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X M Sun

Publications and source records attributed to X M Sun.

At least 37 records · Page 2Linked to original sources
PubMed2000

[On-line measurement of oxygen uptake rate in the cultivation of Vero cells using the dynamic method].

The oxygen uptake rate(OUR) during the cultivation of Vero cells in 1.5 L CelliGen bioreactor was on-line determined using the dynamic method. The results showed that the cell growth and metabolic state during the exponential growth phase was lineally related to the OUR. This implies that the on-line measurement of OUR can be used to promptly monitor the physiological state of cultured cells and to efficiently avoid contamination because of frequent sampling in the large-scale cultivation of mammalian cells.

Animals↗
PubMed1999

Distinct caspase cascades are initiated in receptor-mediated and chemical-induced apoptosis.

Release of cytochrome c is important in many forms of apoptosis. Recent studies of CD95 (Fas/APO-1)-induced apoptosis have implicated caspase-8 cleavage of Bid, a BH3 domain-containing proapoptotic member of the Bcl-2 family, in this release. We now demonstrate that both receptor-induced (CD95 and tumor necrosis factor) and chemical-induced apoptosis result in a similar time-dependent activation of caspases-3, -7, -8, and -9 in Jurkat T cells and human leukemic U937 cells. In receptor-mediated apoptosis, the caspase inhibitor, benzyloxycarbonyl-Val-Ala-Asp fluoromethyl ketone (Z-VAD. FMK), inhibits apoptosis prior to commitment to cell death by inhibiting the upstream activator caspase-8, cleavage of Bid, release of mitochondrial cytochrome c, processing of effector caspases, loss of mitochondrial membrane potential, and externalization of phosphatidylserine. However, Z-VAD.FMK inhibits chemical-induced apoptosis at a stage after commitment to cell death by inhibiting the initiator caspase-9 and the resultant postmitochondrial activation of effector caspases. Cleavage of Bid but not release of cytochrome c is blocked by Z-VAD.FMK demonstrating that in chemical-induced apoptosis cytochrome c release is caspase-independent and is not mediated by activation of Bid. We propose that caspases form an integral part of the cell death-inducing mechanism in receptor-mediated apoptosis, whereas in chemical-induced apoptosis they act solely as executioners of apoptosis.

Amino Acid Chloromethyl Ketones↗
PubMed1999

Distortion product otoacoustic emissions in the CBA/J mouse model of presbycusis.

CBA mice do not exhibit age-related loss of auditory sensitivity or cochlear pathology until relatively late in life. Therefore, this strain is believed to be an excellent animal model for the examination of the effects of age on the cochlea. To evaluate the effects of age on outer hair cell function, 2f1-f2 distortion product otoacoustic emissions (DPOAEs) were measured for f2 between 8 and 16 kHz in CBA/J mice between 1 and 25 months of age. CBA mice exhibited mild age-related changes in DPOAE level and detection threshold at 17 months of age, and changes of 20-40 dB by 25 months of age. The DPOAE level decreased and detection threshold increased with age in a frequency-dependent manner, starting at high frequencies and eventually extending to low frequencies. The range of frequencies in which notches were observed in the DPOAE input/output (I/O) functions extended toward lower frequencies by 17 months of age. Notches were absent in the I/O functions of 25-month-old mice. The present results for a frequency range of 8-16 kHz suggest that age has modest effects on outer hair cell function in CBA mice.

Aging↗
PubMed1999

An individual with a healthy phenotype in spite of a pathogenic LDL receptor mutation (C240F).

