Self-perceived attention difficulties are associated with sensory hypersensitivity in migraine

BACKGROUND

Attention is the process which enables to preferentially select salient or relevant stimuli and to attenuate the response to irrelevant incoming stimuli. Migraine is characterized by both attentional alterations and an abnormal sensory processing to external stimulations. The aim of the study was to investigate potential interactions between self-perceived attentional difficulties and sensory hypersensitivity in migraine patients.

METHODS

Forty-six episodic migraineurs without aura and 46 healthy controls filled out questionnaires on self-perceived attention difficulties and self-reported sensitivity to visual, auditory and olfactory stimulations.

RESULTS

Compared to controls, migraineurs reported significantly higher levels of attention difficulty and sensory sensitivity. Sensory hypersensitivity correlated significantly with self-perceived attentional difficulties in migraineurs (P=0.002), but not with migraine disability or levels of anxiety or depression. Ictal and interictal sensory sensitivities were significantly correlated in migraineurs within visual (P<0.001), auditory (P<0.001) and olfactory (P=0.001) modalities.

CONCLUSION

This study shows for the first time an association between self-reported attentional difficulties and multimodal sensory hypersensitivity. Studies combining behavioral and physiological measures of sensory processing and attention processes are necessary to further understand the peculiar vulnerability of migraineurs to sensory stimuli.

Orbital exenteration and conjunctival melanoma: a 14-year study at the Jules Gonin Eye Hospital

Purpose

To report our 14-year experience with orbital exenteration and assess risk factors for poor prognosis by focusing on conjunctival melanoma.

Patients and method

A retrospective study was conducted in our tertiary care centre (Jules Gonin Eye Hospital, Lausanne, Switzerland) between 2003 and 2017. Inclusion criteria were patients aged  ≥18 years with a follow-up >12 months, without metastatic spread at the time of surgery. Data recorded were age, gender, tumour histology, surgical technique, postoperative complications, surgical margin status, local recurrence, postoperative radiation beam therapy and metastatic status.

Results

Twenty-five patients with a mean age of 63.2 years (38–92) were included. Conjunctival melanoma was the most frequently identified tumour (n = 14, 56%) followed by conjunctival squamous cell carcinoma (n = 4, 16%), sebaceous carcinoma (n = 3, 12%), choroidal melanoma (n = 2, 8%) and basal cell carcinoma (n = 2, 8%). Eighteen tumours (72%) originated from the conjunctival tissue. Clear surgical margins were achieved in 21 (84%) patients. Fourteen (56%) patients experienced distant metastases and died from metastatic spread after a mean follow-up of 52.3 months (6–120). The 1-, 3- and 5-year overall survival (OS) was 96%, 72% and 60%, respectively. In the univariate analysis, positive surgical margins, local recurrence and metachronous metastases were associated with a decreased OS (p = 0.002, p = 0.005 and p = 0.007, respectively). In the multivariate analysis, positive surgical margins and metachronous metastases were also associated with a decreased OS (p = 0.02 and p = 0.042, respectively). Conjunctival melanoma was not associated with a poorer prognosis (p = 0.280).

Conclusion

Free surgical margins are needed to increase OS. To achieve clearer surgical margins, neoadjuvant targeted therapies/immunotherapies may be considered.

[Clinical, radiological, pathological features, treatment and follow-up of periocular and/or orbital amyloidosis: Report of 6 cases and literature review]

PURPOSE

To assess demographic, clinical, radiological, pathological features, treatment and follow-up of periocular or/and orbital amyloidosis.

PATIENTS AND METHODS

We conducted an observational retrospective monocentric study from January 2004 to April 2017 in patients diagnosed with histologically proven periocular or/and orbital amyloidosis.

RESULTS

Six patients were included (2 females, 4 males). Mean age was 76.8 years (range 66-88 years). Mean time between first ophthalmological symptoms and diagnosis was 27 months (range 11-36 months). The main symptoms were subconjunctival infiltration (6 patients; 100%), periocular pain or discomfort (4 patients; 66.6%) and subconjunctival hemorrhage (1 patient; 16.6%). Clinical findings included ptosis (4 patients; 66.6%), keratitis (3 patients; 50%) leading to corneal perforation in one patient, and proptosis (3 patients; 50%). One-half of the patients showed bilateral involvement. AL amyloidosis was identified on immunohistochemistry in 5 patients (83.3%). One case of B cell marginal zone orbital lymphoma was diagnosed. Systemic work-up was negative for all patients. Treatment consisted of simple monitoring (1 patient; 16.6%), surgical debulking (3 patients; 50%), ptosis surgery (1 patient; 16.6%), eyelid or eyelash malposition surgery (2 patients; 33.3%) and orbital radiation beam therapy (2 patients; 33.3%). Mean follow-up was 14.6 months (range 6-36 months), and no progression nor recurrence were noted.

CONCLUSION

Periocular or/and orbital amyloidosis is rarely encountered. Diagnosis is based on pathological examination, and immunohistochemistry analysis should always be performed to guide systemic work-up. Orbital lymphoma and multiple myeloma should be ruled out if AL amyloidosis is diagnosed. Progression is slow, and surgery is the mainstay of treatment in symptomatic patients. Long-term multidisciplinary follow-up is advocated.

