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Biomedical subjects

K C Campbell

Publications and source records attributed to K C Campbell.

7 recordsLinked to original sources

Electrocochleographic recordings in acute and healed perilymphatic fistula.

In this study, the summating potential (SP) and action potential (AP) amplitude ratio was measured in 15 guinea pigs before and after surgical induction of a round window fistula. The round window fistula was then allowed to heal, and recordings were obtained after 1 month. Stimuli included 8000-Hz and 2000-Hz tone bursts and click stimuli at levels ranging from 100-dB peak equivalent sound pressure level to AP threshold. Immediately after fistula induction, a statistically significant enlargement in the SP/AP amplitude ratio occurred in response to the click and the 8000-Hz tone-burst stimuli. No change in the SP/AP amplitude ratio was observed for the 2000-Hz stimuli. After healing, the SP/AP amplitude ratio generally returned to prelesion values. No unhealed perilymphatic fistulas were observed in any of the 15 guinea pigs at 1 month after fistula induction. Considering the difficulty of diagnosing perilymphatic fistula in humans, it is encouraging to note that, at least in animals, noninvasive electrophysiologic recordings may perhaps be sensitive to the presence of patent perilymphatic fistula.

Action Potentials

Chronic perilymph fistula in the guinea pig with implications in the human.

To improve understanding of the pathophysiology of perilymph fistulas, a predictable animal model of a chronic fistula was developed. Our findings suggest that guinea pig fistulas do not remain patent for prolonged periods. By extrapolating these findings to humans, we postulate that the symptoms and signs of perilymph fistula are possibly due not to one prolonged constant fistula, but rather a series of "blowouts" from an inherent congenital or posttraumatic weak spot in either the round or oval window. We feel that a diagnosis of perilymph fistula must be considered in any patient presenting with a Meniere's-like symptom set concomitant with a congenital inner ear deformity or a history of inner ear trauma.

Acoustic Stimulation

Electrocochleography in the presence and absence of perilymphatic fistula.

The purpose of the present study was to evaluate the effect of an acute perilymphatic fistula on the amplitude ratio (SP/AP) of the summating potential (SP) and action potential (AP). The effect of the acute fistula on AP threshold was also addressed. Electrocochleographic recordings were obtained before and immediately after surgical laceration of the round window membrane in 19 guinea pigs. Stimuli comprised clicks and 2,000-Hz and 8,000-Hz tone bursts, presented initially at 100 dB peak equivalent sound pressure level and in descending 10-dB steps. After fistula induction the SP/AP significantly increased for the click and 8,000-Hz tone burst stimuli but not for the 2,000-Hz tone burst stimuli. No significant change in AP threshold occurred. These findings suggest that the SP/AP may be sensitive to perilymphatic fistula, at least in guinea pigs. The changes in the SP/AP do not appear to be related to changes in threshold.

Action Potentials

Interpretation of electrocochleography in Menière's disease and normal subjects.

Electrocochleographic recordings were obtained from 20 subjects with normal hearing and 10 subjects with Menière's disease by using an eardrum electrode. Stimuli included clicks and 6,000-Hz tone bursts. Results were not significantly different between the two groups for summating potential (SP) amplitude, action potential (AP) amplitude, or the SP/AP amplitude ratio. Interpreting the results in light of symptoms on the date of assessment or hearing threshold did not appear to improve separation between the two groups. Various SP/AP amplitude ratio criteria have been proposed in order to separate normal patients from those with Menière's disease. Applying these proposed criteria to our data did not successfully separate the two groups.

Acoustic Stimulation

Electrocochleographic recordings in chronic and healed perilymphatic fistula.

This study examined electrocochleographic recordings in 15 guinea pigs with perilymphatic fistulas. A chronic round window fistula was induced in each animal by insertion of a sigmoid stainless steel needle with the lumen intact. In the contralateral control ear, a similar needle was inserted with the lumen crushed. In this way the model compared acute (control group) versus chronic (experimental group) perilymphatic fisulae. Electrocochleographic recordings were obtained before, immediately after needle insertion, in a subset at two to three weeks after needle insertion, and again at 17-22 weeks when the fistulas had healed with the needles still in place. Minimal threshold changes were noted from the pre- to the acute post-condition. More marked elevation of threshold was noted for the 17-22 weeks condition. Threshold elevation was greater in the experimental ears but was present in the control ears. The SP/AP amplitude ratio was generally stable for the pre- to post-conditions in both ears. For the 17-22 week epoch the SP/AP amplitude ratio was still fairly stable for the click stimulus but the ratio diminished for the toneburst stimuli. For the subset analyzed at 7-21 days the SP/AP amplitude ratio tended to increase for both groups for all stimuli although AP thresholds were normal.

Animals

Evaluation of six gentamicin nomograms using a bayesian parameter estimation program.

A new set of guidelines for the administration of gentamicin was developed by estimating steady-state peak and trough gentamicin concentrations for simulated patients with known weights and creatinine clearances. The most appropriate doses to achieve target peak concentrations of 5-10 mg/L and troughs of less than 2 mg/L were then tabulated. The performance of these new guidelines was assessed using data collected from 60 patients who had received gentamicin and had at least two serum concentration measurements. Individual estimates of clearance and volume of distribution were obtained using a Bayesian parameter estimation program and these estimates were used to predict the steady-state peak and trough concentrations that would arise from the new guidelines and five other previously published nomograms (Mawer, Chan, Hull-Sarubbi, Rule of Eight, and Dettli). The new guidelines, the Dettli nomogram, and the Hull-Sarubbi table achieved similar percentages (52-57%) of patients within the target ranges (5-10 mg/L for peak and less than 2 mg/L for trough), although 28% of patients had predicted peak concentrations below 5 mg/L with the new method compared to 15% with the other two. Only 38% of patients were within both ranges when the Mawer nomogram and the Rule of Eight methods were used. Since a large percentage of patients would have achieved concentrations outside of the target ranges no matter which nomogram was used, serum concentration monitoring is still recommended to confirm dose requirements.

Bayes Theorem

The effect of stimulus repetition rate on the auditory brainstem response in tumor and nontumor patients.

Auditory brainstem responses were recorded in two groups of adult subjects with asymmetric sensorineural hearing loss. Clicks were presented at repetition rates of 9.7, 39.7, 49.7, and 59.7/s. One group was composed of 20 patients with no known otoneurologic lesion (cochlear group), and one group was composed of 8 patients with a surgically confirmed acoustic neuroma in the ear with poorer hearing sensitivity (retrocochlear group). Detection of wave V at different repetition rates was not significantly different between the two groups. Average wave-V latency shift was not significantly different between the two groups as repetition rate increased from 9.7/s to 39.7/s but was significantly greater for the retrocochlear group as repetition rate increased from 9.7/s to 49.7/s and 59.7/s. However, the wave-V latency shift showed no improvement over the slow-rate interaural wave-V latency difference in discriminating between the two groups of patients. No significant correlation between the amount of wave-V latency shift and hearing loss at 2000 Hz or 4000 Hz was found for the ears with poorer hearing sensitivity.

Acoustic Stimulation