhythmia Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?171480

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Pili Torti and Nerve Deafness Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?262000

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Prune Belly Syndrome with Pulmonic Stenosis, Mental Retardation, and Deafness Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?264140

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Renal Tubular Acidosis with Progressive Nerve Deafness Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?267300

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Retinitis Pigmentosa Inversa with Deafness Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?268010

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Retinitis Pigmentosa-deafness Syndrome 1, Autosomal Dominant Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?601850

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Sensorineural Hearing Loss, Retinal Pigment Epithelium Lesions, Discolored Teeth Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?602340

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Split-hand/foot Malformation with Sensorineural Hearing Loss Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?605617

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Thumb, Hypoplastic, with Choroid Coloboma, Poorly Developed Antihelix, and Deafness Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?274205

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Tibia, Absence Of, with Congenital Deafness Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?275230

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Tune Deafness Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?191200 Genes and Disease (NCBI - Map)

The Genes and Disease database is produced by the National Center for Biotechnology Information of the National Library of Medicine at the National Institutes of Health. This Web site categorizes each disorder by system of the body. Go to http://www.ncbi.nlm.nih.gov/disease/, and browse the system pages to have a full view of important conditions linked to human genes. Since this site is regularly updated, you may wish to revisit it from time to time. The following systems and associated disorders are addressed: •

Cancer: Uncontrolled cell division. Examples: Breast and ovarian cancer, Burkitt lymphoma, chronic myeloid leukemia, colon cancer, lung cancer, malignant melanoma, multiple endocrine neoplasia, neurofibromatosis, p53 tumor suppressor, pancreatic cancer, prostate cancer, Ras oncogene, RB: retinoblastoma, von Hippel-Lindau syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Cancer.html

•

Immune System: Fights invaders. Examples: Asthma, autoimmune polyglandular syndrome, Crohn’s disease, DiGeorge syndrome, familial Mediterranean fever, immunodeficiency with Hyper-IgM, severe combined immunodeficiency. Web site: http://www.ncbi.nlm.nih.gov/disease/Immune.html

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Metabolism: Food and energy. Examples: Adreno-leukodystrophy, atherosclerosis, Best disease, Gaucher disease, glucose galactose malabsorption, gyrate atrophy, juvenile-onset diabetes, obesity, paroxysmal nocturnal hemoglobinuria, phenylketonuria, Refsum disease, Tangier disease, Tay-Sachs disease. Web site: http://www.ncbi.nlm.nih.gov/disease/Metabolism.html

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Muscle and Bone: Movement and growth. Examples: Duchenne muscular dystrophy, Ellis-van Creveld syndrome, Marfan syndrome, myotonic dystrophy, spinal muscular atrophy. Web site: http://www.ncbi.nlm.nih.gov/disease/Muscle.html

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Nervous System: Mind and body. Examples: Alzheimer disease, amyotrophic lateral sclerosis, Angelman syndrome, Charcot-Marie-Tooth disease, epilepsy, essential tremor, fragile X syndrome, Friedreich’s ataxia, Huntington disease, Niemann-Pick disease, Parkinson disease, Prader-Willi syndrome, Rett syndrome, spinocerebellar atrophy, Williams syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Brain.html

•

Signals: Cellular messages. Examples: Ataxia telangiectasia, Cockayne syndrome, glaucoma, male-patterned baldness, SRY: sex determination, tuberous sclerosis, Waardenburg syndrome, Werner syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Signals.html

•

Transporters: Pumps and channels. Examples: Cystic fibrosis, deafness, diastrophic dysplasia, Hemophilia A, long-QT syndrome, Menkes syndrome, Pendred syndrome, polycystic kidney disease, sickle cell anemia, Wilson’s disease, Zellweger syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Transporters.html Entrez

Entrez is a search and retrieval system that integrates several linked databases at the National Center for Biotechnology Information (NCBI). These databases include nucleotide sequences, protein sequences, macromolecular structures, whole genomes, and MEDLINE through PubMed. Entrez provides access to the following databases: •

3D Domains: Domains from Entrez Structure, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=geo

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Books: Online books, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=books

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Genome: Complete genome assemblies, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Genome

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NCBI’s Protein Sequence Information Survey Results: Web site: http://www.ncbi.nlm.nih.gov/About/proteinsurvey/

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Nucleotide Sequence Database (Genbank): Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Nucleotide

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OMIM: Online Mendelian Inheritance in Man, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=OMIM

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PopSet: Population study data sets, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Popset

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ProbeSet: Gene Expression Omnibus (GEO), Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=geo

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Protein Sequence Database: Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Protein

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PubMed: Biomedical literature (PubMed), Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed

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Structure: Three-dimensional macromolecular structures, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Structure

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Taxonomy: Organisms in GenBank, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Taxonomy

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To access the Entrez system at the National Center for Biotechnology Information, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=search&DB=genome, and then select the database that you would like to search. The databases available are listed in the drop box next to “Search.” Enter “hearing loss” (or synonyms) into the search box and click “Go.” Jablonski’s Multiple Congenital Anomaly/Mental Retardation (MCA/MR) Syndromes Database25 This online resource has been developed to facilitate the identification and differentiation of syndromic entities. Special attention is given to the type of information that is usually limited or completely omitted in existing reference sources due to space limitations of the printed form. At http://www.nlm.nih.gov/mesh/jablonski/syndrome_toc/toc_a.html, you can search across syndromes using an alphabetical index. Search by keywords at http://www.nlm.nih.gov/mesh/jablonski/syndrome_db.html. The Genome Database26 Established at Johns Hopkins University in Baltimore, Maryland in 1990, the Genome Database (GDB) is the official central repository for genomic mapping data resulting from the Human Genome Initiative. In the spring of 1999, the Bioinformatics Supercomputing Centre (BiSC) at the Hospital for Sick Children in Toronto, Ontario assumed the management of GDB. The Human Genome Initiative is a worldwide research effort focusing on structural analysis of human DNA to determine the location and sequence of the estimated 100,000 human genes. In support of this project, GDB stores and curates data generated by researchers worldwide who are engaged in the mapping effort of the Human Genome Project (HGP). GDB’s mission is to provide scientists with an encyclopedia of the human genome which is continually revised and updated to reflect the current state of 25

Adapted from the National Library of Medicine: http://www.nlm.nih.gov/mesh/jablonski/about_syndrome.html. 26 Adapted from the Genome Database: http://gdbwww.gdb.org/gdb/aboutGDB.html - mission.

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scientific knowledge. Although GDB has historically focused on gene mapping, its focus will broaden as the Genome Project moves from mapping to sequence, and finally, to functional analysis. To access the GDB, simply go to the following hyperlink: http://www.gdb.org/. Search “All Biological Data” by “Keyword.” Type “hearing loss” (or synonyms) into the search box, and review the results. If more than one word is used in the search box, then separate each one with the word “and” or “or” (using “or” might be useful when using synonyms).

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APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on hearing loss can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internet-based services that post them.

Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to hearing loss. Due to space limitations, these sources are listed in a concise manner. Do not hesitate to consult the following sources by either using the Internet hyperlink provided, or, in cases where the contact information is provided, contacting the publisher or author directly. The National Institutes of Health The NIH gateway to patients is located at http://health.nih.gov/. From this site, you can search across various sources and institutes, a number of which are summarized below. Topic Pages: MEDLINEplus The National Library of Medicine has created a vast and patient-oriented healthcare information portal called MEDLINEplus. Within this Internet-based system are “health topic pages” which list links to available materials relevant to hearing loss. To access this system, log on to http://www.nlm.nih.gov/medlineplus/healthtopics.html. From there you can either search using the alphabetical index or browse by broad topic areas. Recently, MEDLINEplus listed the following when searched for “hearing loss”:

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Other guides Acoustic Neuroma http://www.nlm.nih.gov/medlineplus/acousticneuroma.html Dizziness and Vertigo http://www.nlm.nih.gov/medlineplus/dizzinessandvertigo.html Ear Disorders http://www.nlm.nih.gov/medlineplus/eardisorders.html Ear Infections http://www.nlm.nih.gov/medlineplus/earinfections.html Hearing Disorders & Deafness http://www.nlm.nih.gov/medlineplus/hearingdisordersdeafness.html Meniere's Disease http://www.nlm.nih.gov/medlineplus/menieresdisease.html Speech & Communication Disorders http://www.nlm.nih.gov/medlineplus/speechcommunicationdisorders.html

Within the health topic page dedicated to hearing loss, the following was listed: •

Diagnosis/Symptoms Five Minute Hearing Test Source: American Academy of Otolaryngology--Head and Neck Surgery http://www.entnet.org/healthinfo/hearing/hearing_test.cfm Hearing Problems: Self-Care Flowcharts Source: American Academy of Family Physicians http://familydoctor.org/flowcharts/508.html Understanding Your Audiogram Source: American Academy of Audiology http://www.audiology.org/consumer/guides/uya.php

•

Treatment Cochlear Implants Source: National Institute on Deafness and Other Communication Disorders http://www.nidcd.nih.gov/health/hearing/coch.asp Cochlear Implants: Who Can Get Them? Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=HQ00441 Digital Hearing Aids: Current “State-of-the-Art” Source: American Speech-Language-Hearing Association http://www.asha.org/public/hearing/treatment/digital_aid.htm Frequently Asked Questions About Hearing Aids Source: American Academy of Audiology http://www.audiology.org/consumer/guides/hafaq.php

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Hearing Aids Source: National Institute on Deafness and Other Communication Disorders http://www.nidcd.nih.gov/health/hearing/hearingaid.asp Mind Hears: Tuning In with a Cochlear Implant Source: American Speech-Language-Hearing Association http://www.asha.org/public/hearing/treatment/mind_hears.htm Straight Talk from FDA About Hearing Loss and Hearing Aids http://www.fda.gov/opacom/lowlit/hearaid.html What Are Assistive Listening Devices or “ALDs”? Source: American Speech-Language-Hearing Association http://www.asha.org/public/hearing/treatment/assist_tech.htm •

Coping Adult Aural Rehabilitation Source: American Speech-Language-Hearing Association http://www.asha.org/public/hearing/treatment/adult_aur_rehab.htm Communication and Alerting Devices for Deaf and Hard of Hearing People: What's Available Now Source: Gallaudet University, Laurent Clerc National Deaf Education Center http://clerccenter.gallaudet.edu/InfoToGo/418.html Deaf or Hard-of-Hearing: Tips for Working With Your Doctor Source: American Academy of Family Physicians http://familydoctor.org/handouts/240.html Frequently Asked Questions about FCC Provisions for People with Disabilities Source: Federal Communications Commission http://www.fcc.gov/cgb/dro/dtffaq.html Getting Through: Talking to a Person Who is Hard of Hearing Source: American Academy of Audiology http://www.audiology.org/consumer/guides/getthru.php

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Specific Conditions/Aspects American Sign Language Source: National Institute on Deafness and Other Communication Disorders http://www.nidcd.nih.gov/health/hearing/asl.asp Auditory Neuropathy Source: National Institute on Deafness and Other Communication Disorders http://www.nidcd.nih.gov/health/hearing/neuropathy.asp Autoimmune Inner Ear Disease (AIED) Source: American Academy of Otolaryngology--Head and Neck Surgery http://www.entnet.org/healthinfo/hearing/autoimmune.cfm Captions for Deaf and Hard-of-Hearing Viewers Source: National Institute on Deafness and Other Communication Disorders http://www.nidcd.nih.gov/health/hearing/caption.asp

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Earwax Source: American Academy of Otolaryngology--Head and Neck Surgery http://www.entnet.org/healthinfo/ears/earwax.cfm Hearing Loss and Bone Disorders Source: Osteoporosis and Related Bone Diseases-National Resource Center http://www.osteo.org/newfile.asp?doc=r604i&doctitle=Hearing%2BLoss%2B%252 6%2BBone%2BDisorders&doctype=HTML%2BFact%2BSheet How Deaf People Communicate Source: Gallaudet University, Laurent Clerc National Deaf Education Center http://clerccenter.gallaudet.edu/InfoToGo/492/492-1.html Medication Effects on Hearing Source: American Speech-Language-Hearing Association http://www.asha.org/public/hearing/disorders/med_effects.htm Otosclerosis Source: National Institute on Deafness and Other Communication Disorders http://www.nidcd.nih.gov/health/hearing/otosclerosis.asp Perforated Eardrum Source: American Academy of Otolaryngology--Head and Neck Surgery http://www.entnet.org/healthinfo/ears/perforation.cfm Risk of Bacterial Meningitis in Children with Cochlear Implants Source: National Center on Birth Defects and Developmental Disabilities http://www.cdc.gov/ncbddd/ehdi/cochlear/default.htm Sudden Deafness Source: National Institute on Deafness and Other Communication Disorders http://www.nidcd.nih.gov/health/hearing/sudden.asp Types of Hearing Loss Source: American Speech-Language-Hearing Association http://www.asha.org/public/hearing/disorders/types.htm Use of Vaccines for the Prevention Meningitis in Persons with Cochlear Implants Source: National Immunization Program http://www.cdc.gov/nip/issues/cochlear/cochlear-gen.htm Usher Syndrome Source: National Institute on Deafness and Other Communication Disorders http://www.nidcd.nih.gov/health/hearing/usher.asp Waardenburg Syndrome Source: National Institute on Deafness and Other Communication Disorders http://www.nidcd.nih.gov/health/hearing/waard.asp •

From the National Institutes of Health Im Lang Vang http://www.nidcd.nih.gov/health/hearing/VietSilence.pdf NIHSeniorHealth: Hearing Loss Source: National Institute on Deafness and Other Communication Disorders http://nihseniorhealth.gov/hearingloss/toc.html

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Latest News Hearing Loss Risk May Be Set Before Birth Source: 11/21/2003, Reuters Health http://www.nlm.nih.gov//www.nlm.nih.gov/medlineplus/news/fullstory_14780 .html Methotrexate Not Effective in Maintaining Improvements in Hearing Gained from Prednisone Source: 10/07/2003, National Institute on Deafness and Other Communication Disorders http://www.nih.gov/news/pr/oct2003/nidcd-07.htm

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Pictures/Diagrams Atlas of the Body: The Ear Source: American Medical Association http://www.medem.com/MedLB/article_detaillb.cfm?article_ID=ZZZYXNW46JC &sub_cat=198

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Prevention/Screening Choose the Hearing Protection That's Right for You Source: National Institute for Occupational Safety and Health http://www.cdc.gov/niosh/topics/noise/abouthlp/chooseprotection.html Have WISE EARS! For Life: Protect Yourself and Your Family from NoiseInduced Hearing Loss Source: National Institute on Deafness and Other Communication Disorders http://www.nidcd.nih.gov/health/hearing/wiseears.asp Hearing Screening Source: American Speech-Language-Hearing Association http://www.asha.org/public/hearing/testing/ Noise and Hearing Protection Source: American Academy of Otolaryngology--Head and Neck Surgery http://www.entnet.org/healthinfo/hearing/noise_hearing.cfm

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Research Better Communication Needed to Reduce Infants 'Lost to Follow-Up' Source: National Institute on Deafness and Other Communication Disorders http://www.nidcd.nih.gov/health/inside/spr03/pg1.asp Children with Cochlear Implants at Increased Risk for Bacterial Meningitis Source: Centers for Disease Control and Prevention http://www.cdc.gov/od/oc/media/pressrel/r030730.htm Early Diagnosis of Usher Syndrome Type 1 Made Possible by New Findings Source: National Institute on Deafness and Other Communication Disorders http://www.nidcd.nih.gov/news/releases/03/04_23_03.asp

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Key to Lifelong Hearing Identified as Continous Self-Renewal of the Sensory Sterocilia Source: National Institute on Deafness and Other Communication Disorders http://www.nidcd.nih.gov/news/releases/02/8_21_02.asp Methotrexate Not Effective in Maintaining Improvements in Hearing Gained from Prednisone Source: National Institute on Deafness and Other Communication Disorders http://www.nih.gov/news/pr/oct2003/nidcd-07.htm Mutation of Key Protein Causes Rare Form of Hearing Loss That's Easily Confused with Otosclerosis Source: National Institute on Deafness and Other Communication Disorders http://www.nidcd.nih.gov/news/releases/02/8_01_02.asp New 'Deafness' Gene Causes Two Forms of Hearing Loss Source: National Institute on Deafness and Other Communication Disorders http://www.nidcd.nih.gov/news/releases/02/3_01_02.asp New Gene Linked to Deafness in Humans, Mice Source: National Institute on Deafness and Other Communication Disorders http://www.nidcd.nih.gov/news/releases/02/9_03_02.asp Researchers Use Gene Therapy to Grow New Hair Cells in Mammals Source: National Institute on Deafness and Other Communication Disorders http://www.nidcd.nih.gov/news/releases/03/06_05_03.asp 'SWAT'z New? -- A Fly That's Setting the Hearing World Abuzz Source: National Institute on Deafness and Other Communication Disorders http://www.nidcd.nih.gov/health/education/news/swatz.asp Teenage Inventor Brings Sign-Translating Glove to NIDCD Source: National Institute on Deafness and Other Communication Disorders http://www.nidcd.nih.gov/news/releases/02/3_19_02.asp You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on hearing loss. CHID offers summaries that describe the guidelines available, including contact information and pricing. CHID’s general Web site is http://chid.nih.gov/. To search this database, go to http://chid.nih.gov/detail/detail.html. In particular, you can use the advanced search options to look up pamphlets, reports, brochures, and information kits. The following was recently posted in this archive:

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Communication Strategies for People with Hearing Loss Source: Boston, MA: Massachussetts Commission for the Deaf and Hard of Hearing (MCDHH). 200x. [2 p.]. Contact: Available from Massachussetts Commission for the Deaf and Hard of Hearing (MCDHH). 210 South Street, Fifth Floor, Boston, MA 02111-2725. (800) 882-1155 or (617) 695-7500. TTY/TDD (800) 530-7570 or (617) 695-7600. Fax (617) 695-7599. Website: www.mcdhh.state.ma.us. PRICE: Single copy free. Summary: A person with hearing loss faces many life challenges that have no single solution. This brochure, produced by the Massachusetts Commission for the Deaf and Hard of Hearing (MCDHH), provides some information and strategies to help people with hearing loss, their families, friends, and co-workers communicate more effectively. The brochure focuses on practical strategies, including informing people about one's hearing loss, setting up good environments for communication (proper lighting, reduction in background noise, appropriate seating, rules for communicating), and tips for family members and others who want to assist in a good communication process. The brochure reminds readers that hearing loss can have an isolating effect. The brochure includes a checklist of symptoms that readers can use to reveal a hearing loss. The brochure is primarily aimed at elderly readers and is illustrated with full color photographs.

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Information for Teachers About Hearing Loss, Hearing Aids, and FM Systems Source: Naperville, IL: Phonak, Inc. 1997. 12 p. Contact: Available from Phonak, Inc. P.O. Box 3017, Naperville, IL 60566. (800) 777-7333 or (708) 505-7007. Fax (630) 505-2830. E-mail: [email protected]. PRICE: Single copy free. Summary: Children with hearing loss need the educators in their lives to offer support and understanding of how hearing affects their communication, learning, and social development, as well as a willingness to provide the necessary modifications. This brochure outlines some of the strategies that may be used to incorporate those modifications. Topics include the physiology of hearing loss, the different types of hearing losses, how hearing aids work, the use of FM systems in the classroom setting, communication strategies, and how to improve the classroom listening environment for all students. The brochure concludes with a list of instructions for performing a daily listening check. A list of resource organizations is included on the back cover of the brochure. 4 figures.

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Chronic Otitis Media (Middle Ear Infection) and Hearing Loss Source: Alexandria, VA: American Academy of Otolaryngology-Head and Neck Surgery. 2003. Contact: Available from American Academy of Otolaryngology-Head and Neck Surgery. One Prince St., Alexandria, VA 22314-3357. (703) 836-4444. TTY: (703) 519-1585. Web site: www.entnet.org/kidsent. PRICE: Available free online. Summary: Chronic ear infections, if left untreated, can cause temporary or permanent hearing loss in a child. This fact sheet describes what otitis media is as well as how otitis media affects a child's hearing. The two types of hearing loss, the appropriate time for having a child's hearing tested, and other possible causes of temporary hearing loss are also described.

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HIV/AIDS Related Hearing Loss Source: American Academy of Audiology. Reston, VA. 2002. Contact: American Academy of Audiology. Publications, 11730 Plaza America Drive, Suite 300, Reston, VA 20190. Voice 800-AAA-2336; 703-790-8466. Fax: 703-790-8631. Web site: http://www.audiology.org/store. PRICE: Pkgs. of 100. Members: $25.00; NonMembers: $30.00. Summary: Intended for anyone concerned about this issue for themselves, a family member or a friend, this brochure discusses the connection between HIV/AIDS and hearing loss and explains how this type of hearing loss can be prevented, what treatments are available, and why it is crucial for HIV/AIDS patients with hearing loss to work closely with an audiologist. 6-page fold-out.

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Coping with Hearing Loss Source: Postgraduate Medicine. 104(3): 93-99, 103-104. September 1998. Contact: Available from Postgraduate Medicine. P.O. Box 459, Hightstown, NJ 085209201. (609) 426-7070. Fax (609) 426-7087. Summary: Loss of hearing is a national health problem with significant physical and psychological repercussions. This patient education handout accompanies an article for professionals that discusses the important role of primary care physicians in early identification, management, and counseling of patients with hearing loss. The handout emphasizes that there are many resources available to help overcome hearing loss, however many people choose to ignore the problem and risk increased damage before they seek help or information. The handout briefly reviews conductive and sensorineural hearing loss, the latter including age-related hearing loss (presbycusis). The handout also advises readers that the new generations of hearing aids are common and powerful and can help many people with hearing loss. The handout includes an illustration of the anatomy of the ear, a quick self-test to determine if a hearing loss is present, a list of suggestions to protect hearing in noisy situations, and a list of the sound levels of common noises in the safe, risk, and injury ranges. 1 figure.

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Safe, In Sound: Protecting Yourself from Hearing Loss Source: Livonia, MI: International Hearing Society (IHS). 1999. [4 p.]. Contact: Available from International Hearing Society (IHS). 16880 Middlebelt Road, Suite 4, Livonia, MI 48154. (734) 522-7200. Fax (734) 522-0200. Website: www.hearingihs.org. PRICE: Available in bulk orders only, $25.00 for 100 plus shipping and handling. Summary: Noise induced hearing loss (NIHL) is a growing concern among people of all ages. NIHL can happen over time or with a single exposure to a loud sound. This brochure reviews the related concepts and offers common sense hearing precautions. Topics include how the hearing loss can occur, how to detect hearing loss, practicing safe hearing strategies (including being aware of noisy environments, using ear protection devices, and decreasing the volume whenever possible), and the identification of hearing loss. The brochure describes the certification process for hearing instrument specialists and the role of the International Hearing Society. The brochure notes that sensitivity to noise differs between individuals, but encourages readers to pay attention to both their own body and their sound environment. One chart demonstrates the loudness of everyday sounds and activities, from a whispered voice,

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through common household appliances, to jet planes, jackhammers, and firearms. The brochure is produced by the International Hearing Society (IHS) that advocates and supports the highest standard of professional competency, business integrity, and excellence in serving the hearing impaired. The toll free telephone number of the Hearing Aid Helpline is provided (800 521 5247). •

Understanding Otosclerosis: What To Expect from Stapes Surgery Source: Seattle, WA: Otolaryngology-Head and Neck Surgery Center, University of Washington Medical Center. 1997. 8 p. Contact: Available from Virginia Merrill Bloedel Hearing Research Center. University of Washington, Box 357923, Seattle, WA 98195-7923. (206) 616-4105. E-mail: [email protected]. Website: weber.u.washington.edu/~hearing. PRICE: Single copy free. Summary: Otosclerosis is a common cause of conductive hearing loss in adults. This brochure reviews the problem of otosclerosis and its treatment with stapes surgery. The brochure stresses that modern stapes surgery, in most cases, restores hearing without complications. The brochure first reviews the problem of otosclerosis, normal ear function, and the different types of hearing loss. The brochure then discusses hearing loss from otosclerosis, including stapedial otosclerosis and cochlear otosclerosis; the treatment of otosclerosis, including hearing aids and surgical options (drug therapy is not effective for otosclerosis); recommendations for surgery, which are based on the level of hearing loss in both ears and the status of the inner ear function; the stapes operation (stapedectomy or stapedotomy); what to expect in hearing improvement following stapes surgery; tinnitus; complications following stapedectomy, including dizziness, taste disturbance, loss of hearing, ear drum perforation, and weakness of the face; and the role of hearing aids for people with otosclerosis. One illustration familiarizes readers with the anatomy of the inner ear. 4 figures.

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Otosclerosis Source: Bethesda, MD: National Institute on Deafness and Other Communication Disorders (NIDCD), National Institutes of Health (NIH). May 1999. [3 p.]. Contact: Available from NIDCD Information Clearinghouse. 1 Communication Avenue, Bethesda, MD 20892-3456. Voice (800) 241-1044. TTY (800) 241-1055. Fax (301) 907-8830. E-mail: [email protected]. Website: www.nidcd.nih.gov. PRICE: Single copy free. NIH Publication Number 99-4234. Summary: Otosclerosis is the abnormal growth of bone of the inner ear. This abnormal growth prevents structures within the ear from working properly and causes hearing loss. This fact sheet describes otosclerosis and how it is managed. Written in a question and answer format, the fact sheet covers the physiology and anatomy of hearing, the different ways that otosclerosis can cause hearing impairment, the causes of otosclerosis, the symptoms of otosclerosis, diagnostic tests and treatment options for otosclerosis, and research studies being conducted to improve understanding of otosclerosis. The fact sheet concludes with a list of resource organizations through which readers can obtain additional information. 1 figure.

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Asking Your Audiologist About Preventing and Identifying Hearing Loss Through Audiologic Screening and Audiology Services Source: Rockville, MD: American Speech-Language-Hearing Association (ASHA). 2000. 4 p. Contact: Available from American Speech-Language-Hearing Association (ASHA). Action Center, 10801 Rockville Pike, Rockville, MD 20852. (800) 638-8255. E-mail: [email protected]. Website: www.asha.org. PRICE: Single copy free for members. Summary: Prevention and early detection of hearing disorders can reduce the prevalence of hearing loss and the associated disability when hearing loss interferes with daily communication and quality of life. This fact sheet offers information on the role of audiologic screening and audiology services in the prevention and identification of hearing loss. Written in a question and answer format, the fact sheet discusses the following topics: who should receive audiologic screenings; three core procedures that make up the audiologic screening program; the screening of newborns and infants; recommended screenings through childhood; adult audiologic screenings; steps that may be recommended following an audiologic screening; and the other services that an audiologist can provide. Adults who do not pass audiologic screening are counseled regarding hearing loss and may receive a recommendation for a comprehensive audiologic assessment. A medical evaluation may be recommended if the screening indicates a medical condition requiring evaluation, monitoring, or treatment. The fact sheet concludes with the contact information for the American Speech Language Hearing Association (ASHA), including their web site (www.asha.org). 2 references.

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Noise-Induced Hearing Loss: Fact Sheet Source: St. Paul, MN: Sight and Hearing Association. 1997. 2 p. Contact: Available from Sight and Hearing Association. 674 Transfer Road, St. Paul, MN 55114. (800) 992-0424 or (612) 992-0424. Fax (612) 645-2742. E-mail: [email protected]. Website: www.sightandhearing.org. PRICE: Single copy free; $20.00 per 100 copies. Summary: Sounds of sufficient intensity and duration will damage the ear and result in temporary or permanent hearing loss. This fact sheet outlines noise-induced hearing loss (NIHL), which is hearing loss resulting from overexposure to noise. NIHL occurs gradually and without pain. The fact sheet reviews the causes of NIHL, prevention strategies, and statistics about NIHL (including common sources of loud sounds and their decibel levels). Noise-induced hearing loss affects both the quantity and quality of sound. Hearing damaged by noise is permanently lost and cannot be repaired. Adequate hearing protection should be utilized when one is exposed to loud noise at work or play. One line drawing illustrates the anatomy of the ear. 1 figure.

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Practical Guide to: Hearing Loss Prevention for Musicians Source: Denver, CO: National Hearing Conservation Association. 1997. [2 p.]. Contact: Available from National Hearing Conservation Association. 9101 Kenyon Avenue, Suite 3000, Denver, CO 80237. (303) 224-9022. Fax (303) 770-1812. Website: www.hearingconservation.org. PRICE: $0.25; bulk copies available. Summary: The mission of the National Hearing Conservation Association (NHCA) is to prevent hearing loss due to noise and other environmental factors in all sectors of society. This brochure from the NHCA offers a practical guide to hearing loss prevention for musicians. The brochure begins with a section that describes the

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symptoms of noisy environments that can affect the hearing, including tinnitus (ringing in the ears), temporary threshold shift, and the need to raise one's voice in the environment. The next section offers specific strategies for musicians to lower their risk of noise induced hearing loss (NIHL). These include: turn down the stage volume, monitor the monitors, use hearing protection devices (special versions are available for musicians), position equipment properly, and keep rehearsal noise levels down. One section describes the total cumulative noise dose one is exposed to each day; a chart of typical sound levels is included. The brochure notes that while rock musicians get their share of the blame for playing too loud, significant exposure to noise can occur in many other musical settings. A final section briefly reviews the physiology of the hearing mechanism and how noise can affect the hair cells in the inner ear. 2 figures. •

NICD: Publications from the National Information Center on Deafness Source: Washington, DC: National Deaf Education Network and Clearinghouse, Laurent Clerc National Deaf Education Center. 1996. 8 p. Contact: National Deaf Education Network and Clearinghouse. KDES PAS-6, 800 Florida Avenue, NE, Washington, DC 20002-3695. Voice/TTY (800) 526-9105 or (202) 651-5340. Fax (202) 651-5708. E-mail: [email protected]. Website: clerccenter.gallaudet.edu. PRICE: Single copy free. Summary: The National Information Center on Deafness (NICD) is a centralized source of information about hearing loss and deafness. This brochure lists the publications available from NICD. The brochure provides a description and price for materials in twelve categories: for and about deaf and hard of hearing people; especially for children and their teachers; assistive devices and hearing aids; careers and employment; communication and sign language; education; Gallaudet University; health and mental health; legal focus; especially for parents; special interest; and free handouts. The brochure includes an order form and ordering information.

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Physician's Guide for Identifying Hearing Loss: Practical Information on Screening, Referral, Reimbursement Source: Washington, DC: Better Hearing Institute. 1997. 20 p. Contact: Available from Better Hearing Institute. P.O. Box 1840, Washington, DC 20013. (800) EAR-WELL. Fax (703) 750-9302. E-mail: [email protected]. Website: www.betterhearing.org. PRICE: Single copy free. Summary: The primary care physician plays a major role in the early identification of hearing loss, in both children and adults. This brochure provides physicians with a guide to identifying hearing loss in their patients. The brochure explains why hearing loss can be considered a health problem and thus an appropriate concern for a physician. The brochure provides a brief overview of the physiology of hearing, and discusses types of hearing loss (conductive and sensorineural); consequences of impaired hearing; psychological effects of hearing loss; screening, referral and reimbursement issues; types of hearing aids that are presently available; counseling advice for the patients; and the physician's role. The issues discussed in the screening, referral, and reimbursement section include which patients should be screened (indications for screening), self-hearing test (a 10-item checklist of questions is included), screening audiometers, reimbursement policies and codes, and how to determine which patients should be referred to an audiologist for more extensive screening.

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Your Child's Hearing Loss: First Steps for You and Your Family Source: Minneapolis, MN: Miracle-Ear Children's Foundation. 1995. 16 p. Contact: Available from Miracle-Ear Children's Foundation. P.O. Box 59261, Minneapolis, MN 55459-0261. (800) 234-5422. PRICE: Single copy free; bulk rates available. Summary: This booklet educates parents on hearing loss in children, focusing particularly on the role of hearing aids for children. Written for parents who have just learned that their child has a hearing loss, the booklet first explains the types of hearing loss and the physiology of hearing. The brochure stresses that early identification enables both conductive and sensorineural hearing losses to be addressed before there is a long-term impact on the child's communication and learning skills. The brochure describes hearing aids, alternative communication devices (FM systems, TTYs, alerting devices), suggestions for communicating with the child in the home environment, strategies for classroom communication, and the emotional issues surrounding the hearing loss. The brochure reminds parents that they must also tend to their own needs as the family adjusts to having a child with a hearing loss. The brochure concludes with a list of resource organizations through which parents can obtain support and additional information. The brochure is available in either English or Spanish.

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People with Hearing Loss and Health Care Facilities: A Guide for Hospitals to Comply with the Americans with Disabilities Act Source: Bethesda, MD: Self Help for Hard of Hearing People, Inc. (SHHH). 1993. 56 p. Contact: Available from SHHH Publications. 7910 Woodmont Avenue, Suite 1200, Bethesda, MD 20814. (301) 657-2248. Fax (301) 913-9413. TTY (301) 657-2249. E-mail: [email protected]. Website: www.shhh.org. PRICE: $25.00 for SHHH members, $30.00 for nonmembers; plus shipping and handling. Order number HOSPB. Summary: This booklet is designed to help hospitals and other health care facilities offer better services to their clients with hearing loss and better comply with the Americans With Disabilities Act (ADA). The booklet discusses Access 2000, an international commitment to communication access for people with hearing loss, that focuses on community-wide accessibility in public facilities and service industries, and the establishment of the International Symbol of Access for Hearing Loss. The booklet includes five sections: understanding hearing loss; the role of the ADA and other laws; other Title II provisions; Access 2000 and the 4-point program for hospitals, which covers technology, patient identification, staff training, and publicity; and technology, i.e., the equipment and services recommended for the 4-point program. The authors include case studies of what other hospitals are doing to improve communication access. The booklet includes a checklist of hospital accessibility for people with hearing loss, and six appendices, including guidelines for new construction, the use of sign language interpreters and interpreter services, text telephones and their use, troubleshooting hearing aids, and equipment and services. The booklet concludes with a list of resource organizations and companies and a glossary of terms.

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What Parents Should Know About Hearing Loss Source: New York, NY: League for the Hard of Hearing. 1997. 12 p. Contact: Available from League for the Hard of Hearing. 71 West 23rd Street, New York, NY 10010. Voice (212) 741-7650. TTY (212) 255-1932. Fax (212) 255-4413. E-mail:

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[email protected]. Website: www.lhh.org. PRICE: $0.75 each for 1-25 copies; $0.60 each for 26100 copies; $0.50 each for 100 plus copies. Summary: This booklet present information for parents who are faced with decisions after their child is diagnosed with a hearing loss. The booklet emphasizes that informed parents can be better advocates for their child. The booklet reflects the League for the Hard of Hearing's experience since 1910, offers introductory information, and emphasizes the aural and oral habilitative approach for children who have a hearing loss. This is the approach used by the League's Children's Communication Program. Specific topics include a definition of hearing loss, the causes of hearing loss in young children, acquired hearing loss, the different types of hearing loss, the role of colds and ear infections, diagnostic strategies, the team approach to care (audiologist, otologist, psychologist, speech language pathologist, parents), the importance of early diagnosis, the beginnings of speech in a child with hearing loss, the role of hearing aids, binaural (both ears) versus monaural (one ear) hearing aids, progressive hearing loss, and cochlear implants. The booklet concludes with a brief glossary and a list of related pamphlets from the League. •

Altered World: Living with New Deafness Source: Washington, DC: National Deaf Education Network and Clearinghouse, Laurent Clerc National Deaf Education Center. 1998. 52 p. Contact: National Deaf Education Network and Clearinghouse. KDES PAS-6, 800 Florida Avenue, NE, Washington, DC 20002-3695. Voice/TTY (800) 526-9105 or (202) 651-5340. Fax (202) 651-5708. E-mail: [email protected]. Website: clerccenter.gallaudet.edu. PRICE: $3.00 plus shipping and handling. Summary: This booklet provides information for late-deafened people, focusing on the adaptations required for previously hearing people to learn to cope with their hearing loss. The booklet first identifies two crucial aspects to defining this group of people. First, late-deafened people have an acquired hearing loss; for many years they have had normal or nearly normal hearing; and their language, identities, and cultural and educational experiences are those of hearing people. Second, late-deafened people are, in the audiological sense, deaf. That is, even with the best amplification, they cannot continue to use hearing to understand speech. The authors note that this line separating hard of hearing people from deafened people is not clear or objective. People define themselves based on their experience with communication, their comfort with particular coping strategies, and on social and support groups that match their experience and preferences. After this introductory section on definitions, the booklet covers six main areas: crisis, or the diagnostic stage, including the problem of tinnitus; communication adaptations; work, including vocational rehabilitation, and laws that protect people with disabilities; accommodations for home and recreation; getting support; and moving on. The booklet concludes with a resources section. 19 references.

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Hearing Loss: How to Get Help: A Guide for Consumers by Consumers Source: Bethesda, MD: Self Help for Hard of Hearing People, Inc. (SHHH). 1994. 8 p. Contact: Available from Self Help for Hard of Hearing People, Inc. (SHHH). 7910 Woodmont Avenue, Suite 1200, Bethesda, MD 20814. VOICE (301) 657-2248; TTY (301) 657-2249; FAX (301) 913-9413. PRICE: Single copy free; available in bulk for those who wish to distribute them (shipping cost only).

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Summary: This booklet was written for consumers by consumers in clear, non-technical language to help the person with a hearing loss know where to go for help. The main sections are: Getting Your Hearing Tested; Getting a Hearing Aid; Selecting a Dispenser; Purchasing the Right Hearing Aid for You; What to Expect from Your Hearing Aid; Learning to Use a Hearing Aid; and Aural Rehabilitation. Resources, including telephone numbers, are listed in each section. The booklet also includes helpful hints and quotations from people who have been through the process of needing, purchasing, and learning to use a hearing aid. •

So Your Child Has a Hearing Loss: Next Steps for Parents Source: Washington, DC: Alexander Graham Bell Association for the Deaf and Hard of Hearing. February 2000. 31 p. Contact: Available from Alexander Graham Bell Association for the Deaf and Hard of Hearing. 3417 Volta Place, NW, Washington, DC 20007-2778. Voice (202) 337-5220. TTY (202) 337-5221. Fax (202) 337-8314. Website: www.agbell.org. PRICE: Single copy free. Summary: This booklet was written for parents of children of all ages who have been diagnosed with any degree of hearing loss. The booklet offers an overview of early identification of hearing loss, the types of hearing screenings used for babies and children, early intervention, hearing aids, cochlear implants, communication options, guidelines for auditory education, special education (the IDEA and IEP), classroom support aids, mainstreaming, the use of communication aids at home, and social development. The authors stress that, as with all children, there is no magic formula for raising a child with hearing loss. It helps to maintain a positive attitude, educate oneself about hearing loss, seek out the best resources, and take an active role in the child's education. The booklet is illustrated with black and white photographs and concludes with an annotated list of references and resources, including organizations serving parents of children using auditory approaches, organizations providing general information about hearing loss, and organizations serving families primarily using manual approaches. 5 figures.

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Hearing and Hearing Loss: How the Ear Functions and Possible Causes of Hearing Loss Source: Naperville, IL: Phonak, Inc. 1998. [6 p.]. Contact: Available from Phonak, Inc. P.O. Box 3017, Naperville, IL 60566. (800) 777-7333 or (708) 505-7007. Fax (630) 505-2830. E-mail: [email protected]. PRICE: Single copy free. Summary: This booklet, one in a series describing the role of hearing in one's quality of life, reviews the anatomy and physiology (including function) of the ears and the hearing system. Topics include the parts of the outer, middle, and inner ear, and what each part does; the possible causes of hearing loss arising in each part of the ear; and the impact of hearing loss on speech perception. Typical problems in the middle ear include perforation of the eardrum, infection (otitis media) and otosclerosis (a calcification around the stapes, limiting its ability to move). Many outer and middle ear problems can be treated medically or surgically. When this is not possible, a remaining conductive hearing loss can be assisted by using hearing aids. The vast majority of hearing losses are a result of damage to the inner ear structures. Typical problems include the natural aging process (the most frequent cause of hearing loss), excessive exposure to noise, intake of medication which is toxic to the auditory system, head trauma, and hereditary factors. In these cases, the tiny hair cells in the cochlea are damaged, usually

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permanently. This damage cannot be corrected medically but most of sensorineural hearing losses can be alleviated by the use of hearing instruments. 6 figures. •

About Hearing Loss Source: South Deerfield, MA: Channing L. Bete Co., Inc. 1995. 16 p. Contact: Available from Channing L. Bete Co., Inc. 200 State Road, South Deerfield, MA 01373. Voice (800) 628-7733 or (413) 665-7611; Fax (413) 665-2671. PRICE: $1.25 each for 1-24 copies; bulk prices available; shipping and handling additional. Item Number S12740. Summary: This booklet, written for the general public, uses line drawings to explain ear anatomy, function, hearing impairments, diagnoses, and treatments, including hearing aids. A description of the various health professionals who treat and evaluate hearing impairments is included.

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Living with a Hearing Loss Source: New York, NY: League for the Hard of Hearing. 2000. [4 p.]. Contact: Available from League for the Hard of Hearing. 71 West 23rd Street, New York, NY 10010-4162. Voice (917) 305-7700. TTY (917) 305-7999. Fax (917) 305-7888. Website: www.lhh.org. PRICE: $0.75 plus shipping and handling. Summary: This brochure attempts to describe the different perspectives that hearing people and people with hearing loss have about communication strategies and the psychosocial impact of hearing loss. The brochure offers a set of situations in which communication may be difficult and the resulting strain may make communication seem to be more trouble that it is worth. The brochure notes that socializing, trying to participate and communicate with others often becomes exhausting for people who are deaf or hard of hearing. The brochure then offers some suggestions for improving this situation and increasing the ease with which people communication with each other. The brochure stresses that the challenges are not insurmountable and the rewards of good communication are many. The brochure includes a list of specific tips for good communication with people who have hearing loss. The brochure concludes with a list of other materials available from the League for the Hard of Hearing; contact information is also provided (www.lhh.org).