Triazole GHS-R1a antagonists JMV4208 and JMV3002 attenuate food intake, body weight, and adipose tissue mass in mice

The only peripherally released orexigenic hormone, ghrelin, plays a key role in food intake and body weight regulation. Antagonizing the ghrelin receptor, GHS-R1a, represents a promising approach for anti-obesity therapy. In our study, two novel GHS-R1a antagonists JMV4208 and JMV3002, which are trisubstituted 1,2,4-triazoles, decreased food intake in fasted lean mice in a dose-dependent manner, with ED50 values of 5.25 and 2.05 mg/kg, respectively. Both compounds were stable in mouse blood, with half-lives of 90 min (JMV4208) and 60 min (JMV3002), and disappeared from the blood 8h after administration. Fourteen days of treatment with the ghrelin antagonists (20 mg/kg twice a day) decreased food intake, body weight and adipose tissue mass in mice with diet-induced obesity (DIO). These results are likely attributable to an impact on food intake reduction and an attenuated expression of the lipogenesis-promoting enzymes (acetyl-CoA carboxylase 1 in subcutaneous fat and fatty acid synthase in subcutaneous and intraperitoneal fat). The decrease in fat mass negatively impacted circulating leptin levels. These data suggest that JMV4208 and JMV3002 could be useful therapeutic agents for the treatment of obesity.

Epibulbar osseous choristoma: a clinicopathological case series and review of the literature

BACKGROUND

Choristomas are benign, congenital tumours composed of normal tissue in an abnormal location. Osseous choristomas represent the rarest form of epibulbar choristomas, with now 65 cases reported in the literature. We did a retrospective clinicopathological study of all patients with epibulbar osseous choristoma observed at our institution since 1982 and updated the last review of the literature.

HISTORY AND SIGNS

Three Caucasian male patients, aged between 3 months and 11 years, were identified. All osseous choristomas were located under the superotemporal bulbar conjunctiva of the right eye.

THERAPY AND OUTCOME

All lesions were managed with surgical excision. Histopathology revealed the presence of lamellar bone in all cases, one of which was associated with a dermolipoma.

CONCLUSIONS

We report a small rare case series of 3 epibulbar osseous choristomas and did a review of the literature. In one patient, the osteoma was associated with a dermolipoma, corresponding to the fourth reported complex choristoma of this type, in an otherwise normal eye, in the literature.

Ghrelin control of GH secretion and feeding behaviour: the role of the GHS-R1a receptor studied in vivo and in vitro using novel non-peptide ligands

Energy homeostasis is controlled by a complex regulatory system of molecules that affect food intake and that are critical for maintaining a stable body weight during life. Ghrelin is a peptide of 28 amino acid synthesized predominantly by the stomach and the gut, which activate the type 1a growth hormone (GH) secretagogue receptor (GHS-R1a), a G-protein coupled receptor. The acylated form of ghrelin potently stimulates GH secretion both in vitro and in vivo in several animal species, including humans. Beside the endocrine effect, ghrelin shows also extraendocrine activities, including stimulation of feeding behaviour. Several classes of small synthetic peptide and non-peptide ligands of the GHS-R1a have been described and are able to release GH and stimulate food intake. However, in time, it appeared that the stimulating effects on GH secretion could be divorced from those on food intake, suggesting that more than a single receptor might be involved. Several experimental data have even questioned the physiological role of ghrelin in the control of GH secretion and energy metabolism. By using novel agonists, partial agonists, and antagonists for the GHS-R1a receptor, we have studied whether the stimulation of this receptor could account for the purported physiological role of ghrelin. Our results demonstrate that the ability to bind in vitro the GHS-R1a is not predictive of the in vivo biological activity of the compounds and that the endocrine and extraendocrine effects could be mediated also by receptors different from the GHS-R1a.

The temporal relationship between speech auditory brainstem responses and the acoustic pattern of the phoneme /ba/ in normal-hearing adults

OBJECTIVE

To investigate the temporal relationship between speech auditory brainstem responses and acoustic pattern of the phoneme /ba/.

METHODS

Speech elicited auditory brainstem responses (Speech ABR) to /ba/ were recorded in 23 normal-hearing subjects. Effect of stimulus intensity was assessed on Speech ABR components latencies in 11 subjects. The effect of different transducers on electromagnetic leakage was also measured.

RESULTS

Speech ABR showed a reproducible onset response (OR) 6ms after stimulus onset. The frequency following response (FFR) waveform mimicked the 500Hz low pass filtered temporal waveform of phoneme /ba/ with a latency shift of 14.6ms. In addition, the OR and FFR latencies decreased with increasing stimulus intensity, with a greater rate for FFR (-1.4ms/10dB) than for OR (-0.6ms/10dB).

CONCLUSIONS

A close relationship was found between the pattern of the acoustic stimulus and the FFR temporal structure. Furthermore, differences in latency behaviour suggest different generation mechanisms for FFR and OR.

SIGNIFICANCE

The results provided further insight into the temporal encoding of basic speech stimulus at the brainstem level in humans.

Effect of flavonoids from various Mediterranean plants on enzymatic activity of intestinal carboxylesterase

Flavonol compounds of three Mediterranean plants from the Algerian Atlas used traditionally in Arab folk medicine, Arenaria serpyllifolia, Rhamnus alaternus and Thapsia garganica, were found to inhibit the enzymatic activities of both rat intestine and purified porcine liver carboxylesterase in a concentration-dependent manner. Results indicate that the flavonol compounds from the aerial part of these plants lead to the inactivation of the CE pI = 5.1 with Ki of micromolar range. These results encourage us to perform further biological investigation.

