Computed tomography can differentiate vaginal-origin from uterine-origin lesions in bitches.

OBJECTIVE: To investigate typical computed tomography (CT) features for the differentiation of vaginal from the uterine origin in dogs. ANIMALS: 7 healthy Beagles in the prospective study and 5 bitches in the retrospective study. PROCEDURES: In the prospective study, dual-phase CT images were obtained from sexually intact female Beagles (n = 7) during anestrus and estrus. On the CT images, the vagina and uterine horns, body, and cervix were assessed for diameter, attenuation, and contrast enhancement pattern. In the retrospective study, CT features of large vaginal lesions (leiomyoma, leiomyosarcoma, adenocarcinoma, hematocolpos, and Gartner's duct cyst) were assessed in 5 bitches. RESULTS: In normal bitches, the cervix was thicker with strong central enhancement compared to the uterus and vagina. The uterine artery, which enters the mesometrium at the level of the cervix, was clearly visualized and assisted in identifying the cervix. In bitches with large vaginal masses, uterine arteries were displaced by the lesions and could not be used to locate the cervix. In 4/5 dogs with vaginal masses, identification of the cervix allowed the determination of the organ of origin. In 1 dog with adenocarcinoma, CT vaginography was additionally required for determining the origin of mass. CLINICAL RELEVANCE: Results from this study indicate that the cervix, recognized in CT as focal thickening of the uterus with central enhancement, may be used as a landmark for the differentiation between the uterus and vagina in bitches.

How Does a Face Mask Impact Speech Perception?

Face masks are mandatory during the COVID-19 pandemic, leading to attenuation of sound energy and loss of visual cues which are important for communication. This study explores how a face mask affects speech performance for individuals with and without hearing loss. Four video recordings (a female speaker with and without a face mask and a male speaker with and without a face mask) were used to examine individuals' speech performance. The participants completed a listen-and-repeat task while watching four types of video recordings. Acoustic characteristics of speech signals based on mask type (no mask, surgical, and N95) were also examined. The availability of visual cues was beneficial for speech understanding-both groups showed significant improvements in speech perception when they were able to see the speaker without the mask. However, when the speakers were wearing the mask, no statistical significance was observed between no visual cues and visual cues conditions. Findings of the study demonstrate that provision of visual cues is beneficial for speech perception for individuals with normal hearing and hearing impairment. This study adds value to the importance of the use of communication strategies during the pandemic where visual information is lost due to the face mask.

Influence of the Noise-Canceling Technology on How We Hear Sounds.

PURPOSE: This study explores the influence of the noise-canceling technology in commercial earphones on sound pressure levels and preferred listening levels in terms of hearing protection. MATERIALS AND METHODS: Thirty individuals completed puretone audiometry and real-ear measurements to assess sound pressure levels at the level of the eardrum with and without the activation of the noise-canceling function. The Knowles Electronics Manikin for Acoustic Research was used to investigate the acoustic characteristics of two environmental sounds (bus and café). Two types of earphones (wireless and wired canal type) were utilized in the study. RESULTS: For both bus and café noises, in the low-frequency range, sound pressure levels were significantly decreased for all types of earphones when the noise-canceling function was turned on. The same results were observed for the whole frequency range. In terms of preferred listening levels, the wireless canal type and wired canal type earphones showed significant reduction in volume levels. CONCLUSION: The findings of the study show that for both low- and whole frequency range, the use of noise-canceling function significantly decreases the sound pressure levels of the signal for all styles of earphones, suggesting a potential of the noise-canceling technology in hearing protection.

Surgical management of a metastatic vertebral tumour originating from a mammary adenocarcinoma in a dog.

An 11-year-old spayed female Toy Poodle presented with acute tetraparesis. A small subcutaneous mass was found in the right trunk region, and the magnetic resonance revealed a compressive spinal cord lesion due to an irregular bone proliferation at the third cervical vertebra. After surgical resection of the vertebral lesion, the neurological symptoms improved, and the patient could walk on her own. The excised vertebral and subcutaneous masses were diagnosed as a mammary adenocarcinoma on the histopathological examination, with Ki-67 and HER-2 immunohistochemistry staining. This case report highlights the importance of defining the primary tumours of metastatic vertebral tumours and the necessity of palliative surgery to improve the patient's quality of life.

Auditory Characteristics in Patients With Mucopolysaccharidosis.

OBJECTIVE: The purpose of the study was to evaluate audiologic findings according to mucopolysaccharidosis (MPS) subtypes and to estimate hearing changes as the disease progressed, as well as the therapeutic effect of enzyme replacement therapy on the hearing apparatus. METHODS: A total of 124 patients who were diagnosed with MPS between September 1994 and December 2016 were retrospectively analyzed. Play audiometry or pure-tone audiometry was performed for hearing assessment, and auditory brainstem response was conducted in patients with poor compliance. RESULTS: In total 124 patients were identified, ranging in age at diagnosis from 0 to 33 years. Fourteen of the patients had been diagnosed with type I, while 91 had type II, 2 had type III, 14 had type IV, and 3 had type VI. Mean bone conduction and air conduction for the better ear were 26.13±16.95 dB and 34.77 ±â€Š20.00 dB in all patients, and 34.20±7.64 dB and 40.70±9.67 dB in patients with MPS II. The average auditory brainstem response threshold was 68.96 ±21.93 dB nHL. The most common type of hearing loss was pure sensorineural hearing loss in all subtypes, and the degree of hearing loss was variable mostly within the mild to severe range. The increase in the hearing threshold was also significantly correlated with the disease duration. However, the change in hearing level was not correlated with the duration of enzyme replacement therapy. CONCLUSIONS: Hearing impairment in MPS patients is common and is aggravated as the disease progresses. Thus, adequate intervention and hearing rehabilitation might play an important role in managing hearing disabilities in MPS patients.