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HIV-AIDS-Related Hearing Loss Source: McLean, VA: American Academy of Audiology. 1997. [2 p.]. Contact: Available from American Academy of Audiology. 8300 Greensboro Drive, Suite 750, McLean, VA 22102-3611. (703) 790-8466. Fax (703) 790-8631. Website: www.audiology.org. PRICE: $20.00 for 100 for members; $27.00 for 100 for nonmembers, plus shipping and handling. Summary: This brochure describes the connection between hearing loss and the presence of HIV or AIDS. For people with HIV or AIDS, hearing loss can result from damage in the ear caused by other opportunistic infections, damage in the ear caused by toxic side effects of some medications, and damage in the ear caused by the HIV itself. Various studies show that 20 to 49 percent of people with HIV or AIDS have some degree of temporary or permanent hearing loss during the source of the disease. The brochure reviews the symptoms of hearing loss, prevention strategies, testing to diagnose hearing loss, the types of services available from an audiologist, treatments for

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hearing loss (including medical treatment and audiological rehabilitation), and cost considerations. Readers are encouraged to deal with any impediment to communication, including hearing loss, because of quality of life issues. The brochure concludes with the contact information for the American Academy of Audiology, though which readers can get recommendations for locating an audiologist. 3 figures. •

Dominant Progressive Hearing Loss (DPHL) Project Source: Omaha, NE: DPHL Project, Boys Town National Research Hospital. 1997. [4 p.]. Contact: Available from DPHL Project. Center for Hereditary Communication Disorders, Boys Town National Research Hospital, 555 North 30th Street, Omaha, NE 68131. (800) 320-1171; http://www.boystown.org/. PRICE: Single copy free. Summary: This brochure describes the Dominant Progressive Hearing Loss (DPHL) Project. DPHL is an inherited condition which can cause people to gradually lose their hearing (sensorineural hearing loss). There are no other medical or physical features associated with the condition; however, some may experience ringing of the ears (tinnitus) or balance problems. DPHL is caused by a single dominant gene. The brochure summarizes the characteristics of DPHL and describes a current genetic research project with the goal of discovering the genes for DPHL and determining how the genes cause hearing loss. The brochure encourages readers to participate in the project. The only way to follow the pattern of inheritance in these genes is by working with large families which have DPHL. The brochure briefly describes the requirements of people who participate in the study. The brochure includes a self-mailer for readers who are interested in finding out more about the study or in volunteering. 4 figures.

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Recessive Non-Syndromic Hearing Loss: (RNSD) Project Source: Omaha, NE: RNSD Project, Boys Town National Research Hospital. 1998. [4 p.]. Contact: Available from Boys Town National Research Hospital. Genetics Department, RNSD Project, 555 North 30th Street, Omaha, NE 68131. Voice/TTY (800) 835-1468. Email: [email protected] or [email protected]. Website: www.boystown.org. PRICE: Single copy free. Summary: This brochure describes the recessive nonsyndromic hearing loss (RNSD) project of the Boys Town National Research Hospital. Studies indicate that over 75 percent of people with hereditary hearing loss have RNSD. The brochure explains why it is important to study genetic hearing loss, how a child gets RNSD, and the implications of joining the RNSD project. The study involves obtaining medical histories and blood samples from family members who participate (families who have children with RNSD); additional clinical tests may be performed on some participants. All information provided or developed through genetic testing is confidential. The brochure includes a postage-paid mailing card for readers who wish to participate or find out more about the study. 1 figure.

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Ototoxic Medications: Drugs That Can Cause Hearing Loss and Tinnitus Source: New York, NY: League for the Hard of Hearing. 2000. [4 p.]. Contact: Available from League for the Hard of Hearing. 71 West 23rd Street, New York, NY 10010-4162. Voice (917) 305-7700. TTY (917) 305-7999. Fax (917) 305-7888. Website: www.lhh.org. PRICE: $2.00 plus shipping and handling.

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Summary: This brochure discusses which commonly used medications could potentially cause damage to one's hearing, or aggravate an already existing problem. Ototoxic medications are drugs that can cause hearing loss and tinnitus. The brochure notes that usually any hearing problem will only be caused by exceeding the recommended dosage of the medications. Often these problems are reversible upon discontinuation of the drug. Occasionally there are times when the change in hearing can be permanent. The bulk of the brochure includes lists and brief descriptions of drugs that can cause hearing loss, including salicylates, nonsteroidal antiinflammatory drugs (NSAIDs), antibiotics, diuretics, chemotherapeutic agents, quinine, mucosal protectant, and narcotic analgesics; and drugs that can cause tinnitus, including vapors, solvents, antibiotics, anti-neoplastics, diuretics, cardiac medications, psychopharmacologic agents, NSAIDs, glucocorticosteroids, anesthetics, antimalarials, and miscellaneous toxic substances. In the lists, the generic name of the drug is given first, with the trade name, if available, followed in parentheses and capitalized. Many times a particular generic drug is manufactured under several trade names. The brochure concludes with information about the activities of the League for the Hard of Hearing (www.lhh.org). •

You Have a Hearing Loss: What You Need to Know Source: Minneapolis, MN: Miracle-Ear Children's Foundation. 1997. [4 p.]. Contact: Available from Miracle-Ear Children's Foundation. P.O. Box 59261, Minneapolis, MN 55459-0261. (800) 234-5422. PRICE: Single copy free. Summary: This brochure helps children understand a diagnosis of hearing loss. The brochure emphasizes that, with the help of hearing aids, assistive devices, speechreading, sign language, and other helpful things, children with hearing loss can communicate with just about anyone. The brochure encourages children to ask questions of their health care providers, to talk with family members, and to talk with teachers about changes that need to be made in the classroom setting. The brochure concludes with a section encouraging children to participate in school and after-school activities, even if a hearing loss means they do things differently than some of the other children do. The brochure emphasizes that people with hearing loss can do whatever they set their minds to doing. The brochure is illustrated with full-color photographs of a series of active children.

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Something to talk About: Spoken Language Approaches for Children with Hearing Loss Source: Washington, DC. AGBell. 2002. 6p. Contact: Available from AGBell. 3417 Volta Place, NW, Washington, DC 20007. 202-3375220; TTY 202-337-5221; Fax 202-337-8314. E-mail: [email protected]. Web site: www.agbell.org. PRICE: 10 copies $2.25; 50 copies $9.00; 100 copies $17.00; 1000 copies $170.00. Summary: This brochure outlines different approaches to teaching children with hearing loss that focus on developing speech, listening, and spoken language skills. The approaches covered include auditory/oral, Auditory-Verbal, and Cued Speech. Tips for parents on how to stimulate speech and language development in their hearingimpaired infant are also provided.

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Facts About Hearing Loss in Children Source: Washington, DC: Alexander Graham Bell Association for the Deaf and Hard of Hearing. 2000. [4 p.]. Contact: Available from Alexander Graham Bell Association for the Deaf and Hard of Hearing. 3417 Volta Place, NW, Washington, DC 20007-2778. Voice (202) 337-5220. TTY (202) 337-5221. Fax (202) 337-8314. Website: www.agbell.org. PRICE: $2.00 for 10 copies; $8.00 for 50 copies, plus shipping and handling. Summary: This brochure provides an overview of basic information about hearing loss in children. The brochure stresses that any degree of hearing loss can have a negative impact on the child's education; even children with mild to moderate hearing loss can miss up to 50 percent of classroom discussions. Unmanaged hearing loss in children can affect their speech and language development as well as their academic capabilities and development. It can also affect their self image and social emotional development. The brochure reviews the types of hearing losses that are found in children, the potential impact of frequent middle ear infections on a child's hearing, the symptoms of hearing loss in children (by age group), how newborns and other young infants can be assessed for a hearing loss, what to do for a suspected hearing loss, treatment options for children with hearing loss (hearing aids, cochlear implants, various educational strategies), the problem of loud noises (noise induced hearing loss), and the types of modifications that can be made in a classroom for children with hearing loss. The brochure emphasizes that the key to success in children with hearing loss is early diagnosis and early intervention. The brochure notes 5 related publications that are available from the AG Bell Association (202-337-5220).

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Hearing Conservation: A Guide to Preventing Hearing Loss Source: San Bruno, CA: Krames Communications. 1994. 16 p. Contact: Available from Krames Communications. 1100 Grundy Lane, San Bruno, CA 94066-3030. (800) 333-3032. PRICE: $1.25 plus shipping and handling; bulk discounts available. Stock Number 1092. Summary: This brochure provides basic health education information about hearing conservation. Designed as a guide to preventing hearing loss, the brochure covers the problem of noise pollution; how hearing protection devices can help prevent noiseinduced hearing loss; the physiology of normal hearing; audiological tests that measure hearing; noise and hearing loss; how different intensities of sound affect the hair cells; the components of a comprehensive hearing conservation program, including workplace testing to measure noise levels, hearing protectors, and hearing testing; and the benefits to be gained from a hearing conservation program. The brochure then describes the different types of hearing protectors, including disposable plugs, reusable plugs, headband plugs, and earmuffs. A final section provides suggestions for home and recreational safety and ear care tips. The brochure is illustrated in full-color drawings and written in clear, easy-to-understand language. It is available in either English or Spanish.

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Hearing Facts: Answers to Common Questions About Hearing Loss, Hearing Care, and Amplification Source: Minnetonka, MN: GN Danavox, Inc. 1995. 12 p. Contact: Available from GN Danavox, Inc. 5600 Rowland Road, Suite 250, Minnetonka, MN 55343. (800) 432-7835 or (612) 930-0416; Fax (612) 930-0516. PRICE: Single copy free.

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Summary: This brochure provides basic information about hearing, hearing loss, and assistive listening devices such as hearing aids. The brochure begins with a description of the typical symptoms of hearing loss, emphasizing that many people with gradual hearing loss are not aware of their hearing loss. The brochure then describes the most common types of hearing loss, including sensorineural, conductive, noise-induced, and presbycusis hearing losses; hearing evaluation and the role of the audiologist; understanding the audiogram; the role of hearing instruments as part of an aural rehabilitative process, including the use of two hearing aids (binaural listening); what to expect in the early stages of adjusting to a hearing aid; determining the level of hearing aid use that is appropriate; and communication strategies, including the basics of environmental control and speechreading. 2 figures. •

Signs of Hearing Loss Source: Port Huron, MI: Unitron Industries Ltd. 2002. 2pp. Contact: Available from Unitron Industries Inc. 3555 Walnut Street, P.O. Box 5010, Port Huron, MI 48061-5010. (800) 521-5400 or (810) 982-0166; Fax (810) 987-2011. PRICE: Single copy free; bulk orders available. Summary: This brochure provides information about the symptoms of hearing loss. After a brief description of the frequencies of sound, the brochure describes the symptoms of hearing loss in children and hearing loss in adults. In the section on hearing loss in children, the brochure asks readers questions to help ascertain whether or not a hearing loss is present. The brochure briefly explains the treatment options for hearing loss, notably the use of hearing aids. The brochure includes a space for the health care provider's name and address.

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Presbycusis: Age-Related Hearing Loss Source: Seattle, WA: Otolaryngology-Head and Neck Surgery Center, University of Washington Medical Center. 1997. 12 p. Contact: Available from Virginia Merrill Bloedel Hearing Research Center. University of Washington, Box 357923, Seattle, WA 98195-7923. (206) 616-4105. E-mail: [email protected]. Website: weber.u.washington.edu/~hearing. PRICE: Single copy free. Summary: This brochure reviews the problem of presbycusis, defined as age related hearing loss. Presbycusis is the most common form of hearing loss; everyone who lives long enough will develop some degree of presbycusis, and those who damage their ears from loud noise exposure will develop it sooner. The brochure notes that hearing loss impairs communication, subtly at first and increasing with the magnitude of the loss; this can have an impact on social activities and interpersonal relationships. The brochure reviews normal ear function and then discusses the causes of presbycusis, including aging, noise exposure, diseases, and toxins. The brochure describes the effects of presbycusis, diagnostic issues, and treatment issues and options, including hearing aids, hearing aid candidacy, assistive listening devices, cochlear implants, and medical therapy. The brochure concludes with a section emphasizing the role of prevention, particularly that achieved by preventing noise induced hearing loss (NIHL). One illustration familiarizes readers with the anatomy of the inner ear. 5 figures.

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How to Have a Winning Year Teaching Your Student with Hearing Loss Source: Washington, DC: Alexander Graham Bell Association for the Deaf and Hard of Hearing. 2000. [4 p.]. Contact: Available from Alexander Graham Bell Association for the Deaf and Hard of Hearing. 3417 Volta Place, NW, Washington, DC 20007-2778. Voice (202) 337-5220. TTY (202) 337-5221. Fax (202) 337-8314. Website: www.agbell.org. PRICE: $2.00 for 10 copies; $8.00 for 50 copies, plus shipping and handling. Summary: This brochure was written for teachers who have a student with hearing loss in the classroom. The information presented is based on the premise that in order for a student with a hearing loss to have a successful mainstream experience, all aspects of school life must be considered, and the whole school must be involved. Topics include the importance of preparation (before the school year begins), creating an atmosphere conducive to mainstreaming, support services, hearing technology (hearing aids, cochlear implants, assistive listening devices, personal FM systems, and sound field FM systems), the classroom environment (acoustics and how to improve them), and how to recognize difficult situations for the student with hearing impairment, including listening to instructions, dictation and spelling tests, reading lessons, lessons using television or slide projectors, lessons using tape recorders with language lessons, introducing new topics, and standardized examinations. The brochure encourages teachers to use the ideas in the brochure to create a welcoming environment. In addition to providing the child with hearing loss with a more enriching education, by fostering an atmosphere of openness, acceptance, and sensitivity to others, the teacher will be creating a better place for all children to learn.

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Noise at Work: Is Hearing Loss on the Cards for You? Source: London, United Kingdom: Royal National Institute for Deaf People (RNID). February 1999. 11 p. Contact: Available from RNID Helpline. P.O. Box 16464, London EC1Y 8TT, United Kingdom. Voice 0870 60 50 123. TTY 0870 60 33 007. Fax 020 7296 8199. E-mail: [email protected]. Website: www.rnid.org.uk. PRICE: Single copy free. Summary: This brochure, from the Royal National Institute for Deaf People (RNID, based in London, England) reminds readers of the problem of noise exposure and the potential for noise induced hearing loss, particularly in the workplace. Topics include determining if the workplace is noisy, the effects of hearing loss, tinnitus, the Noise at Work Regulations (the British legal guidelines to protect the hearing of workers), certain high risk occupations and situations, noise measurement, and the role of noise levels outside work. The brochure concludes with a description of other educational materials available. An insert is included with the brochure for readers who would like to request more information or materials from RNID. 1 table.

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First Contact: Information for Professionals About Hearing Loss Source: Boston, MA: Massachussetts Commission for the Deaf and Hard of Hearing (MCDHH). 200x. [2 p.]. Contact: Available from Massachussetts Commission for the Deaf and Hard of Hearing (MCDHH). 210 South Street, Fifth Floor, Boston, MA 02111-2725. (800) 882-1155 or (617) 695-7500. TTY/TDD (800) 530-7570 or (617) 695-7600. Fax (617) 695-7599. Website: www.mcdhh.state.ma.us. PRICE: Single copy free.

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Summary: This brochure, produced by the Massachusetts Commission for the Deaf and Hard of Hearing (MCDHH), was developed for professionals caring for people with or at risk of developing a hearing loss. Hearing professionals need to be aware of the signs, symptoms, or behaviors of a hearing loss in order to make a proper diagnosis and referral. The brochure stresses that undiagnosed hearing loss has a high cost to individuals, families, and society. Even people with mild hearing loss feel the impact in their ability to communicate effectively, particularly in the presence of background noise. They report feeling isolated, which causes stress. Hearing loss can cause even the most conscientious patient to misunderstand physician's instructions, which can result in serious health problems. The brochure reviews the provisions of the Americans with Disabilities Act (ADA) and professional compliance requirements, offers strategies to undertake when there is suspicion of a hearing loss, and reviews the issue of hidden hearing loss in children. The brochure also notes that some medications can cause hearing loss and lists the major drug groups that are implicated. The brochure concludes with a list of the signs, symptoms, and behaviors that may signal a hearing loss. •

The ABCs in Early Intervention: Ensuring the Best Outcomes for Your Child with a Hearing Loss Source: Oberkotter Foundation. Oral Deaf Education Film and Information Office. Palo Alto, CA. 2002. Contact: Available from Oral Deaf Education Film and Information Office. P.O. Box 50215, Palo Alto, CA 94303-9465. Voice (877) ORALDEAF (672-5332). Fax (877) 672-5889. E- mail:[email protected]. Web site: http://www.oraldeafed.org. PRICE: No cost. Order 100 copies or more by telephone. Summary: This colorful brochure is written for parents of infants and children who are deaf or hard-of-hearing. It explains what happens in the first months of the life of an infant with a hearing problem, describes how the auditory brain centers develop, and gives advice on how parents can ensure the best outcomes for children who are deaf or hard-of- hearing. 4pp.

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Worker's Compensation for Occupational Hearing Loss Source: Indianapolis, IN: Aearo Company. 1996. [3 p.]. Contact: Available from Aearo Company. 5457 West 79th Street, Indianapolis, IN 46268. (317) 692-6666. Fax (317) 692-6772. Website: www.aearo.com/html/industrial/earlog.htm. PRICE: Single copy free. Summary: This fact sheet covers workers' compensation (WC) for occupational hearing loss (OHL). The author provides a perspective on the situation by summarizing available data on the current costs of WC claims for OHL, and by developing estimates of potential future costs. Topics covered include state workers' compensation programs, impairment formulas, estimates of actual state costs, estimates of potential future state costs, state workers's compensation trends, and federal and military workers' compensation. The author recounts the recent experience of a company in Georgia, in which 22 former employees filed WC claims after the shutdown of their plant. The author concludes that the potential financial costs of workers' compensation are likely to provide an additional incentive for improved hearing conservation practices. 1 figure. 1 table. 20 references.

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Noise-Induced Hearing Loss Source: Bethesda, MD: National Institute on Deafness and Other Communication Disorders (NIDCD). April 1999. [4 p.]. Contact: Available from NIDCD Information Clearinghouse. 1 Communication Avenue, Bethesda, MD 20892-3456. Voice (800) 241-1044. TTY (800) 241-1055. Fax (301) 907-8830. E-mail: [email protected]. Website: www.nidcd.nih.gov. PRICE: Single copy free. NIH Publication Number 97-4233. Summary: This fact sheet describes noise-induced hearing loss (NIHL). When an individual is exposed to harmful sounds (sounds that are too loud or loud sounds over a long period of time), sensitive structures of the inner ear can be damaged, causing NIHL. The fact sheet describes the anatomy and physiology of the ear and hearing, and outlines the sounds that are likely to cause NIHL. Also discussed are the effects of NIHL, symptoms of NIHL, risk factors and who is typically affected, strategies for preventing NIHL, and related research studies. The effect from impulse sound can be instantaneous and can result in an immediate hearing loss that may be permanent. The damage that occurs from years of continuous exposure to loud noise may be accompanied by various changes in the structure of the hair cells. NIHL can be accompanied by tinnitus, an experience of ringing, buzzing, or roaring in the ears or head. Researchers working on the mechanisms causing NIHL hope to understand more fully the internal workings of the ear, which will result in better prevention and treatment strategies. The fact sheet concludes with the contact addresses and telephone numbers for six resource organizations through which readers can obtain more information. 1 figure.

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Identifying Hearing Loss in Children: Some Basic Evaluations Source: Omaha, NE: Center for Hearing Loss in Children, Boys Town National Research Hospital (BTNRH). 1994. 2 p. Contact: Available from Boys Town National Research Hospital (BTNRH). Information Dissemination Department, 555 North 30th Street, Omaha, NE 68131-2136. (402) 4986749. PRICE: 1-10 copies free; bulk orders available. Item Number A-6 (4-94). Summary: This fact sheet describes some of the hearing tests and evaluations that may be needed when a child seems to have a hearing problem. The fact sheet also discusses why the test information is important to understanding and managing a child's hearing loss. Audiologic and medical evaluations discussed include behavioral tests; auditory brainstem response evaluation; otoacoustic emissions; vestibular evaluation; otolaryngology; medical genetics; and ophthalmology. The fact sheet concludes with a brief description of communication and developmental evaluations.

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Hearing Loss Source: Osteogenesis Imperfecta Foundation. 1998. 3 p. Contact: Available online from Osteogenesis Imperfecta Foundation. Website: www.oif.org. Summary: This fact sheet is for both health professionals and patients with osteogenesis imperfecta (OI) and discusses hearing loss in patients with OI. Hearing loss affects more than half of patients with OI. The fact sheet describes the symptoms and types of hearing loss, diagnosing hearing loss in children and young adults with OI, surgery to correct hearing loss, using hearing aids to amplify sound, and asking for help if

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experiencing a hearing loss. Organizations to contact for additional information about telecommunication devices and other services are listed. •

Hearing Loss and Older Adults Source: Bethesda, MD: National Institute on Deafness and Other Communication Disorders (NIDCD), National Institutes of Health (NIH). January 2001. [5 p.]. Contact: Available from NIDCD Information Clearinghouse. 1 Communication Avenue, Bethesda, MD 20892-3456. Voice (800) 241-1044. TTY (800) 241-1055. Fax (301) 907-8830. E-mail: [email protected]. Website: www.nidcd.nih.gov. PRICE: Single copy free. Summary: This fact sheet offers basic information about hearing loss and older adults. The fact sheet begins with a list of common symptoms of hearing loss, noting that if readers can answer three of the questions affirmatively, they may need to have their hearing checked. The fact sheet then describes the different health care providers who may be helpful in diagnosing and treating hearing loss. The fact sheet continues by noting the causes of hearing loss (including presbycusis or age related hearing loss, noise induced hearing loss, and tinnitus) and describing treatments and devices that may be used to improve one's hearing. These can include hearing aids, personal listening systems, TV listening systems, direct audio input hearing aids, telephone amplifying devices, mobile phone amplifying devices, auditorium type assistive listening devices (ALDs), cochlear implants, and speechreading. The fact sheet also reviews strategies that can be used to improve communication with someone who has a hearing loss. The fact sheet concludes with the contact information for a number of organizations including the National Institute on Deafness and Other Communication Disorders (NIDCD, 800-241-1044, www.nidcd.nih.gov), the Alexander Graham Bell Association for the Deaf and Hard of Hearing (800-HEAR-KID, www.agbell.org), the American Tinnitus Association (800-634-8978, www.ata.org), the American Academy of Otolaryngology Head and Neck Surgery (www.entnet.org), the American Academy of Audiology (800-AAA-2336, www.audiology.org), Self Help for Hard of Hearing People (www.shhh.org), the American Speech-Language-Hearing Association (800-638-8255, www.asha.org), the League for the Hard of Hearing (www.lhh.org), the National Institute on Aging Information Center (800-222-2225, www.nih.gov/nia), and WISE EARS! Health Education Campaign (www.nidcd.nih.gov).

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Hearing Loss and Its Implications for Learning and Communication Source: Rockville, MD: American Speech-Language-Hearing Association (ASHA). 2000. 5 p. Contact: Available from American Speech-Language-Hearing Association (ASHA). Action Center, 10801 Rockville Pike, Rockville, MD 20852. (800) 638-8255. E-mail: [email protected]. Website: www.asha.org. PRICE: Single copy free for members. Summary: This fact sheet offers information on hearing loss and its implications for learning and communication. Written in nontechnical language, the fact sheet discusses the following topics: the incidence of hearing loss in children; the impact of ability to hear on communication development and behavioral skills; the different types of hearing loss; how each type of hearing loss affects children (both the audiologic implications and the communication implications); central auditory processing disorders (CAPD) and how these disorders can affect children; signs and symptoms that may indicate hearing loss; and the types of services offered by an audiologist. The fact

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sheet concludes with the contact information for the American Speech Language Hearing Association (ASHA), including their web site (www.asha.org). 12 references. •

Hearing Impairment or Loss (Deafness) Source: in Griffith, H.W. Instructions for Patients. 5th ed. Orlando, FL: W.B. Saunders Company. 1994. p. 202. Contact: Available from W.B. Saunders Company. Order Fulfillment, 6277 Sea Harbor Drive, Orlando, FL 32887. (800) 545-2522; Fax (800) 874-6418. PRICE: $47.50 plus shipping and handling. ISBN: 0721649300. Summary: This fact sheet on hearing impairment or loss is from a compilation of instructions for patients, published in book format. The fact sheet provides information in three sections: basic information, including a description of the condition, frequent signs and symptoms, causes, risk factors, preventive measures, expected outcome, and possible complications; treatment, including general measures, medication, activity guidelines, and diet; and when to contact one's health care provider. The fact sheet is designed to be photocopied and distributed to patients as a reinforcement of oral instructions and as a teaching tool.

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Facts About Hearing Loss Source: Washington, DC: American Association of Retired Persons (AARP). 1997. [4 p.]. Contact: Available from American Association of Retired Persons (AARP). 601 E Street, N.W., Washington, DC 20049. (800) 424-3410 or (202) 434-2477. TTY (202) 434-6554. PRICE: Single copy free; bulk rates available. Summary: This fact sheet on hearing loss presents basic information about the extent of hearing loss in the U.S. population, the causes of hearing loss, support for people with hearing loss, and AARP (American Association of Retired Persons) resources for people with hearing loss. The fact sheet notes the myth that hearing loss inevitably accompanies aging often results in failure to seek professional help, which can lead to impaired communication, isolation, and even death (if the hearing loss is caused by an underlying medical problem, such as a tumor). Presbycusis, or hearing loss that accompanies aging, usually results from a combination of factors including heredity, circulatory disorders, exposure to excessive noise at any time of life, and changes in the ear's structure. 21 references.

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About Deafness/Hearing Loss Source: Washington, DC: National Deaf Education Network and Clearinghouse, Laurent Clerc National Deaf Education Center. 2002. 6 p. Contact: National Deaf Education Network and Clearinghouse. KDES PAS-6, 800 Florida Avenue, NE, Washington, DC 20002-3695. Voice/TTY (800) 526-9105 or (202) 651-5340. Fax (202) 651-5708. E-mail: [email protected]. Website: clerccenter.gallaudet.edu. PRICE: $1.00 plus shipping and handling. Item Number 085. Summary: This fact sheet presents general information about deafness and people who are deaf. The fact sheet first defines the four types of hearing loss, each of which can result in different problems and different possibilities for medical and nonmedical remediation. Educational implications for children are discussed and different communication choices are presented, including American Sign Language, fingerspelling, manual English, oral communication, speechreading, cued speech,

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simultaneous communication, and total communication. One section about the deaf community and adults who are deaf includes lists of organizations of and for deaf people, educational institutions, special devices and services, and suggested readings. 9 references. •

Middle Ear Problems and Hearing Loss Source: Omaha, NE: Center for Hearing Loss in Children, Boys Town National Research Hospital (BTNRH). 1992. 2 p. Contact: Available from Boys Town National Research Hospital (BTNRH). Information Dissemination Department, 555 North 30th Street, Omaha, NE 68131-2136. (402) 4986749. PRICE: 1-10 copies free; bulk orders available. Item Number A-3 (9-92). Summary: This fact sheet provides an overview of middle ear problems and hearing loss. Written in a question-and-answer format, the fact sheet covers topics including a definition of middle ear dysfunction; how middle ear dysfunction can cause hearing loss; how middle ear dysfunction can affect speech and language development or school performance; and four steps to take for the child with middle ear dysfunction and/or conductive hearing loss.

•

Hearing Loss and Bone Disorders Source: Gaithersburg, MD: Osteogenesis Imperfecta Foundation (OIF). 1996. 4 p. Contact: Available from Osteogenesis Imperfecta Foundation. 804 West Diamond Avenue, Suite 210, Gaithersburg, MD 20878. (800) 981-2663 or (301) 947-0083. Fax (301) 947-0456. Website: www.oif.org. PRICE: Single copy free. Summary: This fact sheet provides health professionals and people who have metabolic bone disorders, such as osteogenesis imperfecta (OI), with information on hearing loss. The fact sheet describes the anatomy of the ear and explains the basic mechanism of hearing, as well as the primary types of hearing impairment: conductive, sensorineural, and mixed. In addition, it discusses the diagnosis and management of hearing loss in people with OI and Paget's disease of bone. Hearing aids or a surgical procedure known as a stapedectomy may help people with OI and hearing loss. The fact sheet also lists several organizations that may be contacted for information about hearing devices and available services. 1 figure.

•

Laws that Relate to Hiring Workers with Disabilities, Including Hearing Loss Source: Washington, DC: National Deaf Education Network and Clearinghouse, Laurent Clerc National Deaf Education Center. October 1992. 4 p. Contact: National Deaf Education Network and Clearinghouse. KDES PAS-6, 800 Florida Avenue, NE, Washington, DC 20002-3695. Voice/TTY (800) 526-9105 or (202) 651-5340. Fax (202) 651-5708. E-mail: [email protected]. Website: clerccenter.gallaudet.edu. PRICE: Single copy free. Summary: This fact sheet provides introductory information on the primary laws related to the employment of persons with disabilities, an estimated 43 million people in the U.S. Laws covered include the Rehabilitation Act of 1973, notably Section 503 of this Act; the Vietnam Era Veterans Readjustment Act of 1974; State statutes; the Architectural Barriers Act; the Tax Reform Act of the Internal Revenue Code; the Americans with Disabilities Act (ADA); the Hearing Aid Compatibility Act of 1988; and the Telecommunications Accessibility Enhancement Act of 1988. Each law is described

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briefly, with a focus on how the law affects deaf people. The fact sheet concludes with a list of sources of additional information on laws related to persons with disabilities. (AA-M). •

Hearing Loss. (Perdia Auditiva) Source: Columbia, SC: National Information System for Vietnam Veterans and Their Families. 199x. 2 p. Contact: Available from National Information System for Vietnam Veterans and Their Families. Center for Developmental Disabilities, University of South Carolina, Columbia, SC 29208. (800) 922-9234, ext. 401 (out of state); (800) 922-1107 ext. 401 (in South Carolina). PRICE: Up to 50 copies free. Summary: This fact sheet provides parents with basic information about hearing loss in children. Topics covered include problems related to hearing loss in infants and children; the prevalence of children with hearing loss; the causes of hearing loss, including prenatal causes, trauma, ear infections, ototoxic drugs, and disease; the two types of hearing loss, conductive and sensorineural; and helping a child with a hearing loss through early identification, the assistance of an ENT specialist, hearing aids, ear surgery, and language training. The fact sheet concludes with a brief discussion of the educational options for children with hearing loss, and a note about the role of support groups for parents coping with the challenge of raising a child with hearing impairment. A brief list of resource organizations is included. The fact sheet is available in English or Spanish.

•

Noise Exposure and Hearing Loss Source: London, England: Royal National Institute for Deaf People. 1999. 10 p. Contact: Available from RNID Helpline. P.O. Box 16464, London EC1Y 8TT, United Kingdom. 0870 60 50 123. Fax 0171-296 8199. E-mail: [email protected]. Website: www.rnid.org.uk. PRICE: Single copy free. Summary: This fact sheet, from the British Royal National Institute for Deaf People (RNID), gives basic information about noise exposure and hearing loss. The fact sheet first briefly reviews the differences between conductive and sensorineural hearing losses, then discusses hearing loss caused by noise, including temporary threshold shift, permanent threshold shift, noise induced or occupational hearing loss, and acoustic trauma. Other topics covered include the practical effects of noise induced hearing loss (NIHL); conditions related to noise exposure, including tinnitus (ringing or other noises in the ears or head) and recruitment (narrowing of the dynamic range of hearing); the causes of NIHL; permanent damage to the cochlea; age related deafness (presbycusis); treatment options; preventing NIHL at work, including reducing noise at the source, and using ear protectors; regulations and compensation issues (in England), including industrial injuries benefits, and benefits for those in the armed forces; socioacusis (hearing loss caused by sources of noise encountered outside work); and research in the area of NIHL.

•

Hearing Loss and Medications: A Listing of Prescription Drugs and Side Effects as They Relate to the Human Ear and Central Nervous System Source: Audiology Today. 5(6): 32-35. November-December 1993. Summary: This fact sheet, printed in Audiology Today, lists prescription drugs and their side effects as they relate to the human ear and central nervous system. The fact sheet

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first lists and codifies 83 related side effects, then lists drugs alphabetically. Each drug name is followed by the code number for the related side effect. The information is taken from the 1992 PDR Drug Interactions/Side Effects Index. •

Hearing Loss? Source: American Academy of Audiology. Reston, VA. 2002. Contact: American Academy of Audiology. Publications, 11730 Plaza America Drive, Suite 300, Reston, VA 20190. Voice 800-AAA-2336; 703-790-8466. Fax: 703-790-8631. Web site: http://www.audiology.org/store. PRICE: Pkgs. of 100. Members: $40.00; NonMembers: $50.00. Summary: This full-color educational patient brochure on hearing loss includes indicators for detecting hearing loss, reasons why the patient may be unaware of a hearing loss, general information on hearing aids, the Hearing Health Quick Test, and room on the back for the physician's practice's contact information. 8-page fold-out.

•

For Consumers with a Hearing Loss: A Kit for Travel Access Source: New York, NY: League of the Hard of Hearing. 199x. [32 p.]. Contact: Available from League for the Hard of Hearing. 71 West 23rd Street, New York, NY 10010. (212) 741-7650. Fax (212) 255-4413. TTY (212) 255-1932. Website: www.lhh.org. PRICE: $10.00. Order number KA 85. Summary: This kit is designed to help people with hearing loss achieve improved accessibility when they travel. The kit reviews the rights guaranteed by the Americans with Disabilities Act (ADA), the equipment and services that are required, how to arrange a trip to make it more hearing or communication accessible, and procedures that can be helpful for travel abroad. Specific areas covered include making reservations, making hotel reservations, making a convention or meeting reservation, coping at travel terminals, preparing for the trip, packing lists, assistive listening and alerting devices, traveling alone, traveling with a group, and how to handle problems when traveling. The kit includes a sample letter of complaint, a glossary of terms, a list of sources for assistive listening and alerting devices, and a bibliography. The kit also provides international symbol of hearing access stickers, instructions for using an FM system, instructions for using oral or sign language interpreters, using a TTY, instructions for travel agents, and tips for communicating with someone with a hearing loss. The kit was compiled by the organization advocates for better communication (a.b.c.). The organization, founded in 1991, is a group of volunteers whose mission, through education and advocacy, is to make it possible for the 28 million Americans with hearing loss to participate fully in society. 4 references.

•

Nerve Deafness and You Source: Washington, DC: Better Hearing Institute. 1997. [4 p.]. Contact: Available from Better Hearing Institute. P.O. Box 1840, Washington, DC 20013. (800) EAR-WELL or (703) 684-3391. Fax (703) 750-9302. E-mail: [email protected]. Website: www.betterhearing.org. PRICE: Single copy free; bulk orders available. Summary: This pamphlet provides information to patients and the general public about sensorineural hearing loss or nerve deafness. The causes and treatments of nerve deafness are discussed.

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•

Unilateral Hearing Loss: Suggestions for your Child Source: Omaha, NE: Center for Hearing Loss in Children, Boys Town National Research Hospital (BTNRH). 1993. 2 p. Contact: Available from Boys Town National Research Hospital (BTNRH). Information Dissemination Department, 555 North 30th Street, Omaha, NE 68131-2136. (402) 4986749. PRICE: 1-10 copies free; bulk orders available. Item Numbers A-5 (3-93). Summary: This parent education fact sheet describes unilateral hearing loss and provides suggestions for parents who want to help their children deal with unilateral hearing loss. Written in a question-and-answer format, the fact sheet covers topics including a description of a unilateral hearing loss; the causes of a unilateral hearing loss; how this type of hearing loss affects listening in the classroom setting and school performance; how a unilateral hearing loss can affect the child's safety; and protecting the hearing in the child's better ear.

•

Educational Resource Guide: Noise-Induced Hearing Loss Source: Bethesda, MD: National Institute on Deafness and Other Communication Disorders Information Clearinghouse (NIDCD). 2000. 14 p. Contact: Available from National Institute on Deafness and Other Communication Disorders Information Clearinghouse (NIDCD). 1 Communication Avenue, Bethesda, MD 20892-3456. (800) 241-1044. TTY (800) 241-1055. E-mail: [email protected]. Website: www.nidcd.nih.gov. PRICE: Single copy free. Summary: This resource guide lists patient education and professional education materials in the area of noise induced hearing loss (NIHL). The materials listed include fact sheets, booklets, brochures, books, book chapters, journal and newsletter articles, posters, and videotapes. Each entry includes the title of the item, its source, and pricing information. The resource guide lists the contact information for sources (organizations and companies) in a separate section; internet websites are provided where available. The guide concludes with a title index. This resource guide is part of the WISE EARS! program, a national coalition to prevent NIHL.

•

Hearing Loss in Children: Delayed Speech and Language. Information Packet Source: Bethesda, MD: National Institute on Deafness and Other Communication Disorders (NIDCD), National Institutes of Health (NIH). 1996. 45 p. Contact: Available from National Institute on Deafness and Other Communication Disorders (NIDCD) Information Clearinghouse. 1 Communication Avenue, Bethesda, MD 20892-3456. Voice (800) 241-1044. TTY (800) 241-1055. Fax (301) 907-8830. E-mail: [email protected]. Website: www.nidcd.nih.gov. PRICE: Single copy free. Summary: This resource packet provides information about hearing impairment in children and its impact on communication. Materials in the packet include a glossary of terms; a summary of the NIH consensus conference on the early identification of hearing impairment in infants and young children; recommendations from a NIDCD Working Group covering acceptable protocols for early identification in state-wide universal hearing screening programs; an article on early screening; an article on the relationship between hearing and the development of language and speech; a list of organizational resources for speech and language disorders; and a bibliographic search on children's hearing, speech, and language. The resource lists include the name of each organization; address; voice, TTY, and fax numbers; e-mail address; and Internet address.

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Parent's Guide: Information for Parents About Hearing Loss in Children Source: Naperville, IL: Phonak, Inc. 1998. 18 p. Contact: Available from Phonak, Inc. P.O. Box 3017, Naperville, IL 60566. (800) 777-7333 or (708) 505-7007. Fax (630) 505-2830. E-mail: [email protected]. PRICE: Single copy free. Summary: Through hearing, a child develops language and communication skills, learns about the world, learns to read, appreciates music, and is warned of approaching harm. This booklet provides information for parents of children with hearing loss. Topics include speech and language development in children, how to monitor hearing throughout childhood, the types of hearing loss, how to protect the child's hearing and prevent hearing loss, and how to find help if a hearing loss is suspected in a child. One chart lists speech and language related developmental milestones for children at ages 9 months, 10 months, 1 year, 18 months, 24 months, and 3 to 5 years. The brochure stresses that the goal for children with permanent hearing loss is to optimize the auditory abilities they have in order to help them with language and academic development. The brochure concludes with a section describing the hearing aids and assistive devices available, including behind the ear (BTE) and in the ear (ITE) hearing aids, FM systems, and cochlear implants. The brochure reiterates that even a mild hearing loss during the crucial years for language and speech development can delay normal communication skill development; parents are the key to preventing this problem. 5 figures. 1 table. The National Guideline Clearinghouse™

The National Guideline Clearinghouse™ offers hundreds of evidence-based clinical practice guidelines published in the United States and other countries. You can search this site located at http://www.guideline.gov/ by using the keyword “hearing loss” (or synonyms). The following was recently posted: Source: American College of Radiology - Medical Specialty Society; 1996 (revised 1999); 8 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2440&nbr=1666&a mp;string=hearing+AND+loss •

Newborn and infant hearing loss: detection and intervention Source: American Academy of Pediatrics - Medical Specialty Society; 1999 February http://www.guideline.gov/summary/summary.aspx?doc_id=2156&nbr=1382&a mp;string=hearing+AND+loss Healthfinder™

Healthfinder™ is sponsored by the U.S. Department of Health and Human Services and offers links to hundreds of other sites that contain healthcare information. This Web site is located at http://www.healthfinder.gov. Again, keyword searches can be used to find guidelines. The following was recently found in this database:

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•

Ask an Audiologist Summary: Audiologists answer questions from the general public on hearing loss and other related issues and concerns. Source: Academy of Dispensing Audiologists® http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=4548

•

Deafness and Hearing Loss Source: National Information Center for Children and Youth with Disabilities, U.S. Department of Education http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=3408

•

Hearing Loss Source: National Institute on Aging, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=35

•

Hearing Loss and Older Adults Summary: This fact sheets offers a checklist for hearing loss to help users determine if they should see a doctor. Source: National Institute on Deafness and Other Communication Disorders Information Clearinghouse http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=6670

•

Hearing Problems Flowchart Summary: This flow chart is designed to help direct you if hearing loss is a problem for you or a family member. You can check your symptoms to decide on self-care or getting professional help. Source: American Academy of Family Physicians http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=6151

•

Noise-Induced Hearing Loss Summary: An online fact sheet for consumers that details how exposure to impulse and continuous noise can contribute to hearing loss -- temporary and permanent. Source: National Institute on Deafness and Other Communication Disorders Information Clearinghouse http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=2061

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Ten Ways To Recognize Hearing Loss Summary: Take this online quiz to determine if you may have a hearing problem and need to have your hearing evaluated further by a medical professional. Source: National Institute on Deafness and Other Communication Disorders Information Clearinghouse http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=4498

•

Vestibular Schwannoma (Acoustic Neurinoma) and Neurofibromatosis Summary: This fact sheet provides consumers with basic facts about acoustic neurinoma -- a benign tumor which often causes gradual hearing loss, tinnitus or ringing in the ears, and dizziness. Source: National Institute on Deafness and Other Communication Disorders Information Clearinghouse http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=2066 The NIH Search Utility

The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to hearing loss. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. PEDBASE Similar to NORD, PEDBASE covers relatively rare disorders, limited mainly to pediatric conditions. PEDBASE was designed by Dr. Alan Gandy. To access the database, which is more oriented to researchers than patients, you can view the current list of health topics covered at the following Web site: http://www.icondata.com/health/pedbase/pedlynx.htm. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats

•

Family Village: http://www.familyvillage.wisc.edu/specific.htm

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Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/

•

Med Help International: http://www.medhelp.org/HealthTopics/A.html

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Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/

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Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/

•

WebMD®Health: http://my.webmd.com/health_topics

Associations and Hearing Loss The following is a list of associations that provide information on and resources relating to hearing loss: •

Deafness Research Foundation Telephone: (212) 599-0027 Toll-free: (800) 535-3323 Fax: (212) 768-1782 Email: [email protected] Background: The Deafness Research Foundation is a national voluntary health organization that offers seed research grants to help solve the problems of deafness and other serious ear disorders. Founded in 1958, the Deafness Research Foundation is committed to increasing public awareness about hearing health. The four primary objectives of the Deafness Research Foundation include fostering innovative research and education into the causes, treatments, and prevention of hearing loss and other dysfunctions of the auditory and balance systems; increasing awareness of measures to prevent hearing loss and the need to support research; creating greater understanding about the effect of hearing loss on people s lives; and increasing the number of scientists who are committed to hearing health. The Deafness Research Foundation also publishes materials including brochures on deafness and a grants policy fact sheet. Relevant area(s) of interest: Deafness

Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to hearing loss. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with hearing loss. The National Health Information Center (NHIC) The National Health Information Center (NHIC) offers a free referral service to help people find organizations that provide information about hearing loss. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at

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http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “hearing loss” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “hearing loss”. Type the following hyperlink into your Web browser: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Then, select your preferred language and the format option “Organization Resource Sheet.” Type “hearing loss” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months. The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “hearing loss” (or a synonym) into the search box, and click “Submit Query.”

