Hearing loss and heavy metal toxicity in a Nicaraguan mining community: audiological results and case reports.

We measured fingernail metal levels, Békésy-type pure-tone thresholds and distortion product otoacoustic emission (DPOAE) levels in 59 subjects residing in the gold mining community of Bonanza, Nicaragua. Auditory testing revealed widespread hearing loss in the cohort. Nail metal concentrations (mercury, lead, aluminum, manganese and arsenic) far exceeded reference levels. No relationship was found between metal levels and auditory test results for the group as a whole. Statistically significant relationships were found between DPOAE response amplitudes and metal concentrations in a subgroup with less than 40 h per week of significant noise exposure; however, conclusions regarding these relationships should be tempered by the large number of analyses performed. Several young individuals with high metal levels reported neurological symptoms and had poor hearing. The data suggest that metal levels in artisanal mining communities present a significant public health problem and may affect hearing.

Broadband 308 nm vibrational Raman spectroscopy of gaseous species using a potassium hydrogen phthalate liquid filter and polarization fluorescence suppression.

Broadband XeCl excimer lasers operating at 308 nm are not currently used in the field of gas phase vibrational Raman spectroscopy (VRS). An explanation as to why alternative wavelengths, and in particular tuneable, narrowband lasers are currently preferred for gas phase VRS is presented in addition to demonstrating a setup which makes the XeCl laser a viable alternative when considering excitation sources for VRS. A solution of potassium hydrogen phthalate is shown to be a practical low-pass liquid filter and to reduce substantially the effects of Rayleigh scattering on collected Raman spectra. The use of a commercial beam polarizer is also shown to be effective in suppressing background fluorescence that otherwise necessitates the use of expensive tuneable, narrowband lasers when performing VRS with sources of background fluorescence. Finally, an unconventional excitation beam arrangement is shown to produce viable Raman spectra from which species concentrations and distributions can be determined.

Calculating luminous flux and lighting levels for domesticated mammals and birds.

This paper considers whether photometric calculations using standard human spectral sensitivity data are satisfactory for applications with other species or whether it would be worthwhile to use bespoke spectral sensitivity functions for each species or group of species. Applications include the lighting of interior areas and the design of photometers. Published spectral sensitivity data for a number of domesticated animals (human, turkey, duck, chicken, cat, rat and mouse) were used to calculate lighting levels for each species and compared with those derived from standard CIE human photopic and scotopic functions. Calculations were made for spectral power distributions of daylight, incandescent light and 12 fluorescent sources commonly used to light interiors. The calculated lighting levels showed clear differences between species and the standard human. Assuming that the resulting effects on retinal illuminance determine the overall perception of the level of light, there may be applications where these differences are important. However, evidence is also presented that the magnitude of these inter-species effects are similar to, or smaller than, those arising from other optical, physiological and psychological factors, which are also likely to influence the resulting perception. It is also important to recognise that lighting-related parameters such as the good colour rendering of surfaces, the avoidance of glare from lamps and other factors that may be species related are sometimes of greater importance than the lighting levels. Our results suggest that a judicial choice of three spectral sensitivity functions would satisfy most circumstances. Firstly, where the overall sensitivity is maximal in the medium to long wavelengths, the standard CIE photopic function will suffice, chicken, turkey and duck fall in this category. Secondly, in a small number of cases where the sensitivity centres on the short to medium wavelengths, the CIE scotopic function should be used, e.g. for the scotopic cat, photopic rat and photopic mouse. Finally, where an animal is also sensitive to the UV region of the spectrum and there is a significant component of UV radiation, then an additional measure of the UV response should be included, as for the photopic rat and photopic mouse.

Use of a quality index in threshold contrast detail detection measurements in television fluoroscopy.

The use of a single index to assist in quality control procedures of X-ray television fluoroscopy systems was investigated. A single quality index was devised incorporating a measure of threshold contrast detail detectability (TCDD) performance and taking into account image intensifier input kerma rate, field size, differences in radiation beam quality, and pulsed fluoroscopy. This was applied to a number of clinical systems to investigate changes in image quality index quantified over time. Accepted measurement protocols were used to obtain these measurements. The results show system performance for different systems and can establish the decline in performance parameters over time or assess non-optimal image quality with clinical systems in field measurements. The systems studied were assessed with a variety of performance parameters including TCDD results, low contrast sensitivity, limiting resolution, and image intensifier input kerma rate under clinical modes of operation. The TCDD quality index, and dose normalized quality index, were found to be useful image quality assessment parameters for serial testing of systems, which augment the use of graphical methods for the display of TCDD curves.

Traceable calibration of ultraviolet meters used with broadband, extended sources.