Contrast-enhanced ultrasonography for evaluation of blood perfusion in normal canine eyes.

OBJECTIVE: This study was performed to evaluate ocular structures using contrast-enhanced ultrasonography (CEUS) in dogs to assess the feasibility of CEUS for investigating the blood perfusion of canine eyes. ANIMAL STUDIED: Eight purpose-bred beagles were used. PROCEDURES: Blood perfusion and vascularity of the right eye were evaluated using color Doppler, power Doppler, and CEUS with Sonazoid® . Vascular changes were quantitatively evaluated by measuring peak intensity, time to initial upslope, and time to peak from the ciliary body, iris, choroid, retina, and the retrobulbar region by CEUS. RESULTS: On CEUS images, all parts of the examined ocular structures were markedly enhanced and clearly identified from the adjacent region. After injection, the contrast agent initially flowed to the choroid and retina at 14.2 seconds, then to the ciliary body and iris at 20 seconds. The blood signal reached its peak intensity in the ciliary body at 27.2 seconds (47.4 ± 10.63), in the iris at 31.6 seconds (74.00 ± 41.85), and in the retrobulbar region at 23.4 seconds (149 ± 24.59). The optic nerve was clearly distinguished from the retrobulbar region over 5 minutes after the initiation of CEUS. Significantly, more vascular signals were detected in the ciliary body and iris by CEUS than by color and power Doppler. CONCLUSION: Blood perfusion of the intraocular structures and the retrobulbar region can be quantitatively and qualitatively analyzed by CEUS. CEUS may be a useful, noninvasive, and sensitive tool for the evaluation of blood perfusion in ocular diseases.

Effect of position and time held in that position on ground-glass opacity in computed tomography images of dogs.

OBJECTIVE To evaluate effects of position, time in that position, and positive end-expiratory pressure on ground-glass opacity caused by physiologic atelectasis on lung CT images and to determine effects of recumbency position before CT. ANIMALS 6 healthy Beagles. PROCEDURES In a crossover study, dogs were placed in 4 positions (sternal, dorsal, right lateral, and left lateral recumbency) for 2 holding times (30 and 60 minutes). Dogs were then repositioned in sternal recumbency, and CT was performed at 2 positive end-expiratory pressures (0 and 15 mm Hg). Location, distribution, and degree of ground-glass opacities were evaluated on lung CT images. Volume and mean density of the lungs and ground-glass opacities as well as maximum density of ground-glass opacities were evaluated. RESULTS Ground-glass opacities were mainly observed in parts of the lungs that were dependent during the various positions before CT, except for sternal recumbency. Opacities were reversible and decreased or disappeared after lung inflation. Ground-glass opacities were observed most frequently and had greatest severity when dogs were positioned in left lateral recumbency before CT. Ground-glass opacities were negligible for dogs positioned in sternal recumbency before CT. CONCLUSIONS AND CLINICAL RELEVANCE Location and reversibility of ground-glass opacities may help clinicians distinguish whether they are attributable to atelectasis or a result of pathological changes. Dogs should be positioned in sternal recumbency to minimize the occurrence of ground-glass opacities, particularly when several procedures are performed before CT, which increases the time that a dog will remain in the same position.

Comparison of elastography, contrast-enhanced ultrasonography, and computed tomography for assessment of lesion margin after radiofrequency ablation in livers of healthy dogs.

OBJECTIVE To assess by use of various diagnostic imaging modalities acute changes in livers of healthy dogs after radiofrequency ablation (RFA) and determine the capability of each imaging modality to monitor ablation lesion changes. ANIMALS 6 healthy Beagles. PROCEDURES 12 ablation lesions were created in the liver of the dogs (2 lesions/dog). Ablation lesions were evaluated by use of conventional ultrasonography, strain elastography, and contrast-enhanced ultrasonography immediately after (time 0), 30 to 60 minutes after, and 3 days after RFA, and by use of CT 30 minutes and 3 days after RFA. Three dogs were euthanized shortly after RFA, and the other 3 dogs were euthanized on day 3. Lesion size measured by each imaging modality was compared with necropsy findings. RESULTS Immediately after RFA, clear margins were more visible with elastography and contrast-enhanced ultrasonography than with conventional ultrasonography, which had acoustic shadowing. On triphasic contrast CT, the ablation zone, which indicated necrosis and hemorrhage, was not enhanced and could be measured. Marked enhancement of the periablation rim was observed during the venous phase and was identified as granulation tissue. Size of the ablation area measured on enhanced CT images was strongly correlated with actual lesion size. CONCLUSIONS AND CLINICAL RELEVANCE For dogs of this study, CT was the most reliable method for lesion size determination. Although ultrasonographic imaging measurements underestimated lesion size, all modalities could be used to provide additional real-time guidance for RFA procedures of the liver as well as for other RFA procedures.

