Effect of ethacrynic acid, furosemide, and ouabain upon the endolymphatic potential and upon high energy phosphates of the stria vascularis

The effect of vasopressin upon the cochlear potentials in the guinea pig

The change in the EP, CM, SP and AP during perilymphatic perfusion of vasopressin (antidiuretic hormone) was examined in the guinea pig. The EP was recorded with a microelectrode through the spiral ligament of the second turn. The CM, SP and AP were measured with the differential electrodes in the basal turn. The perfusion of vasopressin at concentration of more than 10(-5)M produced a reversible decrease in the EP. The extent of the EP decline was dependent upon the concentration of vasopressin. Abolition of the effect of vasopressin upon the EP by the resumption of respiration after transient asphyxia was observed. During the perfusion of vasopressin, the CM and AP decreased, while the negative component of the SP increased. The mechanism causing the effect of vasopressin upon the cochlear potentials is discussed.

Comparative ototoxicity of furosemide and piretanide

The purpose of these studies was to compare the ototoxicity of piretanide to that of furosemide in the chinchilla. Chinchillas weighing 400 to 700 g were anesthetized with ketamine plus pentobarbital. Endocochlear potential (EP) was measured continuously by the round window approach using glass microelectrodes. Piretanide or furosemide injected through a jugular vein catheter in adults range from 10-100 mg/kg. Little or no change in EP was noted with doses below 15 mg/kg of either diuretic. The overall pattern of decline of EP was rather similar in piretanide-treated and furosemide-injected animals, and it was interesting to find that the dose-ototoxicity response curve for piretanide was similar to that for furosemide. The diuretic effect of equal ototoxic doses of either diuretic was equivalent. Both diuretics cause a decrease of endocochlear potential when applied locally to the round window membrane of the chinchilla as well as by systemic administration. These findings suggest that piretanide and furosemide have approximately the same propensity for ototoxicity.

Saccular and cochlear endolymphatic potentials in experimentally induced endolymphatic hydrops of guinea pigs

Saccular and cochlear endolymphatic potentials (SEP and CEP) were recorded in 33 normal animals. We confirmed that SEP is not produced in the saccule per se, but is a potential leak from the cochlea. CEP was reduced to one-tenth of the original value when it reached the saccule. Endolymphatic hydrops was provoked in 32 animals, and CEP and SEP were successfully recorded in 29 and 20 cases, respectively. The measurements were performed in the 2nd, 4th and 12th postoperative week. Both CEP and SEP decreased in magnitude as time elapsed after the surgery. This reduction is attributed to the strial dysfunction. In advanced hydrops, CEP transmission to the saccule is greatly inhibited. It is concluded that the saccular dysfunction can occur in the hydropic ear.

An experimental study using sodium salicylate to reduce cochlear changes induced by furosemide

Furosemide is a loop diuretic which has been found to be ototoxic in humans and experimental animals. The ototoxic effects seem to be directed primarily towards the stria vascularis, since its shrinkage and extracellular edema have been observed in correlation with electrophysiologic changes. The present study was designed to examine the interaction of sodium salicylate and furosemide on the cochlear microstructures. Chinchillas weighing 400-600 g were used in all tests performed. The endocochlear potential (EP) was monitored continuously through a microelectrode inserted through the basilar membrane. A control group of animals was injected with 0.5 ml saline intravenously (IV) 30 min before 25 mg/kg furosemide was given. The experimental group of animals was injected with 50 mg/kg sodium salicylate IV 30 min before 25 mg/kg furosemide. The control animals were found to have a mean decrease in EP of 61.1 +/- 7.0 mV. In contrast, the experimental group had very little alteration of the EP following furosemide injection (18.7 +/- 3.9 mV). These findings suggest that sodium salicylate markedly reduces the ototoxic effect of furosemide. This effect may be mediated by an alteration of local or systemic prostaglandin metabolism, or may be due to inhibition of organic acid uptake in the cochlea.

