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Biomedical subjects

M Suckfüll

Publications and source records attributed to M Suckfüll.

30 records · Page 2Linked to original sources

Changes in serum osmolarity influence the function of outer hair cells.

Fast motility of outer hair cells (OHC) is thought to be based on a hydromechanic principle. In vitro, the function of OHCs can be disturbed by a change in the osmolarity of the culture medium. Whether changes in the serum osmolarity in vivo can also interfere with OHC motility has not been investigated as yet. Serum osmolarity of New Zealand White rabbits (n = 18) was elevated by a continuous infusion of glucose 40%, decreased by an infusion of aqua dest, or kept constant by an infusion of saline. OHC function was monitored using distortion products of otoacoustic emissions (DPOAE). Input output curves were established between 2 and 5 kHz (geometric mean of f2) with primaries of levels between 35 and 55 dB SPL. Cochlear perfusion was measured using a fluorescence microsphere method. Elevation of the serum osmolarity from 306 +/- 17 mosm/l to 365 +/- 23 induced a decrease of DPOAE between 3 and 12 dB SPL. Cochlear blood flow increased from 0.11 +/- 0.09 to 0.15 +/- 0.10 ml/min/g. When decreasing the serum osmolarity from 303 +/- 9 to 281 +/- 8 mosm/l, only slight changes of the DPOAE could be verified. As in the control group, cochlear perfusion was almost unchanged. In the control group, neither serum osmolarity nor DPOAE changed. Comparable to findings in vitro, increasing the serum osmolarity can lead to a disturbance of OHC function. In patients suffering from sudden hearing loss. dehydration due to physical or mental stress is often observed. This new and promising pathophysiological concept needs further clinical evaluation.

Acoustic Stimulation↗

Hemoconcentration as a possible pathogenic factor of sudden hearing loss.

Hemodilution is considered to be a useful therapy for sudden hearing loss by improving cochlear blood flow (COBF) as a result of decreasing viscosity of the whole blood. The purpose of this investigation was to evaluate whether hemoconcentration actually leads to a diminished COBF and impaired function of the cochlea to thus play a role in the pathogenesis of sudden hearing loss. Ten New Zealand White rabbits were anesthetized and ventilated. Cochlear function was evaluated by measuring distortion products of otoacoustic emissions (DPOAEs) at the beginning of each experiment and after 120 min. In the interim, each test animal's hematocrit was raised by an infusion of packed red cells. Control animals were not infused, so hematocrits were left unchanged. Reproducibility of DPOAE measurements were found to be dependent upon the stimulus level. Correlation coefficients were 0.83 for 65 dB SPL and 0.78 for 45 dB SPL. Although no changes in the absolute level of DPOAEs were observed after raising the hematocrit, correlation coefficients were diminished to 0.68 at 65 dB SPL and 0.58 at 45 dB SPL. Hemoconcentration caused no apparent changes in the cochlear function in our animals. Although these findings may reflect species differences, hemoconcentration might still be a factor causing sudden hearing loss in older, atherosclerotic patients.

Acoustic Stimulation↗

Tissue oxygen measurement and 31P magnetic resonance spectroscopy in patients with muscle tension and fibromyalgia.

Muscle tissue oxygen tension was measured by a polarographic oxygen fine-needle probe, and inorganic phosphate and creatine phosphate spectra were recorded using magnetic resonance spectroscopy in patients with chronic low back pain and in patients with fibromyalgia. Results were compared with healthy controls. The tissue oxygen tension was markedly higher in those with tense muscles than in normal subjects. Magnetic resonance spectra for inorganic phosphate were higher in patients demonstrating muscle contraction, and intracellular pH was shifted in the alkaline direction in cases with increased muscle tension. Results show that hypoxia is not the result of increased muscle tension, as was thought previously, but results from oversupply of oxygen demanded by the muscle, leading to increased capillary perfusion and rising oxygen tension.

Adult↗

[Possibility for quantitative and frequency-specific assessment of auditory threshold with otoacoustic emissions].

