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Protein thiol modifications of human red blood cells treated with t-butyl hydroperoxide.

Oxidative stress causes modification of cellular macromolecules and leads to cell damage. The objective of this study was to identify protein modifications that relate to thiol groups in human red blood cells under oxidative stress. With t-butyl hydroperoxide (t-BH) treatment, results of isoelectric focusing (IEF) analysis showed that two dithiothreitol-reversible modifications are observed, one toward the cathode and the other to the anode. Protein change toward the cathode was demonstrated to be hemoglobin oxidation, which gains a net positive charge, based on the same focus on IEF gels as hemoglobin and methemoglobin and molecular weight analysis by SDS-polyacrylamide gel electrophoresis (SDS-PAGE). Otherwise, the change toward the anode was the result of mixed disulfide formation between GSH and protein thiols. Based on the results of molecular weight analysis and its reversion from methemoglobin, protein formed mixed disulfides with GSH were also regarded as hemoglobin. As red blood samples were treated with diamide or GSSG, in addition to the mixed disulfides observed in t-BH-treated cells, additional hemoglobin-GSH mixed disulfide appeared. But the disappearance of this diamide-induced additional mixed disulfide by treating cells with t-BH after diamide treatment suggests that the increase of negative charges from GSH are offset by ferrohemoglobin oxidation to ferrihemoglobin. Additionally, other dithiothreitol-reversible modifications of one cell membrane protein, spectrin, were also observed from the formation of high molecular weight molecules as detected by SDS-PAGE. Results indicate that protein thiols in human red blood cells are susceptible to modification under oxidative stress. IEF analysis provides a useful tool to measure methemoglobin and hemoglobin GSH mixed disulfide formation.

Adult↗

[Evoked potentials and structured and colored stimuli].

After a historical account and a brief description of the techniques of signal analysis used in their laboratory (visual evoked potentials (VEPs) with statistical calculations, Fast Fourier Transform, correlation function), the authors present the experiments they undertook concerning colored stimulations. These experiments were carried out in 3 steps: colored stimulations on a cathode-ray screen, with constant luminance, concerning 8 healthy volunteers (72 VEPs analyzed); colored stimulations on a 'structured' screen (pattern reversal), concerning 31 healthy volunteers (186 VEPs analyzed); colored and pattern stimulations on a new cathode-ray stimulator built in the 'Centre National des Arts et Métiers' enabling both preceding types of stimulations with increased reliability and offering new possibilities of stimulation (variation of contrast, luminance or chromaticity precisely controlled) with various patterns in the background. The results evidence two different groups of electrophysiological responses, distinctly related to the presence or absence of a morphological structure in the stimulation. As well as this, a significant increase in latencies is observed with blue stimulations.

Adult↗

An in vivo investigation of the rabbit skin responses to transdermal iontophoresis.

To optimize the benefits of transdermal iontophoresis, it is necessary to develop a suitable animal model that would allow for extensive assessments of the biological effects associated with electro-transport. Rabbit skin responses to iontophoresis treatments were evaluated by visual scoring and by non-invasive bioengineering parameters and compared with available human data. In the current density range 0.1-1.0 mA/cm(2) applied for 1 h using 0.9% w/v NaCl and 0.5 mA/cm(2) for up to 4 h, no significant irritation was observed. 2 mA/cm(2) applied through an area of 1 cm(2) for 1 h resulted in slight erythema at both active electrode sites but without significant changes in transepidermal water loss (TEWL) and laser Doppler velocimetry (LDV). A value of 4 mA/cm(2) under similar conditions caused moderate erythema at the anode and cathode with TEWL and LDV being significantly elevated at both sites; 1 mA/cm(2) current applied for 4 h, caused moderate erythema at both anode and cathode; and 1 mA/cm(2) applied for 1 h caused no irritation when the area of exposure was increased from 1 to 4.5 cm(2). When significant irritation and barrier impairment occurred, the erythema was resolved within 24 h with barrier recovery complete 3-5 days post-treatment. Rabbit skin thus shows promise as an acceptable model for iontophoresis experiments.

Administration, Cutaneous↗

The neuronal response to electrical constant-amplitude pulse train stimulation: evoked compound action potential recordings.