Familial hypercholesterolemia (FH) is caused by a defect in the function of the low density lipoprotein (LDL) receptor and inherited in an autosomal, codominant way. In this study we present a 13-year-old girl, compound heterozygote for the LDL receptor mutations C240F and Y167X. Fibroblasts from the patient showed very low cholesterol esterification rate, LDL uptake, and degradation compared to normal fibroblasts (< 2%, 8%, and < 2%, respectively). The C240F mutant was expressed in LDL receptor deficient CHOMldlA7 cells. Analysis of cell extracts by immunoblotting demonstrated delayed processing of the mutated LDL receptor, which was accumulated as a precursor protein of normal size. A high molecular weight form of the receptor was also detectable in these cells, which probably reflects cross-linking through the unpaired cysteine residue in the binding domain. Cells expressing the C240F mutant protein were unable to mediate uptake and degradation of LDL. The two siblings of the index case also carried the C240F mutation, but surprisingly one of them (a 17-year-old brother) showed no signs of hypercholesterolemia. This observation is consistent with the view that there may be cholesterol lowering mechanisms that can be activated, perhaps by mutations in known or hitherto unknown genes.

Adolescent↗
PubMed1999

Inheritance of two different alleles of the low-density lipoprotein (LDL)-receptor gene carrying the recurrent Pro664Leu mutation in a patient with homozygous familial hypercholesterolaemia.

Familial hypercholesterolaemia (FH) is caused by mutations in the low-density lipoprotein (LDL)-receptor gene that result in impaired clearance of plasma LDL and increased risk of coronary heart disease. Numerous different mutations have been found in FH patients worldwide, the majority of which are infrequent in out-bred populations and account for 2% or less of patients with the disorder in large cohorts. Thus, it was surprising to find that two homozygous FH patients referred to a single hospital in the UK were both apparently homozygous for the Pro664Leu mutation. One, an Asian patient, was a true homozygote. The other, of English origin, had inherited two different alleles of the LDL-receptor gene with the same mutation from unrelated parents, as inferred from the haplotype of polymorphic markers. A third, clinically homozygous FH patient, despite being the offspring of first cousins, had inherited one 'Asian' Pro664Leu allele, but an allele with a 1-bp deletion in exon 5 from the other parent. The Pro664Leu mutation in the LDL-receptor gene has now been described in heterozygous patients of very different ethnic origin and is associated with different haplotypes, suggesting that the same base change at a CpG may have recurred as many as six times.

Alleles↗
PubMed1999

Expression in vitro of alternatively spliced variants of the messenger RNA for human apolipoprotein E receptor-2 identified in human tissues by ribonuclease protection assays.

The apolipoprotein E receptor-2 (apoER2), also called LR7/8B, is a member of the low-density lipoprotein (LDL)-receptor family that is expressed in brain. We have identified mRNA splicing variants in human tissues by ribonuclease protection assays and found that some variants are preferentially amplified by reverse transcription-polymerase chain reaction (RT-PCR). Transcripts were found that lacked sequences encoding three repeats in the putative ligand-binding domain, the O-linked sugar domain or a novel region in the cytoplasmic domain. When mammalian expression vectors for eight potential protein isoforms were transfected into LDL-receptor-deficient Chinese hamster ovary cells, the proteins were all expressed on the cell surface, as detected by immunoblotting of cell extracts with a specific antipeptide antiserum to apoER2 before and after treatment of intact cells with pronase. Although cells expressing all the variants bound very low-density lipoprotein of beta mobility (beta-VLDL), it was with lower affinity and capacity than binding by the LDL-receptor and none was able to degrade beta-VLDL. Ligand blotting of cell extracts showed that all variants bound recombinant histidine6-tagged receptor-associated protein (His6-RAP) with high affinity, although variants lacking exon 5 bound less strongly. The presence of vestiges of the novel insert in the cytoplasmic domain of apoER2 in the LDL- or VLDL-receptor genes was investigated, but nucleotide sequencing showed that no sequences homologous to it could be detected in the final intron of these genes.

Alternative Splicing↗
PubMed1999

Adaptation of 2f1-2f2 distortion product otoacoustic emission in young-adult and old CBA and C57 mice.

