Michiro Kawakami

Autoregulation of cochlear blood flow

SummaryThe cochlear blood flow of healthy adult guinea pigs was measured with a laser Doppler flowmeter and flow dynamics were anaylzed on the basis of autoregulation. Angiotensin Il infusion was used to raise blood pressure, while phlebotomy was done to lower blood pressure. The characteristics of autoregulation of cerebral blood flow and muscular blood flow were also investigated. Cochlear blood flow was considered to have some autoregulation but was less than brain blood flow, which showed significant regulation. Muscular blood flow seemed to have no similar regulatory mechanism.

Effect of Lidocaine Injection on EOAE in Patients with Tinnitus

In the present study, evoked otoacoustic emissions (EOAEs) were measured in 30 patients with tinnitus before and after intravenous lidocaine injection (1 mg/kg). For EOAE recordings, 1 kHz tone burst stimuli were used. Intravenous lidocaine injection resulted in suppression of tinnitus in 22 (73%) ears, and changes of EOAE amplitude (increase or decrease) in 18 (60%) ears. Of the 18 ears with EOAE amplitude changes, tinnitus disappeared or decreased in 17 (94%) ears. In 12 ears without changes of EOAE amplitude, tinnitus was suppressed in only 5 (42%). Changes in latency were not detected in any of the ears. These results indicate that there is a relationship between the effect of lidocaine in tinnitus suppression and changes in cochlear micromechanics caused by lidocaine.

Observations of cochlear blood flow dynamics using the laser Doppler flowmeter.

SummaryThe cochlear blood flow of normal adult guinea pigs was measured by a laser Doppler flowmeter. The validity of this flowmeter was ascertained by its specificity for blood flow and its sensitivity to blood flow changes. Angiotensin II was infused into the animals and asphyxia was induced. The responses of the cochlear blood flow showed a close correlation with those of the systolic blood pressure. These results suggest a passive aspect in the physiology of cochlear blood circulation. On the other hand, there was a negative correlation between the responses of auricular skin blood flow and those of systolic blood pressure to a certain dose range of angiotensin II. To clarify the specific details of inner ear blood flow, further studies of the hemodynamics of the inner ear blood circulation should be continued under various experimental conditions.

The effect of batroxobin on cochlear blood flow.

Cochlear blood flow is considered to be closely related to cochlear function. Among several etiologic factors implicated in inner ear diseases, disturbance of local blood flow is held to be one of the most important. With this in view, various pharmaceuticals are currently being used to increase local blood flow in patients with inner ear diseases. In the control of blood flow there are three major factors; systemic blood pressure (perfusion pressure), vascular tone, and blood viscosity. Batroxobin (BX) was developed to increase local blood flow by lowering blood viscosity through defibrinogenation; it is used in the treatment of thrombosis and occasionally for the treatment of sudden deafness. In the present study, we observed the effect of BX on cochlear blood flow in guinea pigs, using a laser Doppler flowmeter, and measured the blood fibrinogen concentration after BX infusion. There was an obvious increase in cochlear blood flow during the observation period of 3 h after 10 BU/kg were infused, and a slight increase when 2 BU/kg were infused. Blood fibrinogen levels decreased dramatically by 30 min after BX infusion (10 BU/kg), and the extremely low level attained was maintained throughout the 3-h observation period. Hemorrhage from the surgically opened ear was noted in 2 animals during the experiment and rectal bleeding in one.

Relationship between cochlear blood flow and perilymphatic oxygen tension.

SummaryTo clarify the characteristics of the blood circulation in the cochlea, we correlated cochlear blood flow and perilymphatic oxygen tension at various blood pressures. Cochlear blood flow was measured in guinea pigs by laser Doppler flowmetry, and perilymphatic oxygen tension by polarography. Blood pressure changes were induced by angiotensin II injection, trimetaphan camsylate injection and blood withdrawal. Cochlear blood flow generally paralleled systemic blood pressure, indicating a close correlation. In contrast, perilymphatic oxygen tension was slower to increase and decrease. However, when systemic blood pressure was lowered more gradually, perilymphatic oxygen tension did not show the same lag. These findings indicate that perilymphatic oxygen tension parallels systemic blood pressure when changes induced are slower and in a physiological range.