Furosemide ototoxicity: clinical and experimental aspects

Furosemide is an ototoxic diuretic. Furosemide injection is followed by a rapid, but reversible decrease of the endocochlear potential and eighth nerve action potential with a more gradual decrease of the endolymph potassium concentration. In contrast to the reversible effects of furosemide alone on the cochlea, the combination of kanamycin with furosemide resulted in irreversible changes in cochlear function which were associated with elevated levels of kanamycin in the blood and perilymph of the experimental animals. There was a striking similarity between the blood level measured by high pressure liquid chromatography at the time of recovery of auditory function in experimental animals and the ototoxic blood levels proposed by others in clinical literature. These findings help to provide a pharmacologic basis for the clinical observation of furosemide-induced hearing loss.

The effect of furosemide on glucose oxidation of the cochlea and other tissues

We tested the hypothesis that furosemide interferes with energy generation in the cochlea, and determined its effect on CO2 formation from glucose and glyceroaldehyde-3-phosphate dehydrogenase (GAPDH) activity by examining biochemical and histochemical changes in the cochlea, the kidney, and the liver. We found that furosemide suppressed CO2 formation in vitro at relatively low concentrations in all tissues examined. GAPDH was inhibited as soon as 2 min after its administration (80 mg/kg, i.v.). Recovery of this enzyme activity was most rapid in the liver. We concluded that furosemide does interfere with energy generation in the cochlea, kidney, and liver as a result of its inhibition of GAPDH.

Principles in cochlear toxicity

The hair cells of the cochlea (neuroepithelium) represent the primary target in most drug-induced ototoxic adverse effects on hearing (e.g. aminoglycoside antibiotics). To what extent an exogenically-induced morphologic damage to hair cells is reversible is not known. In aging structurally altered hair cells can persist for years likewisely not any longer participating in sensory transduction as the hair cells degenerate, secondary changes occur in the spiral ganglion cells and the neuronal pathways. Following heavy metal poisoning an adverse effect is observed on both central and peripheral innervation of the cochlea and only minor primary changes occur in the receptor cells. The link between function and morphology in the cochlea is very obvious regarding the high and middle frequencies with a distinct tonotopic localisation whereas for low frequencies (below 1 khz) such a specific morphologic correlation is lacking. Ototoxic effects primarily affecting the source for the production of endolymph, i.e. the stria vascularis, become manifest at all frequencies and at a rather early stage. Independent of type of substance penetrating into the inner ear, the substance has a considerably slower elimination rate as compared with all other compartments in the body. The toxicity of the drugs seems to be more related to its tissue binding capacity and saturation of receptor sites than related to the concentration of the drug in endo-or perilymph.

An energy-dependent step in aminoglycoside ototoxicity: prevention of gentamicin ototoxicity during reduced endolymphatic potential

Guinea pigs received a bolus of gentamicin (10 mM for 5 min) by perilymphatic perfusion which normally led to an irreversible loss of the cochlear microphonic potential (CM). Various experimental conditions that reduced the endolymphatic potential (EP) were then superimposed on the gentamicin application. Reversible reductions in EP (and, concomitantly, in CM) were induced by asphyxia (3 min), intravenous furosemide (50 mg/kg), and perilymphatic perfusion of aminooxyacetic acid (10 mM). When the administration of gentamicin was initiated at the time of maximal EP reduction the usual irreversible gentamicin-induced decline of CM was prevented. The results indicate that a metabolic process is essential in the expression of gentamicin toxicity. The data are consistent with the inhibition of an energy-dependent transport of the aminoglycoside. Alternatively, the data are also compatible with the hypothesis that entry of gentamicin into hair cells is prevented by a reduction in their transmembrane electrical potential.

Abolition of the negative endocochlear potential as a consequence of the gentamicin-furosemide interaction

The DC endocochlear potential and the AC cochlear potential in response to a 4 kHz tone were recorded in pigmented guinea pigs before and during ototoxic damage induced by sequential administration of the aminoglycoside antibiotic, gentamicin, and the loop diuretic, furosemide. Within 4 h significant diminution of the amplitude of the AC cochlear potential was accompanied by an almost complete abolition of the negative diffusion potential revealed by either furosemide administration or terminal anoxia. Thus, one of the effects of this interaction appears to involve a reduction in the potassium permeability of the cochlear partitions.