Maackiain 3-O-(6′-O-malonyl-β-D-glucopyranoside) from Oudneya africana, a powerful inhibitor of porcine kidney acylase I

The inhibitory effect of phenolic extracts of several plants from the Algerian Atlas used traditionally in Arab folk medicine was tested on the porcine kidney acylase I activity. An endemic Saharan plant of the Brassicaceae family, Oudneya africana, has shown a strong inhibitory effect. The active compound was isolated and purified by semi-preparative HPLC and HPLC-photodiode array detection, and structurally determined using 1H, 13C NMR and mass spectroscopy methods. Results indicate that maackiain 3-O-(6'-O-malonyl-beta-D-glucopyranoside) showed a competitive inhibition of porcine kidney acylase I with a Ki value of 11 microM. The malonyl moiety appeared to be a structural key element for the inhibitory activity. This observation indicates interesting structure-activity relationships for the inhibitory action of this compound on the acylase I and its potential role in the toxicity of haloalkene-derived mercapturates and that of the enzyme in detoxication and bioactivation.

[Systematic screening of deafness at a maternity ward using evoked otoacoustic emissions: practical aspects and parental attitudes]

OBJECTIVE

Evaluation of the feasibility and parental attitudes towards a hearing screening programme using evoked otoacoustic emissions, implemented in a maternity ward in France.

METHODS

A hearing screening test using transiently evoked otoacoustic emissions (TEOAE) was proposed to each baby, and an anonymous questionnaire was given to parents to assess their attitudes towards the screening procedure.

RESULTS

Although the refusal of the test reached 16% (mainly during the first two weeks of the program), more than 92% of parents judged the test as being useful, and 65% wished it to be systematically done. However, nearly 35% of parents admitted to have a low level anxiety about being unnecessarily worried by the test results. One hundred and twenty-four babies were screened. Fifty three per cent of the tests have been performed in less than ten minutes, with an average of 12.2 minutes. This duration does not include delays due to programme and babies management. False positive rate (uni or bilateral fail) was 10.5% at the first stage. Repeating the test before discharge decreased the false positive rate to 6.5%.

CONCLUSION

Although limited in time, this study shows that a systematic hearing screening programme using TEOAE is possible and should be done in France. False positive rate was below 7%, and the test was considered as useful by more than 90% of parents, although knowledge about deafness in childhood and its consequences were clearly insufficient.

[Hearing disorders screening in neonates at risk]

The present report concerns a three year, eight month hearing screening in 1 531 high-risk neonates by means of two successive transient evoked otoacoustic emissions (TEOAE) recordings followed, cin cases of suspected hearing loss, by brainstem auditory evoked potential (BAEP) recording and otolaryngology (ORL) consultation. After TEOAE1 and 2 and BAEP testing, 1 361 infants (88.9%) were declared normal, and 170 (11%) suspected of hearing loss. Of these 170, 58 showed bilateral and 26 unilateral impairment. Definite hearing loss on ORL consultation was diagnosed in 14 infants (0.9% of the screened population as a whole); 22 are still followed, while 86 (5.6%) failed to consult for diagnosis. The mean age on diagnosis of definite hearing loss on ORL consultation was 9.9 +/- 4.9 (range 4-20) months. Several auditory function risk factors have been proved to be more frequent in deaf than in normal children. Our results show that early hearing loss screening in at-risk neonates needs to be pursued.

TEP1, the yeast homolog of the human tumor suppressor gene PTEN/MMAC1/TEP1, is linked to the phosphatidylinositol pathway and plays a role in the developmental process of sporulation

PTEN/MMAC1/TEP1 (PTEN, phosphatase deleted on chromosome ten; MMAC1, mutated in multiple advanced cancers; TEP1, tensin-like phosphatase) is a major human tumor suppressor gene whose suppressive activity operates on the phosphatidylinositol pathway. A single homologue of this gene, TEP1 (YNL128w), exists in the budding yeast Saccharomyces cerevisiae. Yeast strains deleted for TEP1 exhibit essentially no phenotype in haploids; however, diploids exhibit resistance to the phosphatidylinositol-3-phosphate kinase inhibitor wortmannin and to lithium ions. Although rates of cancer increase with age, neither tep1 haploids nor diploids have altered life spans. TEP1 RNA is present throughout the cell cycle, and levels are dramatically up-regulated during meiotic development. Although homozygous tep1 mutants initiate the meiotic program and form spores with wild-type kinetics, analysis of the spores produced in tep1 mutants indicates a specific defect in the trafficking or deposition of dityrosine, a major component of yeast spore walls, to the surface. Introduction of a common PTEN mutation found in human tumors into the analogous position in Tep1p produces a nonfunctional protein based on in vivo activity. These studies implicate Tep1p in a specific developmental trafficking or deposition event and suggest that Tep1p, like its mammalian counterpart, impinges on the phosphatidylinositol pathway.