The purpose of this study was to gain a greater understanding of the electrically evoked compound action potential (EAP) responses to pulse train stimulation. Analysis of EAP amplitude responses suggested that an alternating pattern varied depending upon stimulus level, interpulse interval (IPI), stimulus waveform, and stimulus polarity. Stimulus level-dependent recovery was seen in the cat and the guinea pig: higher stimulus level tended to provide faster recovery. Both polarity-dependent recovery and polarity-dependent adaptation were observed in the cat and these stimulus polarity effects were less consistent in the guinea pig. The polarity-dependent recovery effect supports the hypothesis that anodal and cathodal stimuli excite different sites along auditory nerve fibers. Amplitude differences between the response to the second pulse and the steady-state response at the same IPI are significantly greater for anodal stimuli than for cathodal stimuli in all cats. These data suggest that there is a cumulative refractory effect in the auditory nerve of cats, especially in response to anodal stimuli.

Action Potentials↗

Interactions between pulse separation and pulse polarity order in cochlear implants.

Interactions between pulse separation and pulse polarity order were examined using psychophysical studies of electrical detection thresholds in nonhuman primates. Subjects were trained using acoustic stimuli, then deafened in one ear and implanted with an electrode array for electrical stimulation of the cochlea. Threshold vs pulse separation functions for trains of biphasic electrical pulses were compared for constant and alternating leading phase polarity. When leading phase polarity was held constant, threshold vs pulse separation functions were nonmonotonic (U-shaped). Small polarity-dependent (cathodic vs anodic leading phase) differences in absolute thresholds were observed at long pulse separations, but function shape was independent of leading phase. When leading phase polarity alternated, there was a pronounced reduction in thresholds at short pulse separations (below about 1 ms), resulting in monotonically increasing threshold vs pulse separation functions. At long pulse separations, functions for alternating and constant polarity stimuli were similar. Polarity effects were most apparent for longer duration trains (20 pulses) at long pulse durations (1-2 ms/phase). For stimuli consisting of only two biphasic pulses, alternating polarity effects depended on whether cathodic or anodic phases were adjacent. The neural mechanisms underlying these effects probably include refractory properties and/or residual potentials.

Acoustic Stimulation↗

Effects of galvanic stimulation of the mastoid process on the gastric motility induced by caloric stimulation.

The effects of galvanic stimulation to the mastoid portion on the vestibuloautonomic symptoms induced by caloric stimulation, such as nausea, vomiting, and vertigo, were evaluated in this study. Gastric motility was measured by electrogastrography (EGG) in 20 healthy volunteers (11 male and nine female) aged 20-30 (average: 25.4) years. Electrical stimulation of the mastoid process with 1.0-3.0 mA, 1.0 ms, 100 Hz was applied using a bipolar-biaural method during caloric stimulation of the external auditory canal. The dominant frequency and power of EGG were determined using running spectral frequency analysis and the time-course of EGG was evaluated in a pseudo three dimensional graphic. Frequency of EGG was classified into normogastria with 3 cpm, bradygastria with lower than 3 cpm, and tachygastria with higher than 3 cpm. At quiescent period, normogastria was 78.7 +/- 3.7%, bradygastria 5.0 +/- 1.1%, and tachygastria 16.4 +/- 3.7%. Caloric stimulation with warm water in the unilateral ear and cold water in the contralateral ear elicited vestibuloautonomic symptoms, with accompanied decreases in normogastria (57.7 +/-4.6%, P < 0.01) and increases in tachygastria (34.8 +/- 4.8%, P < 0.01). Cathodal stimulation to the mastoid process ipsilateral to cold water irrigation during caloric stimulation restored normal pattern of gastric motility: normogastria in 77.1 + 5.3% and tachygastria in 19.3 +/- 4.7%, and relieved vestibuloautonomic symptoms. Cathodal stimulation to the inhibited vestibular system ameliorates the vestibular symptoms induced by caloric stimulation.

Adult↗

Voltammetric determination of isoxsuprine and fenoterol in dosage forms and biological fluids through nitrosation.