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APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.

Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.27

Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.

Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of

27

Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.

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libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)28: •

Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/

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Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)

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Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm

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California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html

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California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html

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California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html

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California: Gateway Health Library (Sutter Gould Medical Foundation)

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California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/

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California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp

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California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html

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California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/

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California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/

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California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/

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California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html

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California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/

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Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/

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Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/

•

Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/

28

Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.

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•

Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml

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Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm

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Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html

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Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm

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Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp

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Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/

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Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm

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Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html

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Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/

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Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm

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Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/

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Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/

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Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/

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Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm

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Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html

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Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm

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Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/

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Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/

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Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10

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Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/

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Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html

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Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp

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Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp

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Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/

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Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html

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Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm

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Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp

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Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/

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Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html

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Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/

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Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm

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Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/

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Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html

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Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm

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Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330

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Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)

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National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html

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National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/

•

National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/

Finding Medical Libraries

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•

Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm

•

New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/

•

New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm

•

New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm

•

New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/

•

New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html

•

New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/

•

New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html

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New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/

•

Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm

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Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp

•

Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/

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Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/

•

Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml

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Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html

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Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html

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Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml

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Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp

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Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm

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Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/

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South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp

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Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/

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Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/

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Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72

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ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •

ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html

•

MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp

•

Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/

•

Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html

•

On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/

•

Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp

•

Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm

Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a). The NIH suggests the following Web sites in the ADAM Medical Encyclopedia when searching for information on hearing loss: •

Basic Guidelines for Hearing Loss Hearing loss Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003044.htm Otosclerosis Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001036.htm

•

Signs & Symptoms for Hearing Loss Deafness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003044.htm Discouraged Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003213.htm Dizziness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003093.htm

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Ear pain Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003046.htm Fever Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003090.htm Hearing loss Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003044.htm Loss of hearing Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003044.htm Nerve deafness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003291.htm Paralysis Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003190.htm Ringing in the ears (tinnitus) Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003043.htm Tinnitus Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003043.htm •

Diagnostics and Tests for Hearing Loss Audiology Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003341.htm Audiometry Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003341.htm Caloric test Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003429.htm CT scan of the head Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003786.htm Head CT scan Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003786.htm Head x-ray Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003802.htm Hearing test Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003341.htm MRI of the ear Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003791.htm MRI of the head Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003791.htm

Online Glossaries 325

Tympanometry Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003390.htm X-ray of the head Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003802.htm •

Nutrition for Hearing Loss Vitamin D Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002405.htm

•

Background Topics for Hearing Loss Acute Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002215.htm Blood clot Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001124.htm Chronic Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002312.htm Fireworks Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002785.htm Fistula Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002365.htm Foreign body lodged in the ear canal Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000052.htm Fracture Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000001.htm Injury to the head Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000028.htm Lentigines Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002245.htm Mercury Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002476.htm Physical examination Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002274.htm Prosthesis Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002286.htm Respiratory Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002290.htm

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Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •

Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical

•

MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html

•

Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/

•

Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine

327

HEARING LOSS DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. 3-dimensional: 3-D. A graphic display of depth, width, and height. Three-dimensional radiation therapy uses computers to create a 3-dimensional picture of the tumor. This allows doctors to give the highest possible dose of radiation to the tumor, while sparing the normal tissue as much as possible. [NIH] Abdomen: That portion of the body that lies between the thorax and the pelvis. [NIH] Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Ablation: The removal of an organ by surgery. [NIH] Abscess: Accumulation of purulent material in tissues, organs, or circumscribed spaces, usually associated with signs of infection. [NIH] Absenteeism: Chronic absence from work or other duty. [NIH] Acceptor: A substance which, while normally not oxidized by oxygen or reduced by hydrogen, can be oxidized or reduced in presence of a substance which is itself undergoing oxidation or reduction. [NIH] Acclimatization: Adaptation to a new environment or to a change in the old. [NIH] Accommodation: Adjustment, especially that of the eye for various distances. [EU] Acetylcholine: A neurotransmitter. Acetylcholine in vertebrates is the major transmitter at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system. It is generally not used as an administered drug because it is broken down very rapidly by cholinesterases, but it is useful in some ophthalmological applications. [NIH] Acidosis: A pathologic condition resulting from accumulation of acid or depletion of the alkaline reserve (bicarbonate content) in the blood and body tissues, and characterized by an increase in hydrogen ion concentration. [EU] Acoustic: Having to do with sound or hearing. [NIH] Actin: Essential component of the cell skeleton. [NIH] Activities of Daily Living: The performance of the basic activities of self care, such as dressing, ambulation, eating, etc., in rehabilitation. [NIH] Acuity: Clarity or clearness, especially of the vision. [EU] Adaptability: Ability to develop some form of tolerance to conditions extremely different from those under which a living organism evolved. [NIH] Adaptation: 1. The adjustment of an organism to its environment, or the process by which it enhances such fitness. 2. The normal ability of the eye to adjust itself to variations in the intensity of light; the adjustment to such variations. 3. The decline in the frequency of firing of a neuron, particularly of a receptor, under conditions of constant stimulation. 4. In dentistry, (a) the proper fitting of a denture, (b) the degree of proximity and interlocking of restorative material to a tooth preparation, (c) the exact adjustment of bands to teeth. 5. In microbiology, the adjustment of bacterial physiology to a new environment. [EU]

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Adenine: A purine base and a fundamental unit of adenine nucleotides. [NIH] Adenosine: A nucleoside that is composed of adenine and d-ribose. Adenosine or adenosine derivatives play many important biological roles in addition to being components of DNA and RNA. Adenosine itself is a neurotransmitter. [NIH] Adhesives: Substances that cause the adherence of two surfaces. They include glues (properly collagen-derived adhesives), mucilages, sticky pastes, gums, resins, or latex. [NIH] Adjustment: The dynamic process wherein the thoughts, feelings, behavior, and biophysiological mechanisms of the individual continually change to adjust to the environment. [NIH] Adolescence: The period of life beginning with the appearance of secondary sex characteristics and terminating with the cessation of somatic growth. The years usually referred to as adolescence lie between 13 and 18 years of age. [NIH] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH] Adrenergic: Activated by, characteristic of, or secreting epinephrine or substances with similar activity; the term is applied to those nerve fibres that liberate norepinephrine at a synapse when a nerve impulse passes, i.e., the sympathetic fibres. [EU] Adrenergic beta-Antagonists: Drugs that bind to but do not activate beta-adrenergic receptors thereby blocking the actions of beta-adrenergic agonists. Adrenergic betaantagonists are used for treatment of hypertension, cardiac arrythmias, angina pectoris, glaucoma, migraine headaches, and anxiety. [NIH] Adverse Effect: An unwanted side effect of treatment. [NIH] Aerobic: In biochemistry, reactions that need oxygen to happen or happen when oxygen is present. [NIH] Aetiology: Study of the causes of disease. [EU] Afferent: Concerned with the transmission of neural impulse toward the central part of the nervous system. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Age Distribution: The frequency of different ages or age groups in a given population. The distribution may refer to either how many or what proportion of the group. The population is usually patients with a specific disease but the concept is not restricted to humans and is not restricted to medicine. [NIH] Age Groups: Persons classified by age from birth (infant, newborn) to octogenarians and older (aged, 80 and over). [NIH] Age of Onset: The age or period of life at which a disease or the initial symptoms or manifestations of a disease appear in an individual. [NIH]

Dictionary 329

Age-Adjusted: Summary measures of rates of morbidity or mortality in a population using statistical procedures to remove the effect of age differences in populations that are being compared. Age is probably the most important and the most common variable in determining the risk of morbidity and mortality. [NIH] Aged, 80 and Over: A person 80 years of age and older. [NIH] Ageing: A physiological or morphological change in the life of an organism or its parts, generally irreversible and typically associated with a decline in growth and reproductive vigor. [NIH] Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Akathisia: 1. A condition of motor restlessness in which there is a feeling of muscular quivering, an urge to move about constantly, and an inability to sit still, a common extrapyramidal side effect of neuroleptic drugs. 2. An inability to sit down because of intense anxiety at the thought of doing so. [EU] Aldehydes: Organic compounds containing a carbonyl group in the form -CHO. [NIH] Aldosterone: (11 beta)-11,21-Dihydroxy-3,20-dioxopregn-4-en-18-al. A hormone secreted by the adrenal cortex that functions in the regulation of electrolyte and water balance by increasing the renal retention of sodium and the excretion of potassium. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alkaline: Having the reactions of an alkali. [EU] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH] Alkalosis: A pathological condition that removes acid or adds base to the body fluids. [NIH] Alleles: Mutually exclusive forms of the same gene, occupying the same locus on homologous chromosomes, and governing the same biochemical and developmental process. [NIH] Alopecia: Absence of hair from areas where it is normally present. [NIH] Alpha Particles: Positively charged particles composed of two protons and two neutrons, i.e., helium nuclei, emitted during disintegration of very heavy isotopes; a beam of alpha particles or an alpha ray has very strong ionizing power, but weak penetrability. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Aluminum: A metallic element that has the atomic number 13, atomic symbol Al, and atomic weight 26.98. [NIH] Alveoli: Tiny air sacs at the end of the bronchioles in the lungs. [NIH] Ambulatory Care: Health care services provided to patients on an ambulatory basis, rather than by admission to a hospital or other health care facility. The services may be a part of a hospital, augmenting its inpatient services, or may be provided at a free-standing facility. [NIH]

Ameliorating: A changeable condition which prevents the consequence of a failure or accident from becoming as bad as it otherwise would. [NIH]

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Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] Amino Acid Substitution: The naturally occurring or experimentally induced replacement of one or more amino acids in a protein with another. If a functionally equivalent amino acid is substituted, the protein may retain wild-type activity. Substitution may also diminish or eliminate protein function. Experimentally induced substitution is often used to study enzyme activities and binding site properties. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Aminopropionitrile: 3-Aminopropanenitrile. Reagent used as an intermediate in the manufacture of beta-alanine and pantothenic acid. [NIH] Ammonia: A colorless alkaline gas. It is formed in the body during decomposition of organic materials during a large number of metabolically important reactions. [NIH] Amniotic Fluid: Amniotic cavity fluid which is produced by the amnion and fetal lungs and kidneys. [NIH] Amplification: The production of additional copies of a chromosomal DNA sequence, found as either intrachromosomal or extrachromosomal DNA. [NIH] Anaesthesia: Loss of feeling or sensation. Although the term is used for loss of tactile sensibility, or of any of the other senses, it is applied especially to loss of the sensation of pain, as it is induced to permit performance of surgery or other painful procedures. [EU] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Analeptic: A drug which acts as a restorative, such as caffeine, amphetamine, pentylenetetrazol, etc. [EU] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Analog: In chemistry, a substance that is similar, but not identical, to another. [NIH] Analysis of Variance: A statistical technique that isolates and assesses the contributions of categorical independent variables to variation in the mean of a continuous dependent variable. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Androgens: A class of sex hormones associated with the development and maintenance of the secondary male sex characteristics, sperm induction, and sexual differentiation. In addition to increasing virility and libido, they also increase nitrogen and water retention and stimulate skeletal growth. [NIH] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] Anesthetics: Agents that are capable of inducing a total or partial loss of sensation, especially tactile sensation and pain. They may act to induce general anesthesia, in which an unconscious state is achieved, or may act locally to induce numbness or lack of sensation at

Dictionary 331

a targeted site. [NIH] Aneurysm: A sac formed by the dilatation of the wall of an artery, a vein, or the heart. [NIH] Angiotensin-Converting Enzyme Inhibitors: A class of drugs whose main indications are the treatment of hypertension and heart failure. They exert their hemodynamic effect mainly by inhibiting the renin-angiotensin system. They also modulate sympathetic nervous system activity and increase prostaglandin synthesis. They cause mainly vasodilation and mild natriuresis without affecting heart rate and contractility. [NIH] Animal model: An animal with a disease either the same as or like a disease in humans. Animal models are used to study the development and progression of diseases and to test new treatments before they are given to humans. Animals with transplanted human cancers or other tissues are called xenograft models. [NIH] Anions: Negatively charged atoms, radicals or groups of atoms which travel to the anode or positive pole during electrolysis. [NIH] Anomalies: Birth defects; abnormalities. [NIH] Anoxia: Clinical manifestation of respiratory distress consisting of a relatively complete absence of oxygen. [NIH] Antagonism: Interference with, or inhibition of, the growth of a living organism by another living organism, due either to creation of unfavorable conditions (e. g. exhaustion of food supplies) or to production of a specific antibiotic substance (e. g. penicillin). [NIH] Anterior Cerebral Artery: Artery formed by the bifurcation of the internal carotid artery. Branches of the anterior cerebral artery supply the caudate nucleus, internal capsule, putamen, septal nuclei, gyrus cinguli, and surfaces of the frontal lobe and parietal lobe. [NIH] Antiallergic: Counteracting allergy or allergic conditions. [EU] Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]

Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Anticoagulant: A drug that helps prevent blood clots from forming. Also called a blood thinner. [NIH] Antiemetic: An agent that prevents or alleviates nausea and vomiting. Also antinauseant. [EU]

Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Antihypertensive: An agent that reduces high blood pressure. [EU]

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Antihypertensive Agents: Drugs used in the treatment of acute or chronic hypertension regardless of pharmacological mechanism. Among the antihypertensive agents are diuretics (especially diuretics, thiazide), adrenergic beta-antagonists, adrenergic alpha-antagonists, angiotensin-converting enzyme inhibitors, calcium channel blockers, ganglionic blockers, and vasodilator agents. [NIH] Anti-infective: An agent that so acts. [EU] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Anti-Inflammatory Agents: Substances that reduce or suppress inflammation. [NIH] Antimicrobial: Killing microorganisms, or suppressing their multiplication or growth. [EU] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] Antioxidant: A substance that prevents damage caused by free radicals. Free radicals are highly reactive chemicals that often contain oxygen. They are produced when molecules are split to give products that have unpaired electrons. This process is called oxidation. [NIH] Antipsychotic: Effective in the treatment of psychosis. Antipsychotic drugs (called also neuroleptic drugs and major tranquilizers) are a chemically diverse (including phenothiazines, thioxanthenes, butyrophenones, dibenzoxazepines, dibenzodiazepines, and diphenylbutylpiperidines) but pharmacologically similar class of drugs used to treat schizophrenic, paranoid, schizoaffective, and other psychotic disorders; acute delirium and dementia, and manic episodes (during induction of lithium therapy); to control the movement disorders associated with Huntington's chorea, Gilles de la Tourette's syndrome, and ballismus; and to treat intractable hiccups and severe nausea and vomiting. Antipsychotic agents bind to dopamine, histamine, muscarinic cholinergic, a-adrenergic, and serotonin receptors. Blockade of dopaminergic transmission in various areas is thought to be responsible for their major effects : antipsychotic action by blockade in the mesolimbic and mesocortical areas; extrapyramidal side effects (dystonia, akathisia, parkinsonism, and tardive dyskinesia) by blockade in the basal ganglia; and antiemetic effects by blockade in the chemoreceptor trigger zone of the medulla. Sedation and autonomic side effects (orthostatic hypotension, blurred vision, dry mouth, nasal congestion and constipation) are caused by blockade of histamine, cholinergic, and adrenergic receptors. [EU] Antipyretic: An agent that relieves or reduces fever. Called also antifebrile, antithermic and febrifuge. [EU] Antiviral: Destroying viruses or suppressing their replication. [EU] Anuria: Inability to form or excrete urine. [NIH] Anus: The opening of the rectum to the outside of the body. [NIH] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Aphakia: Absence of crystalline lens totally or partially from field of vision, from any cause except after cataract extraction. Aphakia is mainly congenital or as result of lens dislocation and subluxation. [NIH] Apheresis: Components plateletpheresis. [NIH]

being

separated

out,

as

leukapheresis,

plasmapheresis,

Aponeurosis: Tendinous expansion consisting of a fibrous or membranous sheath which serves as a fascia to enclose or bind a group of muscles. [NIH] Apoptosis: One of the two mechanisms by which cell death occurs (the other being the pathological process of necrosis). Apoptosis is the mechanism responsible for the physiological deletion of cells and appears to be intrinsically programmed. It is

Dictionary 333

characterized by distinctive morphologic changes in the nucleus and cytoplasm, chromatin cleavage at regularly spaced sites, and the endonucleolytic cleavage of genomic DNA (DNA fragmentation) at internucleosomal sites. This mode of cell death serves as a balance to mitosis in regulating the size of animal tissues and in mediating pathologic processes associated with tumor growth. [NIH] Applicability: A list of the commodities to which the candidate method can be applied as presented or with minor modifications. [NIH] Approximate: Approximal [EU] Aptitude: The ability to acquire general or special types of knowledge or skill. [NIH] Aqueous: Having to do with water. [NIH] Arachidonate 12-Lipoxygenase: An enzyme that catalyzes the oxidation of arachidonic acid to yield 12-hydroperoxyarachidonate (12-HPETE) which is itself rapidly converted by a peroxidase to 12-hydroxy-5,8,10,14-eicosatetraenoate (12-HETE). The 12-hydroperoxides are preferentially formed in platelets. EC 1.13.11.31. [NIH] Arachidonate 15-Lipoxygenase: An enzyme that catalyzes the oxidation of arachidonic acid to yield 15-hydroperoxyarachidonate (15-HPETE) which is rapidly converted to 15-hydroxy5,8,11,13-eicosatetraenoate (15-HETE). The 15-hydroperoxides are preferentially formed in neutrophils and lymphocytes. EC 1.13.11.33. [NIH] Arachidonate Lipoxygenases: Enzymes catalyzing the oxidation of arachidonic acid to hydroperoxyarachidonates (HPETES). These products are then rapidly converted by a peroxidase to hydroxyeicosatetraenoic acids (HETES). The positional specificity of the enzyme reaction varies from tissue to tissue. The final lipoxygenase pathway leads to the leukotrienes. EC 1.13.11.- . [NIH] Arachidonic Acid: An unsaturated, essential fatty acid. It is found in animal and human fat as well as in the liver, brain, and glandular organs, and is a constituent of animal phosphatides. It is formed by the synthesis from dietary linoleic acid and is a precursor in the biosynthesis of prostaglandins, thromboxanes, and leukotrienes. [NIH] Aromatic: Having a spicy odour. [EU] Arrhythmia: Any variation from the normal rhythm or rate of the heart beat. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arterioles: The smallest divisions of the arteries located between the muscular arteries and the capillaries. [NIH] Arteriovenous: Both arterial and venous; pertaining to or affecting an artery and a vein. [EU] Aseptic: Free from infection or septic material; sterile. [EU] Aspartate: A synthetic amino acid. [NIH] Asphyxia: A pathological condition caused by lack of oxygen, manifested in impending or actual cessation of life. [NIH] Aspirin: A drug that reduces pain, fever, inflammation, and blood clotting. Aspirin belongs to the family of drugs called nonsteroidal anti-inflammatory agents. It is also being studied in cancer prevention. [NIH] Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [EU] Asymptomatic: Having no signs or symptoms of disease. [NIH] Ataxia: Impairment of the ability to perform smoothly coordinated voluntary movements.

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This condition may affect the limbs, trunk, eyes, pharnyx, larnyx, and other structures. Ataxia may result from impaired sensory or motor function. Sensory ataxia may result from posterior column injury or peripheral nerve diseases. Motor ataxia may be associated with cerebellar diseases; cerebral cortex diseases; thalamic diseases; basal ganglia diseases; injury to the red nucleus; and other conditions. [NIH] Atresia: Lack of a normal opening from the esophagus, intestines, or anus. [NIH] Atrial: Pertaining to an atrium. [EU] Atrium: A chamber; used in anatomical nomenclature to designate a chamber affording entrance to another structure or organ. Usually used alone to designate an atrium of the heart. [EU] Atrophy: Decrease in the size of a cell, tissue, organ, or multiple organs, associated with a variety of pathological conditions such as abnormal cellular changes, ischemia, malnutrition, or hormonal changes. [NIH] Attenuated: Strain with weakened or reduced virulence. [NIH] Attenuation: Reduction of transmitted sound energy or its electrical equivalent. [NIH] Audiologist: Study of hearing including treatment of persons with hearing defects. [NIH] Audiology: The study of hearing and hearing impairment. [NIH] Audiometer: An instrument for the measurement of hearing acuity and, specifically, for the threshold of audibility. [NIH] Audiometry: The testing of the acuity of the sense of hearing to determine the thresholds of the lowest intensity levels at which an individual can hear a set of tones. The frequencies between 125 and 8000 Hz are used to test air conduction thresholds, and the frequencies between 250 and 4000 Hz are used to test bone conduction thresholds. [NIH] Audition: The sense of hearing. [NIH] Auditory: Pertaining to the sense of hearing. [EU] Auditory Cortex: Area of the temporal lobe concerned with hearing. [NIH] Auditory nerve: The eight cranial nerve; also called vestibulocochlear nerve or acoustic nerve. [NIH] Auditory Perception: The process whereby auditory stimuli are selected, organized and interpreted by the organism; includes speech discrimination. [NIH] Aural: Pertaining to or perceived by the ear, as an aural stimulus. [EU] Autacoids: A chemically diverse group of substances produced by various tissues in the body that cause slow contraction of smooth muscle; they have other intense but varied pharmacologic activities. [NIH] Autoantibodies: Antibodies that react with self-antigens (autoantigens) of the organism that produced them. [NIH] Autoantigens: Endogenous tissue constituents that have the ability to interact with autoantibodies and cause an immune response. [NIH] Autoimmune disease: A condition in which the body recognizes its own tissues as foreign and directs an immune response against them. [NIH] Autoimmunity: Process whereby the immune system reacts against the body's own tissues. Autoimmunity may produce or be caused by autoimmune diseases. [NIH] Autonomic: Self-controlling; functionally independent. [EU] Autoradiography: A process in which radioactive material within an object produces an

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image when it is in close proximity to a radiation sensitive emulsion. [NIH] Autosuggestion: Suggestion coming from the subject himself. [NIH] Axonal: Condition associated with metabolic derangement of the entire neuron and is manifest by degeneration of the distal portion of the nerve fiber. [NIH] Axons: Nerve fibers that are capable of rapidly conducting impulses away from the neuron cell body. [NIH] Babesiosis: A group of tick-borne diseases of mammals including zoonoses in humans. They are caused by protozoans of the genus babesia, which parasitize erythrocytes, producing hemolysis. In the U.S., the organism's natural host is mice and transmission is by the deer tick ixodes scapularis. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bacterial Infections: Infections by bacteria, general or unspecified. [NIH] Bacterial Physiology: Physiological processes and activities of bacteria. [NIH] Bactericidal: Substance lethal to bacteria; substance capable of killing bacteria. [NIH] Bacteriophage: A virus whose host is a bacterial cell; A virus that exclusively infects bacteria. It generally has a protein coat surrounding the genome (DNA or RNA). One of the coliphages most extensively studied is the lambda phage, which is also one of the most important. [NIH] Bacteriostatic: 1. Inhibiting the growth or multiplication of bacteria. 2. An agent that inhibits the growth or multiplication of bacteria. [EU] Bacterium: Microscopic organism which may have a spherical, rod-like, or spiral unicellular or non-cellular body. Bacteria usually reproduce through asexual processes. [NIH] Barbiturate: A drug with sedative and hypnotic effects. Barbiturates have been used as sedatives and anesthetics, and they have been used to treat the convulsions associated with epilepsy. [NIH] Barotrauma: Injury following pressure changes; includes injury to the eustachian tube, ear drum, lung and stomach. [NIH] Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres. [NIH] Basal Ganglia Diseases: Diseases of the basal ganglia including the putamen; globus pallidus; claustrum; amygdala; and caudate nucleus. Dyskinesias (most notably involuntary movements and alterations of the rate of movement) represent the primary clinical manifestations of these disorders. Common etiologies include cerebrovascular disease; neurodegenerative diseases; and craniocerebral trauma. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Basement Membrane: Ubiquitous supportive tissue adjacent to epithelium and around smooth and striated muscle cells. This tissue contains intrinsic macromolecular components such as collagen, laminin, and sulfated proteoglycans. As seen by light microscopy one of its subdivisions is the basal (basement) lamina. [NIH] Basilar Membrane: A membrane that stretches from the spiral lamina to the basilar crest consisting of an inner and an outer part. The inner part supports the spiral organ of Corti.

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[NIH]

Behavior Therapy: The application of modern theories of learning and conditioning in the treatment of behavior disorders. [NIH] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

Benign tumor: A noncancerous growth that does not invade nearby tissue or spread to other parts of the body. [NIH] Beta-Thalassemia: A disorder characterized by reduced synthesis of the beta chains of hemoglobin. There is retardation of hemoglobin A synthesis in the heterozygous form (thalassemia minor), which is asymptomatic, while in the homozygous form (thalassemia major, Cooley's anemia, Mediterranean anemia, erythroblastic anemia), which can result in severe complications and even death, hemoglobin A synthesis is absent. [NIH] Bilateral: Affecting both the right and left side of body. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Bilirubin: A bile pigment that is a degradation product of heme. [NIH] Binaural: Used of the two ears functioning together. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biological therapy: Treatment to stimulate or restore the ability of the immune system to fight infection and disease. Also used to lessen side effects that may be caused by some cancer treatments. Also known as immunotherapy, biotherapy, or biological response modifier (BRM) therapy. [NIH] Biomechanics: The study of the application of mechanical laws and the action of forces to living structures. [NIH] Biosynthesis: The building up of a chemical compound in the physiologic processes of a living organism. [EU] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bladder: The organ that stores urine. [NIH] Blast phase: The phase of chronic myelogenous leukemia in which the number of immature, abnormal white blood cells in the bone marrow and blood is extremely high. Also called blast crisis. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood Sedimentation: Measurement of rate of settling of erythrocytes in anticoagulated blood. [NIH]

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Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Blood Viscosity: The internal resistance of the blood to shear forces. The in vitro measure of whole blood viscosity is of limited clinical utility because it bears little relationship to the actual viscosity within the circulation, but an increase in the viscosity of circulating blood can contribute to morbidity in patients suffering from disorders such as sickle cell anemia and polycythemia. [NIH] Blot: To transfer DNA, RNA, or proteins to an immobilizing matrix such as nitrocellulose. [NIH]

Body Fluids: Liquid components of living organisms. [NIH] Body Mass Index: One of the anthropometric measures of body mass; it has the highest correlation with skinfold thickness or body density. [NIH] Bone Conduction: Sound transmission through the bones of the skull to the inner ear. [NIH] Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. [NIH] Bone scan: A technique to create images of bones on a computer screen or on film. A small amount of radioactive material is injected into a blood vessel and travels through the bloodstream; it collects in the bones and is detected by a scanner. [NIH] Bone-conduction: The means by which sound can reach the inner ear and be heard without traveling via the air in the ear canal or meatus. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bowel Movement: Body wastes passed through the rectum and anus. [NIH] Brachytherapy: A collective term for interstitial, intracavity, and surface radiotherapy. It uses small sealed or partly-sealed sources that may be placed on or near the body surface or within a natural body cavity or implanted directly into the tissues. [NIH] Brain Diseases: Pathologic conditions affecting the brain, which is composed of the intracranial components of the central nervous system. This includes (but is not limited to) the cerebral cortex; intracranial white matter; basal ganglia; thalamus; hypothalamus; brain stem; and cerebellum. [NIH] Brain Ischemia: Localized reduction of blood flow to brain tissue due to arterial obtruction or systemic hypoperfusion. This frequently occurs in conjuction with brain hypoxia. Prolonged ischemia is associated with brain infarction. [NIH] Brain Stem: The part of the brain that connects the cerebral hemispheres with the spinal cord. It consists of the mesencephalon, pons, and medulla oblongata. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]

Breakdown: A physical, metal, or nervous collapse. [NIH] Broadband: A wide frequency range. Sound whose energy is distributed over a broad range of frequency (generally, more than one octave). [NIH] Broad-spectrum: Effective against a wide range of microorganisms; said of an antibiotic. [EU] Buccal: Pertaining to or directed toward the cheek. In dental anatomy, used to refer to the

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buccal surface of a tooth. [EU] Buffers: A chemical system that functions to control the levels of specific ions in solution. When the level of hydrogen ion in solution is controlled the system is called a pH buffer. [NIH]

Bullous: Pertaining to or characterized by bullae. [EU] Bupivacaine: A widely used local anesthetic agent. [NIH] Calcification: Deposits of calcium in the tissues of the breast. Calcification in the breast can be seen on a mammogram, but cannot be detected by touch. There are two types of breast calcification, macrocalcification and microcalcification. Macrocalcifications are large deposits and are usually not related to cancer. Microcalcifications are specks of calcium that may be found in an area of rapidly dividing cells. Many microcalcifications clustered together may be a sign of cancer. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Calcium channel blocker: A drug used to relax the blood vessel and heart muscle, causing pressure inside blood vessels to drop. It also can regulate heart rhythm. [NIH] Calcium Channel Blockers: A class of drugs that act by selective inhibition of calcium influx through cell membranes or on the release and binding of calcium in intracellular pools. Since they are inducers of vascular and other smooth muscle relaxation, they are used in the drug therapy of hypertension and cerebrovascular spasms, as myocardial protective agents, and in the relaxation of uterine spasms. [NIH] Calcium Oxalate: The calcium salt of oxalic acid, occurring in the urine as crystals and in certain calculi. [NIH] Callus: A callosity or hard, thick skin; the bone-like reparative substance that is formed round the edges and fragments of broken bone. [NIH] Calmodulin: A heat-stable, low-molecular-weight activator protein found mainly in the brain and heart. The binding of calcium ions to this protein allows this protein to bind to cyclic nucleotide phosphodiesterases and to adenyl cyclase with subsequent activation. Thereby this protein modulates cyclic AMP and cyclic GMP levels. [NIH] Caloric Tests: Elicitation of a rotatory nystagmus by stimulating the semicircular canals with water or air which is above or below body temperature. In warm caloric stimulation a rotatory nystagmus is developed toward the side of the stimulated ear; in cold, away from the stimulated side. Absence of nystagmus indicates the labyrinth is not functioning. [NIH] Capsules: Hard or soft soluble containers used for the oral administration of medicine. [NIH] Carbogen: An inhalant of oxygen and carbon dioxide that increases the sensitivity of tumor cells to the effects of radiation therapy. [NIH] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU] Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. [NIH]

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Carboplatin: An organoplatinum compound that possesses antineoplastic activity. [NIH] Carcinogenic: Producing carcinoma. [EU] Carcinogens: Substances that increase the risk of neoplasms in humans or animals. Both genotoxic chemicals, which affect DNA directly, and nongenotoxic chemicals, which induce neoplasms by other mechanism, are included. [NIH] Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [NIH]

Cardiac: Having to do with the heart. [NIH] Cardiac arrest: A sudden stop of heart function. [NIH] Cardiology: The study of the heart, its physiology, and its functions. [NIH] Cardiomyopathy: A general diagnostic term designating primary myocardial disease, often of obscure or unknown etiology. [EU] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Cardiovascular Abnormalities: Congenital structural abnormalities of the cardiovascular system. [NIH] Cardiovascular disease: Any abnormal condition characterized by dysfunction of the heart and blood vessels. CVD includes atherosclerosis (especially coronary heart disease, which can lead to heart attacks), cerebrovascular disease (e.g., stroke), and hypertension (high blood pressure). [NIH] Cardiovascular System: The heart and the blood vessels by which blood is pumped and circulated through the body. [NIH] Carotene: The general name for a group of pigments found in green, yellow, and leafy vegetables, and yellow fruits. The pigments are fat-soluble, unsaturated aliphatic hydrocarbons functioning as provitamins and are converted to vitamin A through enzymatic processes in the intestinal wall. [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Case series: A group or series of case reports involving patients who were given similar treatment. Reports of case series usually contain detailed information about the individual patients. This includes demographic information (for example, age, gender, ethnic origin) and information on diagnosis, treatment, response to treatment, and follow-up after treatment. [NIH] Caspase: Enzyme released by the cell at a crucial stage in apoptosis in order to shred all cellular proteins. [NIH] Cataract: An opacity, partial or complete, of one or both eyes, on or in the lens or capsule, especially an opacity impairing vision or causing blindness. The many kinds of cataract are classified by their morphology (size, shape, location) or etiology (cause and time of occurrence). [EU] Cations: Postively charged atoms, radicals or groups of atoms which travel to the cathode or negative pole during electrolysis. [NIH] Caudal: Denoting a position more toward the cauda, or tail, than some specified point of reference; same as inferior, in human anatomy. [EU] Causal: Pertaining to a cause; directed against a cause. [EU] Cell: The individual unit that makes up all of the tissues of the body. All living things are

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made up of one or more cells. [NIH] Cell Count: A count of the number of cells of a specific kind, usually measured per unit volume of sample. [NIH] Cell Cycle: The complex series of phenomena, occurring between the end of one cell division and the end of the next, by which cellular material is divided between daughter cells. [NIH] Cell Death: The termination of the cell's ability to carry out vital functions such as metabolism, growth, reproduction, responsiveness, and adaptability. [NIH] Cell Division: The fission of a cell. [NIH] Cell membrane: Cell membrane = plasma membrane. The structure enveloping a cell, enclosing the cytoplasm, and forming a selective permeability barrier; it consists of lipids, proteins, and some carbohydrates, the lipids thought to form a bilayer in which integral proteins are embedded to varying degrees. [EU] Cell Physiology: Characteristics and physiological processes of cells from cell division to cell death. [NIH] Cell Respiration: The metabolic process of all living cells (animal and plant) in which oxygen is used to provide a source of energy for the cell. [NIH] Cell Survival: The span of viability of a cell characterized by the capacity to perform certain functions such as metabolism, growth, reproduction, some form of responsiveness, and adaptability. [NIH] Cellular Structures: Components of a cell. [NIH] Cellulose: A polysaccharide with glucose units linked as in cellobiose. It is the chief constituent of plant fibers, cotton being the purest natural form of the substance. As a raw material, it forms the basis for many derivatives used in chromatography, ion exchange materials, explosives manufacturing, and pharmaceutical preparations. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Central Nervous System Infections: Pathogenic infections of the brain, spinal cord, and meninges. DNA virus infections; RNA virus infections; bacterial infections; mycoplasma infections; Spirochaetales infections; fungal infections; protozoan infections; helminthiasis; and prion diseases may involve the central nervous system as a primary or secondary process. [NIH] Cerebellar: Pertaining to the cerebellum. [EU] Cerebellopontine: Going from the cerebellum (the part of the brain responsible for coordinating movement) to the pons (part of the central nervous system located near the base of the brain.) [NIH] Cerebellopontine Angle: Junction between the cerebellum and the pons. [NIH] Cerebellum: Part of the metencephalon that lies in the posterior cranial fossa behind the brain stem. It is concerned with the coordination of movement. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebral hemispheres: The two halves of the cerebrum, the part of the brain that controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. The right hemisphere controls muscle movement on the left side of the body, and the left hemisphere controls muscle movement on the right side of the body. [NIH] Cerebral Infarction: The formation of an area of necrosis in the cerebrum caused by an insufficiency of arterial or venous blood flow. Infarcts of the cerebrum are generally

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classified by hemisphere (i.e., left vs. right), lobe (e.g., frontal lobe infarction), arterial distribution (e.g., infarction, anterior cerebral artery), and etiology (e.g., embolic infarction). [NIH]

Cerebral Palsy: Refers to a motor disability caused by a brain dysfunction. [NIH] Cerebrospinal: Pertaining to the brain and spinal cord. [EU] Cerebrospinal fluid: CSF. The fluid flowing around the brain and spinal cord. Cerebrospinal fluid is produced in the ventricles in the brain. [NIH] Cerebrovascular: Pertaining to the blood vessels of the cerebrum, or brain. [EU] Cerebrovascular Disorders: A broad category of disorders characterized by impairment of blood flow in the arteries and veins which supply the brain. These include cerebral infarction; brain ischemia; hypoxia, brain; intracranial embolism and thrombosis; intracranial arteriovenous malformations; and vasculitis, central nervous system. In common usage, the term cerebrovascular disorders is not limited to conditions that affect the cerebrum, but refers to vascular disorders of the entire brain including the diencephalon; brain stem; and cerebellum. [NIH] Cerebrum: The largest part of the brain. It is divided into two hemispheres, or halves, called the cerebral hemispheres. The cerebrum controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. [NIH] Cerumen: The yellow or brown waxy secretions produced by vestigial apocrine sweat glands in the external ear canal. [NIH] Character: In current usage, approximately equivalent to personality. The sum of the relatively fixed personality traits and habitual modes of response of an individual. [NIH] Chelation: Combination with a metal in complexes in which the metal is part of a ring. [EU] Chelation Therapy: Therapy of heavy metal poisoning using agents which sequester the metal from organs or tissues and bind it firmly within the ring structure of a new compound which can be eliminated from the body. [NIH] Chemoreceptor: A receptor adapted for excitation by chemical substances, e.g., olfactory and gustatory receptors, or a sense organ, as the carotid body or the aortic (supracardial) bodies, which is sensitive to chemical changes in the blood stream, especially reduced oxygen content, and reflexly increases both respiration and blood pressure. [EU] Chemotherapy: Treatment with anticancer drugs. [NIH] Child Development: The continuous sequential physiological and psychological maturing of the child from birth up to but not including adolescence. It includes healthy responses to situations, but does not include growth in stature or size (= growth). [NIH] Child Language: The language and sounds expressed by a child at a particular maturational stage in development. [NIH] Child Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders in children. [NIH] Cholesteatoma: A non-neoplastic keratinizing mass with stratified squamous epithelium, frequently occurring in the meninges, central nervous system, bones of the skull, and most commonly in the middle ear and mastoid region. [NIH] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Choline: A basic constituent of lecithin that is found in many plants and animal organs. It is important as a precursor of acetylcholine, as a methyl donor in various metabolic processes, and in lipid metabolism. [NIH]

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Cholinergic: Resembling acetylcholine in pharmacological action; stimulated by or releasing acetylcholine or a related compound. [EU] Chorea: Involuntary, forcible, rapid, jerky movements that may be subtle or become confluent, markedly altering normal patterns of movement. Hypotonia and pendular reflexes are often associated. Conditions which feature recurrent or persistent episodes of chorea as a primary manifestation of disease are referred to as choreatic disorders. Chorea is also a frequent manifestation of basal ganglia diseases. [NIH] Choriocapillaris: A layer of the choroid between the lamina vitrea and Sattler's layer, consisting of a network of capillaries which supplies the outer 5 layers of the retina; the network is densest at the macula. [NIH] Chorioretinitis: Inflammation of the choroid in which the sensory retina becomes edematous and opaque. The inflammatory cells and exudate may burst through the sensory retina to cloud the vitreous body. [NIH] Choroid: The thin, highly vascular membrane covering most of the posterior of the eye between the retina and sclera. [NIH] Chromatin: The material of chromosomes. It is a complex of DNA, histones, and nonhistone proteins (chromosomal proteins, non-histone) found within the nucleus of a cell. [NIH] Chromosomal: Pertaining to chromosomes. [EU] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic lymphocytic leukemia: A slowly progressing disease in which too many white blood cells (called lymphocytes) are found in the body. [NIH] Chronic myelogenous leukemia: CML. A slowly progressing disease in which too many white blood cells are made in the bone marrow. Also called chronic myeloid leukemia or chronic granulocytic leukemia. [NIH] Chronic phase: Refers to the early stages of chronic myelogenous leukemia or chronic lymphocytic leukemia. The number of mature and immature abnormal white blood cells in the bone marrow and blood is higher than normal, but lower than in the accelerated or blast phase. [NIH] Chronic renal: Slow and progressive loss of kidney function over several years, often resulting in end-stage renal disease. People with end-stage renal disease need dialysis or transplantation to replace the work of the kidneys. [NIH] Ciliary: Inflammation or infection of the glands of the margins of the eyelids. [NIH] Ciliary Neurotrophic Factor: A neurotrophic factor that promotes the survival of various neuronal cell types and may play an important role in the injury response in the nervous system. [NIH] Cinchona: A genus of rubiaceous South American trees that yields the toxic cinchona alkaloids from their bark; quinine, quinidine, chinconine, cinchonidine and others are used to treat malaria and cardiac arrhythmias. [NIH] CIS: Cancer Information Service. The CIS is the National Cancer Institute's link to the public, interpreting and explaining research findings in a clear and understandable manner, and providing personalized responses to specific questions about cancer. Access the CIS by calling 1-800-4-CANCER, or by using the Web site at http://cis.nci.nih.gov. [NIH] Cisplatin: An inorganic and water-soluble platinum complex. After undergoing hydrolysis, it reacts with DNA to produce both intra and interstrand crosslinks. These crosslinks appear

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to impair replication and transcription of DNA. The cytotoxicity of cisplatin correlates with cellular arrest in the G2 phase of the cell cycle. [NIH] Clamp: A u-shaped steel rod used with a pin or wire for skeletal traction in the treatment of certain fractures. [NIH] Clinical Medicine: The study and practice of medicine by direct examination of the patient. [NIH]

Clinical study: A research study in which patients receive treatment in a clinic or other medical facility. Reports of clinical studies can contain results for single patients (case reports) or many patients (case series or clinical trials). [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Clone: The term "clone" has acquired a new meaning. It is applied specifically to the bits of inserted foreign DNA in the hybrid molecules of the population. Each inserted segment originally resided in the DNA of a complex genome amid millions of other DNA segment. [NIH]

Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Cochlea: The part of the internal ear that is concerned with hearing. It forms the anterior part of the labyrinth, is conical, and is placed almost horizontally anterior to the vestibule. [NIH]

