Reconstruction of transverse-longitudinal vibrations in the organ of Corti complex via optical coherence tomography.

Optical coherence tomography (OCT) is a common modality for measuring vibrations within the organ of Corti complex (OCC) in vivo. OCT's uniaxial nature leads to limitations that complicate the interpretation of data from cochlear mechanics experiments. The relationship between the optical axis (axis of motion measurement) and anatomically relevant axes in the cochlea varies across experiments, and generally is not known. This leads to characteristically different motion measurements taken from the same structure at different orientations. We present a method that can reconstruct two-dimensional (2-D) motion of intra-OCC structures in the cochlea's longitudinal-transverse plane. The method requires only a single, unmodified OCT system, and does not require any prior knowledge of precise structural locations or measurement angles. It uses the cochlea's traveling wave to register points between measurements taken at multiple viewing angles. We use this method to reconstruct 2-D motion at the outer hair cell/Deiters cell junction in the gerbil base, and show that reconstructed transverse motion resembles directly measured transverse motion, thus validating the method. The technique clarifies the interpretation of OCT measurements, enhancing their utility in probing the micromechanics of the cochlea.

Accuracy of Caudocranial Canine Femoral Radiographs Compared to Computed Tomography Multiplanar Reconstructions for Measurement of Anatomic Lateral Distal Femoral Angle.

OBJECTIVE: This study aimed to compare the accuracy of sternal recumbency caudocranially obtained radiographs of canine femora to computed tomographic (CT) frontal plane reconstructions of the same femora for assessing anatomic distal lateral femoral angles (aLDFA). STUDY DESIGN: Multicentre, retrospective study utilizing 81 matched radiographic and CT studies of clinical patients undergoing assessment for various issues were reviewed. Anatomic lateral distal femoral angles were measured, and accuracy assessed with descriptive statistics and Bland-Altman plot analysis, with CT considered the reference standard. Sensitivity and specificity of a cut-off for measured aLDFA (102 degrees) were determined to assess radiography as a screening tool for significant deformity. RESULTS: Radiographs on average overestimated aLDFA by 1.8 degrees compared to CT. Bland-Altman analysis identified a 15.4 degrees 95% limit of agreement range and a tendency for greater overestimation at higher average measured value. Radiographic measurement of aLDFA of 102 degrees or less had a 90% sensitivity, 71.83% specificity, and 98.08% negative predictive value for the CT measurement being less than 102 degrees. CONCLUSION: Accuracy of aLDFA measurement by caudocranial radiographs does not demonstrate sufficient accuracy when compared to CT frontal plane reconstructions with unpredictable differences. Radiographic assessment is a useful screening tool to exclude animals with a true aLDFA of greater than 102 degrees with a high degree of certainty.

Repair of Retracted Hamstring Tears with Hamstring Pulley Technique and Inferomedial Portal.

Endoscopic repair of hamstring tears is well described in the literature, but endoscopic management for significantly retracted hamstring tears is not well described. Currently, repairing a hamstring tendon that has retracted 8 cm or more from the footprint on the ischial tuberosity is performed as an open procedure. The technique described here details endoscopic repair of retracted hamstring tears using a suture pulley mechanism and an inferomedial portal.

Using volumetric optical coherence tomography to achieve spatially resolved organ of Corti vibration measurements.

Optical coherence tomography (OCT) has become a powerful tool for measuring vibrations within the organ of Corti complex (OCC) in cochlear mechanics experiments. However, the one-dimensional nature of OCT measurements, combined with experimental and anatomical constraints, make these data ambiguous: Both the relative positions of measured structures and their orientation relative to the direction of measured vibrations are not known a priori. We present a method by which these measurement features can be determined via the use of a volumetric OCT scan to determine the relationship between the imaging/measurement axes and the canonical anatomical axes. We provide evidence that the method is functional by replicating previously measured radial vibration patterns of the basilar membrane (BM). We used the method to compare outer hair cell and BM vibration phase in the same anatomical cross section (but different optical cross sections), and found that outer hair cell region vibrations lead those of the BM across the entire measured frequency range. In contrast, a phase lead is only present at low frequencies in measurements taken within a single optical cross section. Relative phase is critical to the workings of the cochlea, and these results emphasize the importance of anatomically oriented measurement and analysis.

Calculating Intraoperative Fluid Deficit to Prevent Abdominal Compartment Syndrome in Hip Arthroscopy.