Structure-function relationships in the carboxylic-ester-hydrolase superfamily. Disulfide bridge arrangement in porcine intestinal glycerol-ester hydrolase

CNBr fragments from porcine intestinal glycerol-ester hydrolase were separated by SDS/PAGE under reducing and nonreducing conditions, and their amino-acid sequences were analysed. Two intra-chain disulfide bridges were identified, namely Cys70-Cys99 (loop A) and Cys256-Cys267 (loop B). As the Cys71 sulfhydryl group could not be alkylated with iodoacetamide, it is suggested that the residue is blocked rather than being present in the free form. The two disulfide bridges of intestinal glycerol-ester hydrolase are present in the cholinesterase family, although the enzyme showed only about 35% identity with these proteins. Furthermore, the finding that glycerol-ester hydrolase was partly inactivated under reducing conditions suggests that one or both disulfide bridges are important for the enzyme conformation. Lastly, glycerol-ester hydrolase was also found to hydrolyse cholinergic substrates, although residues Trp86 and Asp74 which are considered to be the main constituents of the 'anionic' subsite responsible for substrate binding in cholinesterases were absent from loop A. Other amino-acid residues in the glycerol-ester hydrolase may therefore be responsible for the binding of cholinergic substrates to the enzyme.

Influence of primary frequencies ratio on distortion product otoacoustic emissions amplitude. I. Intersubject variability and consequences on the DPOAE-gram

Distortion product otoacoustic emissions (DPOAEs) are used widely in humans to assess cochlear function. The standard procedure consists of recording the 2f1-f2 DPOAE amplitude as a function of the f2 frequency, using a fixed f2/f1 ratio (DPOAE-gram), close to 1.20. DPOAE amplitude, as recorded in the DPOAE-gram, shows a wide range of values in normal-hearing subjects, which can impair the predictive value of the DPOAE-gram for hearing thresholds. This study is aimed at comparing intersubject variability in 2f1-f2 DPOAE amplitude according to three paradigms: a fixed f2/f1 ratio, such as the DPOAE-gram, a variable ratio DPOAE-gram (f2/f1 adapted to frequency) and an "optimum" DPOAE-gram, where the f2/f1 is adapted both to subject and frequency. The 2f1-f2 DPOAE amplitude has been investigated on 18 normally hearing subjects at ten different f2 frequencies (from 0.75 to 6 kHz), using an f2 fixed, f1 sweep paradigm, and allowed to define, for each frequency, the f2/f1 ratio giving the greatest 2f1-f2 DPOAE amplitude (or optimum ratio). Results showed a large intersubject variability of the optimum ratio, especially at frequencies below 1.5 kHz, and a significant decrease of the optimum ratio with frequency. The optimum DPOAE-gram was underestimated by up to 5.8 dB on average (up to 14.9 dB for an individual subject) by the fixed ratio DPOAE-gram, and by up to 3 dB on average (up to 10.6 dB for an individual subject) by the variable ratio DPOAE-gram. Intersubject variability was slightly but significantly reduced in the optimum DPOAE-gram versus the fixed-ratio DPOAE-gram. Lastly, correlations between tone-burst evoked otoacoustic emission (TBOAE) amplitudes and maximum DPOAE amplitudes were significantly greater than correlations between TBOAE amplitudes and fixed-ratio DPOAE amplitudes.

Influence of primary frequencies ratio on distortion product otoacoustic emissions amplitude. II. Interrelations between multicomponent DPOAEs, tone-burst-evoked OAEs, and spontaneous OAEs

Distortion product otoacoustic emissions (DPOAEs) are used widely in humans to assess cochlear function. It is well known that 2f1-f2 DPOAE amplitude increases as the f2/f1 ratio increases from 1.0 to about 1.20, and then decreases as the f2/f1 ratio increases above 1.20, showing an amplitude ratio function, which is thought to be related to cochlear filtering properties. Different lower sideband DPOAEs are believed to show the same amplitude ratio functions as the 2f1-f2 DPOAE, with a magnitude peak situated at a constant DPOAE frequency relative to f2. More recently, several studies have suggested the involvement of a DPOAE component coming from its own distortion product place as well as the DPOAE component coming from the f2 place. To investigate DPOAE generation sites and the importance of the DPOAE frequency place, amplitude ratio functions of 2f1-f2, 3f1-2f2, 4f1-3f2 and 2f2-f1, 3f2-2f1, 4f2-3f1 DPOAE components have been systematically studied in 18 normally hearing subjects, using an f2 fixed, f1 sweep method, and an f1 fixed, f2 sweep method, at ten different f2 frequencies. Results show a dependency of the distortion magnitude peak on f2 frequency for each lower sideband DPOAE, and a small frequency shift of the distortion peak for the high order lower sideband DPOAE components. Strong correlation between the different lower sideband DPOAE amplitude were obtained, whether they were recorded with the same f1 (and a different f2) or with the same f2 (and a different f1), suggesting that lower side-band DPOAE amplitude does not depend on small variations in the f2 frequency. Moreover, correlations between DPOAE amplitude and tone-burst evoked otoacoustic emissions (TBOAEs) are highly significant for TBOAEs centered at the f2 frequency and at 1/2 octave below the f2 frequency, suggesting some degree of importance of the cochlear status at frequencies below f2 in DPOAE amplitude. Subjects presenting spontaneous otoacoustic emissions showed a greater lower sideband DPOAE amplitude recorded for low f2/f1 ratios, and a distortion magnitude peak shifted towards higher frequencies. The best correlation between upper sideband DPOAE amplitude and lower sideband DPOAE amplitude occurred for lower sideband DPOAEs generated by an f2 frequency 1/2 octave to 1 octave below the primaries used to generate upper sideband DPOAEs, suggesting a site of generation basal to f2 for the upper sideband DPOAEs. Correlations between TBOAE amplitude and upper sideband DPOAE amplitude agreed with a site of upper sideband DPOAE generation basal to f2, and which would move with the DPOAE frequency itself.