BACKGROUND: Otoacoustic emissions can be used to study cochlear function in a non-invasive manner. They are an effective clinical tool for infant hearing screening. The purpose of this study was to determine their utility for a frequency-specific and quantitative estimation of the hearing threshold. METHODS: Transiently evoked otoacoustic emissions (TEOAE) and distortion-product emissions (DPOAE) were recorded from 16 normal and 86 hearing impaired ears and correlated with their hearing threshold between 0.5 and 6.0 kHz. RESULTS: The correlations of TEOAE and the hearing threshold ranged from 0.53 (0.5 kHz) to 0.69 (6.0 kHz), of the DPOAE from 0.51 (0.5 kHz) to 0.83 (6.0 kHz). Based on the optimal correlating OAE frequency we tried to predict the hearing threshold. We obtained 95% prediction intervals for TEOA between 19 dB (1.0 kHz) and 39 dB (4.0 and 6.0 kHz), for DPOAE between 21 dB (1.0) and 34 dB (3.0 and 4.0 kHz). CONCLUSION: Despite their clinically irrelevant greater prediction intervals at the low frequencies, our results suggest that DPOAEs are generally more valuable for the frequency-specific estimation of the hearing threshold. Prediction intervals may improve the interpretation of OAEs.

Adolescent↗

[Hypercholesteremia and hyperfibrinogenemia in sudden deafness].

BACKGROUND: The pathogenesis of sudden hearing loss has not been elucidated as yet. Insufficient perfusion of the cochlea due to an increased blood viscosity, microthrombosis, or altered vasomotion are assumed. Hypercholesterolemia and hyperfibrinogenemia are frequently observed in patients with sudden sensorineural hearing loss. The aim of this study was to investigate the incidence of hypercholesterolemia and hyperfibrinogenemia in patients suffering from sudden hearing loss compared to normal controls. In an intervention study the impact of drastic lowering of plasma cholesterol and fibrinogen by a selective extracorporal apheresis was studied. METHODS: In a case-control study of 23 patients suffering from sudden hearing loss, plasma cholesterol and fibrinogen levels as well as erythrocyte aggregation and plasma viscosity were determined. Seven sudden hearing loss patients from this group were treated with H.E.L.P. apheresis, an extracorporal procedure removing fibrinogen and idl-cholesterol from plasma. RESULTS: Plasma fibrinogen and cholesterol levels were higher in sudden hearing loss patients, leading to significantly elevated values of erythrocyte aggregation and plasmaviscosity. Six out of the seven patients treated with a single H.E.L.P. apheresis immediately showed an improvement of auditory thresholds. CONCLUSIONS: We conclude that hyperfibrinogenemia and hypercholesterolemia may contribute to the clinical event of sudden hearing loss. Our study shows for the first time that acute and drastic removal of plasma fibrinogen and low density lipoproteins can be an effective clinical tool in the treatment of patients with sudden hearing loss.

Adult↗

Evaluation of TEOAE and DPOAE measurements for the assessment of auditory thresholds in sensorineural hearing loss.

Transiently evoked otoacoustic emissions (TEOAE) and distortion product otoacoustic emissions (DPOAE) can be quantified concerning their amplitude and frequency. They are known to be diminished or absent in sensorineural hearing loss. It is therefore of interest how TEOAE and DPOAE correlate with the auditory threshold and whether the auditory threshold can be predicted by these variables. In a cross sectional study of 61 patients (102 ears) with sensorineural hearing loss, auditory threshold, tympanometry, stapedius reflexes, TEOAE and DPOAE were measured. Correlation coefficients of the hearing loss (0.5-6 kHz) and the amplitude of the distortion product 2f1-f2 (0.46 4 kHz) respectively TEOAE amplitude (1-4 kHz) were computed. TEOAE showed lower correlation coefficients and less frequency specificity than DPOAE. In order to increase the correlations with the auditory threshold we fitted a multivariate linear regression model with TEOAE and DPOAE simultaneously as predictors for the auditory threshold gaining 95% prediction intervals of 19-39 dB depending on the frequency investigated. By restricting the hearing loss to a maximum of 70 dB HL the 95% prediction interval of the auditory threshold could be decreased to 18-26 dB. Further improvements can be expected if the high inter- and intraindividual variability of TEOAE and particularly DPOAE measurements can be reduced. The results allow us to use TEOAE and DPOAE in addition to click-evoked brainstem audiometry in order to provide more frequency specific information about the hearing loss in newborns, which is of the utmost importance for an ideal fitting of hearing aids.

Acoustic Impedance Tests↗

[A new method for measuring internal ear circulation using colored microspheres].