Effect of glycerol on furosemide-caused EP decrease in guinea pig neonates

Furosemide, a loop diuretic, reduces the endocochlear potential in guinea pigs. In our previous experiment using adult guinea pigs, glycerol was thought to open the blood-cochlea barrier and to help furosemide to reach its site of action in the stria vascularis. The present study was designed to determine whether or not the same potentiation by glycerol occurs in neonate guinea pigs. In one group, furosemide (10-30 mg/kg) was administered, while in another group, 50 v/v% glycerol (1 ml/kg) was administered 15 minutes prior to the injection of furosemide. Furosemide reduced the EP significantly more in neonates than in adults. This effect was not potentiated in the glycerol-pretreated group. From these findings, it seemed conceivable that the neonate blood-cochlea barrier still remains immature in some functions.

The effects of furosemide on the endocochlear potential and auditory-nerve fiber tuning curves in cats

Furosemide was injected intravenously in anesthetized cats while the endocochlear potential (EP) and tuning curves from fibers of the auditory nerve were simultaneously monitored in the same ear. The characteristic frequencies (CF's) of the fibers studied ranged from 0.25 to 28 kHz. Furosemide administration produced reversible, dose-related decreases in the EP which were accompanied by threshold elevations and alterations in the tuning curves of auditory nerve fibers. There was approximately 1 dB of threshold elevation for every millivolt decrease in the EP. For fibers with CF's above 3 kHz, threshold elevation at CF (in the tip of the tuning curve) was three times that in the tail of the tuning curve. Threshold elevation in the tip was always accompanied by threshold elevation in the tuning curve tail. Threshold elevation was dependent upon the CF of the fiber, with higher CF fibers showing larger threshold shifts than lower CF fibers. Threshold elevation was accompanied by a systematic shift in the CF of the fiber. Fibers with CF above 1 kHz exhibited downward shifts in CF, while those with CF less than 1 kHz generally exhibited upward shifts in CF.

The site of involvement of hypertension within the cochlea. A comparative study of normotensive and spontaneously hypertensive rats

The function and morphology of the cochlea of the spontaneously hypertensive rat (SHR) were examined and compared with the age-paired normotensive Wistar Kyoto rat (WKY). Electro- cochleographic study revealed that the function of the cochlea in the SHR declined with increasing age to a greater extent than that of WKY. Electronmicroscopic study revealed that the primary site of the cochlear deterioration of the SHR was the vascular stria, followed by the organ of Corti. Some hypotheses to explain this phenomenon are proposed for further study.

Gap junctions in the stria vascularis and effects of ethacrynic acid

Gap junctions in the stria vascularis of guinea pigs were studied using freeze-fracture. Nearly all junctions were associated with basal cells. They were present between basal cells and spiral ligament cells, adjacent basal cells, basal and marginal cells and basal and intermediate cells. Following administration of ethacrynic acid, gap junction morphology altered. There was a statistically significant decrease in the centre-to-centre spacing of gap junction subunits and the subunits became regularly packed. Such changes were distinct before any other gross morphological change in the stria had occurred. These morphological alterations suggest that physiological uncoupling of stria cells may occur in response to the effects of ethacrynic acid.

Effects of topical sodium potassium ATPase inhibitors upon endocochlear potential in chinchilla

Sodium orthovanadate (vanadate) is a recently discovered inhibitor of the enzyme sodium potassium adenosine triphosphatase, which has properties similar to ouabain in peripheral tissues. The effects of topical application of vanadate and ouabain to the round window membrane of the chinchilla were studied using endocochlear potential (EP) and action potential as measures of cochlear function. The EP demonstrated an initial elevation followed by a secondary decline after topical application of 2 mmol vanadate to the round window membrane. During the EP elevation, the resistance was unchanged, but the action potential response declined, with a greater effect on responses to 8-kHz tone bursts than to 2-kHz tone bursts. Thus, it does not appear that the initial increase of endocochlear potential that was observed was due to a change in the resistance of the cochlear duct; rather, some other mechanism must be involved. The round window topical application of potentially ototoxic drugs accompanied by cochlear function monitoring appears to be a useful method for testing drugs with marked systemic effects such as ouabain or vanadate and is simpler to perform than perilymphatic or vascular perfusion.

