Audio-vocal interaction in the pontine brainstem during self-initiated vocalization in the squirrel monkey

The adjustment of the voice by auditory input happens at several brain levels. The caudal pontine brainstem, though rarely investigated, is one candidate area for such audio-vocal integration. We recorded neuronal activity in this area in awake, behaving squirrel monkeys (Saimiri sciureus) during vocal communication, using telemetric single-unit recording techniques. We found audio-vocal neurons at locations not described before, namely in the periolivary region of the superior olivary complex and the adjacent pontine reticular formation. They showed various responses to external sounds (noise bursts) and activity increases (excitation) or decreases (inhibition) to self-produced vocalizations, starting prior to vocal onset and continuing through vocalizations. In most of them, the responses to noise bursts and self-produced vocalizations were similar, with the only difference that neuronal activity started prior to vocal onset. About one-third responded phasically to noise bursts, independent of whether they increased or decreased their activity to vocalization. The activity of most audio-vocal neurons correlated with basic acoustic features of the vocalization, such as call duration and/or syllable structure. Auditory neurons near audio-vocal neurons showed significantly more frequent phasic response patterns than those in areas without audio-vocal activity. Based on these findings, we propose that audio-vocal neurons showing similar activity to external acoustical stimuli and vocalization play a role in olivocochlear regulation. Specifically, audio-vocal neurons with a phasic response to external auditory stimuli are candidates for the mediation of basal audio-vocal reflexes such as the Lombard reflex. Thus, our findings suggest that complex audio-vocal integration mechanisms exist in the ventrolateral pontine brainstem.     

Evaluation of NRT and behavioral measures for MAPping elderly cochlear implant users

We investigated the acceptability of electrophysiologically derived MAPs and the effect of these MAPs on speech perception in elderly adults using Nucleus 24 cochlear implants. Eight implant recipients aged 75 years or older trialed an electrophysiologically derived MAP and a behavioral MAP. The electrophysiologically derived MAP was based on the threshold and maximum comfort level for electrode 10 and evoked compound action potential thresholds measured on six electrodes using neural response telemetry (NRT). Word perception at 55 dB SPL and sentence perception in noise at 70 dB SPL were assessed after six weeks take-home experience and again after an additional two weeks of experience. During the final two weeks of take-home experience participants indicated their preferred MAP for different listening situations. The NRT derived MAP estimated behavioral T levels well, but underestimated behavioral C levels for apical electrodes in some subjects. Speech perception with NRT derived MAPs was comparable to speech perception with behaviorally measured MAPs. MAPs estimated from NRT data provided good speech perception outcomes for elderly implant recipients and were well tolerated.     

心电遥测在老年心血管疾病中的应用和护理

目的:探讨心电遥测监护系统在老年心血管疾病中的应用和护理。方法:对某医院80例老年心血管病人使用心电遥测监护,观察心血管疾病异常率。结果:80例患者中,发生严重早搏占所有病例的35.0%,其次分别为快速心律失常、T波变化,所占比例分别为30.5%、25.0%。心律失常发生数为34例,占41.75%;在发生严重室性早搏患者中,以频发为主,占所有病例25.0%。结论:心电遥测技术在老年心血管疾病中的应用非常重要,可预防恶性事件的发生。     

应用植入遥测技术对恒河猴部分生理指标的观测

目的应用植入遥测技术观测清醒恒河猴呼吸、血压、心电、体温等生理指标的昼夜变化规律和应激时的变化。方法取3~5岁雌雄各半的8只恒河猴行遥测植入子植入手术,恢复3周后用DSI遥测系统获取清醒无束缚恒河猴连续24 h的呼吸、血压、心电、体温数据,用Ponemah软件分析上述指标并统计实验结果。结果恒河猴的部分心电指标存在明显的昼夜差异(P0.05或P0.01),其中心率(HR)的昼夜均值在每分钟155.0~122.4次之间波动;呼吸频率间期(RR-I)为410.8~535.7 ms;T波幅度(T-A)为0.181~0.157 m V;PR间期(PRI)为80.4~87.4;QT间期(QT-I)为224.8~263.9 ms;校正QT间期(QTcb)为352.3~366.7 ms。猴的血压与呼吸指标白昼均值显著高于夜晚(P0.01),其中收缩压(SYS)昼夜波动范围为144.6~131.6 mm Hg;舒张压(DIA)为99.8~89.9 mm Hg;平均动脉压(MAP)为121.5~110.2 mm Hg;潮气量(TV)为64.5~36.6 m L;分钟通气量(MV)为1931.9~920.1 m L/min;呼吸频率(RR)为每分钟32.3~25.4次。实验室工作人员清扫、喂食活动对猴有一定的应激影响。结论应用植入遥测技术观察到的恒河猴呼吸、血压、心电、体温等生理指标基本均有明显的昼夜节律变化,呼吸、血压、心电、体温等指标白昼均高于夜晚,符合正常恒河猴的生理周期特性。经过驯养的恒河猴在饥饿状态下受工作人员的喂食、清扫活动的应激影响比较强烈。应用植入遥测技术可以对清醒无束缚状态下恒河猴心电、血压、呼吸、体温等进行连续监测,能真实地反映恒河猴24 h内上述生理指标的变化规律,为恒河猴在药理毒理学研究中的应用提供参考。同时应用植入遥测技术,有助于提高药物安全药理学研究的效率,减少动物的使用数量,符合3R原则。     