A calibration system has been developed to provide increased accuracy in the measurement of the irradiance responsivity appropriate for UV meters used with broadband, extended sources of the type employed in phototherapy. The single wavelength responsivity of the test meter is obtained in the wavelength range 250-400 nm by intercomparison with a transfer standard meter in a narrow, monochromatic beam. Traceability to primary standard irradiance scales is provided via the National Measurement System with a best uncertainty of 7% (at 95% confidence). The effective responsivity of the test meter, when used with broadband extended sources, is calculated using the measured spectral and angular response of the meter and tabulated data on the spectral and spatial characteristics of the source radiance. The uncertainty in the effective responsivity, independent of the source variability, is estimated to be 10% (at 95% confidence). The advantages of this calibration system over existing approaches are discussed.

Temperature Effects on Heterorhabditis megidis and Steinernema carpocapsae Infectivity to Galleria mellonella.

The effect of temperature on the infection of larvae of the greater wax moth, Galleria mellonella, by Heterorhabditis megidis H90 and Steinernema carpocapsae strain All, was determined. For both species, infection, reproduction, and development were fastest at 20 to 24 degrees C. Infection by both H. megidis and S. carpocapsae occurred between 8 and 16 degrees C; however, neither species reproduced at 8 degrees C. Among the nematodes used in experiments at 8 degrees C, no H. megidis and very few S. carpocapsae developed beyond the infective juvenile stage. Compared with H. megidis, S. carpocapsae invaded and killed G. mellonella larvae faster at 8 to 16 degrees C. By comparing invasion rates, differences in infectivity between the two nematode species were detected that could not be detected in conventional petri dish bioassays where mortality was measured after a specified period. Invasion of G. mellonella larvae by H. megidis was faster at 24 than at 16 degrees C.

Isokinetic profile of baseball pitchers' internal/external rotation 180, 300, 450 degrees.s-1.

PURPOSE: The purpose of this study was to develop further normative data for an isokinetic profile for intercollegiate baseball pitchers at 180, 300, and 450 degrees.s-1. Information on isokinetic performance at 450 degrees.s-1 was not found in previously published literature. METHODS: Sixteen intercollegiate baseball pitchers volunteered for isokinetic strength testing of internal and external rotators of the shoulder. The testing was conducted at 180, 300, and 450 degrees.s-1; with the pitchers in a position of function (90 degrees/90 degrees). RESULTS: The subjects were able to reach maximal velocity for each of the speeds tested, including 450 degrees.s-1. These pitchers demonstrated no significant difference between dominant and nondominant arms for peak torque, torque/body weight, work/body weight, or average power (P < 0.05). Torque produced at 0.2 s was significantly greater in the dominant arm compared with the nondominant arm at 450 degrees.s-1 only. Internal rotation values were significantly greater than external rotation values for all areas of comparison. External rotation/internal rotation ratios remained consistent for each speed tested (approximately 0.65). CONCLUSIONS: There is minimal difference in strength values between dominant and nondominant arms of intercollegiate baseball pitchers, with the exception of significantly greater internal rotation peak torque at 0.2 s at 450 degrees.s-1 in the dominant arm. Dominant arm, as well as nondominant arm, ER/IR ratios remain consistent throughout the velocity spectrum. A valid test speed for intercollegiate baseball pitchers appears to be 450 degrees.s-1 when tested before the start of throwing from the pitcher's mound.

Automobile airbag impulse noise: otologic symptoms in six patients.

Automobile airbag safety systems have successfully reduced the number of occupant injuries from motor vehicle accidents. Unfortunately, airbags are also associated with some inherent risk, including a high-amplitude, short-duration noise from airbag deployment. A review of the available research in the automobile industry indicates that the peak amplitude of this noise may exceed 170 dB sound pressure level. Despite the increasingly wide application of airbags in automobiles, there have been no previous reports of airbag-related otologic injuries. We have encountered six patients with otologic symptoms that appear to be related to airbag impulse noise. Five of these patients have documented hearing loss, one patient reported persistent tinnitus, and two patients have significant dysequilibrium. Although permanent hearing loss from airbag noise appears to be rare, temporary threshold shifts are probably much more common. It is important, therefore, that the clinician be aware of the noise associated with airbag inflation and the possibility of acoustic trauma from these safety devices.

Acoustic performance and clinical use of a fibreoptic hydrophone.