Effect of glycerol on the EP decrease caused by furosemide

A change in endocochlear potential (EP) following furosemide injection was observed in regard to prior glycerol administration in two groups of guinea pigs. In one group, various doses of furosemide (20, 30, 40, 50 mg/kg) were injected, while in the other, glycerol (50 v/v %, 1 ml/kg) was injected prior to the furosemide (20, 30, 40 mg/kg) injection. In the glycerol-furosemide group, the decrease in EP was 40% greater than in the furosemide group. Therefore, glycerol was thought to potentiate the EP lowering action of furosemide. Such an effect of glycerol was assumed to be resulted by facilitating the access of furosemide to the site of action in the stria vascularis.

The effects of intracochlear and systemic furosemide on the properties of single cochlear nerve fibres in the cat

1. Tuning properties and spontaneous discharge rate of single cochlear fibres in the anaesthetized cat were determined during short- and long-term poisoning of the cochlea by locally and systemically applied furosemide.2. With intra-arterial administration of furosemide, short-term reversible elevation occurred of the low threshold sharply tuned ;tip' segment of the frequency threshold (;tuning') curve (f.t.c.) by up to 40 db, without substantial changes in the threshold of the low frequency ;tail' segment of the f.t.c. These changes could occur in part without changes in the spontaneous activity and entirely without changes in the maximal evoked activity. These effects were observed in all fibres examined, the characteristic frequencies of which ranged from 3.5 to 31 kHz.3. Intracochlear administration of furosemide in 0.9 mM concentrations produced similar changes, but these were not reversible.4. The changes correlated with the depression of the amplitude of the gross cochlear action potential. The cochlear microphonic potential, however, was either unchanged, or only slightly reduced.5. In long-term furosemide poisoning of the cochlea, fibres with anomalous response properties were found alongside fibres having normal tuning. The former exhibited either reduced excitability of the low threshold tip segment, or a tip segment attenuated in both excitability and threshold.6. It is concluded that the selective effects of furosemide on the tip segment of cochlear fibre f.t.c.s offer further evidence for a physiologically vulnerable ;second filter' in the cochlea. The selective influence of the furosemide on the low threshold tip segment provides support for the hypothesis that the normal f.t.c. is generated by two largely independent processes: one vulnerable, low threshold and sharply tuned, and the other less vulnerable, but high threshold and more broadly tuned.7. The findings, obtained with an agent known to produce reversible impairment of hearing in man, provide direct physiological evidence in support of the hypothesis that in sensorineural hearing loss of cochlear origin the frequency selectivity of cochlear nerve fibres is impaired.

Possible functional roles of Na+,K+-ATPase in the inner ear and their relevance to Ménière's disease

This article reviews the functions of the enzyme Na+,K+-ATPase in epithelial tissues and discusses early and recent biochemical, physiologic and morphologic studies of the enzyme in the inner ear. The purpose of the investigation was to learn whether a relationship between perturbations in activity of the enzyme and Ménière's disease is possible. It is concluded that the preponderance of the evidence indicates that Na+,K+-ATPase plays a role in regulating ion transport into the scala media, but that the significance of the distribution of the enzyme along only one cell type (the marginal) in the functional chains of cells of the outer cochlear wall needs further study. The possible vasoconstrictive effects of ouabain perfusions employed by some investigators must also be taken into account. Recent cytochemical and autoradiographic studies have demonstrated high levels of Na+, K+-ATPase on cochlear nerve fibers, especially near the foramina nervosa and within the organ of Corti. Thus, perturbations in Na+,K+-ATPase activity in the inner ear not only could affect certain aspects of fluid balance, but also could account for the sensory disturbances experienced by patients who have Ménière's disease.

