Concomitant changes in the acoustic impedance and the cochlear microphonic potentials during twitch contractions of the middle ear muscles in cats

The effect of twitch contractions of the middle ear muscles in cats on sound transmission through the middle ear (as measured by the cochlear microphonic potential of the inner ear) was compared with the simultaneous changes in the acoustic input impedance of the middle ear at the same frequency. It was found that decreases in impedance were related to an increase in the amplitude of the cochlear microphonics and vice versa. This may imply that decreases in impedance measured during the initial phase of the acoustic reflex in man are true decreases and are not due to transient decoupling of the ossicular chain at any point.     

Short latency vestibular evoked response to angular acceleration impulse in human beings

Vestibular evoked response (VsEP) to acceleration stimuli were recorded in experimental animals and in human beings by scalp electrodes. The stimuli are angular acceleration impulses (up to 30,000 deg/sec2) transmitted to the skull by special devices. The short latency vestibular evoked response consisted of several waves during the first 10 msec. The first two waves (P1 and P2), which are the most consistent, have been shown in cats to originate from the vestibular nerve and nucleus, respectively. The middle latency response is believed to be of myogenic origin. It is hoped that the recording of VsEP in human beings will enable the localization of the site of lesion in vertiginous patients.     

Extended survival of neocytes produced by a new system

Red cells (RBCs) prepared by a new system using centrifugation to produce neocyte enrichment were studied in two laboratories. The system used a blood bag with a geometric configuration such that younger, less dense cells could be separated from older, denser cells. Phthalate ester density gradient curves determined that neocyte enrichment was 81.3 percent in one laboratory and 82 percent in the other. RBC viability was studied by 51Cr autologous transfusion in normal volunteer donors. A randomized, paired design was used in which each donor was transfused once each with neocytes and with RBCs of all ages. The mean control half-life was 34.8 +/- 5.4 days in one laboratory and 34.0 +/- 3.6 days in the other. The mean half-life of the neocyte-enriched RBCs was 45.2 +/- 8.2 days in one laboratory and 45.1 +/- 4.4 days in the other. This represented a more than 30 percent increase in half-life for the neocyte-enriched RBCs, a significant difference. This new system, a two-bag set that costs +15, allows the simple, efficient separation of neocyte-enriched RBCs that would have a longer half-life and could reduce the transfusion requirement in patients receiving chronic transfusion therapy.     

Usher's syndrome: Electrophysiological tests of the visual and auditory systems

The symptoms of Usher's syndrome — congenital hearing impairment and tapetoretinal dystrophy — are difficult to detect in young children. The electroretinogram (ERG), visual evoked potential (VEP), auditory nerve and brain-stem responses as well as the cochlear microphonic potentials were used to evaluate the defects of the visual and auditory systems in 20 patients, 3–45 years of age. This study demonstrates the usefulness, reliability and convenience of the electrophysiological tests for early diagnosis and functional evaluation of Usher's syndrome.     

Patterns of auditory nerve and brainstem-evoked responses (ABR) in different types of peripheral hearing loss

Auditory brainstem response (ABR) recordings were made in different types of peripheral hearing loss (sensorineural, conductive, and mixed). Scatter diagrams were constructed by plotting different expressions of the hearing loss (audiometric and electrophysiologic) against the obtained wave latencies and for these two sets of variables, correlation coefficients and the parameters of the regression equation were calculated. Consideration is given to the possibility of diagnosing the type of peripheral hearing loss by correlating wave latencies and the electrophysiologic (ABR) threshold.     