The phenomenon of efferent-mediated adaptation of 2f1-f2 distortion product otoacoustic emission (DPOAE) was investigated in two strains (CBA/JNia and C57BL/6JNia) of mice of various ages using stimuli presented monaurally or binaurally. The present study demonstrated the existence of the DPOAE adaptation phenomenon in mice analogous to that previously reported in cats. The present data were fitted with one- or two-exponential functions. With a one-exponential fit in 2-month old mice, the adaptation magnitude ranged from 0 to 4 dB with the average value of 0.5 to 1.6 dB and the average time constant was 0.5 to 2.3 s. With a two-exponential fit, the shorter time constant was 0.3 to 1.7 s. The adaptation magnitude and time constant were similar between the monaural and binaural stimulations. We observed that there was a statistically significant decrease of adaptation magnitude in older CBA mice with age-related hearing loss when compared with young adult mice. The results from the young adult mice should be useful in future studies, e.g., a study of developmental changes in post-natal mice, or changes accompanying an alteration in the central auditory system arising from any etiology. We suggest that this phenomenon can be used as a tool for advancing basic knowledge of the auditory system and for assessing an impairment of the olivocochlear system, e.g., in aging.

Acoustic Stimulation↗
PubMed1999

Characterization of a novel cellular defect in patients with phenotypic homozygous familial hypercholesterolemia.

Familial hypercholesterolemia (FH) is characterized by a raised concentration of LDL in plasma that results in a significantly increased risk of premature atherosclerosis. In FH, impaired removal of LDL from the circulation results from inherited mutations in the LDL receptor gene or, more rarely, in the gene for apo B, the ligand for the LDL receptor. We have identified two unrelated clinically homozygous FH patients whose cells exhibit no measurable degradation of LDL in culture. Extensive analysis of DNA and mRNA revealed no defect in the LDL receptor, and alleles of the LDL receptor or apo B genes do not cosegregate with hypercholesterolemia in these families. FACS((R)) analysis of binding and uptake of fluorescent LDL or anti-LDL receptor antibodies showed that LDL receptors are on the cell surface and bind LDL normally, but fail to be internalized, suggesting that some component of endocytosis through clathrin-coated pits is defective. Internalization of the transferrin receptor occurs normally, suggesting that the defective gene product may interact specifically with the LDL receptor internalization signal. Identification of the defective gene will aid genetic diagnosis of other hypercholesterolemic patients and elucidate the mechanism by which LDL receptors are internalized.

Adolescent↗
PubMed1999

Properties of transient outward potassium current and inward rectifier potassium current in immature human atrial myocytes.

AIM: To study the properties of transient outward K+ current (Ito) and inward rectifier K+ current (IKl) in immature human heart. METHODS: Ito and IKl were recorded using whole-cell patch-clamp technique in atrial myocytes isolated from 12 immature (aged from 6 months to 5 a) human hearts. RESULTS: Ito was voltage-dependent, activated and inactivated rapidly. The IC50 (95% confidence limits) of 4-AP on Ito was 0.64 (0.48-0.87) mmol.L-1. 4-AP 1 mmol.L-1 shifted V1/2 of activation from (6.6 +/- 2.0) mV to (19.8 +/- 3.0) mV (n = 4-10, P < 0.01). 4-AP 0.3 mmol.L-1 changed V1/2 of inactivation from (-49 +/- 4) mV to (-61.4 +/- 2.1) mV (n = 3, P < 0.01), but there were no obvious influence on voltage-dependent activation of Ito (P > 0.05). At the same concentration, the recovery time constant (tau value) was prolonged from (108 +/- 16) ms to (220 +/- 67) ms (n = 3-12, P < 0.01). IKl was also voltage-dependent. Its reverse potential was -40 mV. CONCLUSION: Both Ito and IKl are important K+ channel currents in immature human atrial myocytes. 4-AP can affect the inactivation and recovery of Ito at low concentration (0.3 mmol.L-1) and affect its activation at high concentration (1 mmol.L-1).