A simple and highly sensitive voltammetric method was developed for the determination of isoxsuprine HCl (I) and fenoterol HBr (II) in dosage forms and biological fluids. The method is based on treatment of the two compounds with nitrous acid followed by measuring the cathodic current produced by the resulting nitroso derivatives. The voltammetric behavior was studied adopting Direct Current (DCt), Differential Pulse (DPP) and Alternating Current (ACt) polarography. Both compounds produced well-defined, diffusion-controlled cathodic waves over the whole pH range in Britton-Robinson buffers (BRb). At pH 11 and pH 9, the values of diffusion-current constants (Id), were 9.4 +/- 0.3 and 7.7 +/- 0.4 for I and II, respectively. The current-concentration plots for I were rectilinear over the range of 0.6-12 microg/ml and 0.1-12 microg/ml in the DCt and DPP modes, respectively. As for II, the range was 1-20 microg/ml and 0.1-20 microg/ml in the DCt and DPP modes, respectively. The minimum detectability (S/N = 2) were 0.02 microg/ml (approximately 6 x 10(-8) M) and 0.01 microg/ml (approximately 2.6 x 10(-8) M) for I and II, respectively, adopting the DPP mode. The proposed method was applied to the determination of both compounds in dosage forms and the results obtained were in good agreement with those obtained using reference methods. The proposed method was further applied to the determination of isoxsuprine in spiked human urine and plasma. The percentage recoveries adopting the DPP mode were 98.84 +/- 1.18 and 99.26 +/- 0.97, respectively.

Aerosols↗

Optimization of preparative electrophoretic chiral separation of ritalin enantiomers.

Continuous free flow electrophoresis (CFFE) was applied to the preparative chiral separation of ritalin enantiomers. Sulfated beta-cyclodextrin (sbeta-CD) was used as the chiral additive. Liquid chromatography-mass spectrometry (LC-MS) experiments were applied to study the time averaged concentration of sbeta-CD in the separation chamber. The distribution of sbeta-CD in the separation chamber greatly influenced resolution and the angle of deflection. To optimize the separation, several parameters (methanol, concentration of sbeta-CD in the cathodic wash and in the separation buffer, and the introduction of a low conductivity zone) were investigated. The dependence of the resolution and deflection angles of ritalin enantiomers on the concentration of sbeta-CD in both the separation buffer and in the cathode wash solution appeared to be non-linear. Under close to optimal conditions, resolution of ritalin enantiomers was about 0.8 with an average processing rate of 0.5 mg/h. Overall, the enantiomeric purity of the individual isomers was approximately 83%; however, of the 20 vials containing ritalin, the presence of both enantiomers was only detected in three vials.

Central Nervous System Stimulants↗

Voltammetric determination of josamycin (a macrolide antibiotic) in dosage forms and spiked human urine.

The voltammetric behaviour of josamycin (a macrolide antibiotic) has been studied using direct current (DC(t)) alternating current (AC(t)) and differential pulse polarography (DPP). In Britton-Robinson buffers, josamycin developed cathodic waves over the pH range 7-12. At pH 10, a well-defined cathodic wave with diffusion current constant of 1.06 +/- 0.19 (n = 5) was obtained. The wave was characterized as being diffusion-controlled; and partially affected by adsorption phenomenon. The current-concentrations plots are rectilinear over the range 10-60 and 6-50 microg/ml using DC(t) mode and DPP mode, respectively. The minimum detectability limit was 1.2 microg/ml (1.9 x 10(-6) M) adopting the DPP mode. A method was proposed for the determination of josamycin in its tablets adopting both DC(t) and DPP modes. The results obtained were in good agreement with those given by the manufacturer. The method was extended to the in-vitro determination of the drug in spiked human urine; the % recovery was 98.06 +/- 1.76% (n = 5). The number of electrons involved in the reduction process was accomplished and a proposal of the electrode reaction was presented.

Anti-Bacterial Agents↗

Electrochemical behavior of the antituberculosis drug isoniazid and its square-wave adsorptive stripping voltammetric estimation in bulk form, tablets and biological fluids at a mercury electrode.