Effect of furosemide upon endolymph potassium concentration

Chinchillas were anesthetized with ketamine (40 mg/kg i.m.) and endocochlear potential (EP) and potassium concentration in endolymph (Ke+) were determined in control animals and in animals injected with various doses of furosemide (25, 50 or 100 mg/kg i.v.) by means of microelectrodes inserted into scala media. Control EP and Ke+ in the chinchilla were 81.3 +/- 3.8 mV and 158.5 +/- 3.2 mequiv./l, respectively. Following injection of furosemide, a dose-related fall in EP and Ke+ was observed. However, the EP declined much more rapidly than the Ke+, and recovered more quickly than the latter. The recovery of Ke+ tended to lag behind the EP recovery. The debate over whether potassium transport into endolymph and endocochlear potential generation are related or independent events is discussed in the light of recent literature and the present study.

Comparison of the non-adrenergic action of phentolamine with that of vanadate on cochlear function

Two drugs, which upon superficial examination appeared to be acting on common processes, have been found upon closer investigation to act by quite different means. Both act primarily at the organ of Corti, causing a pronounced increase of the endocochlear potential and a depression of the cochlear microphonic (CM). These effects are accompanied by the elimination of a negative component of the EP; however, it was found that these three effects are produced by phentolamine in scala media (or, more slowly, in scala tympani) but by vanadate only in scala tympani. This difference in locus of action isd manifested further by different changes of the summating potential (SP): phentolamine has little effect on the magnitude of SP-, while vanadate leads to an elevated SP-. In spite of this difference in the 'zeroth order harmonic', the second harmonic of the CM is depressed by both agents. It is argued that phentolamine may act either by blocking the acoustically-modulated ion channels in the luminal membranes of the hair cells or by inducing a large, non-selective, paracellular conductance in the organ of Corti. The present results, in conjunction with our previous results (Marcus, D.C., DeMott, J.E., Kobayashi, T., Ge, X.-X. and Thalmann, R. (1981): Hearing Res. 5, 231-243), are further interpreted as suggesting that vanadate may initially act by depolarizing the hair cells.

Ultrastructural and electrophysiological studies of acute ototoxic effects of furosemide

Previous studies of the effects of ethacrynic acid on the inner ear following intraperitoneal injection of the diuretic have shown a progression of reversible changes occurring in the stria vascularis. The time course of these changes approximately parallels alterations in endolymphatic potential (EP). In this report, some preliminary findings concerning the effects of furosemide after intraperitoneal injection of 80 mg/kg are described. EP declined over a longer time course than that recorded with intravenous injection. Cochlear microphonic (CM) and compound action potential (CAP) also declined but to differing degrees. In the stria vascularis a progression of changes was apparent. In general, the changes were similar to those observed following ethacrynic acid intoxication and affected marginal cells, intermediate cells and strial capillaries. The upper basal turn of the cochlea was affected first and the damage spread apically. In the organ of Corti, stereocilia on the outermost row of outer hair cells were disorganized. This was apparent in approximately the same region as initial strial effects and was only observed when strial derangement was quite marked.

Adenine nucleotides of the organ of Corti under metabolic stress

The purpose of the reported experiments was to measure the concentrations of adenosine triphosphate (ATP), adenosine diphosphate (ADP), and adenosine monophosphate (AMP) in the organ of Corti in order to arrive at estimates of three commonly used adenylate ratios. Under normal conditions the concentrations of ATP, ADP, and AMP amounted to 15.8, 3.9, and 0.53 mmoles/kg dry weight, respectively. Of the three substances, AMP is the most sensitive indicator of metabolic stress, since ischemia of 65 seconds leads to an increase of 155%. Under normal conditions the adenylate energy charge, the energy status, and the phosphorylation state amounted to 0.83, 4.1, and 2.5 gram wet weight/mumole, respectively. Within 10 minutes of ischemia the energy charge had declined by 26%, the energy status by 50%, and the phosphorylation state by 76%. The apparent equilibrium constant of adenylate kinase of the organ of Corti was found to be 0.55. The potential significance of these data and their relationship to the situation in the stria vascularis are discussed.