Cochlear: Of or pertaining to the cochlea. [EU] Cochlear Diseases: Diseases of the cochlea, the part of the inner ear that is concerned with hearing. [NIH] Cochlear Duct: Spiral tube in the bony canal of the cochlea, lying on its outer wall between the scala vestibuli and scala tympani. [NIH] Cochlear Implantation: Surgical insertion of an electronic device implanted beneath the skin with electrodes to the cochlear nerve to create sound sensation in persons with sensorineural deafness. [NIH] Cochlear Implants: Electronic devices implanted beneath the skin with electrodes to the cochlear nerve to create sound sensation in persons with sensorineural deafness. [NIH] Cochlear Nerve: The cochlear part of the 8th cranial nerve (vestibulocochlear nerve). The cochlear nerve fibers originate from neurons of the spiral ganglion and project peripherally to cochlear hair cells and centrally to the cochlear nuclei (cochlear nucleus) of the brain stem. They mediate the sense of hearing. [NIH] Cochlear Nucleus: The brain stem nucleus that receives the central input from the cochlear nerve. The cochlear nucleus is located lateral and dorsolateral to the inferior cerebellar peduncles and is functionally divided into dorsal and ventral parts. It is tonotopically organized, performs the first stage of central auditory processing, and projects (directly or indirectly) to higher auditory areas including the superior olivary nuclei, the medial geniculi, the inferior colliculi, and the auditory cortex. [NIH] Coenzyme: An organic nonprotein molecule, frequently a phosphorylated derivative of a water-soluble vitamin, that binds with the protein molecule (apoenzyme) to form the active enzyme (holoenzyme). [EU] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH]

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Cognition: Intellectual or mental process whereby an organism becomes aware of or obtains knowledge. [NIH] Cognitive behavior therapy: A system of psychotherapy based on the premise that distorted or dysfunctional thinking, which influences a person's mood or behavior, is common to all psychosocial problems. The focus of therapy is to identify the distorted thinking and to replace it with more rational, adaptive thoughts and beliefs. [NIH] Cognitive restructuring: A method of identifying and replacing fear-promoting, irrational beliefs with more realistic and functional ones. [NIH] Collagen: A polypeptide substance comprising about one third of the total protein in mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline, hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the high content of polar groups which are responsible for its swelling properties. [NIH] Communication Disorders: Disorders of verbal and nonverbal communication caused by receptive or expressive language disorders, cognitive dysfunction (e.g., mental retardation), psychiatric conditions, and hearing disorders. [NIH] Competency: The capacity of the bacterium to take up DNA from its surroundings. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements,

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megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Compress: A plug used to occludate an orifice in the control of bleeding, or to mop up secretions; an absorbent pad. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Computed tomography: CT scan. A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computerized tomography and computerized axial tomography (CAT) scan. [NIH] Computerized axial tomography: A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called CAT scan, computed tomography (CT scan), or computerized tomography. [NIH] Computerized tomography: A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computerized axial tomography (CAT) scan and computed tomography (CT scan). [NIH] Conception: The onset of pregnancy, marked by implantation of the blastocyst; the formation of a viable zygote. [EU] Concomitant: Accompanying; accessory; joined with another. [EU] Concretion: Minute, hard, yellow masses found in the palpebral conjunctivae of elderly people or following chronic conjunctivitis, composed of the products of cellular degeneration retained in the depressions and tubular recesses in the conjunctiva. [NIH] Conduction: The transfer of sound waves, heat, nervous impulses, or electricity. [EU] Cone: One of the special retinal receptor elements which are presumed to be primarily concerned with perception of light and color stimuli when the eye is adapted to light. [NIH] Congenita: Displacement, subluxation, or malposition of the crystalline lens. [NIH] Congestion: Excessive or abnormal accumulation of blood in a part. [EU] Conjugated: Acting or operating as if joined; simultaneous. [EU] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue Cells: A group of cells that includes fibroblasts, cartilage cells, adipocytes, smooth muscle cells, and bone cells. [NIH] Connexins: A group of homologous proteins which form the intermembrane channels of gap junctions. The connexins are the products of an identified gene family which has both highly conserved and highly divergent regions. The variety contributes to the wide range of functional properties of gap junctions. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Constipation: Infrequent or difficult evacuation of feces. [NIH]

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Constitutional: 1. Affecting the whole constitution of the body; not local. 2. Pertaining to the constitution. [EU] Constriction: The act of constricting. [NIH] Consultation: A deliberation between two or more physicians concerning the diagnosis and the proper method of treatment in a case. [NIH] Consumer Organizations: Organized groups of users of goods and services. [NIH] Consumption: Pulmonary tuberculosis. [NIH] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Contralateral: Having to do with the opposite side of the body. [NIH] Control group: In a clinical trial, the group that does not receive the new treatment being studied. This group is compared to the group that receives the new treatment, to see if the new treatment works. [NIH] Controlled study: An experiment or clinical trial that includes a comparison (control) group. [NIH]

Contusion: A bruise; an injury of a part without a break in the skin. [EU] Conventional therapy: A currently accepted and widely used treatment for a certain type of disease, based on the results of past research. Also called conventional treatment. [NIH] Conventional treatment: A currently accepted and widely used treatment for a certain type of disease, based on the results of past research. Also called conventional therapy. [NIH] Convulsions: A general term referring to sudden and often violent motor activity of cerebral or brainstem origin. Convulsions may also occur in the absence of an electrical cerebral discharge (e.g., in response to hypotension). [NIH] Convulsive: Relating or referring to spasm; affected with spasm; characterized by a spasm or spasms. [NIH] Coordination: Muscular or motor regulation or the harmonious cooperation of muscles or groups of muscles, in a complex action or series of actions. [NIH] Cornea: The transparent part of the eye that covers the iris and the pupil and allows light to enter the inside. [NIH] Corneum: The superficial layer of the epidermis containing keratinized cells. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary heart disease: A type of heart disease caused by narrowing of the coronary arteries that feed the heart, which needs a constant supply of oxygen and nutrients carried by the blood in the coronary arteries. When the coronary arteries become narrowed or clogged by fat and cholesterol deposits and cannot supply enough blood to the heart, CHD results. [NIH] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Cortical: Pertaining to or of the nature of a cortex or bark. [EU] Cortices: The outer layer of an organ; used especially of the cerebrum and cerebellum. [NIH]

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Corticosteroid: Any of the steroids elaborated by the adrenal cortex (excluding the sex hormones of adrenal origin) in response to the release of corticotrophin (adrenocorticotropic hormone) by the pituitary gland, to any of the synthetic equivalents of these steroids, or to angiotensin II. They are divided, according to their predominant biological activity, into three major groups: glucocorticoids, chiefly influencing carbohydrate, fat, and protein metabolism; mineralocorticoids, affecting the regulation of electrolyte and water balance; and C19 androgens. Some corticosteroids exhibit both types of activity in varying degrees, and others exert only one type of effect. The corticosteroids are used clinically for hormonal replacement therapy, for suppression of ACTH secretion by the anterior pituitary, as antineoplastic, antiallergic, and anti-inflammatory agents, and to suppress the immune response. Called also adrenocortical hormone and corticoid. [EU] Cortisone: A natural steroid hormone produced in the adrenal gland. It can also be made in the laboratory. Cortisone reduces swelling and can suppress immune responses. [NIH] Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU] Craniocerebral Trauma: Traumatic injuries involving the cranium and intracranial structures (i.e., brain; cranial nerves; meninges; and other structures). Injuries may be classified by whether or not the skull is penetrated (i.e., penetrating vs. nonpenetrating) or whether there is an associated hemorrhage. [NIH] Cues: Signals for an action; that specific portion of a perceptual field or pattern of stimuli to which a subject has learned to respond. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cytochrome: Any electron transfer hemoprotein having a mode of action in which the transfer of a single electron is effected by a reversible valence change of the central iron atom of the heme prosthetic group between the +2 and +3 oxidation states; classified as cytochromes a in which the heme contains a formyl side chain, cytochromes b, which contain protoheme or a closely similar heme that is not covalently bound to the protein, cytochromes c in which protoheme or other heme is covalently bound to the protein, and cytochromes d in which the iron-tetrapyrrole has fewer conjugated double bonds than the hemes have. Well-known cytochromes have been numbered consecutively within groups and are designated by subscripts (beginning with no subscript), e.g. cytochromes c, c1, C2, . New cytochromes are named according to the wavelength in nanometres of the absorption maximum of the a-band of the iron (II) form in pyridine, e.g., c-555. [EU] Cytokine: Small but highly potent protein that modulates the activity of many cell types, including T and B cells. [NIH] Cytomegalovirus: A genus of the family Herpesviridae, subfamily Betaherpesvirinae, infecting the salivary glands, liver, spleen, lungs, eyes, and other organs, in which they produce characteristically enlarged cells with intranuclear inclusions. Infection with Cytomegalovirus is also seen as an opportunistic infection in AIDS. [NIH] Cytoplasm: The protoplasm of a cell exclusive of that of the nucleus; it consists of a continuous aqueous solution (cytosol) and the organelles and inclusions suspended in it (phaneroplasm), and is the site of most of the chemical activities of the cell. [EU] Cytoskeleton: The network of filaments, tubules, and interconnecting filamentous bridges which give shape, structure, and organization to the cytoplasm. [NIH] Cytotoxic: Cell-killing. [NIH]

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Cytotoxicity: Quality of being capable of producing a specific toxic action upon cells of special organs. [NIH] Data Collection: Systematic gathering of data for a particular purpose from various sources, including questionnaires, interviews, observation, existing records, and electronic devices. The process is usually preliminary to statistical analysis of the data. [NIH] Databases, Bibliographic: Extensive collections, reputedly complete, of references and citations to books, articles, publications, etc., generally on a single subject or specialized subject area. Databases can operate through automated files, libraries, or computer disks. The concept should be differentiated from factual databases which is used for collections of data and facts apart from bibliographic references to them. [NIH] Day Care: Institutional health care of patients during the day. The patients return home at night. [NIH] Deamination: The removal of an amino group (NH2) from a chemical compound. [NIH] Decision Making: The process of making a selective intellectual judgment when presented with several complex alternatives consisting of several variables, and usually defining a course of action or an idea. [NIH] Decompression: Decompression external to the body, most often the slow lessening of external pressure on the whole body (especially in caisson workers, deep sea divers, and persons who ascend to great heights) to prevent decompression sickness. It includes also sudden accidental decompression, but not surgical (local) decompression or decompression applied through body openings. [NIH] Decompression Sickness: A condition occurring as a result of exposure to a rapid fall in ambient pressure. Gases, nitrogen in particular, come out of solution and form bubbles in body fluid and blood. These gas bubbles accumulate in joint spaces and the peripheral circulation impairing tissue oxygenation causing disorientation, severe pain, and potentially death. [NIH] Deferoxamine: Natural product isolated from Streptomyces pilosus. It forms iron complexes and is used as a chelating agent, particularly in the form of its mesylate. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Deletion: A genetic rearrangement through loss of segments of DNA (chromosomes), bringing sequences, which are normally separated, into close proximity. [NIH] Delirium: (DSM III-R) an acute, reversible organic mental disorder characterized by reduced ability to maintain attention to external stimuli and disorganized thinking as manifested by rambling, irrelevant, or incoherent speech; there are also a reduced level of consciousness, sensory misperceptions, disturbance of the sleep-wakefulness cycle and level of psychomotor activity, disorientation to time, place, or person, and memory impairment. Delirium may be caused by a large number of conditions resulting in derangement of cerebral metabolism, including systemic infection, poisoning, drug intoxication or withdrawal, seizures or head trauma, and metabolic disturbances such as hypoxia, hypoglycaemia, fluid, electrolyte, or acid-base imbalances, or hepatic or renal failure. Called also acute confusional state and acute brain syndrome. [EU] Delusions: A false belief regarding the self or persons or objects outside the self that persists despite the facts, and is not considered tenable by one's associates. [NIH] Dementia: An acquired organic mental disorder with loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning. The dysfunction is multifaceted and involves memory, behavior, personality, judgment, attention, spatial

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relations, language, abstract thought, and other executive functions. The intellectual decline is usually progressive, and initially spares the level of consciousness. [NIH] Dendrites: Extensions of the nerve cell body. They are short and branched and receive stimuli from other neurons. [NIH] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Deprivation: Loss or absence of parts, organs, powers, or things that are needed. [EU] Developed Countries: Countries that have reached a level of economic achievement through an increase of production, per capita income and consumption, and utilization of natural and human resources. [NIH] Developing Countries: Countries in the process of change directed toward economic growth, that is, an increase in production, per capita consumption, and income. The process of economic growth involves better utilization of natural and human resources, which results in a change in the social, political, and economic structures. [NIH] Dexamethasone: (11 beta,16 alpha)-9-Fluoro-11,17,21-trihydroxy-16-methylpregna-1,4diene-3,20-dione. An anti-inflammatory glucocorticoid used either in the free alcohol or esterified form in treatment of conditions that respond generally to cortisone. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diabetic Retinopathy: Retinopathy associated with diabetes mellitus, which may be of the background type, progressively characterized by microaneurysms, interretinal punctuate macular edema, or of the proliferative type, characterized by neovascularization of the retina and optic disk, which may project into the vitreous, proliferation of fibrous tissue, vitreous hemorrhage, and retinal detachment. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diaphragm: The musculofibrous partition that separates the thoracic cavity from the abdominal cavity. Contraction of the diaphragm increases the volume of the thoracic cavity aiding inspiration. [NIH] Diastolic: Of or pertaining to the diastole. [EU] Diencephalon: The paired caudal parts of the prosencephalon from which the thalamus, hypothalamus, epithalamus, and subthalamus are derived. [NIH] Diffusion: The tendency of a gas or solute to pass from a point of higher pressure or concentration to a point of lower pressure or concentration and to distribute itself throughout the available space; a major mechanism of biological transport. [NIH] Digestive system: The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Dilatation: The act of dilating. [NIH] Dilatation, Pathologic: The condition of an anatomical structure's being dilated beyond normal dimensions. [NIH] Dilation: A process by which the pupil is temporarily enlarged with special eye drops (mydriatic); allows the eye care specialist to better view the inside of the eye. [NIH] Diploid: Having two sets of chromosomes. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU]

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Directivity: A measure of the degree to which a microphone is able to differentiate between sounds from different directions. [NIH] Discrimination: The act of qualitative and/or quantitative differentiation between two or more stimuli. [NIH] Dispenser: Glass, metal or plastic shell fitted with valve from which a pressurized formulation is dispensed; an instrument for atomizing. [NIH] Dissociation: 1. The act of separating or state of being separated. 2. The separation of a molecule into two or more fragments (atoms, molecules, ions, or free radicals) produced by the absorption of light or thermal energy or by solvation. 3. In psychology, a defense mechanism in which a group of mental processes are segregated from the rest of a person's mental activity in order to avoid emotional distress, as in the dissociative disorders (q.v.), or in which an idea or object is segregated from its emotional significance; in the first sense it is roughly equivalent to splitting, in the second, to isolation. 4. A defect of mental integration in which one or more groups of mental processes become separated off from normal consciousness and, thus separated, function as a unitary whole. [EU] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] Diuretic: A drug that increases the production of urine. [NIH] Diuretics, Thiazide: Diuretics characterized as analogs of 1,2,4-benzothiadiazine-1,1dioxide. All have a common mechanism of action and differ primarily in the dose required to produce a given effect. They act directly on the kidney to increase the excretion of sodium chloride and water and also increase excretion of potassium ions. [NIH] Diving: An activity in which the organism plunges into water. It includes scuba and bell diving. Diving as natural behavior of animals goes here, as well as diving in decompression experiments with humans or animals. [NIH] Dizziness: An imprecise term which may refer to a sense of spatial disorientation, motion of the environment, or lightheadedness. [NIH] Domesticated: Species in which the evolutionary process has been influenced by humans to meet their needs. [NIH] Dominance: In genetics, the full phenotypic expression of a gene in both heterozygotes and homozygotes. [EU] Dopamine: An endogenous catecholamine and prominent neurotransmitter in several systems of the brain. In the synthesis of catecholamines from tyrosine, it is the immediate precursor to norepinephrine and epinephrine. Dopamine is a major transmitter in the extrapyramidal system of the brain, and important in regulating movement. A family of dopaminergic receptor subtypes mediate its action. Dopamine is used pharmacologically for its direct (beta adrenergic agonist) and indirect (adrenergic releasing) sympathomimetic effects including its actions as an inotropic agent and as a renal vasodilator. [NIH] Dorsal: 1. Pertaining to the back or to any dorsum. 2. Denoting a position more toward the back surface than some other object of reference; same as posterior in human anatomy; superior in the anatomy of quadrupeds. [EU] Dorsum: A plate of bone which forms the posterior boundary of the sella turcica. [NIH] Double-blinded: A clinical trial in which neither the medical staff nor the person knows which of several possible therapies the person is receiving. [NIH] Drive: A state of internal activity of an organism that is a necessary condition before a given stimulus will elicit a class of responses; e.g., a certain level of hunger (drive) must be present before food will elicit an eating response. [NIH]

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Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Drug Tolerance: Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from drug resistance wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from maximum tolerated dose and no-observed-adverse-effect level. [NIH] Duct: A tube through which body fluids pass. [NIH] Duke: A lamp which produces ultraviolet radiations for certain ophthalmologic therapy. [NIH]

Dura mater: The outermost, toughest, and most fibrous of the three membranes (meninges) covering the brain and spinal cord; called also pachymeninx. [EU] Dyskinesia: Impairment of the power of voluntary movement, resulting in fragmentary or incomplete movements. [EU] Dysostosis: Defective bone formation. [NIH] Dysplasia: Cells that look abnormal under a microscope but are not cancer. [NIH] Dystonia: Disordered tonicity of muscle. [EU] Dystrophy: Any disorder arising from defective or faulty nutrition, especially the muscular dystrophies. [EU] Ear Diseases: Diseases of the ear, general or unspecified. [NIH] Eardrum: A thin, tense membrane forming the greater part of the outer wall of the tympanic cavity and separating it from the external auditory meatus; it constitutes the boundary between the external and middle ear. [NIH] Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH] Education, Special: Education of the individual who markedly deviates intellectually, physically, socially, or emotionally from those considered to be normal, thus requiring special instruction. [NIH] Effector: It is often an enzyme that converts an inactive precursor molecule into an active second messenger. [NIH] Effector cell: A cell that performs a specific function in response to a stimulus; usually used to describe cells in the immune system. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Effusion: The escape of fluid into a part or tissue, as an exudation or a transudation. [EU] Elastin: The protein that gives flexibility to tissues. [NIH] Electrode: Component of the pacing system which is at the distal end of the lead. It is the interface with living cardiac tissue across which the stimulus is transmitted. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electromagnetic Fields: Fields representing the joint interplay of electric and magnetic forces. [NIH] Electrons: Stable elementary particles having the smallest known negative charge, present in all elements; also called negatrons. Positively charged electrons are called positrons. The

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numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the latter being a high-energy biproduct of nuclear decay. [NIH] Electrophysiological: Pertaining to electrophysiology, that is a branch of physiology that is concerned with the electric phenomena associated with living bodies and involved in their functional activity. [EU] Electroretinography: Recording of electric potentials in the retina after stimulation by light. [NIH]

Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Embryogenesis: The process of embryo or embryoid formation, whether by sexual (zygotic) or asexual means. In asexual embryogenesis embryoids arise directly from the explant or on intermediary callus tissue. In some cases they arise from individual cells (somatic cell embryoge). [NIH] Embryology: The study of the development of an organism during the embryonic and fetal stages of life. [NIH] Emulsion: A preparation of one liquid distributed in small globules throughout the body of a second liquid. The dispersed liquid is the discontinuous phase, and the dispersion medium is the continuous phase. When oil is the dispersed liquid and an aqueous solution is the continuous phase, it is known as an oil-in-water emulsion, whereas when water or aqueous solution is the dispersed phase and oil or oleaginous substance is the continuous phase, it is known as a water-in-oil emulsion. Pharmaceutical emulsions for which official standards have been promulgated include cod liver oil emulsion, cod liver oil emulsion with malt, liquid petrolatum emulsion, and phenolphthalein in liquid petrolatum emulsion. [EU] Enamel: A very hard whitish substance which covers the dentine of the anatomical crown of a tooth. [NIH] Encephalitis: Inflammation of the brain due to infection, autoimmune processes, toxins, and other conditions. Viral infections (see encephalitis, viral) are a relatively frequent cause of this condition. [NIH] Encephalitis, Viral: Inflammation of brain parenchymal tissue as a result of viral infection. Encephalitis may occur as primary or secondary manifestation of Togaviridae infections; Herpesviridae infections; Adenoviridae infections; Flaviviridae infections; Bunyaviridae infections; Picornaviridae infections; Paramyxoviridae infections; Orthomyxoviridae infections; Retroviridae infections; and Arenaviridae infections. [NIH] Endemic: Present or usually prevalent in a population or geographical area at all times; said of a disease or agent. Called also endemial. [EU] Endocrine System: The system of glands that release their secretions (hormones) directly into the circulatory system. In addition to the endocrine glands, included are the chromaffin system and the neurosecretory systems. [NIH] Endolymph: The fluid contained in the membranous labyrinth of the ear. [NIH] Endolymphatic Duct: Duct connecting the endolymphatic sac with the membranous labyrinth. [NIH] Endolymphatic Sac: The blind pouch at the end of the endolymphatic duct. [NIH] Endometrial: Having to do with the endometrium (the layer of tissue that lines the uterus). [NIH]

Endometriosis: A condition in which tissue more or less perfectly resembling the uterine mucous membrane (the endometrium) and containing typical endometrial granular and

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stromal elements occurs aberrantly in various locations in the pelvic cavity. [NIH] Endometrium: The layer of tissue that lines the uterus. [NIH] Endoscopy: Endoscopic examination, therapy or surgery performed on interior parts of the body. [NIH] Endothelial cell: The main type of cell found in the inside lining of blood vessels, lymph vessels, and the heart. [NIH] Endotoxins: Toxins closely associated with the living cytoplasm or cell wall of certain microorganisms, which do not readily diffuse into the culture medium, but are released upon lysis of the cells. [NIH] End-stage renal: Total chronic kidney failure. When the kidneys fail, the body retains fluid and harmful wastes build up. A person with ESRD needs treatment to replace the work of the failed kidneys. [NIH] Enhancers: Transcriptional element in the virus genome. [NIH] Environmental Exposure: The exposure to potentially harmful chemical, physical, or biological agents in the environment or to environmental factors that may include ionizing radiation, pathogenic organisms, or toxic chemicals. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Epidemic: Occurring suddenly in numbers clearly in excess of normal expectancy; said especially of infectious diseases but applied also to any disease, injury, or other healthrelated event occurring in such outbreaks. [EU] Epidemiological: Relating to, or involving epidemiology. [EU] Epidermis: Nonvascular layer of the skin. It is made up, from within outward, of five layers: 1) basal layer (stratum basale epidermidis); 2) spinous layer (stratum spinosum epidermidis); 3) granular layer (stratum granulosum epidermidis); 4) clear layer (stratum lucidum epidermidis); and 5) horny layer (stratum corneum epidermidis). [NIH] Epidural: The space between the wall of the spinal canal and the covering of the spinal cord. An epidural injection is given into this space. [NIH] Epidural block: An injection of an anesthetic drug into the space between the wall of the spinal canal and the covering of the spinal cord. [NIH] Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Epithelial Cells: Cells that line the inner and outer surfaces of the body. [NIH] Epithelium: One or more layers of epithelial cells, supported by the basal lamina, which covers the inner or outer surfaces of the body. [NIH] Epitopes: Sites on an antigen that interact with specific antibodies. [NIH] Equipment and Supplies: Expendable and nonexpendable equipment, supplies, apparatus, and instruments that are used in diagnostic, surgical, therapeutic, scientific, and

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experimental procedures. [NIH] Erbium: Erbium. An element of the rare earth family of metals. It has the atomic symbol Er, atomic number 68, and atomic weight 167.26. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Essential Tremor: A rhythmic, involuntary, purposeless, oscillating movement resulting from the alternate contraction and relaxation of opposing groups of muscles. [NIH] Etidronate: A drug that belongs to the family of drugs called bisphosphonates. Bisphosphonates are used as treatment for hypercalcemia (abnormally high levels of calcium in the blood) and for cancer that has spread to the bone (bone metastases). [NIH] Eukaryotic Cells: Cells of the higher organisms, containing a true nucleus bounded by a nuclear membrane. [NIH] Eustachian tube: The middle ear cavity is in communication with the back of the nose through the Eustachian tube, which is normally closed, but opens on swallowing, in order to maintain equal air pressure. [NIH] Evoke: The electric response recorded from the cerebral cortex after stimulation of a peripheral sense organ. [NIH] Evoked Potentials: The electric response evoked in the central nervous system by stimulation of sensory receptors or some point on the sensory pathway leading from the receptor to the cortex. The evoked stimulus can be auditory, somatosensory, or visual, although other modalities have been reported. Event-related potentials is sometimes used synonymously with evoked potentials but is often associated with the execution of a motor, cognitive, or psychophysiological task, as well as with the response to a stimulus. [NIH] Excitation: An act of irritation or stimulation or of responding to a stimulus; the addition of energy, as the excitation of a molecule by absorption of photons. [EU] Excitatory: When cortical neurons are excited, their output increases and each new input they receive while they are still excited raises their output markedly. [NIH] Excitatory Amino Acid Agonists: Drugs that bind to and activate excitatory amino acid receptors. [NIH] Excitatory Amino Acids: Endogenous amino acids released by neurons as excitatory neurotransmitters. Glutamic acid is the most common excitatory neurotransmitter in the brain. Aspartic acid has been regarded as an excitatory transmitter for many years, but the extent of its role as a transmitter is unclear. [NIH] Excitotoxicity: Excessive exposure to glutamate or related compounds can kill brain neurons, presumably by overstimulating them. [NIH] Excrete: To get rid of waste from the body. [NIH] Exhaustion: The feeling of weariness of mind and body. [NIH] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Expander: Any of several colloidal substances of high molecular weight. used as a blood or plasma substitute in transfusion for increasing the volume of the circulating blood. called also extender. [NIH] Expiration: The act of breathing out, or expelling air from the lungs. [EU] Extender: Any of several colloidal substances of high molecular weight, used as a blood or

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plasma substitute in transfusion for increasing the volume of the circulating blood. [NIH] External-beam radiation: Radiation therapy that uses a machine to aim high-energy rays at the cancer. Also called external radiation. [NIH] Extracellular: Outside a cell or cells. [EU] Extracellular Matrix: A meshwork-like substance found within the extracellular space and in association with the basement membrane of the cell surface. It promotes cellular proliferation and provides a supporting structure to which cells or cell lysates in culture dishes adhere. [NIH] Extracellular Matrix Proteins: Macromolecular organic compounds that contain carbon, hydrogen, oxygen, nitrogen, and usually, sulfur. These macromolecules (proteins) form an intricate meshwork in which cells are embedded to construct tissues. Variations in the relative types of macromolecules and their organization determine the type of extracellular matrix, each adapted to the functional requirements of the tissue. The two main classes of macromolecules that form the extracellular matrix are: glycosaminoglycans, usually linked to proteins (proteoglycans), and fibrous proteins (e.g., collagen, elastin, fibronectins and laminin). [NIH] Extracellular Space: Interstitial space between cells, occupied by fluid as well as amorphous and fibrous substances. [NIH] Extraction: The process or act of pulling or drawing out. [EU] Extrapyramidal: Outside of the pyramidal tracts. [EU] Extremity: A limb; an arm or leg (membrum); sometimes applied specifically to a hand or foot. [EU] Eye Movements: Voluntary or reflex-controlled movements of the eye. [NIH] Facial: Of or pertaining to the face. [EU] Facial Nerve: The 7th cranial nerve. The facial nerve has two parts, the larger motor root which may be called the facial nerve proper, and the smaller intermediate or sensory root. Together they provide efferent innervation to the muscles of facial expression and to the lacrimal and salivary glands, and convey afferent information for taste from the anterior two-thirds of the tongue and for touch from the external ear. [NIH] Facial Nerve Diseases: Diseases of the facial nerve or nuclei. Pontine disorders may affect the facial nuclei or nerve fascicle. The nerve may be involved intracranially, along its course through the petrous portion of the temporal bone, or along its extracranial course. Clinical manifestations include facial muscle weakness, loss of taste from the anterior tongue, hyperacusis, and decreased lacrimation. [NIH] Facial Paralysis: Severe or complete loss of facial muscle motor function. This condition may result from central or peripheral lesions. Damage to CNS motor pathways from the cerebral cortex to the facial nuclei in the pons leads to facial weakness that generally spares the forehead muscles. Facial nerve diseases generally results in generalized hemifacial weakness. Neuromuscular junction diseases and muscular diseases may also cause facial paralysis or paresis. [NIH] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Family Relations: Behavioral, psychological, and social relations among various members of the nuclear family and the extended family. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatigue: The state of weariness following a period of exertion, mental or physical,

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characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. [NIH]

Fatty acids: A major component of fats that are used by the body for energy and tissue development. [NIH] Femur: The longest and largest bone of the skeleton, it is situated between the hip and the knee. [NIH] Ferritin: An iron-containing protein complex that is formed by a combination of ferric iron with the protein apoferritin. [NIH] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Fibrin: A protein derived from fibrinogen in the presence of thrombin, which forms part of the blood clot. [NIH] Fibroblast Growth Factor: Peptide isolated from the pituitary gland and from the brain. It is a potent mitogen which stimulates growth of a variety of mesodermal cells including chondrocytes, granulosa, and endothelial cells. The peptide may be active in wound healing and animal limb regeneration. [NIH] Fibronectins: Glycoproteins found on the surfaces of cells, particularly in fibrillar structures. The proteins are lost or reduced when these cells undergo viral or chemical transformation. They are highly susceptible to proteolysis and are substrates for activated blood coagulation factor VIII. The forms present in plasma are called cold-insoluble globulins. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Filtration: The passage of a liquid through a filter, accomplished by gravity, pressure, or vacuum (suction). [EU] Firearms: Small-arms weapons, including handguns, pistols, revolvers, rifles, shotguns, etc. [NIH]

Fistula: Abnormal communication most commonly seen between two internal organs, or between an internal organ and the surface of the body. [NIH] Fixation: 1. The act or operation of holding, suturing, or fastening in a fixed position. 2. The condition of being held in a fixed position. 3. In psychiatry, a term with two related but distinct meanings : (1) arrest of development at a particular stage, which like regression (return to an earlier stage), if temporary is a normal reaction to setbacks and difficulties but if protracted or frequent is a cause of developmental failures and emotional problems, and (2) a close and suffocating attachment to another person, especially a childhood figure, such as one's mother or father. Both meanings are derived from psychoanalytic theory and refer to 'fixation' of libidinal energy either in a specific erogenous zone, hence fixation at the oral, anal, or phallic stage, or in a specific object, hence mother or father fixation. 4. The use of a fixative (q.v.) to preserve histological or cytological specimens. 5. In chemistry, the process whereby a substance is removed from the gaseous or solution phase and localized, as in carbon dioxide fixation or nitrogen fixation. 6. In ophthalmology, direction of the gaze so that the visual image of the object falls on the fovea centralis. 7. In film processing, the chemical removal of all undeveloped salts of the film emulsion, leaving only the developed silver to form a permanent image. [EU] Flaccid: Weak, lax and soft. [EU] Flatus: Gas passed through the rectum. [NIH] Focus Groups: A method of data collection and a qualitative research tool in which a small group of individuals are brought together and allowed to interact in a discussion of their opinions about topics, issues, or questions. [NIH]

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Fold: A plication or doubling of various parts of the body. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Fossa: A cavity, depression, or pit. [NIH] Founder Effect: The principle that when a small subgroup of a larger population establishes itself as a separate and isolated entity, its gene pool carries only a fraction of the genetic diversity of the parental population. This may result in an increased frequency of certain diseases in the subgroup, especially those diseases known to be autosomal recessive. [NIH] Fovea: The central part of the macula that provides the sharpest vision. [NIH] Frontal Lobe: The anterior part of the cerebral hemisphere. [NIH] Functional magnetic resonance imaging: A noninvasive tool used to observe functioning in the brain or other organs by detecting changes in chemical composition, blood flow, or both. [NIH]

Furosemide: A sulfamyl saluretic and diuretic. It has a fast onset and short duration of action and is used in edema and chronic renal insufficiency. [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gamma knife: Radiation therapy in which high-energy rays are aimed at a tumor from many angles in a single treatment session. [NIH] Gamma Rays: Very powerful and penetrating, high-energy electromagnetic radiation of shorter wavelength than that of x-rays. They are emitted by a decaying nucleus, usually between 0.01 and 10 MeV. They are also called nuclear x-rays. [NIH] Ganglia: Clusters of multipolar neurons surrounded by a capsule of loosely organized connective tissue located outside the central nervous system. [NIH] Ganglion: 1. A knot, or knotlike mass. 2. A general term for a group of nerve cell bodies located outside the central nervous system; occasionally applied to certain nuclear groups within the brain or spinal cord, e.g. basal ganglia. 3. A benign cystic tumour occurring on a aponeurosis or tendon, as in the wrist or dorsum of the foot; it consists of a thin fibrous capsule enclosing a clear mucinous fluid. [EU] Ganglionic Blockers: Agents having as their major action the interruption of neural transmission at nicotinic receptors on postganglionic autonomic neurons. Because their actions are so broad, including blocking of sympathetic and parasympathetic systems, their therapeutic use has been largely supplanted by more specific drugs. They may still be used in the control of blood pressure in patients with acute dissecting aortic aneurysm and for the induction of hypotension in surgery. [NIH] Gap Junctions: Connections between cells which allow passage of small molecules and electric current. Gap junctions were first described anatomically as regions of close apposition between cells with a narrow (1-2 nm) gap between cell membranes. The variety in the properties of gap junctions is reflected in the number of connexins, the family of proteins which form the junctions. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gas exchange: Primary function of the lungs; transfer of oxygen from inhaled air into the blood and of carbon dioxide from the blood into the lungs. [NIH] Gelatin: A product formed from skin, white connective tissue, or bone collagen. It is used as a protein food adjuvant, plasma substitute, hemostatic, suspending agent in pharmaceutical preparations, and in the manufacturing of capsules and suppositories. [NIH]

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Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] Gene Targeting: The integration of exogenous DNA into the genome of an organism at sites where its expression can be suitably controlled. This integration occurs as a result of homologous recombination. [NIH] Genetic Code: The specifications for how information, stored in nucleic acid sequence (base sequence), is translated into protein sequence (amino acid sequence). The start, stop, and order of amino acids of a protein is specified by consecutive triplets of nucleotides called codons (codon). [NIH] Genetic Counseling: Advising families of the risks involved pertaining to birth defects, in order that they may make an informed decision on current or future pregnancies. [NIH] Genetic Engineering: Directed modification of the gene complement of a living organism by such techniques as altering the DNA, substituting genetic material by means of a virus, transplanting whole nuclei, transplanting cell hybrids, etc. [NIH] Genetic Techniques: Chromosomal, biochemical, intracellular, and other methods used in the study of genetics. [NIH] Genetic testing: Analyzing DNA to look for a genetic alteration that may indicate an increased risk for developing a specific disease or disorder. [NIH] Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH] Geriatric: Pertaining to the treatment of the aged. [EU] Germ Cells: The reproductive cells in multicellular organisms. [NIH] Gestation: The period of development of the young in viviparous animals, from the time of fertilization of the ovum until birth. [EU] Gestures: Movement of a part of the body for the purpose of communication. [NIH] Giant Cells: Multinucleated masses produced by the fusion of many cells; often associated with viral infections. In AIDS, they are induced when the envelope glycoprotein of the HIV virus binds to the CD4 antigen of uninfected neighboring T4 cells. The resulting syncytium leads to cell death and thus may account for the cytopathic effect of the virus. [NIH] Gifted: As used in child psychiatry, this term is meant to refer to a child whose intelligence is in the upper 2 per cent of the total population of his age. [NIH] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Glucocorticoid: A compound that belongs to the family of compounds called corticosteroids (steroids). Glucocorticoids affect metabolism and have anti-inflammatory and immunosuppressive effects. They may be naturally produced (hormones) or synthetic (drugs). [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glucose Intolerance: A pathological state in which the fasting plasma glucose level is less

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than 140 mg per deciliter and the 30-, 60-, or 90-minute plasma glucose concentration following a glucose tolerance test exceeds 200 mg per deciliter. This condition is seen frequently in diabetes mellitus but also occurs with other diseases. [NIH] Glutamate: Excitatory neurotransmitter of the brain. [NIH] Glutamic Acid: A non-essential amino acid naturally occurring in the L-form. Glutamic acid (glutamate) is the most common excitatory neurotransmitter in the central nervous system. [NIH]

Glutathione Peroxidase: An enzyme catalyzing the oxidation of 2 moles of glutathione in the presence of hydrogen peroxide to yield oxidized glutathione and water. EC 1.11.1.9. [NIH]

Glycine: A non-essential amino acid. It is found primarily in gelatin and silk fibroin and used therapeutically as a nutrient. It is also a fast inhibitory neurotransmitter. [NIH] Glycoprotein: A protein that has sugar molecules attached to it. [NIH] Glycosaminoglycans: Heteropolysaccharides which contain an N-acetylated hexosamine in a characteristic repeating disaccharide unit. The repeating structure of each disaccharide involves alternate 1,4- and 1,3-linkages consisting of either N-acetylglucosamine or Nacetylgalactosamine. [NIH] Glycosidic: Formed by elimination of water between the anomeric hydroxyl of one sugar and a hydroxyl of another sugar molecule. [NIH] Goiter: Enlargement of the thyroid gland. [NIH] Gonadal: Pertaining to a gonad. [EU] Gonads: The gamete-producing glands, ovary or testis. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Grade: The grade of a tumor depends on how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. Grading systems are different for each type of cancer. [NIH] Grafting: The operation of transfer of tissue from one site to another. [NIH] Gramicidin: Antibiotic mixture that is one of the two principle components of tyrothricin from Bacillus brevis. Gramicidin C or S is a cyclic, ten-amino acid polypeptide and gramicidins A, B, D, etc., seem to be linear polypeptides. The mixture is used topically for gram-positive organisms. It is toxic to blood, liver, kidneys, meninges, and the olfactory apparatus. [NIH] Gram-negative: Losing the stain or decolorized by alcohol in Gram's method of staining, a primary characteristic of bacteria having a cell wall composed of a thin layer of peptidoglycan covered by an outer membrane of lipoprotein and lipopolysaccharide. [EU] Gram-positive: Retaining the stain or resisting decolorization by alcohol in Gram's method of staining, a primary characteristic of bacteria whose cell wall is composed of a thick layer of peptidologlycan with attached teichoic acids. [EU] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Growth factors: Substances made by the body that function to regulate cell division and cell survival. Some growth factors are also produced in the laboratory and used in biological therapy. [NIH] Guinea Pigs: A common name used for the family Caviidae. The most common species is Cavia porcellus which is the domesticated guinea pig used for pets and biomedical research.