Isoniazid, pyridine-4-carboxylic acid hydrazide, is an antituberculosis-agent, which is used to prevent the development of clinical tuberculosis. A validated square-wave adsorptive cathodic stripping voltammetric procedure for the trace determination of the bulk drug at the hanging mercury drop electrode (HMDE) has been developed. Under the optimized conditions, (accumulation potential=-0.9 V, accumulation time=50-300 s, scan increment=8 mV, pulse-amplitude=25 mV, frequency=120 Hz and acetate buffer at pH 5.5) isoniazed generated two irreversible cathodic peaks. The first peak current showed a linear dependence with the drug concentration over the range 5 x 10(-10)-21 x 0(-6) M. The mean percentage recoveries, based on the average of five replicate measurements, for 7 x 10(-9) and 5 x 10(-8) M isoniazid were 97.71+/-2.93 and 99.76+/-0.77, respectively. The achieved limits of detection (LOD) and quantitation (LOQ) were 1.18 x 10(-10) and 3.93 x 10(-10) M isoniazid, respectively. The procedure was applied to the assay of the drug in tablets (Isocid and T.B. Zide), spiked human serum and urine with mean percentage recoveries of 97.81+/-1.49, 97.45+/-2.09, and 97.08+/-1.06, respectively. The limits of detection of 1.47 x 10(-9) and 2.4 x 10(-8) M, and quantitation of 4.9 x 10(-9) and 8 x 10(-8) M drug in human serum and urine, respectively, were achieved. The mean values of the various pharmackinetic parameters of isoniazid (C(max), T(max), t(1/2), AUC, and K(e)), estimated from analysis of plasma of two volunteers by means of the proposed procedure were similar to literature values.

Adult↗

Flow injection and HPLC determination of furosemide using pulsed amperometric detection at microelectrodes.

The flow-injection and HPLC determination of the diuretic drug furosemide using pulsed amperometric detection (PAD) at cylindrical carbon fibre microelectrodes (CFMEs) is reported. Experimental conditions such as pH (6.5) and buffer concentration (0.05 mol l(-1) HPO4(2-)/H2PO4(-)) were optimized using square-wave voltammetry (SWV). Repetitive flow-injection amperometric measurements at +1.25 V for furosemide showed a continuous decrease in the peak current, probably as a consequence of the microelectrode surface fouling. However, a suitable amperometric detection of furosemide was achieved using a PAD program consisting of a two-step potential waveform with alternating anodic and cathodic polarization. The anodic (detection) potential was +1.25 V (time of application 0.1 s), and the cathodic (cleaning) potential was -0.20 V (t=0.2 s). A linear calibration graph was obtained for furosemide in the 5.0 x 10(-7)-1.0 x 10(-4) mol l(-1) concentration range, with a limit of detection of 1.7 x 10(-7) mol l(-1). HPLC-PAD at carbon fibre microelectrodes was used for the determination of furosemide in the presence of several thiouracil drugs and oxytetracycline (OTC). The mobile phase selected was a 25:75 acetonitrile:5.0 x 10(-3) mol l(-1) NaH2PO4 (pH 5.0) mixture. A linear calibration graph was obtained for furosemide in the 1-100 microM range, with a limit of detection of 0.55 microM. The usefulness of this method for the determination of furosemide in real samples was evaluated by performing the analysis of commercial milk samples spiked with furosemide at a concentration level of 4.5 x 10(-7) mol l(-1) (150 ng ml(-1)), as well as with other thiouracil drugs and OTC. A mean recovery of 95+/-5% furosemide was obtained.

Chromatography, High Pressure Liquid↗

Effect of pacing current strength on indexes of myocardial activation in humans: influence of chronic infarction and polarity of pacing.

The effects of current strength (threshold to 20 mA) and pacing polarity (bipolar versus unipolar) on indexes of ventricular activation during endocardial pacing (cycle length 400 to 500 ms) from 10 normal and 17 abnormal left ventricular sites were assessed in 19 patients. Abnormal sites were infarcted and demonstrated an electrogram duration greater than 70 ms and amplitude less than 3 mV during sinus rhythm. Bipolar pacing was performed from poles 1 (cathode) and 3 (1 cm interelectrode distance) of a quadripolar catheter. Unipolar cathodal pacing was performed from the tip electrode (pole 1). Local activation was indexed by the interval from the pacing stimulus to 1) the onset of the QRS complex, 2) the largest rapid deflection of the local electrogram, and 3) the end (total duration) of the local electrogram recorded from poles 2 and 4 of the quadripolar catheter used for left ventricular pacing. Distant activation was indexed by the interval from pacing stimulus to electrograms recorded at the right ventricular apex and outflow tract. Bipolar and unipolar pacing of normal sites produced a modest homogeneous reduction of all activation times by 3 to 11 ms (median) with increments in current strength from threshold (0.8 mA) to 20 mA. Bipolar pacing of abnormal sites showed marked (up to 110 ms) and heterogeneous changes in local (median 22 to 30 ms) as well as distant (median 14 to 23 ms) activation times with increases in current strength from threshold (2.7 mA) to 20 mA.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

The automatic implantable cardioverter-defibrillator: effect of patch polarity on defibrillation threshold.