Initial clinical experience with the use of an optical fibre hydrophone for in vivo ultrasound dosimetry is reported. The hydrophone, originally described by Beard and Mills (1997), operates as an extrinsic, low-finesse Fabry-Perot optical sensor where acoustically-induced thickness changes in a polymer film modulate the phase difference between light beams reflected from the two surfaces of the film. The pressure waveforms from the sensor are compared with those from a calibrated piezoelectric polymer membrane hydrophone. The sensor is found to have a frequency resonance at around 12 MHz, corresponding to the thickness mode of the 50-micron polymer film. The directional responses at 0.16 MHz, 1.0 MHz and 5.0 MHz are found to be similar to those predicted for a plane piston receiver with the same diameter as that of the polymer film (400 microns). The performance of the sensor as a broad-band hydrophone is degraded by the relatively low acoustical impedance of the adhesive used in the fibre-film bond. The hydrophone was used in the clinic for measurement of acoustic pressures within the ureter of 4 patients undergoing clinical extracorporeal shock-wave lithotripsy on a Dornier HM3 lithotripter. Pressures in the range 0.5 to 5.0 MPa were recorded in the ureter at positions over 10 cm from the renal pelvis. Problems related to the clinical use of the sensor, including instability in the sensitivity of the sensor following handling and its mechanical strength in high-amplitude acoustic fields, are discussed.

In vitro estimation of foetal liver volume using ultrasound, x-ray computed tomography and magnetic resonance imaging.

Sixteen formalin-fixed foetal livers were scanned in vitro using a new system for estimating volume from a sequence of multiplanar 2D ultrasound images. Three different scan techniques were used (radial, parallel and slanted) and four volume estimation algorithms (ellipsoid, planimetry, tetrahedral and ray tracing). Actual liver volumes were measured by water displacement. Twelve of the sixteen livers also received x-ray computed tomography (CT) and magnetic resonance (MR) scans and the volumes were calculated using voxel counting and planimetry. The percentage accuracy (mean +/- SD) was 5.3 +/- 4.7%, -3.1 +/- 9.6% and -0.03 +/- 9.7% for ultrasound (radial scans, ray volumes), MR and CT (voxel counting) respectively. The new system may be useful for accurately estimating foetal liver volume in utero.

The accuracy of a new system for estimating organ volume using ultrasound.

A new system is described for estimating volume from a series of multiplanar 2D ultrasound images. Ultrasound images are captured using a personal computer video digitizing card and an electromagnetic localization system is used to record the pose of the ultrasound images. The accuracy of the system was assessed by scanning four groups of ten cadaveric kidneys on four different ultrasound machines. Scan image planes were oriented either radially, in parallel or slanted at 30 degrees to the vertical. The cross-sectional images of the kidneys were traced using a mouse and the outline points transformed to 3D space using the Fastrak position and orientation data. Points on adjacent region of interest outlines were connected to form a triangle mesh and the volume of the kidneys estimated using the ellipsoid, planimetry, tetrahedral and ray tracing methods. There was little difference between the results for the different scan techniques or volume estimation alogorithms, although, perhaps as expected, the ellipsoid results were the least precise. For radial scanning and ray tracing, the mean and standard deviation of the percentage errors for the four different machines were as follows: Hitachi EUB-240, -3.0 +/- 2.7%; Tosbee RM3, -0.1 +/- 2.3%; Hitachi EUB-415, 0.2 +/- 2.3%; Acuson, 2.7 +/- 2.3%.

Sudden bilateral sensorineural hearing loss.

Most cases of sudden sensorineural hearing loss (SHL) remain idiopathic, and the majority are unilateral. From 1989 to 1993, 823 patients with sudden SHL were evaluated. Of these, 14 (1.7%) had sudden bilateral SHL. We reviewed the charts of these 14 patients to compare sudden bilateral SHL with sudden unilateral SHL. Usually, bilateral SHL was asymmetric. Most bilateral cases received combined steroid and vasodilator treatment, while unilateral cases were more likely to receive only one of these treatments. By audiological criteria, 67% of bilateral SHL cases improved, while the improvement rate in unilateral SHL was 52%; however, this difference was not statistically significant. In bilateral SHL patients showing improvement, both ears responded. Bilateral SHL patients were older at the onset of hearing loss, had a higher incidence of vascular disease, and were more likely to have positive antinuclear antibody titer. Recognition of similarities and differences between sudden unilateral and bilateral SHL can help in counseling patients.

Application of a new discreet form of Gauss' theorem for measuring volume.

Volume measurements are useful in many branches of science and medicine. They are usually accomplished by acquiring a sequence of cross sectional images through the object using an appropriate scanning modality, for example x-ray computed tomography (CT), magnetic resonance (MR) or ultrasound (US). In the cases of CT and MR, a dividing cubes algorithm can be used to describe the surface as a triangle mesh. However, such algorithms are not suitable for US data, especially when the image sequence is multiplanar (as it usually is). This problem may be overcome by manually tracing regions of interest (ROIs) on the registered multiplanar images and connecting the points into a triangular mesh. In this paper we describe and evaluate a new discreet form of Gauss' theorem which enables the calculation of the volume of any enclosed surface described by a triangular mesh. The volume is calculated by summing the vector product of the centroid, area and normal of each surface triangle. The algorithm was tested on computer-generated objects, US-scanned balloons, livers and kidneys and CT-scanned clay rocks. The results, expressed as the mean percentage difference +/- one standard deviation were 1.2 +/- 2.3, 5.5 +/- 4.7, 3.0 +/- 3.2 and -1.2 +/- 3.2% for balloons, livers, kidneys and rocks respectively. The results compare favourably with other volume estimation methods such as planimetry and tetrahedral decomposition.