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[NIH]

Hair Cells: Mechanoreceptors located in the organ of Corti that are sensitive to auditory stimuli and in the vestibular apparatus that are sensitive to movement of the head. In each case the accessory sensory structures are arranged so that appropriate stimuli cause movement of the hair-like projections (stereocilia and kinocilia) which relay the information centrally in the nervous system. [NIH] Hair Color: Color of hair or fur. [NIH] Hammer: The largest of the three ossicles of the ear. [NIH] Handicap: A handicap occurs as a result of disability, but disability does not always constitute a handicap. A handicap may be said to exist when a disability causes a substantial and continuing reduction in a person's capacity to function socially and vocationally. [NIH] Haploid: An organism with one basic chromosome set, symbolized by n; the normal condition of gametes in diploids. [NIH] Haptens: Small antigenic determinants capable of eliciting an immune response only when coupled to a carrier. Haptens bind to antibodies but by themselves cannot elicit an antibody response. [NIH] Headache: Pain in the cranial region that may occur as an isolated and benign symptom or as a manifestation of a wide variety of conditions including subarachnoid hemorrhage; craniocerebral trauma; central nervous system infections; intracranial hypertension; and other disorders. In general, recurrent headaches that are not associated with a primary disease process are referred to as headache disorders (e.g., migraine). [NIH] Headache Disorders: Common conditions characterized by persistent or recurrent headaches. Headache syndrome classification systems may be based on etiology (e.g., vascular headache, post-traumatic headaches, etc.), temporal pattern (e.g., cluster headache, paroxysmal hemicrania, etc.), and precipitating factors (e.g., cough headache). [NIH] Health Education: Education that increases the awareness and favorably influences the attitudes and knowledge relating to the improvement of health on a personal or community basis. [NIH] Health Services: Services for the diagnosis and treatment of disease and the maintenance of health. [NIH] Health Status: The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures. [NIH] Hearing aid: A miniature, portable sound amplifier for persons with impaired hearing, consisting of a microphone, audio amplifier, earphone, and battery. [NIH] Hearing Disorders: Conditions that impair the transmission or perception of auditory impulses and information from the level of the ear to the temporal cortices, including the sensorineural pathways. [NIH] Hearing Impaired Persons: Persons with any degree of loss of hearing that has an impact on their activities of daily living or that requires special assistance or intervention. [NIH] Hearing Loss, Conductive: Hearing loss due to interference with the acoustic transmission of sound to the cochlea. The interference is in the outer or middle ear. [NIH] Heart attack: A seizure of weak or abnormal functioning of the heart. [NIH] Hematoma: An extravasation of blood localized in an organ, space, or tissue. [NIH] Heme: The color-furnishing portion of hemoglobin. It is found free in tissues and as the prosthetic group in many hemeproteins. [NIH] Hemodialysis: The use of a machine to clean wastes from the blood after the kidneys have

Dictionary 361

failed. The blood travels through tubes to a dialyzer, which removes wastes and extra fluid. The cleaned blood then flows through another set of tubes back into the body. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH] Hemoglobinuria: The presence of free hemoglobin in the urine. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hemorrhagic stroke: A disorder involving bleeding within ischemic brain tissue. Hemorrhagic stroke occurs when blood vessels that are damaged or dead from lack of blood supply (infarcted), located within an area of infarcted brain tissue, rupture and transform an "ischemic" stroke into a hemorrhagic stroke. Ischemia is inadequate tissue oxygenation caused by reduced blood flow; infarction is tissue death resulting from ischemia. Bleeding irritates the brain tissues, causing swelling (cerebral edema). Blood collects into a mass (hematoma). Both swelling and hematoma will compress and displace brain tissue. [NIH] Hereditary: Of, relating to, or denoting factors that can be transmitted genetically from one generation to another. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Heritability: The proportion of observed variation in a particular trait that can be attributed to inherited genetic factors in contrast to environmental ones. [NIH] Heterogeneity: The property of one or more samples or populations which implies that they are not identical in respect of some or all of their parameters, e. g. heterogeneity of variance. [NIH]

Heterozygotes: Having unlike alleles at one or more corresponding loci on homologous chromosomes. [NIH] Histamine: 1H-Imidazole-4-ethanamine. A depressor amine derived by enzymatic decarboxylation of histidine. It is a powerful stimulant of gastric secretion, a constrictor of bronchial smooth muscle, a vasodilator, and also a centrally acting neurotransmitter. [NIH] Histiocytosis: General term for the abnormal appearance of histiocytes in the blood. Based on the pathological features of the cells involved rather than on clinical findings, the histiocytic diseases are subdivided into three groups: Langerhans cell histiocytosis, nonLangerhans cell histiocytosis, and malignant histiocytic disorders. [NIH] Homeostasis: The processes whereby the internal environment of an organism tends to remain balanced and stable. [NIH] Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU] Homozygotes: An individual having a homozygous gene pair. [NIH] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH]

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Host: Any animal that receives a transplanted graft. [NIH] Hybrid: Cross fertilization between two varieties or, more usually, two species of vines, see also crossing. [NIH] Hybridization: The genetic process of crossbreeding to produce a hybrid. Hybrid nucleic acids can be formed by nucleic acid hybridization of DNA and RNA molecules. Protein hybridization allows for hybrid proteins to be formed from polypeptide chains. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrogen Peroxide: A strong oxidizing agent used in aqueous solution as a ripening agent, bleach, and topical anti-infective. It is relatively unstable and solutions deteriorate over time unless stabilized by the addition of acetanilide or similar organic materials. [NIH] Hydrolysis: The process of cleaving a chemical compound by the addition of a molecule of water. [NIH] Hydroxylysine: A hydroxylated derivative of the amino acid lysine that is present in certain collagens. [NIH] Hydroxyproline: A hydroxylated form of the imino acid proline. A deficiency in ascorbic acid can result in impaired hydroxyproline formation. [NIH] Hyperacusis: An abnormally disproportionate increase in the sensation of loudness in response to auditory stimuli of normal volume. Cochlear diseases; vestibulocochlear nerve diseases; facial nerve diseases; stapes surgery; and other disorders may be associated with this condition. [NIH] Hyperbilirubinemia: Pathologic process consisting of an abnormal increase in the amount of bilirubin in the circulating blood, which may result in jaundice. [NIH] Hypercalcemia: Abnormally high level of calcium in the blood. [NIH] Hyperlipidaemia: A general term for elevated concentrations of any or all of the lipids in the plasma, including hyperlipoproteinaemia, hypercholesterolaemia, etc. [EU] Hyperlipidemia: An excess of lipids in the blood. [NIH] Hyperlipoproteinemia: Metabolic disease characterized by elevated plasma cholesterol and/or triglyceride levels. The inherited form is attributed to a single gene mechanism. [NIH] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hypertrophy: General increase in bulk of a part or organ, not due to tumor formation, nor to an increase in the number of cells. [NIH] Hypnotic: A drug that acts to induce sleep. [EU] Hypoglycemia: Abnormally low blood sugar [NIH] Hypogonadism: Condition resulting from or characterized by abnormally decreased functional activity of the gonads, with retardation of growth and sexual development. [NIH] Hypoplasia: Incomplete development or underdevelopment of an organ or tissue. [EU] Hypotension: Abnormally low blood pressure. [NIH] Hypoxanthine: A purine and a reaction intermediate in the metabolism of adenosine and in

Dictionary 363

the formation of nucleic acids by the salvage pathway. [NIH] Hypoxia: Reduction of oxygen supply to tissue below physiological levels despite adequate perfusion of the tissue by blood. [EU] Iatrogenic: Resulting from the activity of physicians. Originally applied to disorders induced in the patient by autosuggestion based on the physician's examination, manner, or discussion, the term is now applied to any adverse condition in a patient occurring as the result of treatment by a physician or surgeon, especially to infections acquired by the patient during the course of treatment. [EU] Ichthyosis: Any of several generalized skin disorders characterized by dryness, roughness, and scaliness, due to hypertrophy of the stratum corneum epidermis. Most are genetic, but some are acquired, developing in association with other systemic disease or genetic syndrome. [NIH] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Idiopathic: Describes a disease of unknown cause. [NIH] Illusion: A false interpretation of a genuine percept. [NIH] Imaging procedures: Methods of producing pictures of areas inside the body. [NIH] Immune function: Production and action of cells that fight disease or infection. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

Immune Sera: Serum that contains antibodies. It is obtained from an animal that has been immunized either by antigen injection or infection with microorganisms containing the antigen. [NIH] Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunity: Nonsusceptibility to the invasive or pathogenic microorganisms or to the toxic effect of antigenic substances. [NIH]

effects

of

foreign

Immunization: Deliberate stimulation of the host's immune response. Active immunization involves administration of antigens or immunologic adjuvants. Passive immunization involves administration of immune sera or lymphocytes or their extracts (e.g., transfer factor, immune RNA) or transplantation of immunocompetent cell producing tissue (thymus or bone marrow). [NIH] Immunocompromised: Having a weakened immune system caused by certain diseases or treatments. [NIH] Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunoglobulin: A protein that acts as an antibody. [NIH] Immunohistochemistry: Histochemical localization of immunoreactive substances using labeled antibodies as reagents. [NIH] Immunologic: The ability of the antibody-forming system to recall a previous experience with an antigen and to respond to a second exposure with the prompt production of large amounts of antibody. [NIH] Immunology: The study of the body's immune system. [NIH] Immunosuppressant: An agent capable of suppressing immune responses. [EU] Immunosuppressive: Describes the ability to lower immune system responses. [NIH] Immunosuppressive Agents: Agents that suppress immune function by one of several

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mechanisms of action. Classical cytotoxic immunosuppressants act by inhibiting DNA synthesis. Others may act through activation of suppressor T-cell populations or by inhibiting the activation of helper cells. While immunosuppression has been brought about in the past primarily to prevent rejection of transplanted organs, new applications involving mediation of the effects of interleukins and other cytokines are emerging. [NIH] Immunosuppressive therapy: Therapy used to decrease the body's immune response, such as drugs given to prevent transplant rejection. [NIH] Impaction: The trapping of an object in a body passage. Examples are stones in the bile duct or hardened stool in the colon. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] Implant radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called [NIH] Implantation: The insertion or grafting into the body of biological, living, inert, or radioactive material. [EU] In situ: In the natural or normal place; confined to the site of origin without invasion of neighbouring tissues. [EU] In Situ Hybridization: A technique that localizes specific nucleic acid sequences within intact chromosomes, eukaryotic cells, or bacterial cells through the use of specific nucleic acid-labeled probes. [NIH] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incontinence: Inability to control the flow of urine from the bladder (urinary incontinence) or the escape of stool from the rectum (fecal incontinence). [NIH] Incus: One of three ossicles of the middle ear. It conducts sound vibrations from the malleus to the stapes. [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Indomethacin: A non-steroidal anti-inflammatory agent (NSAID) that inhibits the enzyme cyclooxygenase necessary for the formation of prostaglandins and other autacoids. It also inhibits the motility of polymorphonuclear leukocytes. [NIH] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Infancy: The period of complete dependency prior to the acquisition of competence in walking, talking, and self-feeding. [NIH] Infant, Newborn: An infant during the first month after birth. [NIH] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the

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microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Information Centers: Facilities for collecting and organizing information. They may be specialized by subject field, type of source material, persons served, location, or type of services. [NIH] Informed Consent: Voluntary authorization, given to the physician by the patient, with full comprehension of the risks involved, for diagnostic or investigative procedures and medical and surgical treatment. [NIH] Infusion: A method of putting fluids, including drugs, into the bloodstream. Also called intravenous infusion. [NIH] Ingestion: Taking into the body by mouth [NIH] Inhalation: The drawing of air or other substances into the lungs. [EU] Initiation: Mutation induced by a chemical reactive substance causing cell changes; being a step in a carcinogenic process. [NIH] Inlay: In dentistry, a filling first made to correspond with the form of a dental cavity and then cemented into the cavity. [NIH] Inner ear: The labyrinth, comprising the vestibule, cochlea, and semicircular canals. [NIH] Innervation: 1. The distribution or supply of nerves to a part. 2. The supply of nervous energy or of nerve stimulus sent to a part. [EU] Inoperable: Not suitable to be operated upon. [EU] Inorganic: Pertaining to substances not of organic origin. [EU] Inositol: An isomer of glucose that has traditionally been considered to be a B vitamin although it has an uncertain status as a vitamin and a deficiency syndrome has not been identified in man. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1379) Inositol phospholipids are important in signal transduction. [NIH] Insight: The capacity to understand one's own motives, to be aware of one's own psychodynamics, to appreciate the meaning of symbolic behavior. [NIH] Insulator: Material covering the metal conductor of the lead. It is usually polyurethane or silicone. [NIH] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Insulin-dependent diabetes mellitus: A disease characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action, or both. Autoimmune, genetic, and environmental factors are involved in the development of type I diabetes. [NIH] Interferometry: Measurement of distances or movements by means of the phenomena caused by the interference of two rays of light (optical interferometry) or of sound (acoustic interferometry). [NIH] Interleukins: Soluble factors which stimulate growth-related activities of leukocytes as well as other cell types. They enhance cell proliferation and differentiation, DNA synthesis, secretion of other biologically active molecules and responses to immune and inflammatory stimuli. [NIH]

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Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Internal Medicine: A medical specialty concerned with the diagnosis and treatment of diseases of the internal organ systems of adults. [NIH] Internal radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called brachytherapy, implant radiation, or interstitial radiation therapy. [NIH] Interpersonal Relations: The reciprocal interaction of two or more persons. [NIH] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU] Intestinal: Having to do with the intestines. [NIH] Intestines: The section of the alimentary canal from the stomach to the anus. It includes the large intestine and small intestine. [NIH] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Intracellular Membranes: Membranes of subcellular structures. [NIH] Intracranial Embolism: The sudden obstruction of a blood vessel by an embolus. [NIH] Intracranial Embolism and Thrombosis: Embolism or thrombosis involving blood vessels which supply intracranial structures. Emboli may originate from extracranial or intracranial sources. Thrombosis may occur in arterial or venous structures. [NIH] Intracranial Hypertension: Increased pressure within the cranial vault. This may result from several conditions, including hydrocephalus; brain edema; intracranial masses; severe systemic hypertension; pseudotumor cerebri; and other disorders. [NIH] Intramuscular: IM. Within or into muscle. [NIH] Intrathecal: Describes the fluid-filled space between the thin layers of tissue that cover the brain and spinal cord. Drugs can be injected into the fluid or a sample of the fluid can be removed for testing. [NIH] Intravenous: IV. Into a vein. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]

Involuntary: Reaction occurring without intention or volition. [NIH] Iodine: A nonmetallic element of the halogen group that is represented by the atomic symbol I, atomic number 53, and atomic weight of 126.90. It is a nutritionally essential element, especially important in thyroid hormone synthesis. In solution, it has anti-infective properties and is used topically. [NIH] Ion Channels: Gated, ion-selective glycoproteins that traverse membranes. The stimulus for channel gating can be a membrane potential, drug, transmitter, cytoplasmic messenger, or a mechanical deformation. Ion channels which are integral parts of ionotropic neurotransmitter receptors are not included. [NIH] Ion Transport: The movement of ions across energy-transducing cell membranes. Transport can be active or passive. Passive ion transport (facilitated diffusion) derives its energy from the concentration gradient of the ion itself and allows the transport of a single solute in one direction (uniport). Active ion transport is usually coupled to an energy-yielding chemical or photochemical reaction such as ATP hydrolysis. This form of primary active transport is called an ion pump. Secondary active transport utilizes the voltage and ion gradients

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produced by the primary transport to drive the cotransport of other ions or molecules. These may be transported in the same (symport) or opposite (antiport) direction. [NIH] Ionizing: Radiation comprising charged particles, e. g. electrons, protons, alpha-particles, etc., having sufficient kinetic energy to produce ionization by collision. [NIH] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Ipsilateral: Having to do with the same side of the body. [NIH] Irradiation: The use of high-energy radiation from x-rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy) or from materials called radioisotopes. Radioisotopes produce radiation and can be placed in or near the tumor or in the area near cancer cells. This type of radiation treatment is called internal radiation therapy, implant radiation, interstitial radiation, or brachytherapy. Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Irradiation is also called radiation therapy, radiotherapy, and x-ray therapy. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Jaundice: A clinical manifestation of hyperbilirubinemia, consisting of deposition of bile pigments in the skin, resulting in a yellowish staining of the skin and mucous membranes. [NIH]

Job Satisfaction: Personal satisfaction relative to the work situation. [NIH] Joint: The point of contact between elements of an animal skeleton with the parts that surround and support it. [NIH] Kainate: Glutamate receptor. [NIH] Kainic Acid: (2S-(2 alpha,3 beta,4 beta))-2-Carboxy-4-(1-methylethenyl)-3-pyrrolidineacetic acid. Ascaricide obtained from the red alga Digenea simplex. It is a potent excitatory amino acid agonist at some types of excitatory amino acid receptors and has been used to discriminate among receptor types. Like many excitatory amino acid agonists it can cause neurotoxicity and has been used experimentally for that purpose. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Keto: It consists of 8 carbon atoms and within the endotoxins, it connects poysaccharide and lipid A. [NIH] Ketorolac: A drug that belongs to a family of drugs called nonsteroidal anti-inflammatory agents. It is being studied in cancer prevention. [NIH] Kidney Disease: Any one of several chronic conditions that are caused by damage to the cells of the kidney. People who have had diabetes for a long time may have kidney damage. Also called nephropathy. [NIH] Kidney Failure: The inability of a kidney to excrete metabolites at normal plasma levels under conditions of normal loading, or the inability to retain electrolytes under conditions of normal intake. In the acute form (kidney failure, acute), it is marked by uremia and usually by oliguria or anuria, with hyperkalemia and pulmonary edema. The chronic form (kidney failure, chronic) is irreversible and requires hemodialysis. [NIH] Kidney Failure, Acute: A clinical syndrome characterized by a sudden decrease in glomerular filtration rate, often to values of less than 1 to 2 ml per minute. It is usually associated with oliguria (urine volumes of less than 400 ml per day) and is always associated

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with biochemical consequences of the reduction in glomerular filtration rate such as a rise in blood urea nitrogen (BUN) and serum creatinine concentrations. [NIH] Kidney Failure, Chronic: An irreversible and usually progressive reduction in renal function in which both kidneys have been damaged by a variety of diseases to the extent that they are unable to adequately remove the metabolic products from the blood and regulate the body's electrolyte composition and acid-base balance. Chronic kidney failure requires hemodialysis or surgery, usually kidney transplantation. [NIH] Kidney stone: A stone that develops from crystals that form in urine and build up on the inner surfaces of the kidney, in the renal pelvis, or in the ureters. [NIH] Kinetics: The study of rate dynamics in chemical or physical systems. [NIH] Labyrinth: The internal ear; the essential part of the organ of hearing. It consists of an osseous and a membranous portion. [NIH] Labyrinthine: A vestibular nystagmus resulting from stimulation, injury, or disease of the labyrinth. [NIH] Labyrinthitis: Inflammation of the inner ear. [NIH] Lacrimal: Pertaining to the tears. [EU] Laminin: Large, noncollagenous glycoprotein with antigenic properties. It is localized in the basement membrane lamina lucida and functions to bind epithelial cells to the basement membrane. Evidence suggests that the protein plays a role in tumor invasion. [NIH] Language Development: The gradual expansion in complexity and meaning of symbols and sounds as perceived and interpreted by the individual through a maturational and learning process. Stages in development include babbling, cooing, word imitation with cognition, and use of short sentences. [NIH] Language Development Disorders: Conditions characterized by language abilities (comprehension and expression of speech and writing) that are below the expected level for a given age, generally in the absence of an intellectual impairment. These conditions may be associated with deafness; brain diseases; mental disorders; or environmental factors. [NIH] Language Disorders: Conditions characterized by deficiencies of comprehension or expression of written and spoken forms of language. These include acquired and developmental disorders. [NIH] Language Therapy: Rehabilitation of persons with language disorders or training of children with language development disorders. [NIH] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Latency: The period of apparent inactivity between the time when a stimulus is presented and the moment a response occurs. [NIH] Latent: Phoria which occurs at one distance or another and which usually has no troublesome effect. [NIH] Lathyrism: A paralytic condition of the legs caused by ingestion of lathyrogens, especially beta-aminopropionitrile, found in the seeds of plants of the genus Lathyrus. [NIH] Lectin: A complex molecule that has both protein and sugars. Lectins are able to bind to the outside of a cell and cause biochemical changes in it. Lectins are made by both animals and plants. [NIH] Lesion: An area of abnormal tissue change. [NIH]

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Lethal: Deadly, fatal. [EU] Leukapheresis: The preparation of leukocyte concentrates with the return of red cells and leukocyte-poor plasma to the donor. [NIH] Leukemia: Cancer of blood-forming tissue. [NIH] Leukocytes: White blood cells. These include granular leukocytes (basophils, eosinophils, and neutrophils) as well as non-granular leukocytes (lymphocytes and monocytes). [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]

Lidocaine: A local anesthetic and cardiac depressant used as an antiarrhythmia agent. Its actions are more intense and its effects more prolonged than those of procaine but its duration of action is shorter than that of bupivacaine or prilocaine. [NIH] Life Expectancy: A figure representing the number of years, based on known statistics, to which any person of a given age may reasonably expect to live. [NIH] Ligament: A band of fibrous tissue that connects bones or cartilages, serving to support and strengthen joints. [EU] Ligands: A RNA simulation method developed by the MIT. [NIH] Limbic: Pertaining to a limbus, or margin; forming a border around. [EU] Linkage: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Linkage Disequilibrium: Nonrandom association of linked genes. This is the tendency of the alleles of two separate but already linked loci to be found together more frequently than would be expected by chance alone. [NIH] Lip: Either of the two fleshy, full-blooded margins of the mouth. [NIH] Lipid: Fat. [NIH] Lipid Peroxidation: Peroxidase catalyzed oxidation of lipids using hydrogen peroxide as an electron acceptor. [NIH] Lipoxygenase: An enzyme of the oxidoreductase class that catalyzes reactions between linoleate and other fatty acids and oxygen to form hydroperoxy-fatty acid derivatives. Related enzymes in this class include the arachidonate lipoxygenases, arachidonate 5lipoxygenase, arachidonate 12-lipoxygenase, and arachidonate 15-lipoxygenase. EC 1.13.11.12. [NIH] Lithium: An element in the alkali metals family. It has the atomic symbol Li, atomic number 3, and atomic weight 6.94. Salts of lithium are used in treating manic-depressive disorders. [NIH]

Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Liver scan: An image of the liver created on a computer screen or on film. A radioactive substance is injected into a blood vessel and travels through the bloodstream. It collects in the liver, especially in abnormal areas, and can be detected by the scanner. [NIH] Lobe: A portion of an organ such as the liver, lung, breast, or brain. [NIH] Localization: The process of determining or marking the location or site of a lesion or disease. May also refer to the process of keeping a lesion or disease in a specific location or site. [NIH] Localized: Cancer which has not metastasized yet. [NIH]

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Locomotion: Movement or the ability to move from one place or another. It can refer to humans, vertebrate or invertebrate animals, and microorganisms. [NIH] Longitudinal study: Also referred to as a "cohort study" or "prospective study"; the analytic method of epidemiologic study in which subsets of a defined population can be identified who are, have been, or in the future may be exposed or not exposed, or exposed in different degrees, to a factor or factors hypothesized to influence the probability of occurrence of a given disease or other outcome. The main feature of this type of study is to observe large numbers of subjects over an extended time, with comparisons of incidence rates in groups that differ in exposure levels. [NIH] Long-Term Care: Care over an extended period, usually for a chronic condition or disability, requiring periodic, intermittent, or continuous care. [NIH] Loop: A wire usually of platinum bent at one end into a small loop (usually 4 mm inside diameter) and used in transferring microorganisms. [NIH] Loudness Perception: The perceived attribute of a sound which corresponds to the physical attribute of intensity. [NIH] Lumbar: Pertaining to the loins, the part of the back between the thorax and the pelvis. [EU] Lumen: The cavity or channel within a tube or tubular organ. [EU] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]

Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphocyte: A white blood cell. Lymphocytes have a number of roles in the immune system, including the production of antibodies and other substances that fight infection and diseases. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Lymphoma: A general term for various neoplastic diseases of the lymphoid tissue. [NIH] Macula: A stain, spot, or thickening. Often used alone to refer to the macula retinae. [EU] Macula Lutea: An oval area in the retina, 3 to 5 mm in diameter, usually located temporal to the superior pole of the eye and slightly below the level of the optic disk. [NIH] Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. [NIH] Malabsorption: Impaired intestinal absorption of nutrients. [EU] Malformation: A morphologic developmental process. [EU]

defect

resulting

from

an

intrinsically

abnormal

Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malingering: Simulation of symptoms of illness or injury with intent to deceive in order to obtain a goal, e.g., a claim of physical illness to avoid jury duty. [NIH]

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Malleus: The largest of the auditory ossicles, and the one attached to the membrana tympani (tympanic membrane). Its club-shaped head articulates with the incus. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]

Mammogram: An x-ray of the breast. [NIH] Manic: Affected with mania. [EU] Manic-depressive psychosis: One of a group of psychotic reactions, fundamentally marked by severe mood swings and a tendency to remission and recurrence. [NIH] Manifest: Being the part or aspect of a phenomenon that is directly observable : concretely expressed in behaviour. [EU] Mannosidosis: Inborn error of metabolism marked by a defect in alpha-mannosidase activity that results in lysosomal accumulation of mannose-rich substrates. Virtually all patients have psychomotor retardation, facial coarsening, and some degree of dysostosis multiplex. It is thought to be an autosomal recessive disorder. [NIH] Mastoiditis: Inflammation of the cavity and air cells in the mastoid part of the temporal bone. [NIH] Meatus: A canal running from the internal auditory foramen through the petrous portion of the temporal bone. It gives passage to the facial and auditory nerves together with the auditory branch of the basilar artery and the internal auditory veins. [NIH] Medial: Lying near the midsaggital plane of the body; opposed to lateral. [NIH] Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] Medical Records: Recording of pertinent information concerning patient's illness or illnesses. [NIH] Medical Staff: Professional medical personnel who provide care to patients in an organized facility, institution or agency. [NIH] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Meiosis: A special method of cell division, occurring in maturation of the germ cells, by means of which each daughter nucleus receives half the number of chromosomes characteristic of the somatic cells of the species. [NIH] Melanin: The substance that gives the skin its color. [NIH] Melanocytes: Epidermal dendritic pigment cells which control long-term morphological color changes by alteration in their number or in the amount of pigment they produce and store in the pigment containing organelles called melanosomes. Melanophores are larger cells which do not exist in mammals. [NIH] Melanoma: A form of skin cancer that arises in melanocytes, the cells that produce pigment. Melanoma usually begins in a mole. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Membrane Potentials: Ratio of inside versus outside concentration of potassium, sodium, chloride and other ions in diffusible tissues or cells. Also called transmembrane and resting potentials, they are measured by recording electrophysiologic responses in voltagedependent ionic channels of (e.g.) nerve, muscle and blood cells as well as artificial membranes. [NIH] Membrane Proteins: Proteins which are found in membranes including cellular and intracellular membranes. They consist of two types, peripheral and integral proteins. They

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include most membrane-associated enzymes, antigenic proteins, transport proteins, and drug, hormone, and lectin receptors. [NIH] Memory: Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. [NIH] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Meningitis: Inflammation of the meninges. When it affects the dura mater, the disease is termed pachymeningitis; when the arachnoid and pia mater are involved, it is called leptomeningitis, or meningitis proper. [EU] Menstrual Cycle: The period of the regularly recurring physiologic changes in the endometrium occurring during the reproductive period in human females and some primates and culminating in partial sloughing of the endometrium (menstruation). [NIH] Menstruation: The normal physiologic discharge through the vagina of blood and mucosal tissues from the nonpregnant uterus. [NIH] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH] Mental Health: The state wherein the person is well adjusted. [NIH] Mental Processes: Conceptual functions or thinking in all its forms. [NIH] Mental Retardation: Refers to sub-average general intellectual functioning which originated during the developmental period and is associated with impairment in adaptive behavior. [NIH]

Mesolimbic: Inner brain region governing emotion and drives. [NIH] Metabotropic: A glutamate receptor which triggers an increase in production of 2 intracellular messengers: diacylglycerol and inositol 1, 4, 5-triphosphate. [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microbe: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Microcalcifications: Tiny deposits of calcium in the breast that cannot be felt but can be detected on a mammogram. A cluster of these very small specks of calcium may indicate that cancer is present. [NIH] Microcirculation: The vascular network lying between the arterioles and venules; includes capillaries, metarterioles and arteriovenous anastomoses. Also, the flow of blood through this network. [NIH] Microorganism: An organism that can be seen only through a microscope. Microorganisms include bacteria, protozoa, algae, and fungi. Although viruses are not considered living organisms, they are sometimes classified as microorganisms. [NIH] Microscopy: The application of microscope magnification to the study of materials that cannot be properly seen by the unaided eye. [NIH] Microwaves: That portion of the electromagnetic spectrum lying between UHF (ultrahigh frequency) radio waves and heat (infrared) waves. Microwaves are used to generate heat, especially in some types of diathermy. They may cause heat damage to tissues. [NIH]

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Mineralocorticoid: 1. Any of the group of C21 corticosteroids, principally aldosterone, predominantly involved in the regulation of electrolyte and water balance through their effect on ion transport in epithelial cells of the renal tubules, resulting in retention of sodium and loss of potassium; some also possess varying degrees of glucocorticoid activity. Their secretion is regulated principally by plasma volume, serum potassium concentration and angiotensin II, and to a lesser extent by anterior pituitary ACTH. 2. Of, pertaining to, having the properties of, or resembling a mineralocorticoid. [EU] Mitochondria: Parts of a cell where aerobic production (also known as cell respiration) takes place. [NIH] Mitochondrial Swelling: Increase in volume of mitochondria due to an influx of fluid; it occurs in hypotonic solutions due to osmotic pressure and in isotonic solutions as a result of altered permeability of the membranes of respiring mitochondria. [NIH] Mitosis: A method of indirect cell division by means of which the two daughter nuclei normally receive identical complements of the number of chromosomes of the somatic cells of the species. [NIH] Mitotic: Cell resulting from mitosis. [NIH] Mitotic inhibitors: Drugs that kill cancer cells by interfering with cell division (mitostis). [NIH]

Modeling: A treatment procedure whereby the therapist presents the target behavior which the learner is to imitate and make part of his repertoire. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Monoclonal: An antibody produced by culturing a single type of cell. It therefore consists of a single species of immunoglobulin molecules. [NIH] Monocytes: Large, phagocytic mononuclear leukocytes produced in the vertebrate bone marrow and released into the blood; contain a large, oval or somewhat indented nucleus surrounded by voluminous cytoplasm and numerous organelles. [NIH] Monogenic: A human disease caused by a mutation in a single gene. [NIH] Monophosphate: So called second messenger for neurotransmitters and hormones. [NIH] Morale: The prevailing temper or spirit of an individual or group in relation to the tasks or functions which are expected. [NIH] Morphine: The principal alkaloid in opium and the prototype opiate analgesic and narcotic. Morphine has widespread effects in the central nervous system and on smooth muscle. [NIH] Morphogenesis: The development of the form of an organ, part of the body, or organism. [NIH]

Morphological: Relating to the configuration or the structure of live organs. [NIH] Morphology: The science of the form and structure of organisms (plants, animals, and other forms of life). [NIH]

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Motility: The ability to move spontaneously. [EU] Motivations: The most compelling inner determinants of human behavior; also called drives, urges, impulses, needs, wants, tensions, and willful cravings. [NIH] Motor Activity: The physical activity of an organism as a behavioral phenomenon. [NIH] Movement Disorders: Syndromes which feature dyskinesias as a cardinal manifestation of the disease process. Included in this category are degenerative, hereditary, post-infectious, medication-induced, post-inflammatory, and post-traumatic conditions. [NIH] Mucinous: Containing or resembling mucin, the main compound in mucus. [NIH] Mucins: A secretion containing mucopolysaccharides and protein that is the chief constituent of mucus. [NIH] Multiple sclerosis: A disorder of the central nervous system marked by weakness, numbness, a loss of muscle coordination, and problems with vision, speech, and bladder control. Multiple sclerosis is thought to be an autoimmune disease in which the body's immune system destroys myelin. Myelin is a substance that contains both protein and fat (lipid) and serves as a nerve insulator and helps in the transmission of nerve signals. [NIH] Muscle Fibers: Large single cells, either cylindrical or prismatic in shape, that form the basic unit of muscle tissue. They consist of a soft contractile substance enclosed in a tubular sheath. [NIH] Muscular Atrophy: Derangement in size and number of muscle fibers occurring with aging, reduction in blood supply, or following immobilization, prolonged weightlessness, malnutrition, and particularly in denervation. [NIH] Muscular Diseases: Acquired, familial, and congenital disorders of skeletal muscle and smooth muscle. [NIH] Muscular Dystrophies: A general term for a group of inherited disorders which are characterized by progressive degeneration of skeletal muscles. [NIH] Musculoskeletal System: Themuscles, bones, and cartilage of the body. [NIH] Myelin: The fatty substance that covers and protects nerves. [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myopia: That error of refraction in which rays of light entering the eye parallel to the optic axis are brought to a focus in front of the retina, as a result of the eyeball being too long from front to back (axial m.) or of an increased strength in refractive power of the media of the eye (index m.). Called also nearsightedness, because the near point is less distant than it is in emmetropia with an equal amplitude of accommodation. [EU] Myosin: Chief protein in muscle and the main constituent of the thick filaments of muscle fibers. In conjunction with actin, it is responsible for the contraction and relaxation of muscles. [NIH] Myotonia: Prolonged failure of muscle relaxation after contraction. This may occur after voluntary contractions, muscle percussion, or electrical stimulation of the muscle. Myotonia is a characteristic feature of myotonic disorders. [NIH] Myotonic Dystrophy: A condition presenting muscle weakness and wasting which may be progressive. [NIH] Narcosis: A general and nonspecific reversible depression of neuronal excitability, produced by a number of physical and chemical aspects, usually resulting in stupor. [NIH] Narcotic: 1. Pertaining to or producing narcosis. 2. An agent that produces insensibility or stupor, applied especially to the opioids, i.e. to any natural or synthetic drug that has

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morphine-like actions. [EU] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH] NCI: National Cancer Institute. NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the federal government's principal agency for cancer research. NCI conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://cancer.gov. [NIH] Nearsightedness: The common term for myopia. [NIH] Nebramycin: A complex of antibiotic substances produced by Streptomyces tenebrarius. [NIH]

Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Neonatal: Pertaining to the first four weeks after birth. [EU] Neonatal Screening: The identification of selected parameters in newborn infants by various tests, examinations, or other procedures. Screening may be performed by clinical or laboratory measures. A screening test is designed to sort out healthy neonates from those not well, but the screening test is not intended as a diagnostic device, rather instead as epidemiologic. [NIH] Neoplasia: Abnormal and uncontrolled cell growth. [NIH] Neoplasm: A new growth of benign or malignant tissue. [NIH] Neoplastic: Pertaining to or like a neoplasm (= any new and abnormal growth); pertaining to neoplasia (= the formation of a neoplasm). [EU] Nephropathy: Disease of the kidneys. [EU] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nerve Endings: Specialized terminations of peripheral neurons. Nerve endings include neuroeffector junction(s) by which neurons activate target organs and sensory receptors which transduce information from the various sensory modalities and send it centrally in the nervous system. Presynaptic nerve endings are presynaptic terminals. [NIH] Nerve Fibers: Slender processes of neurons, especially the prolonged axons that conduct nerve impulses. [NIH] Nerve Growth Factor: Nerve growth factor is the first of a series of neurotrophic factors that were found to influence the growth and differentiation of sympathetic and sensory neurons. It is comprised of alpha, beta, and gamma subunits. The beta subunit is responsible for its growth stimulating activity. [NIH] Nerve Regeneration: Renewal or physiological repair of damaged nerve tissue. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Networks: Pertaining to a nerve or to the nerves, a meshlike structure of interlocking fibers or strands. [NIH]

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Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neuraminidase: An enzyme that catalyzes the hydrolysis of alpha-2,3, alpha-2,6-, and alpha-2,8-glycosidic linkages (at a decreasing rate, respectively) of terminal sialic residues in oligosaccharides, glycoproteins, glycolipids, colominic acid, and synthetic substrate. (From Enzyme Nomenclature, 1992) EC 3.2.1.18. [NIH] Neuroanatomy: Study of the anatomy of the nervous system as a specialty or discipline. [NIH]

Neurodegenerative Diseases: Hereditary and sporadic conditions which are characterized by progressive nervous system dysfunction. These disorders are often associated with atrophy of the affected central or peripheral nervous system structures. [NIH] Neuroeffector Junction: The synapse between a neuron (presynaptic) and an effector cell other than another neuron (postsynaptic). Neuroeffector junctions include synapses onto muscles and onto secretory cells. [NIH] Neuroendocrine: Having to do with the interactions between the nervous system and the endocrine system. Describes certain cells that release hormones into the blood in response to stimulation of the nervous system. [NIH] Neuroleptic: A term coined to refer to the effects on cognition and behaviour of antipsychotic drugs, which produce a state of apathy, lack of initiative, and limited range of emotion and in psychotic patients cause a reduction in confusion and agitation and normalization of psychomotor activity. [EU] Neurologic: Having to do with nerves or the nervous system. [NIH] Neuroma: A tumor that arises in nerve cells. [NIH] Neuromuscular: Pertaining to muscles and nerves. [EU] Neuromuscular Junction: The synapse between a neuron and a muscle. [NIH] Neuronal: Pertaining to a neuron or neurons (= conducting cells of the nervous system). [EU] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH] Neuropathy: A problem in any part of the nervous system except the brain and spinal cord. Neuropathies can be caused by infection, toxic substances, or disease. [NIH] Neurophysiology: The scientific discipline concerned with the physiology of the nervous system. [NIH] Neuroprotective Agents: Drugs intended to prevent damage to the brain or spinal cord from ischemia, stroke, convulsions, or trauma. Some must be administered before the event, but others may be effective for some time after. They act by a variety of mechanisms, but often directly or indirectly minimize the damage produced by endogenous excitatory amino acids. [NIH] Neuroretinitis: Inflammation of the optic nerve head and adjacent retina. [NIH] Neurotoxicity: The tendency of some treatments to cause damage to the nervous system. [NIH]

Neurotoxin: A substance that is poisonous to nerve tissue. [NIH] Neurotransmitters: Endogenous signaling molecules that alter the behavior of neurons or effector cells. Neurotransmitter is used here in its most general sense, including not only messengers that act directly to regulate ion channels, but also those that act through second messenger systems, and those that act at a distance from their site of release. Included are

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neuromodulators, neuroregulators, neuromediators, and neurohumors, whether or not acting at synapses. [NIH] Neurotrophins: A nerve growth factor. [NIH] Neutrons: Electrically neutral elementary particles found in all atomic nuclei except light hydrogen; the mass is equal to that of the proton and electron combined and they are unstable when isolated from the nucleus, undergoing beta decay. Slow, thermal, epithermal, and fast neutrons refer to the energy levels with which the neutrons are ejected from heavier nuclei during their decay. [NIH] Night Blindness: Anomaly of vision in which there is a pronounced inadequacy or complete absence of dark-adaptation. [NIH] Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Nonverbal Communication: Transmission of emotions, ideas, and attitudes between individuals in ways other than the spoken language. [NIH] Normotensive: 1. Characterized by normal tone, tension, or pressure, as by normal blood pressure. 2. A person with normal blood pressure. [EU] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nuclear Family: A family composed of spouses and their children. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Nucleic Acid Hybridization: The process whereby two single-stranded polynucleotides form a double-stranded molecule, with hydrogen bonding between the complementary bases in the two strains. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nursing Care: Care given to patients by nursing service personnel. [NIH] Nystagmus: Rhythmical oscillation of the eyeballs, either pendular or jerky. [NIH] Occipital Lobe: Posterior part of the cerebral hemisphere. [NIH] Occupational Exposure: The exposure to potentially harmful chemical, physical, or biological agents that occurs as a result of one's occupation. [NIH] Occupational Health: The promotion and maintenance of physical and mental health in the work environment. [NIH] Ocular: 1. Of, pertaining to, or affecting the eye. 2. Eyepiece. [EU] Oligosaccharides: Carbohydrates consisting of between two and ten monosaccharides connected by either an alpha- or beta-glycosidic link. They are found throughout nature in both the free and bound form. [NIH] Oliguria: Clinical manifestation of the urinary system consisting of a decrease in the amount of urine secreted. [NIH]

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Oncogene: A gene that normally directs cell growth. If altered, an oncogene can promote or allow the uncontrolled growth of cancer. Alterations can be inherited or caused by an environmental exposure to carcinogens. [NIH] On-line: A sexually-reproducing population derived from a common parentage. [NIH] Oocytes: Female germ cells in stages between the prophase of the first maturation division and the completion of the second maturation division. [NIH] Opacity: Degree of density (area most dense taken for reading). [NIH] Ophthalmologic: Pertaining to ophthalmology (= the branch of medicine dealing with the eye). [EU] Ophthalmology: A surgical specialty concerned with the structure and function of the eye and the medical and surgical treatment of its defects and diseases. [NIH] Opportunistic Infections: An infection caused by an organism which becomes pathogenic under certain conditions, e.g., during immunosuppression. [NIH] Opsin: A visual pigment protein found in the retinal rods. It combines with retinaldehyde to form rhodopsin. [NIH] Optic Chiasm: The X-shaped structure formed by the meeting of the two optic nerves. At the optic chiasm the fibers from the medial part of each retina cross to project to the other side of the brain while the lateral retinal fibers continue on the same side. As a result each half of the brain receives information about the contralateral visual field from both eyes. [NIH]

Optic Disk: The portion of the optic nerve seen in the fundus with the ophthalmoscope. It is formed by the meeting of all the retinal ganglion cell axons as they enter the optic nerve. [NIH]

Optic Nerve: The 2nd cranial nerve. The optic nerve conveys visual information from the retina to the brain. The nerve carries the axons of the retinal ganglion cells which sort at the optic chiasm and continue via the optic tracts to the brain. The largest projection is to the lateral geniculate nuclei; other important targets include the superior colliculi and the suprachiasmatic nuclei. Though known as the second cranial nerve, it is considered part of the central nervous system. [NIH] Orthostatic: Pertaining to or caused by standing erect. [EU] Ossicle: A small bone. [EU] Ossicular Replacement: Surgical insertion of an implant to replace one or more of the ear ossicles. [NIH] Ossification: The formation of bone or of a bony substance; the conversion of fibrous tissue or of cartilage into bone or a bony substance. [EU] Osteoblasts: Bone-forming cells which secrete an extracellular matrix. Hydroxyapatite crystals are then deposited into the matrix to form bone. [NIH] Osteochondroma: A cartilage-capped benign tumor that often appears as a stalk on the surface of bone. It is probably a developmental malformation rather than a true neoplasm and is usually found in the metaphysis of the distal femur, proximal tibia, or proximal humerus. Osteochondroma is the most common of benign bone tumors. [NIH] Osteogenesis: The histogenesis of bone including ossification. It occurs continuously but particularly in the embryo and child and during fracture repair. [NIH] Osteogenesis Imperfecta: A collagen disorder resulting from defective biosynthesis of type I collagen and characterized by brittle, osteoporotic, and easily fractured bones. It may also present with blue sclerae, loose joints, and imperfect dentin formation. There are four major

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types, I-IV. [NIH] Osteoporosis: Reduction of bone mass without alteration in the composition of bone, leading to fractures. Primary osteoporosis can be of two major types: postmenopausal osteoporosis and age-related (or senile) osteoporosis. [NIH] Otitis: Inflammation of the ear, which may be marked by pain, fever, abnormalities of hearing, hearing loss, tinnitus, and vertigo. [EU] Otitis Media: Inflammation of the middle ear. [NIH] Otitis Media with Effusion: Inflammation of the middle ear with a clear pale yellowcolored transudate. [NIH] Otolaryngologist: A doctor who specializes in treating diseases of the ear, nose, and throat. Also called an ENT doctor. [NIH] Otolaryngology: A surgical specialty concerned with the study and treatment of disorders of the ear, nose, and throat. [NIH] Otolith: A complex calcareous concretion in the inner ear which controls man's sense of balance and reactions to acceleration. [NIH] Otology: The branch of medicine which deals with the diagnosis and treatment of the disorders and diseases of the ear. [NIH] Otorrhea: A discharge from the ear, especially a purulent one. [EU] Otosclerosis: The formation of spongy bone in the labyrinth capsule. The ossicles can become fixed and unable to transmit sound vibrations, thereby causing deafness. [NIH] Ototoxic: Having a deleterious effect upon the eighth nerve, or upon the organs of hearing and balance. [EU] Outer ear: The pinna and external meatus of the ear. [NIH] Outpatient: A patient who is not an inmate of a hospital but receives diagnosis or treatment in a clinic or dispensary connected with the hospital. [NIH] Oval Window: Fenestra of the vestibule; an oval opening in the medial wall of the middle ear leading into the vestibule. Normally it is covered by the base of the stapes. [NIH] Overexpress: An excess of a particular protein on the surface of a cell. [NIH] Oxalate: A chemical that combines with calcium in urine to form the most common type of kidney stone (calcium oxalate stone). [NIH] Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]

Oxidative Phosphorylation: Electron transfer through the cytochrome system liberating free energy which is transformed into high-energy phosphate bonds. [NIH] Oxidative Stress: A disturbance in the prooxidant-antioxidant balance in favor of the former, leading to potential damage. Indicators of oxidative stress include damaged DNA bases, protein oxidation products, and lipid peroxidation products (Sies, Oxidative Stress, 1991, pxv-xvi). [NIH] Oxygen Consumption: The oxygen consumption is determined by calculating the difference between the amount of oxygen inhaled and exhaled. [NIH] Oxygenation: The process of supplying, treating, or mixing with oxygen. No:1245 -