An automatic implantable cardioverter-defibrillator (AICD) was implanted in 40 patients with sudden cardiac arrest (n = 29), sustained monomorphic ventricular tachycardia (n = 10) or recurrent syncope (n = 1) who were unsuitable for direct ablative surgery or had had unsuccessful medical therapy. The effect of patch electrode polarity on the defibrillation threshold was prospectively evaluated. Two large epicardial patches were used. Initial polarity was selected at random. Ventricular fibrillation was induced by direct current and a preestablished defibrillation protocol employed to assess the minimal energy that would reproducibly defibrillate the heart. Nineteen patients had a lower defibrillation threshold with the inferior left ventricular patch as an anode and nine patients had a lower defibrillation threshold with this patch as a cathode. In general, the defibrillation threshold was lower when this patch was used as an anode than when it was used as a cathode (18 +/- 10 versus 22.6 +/- 12.2 J; p less than 0.01). No preoperative variable predicted optimal polarity. Therefore, the effect of patch polarity on defibrillation threshold should be assessed in each patient at the time of AICD implantation so that the safety margin for satisfactory device function can be maximized.

Aged↗

The implanted defibrillator: relation of defibrillating lead configuration and clinical variables to defibrillation threshold.

Forty-two defibrillating lead systems for the automatic implantable defibrillator were implanted and tested in 41 patients. Two basic lead configurations were used: 1) spring-patch, consisting of a transvenous superior vena cava spring electrode as the anode and an apical or left lateral ventricular patch electrode (either small [13.9 cm2] or large [27.9 cm2]) as the cathode; and 2) patch-patch, consisting of an anterior right ventricular patch as the anode and a posterior left ventricular patch as the cathode. Of the 42 lead systems, 10 were spring-patch and 32 were patch-patch combinations. The defibrillation threshold for the patch-patch combinations (9.8 +/- 6.5 J, mean +/- standard deviation) was significantly (p less than 0.01) lower than that for the spring-patch combinations (19.1 +/- 10.3 J). Subgroup analysis revealed the lowest defibrillation thresholds for patch-patch combinations with at least one large patch. Total surface area of defibrillating leads was strongly negatively correlated with the defibrillation threshold (p less than 0.005). Analysis of the relation of clinical variables to defibrillation threshold revealed that only amiodarone therapy was independently associated with a significantly (p less than 0.05) higher defibrillation threshold. Thus, surface area of the defibrillating leads is a critical determinant of the defibrillation threshold for the implanted defibrillator. Patch-patch lead systems with at least one large patch may provide an increased safety margin for defibrillation. Conversely, amiodarone therapy is associated with higher defibrillation thresholds and may decrease the margin of safety.

Adolescent↗

Marked reduction in atrial defibrillation thresholds with repeated internal cardioversion.

OBJECTIVES: This study was performed to assess the atrial defibrillation threshold in patients with recurrent atrial fibrillation (AF) using repeated internal cardioversion. BACKGROUND: Previous studies in patients with chronic AF undergoing internal cardioversion have shown this method to be effective and safe. However, current energy requirements might preclude patients with longer-lasting AF from being eligible for an implantable atrial defibrillator. METHODS: Internal shocks were delivered via defibrillation electrodes placed in the right atrium (cathode) and the coronary sinus (anode) or the right atrium (cathode) and the left pulmonary artery. After cardioversion, patients were orally treated with sotalol (mean 189 +/- 63 mg/day). Eighty consecutive patients with chronic AF (mean duration 291 +/- 237 days) underwent internal cardioversion, and sinus rhythm was restored in 74 patients. Eighteen patients underwent repeated internal cardioversion using the same electrode position and shock configuration after recurrence of AF (mean duration 34 +/- 25 days). RESULTS: In these 18 patients, the overall mean defibrillation threshold was 6.67 +/- 3.09 J for the first cardioversion and 3.83 +/- 2.62 J for the second (p = 0.003). Mean lead impedance was 55.6 +/- 5.1 ohms and 57.1 +/- 3.7 ohms, respectively (not significant). For sedation, 6.7 +/- 2.9 mg and 3.9 +/- 2.2 mg midazolam were administered intravenously (p = 0.003), and the pain score (0 = not felt, 10 = intolerable) was 5.1 +/- 1.9 and 2.7 +/- 1.8 (p = 0.001). Uni- and multivariate analyses revealed only the duration of AF before cardioversion to be of relevance, lasting 175 +/- 113 days before the first and 34 +/- 25 days before the second cardioversion in these 18 patients (p = 0.002). CONCLUSIONS: If the duration of AF is reduced, a significant reduction in defibrillation energy requirements for internal cardioversion ensues. This might extend the group of patients eligible for an implantable atrial defibrillator despite relatively high initial defibrillation thresholds.