Prognosis and treatment of sudden sensorineural hearing loss.

Most cases of sudden sensorineural hearing loss (SHL) are idiopathic. Consequently, the otologist may be asked to predict hearing recovery and select a treatment strategy without fully understanding the disease process. We retrospectively reviewed the charts of 837 patients with SHL to evaluate the prognostic value of specific clinical parameters and the effectiveness of steroid and vasodilator treatments. Treatment response was defined by the patient's subjective response and audiological criteria. Patients who were treated with steroids and/or vasodilators were more likely to improve. Patients who improved had a worse initial pure-tone average (PTA) than those who did not improve. In addition, those with poorer initial speech discrimination scores, worse initial thresholds at 4,000 Hz, younger age, and greater number of treatments were more likely to improve. Neither the electronystagmogram results nor the initial audiogram shape were valuable indicators. Recognition of prognostic indicators can help in counselling patients and in the evaluation of treatment response.

Volume estimation from multiplanar 2D ultrasound images using a remote electromagnetic position and orientation sensor.

A system is described for calculating volume from a sequence of multiplanar 2D ultrasound images. Ultrasound images are captured using a video digitising card (Hauppauge Win/TV card) installed in a personal computer, and regions of interest transformed into 3D space using position and orientation data obtained from an electromagnetic device (Polhemus, Fastrak). The accuracy of the system was assessed by scanning 10 water filled balloons (13-141 mL), 10 kidneys (147-200 mL) and 16 fetal livers (8-37 mL) in water using an Acuson 128XP/10 (5 MHz curvilinear probe). Volume was calculated using the ellipsoid, planimetry, tetrahedral and ray tracing methods and compared with the actual volume measured by weighing (balloons) and water displacement (kidneys and livers). The mean percentage error for the ray tracing method was 0.9 +/- 2.4%, 2.7 +/- 2.3%, 6.6 +/- 5.4% for balloons, kidneys and livers, respectively. So far the system has been used clinically to scan fetal livers and lungs, neonate brain ventricles and adult prostate glands.

Detection of acoustic emission from cavitation in tissue during clinical extracorporeal lithotripsy.

A 1-MHz focused hydrophone has been used to search for acoustic emission expected to arise from cavitation occurring in tissue during clinical extracorporeal shock-wave lithotripsy (ESWL). The hydrophone is acoustically coupled to the patient's skin and the focus directed at depth in tissue under ultrasound guidance. The measured amplitude-time variation of the acoustic emission from tissue near the shock-wave focus of the Storz Modulith SL20 lithotripter has been examined in four patients. There is evidence of increased amplitude acoustic emission at 1 MHz from regions within tissue that also appear hyperechoic in simultaneously acquired ultrasound images. The acoustic emission from these regions decays from an initial peak to the noise level in about 500 microseconds following each shock-wave pulse. Within this period, a second peak, often of higher amplitude than the first, is typically observed about 100 microseconds after the shockwave. The time between the initial and second peaks is found to increase with increasing shock-wave amplitude. The results are similar to those previously observed from cavitation induced by shock-wave exposure in water and indicate that the 1-MHz acoustic emission arises from inertial cavitation in tissue during clinical ESWL.

Sudden hearing loss in acoustic neuroma patients.

Patients with acoustic neuroma may have sudden sensorineural hearing loss. Most patients with sudden hearing loss seek medical attention promptly, but the diagnosis of an acoustic neuroma may be delayed for months or years because sudden hearing loss is an unusual initial symptom of an acoustic neuroma. In a retrospective review of 836 cases of sudden hearing loss, we found 13 patients with acoustic neuromas. The prevalence of acoustic neuromas for those screened with auditory brain stem response or magnetic resonance imaging was 2.5%. In addition to these 13 patients, 79 acoustic neuroma patients treated in our clinic had well-documented sudden hearing loss as the initial symptom. Hearing loss in these 92 patients ranged from mild to profound. Associated symptoms of pain, facial paresthesia, or unilateral tinnitus preceding the sudden hearing loss were suggestive of an acoustic neuroma, as was a midfrequency (U-shaped) hearing loss. A history of other diseases or events that might explain the sudden hearing loss, a normal electronystagmogram, or recovery of hearing does not eliminate the possibility of a tumor. Because there are no clinical findings that clearly distinguish those patients with acoustic neuromas from other patients with sudden hearing loss, we recommend either an evaluation with auditory brain stem response or gadolinium-enhanced magnetic resonance imaging for any patient with sudden hearing loss.