利用无创遥测技术开展伴随重复给药毒性试验的食蟹猴安全药理学研究

目的 应用食蟹猴重复给药毒性伴随安全药理学研究的实例,探究利用无创遥测技术进行伴随于重复给药毒性试验的心血管、呼吸系统安全药理学研究的可行性。方法 重复给药毒性试验取食蟹猴40只（雌雄各半,其中32只进行安全药理学研究）,分为4组,即空白对照组、佐剂对照组和四价重组诺如病毒疫苗（毕赤酵母）低、高剂量组,分别为不给任何受试物,每次im佐剂对照品1 mL（2人份）/猴、四价重组诺如病毒疫苗（毕赤酵母）0.5 mL（1人份）/猴和1 mL（2人份）/猴,每4周给药1次,共给药4次。食蟹猴经穿脱马甲和猴椅固定的适应性训练后开始正式试验;安全药理学试验数据的采集安排在首次与第3次给药时,使用马甲式遥测系统采集给药后0~24 h的呼吸、心电、体温等相关参数,并增加采集给药后0~2、5~6、23~24 h时间段的血压数据（将猴保定在猴椅上）。结果 单次及3次给予四价重组诺如病毒疫苗（毕赤酵母）低、高剂量以及佐剂对照品对食蟹猴呼吸、心电、血压、体温等各项指标均未见明显影响。部分时段的指标波动均属猴正常的应激（受束缚状态下）变化或昼夜生理节律性变化。结论 在本试验剂量条件下,单次及多次im四价重组诺如病毒疫苗（毕赤酵母）,对食蟹猴呼吸系统、心血管系统均未见明显影响;利用马甲式无创遥测系统结合重复给药毒性试验进行安全药理学研究（心血管、呼吸系统）具有良好的可行性,符合动物福利3R原则,尤其适合于重复给药后的安全药理学研究。     

客观听觉监测技术在人工耳蜗植入中的临床应用

目的：比较电诱发镫骨肌反射技术（ESR）及神经反应遥测技术（NRT）的临床特点及应用价值。方法：对21例行Cochlear Nucleus 24R（CA）型人工耳蜗植入者分别选取1、7、11、17、22号电极,应用Cochlear公司提供的NRT3.0软件分别进行术中ESR和NRT检测、术后主观心理物理测试,测定电诱发镫骨肌反射阈值（ESRT）、电诱发听神经复合动作电位阈值（ECAP）和听阈阈值（T-levels）,并对其ESRT、ECAP和T-levels进行相关性研究。结果：ESRT、NRT、T-levels检出率分别为96.19%、93.33%、100%。ESRT平均阈值为206.61±10.74、208.48±13.64、205.52±14.63、203.76±12.97、199.5±11.19;NRT平均阈值分别为184.11±6.35、188.55±11.70、187.00±12.29、181.85±13.22、179.00±10.50;T-levels平均阈值分别为145.48±18.66、148.62±8.22、146.62±18.08、142.52±13.11、140.33±13.68。各电极ESRT阈值均远远大于心理物理测试得到的T-levels阈值。ESRT、NRT、T-levels三者的均值趋势有较强的一致性。术中测试时间、测试方式、单方检出率、ESR均优于NRT。以所有电极作为观察对象,ESRT与NRT的相关性为0.69,NRT与T值的相关性为0.62,ESRT与T值之间的相关性为0.39。结论：术中应用ESR和NRT技术,可以第一时间反映植入体及听觉传导通路的情况,相对于NRT而言,ESR更为灵活、方便、精确和直观,在低龄患儿术后调试方面前者显示出更加客观的优越性。     

Cochlear implant in the carotid canal. Case report and literature review

Background

Numerous complications have been described following cochlear implantation. Most of them are post-operative and benign, but some are intra-operative and can be more difficult to manage.