The persistence of somatosensory and auditory pathway evoked potentials in severe hypoglycemia in the cat

In a previous study it was shown that during severe insulin-induced hypoglycemia in rats and cats (0.38 mmol/l, i.e., 6.8 mg% and 0.8 mmol/l, i.e., 14 mg% respectively) with isoelectric EEG, the latency and amplitude of the auditory nerve-brain-stem evoked responses were not affected. In the present study on cats, the above evoked responses were complemented by recording in addition the cortical auditory evoked potential and the peripheral, brain-stem and cortical components of the somatosensory evoked potentials. Each of these evoked potentials remained in the presence of 0.75 mmol/l glucose in plasma. The persistence of the somatosensory cortical evoked potential was unexpected since two other groups have reported the disappearance of this potential during hypoglycemia. The types of neuronal activity which can still be recorded in severe hypoglycemia are probably generated by neuronal structures with lower metabolic demands such as axons and oligosynaptic pathways, surviving on the consumption of endogenous substrates with compensatory elevation of local cerebral blood flow.     

Quantitative experimental assessment of the factors contributing to hearing loss in serous otitis media.

OBJECTIVE: This study was designed to quantitatively assess the contribution of various factors to the conductive hearing loss in otitis media. BACKGROUND: In the conductive hearing loss seen in cases of serous otitis media, various volumes of fluid of different viscosities along with subatmospheric (negative) pressure are found in the middle ear. METHODS: To evaluate the contribution of each of these factors to hearing loss, various volumes of saline, whole blood, or glycerol were applied to the open middle ear cavity of guinea pigs for short periods of time and auditory function was evaluated by recording the threshold of auditory nerve-brainstem evoked responses. In some of the saline experiments, the bulla cavity was also sealed, allowing a subatmospheric (negative) pressure to develop in the cavity as water was osmotically absorbed because of the gradient in colloid osmotic pressure between saline and blood in the vessels lining the middle ear cavity. In other experiments, a thoracic drainage system was connected to the middle ear cavity to induce desired negative middle ear pressures. RESULTS: The degree of hearing loss increased as larger volumes of fluid were introduced into the middle ear, reaching a maximum of 15 to 16 dB. There was no difference in the degree of hearing loss induced by saline or by fluids with viscosities up to 1,000 times greater than that of water (glycerol). A subatmospheric pressure in the middle ear contributed only a small additional (1-2 dB) threshold elevation. CONCLUSION: The major factor contributing to hearing loss in serous otitis media is the volume of fluid in the middle ear, irrespective of its viscosity. The contribution of negative middle ear pressure is much smaller.     

Minimally invasive coronary artery bypass grafting via a small thoracotomy versus off-pump: a case-matched study

Objective: The minimally invasive coronary artery bypass grafting (MICS CABG) operation performed via a small thoracotomy has not previously been examined in a direct comparison to sternotomy off-pump coronary artery bypass grafting (OPCAB). Methods: We matched, according to age, gender, left ventricular function, and median number of distal anastomoses, 150 patients who underwent MICS CABG via small left thoracotomy, and 150 patients who received sternotomy OPCAB. All operations were performed by the same surgeon. Results: There was no perioperative mortality (0/300). In the MICS CABG group, pump assistance was used in 28/150 (19%) patients, and conversion to sternotomy occurred in 10/150 (6.7%) patients. In the OPCAB group, conversion to on-pump occurred in 3/150 (2.0%) patients. There were four (2.7%) reoperations for bleeding and one (0.7%) for anastomotic revision in each group. The median hospital length of stay was 5 days for MICS CABG (average 5.4), and 6 days for OPCAB (average 7.2) (P = 0.02). New-onset atrial fibrillation occurred in 35 (23%) MICS CABG patients and in 42 (28%) OPCAB patients (P = 0.3). No wound infection occurred with MICS CABG versus six (4.0%) with OPCAB (P = 0.03). A self-limiting left pleural effusion developed in 22 (15%) MICS CABG patients and in six (4.0%) OPCAB patients (P = 0.002). The median time to return to full physical activity was 12 days in MICS CABG patients versus >5 weeks in OPCAB patients (P < 0.001). Conclusions: MICS CABG is a valuable alternative for patients in need of multivessel CABG. The operation appears at least as safe as OPCAB, and associated with shorter hospital length of stay, less wound infections, and faster postoperative recovery than OPCAB.