Effect of substrate-free vascular perfusion upon cochlear potentials and glycogen of the stria vascularis

The effect of vascular perfusion of the anterior inferior cerebellar artery with synthetic blood containing no metabolic substrates upon the endolymphatic potential (EP) and the cochlear microphonics (CM) was determined in the guinea pig. In substrate-free perfusion the potentials were maintained for an average of 84 min. Subsequently, the EP declined at an average rate of 1.4 mV/min until a new steady-state level was temporarily established when the potential had dropped to about 30 mV. The decline of the CM appeared to be accounted for largely by the decline of the EP. During substrate-free perfusion prior to the onset of the decline of the potentials, the level of strial glycogen remained unchanged; glycogen decreased significantly only after the potentials had started to decline. When substrate-free vascular perfusion was accompanied by simultaneous substrate-free perilymphatic perfusion, the potentials started to decline immediately. On the basis of these data, we conclude that strial glycogen plays no role in the prolonged maintenance of the EP during substrate-free perfusion; rather, the potential seems to be maintained by entry of glucose (and presumably other substrates) from perilymph into the stria vascularis.

Ultrastructure in the stria vascularis of the guinea pig following intraperitoneal injection of ethacrynic acid

Following intraperitoneal injection of ethacrynic acid, progressive, mainly reversible changes occurred in the stria vascularis, affecting all three cell types and the capillary basal laminae. Both marginal and intermediate cells showed abnormalities early, at a time when EP was just beginning to decline. Progressive changes in marginal cells culminated in apical bulging followed by recession of the swelling and stretching of the cells concomitant with gross interstitial oedema. Marginal cell mitochondria showed damage and the transcellular tubule system was dilated. Intermediate cells also showed a progression of changes, culminating in a marked, but reversible, shrinkage. The time of appearance of severe strial derangement correlated with the time of maximal depression of EP. The ability of the stria to regain rapidly an almost normal morphology appeared to be due partly to the distribution and orientation of microtubules in marginal and intermediate cells preventing major disruption of stria vascularis architecture.

Specificity of action of vanadate to the organ of corti

Although vanadate strongly inhibits Na/K-ATPase activity of the stria vascularis in vitro, it initially causes no depression of the ouabain-sensitive endocochlear potential (EP) when perfused perilymphatically or via the vasculature. However, when the perilymph of scala tympani is replaced with artificial media containing 0.1 to 1 mM vanadate, there is a large (about 17 mV) increase in the EP of the second cochlear turn. Further experiments showed that the cochlear microphonics declined during the time in which the EP increased, and that the response of these two potentials to vanadate is greater in the second turn than in the first. Injection of 50 n1 of 1 mM vanadate (in artificial endolymph) into the endolymphatic space of the second turn caused no increase in the EP. These results support the notion that the early effects of vanadate are on the contra-luminal membranes of cells of the organ of Corti rather than on the stria vascularis. By superimposing anoxia or furosemide (i.v.) upon vanadate intoxication, we determined that the initial increase of the compound EP due to vanadate alone was due to a reduction in magnitude of the negative component of the EP. It is argued that of the three prevalent theories concerning the generation of the negative EP, the data tend to support the hypothesis that the intracellular potential of the hair cells gives rise to the negative EP.

The effects of inhibition of the strial Na+-K+-activated ATPase by perilymphatic ouabain in the guinea pig

The endolymphatic effects of perilymphatic ouabain (2 X 10(-3) M) were followed in 3 guinea pigs using ion-sensitive micro-electrodes, enabling a Na+-related permeability increase to be identified. Investigation of the strial ultrastructural changes in 11 more animals revealed early swelling of the marginal cells, while the intermediate and basal cells became shrunken with characteristically dark-staining cytoplasm. The subsequent cellular alterations were complex. The findings suggest that a major function of the Na+-K+-activated ATPase is preservation of the normal intracellular environment, inhibition resulting in widespread indirect effects. General measures of strial function, consequently, do not document just ATPase inhibition.