Methods

Case report of a pediatric case of misplaced cochlear electrode in the carotid canal and literature review.

Results and conclusions

Post-operative CT-scan allowed the diagnosis. The misplaced cochlear implant in the carotid canal was successfully removed and a successful re-implantation followed immediately. Anatomy of the interval between the cochlea and the carotid canal is reviewed, together with information regarding the neural telemetry response.In each case, specific anatomical landmarks must be identified to perform the cochleostomy in the right position. If not, or if surgery proves itself difficult, the surgeon should intra-operatively control the position of the electrode.     

The use of permanent pacemakers in the detection of cardiac arrhythmias.

AIMS: To compare pacemaker telemetry with simultaneous Holter recordings in the diagnosis of atrial fibrillation and to evaluate the STOP-AF study telemetry criteria for the presence of atrial fibrillation. METHODS AND RESULTS: 18 consecutive patients enrolled in the STOP-AF study had simultaneous 24 h Holter recordings and down-loaded pacemaker telemetry. There was good agreement on heart rate, but the STOP-AF pacemaker criteria achieved only 57% sensitivity with 64% specificity for the presence of atrial fibrillation on Holter recording over 24 h. False-positives appeared to result from far-field sensing while false-negatives occurred with very short episodes of atrial fibrillation. The pacemaker's antitachycardia responses were not specific for the presence of atrial fibrillation. CONCLUSION: Pacemaker telemetry is a potentially important source of data on cardiac arrhythmias. Further studies are required to define the limitations of these data in specific devices before they can be interpreted with confidence.     

Wireless contact lens sensor for intraocular pressure monitoring: assessment on enucleated pig eyes

Purpose: Assessment on enucleated pig eyes of a novel and minimally invasive method for the continuous monitoring of intraocular pressure (IOP), based on a novel wireless contact lens sensor (CLS). Methods: The wireless CLS is a disposable silicone soft contact lens with a sensor embedded in it, allowing the wireless measurement of changes in corneal curvature induced by IOP variations. A CLS was adapted and tested on enucleated pig eyes. To demonstrate the measurement principle of the device, the enucleated pig eye was cannulated, allowing precise control of IOP. The CLS signal was then compared to the imposed IOP. Results: First, the IOP of enucleated pig eyes was changed between 11 and 14 mmHg, simulating ocular pulsation. Then, IOP was changed with static steps of 1 mmHg between 20 and 30 mmHg to assess the reproducibility and linearity of the CLS. In both cases, measurements from the CLS and IOP showed very good correlation. A calibration graph shows that the CLS is capable of monitoring the IOP of each individual eye with a reproducibility of ± 0.2 mmHg (95% confidence interval). Conclusion: The wireless CLS shows a good functionality to monitor the IOP on enucleated pig eyes. The device is placed in the same way as a soft disposable contact lens. This device would allow a minimally invasive and continuous monitoring of IOP over prolonged periods of up to 24 hr, regardless of patient activity, thus opening up new diagnostic and therapeutic methods to manage glaucoma.     

清醒Beagle犬呼吸和循环系统功能监测模型建立及生物学特性分析

目的:应用植入式遥测技术,建立Beagle犬清醒动物呼吸和循环系统功能检测模型,应用遥测技术对Beagle犬生理参数进行长时程采集和分析,为临床前药物安全性评价试验提供重要的生理基础参考值。方法:通过外科手术,在Beagle犬体内埋植TL11M3-D70-PCTP遥测传感器,以DSI遥测生理信号采集系统连续记录并分析Beagle犬在无束缚条件下24 h生理信号,分析其昼夜节律,并以特非那定作为阳性药物进行验证。结果:成功建立了Beagle犬植入式清醒动物模型,Beagle犬的生理活动具有明显的昼夜节律性,早上09:00左右是多项生理指标的最高点,特非那定能够明显延长Beagle犬的QTc间期。结论:试验获得了本中心GLP试验室饲养条件下动物的基础值,可为其在药物临床前试验中的应用提供重要的参考数据。