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oxygenation the process of supplying, treating, or mixing with oxygen. [EU] Pachymeningitis: Inflammation of the dura mater of the brain, the spinal cord or the optic nerve. [NIH] Paediatric: Of or relating to the care and medical treatment of children; belonging to or concerned with paediatrics. [EU] Palate: The structure that forms the roof of the mouth. It consists of the anterior hard palate and the posterior soft palate. [NIH] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Palsy: Disease of the peripheral nervous system occurring usually after many years of increased lead absorption. [NIH] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Pancreatic: Having to do with the pancreas. [NIH] Pancreatic cancer: Cancer of the pancreas, a salivary gland of the abdomen. [NIH] Papilla: A small nipple-shaped elevation. [NIH] Paralysis: Loss of ability to move all or part of the body. [NIH] Paraplegia: Severe or complete loss of motor function in the lower extremities and lower portions of the trunk. This condition is most often associated with spinal cord diseases, although brain diseases; peripheral nervous system diseases; neuromuscular diseases; and muscular diseases may also cause bilateral leg weakness. [NIH] Paresis: A general term referring to a mild to moderate degree of muscular weakness, occasionally used as a synonym for paralysis (severe or complete loss of motor function). In the older literature, paresis often referred specifically to paretic neurosyphilis. "General paresis" and "general paralysis" may still carry that connotation. Bilateral lower extremity paresis is referred to as paraparesis. [NIH] Parkinsonism: A group of neurological disorders characterized by hypokinesia, tremor, and muscular rigidity. [EU] Parotid: The space that contains the parotid gland, the facial nerve, the external carotid artery, and the retromandibular vein. [NIH] Paroxysmal: Recurring in paroxysms (= spasms or seizures). [EU] Particle: A tiny mass of material. [EU] Patch: A piece of material used to cover or protect a wound, an injured part, etc.: a patch over the eye. [NIH] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]

Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Pathologic Processes: The abnormal mechanisms and forms involved in the dysfunctions of tissues and organs. [NIH] Pathologies: The study of abnormality, especially the study of diseases. [NIH] Pathophysiology: Altered functions in an individual or an organ due to disease. [NIH]

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Patient Care Management: Generating, planning, organizing, and administering medical and nursing care and services for patients. [NIH] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]

Pediatrics: A medical specialty concerned with maintaining health and providing medical care to children from birth to adolescence. [NIH] Pedigree: A record of one's ancestors, offspring, siblings, and their offspring that may be used to determine the pattern of certain genes or disease inheritance within a family. [NIH] Pelvic: Pertaining to the pelvis. [EU] Penicillin: An antibiotic drug used to treat infection. [NIH] Pentoxifylline: A methylxanthine derivative that inhibits phosphodiesterase and affects blood rheology. It improves blood flow by increasing erythrocyte and leukocyte flexibility. It also inhibits platelet aggregation. Pentoxifylline modulates immunologic activity by stimulating cytokine production. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Perception: The ability quickly and accurately to recognize similarities and differences among presented objects, whether these be pairs of words, pairs of number series, or multiple sets of these or other symbols such as geometric figures. [NIH] Perforation: 1. The act of boring or piercing through a part. 2. A hole made through a part or substance. [EU] Perfusion: Bathing an organ or tissue with a fluid. In regional perfusion, a specific area of the body (usually an arm or a leg) receives high doses of anticancer drugs through a blood vessel. Such a procedure is performed to treat cancer that has not spread. [NIH] Perilymph: The fluid contained within the space separating the membranous from the osseous labyrinth of the ear. [NIH] Perinatal: Pertaining to or occurring in the period shortly before and after birth; variously defined as beginning with completion of the twentieth to twenty-eighth week of gestation and ending 7 to 28 days after birth. [EU] Peripheral Nervous System: The nervous system outside of the brain and spinal cord. The peripheral nervous system has autonomic and somatic divisions. The autonomic nervous system includes the enteric, parasympathetic, and sympathetic subdivisions. The somatic nervous system includes the cranial and spinal nerves and their ganglia and the peripheral sensory receptors. [NIH] Peripheral Nervous System Diseases: Diseases of the peripheral nerves external to the brain and spinal cord, which includes diseases of the nerve roots, ganglia, plexi, autonomic nerves, sensory nerves, and motor nerves. [NIH] Peroneal Nerve: The lateral of the two terminal branches of the sciatic nerve. The peroneal (or fibular) nerve provides motor and sensory innervation to parts of the leg and foot. [NIH] Peroxidase: A hemeprotein from leukocytes. Deficiency of this enzyme leads to a hereditary disorder coupled with disseminated moniliasis. It catalyzes the conversion of a donor and peroxide to an oxidized donor and water. EC 1.11.1.7. [NIH] Peroxide: Chemical compound which contains an atom group with two oxygen atoms tied to each other. [NIH] Phallic: Pertaining to the phallus, or penis. [EU] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU]

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Pharynx: The hollow tube about 5 inches long that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes to the stomach). [NIH] Phenotype: The outward appearance of the individual. It is the product of interactions between genes and between the genotype and the environment. This includes the killer phenotype, characteristic of yeasts. [NIH] Phenylalanine: An aromatic amino acid that is essential in the animal diet. It is a precursor of melanin, dopamine, noradrenalin, and thyroxine. [NIH] Phosphodiesterase: Effector enzyme that regulates the levels of a second messenger, the cyclic GMP. [NIH] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Phosphorylated: Attached to a phosphate group. [NIH] Phosphorylation: The introduction of a phosphoryl group into a compound through the formation of an ester bond between the compound and a phosphorus moiety. [NIH] Photoreceptor: Receptor capable of being activated by light stimuli, as a rod or cone cell of the eye. [NIH] Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [NIH] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]

Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Pigment: A substance that gives color to tissue. Pigments are responsible for the color of skin, eyes, and hair. [NIH] Pigmentation: Coloration or discoloration of a part by a pigment. [NIH] Pilot study: The initial study examining a new method or treatment. [NIH] Piperidines: A family of hexahydropyridines. Piperidine itself is found in the pepper plant as the alkaloid piperine. [NIH] Pitch: The subjective awareness of the frequency or spectral distribution of a sound. [NIH] Pituitary Gland: A small, unpaired gland situated in the sella turcica tissue. It is connected to the hypothalamus by a short stalk. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma cells: A type of white blood cell that produces antibodies. [NIH] Plasma expander: Artificial plasma extender. [EU] Plasma protein: One of the hundreds of different proteins present in blood plasma, including carrier proteins ( such albumin, transferrin, and haptoglobin), fibrinogen and other coagulation factors, complement components, immunoglobulins, enzyme inhibitors,

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precursors of substances such as angiotension and bradykinin, and many other types of proteins. [EU] Plasma Volume: Volume of plasma in the circulation. It is usually measured by indicator dilution techniques. [NIH] Plasmapheresis: Procedure whereby plasma is separated and extracted from anticoagulated whole blood and the red cells retransfused to the donor. Plasmapheresis is also employed for therapeutic use. [NIH] Plasmin: A product of the lysis of plasminogen (profibrinolysin) by plasminogen activators. It is composed of two polypeptide chains, light (B) and heavy (A), with a molecular weight of 75,000. It is the major proteolytic enzyme involved in blood clot retraction or the lysis of fibrin and quickly inactivated by antiplasmins. EC 3.4.21.7. [NIH] Plasminogen: Precursor of fibrinolysin (plasmin). It is a single-chain beta-globulin of molecular weight 80-90,000 found mostly in association with fibrinogen in plasma; plasminogen activators change it to fibrinolysin. It is used in wound debriding and has been investigated as a thrombolytic agent. [NIH] Plasticity: In an individual or a population, the capacity for adaptation: a) through gene changes (genetic plasticity) or b) through internal physiological modifications in response to changes of environment (physiological plasticity). [NIH] Platelet Aggregation: The attachment of platelets to one another. This clumping together can be induced by a number of agents (e.g., thrombin, collagen) and is part of the mechanism leading to the formation of a thrombus. [NIH] Plateletpheresis: The preparation of platelet concentrates with the return of red cells and platelet-poor plasma to the donor. [NIH] Platinum: Platinum. A heavy, soft, whitish metal, resembling tin, atomic number 78, atomic weight 195.09, symbol Pt. (From Dorland, 28th ed) It is used in manufacturing equipment for laboratory and industrial use. It occurs as a black powder (platinum black) and as a spongy substance (spongy platinum) and may have been known in Pliny's time as "alutiae". [NIH]

Plexus: A network or tangle; a general term for a network of lymphatic vessels, nerves, or veins. [EU] Point Mutation: A mutation caused by the substitution of one nucleotide for another. This results in the DNA molecule having a change in a single base pair. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Polycystic: An inherited disorder characterized by many grape-like clusters of fluid-filled cysts that make both kidneys larger over time. These cysts take over and destroy working kidney tissue. PKD may cause chronic renal failure and end-stage renal disease. [NIH] Polyhydramnios: Excess of amniotic fluid greater than 2,000 ml. It is a common obstetrical complication whose major causes include maternal diabetes, chromosomal disorders, isoimmunological disease, congenital abnormalities, and multiple gestations. [NIH] Polymers: Compounds formed by the joining of smaller, usually repeating, units linked by covalent bonds. These compounds often form large macromolecules (e.g., polypeptides, proteins, plastics). [NIH] Polymorphic: Occurring in several or many forms; appearing in different forms at different stages of development. [EU] Polypeptide: A peptide which on hydrolysis yields more than two amino acids; called tripeptides, tetrapeptides, etc. according to the number of amino acids contained. [EU]

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Polysaccharide: A type of carbohydrate. It contains sugar molecules that are linked together chemically. [NIH] Pons: The part of the central nervous system lying between the medulla oblongata and the mesencephalon, ventral to the cerebellum, and consisting of a pars dorsalis and a pars ventralis. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Postmenopausal: Refers to the time after menopause. Menopause is the time in a woman's life when menstrual periods stop permanently; also called "change of life." [NIH] Postnatal: Occurring after birth, with reference to the newborn. [EU] Postoperative: After surgery. [NIH] Postsynaptic: Nerve potential generated by an inhibitory hyperpolarizing stimulation. [NIH] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [NIH] Potentiates: A degree of synergism which causes the exposure of the organism to a harmful substance to worsen a disease already contracted. [NIH] Potentiation: An overall effect of two drugs taken together which is greater than the sum of the effects of each drug taken alone. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Predisposition: A latent susceptibility to disease which may be activated under certain conditions, as by stress. [EU] Prednisolone: A glucocorticoid with the general properties of the corticosteroids. It is the drug of choice for all conditions in which routine systemic corticosteroid therapy is indicated, except adrenal deficiency states. [NIH] Prednisone: A synthetic anti-inflammatory glucocorticoid derived from cortisone. It is biologically inert and converted to prednisolone in the liver. [NIH] Prenatal: Existing or occurring before birth, with reference to the fetus. [EU] Prenatal Diagnosis: Determination of the nature of a pathological condition or disease in the postimplantation embryo, fetus, or pregnant female before birth. [NIH] Presbycusis: Progressive bilateral loss of hearing that occurs in the aged. Syn: senile deafness. [NIH] Presynaptic: Situated proximal to a synapse, or occurring before the synapse is crossed. [EU] Presynaptic Terminals: The distal terminations of axons which are specialized for the release of neurotransmitters. Also included are varicosities along the course of axons which have similar specializations and also release transmitters. Presynaptic terminals in both the central and peripheral nervous systems are included. [NIH]

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Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Private Sector: That distinct portion of the institutional, industrial, or economic structure of a country that is controlled or owned by non-governmental, private interests. [NIH] Probe: An instrument used in exploring cavities, or in the detection and dilatation of strictures, or in demonstrating the potency of channels; an elongated instrument for exploring or sounding body cavities. [NIH] Problem Solving: A learning situation involving more than one alternative from which a selection is made in order to attain a specific goal. [NIH] Procaine: A local anesthetic of the ester type that has a slow onset and a short duration of action. It is mainly used for infiltration anesthesia, peripheral nerve block, and spinal block. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1016). [NIH] Progeny: The offspring produced in any generation. [NIH] Progesterone: Pregn-4-ene-3,20-dione. The principal progestational hormone of the body, secreted by the corpus luteum, adrenal cortex, and placenta. Its chief function is to prepare the uterus for the reception and development of the fertilized ovum. It acts as an antiovulatory agent when administered on days 5-25 of the menstrual cycle. [NIH] Program Evaluation: Studies designed to assess the efficacy of programs. They may include the evaluation of cost-effectiveness, the extent to which objectives are met, or impact. [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Projection: A defense mechanism, operating unconsciously, whereby that which is emotionally unacceptable in the self is rejected and attributed (projected) to others. [NIH] Proline: A non-essential amino acid that is synthesized from glutamic acid. It is an essential component of collagen and is important for proper functioning of joints and tendons. [NIH] Promoter: A chemical substance that increases the activity of a carcinogenic process. [NIH] Prone: Having the front portion of the body downwards. [NIH] Prophase: The first phase of cell division, in which the chromosomes become visible, the nucleus starts to lose its identity, the spindle appears, and the centrioles migrate toward opposite poles. [NIH] Prospective study: An epidemiologic study in which a group of individuals (a cohort), all free of a particular disease and varying in their exposure to a possible risk factor, is followed over a specific amount of time to determine the incidence rates of the disease in the exposed and unexposed groups. [NIH] Prostaglandin: Any of a group of components derived from unsaturated 20-carbon fatty acids, primarily arachidonic acid, via the cyclooxygenase pathway that are extremely potent mediators of a diverse group of physiologic processes. The abbreviation for prostaglandin is PG; specific compounds are designated by adding one of the letters A through I to indicate the type of substituents found on the hydrocarbon skeleton and a subscript (1, 2 or 3) to indicate the number of double bonds in the hydrocarbon skeleton e.g., PGE2. The predominant naturally occurring prostaglandins all have two double bonds and are synthesized from arachidonic acid (5,8,11,14-eicosatetraenoic acid) by the pathway shown in the illustration. The 1 series and 3 series are produced by the same pathway with fatty acids having one fewer double bond (8,11,14-eicosatrienoic acid or one more double bond

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(5,8,11,14,17-eicosapentaenoic acid) than arachidonic acid. The subscript a or ß indicates the configuration at C-9 (a denotes a substituent below the plane of the ring, ß, above the plane). The naturally occurring PGF's have the a configuration, e.g., PGF2a. All of the prostaglandins act by binding to specific cell-surface receptors causing an increase in the level of the intracellular second messenger cyclic AMP (and in some cases cyclic GMP also). The effect produced by the cyclic AMP increase depends on the specific cell type. In some cases there is also a positive feedback effect. Increased cyclic AMP increases prostaglandin synthesis leading to further increases in cyclic AMP. [EU] Prostaglandins A: (13E,15S)-15-Hydroxy-9-oxoprosta-10,13-dien-1-oic acid (PGA(1)); (5Z,13E,15S)-15-hydroxy-9-oxoprosta-5,10,13-trien-1-oic acid (PGA(2)); (5Z,13E,15S,17Z)-15hydroxy-9-oxoprosta-5,10,13,17-tetraen-1-oic acid (PGA(3)). A group of naturally occurring secondary prostaglandins derived from PGE. PGA(1) and PGA(2) as well as their 19hydroxy derivatives are found in many organs and tissues. [NIH] Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Prosthesis: An artificial replacement of a part of the body. [NIH] Protease: Proteinase (= any enzyme that catalyses the splitting of interior peptide bonds in a protein). [EU] Protective Agents: Synthetic or natural substances which are given to prevent a disease or disorder or are used in the process of treating a disease or injury due to a poisonous agent. [NIH]

Protective Devices: Devices designed to provide personal protection against injury to individuals exposed to hazards in industry, sports, aviation, or daily activities. [NIH] Protein Binding: The process in which substances, either endogenous or exogenous, bind to proteins, peptides, enzymes, protein precursors, or allied compounds. Specific proteinbinding measures are often used as assays in diagnostic assessments. [NIH] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein Kinases: A family of enzymes that catalyze the conversion of ATP and a protein to ADP and a phosphoprotein. EC 2.7.1.37. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proteoglycans: Glycoproteins which have a very high polysaccharide content. [NIH] Proteolytic: 1. Pertaining to, characterized by, or promoting proteolysis. 2. An enzyme that promotes proteolysis (= the splitting of proteins by hydrolysis of the peptide bonds with formation of smaller polypeptides). [EU] Prothrombin: A plasma protein that is the inactive precursor of thrombin. It is converted to thrombin by a prothrombin activator complex consisting of factor Xa, factor V, phospholipid, and calcium ions. Deficiency of prothrombin leads to hypoprothrombinemia. [NIH]

Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or

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vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Psychiatric: Pertaining to or within the purview of psychiatry. [EU] Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders. [NIH] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Psychoacoustic: That branch of psychophysics dealing with acoustic stimuli. [NIH] Psychology: The science dealing with the study of mental processes and behavior in man and animals. [NIH] Psychomotor: Pertaining to motor effects of cerebral or psychic activity. [EU] Psychophysics: The science dealing with the correlation of the physical characteristics of a stimulus, e.g., frequency or intensity, with the response to the stimulus, in order to assess the psychologic factors involved in the relationship. [NIH] Psychosis: A mental disorder characterized by gross impairment in reality testing as evidenced by delusions, hallucinations, markedly incoherent speech, or disorganized and agitated behaviour without apparent awareness on the part of the patient of the incomprehensibility of his behaviour; the term is also used in a more general sense to refer to mental disorders in which mental functioning is sufficiently impaired as to interfere grossly with the patient's capacity to meet the ordinary demands of life. Historically, the term has been applied to many conditions, e.g. manic-depressive psychosis, that were first described in psychotic patients, although many patients with the disorder are not judged psychotic. [EU] Psychotherapy: A generic term for the treatment of mental illness or emotional disturbances primarily by verbal or nonverbal communication. [NIH] Puberty: The period during which the secondary sex characteristics begin to develop and the capability of sexual reproduction is attained. [EU] Public Facilities: An area of recreation or hygiene for use by the public. [NIH] Public Health: Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level. [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Publishing: "The business or profession of the commercial production and issuance of literature" (Webster's 3d). It includes the publisher, publication processes, editing and editors. Production may be by conventional printing methods or by electronic publishing. [NIH]

Pulmonary: Relating to the lungs. [NIH] Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH] Pulmonary Edema: An accumulation of an excessive amount of watery fluid in the lungs, may be caused by acute exposure to dangerous concentrations of irritant gasses. [NIH]

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Pulmonary hypertension: Abnormally high blood pressure in the arteries of the lungs. [NIH] Pulse: The rhythmical expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle of the heart as it contracts. [NIH]

Purines: A series of heterocyclic compounds that are variously substituted in nature and are known also as purine bases. They include adenine and guanine, constituents of nucleic acids, as well as many alkaloids such as caffeine and theophylline. Uric acid is the metabolic end product of purine metabolism. [NIH] Purulent: Consisting of or containing pus; associated with the formation of or caused by pus. [EU] Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH] Quinine: An alkaloid derived from the bark of the cinchona tree. It is used as an antimalarial drug, and is the active ingredient in extracts of the cinchona that have been used for that purpose since before 1633. Quinine is also a mild antipyretic and analgesic and has been used in common cold preparations for that purpose. It was used commonly and as a bitter and flavoring agent, and is still useful for the treatment of babesiosis. Quinine is also useful in some muscular disorders, especially nocturnal leg cramps and myotonia congenita, because of its direct effects on muscle membrane and sodium channels. The mechanisms of its antimalarial effects are not well understood. [NIH] Race: A population within a species which exhibits general similarities within itself, but is both discontinuous and distinct from other populations of that species, though not sufficiently so as to achieve the status of a taxon. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radiation therapy: The use of high-energy radiation from x-rays, gamma rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body in the area near cancer cells (internal radiation therapy, implant radiation, or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Also called radiotherapy. [NIH] Radio Waves: That portion of the electromagnetic spectrum beyond the microwaves, with wavelengths as high as 30 KM. They are used in communications, including television. Short Wave or HF (high frequency), UHF (ultrahigh frequency) and VHF (very high frequency) waves are used in citizen's band communication. [NIH] Radioactive: Giving off radiation. [NIH] Radioimmunotherapy: Radiotherapy where cytotoxic radionuclides are linked to antibodies in order to deliver toxins directly to tumor targets. Therapy with targeted radiation rather than antibody-targeted toxins (immunotoxins) has the advantage that adjacent tumor cells, which lack the appropriate antigenic determinants, can be destroyed by radiation cross-fire. Radioimmunotherapy is sometimes called targeted radiotherapy, but this latter term can also refer to radionuclides linked to non-immune molecules (radiotherapy). [NIH] Radioisotope: An unstable element that releases radiation as it breaks down. Radioisotopes can be used in imaging tests or as a treatment for cancer. [NIH] Radiolabeled: Any compound that has been joined with a radioactive substance. [NIH]

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Radiological: Pertaining to radiodiagnostic and radiotherapeutic procedures, and interventional radiology or other planning and guiding medical radiology. [NIH] Radiology: A specialty concerned with the use of x-ray and other forms of radiant energy in the diagnosis and treatment of disease. [NIH] Radiotherapy: The use of ionizing radiation to treat malignant neoplasms and other benign conditions. The most common forms of ionizing radiation used as therapy are x-rays, gamma rays, and electrons. A special form of radiotherapy, targeted radiotherapy, links a cytotoxic radionuclide to a molecule that targets the tumor. When this molecule is an antibody or other immunologic molecule, the technique is called radioimmunotherapy. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Reactive Oxygen Species: Reactive intermediate oxygen species including both radicals and non-radicals. These substances are constantly formed in the human body and have been shown to kill bacteria and inactivate proteins, and have been implicated in a number of diseases. Scientific data exist that link the reactive oxygen species produced by inflammatory phagocytes to cancer development. [NIH] Reality Testing: The individual's objective evaluation of the external world and the ability to differentiate adequately between it and the internal world; considered to be a primary ego function. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Recessive gene: A gene that is phenotypically expressed only when homozygous. [NIH] Recombinant: A cell or an individual with a new combination of genes not found together in either parent; usually applied to linked genes. [EU] Recombination: The formation of new combinations of genes as a result of segregation in crosses between genetically different parents; also the rearrangement of linked genes due to crossing-over. [NIH] Recovery of Function: A partial or complete return to the normal or proper physiologic activity of an organ or part following disease or trauma. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Red Nucleus: A pinkish-yellow portion of the midbrain situated in the rostral mesencephalic tegmentum. It receives a large projection from the contralateral half of the cerebellum via the superior cerebellar peduncle and a projection from the ipsilateral motor cortex. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Reflex: An involuntary movement or exercise of function in a part, excited in response to a stimulus applied to the periphery and transmitted to the brain or spinal cord. [NIH] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [NIH] Refractive Power: The ability of an object, such as the eye, to bend light as light passes through it. [NIH] Regeneration: The natural renewal of a structure, as of a lost tissue or part. [EU] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH]

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Registries: The systems and processes involved in the establishment, support, management, and operation of registers, e.g., disease registers. [NIH] Rehabilitative: Instruction of incapacitated individuals or of those affected with some mental disorder, so that some or all of their lost ability may be regained. [NIH] Relapse: The return of signs and symptoms of cancer after a period of improvement. [NIH] Reliability: Used technically, in a statistical sense, of consistency of a test with itself, i. e. the extent to which we can assume that it will yield the same result if repeated a second time. [NIH]

Remission: A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although there still may be cancer in the body. [NIH] Renal tubular: A defect in the kidneys that hinders their normal excretion of acids. Failure to excrete acids can lead to weak bones, kidney stones, and poor growth in children. [NIH] Renal tubular acidosis: A rare disorder in which structures in the kidney that filter the blood are impaired, producing using that is more acid than normal. [NIH] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration (= cell respiration). [NIH] Respiratory failure: Inability of the lungs to conduct gas exchange. [NIH] Respiratory Physiology: Functions and activities of the respiratory tract as a whole or of any of its parts. [NIH] Restoration: Broad term applied to any inlay, crown, bridge or complete denture which restores or replaces loss of teeth or oral tissues. [NIH] Retina: The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outer-most layer is pigmented, whereas the inner nine layers are transparent. [NIH] Retinae: A congenital notch or cleft of the retina, usually located inferiorly. [NIH] Retinal: 1. Pertaining to the retina. 2. The aldehyde of retinol, derived by the oxidative enzymatic splitting of absorbed dietary carotene, and having vitamin A activity. In the retina, retinal combines with opsins to form visual pigments. One isomer, 11-cis retinal combines with opsin in the rods (scotopsin) to form rhodopsin, or visual purple. Another, all-trans retinal (trans-r.); visual yellow; xanthopsin) results from the bleaching of rhodopsin by light, in which the 11-cis form is converted to the all-trans form. Retinal also combines with opsins in the cones (photopsins) to form the three pigments responsible for colour vision. Called also retinal, and retinene1. [EU] Retinal Detachment: Separation of the inner layers of the retina (neural retina) from the pigment epithelium. Retinal detachment occurs more commonly in men than in women, in eyes with degenerative myopia, in aging and in aphakia. It may occur after an uncomplicated cataract extraction, but it is seen more often if vitreous humor has been lost during surgery. (Dorland, 27th ed; Newell, Ophthalmology: Principles and Concepts, 7th ed, p310-12). [NIH] Retinal Ganglion Cells: Cells of the innermost nuclear layer of the retina, the ganglion cell layer, which project axons through the optic nerve to the brain. They are quite variable in

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size and in the shapes of their dendritic arbors, which are generally confined to the inner plexiform layer. [NIH] Retinal pigment epithelium: The pigment cell layer that nourishes the retinal cells; located just outside the retina and attached to the choroid. [NIH] Retinitis: Inflammation of the retina. It is rarely limited to the retina, but is commonly associated with diseases of the choroid (chorioretinitis) and of the optic nerve (neuroretinitis). The disease may be confined to one eye, but since it is generally dependent on a constitutional factor, it is almost always bilateral. It may be acute in course, but as a rule it lasts many weeks or even several months. [NIH] Retinitis Pigmentosa: Hereditary, progressive degeneration of the neuroepithelium of the retina characterized by night blindness and progressive contraction of the visual field. [NIH] Retinoblastoma: An eye cancer that most often occurs in children younger than 5 years. It occurs in hereditary and nonhereditary (sporadic) forms. [NIH] Retinol: Vitamin A. It is essential for proper vision and healthy skin and mucous membranes. Retinol is being studied for cancer prevention; it belongs to the family of drugs called retinoids. [NIH] Retinopathy: 1. Retinitis (= inflammation of the retina). 2. Retinosis (= degenerative, noninflammatory condition of the retina). [EU] Retrocochlear: Hearing loss in which the air conduction threshold and the bone conduction threshold have risen almost equally with no gap between them. In such cases the defect is usually either in the cochlea of the inner ear or in the central pathways. [NIH] Retrograde: 1. Moving backward or against the usual direction of flow. 2. Degenerating, deteriorating, or catabolic. [EU] Retrospective: Looking back at events that have already taken place. [NIH] Retrospective study: A study that looks backward in time, usually using medical records and interviews with patients who already have or had a disease. [NIH] Rheology: The study of the deformation and flow of matter, usually liquids or fluids, and of the plastic flow of solids. The concept covers consistency, dilatancy, liquefaction, resistance to flow, shearing, thixotrophy, and viscosity. [NIH] Rheumatism: A group of disorders marked by inflammation or pain in the connective tissue structures of the body. These structures include bone, cartilage, and fat. [NIH] Rheumatoid: Resembling rheumatism. [EU] Rheumatoid arthritis: A form of arthritis, the cause of which is unknown, although infection, hypersensitivity, hormone imbalance and psychologic stress have been suggested as possible causes. [NIH] Ribose: A pentose active in biological systems usually in its D-form. [NIH] Ribosome: A granule of protein and RNA, synthesized in the nucleolus and found in the cytoplasm of cells. Ribosomes are the main sites of protein synthesis. Messenger RNA attaches to them and there receives molecules of transfer RNA bearing amino acids. [NIH] Rigidity: Stiffness or inflexibility, chiefly that which is abnormal or morbid; rigor. [EU] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Ristocetin: An antibiotic mixture of two components, A and B, obtained from Nocardia lurida (or the same substance produced by any other means). It is no longer used clinically because of its toxicity. It causes platelet agglutination and blood coagulation and is used to assay those functions in vitro. [NIH]

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Rod: A reception for vision, located in the retina. [NIH] Round Window: Fenestra of the cochlea; an opening in the medial wall of the middle ear leading into the cochlea. [NIH] Salicylate: Non-steroidal anti-inflammatory drugs. [NIH] Salicylic: A tuberculosis drug. [NIH] Salicylic Acids: Derivatives and salts of salicylic acid. [NIH] Saliva: The clear, viscous fluid secreted by the salivary glands and mucous glands of the mouth. It contains mucins, water, organic salts, and ptylin. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Saponins: Sapogenin glycosides. A type of glycoside widely distributed in plants. Each consists of a sapogenin as the aglycon moiety, and a sugar. The sapogenin may be a steroid or a triterpene and the sugar may be glucose, galactose, a pentose, or a methylpentose. Sapogenins are poisonous towards the lower forms of life and are powerful hemolytics when injected into the blood stream able to dissolve red blood cells at even extreme dilutions. [NIH] Sarcoidosis: An idiopathic systemic inflammatory granulomatous disorder comprised of epithelioid and multinucleated giant cells with little necrosis. It usually invades the lungs with fibrosis and may also involve lymph nodes, skin, liver, spleen, eyes, phalangeal bones, and parotid glands. [NIH] Scans: Pictures of structures inside the body. Scans often used in diagnosing, staging, and monitoring disease include liver scans, bone scans, and computed tomography (CT) or computerized axial tomography (CAT) scans and magnetic resonance imaging (MRI) scans. In liver scanning and bone scanning, radioactive substances that are injected into the bloodstream collect in these organs. A scanner that detects the radiation is used to create pictures. In CT scanning, an x-ray machine linked to a computer is used to produce detailed pictures of organs inside the body. MRI scans use a large magnet connected to a computer to create pictures of areas inside the body. [NIH] Schizoid: Having qualities resembling those found in greater degree in schizophrenics; a person of schizoid personality. [NIH] Schizophrenia: A mental disorder characterized by a special type of disintegration of the personality. [NIH] Schizotypal Personality Disorder: A personality disorder in which there are oddities of thought (magical thinking, paranoid ideation, suspiciousness), perception (illusions, depersonalization), speech (digressive, vague, overelaborate), and behavior (inappropriate affect in social interactions, frequently social isolation) that are not severe enough to characterize schizophrenia. [NIH] Sciatic Nerve: A nerve which originates in the lumbar and sacral spinal cord (L4 to S3) and supplies motor and sensory innervation to the lower extremity. The sciatic nerve, which is the main continuation of the sacral plexus, is the largest nerve in the body. It has two major branches, the tibial nerve and the peroneal nerve. [NIH] Sclera: The tough white outer coat of the eyeball, covering approximately the posterior fivesixths of its surface, and continuous anteriorly with the cornea and posteriorly with the external sheath of the optic nerve. [EU] Sclerae: A circular furrow between the sclerocorneal junction and the iris. [NIH] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical

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structure, often a vessel or a nerve. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Second cancer: Refers to a new primary cancer that is caused by previous cancer treatment, or a new primary cancer in a person with a history of cancer. [NIH] Second Messenger Systems: Systems in which an intracellular signal is generated in response to an intercellular primary messenger such as a hormone or neurotransmitter. They are intermediate signals in cellular processes such as metabolism, secretion, contraction, phototransduction, and cell growth. Examples of second messenger systems are the adenyl cyclase-cyclic AMP system, the phosphatidylinositol diphosphate-inositol triphosphate system, and the cyclic GMP system. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Secretory: Secreting; relating to or influencing secretion or the secretions. [NIH] Segregation: The separation in meiotic cell division of homologous chromosome pairs and their contained allelomorphic gene pairs. [NIH] Seizures: Clinical or subclinical disturbances of cortical function due to a sudden, abnormal, excessive, and disorganized discharge of brain cells. Clinical manifestations include abnormal motor, sensory and psychic phenomena. Recurrent seizures are usually referred to as epilepsy or "seizure disorder." [NIH] Self-Help Groups: Organizations which provide an environment encouraging social interactions through group activities or individual relationships especially for the purpose of rehabilitating or supporting patients, individuals with common health problems, or the elderly. They include therapeutic social clubs. [NIH] Semen: The thick, yellowish-white, viscid fluid secretion of male reproductive organs discharged upon ejaculation. In addition to reproductive organ secretions, it contains spermatozoa and their nutrient plasma. [NIH] Semicircular canal: Three long canals of the bony labyrinth of the ear, forming loops and opening into the vestibule by five openings. [NIH] Senescence: The bodily and mental state associated with advancing age. [NIH] Senile: Relating or belonging to old age; characteristic of old age; resulting from infirmity of old age. [NIH] Sensor: A device designed to respond to physical stimuli such as temperature, light, magnetism or movement and transmit resulting impulses for interpretation, recording, movement, or operating control. [NIH] Sensory Deprivation: The absence or restriction of the usual external sensory stimuli to which the individual responds. [NIH] Septal: An abscess occurring at the root of the tooth on the proximal surface. [NIH] Sequencing: The determination of the order of nucleotides in a DNA or RNA chain. [NIH] Sequester: A portion of dead bone which has become detached from the healthy bone tissue, as occurs in necrosis. [NIH] Serine: A non-essential amino acid occurring in natural form as the L-isomer. It is synthesized from glycine or threonine. It is involved in the biosynthesis of purines, pyrimidines, and other amino acids. [NIH] Serotonin: A biochemical messenger and regulator, synthesized from the essential amino acid L-tryptophan. In humans it is found primarily in the central nervous system,

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gastrointestinal tract, and blood platelets. Serotonin mediates several important physiological functions including neurotransmission, gastrointestinal motility, hemostasis, and cardiovascular integrity. Multiple receptor families (receptors, serotonin) explain the broad physiological actions and distribution of this biochemical mediator. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Sex Characteristics: Those characteristics that distinguish one sex from the other. The primary sex characteristics are the ovaries and testes and their related hormones. Secondary sex characteristics are those which are masculine or feminine but not directly related to reproduction. [NIH] Sex Determination: The biological characteristics which distinguish human beings as female or male. [NIH] Sharpness: The apparent blurring of the border between two adjacent areas of a radiograph having different optical densities. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]

Shunt: A surgically created diversion of fluid (e.g., blood or cerebrospinal fluid) from one area of the body to another area of the body. [NIH] Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Sigmoid: 1. Shaped like the letter S or the letter C. 2. The sigmoid colon. [EU] Sigmoid Colon: The lower part of the colon that empties into the rectum. [NIH] Sign Language: A system of hand gestures used for communication by the deaf or by people speaking different languages. [NIH] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Skull: The skeleton of the head including the bones of the face and the bones enclosing the brain. [NIH] Sleep apnea: A serious, potentially life-threatening breathing disorder characterized by repeated cessation of breathing due to either collapse of the upper airway during sleep or absence of respiratory effort. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]

Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH] Social Sciences: Disciplines concerned with the interrelationships of individuals in a social environment including social organizations and institutions. Includes Sociology and Anthropology. [NIH] Social Support: Support systems that provide assistance and encouragement to individuals

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with physical or emotional disabilities in order that they may better cope. Informal social support is usually provided by friends, relatives, or peers, while formal assistance is provided by churches, groups, etc. [NIH] Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Sound Localization: Ability to determine the specific location of a sound source. [NIH] Sound wave: An alteration of properties of an elastic medium, such as pressure, particle displacement, or density, that propagates through the medium, or a superposition of such alterations. [NIH] Space Flight: Travel beyond the earth's atmosphere. [NIH] Spasm: An involuntary contraction of a muscle or group of muscles. Spasms may involve skeletal muscle or smooth muscle. [NIH] Spastic: 1. Of the nature of or characterized by spasms. 2. Hypertonic, so that the muscles are stiff and the movements awkward. 3. A person exhibiting spasticity, such as occurs in spastic paralysis or in cerebral palsy. [EU] Spasticity: A state of hypertonicity, or increase over the normal tone of a muscle, with heightened deep tendon reflexes. [EU] Spatial disorientation: Loss of orientation in space where person does not know which way is up. [NIH] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] Spectrin: A high molecular weight (220-250 kDa) water-soluble protein which can be extracted from erythrocyte ghosts in low ionic strength buffers. The protein contains no lipids or carbohydrates, is the predominant species of peripheral erythrocyte membrane proteins, and exists as a fibrous coating on the inner, cytoplasmic surface of the membrane. [NIH]

Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] Speech Acoustics: The acoustic aspects of speech in terms of frequency, intensity, and time. [NIH]

Speech Intelligibility: Ability to make speech sounds that are recognizable. [NIH] Speech pathologist: A specialist who evaluates and treats people with communication and

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swallowing problems. Also called a speech therapist. [NIH] Speech Perception: The process whereby an utterance is decoded into a representation in terms of linguistic units (sequences of phonetic segments which combine to form lexical and grammatical morphemes). [NIH] Sperm: The fecundating fluid of the male. [NIH] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spinal Cord Diseases: Pathologic conditions which feature spinal cord damage or dysfunction, including disorders involving the meninges and perimeningeal spaces surrounding the spinal cord. Traumatic injuries, vascular diseases, infections, and inflammatory/autoimmune processes may affect the spinal cord. [NIH] Spiral Ganglion: The sensory ganglion of the cochlear nerve. The cells of the spiral ganglion send fibers peripherally to the cochlear hair cells and centrally to the cochlear nuclei of the brain stem. [NIH] Spiral Lamina: The bony plate which extends outwards from the modiolus. It is part of the structure which divides trhe cochlea into sections. [NIH] Spirochete: Lyme disease. [NIH] Spleen: An organ that is part of the lymphatic system. The spleen produces lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. It is located on the left side of the abdomen near the stomach. [NIH] Sporadic: Neither endemic nor epidemic; occurring occasionally in a random or isolated manner. [EU] Squamous: Scaly, or platelike. [EU] Squamous Epithelium: Tissue in an organ such as the esophagus. Consists of layers of flat, scaly cells. [NIH] Staging: Performing exams and tests to learn the extent of the cancer within the body, especially whether the disease has spread from the original site to other parts of the body. [NIH]

Stapes: One of the three ossicles of the middle ear. It transmits sound vibrations from the incus to the internal ear. [NIH] Status Epilepticus: Repeated and prolonged epileptic seizures without recovery of consciousness between attacks. [NIH] Steel: A tough, malleable, iron-based alloy containing up to, but no more than, two percent carbon and often other metals. It is used in medicine and dentistry in implants and instrumentation. [NIH] Stem Cells: Relatively undifferentiated cells of the same lineage (family type) that retain the ability to divide and cycle throughout postnatal life to provide cells that can become specialized and take the place of those that die or are lost. [NIH] Stereotactic: Radiotherapy that treats brain tumors by using a special frame affixed directly to the patient's cranium. By aiming the X-ray source with respect to the rigid frame, technicians can position the beam extremely precisely during each treatment. [NIH] Stereotactic radiosurgery: A radiation therapy technique involving a rigid head frame that is attached to the skull; high-dose radiation is administered through openings in the head frame to the tumor while decreasing the amount of radiation given to normal brain tissue. This procedure does not involve surgery. Also called stereotaxic radiosurgery and stereotactic radiation therapy. [NIH]

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Sterility: 1. The inability to produce offspring, i.e., the inability to conceive (female s.) or to induce conception (male s.). 2. The state of being aseptic, or free from microorganisms. [EU] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Steroid therapy: Treatment with corticosteroid drugs to reduce swelling, pain, and other symptoms of inflammation. [NIH] Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stool: The waste matter discharged in a bowel movement; feces. [NIH] Streptomycin: O-2-Deoxy-2-(methylamino)-alpha-L-glucopyranosyl-(1-2)-O-5- deoxy-3-Cformyl-alpha-L-lyxofuranosyl-(1-4)-N,N'-bis(aminoiminomethyl)-D-streptamine. Antibiotic substance produced by the soil actinomycete Streptomyces griseus. It acts by inhibiting the initiation and elongation processes during protein synthesis. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stress management: A set of techniques used to help an individual cope more effectively with difficult situations in order to feel better emotionally, improve behavioral skills, and often to enhance feelings of control. Stress management may include relaxation exercises, assertiveness training, cognitive restructuring, time management, and social support. It can be delivered either on a one-to-one basis or in a group format. [NIH] Stria: 1. A streak, or line. 2. A narrow bandlike structure; a general term for such longitudinal collections of nerve fibres in the brain. [EU] Stria Vascularis: A layer of highly vascular pigmented granular cells on the outer wall of the cochlear duct. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Stromal: Large, veil-like cell in the bone marrow. [NIH] Strychnine: An alkaloid found in the seeds of nux vomica. It is a competitive antagonist at glycine receptors and thus a convulsant. It has been used as an analeptic, in the treatment of nonketotic hyperglycinemia and sleep apnea, and as a rat poison. [NIH] Stupor: Partial or nearly complete unconsciousness, manifested by the subject's responding only to vigorous stimulation. Also, in psychiatry, a disorder marked by reduced responsiveness. [EU] Styrene: A colorless, toxic liquid with a strong aromatic odor. It is used to make rubbers, polymers and copolymers, and polystyrene plastics. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subarachnoid: Situated or occurring between the arachnoid and the pia mater. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU]

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Subcutaneous: Beneath the skin. [NIH] Subspecies: A category intermediate in rank between species and variety, based on a smaller number of correlated characters than are used to differentiate species and generally conditioned by geographical and/or ecological occurrence. [NIH] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]

