Hearing outcome after tympanoplasty type III.

PURPOSE: We assessed overall hearing outcome after tympanoplasty type III in chronically infected ears with cholesteatoma (CH) and without cholesteatoma: otitis media chronica mesotympanalis, tympanosclerosis, and adhesive process (COM_T_AP). METHODS: 303 surgeries were evaluated: 229 CH-group and 74 COM_T_AP-group. Air-bone gaps (PTA-ABG) with pure-tone averages (PTA-4) at four frequencies (0.5, 1, 2 and 4 kHz) were compared preoperatively, early postoperatively (< 40 days) and late postoperatively (40-400 days). Hearing outcome was compared in various types of middle-ear reconstruction and in smokers and non-smokers. Correlations between hearing outcome and predictive staging indices were evaluated: Middle Ear Risk-Index (MER-I) and Ossiculoplasty Outcome Parameter Staging-Index (OOPS-I). RESULTS: Mean PTA-ABG in the CH-group increased from 20.9 ± 11.3 dB to 22.3 ± 10.4 dB early postoperatively and decreased significantly to 19.2 ± 10.1 dB late postoperatively. Mean PTA-ABG in the COM_T_AP-group decreased significantly from 27.3 ± 10.9 dB to 20.6 ± 10.9 dB early postoperatively and decreased to 20.0 ± 12.2 dB late postoperatively. No significant difference was seen between PTA-ABG-closures of partial or total ossicular replacement prosthesis (PORP/TORP) and cartilage ossiculoplasty in the CH-group. Patients receiving TORP showed a significantly higher preoperative PTA-ABG. All reconstruction types exhibited postoperative PTA-ABG around 20 dB. In the COM_T_AP-group, smokers had a significantly higher mean PTA-ABG early postoperatively; this equalized with that of non-smokers late postoperatively. PTA-ABG-closures and MER-I or OOPS-I were not significantly correlated. CONCLUSION: Tympanoplasty type III maintains hearing in patients with cholesteatoma and significantly improves hearing in chronically inflamed ears without cholesteatoma. All investigated ossicular replacement prostheses are equally beneficial. Healing postoperatively takes longer in smokers, but they eventually catch up with non-smokers.

The combined effect of cycling cadence and crank resistance on hamstrings and quadriceps muscle activities during cycling.

The effect of cycling cadence and crank resistance on the activity of hamstrings and quadriceps muscles was investigated during cycling movements of able-bodied subjects on a stationary bike with slow and fast speed against different resistance conditions. The ratio of average EMG amplitudes obtained in the two speed conditions (fast/slow) was computed in each resistance condition. This ratio is higher for both muscles if cycling against higher resistance. This shows that in higher resistance condition muscle activities are not only increased but the change of muscle activities with respect to cadence change varied according to resistance condition. Average EMG amplitudes increased at a higher rate with respect to change of cadence when cycling was performed in higher resistance condition. Besides, when cycling faster, hamstrings activity increased generally at a higher rate than that of quadriceps. The correlation between cadence and EMG amplitudes were also investigated. Considering hamstrings, this correlation was low and decreased as resistance increased. The correlation between the time required to drive one cycle and EMG amplitude is negative but in absolute value it is larger than the correlation of cadence and EMG amplitude.

Catecholamine utilization in specific rat brain nuclei after short-term hyperprolactinaemia.

Endogenous hyperprolactinaemia was induced in intact male rats by transplantation of pituitaries under the kidney capsule. Five days later the utilization of noradrenaline (NA) and dopamine (DA) in individual brain nuclei and changes of plasma prolaction (PRL) were measured. Inhibition of catecholamine synthesis by alpha-methyl-p-tyrosine (alpha-MPT) was used to measure utilization. Hyperprolactinaemia increased the utilization of NA in the locus coeruleus, the cell-body region of the dorsal noradrenergic bundle (DNB), but decreased it in some terminal projections of the same pathway (e.g. the cingulate gyrus). DA utilization was increased by hyperprolactinaemia in the eminentia mediana. In the nigrostriatal DA-ergic projection, hyperprolactinaemia decreased the utilization of DA in the cell-body region (substantia nigra) and increased it in the terminal projection (nucleus caudatus). In the ventral tegmental area (mesolimbic DA-ergic projection), hyperprolactinaemia decreased the utilization of DA. It is concluded that hyperprolactinaemia affects neurotransmission in the hypothalamus and also in specific extrahypothalamic pathways (e.g. DNB, nigrostriatal and mesolimbic DA-ergic projections) and that these changes may correlate with some behavioural effects of the pituitary hormone.