Time course of the medial olivocochlear efferent effect on otoacoustic emissions in humans

The time course of the medial olivocochlear efferent system has been studied in humans, using the suppressive effect of a contralateral broad-band noise (CBBN) on 2f1-f2 distortion product otoacoustic emissions (DPOAE) amplitude. DPOAE were recorded with F2 at 1.5 kHz, with a temporal resolution of 2.6 s, in the presence and absence of a 40 dB SL continuous CBBN, whose duration ranged between 30 s and 20 min. The CBBN suppressive effect on DPOAE amplitude was greatest from the first 2.6 s, and was sustained for 20 min. At the CBBN offset, when the CBBN duration was > or = 2 min, DPOAE amplitude continued to increase for > 1 min, showing an efferent effect outlasting CBBN stimulation.

Purification and molecular cloning of porcine intestinal glycerol-ester hydrolase--evidence for its identity with carboxylesterase

A glycerol-ester hydrolase was purified to homogeneity from porcine intestinal mucosa using a partial delipidation method and an eight-step purification procedure. The isolation scheme used gave a 483-fold purification, resulting in a pure enzyme with a specific activity on tributyrin of 290 micromol x min(-1) x mg(-1). The molecular mass of the enzyme was estimated at 240 kDa, based on the results of size-exclusion chromatography, and at 60 kDa, as determined by SDS/PAGE analysis. The isoelectric focusing data obtained indicated that only one isoform with a pI of 5.1 was present. Complete identity was found to exist between the N-terminal sequence of the first 25 amino acid residues and that of a porcine liver carboxylesterase. A full-length cDNA coding for the enzyme was isolated from pig small intestine. We observed that the corresponding protein originally named intestinal glycerol-ester hydrolase definitely belongs to the carboxylesterase family. The deduced amino acid sequence consisted of 565 residues and showed 97% identity with that of porcine liver carboxylesterase and more than 50% identity with those of other carboxylesterases from different mammalian species.

Comparative quantitative analysis of sucrose and related compounds using ion exchange and reverse phase chromatographic methods

Two analytical methods of sugar determination, namely ion exchange chromatography on an anionic resin coupled with electrochemical detection, and reverse phase chromatography on Nucleosil-NH2 resin equipped with a light scattering detector were tested and compared as regards their rapidity, sensitivity and accuracy with sucrose, fructose, glucose, raffinose, maltose, arabinose, fucose, rhamnose and xylose. Excellent resolution and highly reproducible results were obtained in both cases. Greater sensitivity up to the picomolar range was possible however only with ion exchange chromatography. Reverse phase chromatography was successfully applied to the time course of sucrose hydrolysis under chemical (acid) and enzymatic (invertase) conditions. The hydrolysis was monitored by determining sucrose degradation and the corresponding formation of glucose and fructose.

Multicomponent acoustic distortion product otoacoustic emission phase in humans. I. General characteristics

Phase characteristics and latency of 2f1-f2, 3f1-2f2, and 2f2-f1 acoustic distortion product otoacoustic emissions (DPOAEs) have been analyzed in 12 adults with normal hearing. Phase-versus-frequency functions (PFF) have been recorded at each of ten pairs of primary frequencies, by two methods, depending on which one of the primary frequencies f1 or f2 was swept in frequency. Whichever sweep method was used, local phase irregularities were found in the PFF and were shown to be independent of the phase variability due to the measured noise, to be reproducible and frequency specific. Phase irregularities were significantly greater in subjects exhibiting spontaneous otoacoustic emissions. The latency calculation was unaffected by phase irregularities provided that a suitably large range of f2/f1 ratio was used. The DPOAE latencies that were obtained at low ratios of primaries were significantly longer than those obtained at higher ratios. For all DPOAE components and sweep methods used, the latency decreased as frequency increased from 750 Hz to 6 kHz. Substantial intersubject differences were found. They might be due to two main factors: differences in middle ear acoustic properties and in cochlea mechanical characteristics. The influence of pressure in the outer ear canal increased the DPOAE latencies recorded with both the f1 and f2 sweep methods at low frequencies. Men showed significantly longer 2f2-f1 DPOAE latencies than women, especially at low frequencies, which can be attributed to the difference in length of the cochlea according to gender. Lastly, the latencies measured using the f2 sweep were consistently longer than the latencies obtained using an f1 sweep for lower sideband DPOAEs, but no difference was observed for upper sideband DPOAEs.

Multicomponent acoustic distortion product otoacoustic emission phase in humans. II. Implications for distortion product otoacoustic emissions generation

Phase characteristics and latency of 2f1-f2, 3f1-2f2, and 2f2-f1 acoustic distortion product otoacoustic emissions (DPOAEs) recorded in normally hearing adults have been described in a companion paper [Moulin and Kemp, "Multicomponent acoustic distortion product otoacoustic emission phase in humans. I. General characteristics," J. Acoust. Soc. Am. 100, 1617-1639 (1996)]. Phase-versus-frequency functions (PFF) have been recorded using two methods, depending whether f1 or f2 was swept in frequency, defining, respectively, an "f1 sweep" and an "f2 sweep" method. The present study compares 2f1-f2, 3f1-2f2, 4f1-3f2, and 2f2-f1 DPOAEs phase characteristics, and latencies obtained by these two methods. For lower sideband DPOAEs, the f2 sweep gave consistently longer latencies than the f1 sweep method, whereas no difference was obtained for the 2f2-f1 DPOAE. This suggests that the lower sideband DPOAEs and the 2f2-f1 DPOAE do not come from the same aspect of the traveling wave. The longer delay obtained with an f2 sweep is suggested to be due to an additional delay added by the proximity of the peak of the f2 traveling wave. The place-fixed and the wave-fixed models of DPOAE generation are discussed, and an "intermediate" model of DPOAE generation is introduced to explain such additional delay and the existence of phase irregularities which were observed in the PFF. The ratio of the latencies obtained by the two sweep methods is frequency dependent and a relation to cochlear frequency selectivity is suggested. Finally, analysis of the differences in latency of the different lower sideband DPOAE components allowed an estimation of the return latency of DPOAEs.