The time course of the strial changes produced by intravenous furosemide

The ultrastructural abnormalities produced in the stria vascularis by intravenous furosemide (80 mg/kg) were investigated in 14 guinea pigs. The changes consisted of marginal cell swelling, shrinkage of the intermediate cells and enlargement of the intercellular spaces, as described in other intoxications. The cytological derangements (including characteristic dilatation of the Golgi membranes) differed in detail from those arising after a comparable dose of ethacrynic acid. The morphological alterations were already present at 2 min, were maximal at 10 min, recovered only slowly at first and had not disappeared entirely at 180 min. For comparison, the fall in the endocochlear potential had a latent period of 20 s and was greatest at 2.3 min; its recovery was rapid initially but also incomplete at 180 min. Thus, no gross discrepancy in the time courses occurred, even if the correlation was imperfect. That reported previously must be due, therefore, to the much longer delays found following intraperitoneal administration.

Some ECMR properties in relation to other signals from the auditory periphery

Some basic characteristics of monkey and human acoustic emissions are reviewed and some new data presented. These characteristics are discussed in relation to the sensorineural output of the cochlea. Input--output functions and the frequency dispersal in the waveform of acoustic emissions (AE) from monkeys are described. New findings include changes in the human AE during trains of clicks and sustained suppression of the AE after short bursts of noise of moderate intensity. The similarly of click-evoked AE latencies and whole-nerve action potential (AP) latencies for low stimulus level toneburst stimuli, and the apparent discrepancy between these latencies and those of single cochlear nerve-fibre action potentials and derived impulse responses is discussed. It is argued that at low stimulus levels AE are generated either coincident with the primary cochlear impulse or very soon afterwards. It is proposed that the AE generator is peripheral to the afferent synapse of the inner hair cells because of the lack of adaptation effects in AE. However, attention is drawn to changes in the waveform of the click-evoked AE with increasing stimulus intensity and with diuretic intoxication, that qualitatively parallel known changes in single nerve-fibre firing properties. These observations are consistent with the concept that AE are a product of a sharply tuned and vulnerable cochlear filter mechanism.

The nature of the ototoxic actions of ethacrynic acid upon the mammalian endolymph system. I. Functional aspects

The endolymphatic changes produced by an intravenous injection of 60 mg kg-1 ethacrynic acid were followed for up to 120 min using conventional and ion-sensitive (Na+, K+ and pH) microelectrodes in the rat. They were found to be caused by three distinct effects upon the endolymph system. Initially, the drug completely inhibited the strial potential-producing and cation-transporting processes. Recovery began quickly and was rapid at first. Then its rate declined considerably, probably due to diminution in strial energy production of delayed onset and prolonged duration. Coincident with these actions upon active transport, there was a decrease in the overall cation permeability of the endolymph system. This followed a different time course and affected K+ much more than Na+. The findings also provided further information about the mechanisms responsible for the normal endolymphatic composition. Qualitatively similar results were obtained in a subsidiary study on guinea pigs.

The endolymphatic surface of the stria vascularis in the guinea-pig and the effects of ethacrynic acid as shown by scanning electron microscopy

Examination of the endolymphatic surface of the stria vascularis showed, in agreement with previous studies, the marginal cells to be hexagonal in shape and that most possessed microvilli. However, the cells in the apical turns were more profusely covered with microvilli than those at the base and, particularly in the basal turns, there was some variation in the surface detail of the cells. These results may indicate differences in the physiological state of the cells. In the early period of ethacrynic acid intoxication (15-30 minutes post-injection), when rapid changes in endolymphatic potential and ion-fluxes occur, the surface of the marginal cells showed only slight distortion. The most dramatic changes were noted 1 hour post-injection, and involved swelling of the cells and loss of microvilli. This distortion persisted up to 2 hours post-injection. The possible explanation for these findings is discussed.