4-Aminopyridine↗
PubMed1998

Influence of genotype at the low density lipoprotein (LDL) receptor gene locus on the clinical phenotype and response to lipid-lowering drug therapy in heterozygous familial hypercholesterolaemia. The Familial Hypercholesterolaemia Regression Study Group.

The relationship between molecular defect and clinical phenotype has been examined in 42 patients with heterozygous familial hypercholesterolaemia (FH) and premature coronary heart disease. The defined defects included mutations in the low density lipoprotein (LDL)-receptor gene (23/42) or the apolipoprotein B Arg3500Gln mutation (5/42). Mean LDL-cholesterol was higher, both before and during treatment with simvastatin and bile acid sequestrants, in patients predicted as having a 'severe' mutation than in those with a 'mild' mutation (8.72 +/- 2.02 mmol/l vs 6.63 +/- 1.8, P = 0.05 before and 4.51 +/- 0.90 mmol/l vs 3.19 +/- 0.58, P = 0.05 during treatment). Maximum inducible LDL-receptor activity in cultured lymphoblasts was inversely correlated with LDL-cholesterol before (r2 = 0.499, P = 0.002) and during (r2 = 0.478, P = 0.004) treatment in patients with a defined mutation in the LDL-receptor gene, but not in the 14 patients with no detectable molecular defect. LDL-cholesterol concentrations before and during treatment were significantly correlated in patients with a defined LDL-receptor gene mutation (r2 = 0.548, P = 0.0001), but not in those with no detectable genetic defect. All these correlations were weak, however and there were no differences in the response to treatment in terms of either relative reduction or absolute decrease in LDL-cholesterol concentration between patients with different LDL-receptor defects. We conclude that only part of the variable phenotype of heterozygous FH patients is explained by different LDL-receptor defects and that other factors determine the severity of their hypercholesterolaemia and the onset of coronary disease.

Adult↗
PubMed1998

Phenotypic variation in heterozygous familial hypercholesterolemia: a comparison of Chinese patients with the same or similar mutations in the LDL receptor gene in China or Canada.

Familial hypercholesterolemia (FH) is caused by mutations in the LDL receptor (LDLR) gene and is usually associated with hypercholesterolemia, lipid deposition in tissues, and premature coronary artery disease (CAD). However, individuals with heterozygous FH in China exhibit a milder phenotype despite having deleterious mutations in the LDLR gene (X.-M. Sun et al, Arterioscler Thromb. 1994;14:85-94). Nineteen Chinese FH heterozygotes living in Canada were screened for the 11 mutations that had been described in FH patients living in China. One Chinese Canadian carried one of these mutations (Trp462Stop), 2 carried a previously unreported single-base substitution (Cysl63Arg), and 1 carried a mutation observed in French-Canadian patients (Glu207Lys). Twelve additional carriers of these mutations were identified in the families of the index patients. Significantly higher LDL cholesterol concentrations were observed in FH heterozygotes with defined mutations living in Canada (mean+/-SD, 7.46+/-1.29, n=16) than in those living in China (4.35+/-1.09, n=18; P<.0001). Six of the 16 FH heterozygotes residingin Canada had evidence of tendon xanthomata and 4 had a history of premature CAD, whereas none of those in China had tendon xanthomata or CAD. Complete segregation between hypercholesterolemia and inheritance of a mutant allele was observed in 3 Canadian Chinese FH families. Thus, Chinese FH heterozygotes living in Canada exhibit a phenotype similar to that of other FH patients in Western societies. The difference between patients living in Canada and those living in China could be ascribed to differences in dietary fat consumption, showing that environmental factors such as diet play a significant role in modulating the phenotype of heterozygous FH.

Adult↗
PubMed1997

Processing/activation of at least four interleukin-1beta converting enzyme-like proteases occurs during the execution phase of apoptosis in human monocytic tumor cells.