Lipases of the euphorbiaceae family: purification of a lipase from Euphorbia characias latex and structure-function relationships with the B chain of ricin

A lipase from the latex of Euphorbia characias was purified using a method involving extraction with apolar solvent and adsorption chromatography on silica gel. The lipase (specific activity, 1500 international units/mg of protein) was eluted from silica gel complexes with a lipid. The main protein fraction, which had a molecular mass of 38 kDa, was inactive when dissociated from the lipid fraction. When the lipid and protein fractions were reassociated, 72% of the lipolytic activity was recovered. This lipolytic activity was inhibited by diethyl p-nitrophenyl phosphate, which was shown to bind the lipase with a molar ratio of 0.75. High specific activities (1000 international units/mg) were measured for the lipase of E. characias on lipid extracts rich in galactosyl diacylglycerols. The apolipase was sequenced up to residue 23. The B chain of ricin has a strong homology (43.5%) with that sequence and cross-reacted with antibodies raised against the purified lipase from E. characias. The activity of the B chain of ricin was comparable (54 international units/mg) to that of the apolipase of E. characias (100 international units/mg) mixed with the same lipid cofactor complex. The primary structure (residues 68-72) of the B chain of ricin contains the lipase consensus sequence Gly-Xaa-Ser-Xaa-Gly. Its reactivity with diethyl p-nitrophenyl phosphate indicates the presence of an activated serine that, in addition to its well-documented lectin activity for galactosides, suggests that the B chain of ricin may be a galactosyl diacylglycerol lipase, closely analogous to the lipase from E. characias.

Distortion product otoacoustic emissions and sensorineural hearing loss

As other types of otoacoustic emissions, distortion product otoacoustic emissions (DPOAEs) allow the exploration of the active cochlear mechanisms known to take place in the outer hair cell system. Most authors consider that 2f1-f2 DPOAEs are generated in a cochlear region corresponding to the geometric mean (GM) of the primary frequencies. To verify the relevance of this hypothesis in clinical practice, DPOAEs were recorded at seven different frequencies, ranging from 0.5 to 4 kHz, in 81 hearing-impaired patients and in 24 normally hearing subjects. To test the hypothesis that DPOAEs reflect the hearing threshold at the frequency of the GM rather than at the 2f1-f2 frequency, this study compares the 2f1-f2 frequency and the GM of the primaries to the frequency of hearing loss. DPOAEs can be used to explore a large range of frequencies, especially at high frequencies, but responses at low frequencies are less reliable due to noise contamination. Secondly, DPOAEs can be recorded in ears that have a hearing threshold as high as 65 dB HL at the frequency corresponding to the GM of the primaries. Finally, DPOAE recordings show frequency specificity: i.e., hearing loss at a specific frequency correlates best with DPOAEs whose GM of primary frequencies corresponds to the frequency of the hearing loss. However, this frequency specificity is still unsatisfactory and decreases as the levels of primaries increase above 60 dB SPL. Moreover, DPOAE amplitude is too variable to predict hearing loss at a particular frequency, whereas DPOAE threshold allows a correct prediction of abnormal auditory threshold in more than 80% of the cases at frequencies above 1 kHz.

High-performance liquid chromatographic determination of oxodipine enantiomers, a new 1,4-dihydropyridine, applied to stereoselectivity studies in man and dog

A specific and reproducible HPLC method using a Chiral-AGP column and UV detection was developed for the evaluation of the pharmacokinetic profile of oxodipine enantiomers in dog and man. Each enantiomer was determined in plasma in the concentration range 1-400 ng/ml using the internal standard calibration method with linear regression analysis. After extraction of oxodipine and the internal standard at alkaline pH with diethyl ether-n-hexane (50:50, v/v), this method permitted the determination of each enantiomer at levels down to 10 ng/ml in dog plasma and 25 ng/ml in human plasma with sufficient accuracy (relative error < 11%, n = 6) and precision (coefficient of variation < 16%, n = 6). The extracted plasma volume was 500 microliters and after evaporation of the organic phase, the dry residue was dissolved in 100 microliters of water-2-propranol; an aliquot of 80 microliters was injected into the HPLC system.

Contralateral auditory stimulation and otoacoustic emissions: a review of basic data in humans

The influence of contralateral auditory stimulation on otoacoustic emissions (OAE), spontaneous OAE, evoked OAE and acoustic distortion products, can be summarized as follows: (1) alteration (mainly a decrease) of OAE amplitude; (2) alteration of response spectrum (upward shift frequency of SOAE); (3) alteration of phase; (4) effect dependent on intensity of contralateral stimulation; (5) effect inversely dependent on intensity of ipsilateral stimulation; (6) frequency specificity of the suppressive effect. Involvement of the medial olivocochlear bundle is highly probable but one cannot exclude a double pathway including also the acoustic reflex.