The pathogenesis of sudden hearing loss is as yet unknown. Vascular disturbances are thought to play a major role, but they cannot be diagnosed clinically. We have therefore developed an animal model which allows measurements of the cochlear blood flow (CBF) and function. For CBF measurements a new technique based on coloured microspheres was developed. New Zealand rabbits were anaesthetised, ventilated and blood pressure and heart frequency were continuously monitored. 6 x 10(6) microspheres of one colour were injected in the left ventricle; different colours are available and allow multiple measurements. The amount of microspheres trapped in the capillary bed of the cochlea depends on the regional blood flow. An arterial reference blood sample makes it possible to calculate absolute values of the regional blood flow in the cochlea. The amount of microspheres trapped in the cochlea was determined microscopically after dissecting, dissolving and filtrating the cochlea. Measurements of the CBF in a control group (5 rabbits, 10 inner ears) at the beginning and after 120 minutes were performed. Mean CBF was 3.8 +/- 1.1 microliters/min and 4.3 +/- 1.3 microliters/min. The coloured microsphere technique allows repeated measurements of the CBF with good reproducibility and an acceptable standard deviation. CBF can be measured in absolute values, which is of advantage for determining a lower limit of the CBF for the cochlea function.

Animals↗

Immunohistological studies of complement activation after xenogeneic perfusion of a working heart model.

Transplantation of organs from one species to another leads to immediate hyperacute rejection. Activation of complement is one important factor involved in this process. Whether complement activation is induced by preformed natural antibodies (PNAbs) via the classical pathway or by an "activator surface" via the alternative pathway is unclear. In order to simulate the relevant clinical situation of animal donor/human recipient we perfused working porcine hearts ex vivo with human blood. This also offered the possibility to study the process of complement activation in a precisely defined system with human complement proteins. PNAb titer and complement lytic activity of the plasma were measured. Immunohistological stainings for IgG, IgM, C1q, C4, C3d, C5-9, factor B, and properdin were performed on tissue sections of the left ventricle. PNAb titer almost totally disappeared within the first 5 min of perfusion. Complement lytic activity of the classical pathway decreased similarly within the first 3 h of xenogeneic and autologous perfusion from 70% to 40%. More detailed immunohistological studies revealed positive staining for C3d on endothelium and myocardium of ex vivo perfused xenogeneic hearts. Complement-induced cytotoxicity was proven by the presence of C5-9 (membrane attack complex). However, hardly any C1q and C4 could be found in the ex vivo xenogeneic perfused hearts. Staining for factor B was positive and proved activation via the alternative pathway. Beyond that, the presence of properdin binding even indicated an upregulation of the alternative pathway C3 convertase.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Evolutionary and immunological aspects of xenotransplantation.

Immunological aspects in xenotransplantation are directly linked to evolutionary aspects. The immunological network with its high antigen specificity and species-specific interactions was developed to fight against the host's outside world including xenografts. The tremendous amount of reaction and mechanisms triggered by the performed natural antibody-endothelial cell reaction clearly indicates that only basic changes might overcome these problems. Even the introduction of transgenic donors might not be sufficient to modify more than one parameter, for example, complement activity. Total depletion of preformed natural antibodies is not compatible with normal life and the regulation of hormones and enzymes under xenogeneic conditions has just been discovered. Cellular mechanisms depend, as far as we know, on the delicate system of receptors, interleukins, and MHC antigens. From today's very early results we know that major changes exist already between closely related species. The investigation of xenogenic mechanisms has opened a totally new field of immunological interactions. Up to now there are no signs of solution to bridge clinically relevant times with xenogenic organs from widely divergent suitable donors with promising quality of life.

Animals↗

[Tissue pO2 measurement in taut back musculature (m. erector spinae)].

Measurements with polarographic needle probes in fibromyalgic muscles (mm. erectores spinae) revealed an elevated mean tissue-pO2. The total mean tissue-pO2 in the patient group was significantly higher than that in the control group. Greater pathological tension in fibromyalgic muscles increases the mean tissue-pO2. The distribution of local tissue-pO2 values was normal; there was no evidence of small hypoxic areas in the muscle. The elevated tissue-pO2 in fibromyalgic muscles could either be explained by an increase in local blood flow or by disturbance of oxygen-utilization of the muscle cells. The mean tissue-pO2 in patients treated with NSAD was lower than in patients without this treatment. Myogelosises (i.e., circumscript tautness in muscles, that, contrary to fibromyalgic muscles, do not relax under general anesthesia) showed low tissue-pO2 values and even hypoxia in the core. In myogelosises, pain could be hypoxic in nature. However, in fibromyalgic muscles no evidence for hypoxia or hypoxia-related pain could be found.

Adult↗