Abdominal compartment syndrome (ACS) is a rare but potentially fatal complication that can occur during hip arthroscopy. This usually occurs as a result of arthroscopic fluid passing into the retroperitoneal space through the psoas tunnel. From the retroperitoneal space, the fluid can then enter the intraperitoneal space through defects in the peritoneum. Previous studies have identified female sex, iliopsoas tenotomy, pump pressure, and operative time as potential risk factors for fluid extravasation. We present a method to measure intraoperative fluid deficit during hip arthroscopy to alert surgeons to possible ACS. Our proposed technique requires diligent intraoperative monitoring of fluid output through various suction devices, including suction canisters, puddle vacuums, and suction mats. The difference is then calculated from the fluid intake from the arthroscopic fluid bags. If the difference is greater than 1500 mL, then the anesthesiologist and circulating nurse are instructed to examine the abdomen for distension every 15 minutes. This, combined with other common symptoms such as hypotension and hypothermia, should alert the surgical team to the development of ACS. Despite limitations to this technique, this approach offers an objective method to calculate intra-abdominal fluid extravasation.

A role for tectorial membrane mechanics in activating the cochlear amplifier.

The mechanical and electrical responses of the mammalian cochlea to acoustic stimuli are nonlinear and highly tuned in frequency. This is due to the electromechanical properties of cochlear outer hair cells (OHCs). At each location along the cochlear spiral, the OHCs mediate an active process in which the sensory tissue motion is enhanced at frequencies close to the most sensitive frequency (called the characteristic frequency, CF). Previous experimental results showed an approximate 0.3 cycle phase shift in the OHC-generated extracellular voltage relative the basilar membrane displacement, which was initiated at a frequency approximately one-half octave lower than the CF. Findings in the present paper reinforce that result. This shift is significant because it brings the phase of the OHC-derived electromotile force near to that of the basilar membrane velocity at frequencies above the shift, thereby enabling the transfer of electrical to mechanical power at the basilar membrane. In order to seek a candidate physical mechanism for this phenomenon, we used a comprehensive electromechanical mathematical model of the cochlear response to sound. The model predicts the phase shift in the extracellular voltage referenced to the basilar membrane at a frequency approximately one-half octave below CF, in accordance with the experimental data. In the model, this feature arises from a minimum in the radial impedance of the tectorial membrane and its limbal attachment. These experimental and theoretical results are consistent with the hypothesis that a tectorial membrane resonance introduces the correct phasing between mechanical and electrical responses for power generation, effectively turning on the cochlear amplifier.

Control of hearing sensitivity by tectorial membrane calcium.

When sound stimulates the stereocilia on the sensory cells in the hearing organ, Ca2+ ions flow through mechanically gated ion channels. This Ca2+ influx is thought to be important for ensuring that the mechanically gated channels operate within their most sensitive response region, setting the fraction of channels open at rest, and possibly for the continued maintenance of stereocilia. Since the extracellular Ca2+ concentration will affect the amount of Ca2+ entering during stimulation, it is important to determine the level of the ion close to the sensory cells. Using fluorescence imaging and fluorescence correlation spectroscopy, we measured the Ca2+ concentration near guinea pig stereocilia in situ. Surprisingly, we found that an acellular accessory structure close to the stereocilia, the tectorial membrane, had much higher Ca2+ than the surrounding fluid. Loud sounds depleted Ca2+ from the tectorial membrane, and Ca2+ manipulations had large effects on hair cell function. Hence, the tectorial membrane contributes to control of hearing sensitivity by influencing the ionic environment around the stereocilia.

Coupling and elastic loading affect the active response by the inner ear hair cell bundles.

Active hair bundle motility has been proposed to underlie the amplification mechanism in the auditory endorgans of non-mammals and in the vestibular systems of all vertebrates, and to constitute a crucial component of cochlear amplification in mammals. We used semi-intact in vitro preparations of the bullfrog sacculus to study the effects of elastic mechanical loading on both natively coupled and freely oscillating hair bundles. For the latter, we attached glass fibers of different stiffness to the stereocilia and observed the induced changes in the spontaneous bundle movement. When driven with sinusoidal deflections, hair bundles displayed phase-locked response indicative of an Arnold Tongue, with the frequency selectivity highest at low amplitudes and decreasing under stronger stimulation. A striking broadening of the mode-locked response was seen with increasing stiffness of the load, until approximate impedance matching, where the phase-locked response remained flat over the physiological range of frequencies. When the otolithic membrane was left intact atop the preparation, the natural loading of the bundles likewise decreased their frequency selectivity with respect to that observed in freely oscillating bundles. To probe for signatures of the active process under natural loading and coupling conditions, we applied transient mechanical stimuli to the otolithic membrane. Following the pulses, the underlying bundles displayed active movement in the opposite direction, analogous to the twitches observed in individual cells. Tracking features in the otolithic membrane indicated that it moved in phase with the bundles. Hence, synchronous active motility evoked in the system of coupled hair bundles by external input is sufficient to displace large overlying structures.