Is the test of medial efferent system function a relevant investigation in tinnitus?

The present results are drawn from preliminary observations made in 28 patients suffering from unilateral, permanent, non-pulsatile tinnitus, who were systematically submitted to an investigation of their otoacoustic emissions in both ears. Spontaneous otoemissions (SOAE) were carefully looked for, before recording of transient evoked otoemissions (TEOAE). The effectiveness of the medial olivo-cochlear efferent system (MOC) was also tested. The comparison between TEOAE input/output curves obtained with and without contralateral stimulation allowed a global assessment of the functioning of MOC. Additional information relating to the MOC functioning at the precise frequency of tinnitus and/or around it, was available from the comparison of analogous curves obtained using distortion product otoacoustic emissions (DPOAE) instead of TEOAEs. The results show that: (1) when the amplitude of otoacoustic emissions differs between the two ears, the tinnitus is generally lateralized on the side where amplitude was the lowest, which seems to be related to a greater hearing loss; (2) no general law concerning tinnitus can be drawn from the global testing of MOC functioning; the only result is that the slope of TEOAE input/output function appears as a deciding factor for efficiency of MOC, the least efficiency almost always occurring on the side where the slope is greater, and (3) even in the case of proved global effectiveness of MOC activation, there is, at least in the vicinity and in at least one ear, a part of the cochlea where its functioning is altered. A better comprehension of the mechanisms underlying this symptom will probably come from exhaustive exploration of individual cases rather than a rougher investigation of large samples in which different aetiologies are likely to be mixed.

Evoked and spontaneous otoacoustic emissions. A comparison of neonates and adults

Evoked otoacoustic emissions (EOAEs) and spontaneous otoacoustic emissions (SOAEs) were compared between neonates and adults. Several differences were seen for EOAEs: (i) the occurrence of EOAEs was significantly greater in adults than in neonates, and in neonates it increased with extra-uterine age; (ii) the high frequency EOAE intensity was greater in neonates than in adults; (iii) the EOAE intensity was significantly greater in neonates than in adults. No age-related differences for SOAEs were found: (i) age was not significantly related to the presence/absence of SOAEs in neonates or adults; (ii) the occurrence of SOAEs was, however, significantly greater in females than in males in both neonates and adults.

Effect of contralateral sound stimulation on the distortion product 2f1-f2 in humans: evidence of a frequency specificity

The frequency characteristics of the suppression by contralateral stimulations, of the cubic 2f1-f2 distortion products (DPOAEs), were studied during 63 sessions performed in 39 humans with normal hearing. Each session consisted of exposure to five successive series of randomized contralateral NBN frequencies centered between 0.25 and 8 kHz, while measuring 2f1-f2 set at one of the four studied frequencies, i.e., 1, 2, 3 or 5 kHz. For each value of 2f1-f2, analysis of variance and Student's t-test were used in order to indicate and, if necessary, to localize, a possible significant frequency specificity. Results showed that the suppression exerted on 2f1-f2 DPOAEs by contralateral sound stimulation, is frequency specific, at least for middle frequencies of 1 and 2 kHz. The frequency specificity is specially marked when 2f1-f2 = 1 kHz with contralateral NBN central frequencies around 1 kHz. When 2f1-f2 = 2 kHz, central frequencies which induced a significant suppressive effect include frequencies around 2 kHz and also lower frequencies around 1 kHz. These observations support the interpretation that the suppression of the DPOAE is mediated by the medial olivo-cochlear efferent system.

Interrelations between transiently evoked otoacoustic emissions, spontaneous otoacoustic emissions and acoustic distortion products in normally hearing subjects

Active cochlear mechanisms and especially outer hair cells seem to be involved in oto-acoustic emissions (OAEs) genesis. This study sought to investigate basic characteristics of spontaneous otoacoustic emissions (SOAEs), click-evoked otoacoustic emissions (TOAEs) and interrelations between SOAEs, TOAEs and 2f1-f2 and 2f2-f1 distortion product OAEs (DPOAEs) in 135 normally hearing subjects. A gender effect was shown on TOAEs and DPOAEs amplitude, and is attributed to the higher incidence of SOAEs in women (58%) than in men (22%). Moreover, SOAEs presence seems to mask the age effect found, especially at high frequency components, on TOAEs amplitude. A general influence of SOAEs on TOAEs and DPOAEs is shown, especially at frequencies ranging from 1 kHz to 3 kHz, collecting more than 66% of the SOAEs peaks recorded. Lastly, correlations between TOAEs frequency band amplitude and 2f1-f2 DPOAEs amplitude, shows frequency specificity, at least at low frequencies (i.e., from 0.5 to 2 kHz) in agreement with previous works suggesting that the 2f1-f2 DPOAEs generation site is at the geometric mean of the primaries. The same correlations calculated with 2f2-f1 DPOAEs amplitude show frequency specificity at low frequencies i.e., at 800 Hz and 1600 Hz. 2f2-f1 DPOAEs in humans are shown to be generated near the 2f2-f1 frequency region on the cochlear partition.