Identification of the processing/activation of multiple interleukin-1beta converting enzyme (ICE)-like proteases and their target substrates in the intact cell is critical to our understanding of the apoptotic process. In this study we demonstrate processing/activation of at least four ICE-like proteases during the execution phase of apoptosis in human monocytic tumor THP.1 cells. Apoptosis was accompanied by processing of Ich-1, CPP32, and Mch3alpha to their catalytically active subunits, and lysates from these cells displayed a proteolytic activity with kinetics, characteristic of CPP32/Mch3alpha but not of ICE. Fluorescence-activated cell sorting was used to obtain pure populations of normal and apoptotic cells. In apoptotic cells, extensive cleavage of Ich-1, CPP32, and Mch3alpha. was observed together with proteolysis of the ICE-like protease substrates, poly (ADP-ribose) polymerase (PARP), the 70-kD protein component of U1 small nuclear ribonucleoprotein (U1-70K), and lamins A/B. In contrast, no cleavage of CPP32, Mch3alpha or the substrates was observed in normal cells. In cells exposed to an apoptotic stimulus, some processing of Ich-1 was detected in morphologically normal cells, suggesting that cleavage of Ich-1 may occur early in the apoptotic process. The ICE-like protease inhibitor, benzyloxycarbonyl-Val-Ala-Asp (OMe) fluoromethyl ketone (Z-VAD.FMK), inhibited apoptosis and cleavage of Ich-1, CPP32, Mch3alpha, Mch2alpha, PARP, U1-70K, and lamins. These results suggest that Z-VAD.FMK inhibits apoptosis by inhibiting a key effector protease upstream of Ich-1, CPP32, Mch3alpha, and Mch2alpha. Together these observations demonstrate that processing/activation of Ich-1, CPP32, Mch3alpha, and Mch2alpha accompanies the execution phase of apoptosis in THP.1 cells. This is the first demonstration of the activation of at least four ICE-like proteases in apoptotic cells, providing further evidence for a requirement for the activation of multiple ICE-like proteases during apoptosis.

Apoptosis↗
PubMed1997

Characterization of a novel iodinated ligand, IPMPP, for human dopamine D4 receptors expressed in CHO cells.

A novel radioiodinated ligand with a high specific activity (2,200 Ci/mmol), 3-[4-(4-iodophenyl)piperazin-1-yl]methyl-1H-pyrrolo(2,3-b)pyridine ([125I]IPMPP), was successfully prepared. Binding characteristics of [125I]IPMPP were evaluated using human dopamine D4 (D4.2 variant) receptors expressed in Chinese hamster ovary (CHO) cells. Saturation analysis revealed high-affinity binding sites for [125I]IPMPP (Kd = 0.39 +/- 0.18 nM). The number of D4 receptors labeled with [125I]IPMPP at room temperature was four times higher than that labeled with [125I]S(-)5-OH-PIPAT, a radioiodinated agonist ligand (572 fmol/mg protein vs. 125 fmol/mg protein). A significant decrease in the number of binding sites was observed with [125I]S(-)5-OH-PIPAT when assays were carried out at a higher temperature (37 degrees C vs. 25 degrees C). In contrast to [125I]S(-)5-OH-PIPAT, [125I]IPMPP labeled more D4 sites at 37 degrees C. Neither magnesium ion nor guanylimidodiphosphate (Gpp(NH)p) affected [125I]IPMPP binding. These data support the conclusion that [125I]IPMPP is an antagonist ligand. The potency of various compounds, including clozapine, to inhibit [125I]IPMPP binding is consistent with the rank order measured with other radioligands for D4 receptors. In addition, measuring D4 receptor stimulation of [35S]GTPgammaS binding further demonstrated the antagonist property of IPMPP.

Animals↗
PubMed1997

A new method of measuring distortion product otoacoustic emissions using multiple tone pairs: study of human adults.