Catecholamine utilization in distinct mouse brain nuclei during acute morphine treatment, morphine tolerance and withdrawal syndrome.

The steady-state levels and utilization (alpha-MPT-induced disappearance) of noradrenaline (NA) and dopamine (DA) were measured in distinct mouse brain nuclei after acute morphine challenge, in mice rendered tolerant to morphine, and during the naloxone-precipitated morphine withdrawal syndrome. Mouse brain nuclei containing mainly the cell body areas and some terminal projections of major NA- and DA-containing pathways were selected (nucleus tractus solitarii, locus coeruleus, substantia nigra, area tegmentalis ventralis and nucleus caudatus, nucleus accumbens, gyrus dentatus hippocampi, nucleus raphe dorsalis respectively). Acute morphine treatment reduced the utilization of NA in all brain nuclei but the substantia nigra. In morphine-tolerant mice, all changes characteristic for acute morphine treatment disappeared. Instead, an increased NA utilization was observed in the nucleus tractus solitarii and the area tegmentalis ventralis in the tolerant animals. During morphine withdrawal, an abrupt decrease was observed in the utilization of NA in the nucleus tractus solitarii, whereas the NA utilization in the gyrus dentatus abruptly increased, as compared to the tolerant state. Acute morphine challenge decreased the utilization of DA in the nucleus caudatus, locus coeruleus and nucleus raphe dorsalis. In the tolerant mouse, an increased utilization of DA was observed in the nucleus tractus solitarii. During morphine withdrawal, DA utilization was decreased in the substantia nigra and the area tegmentalis ventralis, while in the nucleus accumbens withdrawal resulted in an increase of DA utilization. The data suggest that acute effects of morphine as well as morphine tolerance/dependence are accompanied by, and likely to be associated with, distinct changes in the catecholamine metabolism of specific mouse brain nuclei.

Influence of Z-Prolyl-D-Leucine on alpha-MPT-induced catecholamine utilization in specific mouse brain nuclei.

The synethetic dipeptide Z-Prolyl-D-Leucine (Z-Pro-D-Leu) inhibits the development of tolerance to and dependence on morphine in mice. The possible mode of action of the dipeptide was studied by measuring the alpha-MPT-induced disappearance of noradrenaline (NA) and dopamine (DA) either by a spectrofluorimetric assay in major brain areas (lower brainstem, striatum) or by a radioenzymatic assay in specific brain nuclei. For the latter purpose, mouse brain nuclei containing mainly the cell body areas (nucl. tractus solitarii, locus coeruleus, substantia nigra, area tegmentalis ventralis) or some selected terminal projections (nucl. caudatus, nucl. accumbens, gyrus dentatus hippocampi, nucl. raphe dorsalis) of major NA- and DA-containing pathways were selected. In the lower brainstem studied as a whole, the dipeptide did not affect the utilization of either NA or DA. Analysis of the data on the NA utilization in specific brain nuclei, however, revealed that the dipeptide affected NA disappearance in some mesencephalic-limbic nuclei which receive noradrenergic innervation from the dorsal noradrenergic bundle (e.g., nucl. raphe dorsalis, area tegmentalis ventralis, gyrus dentatus). NA utilization in the cell body region of the same pathway (locus coeruleus), however, was not affected by the dipeptide. The dipeptide facilitated DA utilization in the main terminal area of the mesolimbic DA-ergic projection (nucl. accumbens), whereas the same treatment inhibited DA utilization in the main terminal region of the nigro-striatal DA-ergic pathway (nucl. caudatus). The data suggest that localized changes in NA and DA utilization following Z-Pro-D-Leu might be important for peptide-induced changes in morphine tolerance and dependence.