Effects of Hyperventilation and Hypoventilation on Cochlear Blood Flow and Endocochlear Direct-Current Potential

To understand the importance of oxygen transport to the inner ear tissue, we studied, in guinea pigs, the relationship between cochlear blood flow and endocochlear direct-current potential (EP) under different respiratory conditions. EP, a functional parameter of the stria vascularis, was recorded by a microelectrode inserted into the lateral wall of the chochlea. To measure the cochlear blood flow (CoBF), we employed laser Doppler flowmetry and recorded the flow with a probe placed on the same spot on the lateral wall. During 3 min of asphyxia, CoBF and systemic blood pressure showed irregular biphasic increases, while the EP decreased to reach a negative value. In the hypoxemia experiment, which was induced by stepwise reduction of the respiratory rate to 60%, increases in CoBF and blood pressure were evident during hypoventilation with an intermediate position of EP in the positive range. The mechanisms of these increases in two parameters are discussed from the viewpoints of sympathicotonic activity in the autonomic nervous system and the vasodilating action of CO2 during hypercapnia. In the hyperoxemia experiment, which was induced by stepwise increase in the respiratory rate to 140%, CoBF and blood pressure were found to decrease during hyperventilation with no significant change of EP. The decrease in blood pressure was considered to be due to the increase in intrathoracic pressure caused by the increased rate of artificial respiration. As for the concomitant decrease in CoBF, chemical regulation of PCO2 in the vascular bed of the lateral wall of the cochlea was thought to be a contributory factor.

Effects of a Depressor on Cochlear Blood Flow and Perilymphatic Oxygen Tension

To clarify the characteristics of the blood circulation in the cochlea, we investigated the relationship between cochlear blood flow and perilymphatic oxygen tension in guinea pigs with trimetaphan camsilate induced hypotension. Cochlear blood flow was measured by laser Doppler flowmetry, and perilymphatic oxygen tension by a polarographic method. Cochlear blood flow generally paralleled systemic blood pressure, while perilymphatic oxygen tension showed a slower response to the decrease of systemic blood pressure. Although there were individual differences in the changes of systemic blood pressure, cochlear blood flow and perilymphatic oxygen tension, they were found to be dose dependent. Since hypotension induced by trimetaphan camsilate is fairly reproducible in the dose range of this experiment, this drug can be used as a ganglion blocking agent in experiments on cochlear blood flow and perilymphatic oxygen tension during systemic hypotension. The change of perilymphatic oxygen tension with a slower response could be considered to be a factor in the homeostasis in the inner ear fluid.

Feasibility of Pulse Oxymetry to Measure Arterial O2 Saturation in Studies on Cochlear Blood Circulation

To understand the characteristics of oxygen transport to the inner ear, the relationship between arterial O2 saturation and cochlear microcirculation was investigated under different respiratory condition in guinea pigs. To monitor arterial O2 saturation a pulse oxymeter instead of an arterial blood gas analyzer was used. When the arterial O2 saturation was measured in the foot pad by a pulse oxymeter under different respiratory conditions, the data showed a close correlation with the results of blood gas analysis. For the measurement of cochlear microcirculation, a pulse oxymeter was found to be a feasible respiratory monitor for animal experiments. With this apparatus our study demonstrated a slower reaction in the decrease of perilymphatic oxygen tension than of cochlear blood flow during stepwise induction of hypoventilation monitored by a pulse oxymeter. Under certain conditions of hyperventilation in which arterial O2 saturation and perilymphatic oxygen tension increased gradually, cochlear blood flow was found to decrease. This decrease of cochlear blood flow could be attributed to chemical controls which are regulated, as in the cerebral blood circulation, by the content of CO2 and H+ in the vascular bed in the cochlea.

Adequate resection of the mandible invaded by carcinoma. Application of rapid cytological examination.

Carcinomas of the mandibular gingiva, oral floor, tongue and buccal mucosa occasionally involve the mandibular bone. In those cases which have developed mandibular invasion, the extent of the invasion or the margin of surgical resection is usually determined by the roentgenologic findings in the mandible. However, we have recently treated some patients with recurrence of carcinoma in the mandible in spite of careful surgical resection based on preoperative roentgenologic assessment. To eliminate such recurrences, we performed rapid cytological examinations during surgery to demonstrate the presence or absence of carcinoma cells near the resection surface. The diagnostic efficacy of this method and its clinical feasibility are discussed.