OBJECTIVE: To increase the speed of a distortion product otoacoustic emissions (DPOE) test of cochlear function by employing a new multiple-tone-pair method and to validate the method. DESIGN: We used a new method of employing multiple tone pairs in measuring DPOEs proposed by Zurek and Rabinowitz and implemented in a modified Grason-Stadler Model GSI-60. We investigated the applicability of the multiple-pair method by comparing the 2f1-f2 DPOEs obtained with a 3-pair method with the conventional 1-pair results in human adults; f1 and f2 represent two frequencies of each tone pair, f1 < f2, f2/f1 = 1.2. We used two sets of 3-pair stimuli: 1) f2 at 1.5, 3, and 6 kHz; and 2) f2 at 2, 4, and 8 kHz. The 1-pair stimuli had f2 at each of the above six frequencies. The primary tone levels were L1 = 65 and L2 = 50 dB SPL re 20 microPa. RESULTS: We obtained DPOEs from 98 ears with normal hearing and 94 ears with sensorineural hearing loss in 103 human adults. We found: 1) that the DPOE levels obtained with the 3-pair method were strongly correlated with those of the 1-pair method, with correlation coefficients of 0.83 to 0.96; 2) that the mean DPOE level versus frequency functions for the normal ears were similar between the 3-pair and 1-pair methods; a 2-way analysis of variance indicated no significant difference between the two methods; 3) that the mean difference between DPOE levels obtained with the 3-pair and 1-pair methods was small (less than 1.3 dB in 11 of the 12 conditions examined, i.e., six frequencies each for normal ears and hearing-impaired ears) although the differences were significant in 6 of the 12 conditions as determined by the paired t-test; and 4) that the DPOE test performances of distinguishing normal from impaired ears were similar between the 3-pair and 1-pair tests; areas under the receiver operating characteristic curves were not significantly different between the two tests for four of the six frequencies tested as determined by a statistical procedure of Hanley and McNeil; for the remaining two frequencies where the differences were significant, each of the two tests was better than the other at one frequency. CONCLUSIONS: The 3-pair DPOE method yielded results generally in good agreement with those of the conventional 1-pair DPOE method. To our knowledge, this is the first systematic study of a multiple-pair DPOE method. Because a 3-pair method can be conducted approximately two to three times as fast as a 1-pair method, the former is advantageous, particularly for an auditory screening test.

Adolescent↗
PubMed1997

Comparison of the genetic defect with LDL-receptor activity in cultured cells from patients with a clinical diagnosis of heterozygous familial hypercholesterolemia. The Familial Hypercholesterolaemia Regression Study Group.

In this study we have analyzed the genetic defect in 42 patients with a diagnosis of heterozygous familial hypercholesterolemia (FH) by Southern blotting, SSCP, and sequencing of PCR-amplified fragments of genomic DNA or sequencing of RT-PCR products from mRNA in cultured cells. The apoB Arg3500Gln mutation was identified in five patients. A molecular defect in the LDL-receptor gene was confirmed in 23 patients; 16 of these mutations have not been described before. No defect in the coding region, intron:exon junctions or proximal promoter of the LDL-receptor gene or in the region of the apoB gene coding for the LDL-receptor binding domain was found in the remaining 14 patients. LDL-receptor activity and protein content of cultured lymphoblasts from the patients was significantly lower in cells from patients with severe rather than mild LDL-receptor mutations. Cells from four patients with no detectable defect showed reduced LDL receptor activity compared with eight normal cell lines, whereas six others had reduced LDL-receptor activity but LDL-receptor protein content within the normal range. Cells from four patients appeared to have normal LDL-receptor function. Cells from two patients with a defined defect also had LDL-receptor activity within the normal range. The findings demonstrate the problems involved in the genetic diagnosis of FH in patients.

Adult↗
PubMed1996

Role of leukocyte beta 2-integrin in PAF-induced shock and intestinal injury.