Contralateral auditory stimulation alters acoustic distortion products in humans

It is now generally accepted that otoacoustic emissions (OAE) represent the only objective and non-intrusive means of functional exploration of the active micromechanical characteristics of the outer hair cells of the organ of Corti. Previous studies showed a decrease of the transiently evoked otoacoustic emissions and spontaneous otoacoustic emissions in humans, during acoustic stimulation of the contralateral ear, and attributed this effect to the medial efferent system. Such an effect has been shown on acoustic distortion product otoacoustic distortion emissions (DPOAE) in guinea pigs, but has not been investigated for DPOAEs recorded in humans, although DPOAEs represent the easiest means of exploring active micromechanical cochlear properties both in humans and in laboratory animals. The present study sought to investigate the existence and characteristics of a contralateral auditory stimulation effect on DPOAEs recorded in humans. This study shows that contralateral broad-band noise (BBN) has a suppressive effect on DPOAEs recorded from 0.5 kHz to 5 kHz. This effect is not due to air conduction, as no change in the noise floor occurred under increasing contralateral stimulation, and as no reduction in DPOAE amplitude was obtained in subjects whose contralateral ear was sealed with a plastic ear plug. Moreover, cross-over attenuation by bone transmission has been ruled out, as no change in DPOAE amplitude was recorded in the healthy ear of total unilaterally deaf patients during acoustic stimulation of the deaf ear. The effect seen was not entirely due to the acoustic reflex, as it was found and could indeed be even greater in subjects with no acoustic reflex. Results presented here show that the contralateral BBN effect is greater at low levels of ipsilateral stimulation, which leads us to discuss the involvement of both passive and active mechanisms in DPOAE generation at high stimulation levels. The contralateral BBN effect seems to be greater in mid frequency cochlear regions. There is strong evidence that the medial efferent system is involved and that afferent and efferent inputs are, at least partly, integrated at a brainstem level in order to ensure cochlear interaction. DPOAEs provide an interesting model for functional exploration of the efferent system, since they seem to be the only type of otoacoustic emission that can be recorded in both humans and in the majority of animals, and since results are obtained in the same way from both animals and humans, which allows experimental animal models very close to the human model.

Influence of spontaneous otoacoustic emissions (SOAE) on acoustic distortion product input/output functions: does the medial efferent system act differently in the vicinity of an SOAE?

Otoacoustic emission (OAE) generation mechanisms reside in the active micromechanical properties of the organ of Corti, and especially in the outer hair cells (OHCs). OHCs are strongly innervated by medial efferent olivo-cochlear fibres. Decrease of the intensity of transiently evoked otoacoustic emissions (TOAEs) and modification of spontaneous otoacoustic emissions (SOAEs) during acoustic stimulation of the contralateral ear have already been shown in humans. Similar results were obtained in guinea pigs with a decrease of 2F1-F2 acoustic distortion products (DPOAEs) and a suppression of the effect with sectioning of the floor of the fourth ventricle. The present study sought to investigate the influence of contralateral auditory stimulation on DPOAEs recorded in humans. It shows a decrease in DPOAE intensity for all frequencies, at levels above 45 dB SPL of contralateral broad band noise. This effect was found at levels of contralateral BBN well below the acoustic reflex threshold, and in subjects without acoustic reflex. Moreover, the influence of transcranial transmission could be ruled out since no effect was found when contralateral BBN applied to the altered ear of totally unilaterally deaf patients. Thus, the contralateral acoustic stimulation effect on DPOAEs provides a new means of functional exploration of the medial efferent system in humans. The effect obtained is more ample at low primary frequency levels. Moreover, as DPOAEs are known to be stronger and to show more irregular input/output function patterns in the vicinity of an SOAE, the influence of contralateral auditory stimulation was studied for DPOAEs recorded at 10 Hz, 50 Hz and 150 Hz from an SOAE frequency.

Inactivation of gastric and pancreatic lipases by diethyl p-nitrophenyl phosphate

Reacting gastric and pancreatic lipases with mixed diethyl p-nitrophenyl phosphate/bile salt micelles resulted in a stoichiometric inactivation of these enzymes as tested on emulsified tributyroylglycerol and trioleoylglycerol as substrates. Diethyl p-nitrophenyl phosphate treated gastric lipases were also inactive on water-soluble p-nitrophenyl acetate, whereas the modified pancreatic lipase was still able to hydrolyze this water-soluble substrate. The binding of diethyl p-nitrophenyl phosphate modified pancreatic and gastric lipases to tributyroylglycerol/water interface was comparable to that of native lipases. The essential free sulfhydryl group of gastric lipases underwent no chemical changes due to the reaction with micellar diethyl p-nitrophenyl phosphate. All in all, these results indicate that, in both gastric and pancreatic lipases, the essential serine residue which was stoichiometrically labeled by this organophosphorus reagent is involved in catalysis and not in lipid binding.

Spontaneous otoacoustic emissions and sensori-neural hearing loss

This study sought to clarify the clinical relevance of spontaneous otoacoustic emissions (SOAEs) and to define the hearing loss level (and frequency) at which absence of SOAE is found. Findings from 126 ears of patients with sensori-neural hearing loss showed an incidence of SOAEs in 18.25% of the cases (23 out of 126 ears). SOAEs were never found when hearing loss at 1,000 Hz exceeded 10 dB. The presence of SOAE seems to indicate a good cochlear functioning at least in the mid-frequencies. Although the incidence of SOAEs is markedly lower than that of evoked otoacoustic emissions (EOAEs), SOAE recording is shown to be a good test, rapid, non-invasive for audiological screening, the presence of SOAE confirming a hearing threshold of less than 10 dB at 1,000 Hz, the absence of SOAE being inconclusive.