Substrate: A substance upon which an enzyme acts. [EU] Substrate Specificity: A characteristic feature of enzyme activity in relation to the kind of substrate on which the enzyme or catalytic molecule reacts. [NIH] Suction: The removal of secretions, gas or fluid from hollow or tubular organs or cavities by means of a tube and a device that acts on negative pressure. [NIH] Sulfur: An element that is a member of the chalcogen family. It has an atomic symbol S, atomic number 16, and atomic weight 32.066. It is found in the amino acids cysteine and methionine. [NIH] Superoxide: Derivative of molecular oxygen that can damage cells. [NIH] Superoxide Dismutase: An oxidoreductase that catalyzes the reaction between superoxide anions and hydrogen to yield molecular oxygen and hydrogen peroxide. The enzyme protects the cell against dangerous levels of superoxide. EC 1.15.1.1. [NIH] Support group: A group of people with similar disease who meet to discuss how better to cope with their cancer and treatment. [NIH] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Suppurative: Consisting of, containing, associated with, or identified by the formation of pus. [NIH] Sweat: The fluid excreted by the sweat glands. It consists of water containing sodium chloride, phosphate, urea, ammonia, and other waste products. [NIH] Sweat Glands: Sweat-producing structures that are embedded in the dermis. Each gland consists of a single tube, a coiled body, and a superficial duct. [NIH] Symphysis: A secondary cartilaginous joint. [NIH] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Synapses: Specialized junctions at which a neuron communicates with a target cell. At classical synapses, a neuron's presynaptic terminal releases a chemical transmitter stored in synaptic vesicles which diffuses across a narrow synaptic cleft and activates receptors on the postsynaptic membrane of the target cell. The target may be a dendrite, cell body, or axon of another neuron, or a specialized region of a muscle or secretory cell. Neurons may also communicate through direct electrical connections which are sometimes called electrical synapses; these are not included here but rather in gap junctions. [NIH] Synapsis: The pairing between homologous chromosomes of maternal and paternal origin during the prophase of meiosis, leading to the formation of gametes. [NIH] Synaptic: Pertaining to or affecting a synapse (= site of functional apposition between neurons, at which an impulse is transmitted from one neuron to another by electrical or chemical means); pertaining to synapsis (= pairing off in point-for-point association of homologous chromosomes from the male and female pronuclei during the early prophase of meiosis). [EU]

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Synaptic Vesicles: Membrane-bound compartments which contain transmitter molecules. Synaptic vesicles are concentrated at presynaptic terminals. They actively sequester transmitter molecules from the cytoplasm. In at least some synapses, transmitter release occurs by fusion of these vesicles with the presynaptic membrane, followed by exocytosis of their contents. [NIH] Synchrony: The normal physiologic sequencing of atrial and ventricular activation and contraction. [NIH] Syncytium: A living nucleated tissue without apparent cellular structure; a tissue composed of a mass of nucleated protoplasm without cell boundaries. [NIH] Syphilis: A contagious venereal disease caused by the spirochete Treponema pallidum. [NIH]

Systemic: Affecting the entire body. [NIH] Systemic disease: Disease that affects the whole body. [NIH] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Tardive: Marked by lateness, late; said of a disease in which the characteristic lesion is late in appearing. [EU] Telangiectasia: The permanent enlargement of blood vessels, causing redness in the skin or mucous membranes. [NIH] Telecommunications: Transmission of information over distances via electronic means. [NIH]

Temporal: One of the two irregular bones forming part of the lateral surfaces and base of the skull, and containing the organs of hearing. [NIH] Temporal Lobe: Lower lateral part of the cerebral hemisphere. [NIH] Thalamic: Cell that reaches the lateral nucleus of amygdala. [NIH] Thalamic Diseases: Disorders of the centrally located thalamus, which integrates a wide range of cortical and subcortical information. Manifestations include sensory loss, movement disorders; ataxia, pain syndromes, visual disorders, a variety of neuropsychological conditions, and coma. Relatively common etiologies include cerebrovascular disorders; craniocerebral trauma; brain neoplasms; brain hypoxia; intracranial hemorrhages; and infectious processes. [NIH] Thalassemia: A group of hereditary hemolytic anemias in which there is decreased synthesis of one or more hemoglobin polypeptide chains. There are several genetic types with clinical pictures ranging from barely detectable hematologic abnormality to severe and fatal anemia. [NIH] Thalidomide: A pharmaceutical agent originally introduced as a non-barbiturate hypnotic, but withdrawn from the market because of its known tetratogenic effects. It has been reintroduced and used for a number of immunological and inflammatory disorders. Thalidomide displays immunosuppresive and anti-angiogenic activity. It inhibits release of tumor necrosis factor alpha from monocytes, and modulates other cytokine action. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thigh: A leg; in anatomy, any elongated process or part of a structure more or less comparable to a leg. [NIH] Thoracic: Having to do with the chest. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level

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(absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombin: An enzyme formed from prothrombin that converts fibrinogen to fibrin. (Dorland, 27th ed) EC 3.4.21.5. [NIH] Thrombomodulin: A cell surface glycoprotein of endothelial cells that binds thrombin and serves as a cofactor in the activation of protein C and its regulation of blood coagulation. [NIH]

Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thymus: An organ that is part of the lymphatic system, in which T lymphocytes grow and multiply. The thymus is in the chest behind the breastbone. [NIH] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Thyroid Gland: A highly vascular endocrine gland consisting of two lobes, one on either side of the trachea, joined by a narrow isthmus; it produces the thyroid hormones which are concerned in regulating the metabolic rate of the body. [NIH] Thyroid Hormones: Hormones secreted by the thyroid gland. [NIH] Tibial Nerve: The medial terminal branch of the sciatic nerve. The tibial nerve fibers originate in lumbar and sacral spinal segments (L4 to S2). They supply motor and sensory innervation to parts of the calf and foot. [NIH] Time Management: Planning and control of time to improve efficiency and effectiveness. [NIH]

Tinnitus: Sounds that are perceived in the absence of any external noise source which may take the form of buzzing, ringing, clicking, pulsations, and other noises. Objective tinnitus refers to noises generated from within the ear or adjacent structures that can be heard by other individuals. The term subjective tinnitus is used when the sound is audible only to the affected individual. Tinnitus may occur as a manifestation of cochlear diseases; vestibulocochlear nerve diseases; intracranial hypertension; craniocerebral trauma; and other conditions. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tissue Distribution: Accumulation of a drug or chemical substance in various organs (including those not relevant to its pharmacologic or therapeutic action). This distribution depends on the blood flow or perfusion rate of the organ, the ability of the drug to penetrate organ membranes, tissue specificity, protein binding. The distribution is usually expressed as tissue to plasma ratios. [NIH] Tissue Plasminogen Activator: A proteolytic enzyme in the serine protease family found in many tissues which converts plasminogen to plasmin. It has fibrin-binding activity and is immunologically different from urinary plasminogen activator. The primary sequence, composed of 527 amino acids, is identical in both the naturally occurring and synthetic proteases. EC 3.4.21.68. [NIH] Tobramycin: An aminoglycoside, broad-spectrum antibiotic produced by Streptomyces tenebrarius. It is effective against gram-negative bacteria, especially the Pseudomonas species. It is a 10% component of the antibiotic complex, nebramycin, produced by the same species. [NIH] Tolerance: 1. The ability to endure unusually large doses of a drug or toxin. 2. Acquired drug tolerance; a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response. [EU]

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Tomography: Imaging methods that result in sharp images of objects located on a chosen plane and blurred images located above or below the plane. [NIH] Tonal: Based on special tests used for a topographic diagnosis of perceptive deafness (damage of the Corti organ, peripheral or central damage, i. e. the auditive cortex). [NIH] Tonicity: The normal state of muscular tension. [NIH] Tooth Loss: The failure to retain teeth as a result of disease or injury. [NIH] Tooth Preparation: Procedures carried out with regard to the teeth or tooth structures preparatory to specified dental therapeutic and surgical measures. [NIH] Topical: On the surface of the body. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH] Tracer: A substance (such as a radioisotope) used in imaging procedures. [NIH] Trachea: The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi. [NIH] Traction: The act of pulling. [NIH] Transcription Factors: Endogenous substances, usually proteins, which are effective in the initiation, stimulation, or termination of the genetic transcription process. [NIH] Transduction: The transfer of genes from one cell to another by means of a viral (in the case of bacteria, a bacteriophage) vector or a vector which is similar to a virus particle (pseudovirion). [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transfer Factor: Factor derived from leukocyte lysates of immune donors which can transfer both local and systemic cellular immunity to nonimmune recipients. [NIH] Translation: The process whereby the genetic information present in the linear sequence of ribonucleotides in mRNA is converted into a corresponding sequence of amino acids in a protein. It occurs on the ribosome and is unidirectional. [NIH] Transmitter: A chemical substance which effects the passage of nerve impulses from one cell to the other at the synapse. [NIH] Transplantation: Transference of a tissue or organ, alive or dead, within an individual, between individuals of the same species, or between individuals of different species. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Treatment Failure: A measure of the quality of health care by assessment of unsuccessful results of management and procedures used in combating disease, in individual cases or series. [NIH] Trigger zone: Dolorogenic zone (= producing or causing pain). [EU]

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Triglyceride: A lipid carried through the blood stream to tissues. Most of the body's fat tissue is in the form of triglycerides, stored for use as energy. Triglycerides are obtained primarily from fat in foods. [NIH] Trophic: Of or pertaining to nutrition. [EU] Tryptophan: An essential amino acid that is necessary for normal growth in infants and for nitrogen balance in adults. It is a precursor serotonin and niacin. [NIH] Tuberculosis: Any of the infectious diseases of man and other animals caused by species of Mycobacterium. [NIH] Tuberous Sclerosis: A rare congenital disease in which the essential pathology is the appearance of multiple tumors in the cerebrum and in other organs, such as the heart or kidneys. [NIH] Tumor Necrosis Factor: Serum glycoprotein produced by activated macrophages and other mammalian mononuclear leukocytes which has necrotizing activity against tumor cell lines and increases ability to reject tumor transplants. It mimics the action of endotoxin but differs from it. It has a molecular weight of less than 70,000 kDa. [NIH] Tumour: 1. Swelling, one of the cardinal signs of inflammations; morbid enlargement. 2. A new growth of tissue in which the multiplication of cells is uncontrolled and progressive; called also neoplasm. [EU] Tympani: The part of the cochlea below the spiral lamina. [NIH] Tympanic membrane: A thin, tense membrane forming the greater part of the outer wall of the tympanic cavity and separating it from the external auditory meatus; it constitutes the boundary between the external and middle ear. [NIH] Type 2 diabetes: Usually characterized by a gradual onset with minimal or no symptoms of metabolic disturbance and no requirement for exogenous insulin. The peak age of onset is 50 to 60 years. Obesity and possibly a genetic factor are usually present. [NIH] Tyrosine: A non-essential amino acid. In animals it is synthesized from phenylalanine. It is also the precursor of epinephrine, thyroid hormones, and melanin. [NIH] Tyrothricin: A polypeptide antibiotic mixture obtained from Bacillus brevis. It consists of a mixture of three tyrocidines (60%) and several gramicidins (20%) and is very toxic to blood, liver, kidneys, meninges, and the olfactory apparatus. It is used topically. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Urea: A compound (CO(NH2)2), formed in the liver from ammonia produced by the deamination of amino acids. It is the principal end product of protein catabolism and constitutes about one half of the total urinary solids. [NIH] Uremia: The illness associated with the buildup of urea in the blood because the kidneys are not working effectively. Symptoms include nausea, vomiting, loss of appetite, weakness, and mental confusion. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urinary Plasminogen Activator: A proteolytic enzyme that converts plasminogen to plasmin where the preferential cleavage is between arginine and valine. It was isolated originally from human urine, but is found in most tissues of most vertebrates. EC 3.4.21.73. [NIH]

Dictionary 403

Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Uvea: The middle coat of the eyeball, consisting of the choroid in the back of the eye and the ciliary body and iris in the front of the eye. [NIH] Uveitis: An inflammation of part or all of the uvea, the middle (vascular) tunic of the eye, and commonly involving the other tunics (the sclera and cornea, and the retina). [EU] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Vancomycin: Antibacterial obtained from Streptomyces orientalis. It is a glycopeptide related to ristocetin that inhibits bacterial cell wall assembly and is toxic to kidneys and the inner ear. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasculitis: Inflammation of a blood vessel. [NIH] Vasodilation: Physiological dilation of the blood vessels without anatomic change. For dilation with anatomic change, dilatation, pathologic or aneurysm (or specific aneurysm) is used. [NIH] Vasodilator: An agent that widens blood vessels. [NIH] VE: The total volume of gas either inspired or expired in one minute. [NIH] Vector: Plasmid or other self-replicating DNA molecule that transfers DNA between cells in nature or in recombinant DNA technology. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venereal: Pertaining or related to or transmitted by sexual contact. [EU] Venous: Of or pertaining to the veins. [EU] Venous blood: Blood that has given up its oxygen to the tissues and carries carbon dioxide back for gas exchange. [NIH] Ventilation: 1. In respiratory physiology, the process of exchange of air between the lungs and the ambient air. Pulmonary ventilation (usually measured in litres per minute) refers to the total exchange, whereas alveolar ventilation refers to the effective ventilation of the alveoli, in which gas exchange with the blood takes place. 2. In psychiatry, verbalization of one's emotional problems. [EU] Ventral: 1. Pertaining to the belly or to any venter. 2. Denoting a position more toward the belly surface than some other object of reference; same as anterior in human anatomy. [EU] Ventricular: Pertaining to a ventricle. [EU] Venules: The minute vessels that collect blood from the capillary plexuses and join together to form veins. [NIH] Verapamil: A calcium channel blocker that is a class IV anti-arrhythmia agent. [NIH] Vertebrae: A bony unit of the segmented spinal column. [NIH] Vertigo: An illusion of movement; a sensation as if the external world were revolving around the patient (objective vertigo) or as if he himself were revolving in space (subjective vertigo). The term is sometimes erroneously used to mean any form of dizziness. [EU] Vestibular: Pertaining to or toward a vestibule. In dental anatomy, used to refer to the tooth surface directed toward the vestibule of the mouth. [EU] Vestibular Aqueduct: A small bony canal linking the vestibule of the inner ear to the posterior part of the internal surface of the petrous temporal bone. It surrounds the

404 Hearing Loss

endolymphatic duct. [NIH] Vestibular Nerve: The vestibular part of the 8th cranial nerve (vestibulocochlear nerve). The vestibular nerve fibers arise from neurons of Scarpa's ganglion and project peripherally to vestibular hair cells and centrally to the vestibular nuclei of the brain stem. These fibers mediate the sense of balance and head position. [NIH] Vestibule: A small, oval, bony chamber of the labyrinth. The vestibule contains the utricle and saccule, organs which are part of the balancing apparatus of the ear. [NIH] Vestibulocochlear Nerve: The 8th cranial nerve. The vestibulocochlear nerve has a cochlear part (cochlear nerve) which is concerned with hearing and a vestibular part (vestibular nerve) which mediates the sense of balance and head position. The fibers of the cochlear nerve originate from neurons of the spiral ganglion and project to the cochlear nuclei (cochlear nucleus). The fibers of the vestibular nerve arise from neurons of Scarpa's ganglion and project to the vestibular nuclei. [NIH] Vestibulocochlear Nerve Diseases: Diseases of the vestibular and/or cochlear (acoustic) nerves, which join to form the vestibulocochlear nerve. Vestibular neuritis, cochlear neuritis, and acoustic neuromas are relatively common conditions that affect these nerves. Clinical manifestations vary with which nerve is primarily affected, and include hearing loss, vertigo, and tinnitus. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Vinca Alkaloids: A class of alkaloids from the genus of apocyanaceous woody herbs including periwinkles. They are some of the most useful antineoplastic agents. [NIH] Vincristine: An anticancer drug that belongs to the family of plant drugs called vinca alkaloids. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU] Virulence: The degree of pathogenicity within a group or species of microorganisms or viruses as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Viscosity: A physical property of fluids that determines the internal resistance to shear forces. [EU] Visual Cortex: Area of the occipital lobe concerned with vision. [NIH] Visual field: The entire area that can be seen when the eye is forward, including peripheral vision. [NIH] Vitreous Body: The transparent, semigelatinous substance that fills the cavity behind the crystalline lens of the eye and in front of the retina. It is contained in a thin hyoid membrane and forms about four fifths of the optic globe. [NIH] Vitreous Hemorrhage: Hemorrhage into the vitreous body. [NIH] Vitreous Humor: The transparent, colorless mass of gel that lies behind the lens and in front of the retina and fills the center of the eyeball. [NIH] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH]

Dictionary 405

Vocational Guidance: Systematic efforts to assist individuals in selecting an occupation or suitable employment on the basis of aptitude, education, etc. [NIH] Voltage-gated: It is opened by the altered charge distribution across the cell membrane. [NIH]

Vomica: The profuse and sudden expectoration of pus and putrescent matter. An abnormal cavity in an organ especially in the lung, caused by suppuration and the breaking down of tissue. [NIH] War: Hostile conflict between organized groups of people. [NIH] White blood cell: A type of cell in the immune system that helps the body fight infection and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others. [NIH]

Windpipe: A rigid tube, 10 cm long, extending from the cricoid cartilage to the upper border of the fifth thoracic vertebra. [NIH] Withdrawal: 1. A pathological retreat from interpersonal contact and social involvement, as may occur in schizophrenia, depression, or schizoid avoidant and schizotypal personality disorders. 2. (DSM III-R) A substance-specific organic brain syndrome that follows the cessation of use or reduction in intake of a psychoactive substance that had been regularly used to induce a state of intoxication. [EU] Wound Healing: Restoration of integrity to traumatized tissue. [NIH] Xanthine: An urinary calculus. [NIH] Xanthine Oxidase: An iron-molybdenum flavoprotein containing FAD that oxidizes hypoxanthine, some other purines and pterins, and aldehydes. Deficiency of the enzyme, an autosomal recessive trait, causes xanthinuria. EC 1.1.3.22. [NIH] Xenograft: The cells of one species transplanted to another species. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH] X-ray therapy: The use of high-energy radiation from x-rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy) or from materials called radioisotopes. Radioisotopes produce radiation and can be placed in or near the tumor or in the area near cancer cells. This type of radiation treatment is called internal radiation therapy, implant radiation, interstitial radiation, or brachytherapy. Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. X-ray therapy is also called radiation therapy, radiotherapy, and irradiation. [NIH] Yeasts: A general term for single-celled rounded fungi that reproduce by budding. Brewers' and bakers' yeasts are Saccharomyces cerevisiae; therapeutic dried yeast is dried yeast. [NIH] Yttrium: An element of the rare earth family of metals. It has the atomic symbol Y, atomic number 39, and atomic weight 88.91. In conjunction with other rare earths, yttrium is used as a phosphor in television receivers and is a component of the yttrium-aluminum garnet (YAG) lasers. [NIH] Zymogen: Inactive form of an enzyme which can then be converted to the active form, usually by excision of a polypeptide, e. g. trypsinogen is the zymogen of trypsin. [NIH]

407

INDEX 3 3-dimensional, 72, 327 A Abdomen, 327, 337, 369, 380, 396, 397 Abdominal, 327, 349, 380 Ablation, 37, 64, 327 Abscess, 327, 393 Absenteeism, 258, 327 Acceptor, 327, 369, 379 Acclimatization, 57, 89, 327 Accommodation, 222, 327, 374 Acetylcholine, 56, 65, 327, 341, 342 Acidosis, 279, 327 Actin, 52, 327, 374 Activities of Daily Living, 327, 360 Acuity, 47, 327, 334 Adaptability, 327, 340 Adaptation, 19, 60, 71, 204, 327, 377, 383 Adenine, 328, 388 Adenosine, 197, 198, 328, 362, 382 Adhesives, 179, 328 Adjustment, 9, 137, 176, 200, 205, 225, 226, 257, 269, 327, 328 Adolescence, 328, 341, 381 Adrenal Cortex, 328, 329, 347, 385 Adrenergic, 328, 332, 350, 353 Adrenergic beta-Antagonists, 328, 332 Adverse Effect, 328, 394 Aerobic, 328, 373 Aetiology, 115, 328 Afferent, 20, 27, 34, 66, 72, 328, 355 Affinity, 22, 173, 328, 329, 395 Age Distribution, 17, 328 Age Groups, 12, 21, 328 Age of Onset, 63, 328, 402 Age-Adjusted, 63, 329 Aged, 80 and Over, 328, 329 Ageing, 114, 118, 124, 329 Agonist, 329, 350, 367 Akathisia, 329, 332 Aldehydes, 329, 405 Aldosterone, 122, 329, 373 Algorithms, 48, 57, 329, 336 Alkaline, 327, 329, 330, 338 Alkaloid, 329, 373, 382, 388, 397 Alkalosis, 13, 329 Alleles, 329, 361, 369 Alopecia, 187, 329

Alpha Particles, 329, 388 Alternative medicine, 249, 329 Aluminum, 125, 329, 405 Alveoli, 329, 403 Ambulatory Care, 329 Ameliorating, 167, 192, 329 Amino Acid Sequence, 330, 331, 358 Amino Acid Substitution, 72, 330 Amino Acids, 195, 330, 354, 358, 381, 383, 386, 391, 393, 398, 400, 401, 402 Aminopropionitrile, 330, 368 Ammonia, 330, 398, 402 Amniotic Fluid, 330, 383 Anaesthesia, 114, 115, 330, 364 Anal, 330, 356, 370 Analeptic, 330, 397 Analgesic, 195, 330, 373, 388 Analog, 19, 26, 162, 165, 330 Analysis of Variance, 37, 330 Anatomical, 18, 27, 41, 42, 330, 334, 349, 352, 364, 392 Androgens, 328, 330, 347 Anemia, 280, 330, 336, 337, 399 Anesthesia, 86, 95, 159, 199, 330, 385 Anesthetics, 299, 330, 335, 353 Aneurysm, 331, 357, 403 Angiotensin-Converting Enzyme Inhibitors, 331, 332 Animal model, 21, 27, 30, 41, 45, 53, 61, 67, 72, 122, 331 Anions, 331, 367, 398 Anomalies, 65, 67, 93, 94, 109, 117, 275, 331 Anoxia, 156, 157, 159, 180, 200, 233, 331 Antagonism, 156, 195, 331 Anterior Cerebral Artery, 331, 341 Antiallergic, 331, 347 Antibacterial, 331, 395, 403 Antibiotic, 139, 249, 331, 337, 359, 375, 381, 391, 395, 397, 400, 402 Antibodies, 22, 40, 77, 81, 173, 176, 188, 194, 331, 334, 353, 360, 363, 370, 382, 388 Antibody, 22, 77, 105, 188, 328, 331, 344, 360, 361, 363, 364, 367, 373, 388, 389, 395, 405 Anticoagulant, 331, 386 Antiemetic, 331, 332

408 Hearing Loss

Antigen, 22, 46, 188, 328, 331, 344, 353, 358, 361, 362, 363, 364 Antihypertensive, 180, 331, 332 Antihypertensive Agents, 180, 332 Anti-infective, 332, 362, 366 Anti-inflammatory, 36, 69, 332, 333, 347, 349, 358, 364, 367, 384, 392 Anti-Inflammatory Agents, 332, 333, 347, 367 Antimicrobial, 160, 332 Antineoplastic, 332, 339, 347, 404 Antioxidant, 32, 53, 59, 68, 123, 197, 198, 332, 379 Antipsychotic, 180, 332, 376 Antipyretic, 332, 388 Antiviral, 9, 182, 248, 332 Anuria, 332, 367 Anus, 330, 332, 334, 337, 366 Anxiety, 8, 156, 157, 159, 179, 180, 195, 199, 328, 329, 332 Aphakia, 332, 390 Apheresis, 90, 332 Aponeurosis, 332, 357 Apoptosis, 28, 31, 49, 332, 339 Applicability, 39, 333 Approximate, 164, 184, 333 Aptitude, 333, 405 Aqueous, 333, 335, 347, 352, 362 Arachidonate 12-Lipoxygenase, 333, 369 Arachidonate 15-Lipoxygenase, 333, 369 Arachidonate Lipoxygenases, 333, 369 Arachidonic Acid, 333, 385 Aromatic, 333, 382, 397 Arrhythmia, 196, 279, 333, 403 Arterial, 173, 277, 333, 337, 340, 362, 366, 386, 399 Arteries, 333, 336, 337, 341, 346, 372, 388 Arterioles, 333, 337, 372 Arteriovenous, 81, 122, 333, 341, 372 Aseptic, 333, 397 Aspartate, 134, 156, 157, 159, 179, 195, 199, 333 Asphyxia, 156, 157, 159, 180, 200, 333 Aspirin, 63, 68, 249, 333 Assay, 56, 188, 333, 391 Asymptomatic, 46, 333, 336 Ataxia, 272, 273, 277, 278, 280, 333, 399 Atresia, 161, 233, 272, 278, 334 Atrial, 90, 334, 399 Atrium, 334 Atrophy, 168, 183, 195, 273, 277, 278, 280, 334, 376

Attenuated, 49, 64, 177, 334 Attenuation, 177, 334 Audiometer, 7, 169, 334 Audiometry, 5, 6, 14, 23, 51, 63, 136, 146, 231, 238, 324, 334 Audition, 24, 66, 214, 230, 334 Auditory Cortex, 28, 41, 334, 343 Auditory nerve, 20, 27, 29, 55, 57, 70, 167, 334, 371 Auditory Perception, 69, 334 Aural, 69, 285, 295, 296, 301, 334 Autacoids, 334, 364 Autoantibodies, 15, 22, 176, 189, 334 Autoantigens, 334 Autoimmune disease, 188, 334, 374 Autoimmunity, 188, 334 Autonomic, 327, 332, 334, 357, 381 Autoradiography, 36, 334 Autosuggestion, 335, 363 Axonal, 172, 278, 335 Axons, 66, 335, 375, 378, 384, 390 B Babesiosis, 335, 388 Bacteria, 36, 331, 335, 359, 372, 389, 395, 400, 401, 403 Bacterial Infections, 229, 233, 335, 340 Bacterial Physiology, 327, 335 Bactericidal, 36, 335 Bacteriophage, 335, 401 Bacteriostatic, 36, 335 Bacterium, 335, 344 Barbiturate, 335, 399 Barotrauma, 11, 335 Basal Ganglia, 332, 334, 335, 337, 342, 357 Basal Ganglia Diseases, 334, 335, 342 Base, 42, 43, 62, 63, 168, 188, 256, 328, 329, 335, 340, 348, 349, 358, 367, 368, 379, 383, 399 Basement Membrane, 71, 335, 355, 368 Basilar Membrane, 23, 63, 335 Behavior Therapy, 336 Benign, 11, 313, 336, 357, 360, 375, 378, 389 Benign tumor, 313, 336, 378 Beta-Thalassemia, 89, 132, 336 Bilateral, 12, 15, 19, 20, 58, 78, 79, 80, 81, 85, 110, 111, 115, 122, 123, 130, 138, 176, 188, 226, 336, 380, 384, 391 Bile, 336, 357, 364, 367, 369, 397 Bilirubin, 336, 362 Binaural, 12, 23, 36, 58, 61, 131, 270, 295, 301, 336

Index 409

Biochemical, 19, 49, 53, 329, 336, 358, 368, 393 Biological therapy, 336, 359 Biomechanics, 52, 336 Biosynthesis, 333, 336, 378, 393 Biotechnology, 72, 74, 223, 249, 267, 272, 279, 280, 281, 336 Bladder, 336, 364, 374, 386, 402, 403 Blast phase, 336, 342 Blood Coagulation, 336, 338, 356, 391, 400 Blood pressure, 186, 331, 336, 339, 341, 357, 362, 373, 377, 388, 395 Blood Sedimentation, 18, 336 Blood Viscosity, 125, 136, 337 Blot, 61, 337 Body Fluids, 329, 337, 351, 395 Body Mass Index, 7, 337 Bone Conduction, 181, 200, 334, 337, 391 Bone Marrow, 336, 337, 342, 363, 370, 373, 397 Bone scan, 337, 392 Bone-conduction, 209, 337 Bowel, 276, 330, 337, 349, 397 Bowel Movement, 337, 349, 397 Brachytherapy, 337, 366, 367, 388, 405 Brain Diseases, 337, 368, 380 Brain Ischemia, 337, 341 Brain Stem, 231, 337, 340, 341, 343, 396, 404 Branch, 19, 321, 337, 352, 371, 378, 379, 380, 387, 395, 399, 400 Breakdown, 73, 337, 357 Broadband, 68, 337 Broad-spectrum, 337, 400 Buccal, 150, 151, 337 Buffers, 338, 395 Bullous, 229, 338 Bupivacaine, 338, 369 C Calcification, 296, 338 Calcium, 31, 34, 56, 84, 195, 332, 338, 344, 354, 362, 372, 379, 386, 403 Calcium channel blocker, 332, 338, 403 Calcium Channel Blockers, 332, 338 Calcium Oxalate, 338, 379 Callus, 338, 352 Calmodulin, 34, 338 Caloric Tests, 72, 338 Capsules, 150, 338, 357 Carbogen, 87, 338 Carbohydrate, 338, 347, 384 Carbon Dioxide, 338, 356, 357, 390, 403

Carboplatin, 18, 66, 339 Carcinogenic, 339, 365, 385, 397 Carcinogens, 339, 378 Carcinoma, 90, 97, 278, 339 Cardiac, 90, 156, 157, 159, 180, 195, 196, 200, 273, 299, 328, 339, 342, 351, 353, 369, 374, 397 Cardiac arrest, 156, 157, 159, 180, 195, 200, 339 Cardiology, 39, 339 Cardiomyopathy, 7, 272, 339 Cardiovascular, 48, 63, 64, 194, 212, 223, 246, 339, 394 Cardiovascular Abnormalities, 194, 339 Cardiovascular disease, 48, 63, 212, 246, 339 Cardiovascular System, 64, 339 Carotene, 339, 390 Case report, 16, 79, 80, 81, 84, 96, 99, 111, 122, 130, 339, 343 Case series, 339, 343 Caspase, 28, 339 Cataract, 81, 273, 332, 339, 390 Cations, 339, 367 Caudal, 339, 349, 384 Causal, 53, 159, 200, 339 Cell Count, 32, 340 Cell Cycle, 340, 343 Cell Death, 28, 34, 49, 53, 59, 60, 69, 129, 172, 183, 195, 197, 198, 332, 340, 358, 375 Cell Division, 279, 335, 340, 359, 371, 373, 382, 385, 393 Cell membrane, 52, 338, 340, 357, 366, 405 Cell Physiology, 57, 340 Cell Respiration, 340, 373, 390 Cell Survival, 340, 359 Cellular Structures, 69, 340 Cellulose, 340, 382 Central Nervous System Infections, 340, 360 Cerebellar, 77, 81, 122, 273, 278, 334, 340, 343, 389 Cerebellopontine, 116, 340 Cerebellopontine Angle, 116, 340 Cerebellum, 337, 340, 341, 346, 384, 389 Cerebral hemispheres, 335, 337, 340, 341 Cerebral Infarction, 156, 157, 159, 180, 200, 340, 341 Cerebral Palsy, 341, 395 Cerebrospinal, 341, 394 Cerebrospinal fluid, 341, 394

410 Hearing Loss

Cerebrovascular, 156, 157, 159, 180, 199, 335, 338, 339, 341, 399 Cerebrovascular Disorders, 156, 157, 159, 180, 199, 341, 399 Cerebrum, 340, 341, 346, 402 Cerumen, 7, 233, 341 Character, 341, 348 Chelation, 89, 132, 341 Chelation Therapy, 89, 132, 341 Chemoreceptor, 332, 341 Chemotherapy, 79, 80, 97, 130, 341 Child Development, 214, 341 Child Language, 228, 341 Child Psychiatry, 341, 358 Cholesteatoma, 161, 168, 233, 341 Cholesterol, 10, 336, 341, 346, 362, 397 Choline, 65, 341 Cholinergic, 27, 57, 64, 332, 342 Chorea, 332, 342 Choriocapillaris, 60, 342 Chorioretinitis, 342, 391 Choroid, 279, 342, 390, 391, 403 Chromatin, 333, 342 Chromosomal, 45, 51, 194, 211, 330, 342, 358, 383 Chromosome, 13, 50, 55, 61, 74, 75, 84, 108, 194, 342, 360, 369, 393 Chronic lymphocytic leukemia, 342 Chronic myelogenous leukemia, 336, 342 Chronic phase, 10, 342 Chronic renal, 13, 342, 357, 383 Ciliary, 187, 342, 403 Ciliary Neurotrophic Factor, 187, 342 Cinchona, 342, 388 CIS, 342, 390 Cisplatin, 26, 197, 342 Clamp, 37, 343 Clinical Medicine, 343, 384 Clinical study, 42, 87, 123, 126, 129, 343 Clinical trial, 18, 20, 72, 149, 153, 267, 343, 346, 350, 386, 389 Clone, 22, 53, 152, 343 Cloning, 51, 54, 67, 336, 343 Cochlear Diseases, 343, 400 Cochlear Duct, 343, 397 Cochlear Implantation, 23, 36, 39, 76, 343 Cochlear Nerve, 178, 343, 396, 404 Cochlear Nucleus, 20, 27, 34, 64, 66, 343, 404 Coenzyme, 125, 343 Cofactor, 343, 386, 400 Cognition, 159, 199, 205, 344, 368, 376

Cognitive behavior therapy, 205, 344 Cognitive restructuring, 344, 397 Collagen, 71, 248, 328, 335, 344, 355, 357, 378, 383, 385 Competency, 291, 344 Complement, 344, 358, 382 Complementary and alternative medicine, 129, 140, 344 Complementary medicine, 129, 344 Compress, 345, 361 Computational Biology, 267, 272, 345 Computed tomography, 104, 150, 151, 228, 345, 392 Computerized axial tomography, 345, 392 Computerized tomography, 123, 345 Conception, 345, 356, 397 Concomitant, 197, 345 Concretion, 345, 379 Conduction, 21, 165, 181, 272, 334, 345, 391 Cone, 345, 382 Congenita, 345, 388 Congestion, 131, 135, 332, 345 Conjugated, 345, 347 Connective Tissue, 49, 337, 344, 345, 356, 357, 370, 391 Connective Tissue Cells, 345 Connexins, 6, 345, 357 Consciousness, 330, 345, 348, 349, 350, 396 Constipation, 332, 345 Constitutional, 227, 346, 391 Constriction, 346, 367 Consultation, 16, 143, 224, 346 Consumer Organizations, 70, 346 Consumption, 158, 346, 349, 379 Contraindications, ii, 346 Contralateral, 131, 231, 346, 378, 389 Control group, 58, 196, 346 Controlled study, 75, 122, 346 Contusion, 173, 346 Conventional therapy, 113, 346 Conventional treatment, 346 Convulsions, 156, 157, 159, 179, 180, 195, 199, 335, 346, 376 Convulsive, 159, 200, 346 Coordination, 340, 346, 374 Cornea, 346, 392, 403 Corneum, 346, 353, 363 Coronary, 339, 346, 372 Coronary heart disease, 339, 346 Coronary Thrombosis, 346, 372

Index 411

Cortex, 29, 41, 65, 334, 337, 346, 354, 355, 389, 401 Cortical, 28, 40, 41, 88, 95, 131, 346, 354, 393, 399 Cortices, 346, 360 Corticosteroid, 78, 189, 248, 347, 384, 397 Cortisone, 347, 349, 384 Cranial, 49, 82, 98, 188, 334, 340, 343, 347, 355, 360, 366, 378, 381, 404 Craniocerebral Trauma, 335, 347, 360, 399, 400 Cues, 19, 28, 36, 48, 57, 87, 131, 233, 347 Curative, 347, 399 Cyclic, 38, 64, 193, 194, 338, 347, 359, 382, 386, 393 Cytochrome, 49, 347, 379 Cytokine, 31, 182, 347, 381, 399 Cytomegalovirus, 30, 56, 76, 84, 149, 213, 347 Cytoplasm, 333, 340, 347, 353, 373, 391, 399 Cytoskeleton, 52, 347 Cytotoxic, 347, 364, 388, 389 Cytotoxicity, 343, 348 D Data Collection, 348, 356 Databases, Bibliographic, 267, 348 Day Care, 28, 348 Deamination, 348, 402 Decision Making, 27, 59, 348 Decompression, 84, 131, 348, 350 Decompression Sickness, 348 Deferoxamine, 125, 348 Degenerative, 53, 54, 156, 157, 159, 173, 180, 348, 374, 390, 391 Deletion, 42, 55, 175, 193, 332, 348 Delirium, 332, 348 Delusions, 348, 387 Dementia, 156, 332, 348 Dendrites, 349, 376 Density, 20, 56, 174, 337, 349, 378, 395 Deprivation, 12, 34, 137, 349 Developed Countries, 169, 175, 193, 349 Developing Countries, 169, 349 Dexamethasone, 49, 135, 349 Diabetes Mellitus, 7, 118, 212, 349, 359, 361 Diabetic Retinopathy, 7, 159, 349 Diagnostic procedure, 155, 249, 349 Diaphragm, 167, 349 Diastolic, 349, 362 Diencephalon, 341, 349

Diffusion, 349, 366 Digestive system, 154, 349 Dilatation, 331, 349, 385, 403 Dilatation, Pathologic, 349, 403 Dilation, 349, 403 Diploid, 349, 382 Directivity, 33, 350 Discrimination, 48, 71, 88, 92, 103, 134, 145, 255, 334, 350 Dispenser, 207, 241, 296, 350 Dissociation, 328, 350 Distal, 85, 107, 278, 335, 350, 351, 378, 384, 387 Diuretic, 350, 357 Diuretics, Thiazide, 332, 350 Diving, 11, 350 Dizziness, 19, 66, 208, 215, 218, 219, 220, 256, 284, 291, 313, 323, 350, 403 Domesticated, 350, 359 Dominance, 95, 350 Dopamine, 332, 350, 382 Dorsal, 187, 343, 350, 384 Dorsum, 350, 357 Double-blinded, 87, 123, 350 Drug Interactions, 261, 309, 351 Drug Tolerance, 351, 400 Duct, 277, 351, 352, 364, 392, 398 Duke, 29, 126, 351 Dura mater, 351, 372, 380 Dyskinesia, 332, 351 Dysostosis, 278, 351, 371 Dysplasia, 96, 273, 277, 278, 280, 351 Dystonia, 73, 332, 351 Dystrophy, 7, 52, 93, 273, 280, 351 E Ear Diseases, 50, 119, 231, 351 Eardrum, 164, 183, 184, 188, 192, 286, 296, 351 Edema, 173, 349, 351, 357, 361, 366 Education, Special, 296, 351 Effector, 327, 344, 351, 376, 382 Effector cell, 351, 376 Efficacy, 9, 20, 32, 36, 69, 126, 146, 147, 149, 351, 385 Effusion, 20, 96, 351 Elastin, 344, 351, 355 Electrode, 23, 38, 66, 170, 178, 351 Electrolyte, 329, 347, 348, 351, 368, 373, 384, 395 Electromagnetic Fields, 162, 351 Electrons, 332, 335, 351, 367, 379, 388, 389 Electrophysiological, 34, 57, 352

412 Hearing Loss

Electroretinography, 61, 352 Embryo, 352, 364, 378, 384 Embryogenesis, 21, 352 Embryology, 212, 352 Emulsion, 335, 352, 356 Enamel, 90, 278, 352 Encephalitis, 30, 160, 248, 352 Encephalitis, Viral, 352 Endemic, 352, 396 Endocrine System, 352, 376 Endolymph, 31, 64, 352 Endolymphatic Duct, 352, 404 Endolymphatic Sac, 49, 84, 352 Endometrial, 352 Endometriosis, 109, 352 Endometrium, 352, 353, 372 Endoscopy, 112, 353 Endothelial cell, 33, 71, 353, 356, 400 Endotoxins, 344, 353, 367 End-stage renal, 342, 353, 383 Enhancers, 160, 353 Environmental Exposure, 353, 378 Environmental Health, 80, 95, 116, 266, 268, 353 Enzymatic, 338, 339, 344, 353, 361, 390 Epidemic, 353, 396 Epidemiological, 175, 193, 353 Epidermis, 346, 353, 363 Epidural, 114, 115, 353 Epidural block, 114, 115, 353 Epinephrine, 328, 350, 353, 402 Epithelial, 40, 71, 353, 368, 373 Epithelial Cells, 40, 353, 368, 373 Epithelium, 61, 173, 174, 279, 335, 353, 390 Epitopes, 176, 353 Equipment and Supplies, 268, 353 Erbium, 125, 354 Erythrocytes, 330, 335, 336, 337, 354 Esophagus, 334, 349, 354, 382, 396, 397 Essential Tremor, 280, 354 Etidronate, 92, 354 Eukaryotic Cells, 354, 364 Eustachian tube, 15, 168, 183, 335, 354 Evoke, 31, 354, 397 Evoked Potentials, 18, 29, 65, 107, 114, 137, 354 Excitation, 156, 157, 159, 166, 180, 195, 199, 341, 354 Excitatory, 37, 156, 157, 159, 180, 195, 199, 354, 359, 367, 376 Excitatory Amino Acid Agonists, 354, 367

Excitatory Amino Acids, 156, 157, 159, 180, 195, 199, 354, 376 Excitotoxicity, 159, 200, 354 Excrete, 332, 354, 367, 390 Exhaustion, 331, 354 Exogenous, 32, 187, 354, 358, 386, 402 Expander, 354 Expiration, 354, 390 Extender, 354, 382 External-beam radiation, 355, 367, 388, 405 Extracellular, 21, 37, 71, 345, 355, 378, 395 Extracellular Matrix, 21, 71, 345, 355, 378 Extracellular Matrix Proteins, 21, 355 Extracellular Space, 355 Extraction, 51, 172, 332, 355, 390 Extrapyramidal, 329, 332, 350, 355 Extremity, 355, 380, 392 Eye Movements, 41, 72, 355 F Facial, 41, 81, 122, 160, 187, 277, 355, 362, 371, 380 Facial Nerve, 160, 187, 355, 362, 380 Facial Nerve Diseases, 355, 362 Facial Paralysis, 81, 122, 355 Family Planning, 267, 355 Family Relations, 207, 355 Fat, 333, 337, 339, 346, 347, 355, 369, 374, 391, 402 Fatigue, 102, 355 Fatty acids, 356, 369, 385 Femur, 356, 378 Ferritin, 125, 356 Fetus, 356, 384 Fibrin, 336, 356, 383, 400 Fibroblast Growth Factor, 61, 356 Fibronectins, 355, 356 Fibrosis, 36, 280, 356, 392 Filtration, 172, 356, 367 Firearms, 248, 291, 356 Fistula, 11, 112, 176, 213, 233, 325, 356 Fixation, 161, 275, 277, 356 Flaccid, 167, 356 Flatus, 356, 357 Focus Groups, 27, 269, 356 Fold, 57, 290, 309, 357 Forearm, 336, 357 Fossa, 49, 340, 357 Founder Effect, 83, 357 Fovea, 174, 356, 357 Frontal Lobe, 331, 341, 357