Maintenance of cochlear function with artificial oxygen carriers

By means of vascular perfusion via the anterior inferior cerebellar artery with a blood substitute containing the perfluorochemical FC 47 as oxygen carrier, it is possible to maintain normal or near normal levels of the cochlear microphonics and the endolymphatic potential of the guinea pig for perios of 90 min, or longer. Following 60 min. of perfusion with artificial blood, the levels of ATP and 5' AMP in the stria vascularis and the organ of Corti are comparable to those of nonperfused control animals maintained at optimal metabolic conditions. Following the same period of perfusion, the appearance of the organ of Corti is normal, but small vacuoles, presumably deposits of FC 47, are visible in the marginal cells of the stria vascularis. Preliminary experiments concerning the survival time and the revival time of the cochlear potentials, as well as the response to furosemide, ouabain, and mersalyl are presented to illustrate the value of this method in elucidating various biochemical and pharmacological problems of the cochlea.

Cell membrane alterations in the stria vascularis of the guinea pig after ethacrynic acid treatment studied by freeze-fracture

A freeze-fracture examination of the stria vascularis during the first 2 h after injection of ethacrynic acid was performed. This showed a re-distribution of the particles on the membrane fracture faces of both marginal and intermediate cells. As oedematous spaces developed, particle-poor, vesicle-like structures were found associated with both cell types. The tight junctions at the apices of the marginal cells and around basal cells were unaffected.

The evoked cochlear mechanical response in laboratory primates. A preliminary report

The evoked cochlear mechanical response has been recorded in two species of laboratory primates, Macaca irus and Erythrocebus patas. The responses are very similar to those obtained in humans although the response to each click is of shorter duration. The response is vulnerable to the ototoxicity of furosemide and etacrynic acid and to noise exposure. At and near threshold an active generator of mechanical energy within the cochlea is proposed. The significance of such a generator and a possible source are discussed.

Elimination kinetics of furosemide in perilymph and serum of the chinchilla. Neuropharmacologic correlates

This study was done to determine the comparative elimination kinetics of furosemide from chinchilla perilymph and serum, and to correlate perilymph concentration with changes in endocochlear potential. The elimination kinetics of furosemide (FU) were determined in sera and perilymph obtained from chinchillas injected with 100 mg/kg i.v. of FU. Concentrations of FU exhibited a linear decay pattern in serum and perilymph over the initial 60 minutes. The rate of decline of furosemide levels in perilymph was about four times slower than the rate of fall in serum. Chronic treatment (25 mg/kg i.p. every 12 hours) did not appear to influence the level of drug at 60 minutes after a dose of FU (100 mg/kg IV). Chinchillas were also studied following doses of FU ranging from 25--200 mg/kg i.v. to see the effect on endocochlear potential (EP). A positive correlation was found between FU dosage, the maximum millivolt reduction of EP and the time to initiation of recovery of EP. The perilymph concentration of furosemide when the EP began to recover was 5 microgram/ml (1.5 x 10(-5) M). Knowledge of furosemide kinetics may ultimately be applied to prevent ototoxicity in patients.

Noxious effects upon cochlear metabolism

The influence of various toxic substances and of drugs with ototoxic side effects upon energy generation, energy utilization, and membrane processes of the cochlea were studied. None of the drugs tested interfered with energy generation to as great an extent as did anoxia or cyanide and 2,4-dinitrophenol. Ouabain produced a pronounced interference with energy utilization of the stria vascularis. The "loop" diuretics ethacrynic acid and furosemide produced a reduction of energy utilization of a lesser degree than did ouabain. The "loop" diuretics do not seem to exert their toxic action upon strial Na+K+-ATPase, but may act by interfering with strial adenylate cyclase. Aminoglycoside antibiotics and diuretic and nondiuretic mercurials seem to exert their primary noxious action upon cochlear function by interfering with membrane processes of the structures bounding the cochlear duct.