Leukocyte adhesion and diapedesis, critical steps in the inflammatory process, depend on the expression of integrin CD11b/CD18. In this study, we examined the preventive effect of monoclonal antibodies (MAb) against CD11b (1B6), CD11a, or CD18 (CL26) on platelet-activating factor (PAF)-induced bowel injury. Young male Sprague-Dawley rats were anesthetized and injected with either of two doses of PAF (2.5 or 3 micrograms/kg iv) to induce transient hypotension and irreversible shock. Some rats wee also injected intravenously with 1B6 (anti-CD11b), anti-CD11a, CL26 (anti-CD18), or combined anti-CD11a and 1B6, 30 min before PAF. Animals receiving a low dose of PAF developed mild hypotension, hemoconcentration, increased intestinal myeloperoxidase, and bowel injury after 1 h. These effects were completely prevented by pretreatment with 1B6. A high dose of PAF induced irreversible shock and gross intestinal necrosis. Both CL26 and 1B6 were partially effective in attenuating PAF-induced bowel injury. Addition of anti-CD11a to 1B6 in the treatment further ameliorated the systemic adverse effects of PAF and intestinal injury. However, focal minor injury still developed. Anti-CD11a alone, fucoidin, or anti-P-selectin was ineffective. Rats depleted of neutrophils were also largely protected from the adverse effects of PAF at high doses, although minor intestinal injury often persisted. We conclude that leukocyte beta 2-integrins play an important role in PAF-induced hypotension, leukopenia, hemoconcentration, and intestinal necrosis, and that CD11b/CD18 is the main adhesion molecule involved in the pathogenesis of injury. However, CD11/CD18- and neutrophil-independent pathways exist for mediating PAF-induced bowel injury, although their role is probably a minor one.

Animals↗
PubMed1996

Distortion product otoacoustic emission test of sensorineural hearing loss in humans: comparison of unequal- and equal-level stimuli.

Distortion product otoacoustic emissions (DPOEs) at the frequency of 2f1 -f2 (f1 < f2) were measured in 77 human adult ears with normal hearing or sensorineural hearing loss. The purpose of this study was to compare the performances of DPOE tests conducted with two sets of stimuli: 1) L1 = 65, L2 = 50 dB sound pressure level (SPL) re 20 microPa ("65/50"), and 2) L1 = L2 = 65 dB SPL ("65/65"). Half-octave DPOE root-mean-square levels at 1,000, 2,000, 4,000, and 6,000 Hz were computed from the initial DPOEs measured at 0.25-octave intervals. Correlation coefficient and decision-theory analyses were applied to evaluate the DPOE test performance. For both stimuli, DPOE level exhibited significant correlation with pure tone hearing threshold. When the criterion DPOE level distinguishing normal from impaired hearing was adjusted, the curves of sensitivity and specificity crossed, and the values at the crossing were higher than 80% at frequencies of 2,000 to 6,000 Hz for both stimuli. The area under the receiver operating characteristic (ROC) curve, which provides an overall evaluation of the test performance independent of the criterion DPOE level, was .90 or higher at 2,000 to 6,000 Hz for both stimuli. At 2,000 and 4,000 Hz, all measures of test performance were higher for the 65/50 stimulus than the 65/65 stimulus: area under the ROC curve (.96 to .97 versus .90 to .91, statistically significant, p < .001, Wilcoxon test), sensitivity/specificity (90% to 93% versus 80% to 85%), and correlation coefficient (.78 to .87 versus .66 to .79). At 1,000 and 6,000 Hz, the performances of the DPOE tests were similar for the two stimuli. These results support the conclusion that a DPOE test with L1 = 65 and L2 = 50 dB SPL provides a better performance than that with L1 = L2 = 65 dB SPL and recommend the use of stimuli with L1 being higher than L2 by about 15 dB. These results also support a growing view that 2f1-f2 DPOEs can be utilized clinically as a reliable method of testing human sensorineural hearing loss.

Acoustic Impedance Tests↗