Index 413

Functional magnetic resonance imaging, 29, 39, 357 Furosemide, 62, 357 G Gallbladder, 327, 349, 357 Gamma knife, 96, 357 Gamma Rays, 357, 388, 389 Ganglia, 327, 335, 357, 375, 381 Ganglion, 174, 187, 357, 378, 390, 396, 404 Ganglionic Blockers, 332, 357 Gap Junctions, 31, 345, 357, 398 Gas, 167, 330, 338, 348, 349, 356, 357, 362, 377, 390, 398, 403 Gas exchange, 357, 390, 403 Gelatin, 357, 359 Gene Expression, 44, 55, 59, 74, 281, 358 Gene Targeting, 44, 358 Genetic Code, 358, 377 Genetic Counseling, 30, 43, 213, 225, 228, 242, 358 Genetic Engineering, 336, 343, 358 Genetic Techniques, 45, 358 Genetic testing, 42, 43, 59, 67, 94, 104, 298, 358 Genotype, 44, 59, 93, 225, 358, 382 Geriatric, 25, 94, 117, 138, 358 Germ Cells, 358, 371, 378 Gestation, 358, 381 Gestures, 358, 394 Giant Cells, 358, 392 Gifted, 16, 358 Gland, 328, 347, 358, 370, 380, 382, 386, 393, 397, 398, 400 Glucocorticoid, 122, 247, 349, 358, 373, 384 Glucose, 280, 340, 349, 358, 361, 365, 392 Glucose Intolerance, 349, 358 Glutamate, 19, 134, 156, 157, 159, 180, 195, 199, 354, 359, 367, 372 Glutamic Acid, 196, 359, 385 Glutathione Peroxidase, 32, 136, 192, 359 Glycine, 37, 196, 359, 393, 397 Glycoprotein, 188, 358, 359, 368, 400, 402 Glycosaminoglycans, 355, 359 Glycosidic, 359, 376, 377 Goiter, 40, 359 Gonadal, 277, 359, 397 Gonads, 359, 362 Governing Board, 359, 384 Grade, 90, 144, 146, 147, 241, 359 Grafting, 359, 364 Gramicidin, 37, 359 Gram-negative, 359, 400

Gram-positive, 359 Growth factors, 61, 359 Guinea Pigs, 52, 53, 73, 124, 359 H Hair Cells, 20, 22, 25, 27, 28, 45, 50, 52, 55, 56, 66, 71, 72, 74, 103, 110, 170, 172, 174, 188, 191, 234, 252, 288, 293, 296, 300, 304, 343, 360, 396, 404 Hair Color, 150, 151, 360 Hammer, 183, 192, 360 Handicap, 4, 5, 6, 7, 8, 25, 69, 97, 175, 193, 360 Haploid, 360, 382 Haptens, 328, 360 Headache, 157, 159, 180, 195, 199, 360 Headache Disorders, 360 Health Education, 300, 305, 360 Health Services, 39, 168, 360 Health Status, 97, 360 Hearing Disorders, 50, 55, 64, 151, 189, 220, 284, 292, 344, 360 Hearing Impaired Persons, 162, 163, 199, 360 Hearing Loss, Conductive, 308, 360 Heart attack, 339, 360 Hematoma, 360, 361 Heme, 336, 347, 360 Hemodialysis, 360, 367, 368 Hemoglobin, 330, 336, 354, 360, 361, 399 Hemoglobinuria, 280, 361 Hemorrhage, 104, 347, 360, 361, 397, 404 Hemorrhagic stroke, 156, 157, 159, 180, 200, 361 Heredity, 56, 62, 212, 219, 306, 358, 361 Heritability, 63, 361 Heterogeneity, 53, 225, 328, 361 Heterozygotes, 56, 350, 361 Histamine, 332, 361 Histiocytosis, 101, 361 Homeostasis, 31, 37, 62, 64, 361 Homologous, 68, 194, 329, 345, 358, 361, 393, 398 Homozygotes, 42, 350, 361 Hormonal, 334, 347, 361 Hormone, 329, 347, 353, 361, 365, 366, 372, 385, 391, 393, 400 Host, 335, 362, 363, 404 Hybrid, 51, 343, 362 Hybridization, 50, 362 Hydrogen, 327, 335, 338, 355, 359, 362, 369, 373, 377, 379, 387, 398 Hydrogen Peroxide, 359, 362, 369, 398

414 Hearing Loss

Hydrolysis, 342, 362, 366, 376, 383, 386 Hydroxylysine, 344, 362 Hydroxyproline, 344, 362 Hyperacusis, 115, 138, 355, 362 Hyperbilirubinemia, 226, 362, 367 Hypercalcemia, 354, 362 Hyperlipidaemia, 75, 362 Hyperlipidemia, 10, 124, 362 Hyperlipoproteinemia, 212, 362 Hypersensitivity, 362, 391 Hypertension, 194, 328, 331, 332, 338, 339, 362, 366 Hypertrophy, 362, 363 Hypnotic, 335, 362, 399 Hypoglycemia, 156, 157, 159, 179, 180, 195, 199, 362 Hypogonadism, 194, 277, 362 Hypoplasia, 90, 278, 362 Hypotension, 332, 346, 357, 362 Hypoxanthine, 362, 405 Hypoxia, 34, 48, 125, 136, 157, 337, 341, 348, 363, 399 I Iatrogenic, 209, 363 Ichthyosis, 278, 363 Id, 127, 139, 213, 284, 311, 313, 320, 322, 363 Idiopathic, 9, 76, 77, 80, 83, 87, 110, 123, 124, 131, 188, 248, 254, 363, 392 Illusion, 363, 403 Imaging procedures, 363, 401 Immune function, 363 Immune response, 46, 49, 182, 331, 334, 347, 360, 363, 364, 398, 404 Immune Sera, 363 Immune system, 49, 176, 334, 336, 351, 363, 370, 374, 403, 405 Immunity, 31, 363, 401 Immunization, 46, 286, 363 Immunocompromised, 30, 46, 363 Immunodeficiency, 30, 159, 200, 279, 363 Immunoglobulin, 175, 331, 363, 373 Immunohistochemistry, 21, 61, 363 Immunologic, 12, 31, 49, 78, 113, 188, 213, 363, 381, 389 Immunology, 189, 328, 363 Immunosuppressant, 187, 363 Immunosuppressive, 49, 254, 358, 363, 364 Immunosuppressive Agents, 49, 363 Immunosuppressive therapy, 254, 364 Impaction, 233, 364 Implant radiation, 364, 366, 367, 388, 405

Implantation, 23, 39, 82, 240, 345, 364 In situ, 30, 61, 181, 364 In Situ Hybridization, 30, 61, 364 In vitro, 22, 38, 42, 52, 64, 73, 175, 193, 337, 364, 391 In vivo, 37, 38, 52, 69, 139, 174, 195, 364 Incontinence, 156, 157, 159, 180, 195, 199, 364 Incus, 192, 364, 371, 396 Indicative, 172, 217, 364, 380, 403 Indomethacin, 13, 364 Induction, 31, 35, 330, 332, 357, 364 Infancy, 114, 364 Infant, Newborn, 328, 364 Infarction, 337, 341, 346, 361, 364, 372 Information Centers, 204, 365 Informed Consent, 43, 365 Infusion, 17, 62, 100, 365 Ingestion, 63, 238, 365, 368, 383 Inhalation, 48, 87, 365, 383 Initiation, 67, 230, 365, 397, 401 Inlay, 365, 390 Innervation, 20, 27, 355, 365, 381, 392, 400 Inoperable, 163, 365 Inorganic, 342, 365 Inositol, 365, 372, 393 Insight, 44, 45, 54, 63, 68, 365 Insulator, 365, 374 Insulin, 7, 365, 402 Insulin-dependent diabetes mellitus, 365 Interferometry, 21, 365 Interleukins, 364, 365 Intermittent, 68, 366, 370 Internal Medicine, 7, 40, 125, 366 Internal radiation, 366, 367, 388, 405 Interpersonal Relations, 204, 301, 366 Interstitial, 337, 355, 366, 367, 405 Intestinal, 339, 366, 370 Intestines, 327, 334, 366 Intoxication, 348, 366, 405 Intracellular, 34, 37, 66, 194, 338, 358, 364, 366, 371, 372, 384, 386, 393 Intracellular Membranes, 366, 371 Intracranial Embolism, 341, 366 Intracranial Embolism and Thrombosis, 341, 366 Intracranial Hypertension, 360, 366, 400 Intramuscular, 182, 366 Intrathecal, 30, 366 Intravenous, 17, 100, 182, 365, 366 Intrinsic, 122, 167, 328, 335, 366 Invasive, 363, 366, 370

Index 415

Involuntary, 335, 342, 354, 366, 374, 389, 395 Iodine, 150, 366 Ion Channels, 6, 194, 196, 366, 376 Ion Transport, 40, 366, 373 Ionizing, 329, 353, 367, 389 Ions, 196, 335, 338, 350, 351, 362, 366, 367, 371, 386 Ipsilateral, 63, 99, 100, 131, 133, 231, 367, 389 Irradiation, 101, 367, 405 Ischemia, 122, 125, 136, 156, 157, 159, 172, 179, 180, 195, 199, 334, 337, 361, 367, 376 J Jaundice, 362, 367 Job Satisfaction, 197, 258, 367 Joint, 60, 348, 351, 367, 398 K Kainate, 195, 367 Kainic Acid, 19, 367 Kb, 266, 367 Keto, 157, 367 Ketorolac, 101, 135, 367 Kidney Disease, 7, 13, 154, 266, 280, 367 Kidney Failure, 13, 353, 367, 368 Kidney Failure, Acute, 367 Kidney Failure, Chronic, 367, 368 Kidney stone, 368, 379, 390 Kinetics, 40, 368 L Labyrinth, 36, 49, 338, 343, 352, 365, 368, 379, 381, 393, 404 Labyrinthine, 36, 212, 368 Labyrinthitis, 11, 30, 31, 35, 160, 176, 248, 368 Lacrimal, 277, 355, 368 Laminin, 335, 355, 368 Language Development, 17, 144, 214, 215, 229, 230, 238, 299, 300, 307, 311, 368 Language Development Disorders, 368 Language Disorders, 218, 310, 344, 368 Language Therapy, 39, 368 Large Intestine, 349, 366, 368, 389 Latency, 114, 130, 137, 368 Latent, 368, 384 Lathyrism, 156, 157, 159, 179, 180, 199, 368 Lectin, 368, 372 Lesion, 7, 28, 81, 111, 215, 231, 368, 369, 399 Lethal, 41, 335, 369 Leukapheresis, 332, 369 Leukemia, 82, 279, 342, 369

Leukocytes, 337, 364, 365, 369, 373, 381, 402 Library Services, 320, 369 Lidocaine, 41, 369 Life Expectancy, 169, 369 Ligament, 31, 36, 369, 386 Ligands, 199, 369 Limbic, 41, 369 Linkage, 13, 30, 50, 54, 61, 63, 93, 225, 369 Linkage Disequilibrium, 30, 50, 369 Lip, 39, 135, 369 Lipid, 53, 341, 365, 367, 369, 374, 379, 402 Lipid Peroxidation, 53, 369, 379 Lipoxygenase, 69, 333, 369 Lithium, 332, 369 Liver, 327, 333, 336, 347, 349, 352, 357, 359, 369, 384, 392, 402 Liver scan, 369, 392 Lobe, 331, 341, 369 Localization, 6, 23, 45, 50, 54, 59, 102, 250, 363, 369 Localized, 29, 64, 146, 182, 194, 225, 337, 356, 360, 364, 368, 369, 382 Locomotion, 370, 382 Longitudinal study, 75, 104, 370 Long-Term Care, 72, 370 Loop, 52, 370 Loudness Perception, 47, 92, 370 Lumbar, 370, 392, 400 Lumen, 35, 370 Lymph, 353, 370, 392 Lymph node, 370, 392 Lymphatic, 365, 370, 383, 396, 400 Lymphocyte, 331, 370 Lymphoid, 331, 370 Lymphoma, 279, 370 M Macula, 174, 342, 357, 370 Macula Lutea, 174, 370 Magnetic Resonance Imaging, 91, 150, 151, 370, 392 Malabsorption, 280, 370 Malformation, 81, 122, 150, 279, 370, 378 Malignant, 111, 279, 332, 361, 370, 375, 389 Malingering, 150, 370 Malleus, 51, 178, 192, 364, 371 Malnutrition, 334, 371, 374 Mammogram, 338, 371, 372 Manic, 332, 369, 371, 387 Manic-depressive psychosis, 371, 387 Manifest, 46, 335, 371 Mannosidosis, 96, 371

416 Hearing Loss

Mastoiditis, 160, 229, 233, 371 Meatus, 337, 351, 371, 379, 402 Medial, 19, 37, 52, 343, 371, 378, 379, 392, 400 Mediate, 41, 56, 66, 71, 195, 343, 350, 371, 404 Medical Records, 150, 151, 371, 391 Medical Staff, 350, 371 MEDLINE, 267, 272, 280, 371 Meiosis, 371, 398 Melanin, 371, 382, 402 Melanocytes, 371 Melanoma, 279, 371 Membrane Potentials, 69, 371 Membrane Proteins, 71, 371, 395 Memory, 13, 46, 161, 164, 184, 187, 198, 348, 372 Meninges, 340, 341, 347, 351, 359, 372, 396, 402 Meningitis, 36, 73, 74, 94, 101, 123, 135, 139, 247, 286, 287, 372 Menstrual Cycle, 91, 372, 385 Menstruation, 372 Mental Disorders, 154, 341, 368, 372, 387 Mental Health, iv, 8, 18, 154, 218, 220, 235, 266, 269, 271, 293, 372, 377, 387 Mental Processes, 350, 372, 387 Mental Retardation, 106, 108, 114, 194, 273, 278, 279, 281, 344, 372 Mesolimbic, 332, 372 Metabotropic, 195, 372 MI, 108, 124, 135, 156, 157, 159, 170, 179, 188, 195, 197, 199, 227, 228, 290, 301, 326, 372 Microbe, 372, 401 Microbiology, 327, 372 Microcalcifications, 338, 372 Microcirculation, 33, 372 Microorganism, 343, 372, 404 Microscopy, 21, 32, 36, 335, 372 Microwaves, 372, 388 Mineralocorticoid, 122, 373 Mitochondria, 49, 60, 373 Mitochondrial Swelling, 373, 375 Mitosis, 333, 373 Mitotic, 60, 62, 373 Mitotic inhibitors, 62, 373 Modeling, 48, 60, 144, 221, 373 Modification, 29, 73, 358, 373, 388 Monitor, 150, 293, 311, 373, 377 Monoclonal, 22, 367, 373, 388, 405 Monocytes, 369, 373, 399

Monogenic, 175, 193, 373 Monophosphate, 64, 373 Morale, 258, 373 Morphine, 373, 375 Morphogenesis, 67, 373 Morphological, 21, 57, 329, 352, 371, 373 Morphology, 20, 339, 373 Motility, 52, 364, 374, 394 Motivations, 18, 94, 374 Motor Activity, 346, 374 Movement Disorders, 332, 374, 399 Mucinous, 357, 374 Mucins, 374, 392 Multiple sclerosis, 191, 374 Muscle Fibers, 374 Muscular Atrophy, 280, 374 Muscular Diseases, 355, 374, 380 Muscular Dystrophies, 351, 374 Musculoskeletal System, 211, 374 Myelin, 374 Myocardium, 372, 374 Myopia, 173, 275, 277, 374, 375, 389, 390 Myosin, 71, 73, 193, 194, 374 Myotonia, 374, 388 Myotonic Dystrophy, 280, 374 N Narcosis, 374 Narcotic, 299, 373, 374 Nausea, 223, 331, 332, 375, 402 NCI, 1, 154, 265, 342, 375 Nearsightedness, 374, 375 Nebramycin, 375, 400 Necrosis, 173, 332, 340, 364, 372, 375, 392, 393 Neonatal, 24, 34, 102, 134, 246, 375 Neonatal Screening, 246, 375 Neoplasia, 279, 375 Neoplasm, 11, 375, 378, 402 Neoplastic, 341, 370, 375 Nephropathy, 367, 375 Nerve Endings, 178, 195, 375 Nerve Fibers, 50, 62, 66, 343, 375, 400, 404 Nerve Growth Factor, 173, 187, 375, 377 Nerve Regeneration, 187, 375 Nervous System, 19, 31, 70, 156, 157, 159, 172, 179, 180, 187, 195, 196, 199, 211, 280, 308, 327, 328, 331, 337, 340, 341, 342, 354, 357, 359, 360, 373, 374, 375, 376, 378, 381, 384, 393 Networks, 177, 375 Neuraminidase, 73, 376 Neuroanatomy, 21, 41, 376

Index 417

Neurodegenerative Diseases, 156, 159, 173, 187, 199, 335, 376 Neuroeffector Junction, 375, 376 Neuroendocrine, 90, 278, 376 Neuroleptic, 329, 332, 376 Neurologic, 231, 376 Neuroma, 76, 122, 233, 284, 376 Neuromuscular, 327, 355, 376, 380 Neuromuscular Junction, 327, 376 Neuronal, 34, 157, 159, 173, 187, 191, 195, 199, 200, 342, 374, 376 Neuropathy, 125, 233, 276, 277, 278, 285, 376 Neurophysiology, 28, 72, 87, 130, 131, 376 Neuroprotective Agents, 156, 157, 179, 199, 376 Neuroretinitis, 376, 391 Neurotoxicity, 367, 376 Neurotoxin, 195, 376 Neurotransmitters, 156, 157, 159, 180, 195, 199, 354, 373, 376, 384 Neurotrophins, 173, 377 Neutrons, 329, 367, 377, 388 Night Blindness, 377, 391 Nitrogen, 33, 329, 330, 348, 355, 356, 368, 377, 402 Nonverbal Communication, 208, 344, 377, 387 Normotensive, 13, 377 Nuclear, 6, 28, 41, 51, 61, 67, 174, 335, 352, 354, 355, 357, 375, 377, 390 Nuclear Family, 355, 377 Nuclei, 329, 331, 343, 352, 355, 358, 370, 373, 377, 378, 387, 396, 404 Nucleic acid, 52, 56, 194, 358, 362, 363, 364, 377, 388 Nucleic Acid Hybridization, 362, 377 Nucleus, 34, 37, 65, 331, 333, 335, 342, 343, 347, 354, 357, 371, 373, 377, 385, 387, 399 Nursing Care, 377, 381 Nystagmus, 338, 368, 377 O Occipital Lobe, 377, 404 Occupational Exposure, 82, 377 Occupational Health, 225, 252, 377 Ocular, 19, 72, 107, 173, 377 Oligosaccharides, 376, 377 Oliguria, 367, 377 Oncogene, 279, 378 On-line, 169, 190, 323, 378 Oocytes, 57, 378 Opacity, 339, 349, 378

Ophthalmologic, 7, 351, 378 Ophthalmology, 81, 90, 93, 108, 125, 244, 304, 356, 378, 390 Opportunistic Infections, 297, 378 Opsin, 378, 390 Optic Chiasm, 378 Optic Disk, 349, 370, 378 Optic Nerve, 174, 376, 378, 380, 390, 391, 392 Orthostatic, 332, 378 Ossicle, 130, 166, 378 Ossicular Replacement, 103, 378 Ossification, 36, 101, 378 Osteoblasts, 36, 378 Osteochondroma, 83, 378 Osteogenesis, 100, 133, 304, 307, 378 Osteogenesis Imperfecta, 100, 133, 304, 307, 378 Osteoporosis, 92, 286, 379 Otitis Media, 7, 12, 20, 36, 51, 73, 96, 108, 124, 161, 167, 213, 222, 229, 233, 289, 296, 379 Otitis Media with Effusion, 12, 20, 96, 108, 124, 379 Otolaryngologist, 59, 114, 212, 226, 227, 229, 379 Otolith, 19, 379 Otorrhea, 20, 89, 379 Ototoxic, 18, 57, 63, 191, 212, 226, 253, 298, 299, 308, 379 Outer ear, 170, 183, 192, 239, 379 Outpatient, 379 Oval Window, 170, 178, 253, 379 Overexpress, 55, 379 Oxalate, 156, 379 Oxidation, 327, 332, 333, 347, 359, 369, 379 Oxidative Phosphorylation, 69, 379 Oxidative Stress, 53, 379 Oxygen Consumption, 379, 390 Oxygenation, 87, 348, 361, 379 P Pachymeningitis, 98, 372, 380 Paediatric, 100, 380 Palate, 135, 277, 380 Palliative, 380, 399 Palsy, 160, 273, 380 Pancreas, 327, 349, 365, 380 Pancreatic, 279, 380 Pancreatic cancer, 279, 380 Papilla, 45, 380 Paralysis, 160, 324, 355, 380, 395 Paraplegia, 173, 380

418 Hearing Loss

Paresis, 355, 380 Parkinsonism, 156, 157, 159, 179, 180, 199, 332, 380 Parotid, 101, 380, 392 Paroxysmal, 280, 360, 380 Particle, 67, 380, 395, 401 Patch, 37, 380 Pathogenesis, 71, 176, 380 Pathologic, 35, 42, 229, 327, 333, 337, 346, 362, 380, 396 Pathologic Processes, 333, 380 Pathologies, 22, 30, 51, 161, 233, 380 Pathophysiology, 212, 215, 227, 380 Patient Care Management, 228, 381 Patient Education, 239, 288, 290, 310, 318, 320, 326, 381 Pediatrics, 13, 46, 51, 88, 98, 102, 105, 112, 123, 133, 311, 381 Pedigree, 106, 152, 381 Pelvic, 353, 381, 386 Penicillin, 331, 381 Pentoxifylline, 17, 122, 381 Peptide, 64, 129, 356, 381, 383, 386 Perforation, 161, 167, 286, 291, 296, 381 Perfusion, 87, 94, 113, 363, 381, 400 Perilymph, 11, 84, 176, 213, 233, 246, 381 Perinatal, 156, 157, 159, 180, 200, 381 Peripheral Nervous System, 376, 380, 381, 384, 398 Peripheral Nervous System Diseases, 380, 381 Peroneal Nerve, 381, 392 Peroxidase, 192, 333, 369, 381 Peroxide, 381 Phallic, 356, 381 Pharmacologic, 330, 334, 381, 400, 401 Pharynx, 183, 382 Phenotype, 42, 44, 53, 59, 63, 67, 225, 382 Phenylalanine, 382, 402 Phosphodiesterase, 381, 382 Phosphorus, 338, 382 Phosphorylated, 34, 343, 382 Phosphorylation, 34, 382 Photoreceptor, 60, 194, 382 Physical Examination, 14, 150, 151, 212, 226, 228, 382 Physiologic, 7, 41, 72, 153, 183, 218, 329, 336, 372, 382, 385, 389, 399 Pigment, 61, 71, 173, 279, 336, 371, 378, 382, 390, 391 Pigmentation, 74, 382 Pilot study, 113, 382

Piperidines, 180, 195, 382 Pitch, 41, 47, 146, 147, 152, 168, 171, 172, 382 Pituitary Gland, 347, 356, 382 Plants, 107, 329, 338, 341, 358, 368, 373, 382, 392, 401 Plasma cells, 331, 382 Plasma expander, 17, 382 Plasma protein, 382, 386 Plasma Volume, 373, 383 Plasmapheresis, 332, 383 Plasmin, 383, 400, 402 Plasminogen, 383, 400, 402 Plasticity, 37, 40, 41, 70, 88, 103, 134, 383 Platelet Aggregation, 381, 383 Plateletpheresis, 332, 383 Platinum, 342, 370, 383 Plexus, 383, 392 Point Mutation, 7, 383 Poisoning, 81, 195, 341, 348, 366, 375, 383 Polycystic, 280, 383 Polyhydramnios, 13, 383 Polymers, 383, 386, 397 Polymorphic, 8, 50, 196, 383 Polypeptide, 175, 193, 330, 344, 359, 362, 383, 399, 402, 405 Polysaccharide, 331, 340, 384, 386 Pons, 337, 340, 355, 384 Posterior, 49, 330, 334, 340, 342, 350, 377, 380, 384, 392, 403 Postmenopausal, 379, 384 Postnatal, 67, 384, 396 Postoperative, 11, 20, 135, 384 Postsynaptic, 37, 195, 376, 384, 398 Potassium, 13, 31, 64, 196, 329, 350, 371, 373, 384 Potentiates, 48, 384 Potentiation, 133, 384 Practice Guidelines, 20, 225, 231, 271, 311, 384 Precursor, 73, 74, 192, 333, 341, 350, 351, 353, 382, 383, 384, 386, 402 Predisposition, 94, 384 Prednisolone, 17, 122, 384 Prednisone, 49, 287, 288, 384 Prenatal, 13, 245, 308, 352, 384 Prenatal Diagnosis, 13, 384 Presynaptic, 375, 376, 384, 398, 399 Presynaptic Terminals, 375, 384, 399 Prevalence, 7, 13, 15, 28, 35, 43, 58, 62, 147, 197, 226, 251, 269, 292, 308, 385 Private Sector, 210, 385

Index 419

Probe, 56, 385 Problem Solving, 209, 385 Procaine, 369, 385 Progeny, 54, 174, 385 Progesterone, 385, 397 Program Evaluation, 225, 385 Progression, 9, 17, 27, 28, 36, 43, 68, 97, 227, 252, 254, 331, 385 Projection, 232, 378, 385, 389 Proline, 344, 362, 385 Promoter, 34, 385 Prone, 32, 385 Prophase, 378, 385, 398 Prospective study, 8, 112, 228, 370, 385 Prostaglandin, 87, 123, 331, 385 Prostaglandins A, 364, 385, 386 Prostate, 279, 386 Prosthesis, 19, 167, 180, 325, 386 Protease, 386, 400 Protective Agents, 159, 338, 386 Protective Devices, 192, 386 Protein Binding, 386, 400 Protein C, 22, 52, 71, 288, 330, 335, 356, 386, 395, 402 Protein Kinases, 59, 386 Protein S, 223, 280, 281, 336, 358, 386, 391, 397 Proteoglycans, 335, 355, 386 Proteolytic, 344, 383, 386, 400, 402 Prothrombin, 114, 386, 400 Protocol, 9, 15, 20, 26, 201, 232, 268, 386 Protons, 329, 362, 367, 387, 388 Proximal, 350, 378, 384, 387, 393 Psychiatric, 344, 372, 387 Psychiatry, 39, 131, 135, 356, 387, 397, 403 Psychic, 387, 393 Psychoacoustic, 12, 25, 47, 64, 387 Psychology, 26, 45, 46, 47, 268, 269, 350, 387 Psychomotor, 348, 371, 376, 387 Psychophysics, 387 Psychosis, 156, 157, 159, 180, 195, 199, 332, 387 Psychotherapy, 206, 344, 387 Puberty, 109, 387 Public Facilities, 294, 387 Public Health, 35, 85, 243, 271, 387 Public Policy, 4, 267, 387 Publishing, 5, 8, 10, 73, 189, 206, 207, 208, 214, 216, 229, 230, 232, 387 Pulmonary, 48, 123, 156, 157, 159, 180, 200, 248, 336, 346, 367, 387, 388, 403

Pulmonary Artery, 336, 387 Pulmonary Edema, 123, 367, 387 Pulmonary hypertension, 248, 388 Pulse, 373, 388 Purines, 388, 393, 405 Purulent, 161, 327, 379, 388 Q Quality of Life, 16, 26, 36, 43, 44, 46, 169, 197, 239, 292, 296, 298, 388 Quinine, 110, 125, 261, 299, 342, 388 R Race, 253, 388 Radiation, 51, 97, 112, 327, 335, 338, 353, 355, 357, 366, 367, 388, 389, 392, 396, 405 Radiation therapy, 327, 338, 355, 357, 366, 367, 388, 396, 405 Radio Waves, 150, 151, 372, 388 Radioactive, 150, 334, 337, 362, 364, 366, 367, 369, 377, 388, 392, 405 Radioimmunotherapy, 388, 389 Radioisotope, 388, 401 Radiolabeled, 367, 388, 405 Radiological, 160, 389 Radiology, 101, 110, 117, 212, 311, 389 Radiotherapy, 96, 101, 337, 367, 388, 389, 396, 405 Randomized, 20, 122, 123, 131, 351, 389 Reactive Oxygen Species, 32, 33, 53, 59, 69, 389 Reality Testing, 387, 389 Recessive gene, 41, 389 Recombinant, 30, 53, 57, 71, 100, 134, 194, 389, 403 Recombination, 358, 389 Recovery of Function, 45, 389 Rectum, 332, 337, 349, 356, 357, 364, 368, 386, 389, 394 Recurrence, 20, 371, 389 Red Nucleus, 334, 389 Refer, 1, 5, 8, 9, 15, 328, 337, 344, 350, 356, 358, 369, 370, 376, 377, 387, 388, 389, 403 Reflex, 52, 66, 355, 389 Refraction, 374, 389, 395 Refractive Power, 374, 389 Regeneration, 45, 174, 356, 389 Regimen, 351, 389 Registries, 242, 390 Rehabilitative, 35, 226, 301, 390 Relapse, 26, 390 Reliability, 6, 390 Remission, 371, 389, 390 Renal tubular, 85, 107, 390

420 Hearing Loss

Renal tubular acidosis, 85, 107, 390 Respiration, 69, 338, 341, 373, 390 Respiratory failure, 102, 390 Respiratory Physiology, 390, 403 Restoration, 17, 111, 178, 197, 390, 405 Retina, 60, 173, 194, 342, 349, 352, 370, 374, 376, 378, 390, 391, 392, 403, 404 Retinae, 370, 390 Retinal, 7, 52, 60, 71, 77, 173, 273, 279, 345, 349, 378, 390, 391 Retinal Detachment, 173, 349, 390 Retinal Ganglion Cells, 378, 390 Retinal pigment epithelium, 60, 77, 391 Retinitis, 30, 61, 71, 108, 156, 157, 159, 173, 179, 180, 194, 195, 199, 251, 273, 279, 391 Retinitis Pigmentosa, 61, 71, 108, 173, 194, 251, 273, 279, 391 Retinoblastoma, 279, 391 Retinol, 390, 391 Retinopathy, 173, 349, 391 Retrocochlear, 111, 391 Retrograde, 20, 391 Retrospective, 13, 17, 76, 117, 126, 222, 391 Retrospective study, 117, 391 Rheology, 381, 391 Rheumatism, 107, 391 Rheumatoid, 118, 125, 391 Rheumatoid arthritis, 118, 125, 391 Ribose, 328, 391 Ribosome, 391, 401 Rigidity, 380, 382, 391 Risk factor, 11, 12, 62, 86, 103, 105, 106, 112, 114, 240, 304, 306, 385, 391 Ristocetin, 391, 403 Rod, 173, 335, 343, 382, 392 Round Window, 73, 170, 192, 197, 392 S Salicylate, 392 Salicylic, 392 Salicylic Acids, 392 Saliva, 46, 392 Salivary, 90, 278, 347, 349, 355, 380, 392 Salivary glands, 90, 347, 349, 355, 392 Saponins, 392, 397 Sarcoidosis, 254, 392 Scans, 42, 150, 151, 392 Schizoid, 392, 405 Schizophrenia, 392, 405 Schizotypal Personality Disorder, 392, 405 Sciatic Nerve, 187, 381, 392, 400 Sclera, 342, 392, 403 Sclerae, 378, 392

Sclerosis, 14, 82, 159, 173, 199, 200, 280, 374, 392 Second cancer, 26, 393 Second Messenger Systems, 376, 393 Secretion, 347, 361, 365, 373, 374, 393 Secretory, 376, 393, 398 Segregation, 63, 389, 393 Seizures, 195, 348, 380, 393, 396 Self-Help Groups, 206, 238, 393 Semen, 386, 393 Semicircular canal, 19, 338, 365, 393 Senescence, 22, 393 Senile, 379, 384, 393 Sensor, 165, 393 Sensory Deprivation, 254, 393 Septal, 90, 273, 331, 393 Sequencing, 8, 14, 22, 393, 399 Sequester, 341, 393, 399 Serine, 393, 400 Serotonin, 332, 393, 402 Serum, 77, 81, 189, 344, 363, 368, 373, 394, 402 Sex Characteristics, 328, 330, 387, 394 Sex Determination, 280, 394 Sharpness, 164, 184, 394 Shock, 22, 394, 401 Shunt, 99, 394 Side effect, 26, 101, 259, 297, 308, 328, 329, 332, 336, 394, 401 Sigmoid, 49, 394 Sigmoid Colon, 394 Sign Language, 4, 39, 208, 214, 215, 216, 285, 293, 294, 299, 306, 309, 394 Signs and Symptoms, 152, 255, 305, 306, 390, 394 Skeletal, 109, 275, 330, 343, 374, 394, 395 Skeleton, 327, 356, 367, 385, 394 Skull, 79, 181, 337, 341, 347, 394, 396, 399 Sleep apnea, 394, 397 Smooth muscle, 34, 334, 338, 345, 361, 373, 374, 394, 395, 398 Social Environment, 388, 394 Social Sciences, 209, 394 Social Support, 394, 397 Sodium, 261, 329, 350, 371, 373, 388, 395, 398 Somatic, 328, 352, 371, 373, 381, 395 Sound Localization, 70, 395 Sound wave, 163, 174, 181, 183, 192, 345, 395 Space Flight, 113, 395 Spasm, 159, 200, 346, 395

Index 421

Spastic, 79, 173, 395 Spasticity, 395 Spatial disorientation, 350, 395 Specialist, 169, 308, 314, 349, 395 Species, 27, 30, 45, 59, 350, 353, 359, 362, 371, 373, 388, 389, 395, 398, 400, 401, 402, 404, 405 Specificity, 15, 30, 51, 328, 333, 395, 400 Spectrin, 52, 395 Spectrum, 39, 253, 372, 388, 395 Speech Acoustics, 38, 238, 395 Speech Intelligibility, 89, 395 Speech pathologist, 239, 395 Speech Perception, 3, 23, 24, 28, 32, 48, 57, 70, 82, 137, 226, 230, 296, 396 Sperm, 330, 342, 396 Spinal cord, 157, 337, 340, 341, 351, 353, 357, 366, 372, 375, 376, 380, 381, 389, 392, 396 Spinal Cord Diseases, 380, 396 Spiral Ganglion, 36, 64, 103, 172, 343, 396, 404 Spiral Lamina, 335, 396, 402 Spirochete, 396, 399 Spleen, 347, 370, 392, 396 Sporadic, 8, 376, 391, 396 Squamous, 341, 396 Squamous Epithelium, 341, 396 Staging, 392, 396 Stapes, 11, 74, 125, 161, 192, 212, 253, 255, 275, 277, 291, 296, 362, 364, 379, 396 Status Epilepticus, 156, 157, 159, 180, 200, 396 Steel, 78, 82, 248, 343, 396 Stem Cells, 191, 396 Stereotactic, 96, 122, 396 Stereotactic radiosurgery, 122, 396 Sterility, 194, 397 Steroid, 9, 83, 98, 113, 150, 248, 347, 392, 397 Steroid therapy, 83, 248, 397 Stimulus, 37, 68, 71, 166, 174, 185, 334, 350, 351, 354, 365, 366, 368, 387, 389, 397, 400 Stomach, 327, 335, 349, 354, 361, 366, 375, 382, 396, 397 Stool, 364, 368, 397 Streptomycin, 81, 146, 397 Stress, 34, 38, 59, 122, 206, 216, 226, 233, 257, 296, 303, 375, 379, 384, 391, 397 Stress management, 206, 397 Stria, 31, 33, 36, 50, 62, 64, 82, 109, 397 Stria Vascularis, 31, 33, 36, 62, 64, 109, 397

Stroke, 154, 156, 157, 159, 172, 179, 180, 191, 195, 199, 266, 339, 361, 376, 397 Stromal, 353, 397 Strychnine, 196, 397 Stupor, 374, 397 Styrene, 130, 246, 397 Subacute, 364, 397 Subarachnoid, 36, 360, 397 Subclinical, 253, 364, 393, 397 Subcutaneous, 182, 351, 398 Subspecies, 395, 398 Substance P, 391, 393, 397, 398 Substrate, 22, 40, 376, 398 Substrate Specificity, 40, 398 Suction, 356, 398 Sulfur, 355, 398 Superoxide, 32, 398 Superoxide Dismutase, 32, 398 Support group, 208, 211, 232, 295, 308, 398 Suppression, 23, 55, 60, 100, 133, 138, 200, 347, 398 Suppurative, 36, 229, 398 Sweat, 341, 398 Sweat Glands, 341, 398 Symphysis, 386, 398 Symptomatic, 46, 161, 183, 398 Synapses, 20, 37, 376, 377, 398, 399 Synapsis, 398 Synaptic, 20, 37, 57, 398, 399 Synaptic Vesicles, 398, 399 Synchrony, 29, 39, 399 Syncytium, 31, 358, 399 Syphilis, 11, 399 Systemic, 14, 49, 61, 126, 182, 183, 188, 260, 261, 336, 337, 348, 353, 363, 364, 366, 367, 384, 388, 392, 399, 401, 405 Systemic disease, 363, 399 Systolic, 362, 399 T Tardive, 332, 399 Telangiectasia, 280, 399 Telecommunications, 177, 178, 219, 235, 307, 399 Temporal Lobe, 99, 133, 334, 399 Thalamic, 334, 399 Thalamic Diseases, 334, 399 Thalassemia, 336, 399 Thalidomide, 182, 399 Therapeutics, 30, 53, 117, 138, 206, 261, 399 Thigh, 150, 399 Thoracic, 349, 399, 405

422 Hearing Loss

Thrombin, 356, 383, 386, 400 Thrombomodulin, 386, 400 Thrombosis, 114, 366, 386, 397, 400 Thymus, 363, 370, 400 Thyroid, 40, 150, 359, 366, 400, 402 Thyroid Gland, 150, 359, 400 Thyroid Hormones, 400, 402 Tibial Nerve, 392, 400 Time Management, 397, 400 Tissue Distribution, 71, 400 Tissue Plasminogen Activator, 100, 111, 400 Tobramycin, 105, 400 Tolerance, 156, 157, 159, 179, 180, 195, 199, 327, 359, 400 Tomography, 41, 104, 115, 138, 401 Tonal, 23, 68, 401 Tonicity, 351, 401 Tooth Loss, 75, 401 Tooth Preparation, 327, 401 Topical, 108, 124, 160, 260, 362, 401 Toxic, iv, 26, 173, 182, 296, 297, 299, 342, 348, 353, 359, 363, 376, 397, 401, 402, 403 Toxicity, 26, 351, 391, 401 Toxicology, 268, 401 Toxins, 197, 301, 331, 352, 353, 364, 388, 401 Tracer, 20, 401 Trachea, 382, 400, 401 Traction, 343, 401 Transcription Factors, 6, 59, 401 Transduction, 62, 178, 365, 401 Transfection, 336, 401 Transfer Factor, 363, 401 Translation, 22, 51, 71, 401 Transmitter, 57, 198, 327, 350, 354, 366, 398, 399, 401 Transplantation, 342, 363, 368, 401 Treatment Failure, 20, 401 Trigger zone, 332, 401 Triglyceride, 362, 402 Trophic, 173, 402 Tryptophan, 344, 393, 402 Tuberculosis, 346, 392, 402 Tuberous Sclerosis, 280, 402 Tumor Necrosis Factor, 399, 402 Tumour, 357, 402 Tympani, 343, 371, 402 Tympanic membrane, 21, 51, 85, 160, 161, 167, 168, 170, 179, 183, 233, 371, 402 Type 2 diabetes, 7, 402 Tyrosine, 173, 350, 402

Tyrothricin, 359, 402 U Unconscious, 330, 363, 402 Urea, 13, 368, 398, 402 Uremia, 367, 402 Urethra, 386, 402, 403 Urinary, 156, 157, 159, 180, 195, 199, 278, 364, 377, 400, 402, 405 Urinary Plasminogen Activator, 400, 402 Urine, 332, 336, 338, 350, 361, 364, 367, 368, 377, 379, 402, 403 Uvea, 403 Uveitis, 173, 403 V Vaccine, 46, 387, 403 Vancomycin, 105, 403 Vascular, 34, 173, 183, 195, 212, 338, 341, 342, 360, 364, 365, 372, 396, 397, 400, 403 Vasculitis, 176, 341, 403 Vasodilation, 33, 331, 403 Vasodilator, 33, 117, 126, 332, 350, 361, 403 VE, 150, 208, 219, 403 Vector, 401, 403 Vein, 331, 333, 366, 377, 380, 403 Venereal, 399, 403 Venous, 131, 135, 173, 333, 340, 366, 386, 403 Venous blood, 340, 403 Ventilation, 168, 403 Ventral, 343, 384, 403 Ventricular, 399, 403 Venules, 337, 372, 403 Verapamil, 110, 403 Vertebrae, 396, 403 Vestibular Aqueduct, 40, 85, 150, 228, 233, 403 Vestibular Nerve, 72, 404 Vestibule, 343, 365, 379, 393, 403, 404 Vestibulocochlear Nerve, 334, 343, 362, 400, 404 Vestibulocochlear Nerve Diseases, 362, 400, 404 Veterinary Medicine, 267, 404 Vinca Alkaloids, 404 Vincristine, 79, 80, 122, 130, 404 Viral, 56, 78, 160, 173, 174, 176, 191, 233, 248, 352, 356, 358, 401, 404 Virulence, 334, 401, 404 Virus, 30, 46, 74, 159, 200, 335, 340, 353, 358, 401, 404 Viscosity, 337, 391, 404 Visual Cortex, 174, 404

Index 423

Visual field, 378, 391, 404 Vitreous Body, 342, 390, 404 Vitreous Hemorrhage, 349, 404 Vitreous Humor, 390, 404 Vitro, 22, 404 Vivo, 73, 404 Vocational Guidance, 205, 405 Voltage-gated, 37, 405 Vomica, 397, 405 W War, 117, 118, 126, 405 White blood cell, 331, 336, 342, 369, 370, 382, 405 Windpipe, 382, 400, 405

Withdrawal, 156, 157, 159, 180, 195, 199, 269, 348, 405 Wound Healing, 356, 405 X Xanthine, 192, 405 Xanthine Oxidase, 192, 405 Xenograft, 331, 405 X-ray, 150, 151, 324, 325, 345, 357, 367, 371, 377, 388, 389, 392, 396, 405 X-ray therapy, 367, 405 Y Yeasts, 382, 405 Yttrium, 125, 405 Z Zymogen, 386, 405

424 Hearing Loss

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