Adult↗

Operational parameters affecting the performannce of a mediator-less microbial fuel cell.

A mediator-less microbial fuel cell was optimized in terms of various operating conditions. Current generation was dependent on several factors such as pH, resistance, electrolyte used, and dissolved oxygen concentration in the cathode compartment. The highest current was generated at pH 7. Under the operating conditions, the resistance was the rate-determining factor at over 500 omega. With resistance lower than 500 omega, proton transfer and dissolved oxygen (DO) supply limited the cathode reaction. A high strength buffer reduced the proton limitation to some extent. The DO concentration was around 6 mg l(-1) at the DO limited condition. The fact that oxygen limitation was observed at high DO concentration is believed to be due to the poor oxygen reducing activity of the electrode used, graphite. The current showed linear relationship with the fuel added at low concentration, and the electronic charge was well correlated with substrate concentration from up to 400 mg l(-1) of COD(cr). The microbial fuel cell might be used as a biochemical oxygen demand (BOD) sensor.

Bioelectric Energy Sources↗

Sonoelectrochemical recovery of silver from photographic processing solutions

This paper describes the effect of ultrasound upon the electrochemical recovery of silver from photographic processing solutions using a newly designed electrochemical cell--SonoEcoCell. Rates of deposition of silver (obtained potentiostatically) were studied in the model 'fix' solutions (dilute aqueous Na2S2O3/NaHSO3 at a stainless steel cylinder electrode in both the absence and the presence of ultrasound. Under silent conditions, the magnitude of the cathodic potential is a major factor in the removal of silver. Under 20 kHz sonication, the rate of deposition of silver increases with increasing ultrasonic intensity. The cathode efficiency is also enhanced under insonation. The position of the ultrasonic probe with respect to the rotating cylinder electrode (RCE) was studied. It was found that for a 'face-on' geometry (probe parallel to the electrode) led to higher rate constants compared with a 'side-on' geometry (probe perpendicular to the electrode). The effect of coupling an RCE with ultrasound upon these rate constants employing the two geometry was also investigated. It was found that, employing either the face-on or the side-on geometry alone, improved rate constants were obtained below approximately 1500 and 2000 rpm, respectively.

Journal Article↗

Galvanic-evoked myogenic responses in patients with an absence of click-evoked vestibulo-collic reflexes.

OBJECTIVES: To show that galvanic-evoked responses on the sternocleidomastoid muscle (SCM) are useful for differentiating labyrinthine lesions from retro-labyrinthine lesions in patients with an absence of click-evoked vestibulo-collic reflexes. METHODS: We studied the average responses in the unrectified electromyographic (EMG) activities of the SCM to galvanic stimulation (3mA, 1ms). The cathodal electrode was on the mastoid, and the anodal electrode was on the forehead. Twenty-two healthy subjects and 28 patients with vestibular disorders were studied. All of the 28 patients showed the unilateral absence of vestibulo-collic reflexes evoked by 95dBnHL clicks on the affected side. RESULTS: In healthy subjects mastoid-forehead galvanic stimulation produced a positive-negative biphasic EMG response at short latency on the SCM ipsilateral to the cathodal electrode. All patients with labyrinthine lesions showed biphasic EMG responses even in the affected side. In contrast, almost all patients with retro-labyrinthine lesions (16/18) showed no response or a decreased response on the affected side. CONCLUSIONS: These results suggest that galvanic-evoked myogenic responses on the SCM may be useful in the differential diagnosis of labyrinthine lesions from retro-labyrinthine lesions in patients with an absence of vestibulo-collic reflexes evoked by clicks.

Acoustic Stimulation↗