Comparison of contrast media for visualization of the colon of healthy dogs during computed tomography and ultrasonography.

OBJECTIVE To evaluate contrast agents for their ability to improve visualization of the colon wall and lumen during CT and ultrasonography. ANIMALS 10 healthy adult Beagles. PROCEDURES Food was withheld from dogs for 36 hours, after which dogs consumed 250 mL of polyethylene glycol solution. Dogs were then anesthetized, a contrast agent (tap water, diluted barium, or air; order randomly assigned) was administered rectally, iodine contrast medium (880 mg of I/kg) was administered IV, and CT and ultrasonography of the colon were performed. After a 1-week washout period, this process was repeated with a different contrast agent until all agents had been evaluated. Two investigators reviewed the CT and ultrasonographic images for colon wall thickness, conspicuity, artifacts, wall layering, and degree of lumen dilation at 4 sites. RESULTS Thickness of the colon wall was greatest in CT and ultrasonographic images with water used as contrast agent, followed by barium and then air. The CT images obtained after water administration had a smooth appearance that outlined the colonic mucosa and had the highest score of the 3 contrast agents for wall conspicuity. Although no substantial artifacts related to any of the contrast agents were identified on CT images, barium- and gas-induced shadowing and reverberation artifacts hindered wall evaluation during ultrasonography. For ultrasonography, the degree of conspicuity was highest with barium in the near-field wall and with water in the far-field wall. In contrast to CT, ultrasonography could be used to distinguish wall layering, and the mucosal and muscular layers were distinct with all contrast agents. CONCLUSIONS AND CLINICAL RELEVANCE Use of water as a contrast agent for both CT and ultrasonography of the colon in dogs compensated for each imaging modality's disadvantages and could be beneficial in the diagnosis of colon disease.

The patterns and risk factors of hearing loss following microvascular decompression for hemifacial spasm.

OBJECTIVE: The aim of this study was to reveal the risk factors including intraoperative brain stem auditory evoked potential (BAEP) changes and to define parameter and warning values of BAEP beyond which the probability of hearing impairment rises significantly. METHODS: From April 1997 to February 2009, 1156 patients underwent microvascular decompression (MVD) for hemifacial spasm (HFS) and their medical records and audiologic data. The intraoperative BAEP monitoring was performed in all operations during surgery from the time of administration of general anesthesia until the time of skin closure. Pure tone audiometry (PTA) and Speech Discrimination Score (SDS) were performed on all patients before and after surgery for categorizing the patterns of hearing loss. There were 825 females and 331 males with a mean age of 48.7 years (range 17-75 years). The mean symptom duration was 67.8 months (range 1-420 months). RESULTS: At the 1-year follow-up examination, 1091 (94.4%) patients of the total 1156 patients exhibited a cured state, and 65 (5.6%) patients had residual spasms. Hearing loss occurred in 46 patients (3.9%). In 26 patients, PTA was decreased more than 15 dB with a proportional decrease of the SDS. In 10 patients, poor SDS without hearing loss occurred. Total deafness was developed in 10 patients. A higher incidence of BAEP change and a poor recovery especially amplitude in wave V during surgery was observed in patients with poor SDS (eight patients) and total deafness (seven patients) (p = 0.000). Reduction of amplitude more than 50% in wave V was a strong indicator for a worse outcome of the hearing capacity. The difference in other risk factors according to hearing loss pattern was not statistically significant (p > 0.05). Only female was significant (p = 0.005). CONCLUSIONS: The intraoperative BAEP change and a poorer recovery, especially reduction of amplitude more than 50% in wave V, was a strong indicator for a worse outcome of the hearing capacity. Vigilant intraoperative monitoring of the BAEP and adequate steps for recovery of the BAEP change could prevent hearing loss after MVD for HFS.

Acetic acid sclerotherapy for treatment of a biliary leak from an isolated bile duct after hepatic surgery.

Bile duct leakage from the main biliary tree is not uncommon after hepatic surgery. In this case, successful percutaneous treatment was performed for bile leakage from an isolated bile duct after left hemihepatectomy in a 48-year-old woman who underwent surgery for biliary cystadenocarcinoma and developed a biloma at the left subphrenic space. Diagnostic procedures revealed that the right posterior segmental bile duct drained aberrantly into the left bile duct, which remained undrained after resection and led to biloma formation. Ablation of the isolated bile duct was performed with acetic acid, resulting in avoidance of repeated operation and other complications.

Roles of cognitive characteristics in tinnitus patients.

To investigate the cognitive characteristics that affect the emotional and functional distress caused by tinnitus and to decide and test the model to explain their relations, 167 patients with tinnitus, who visited Samsung Medical Center, Seoul, Korea between March 2001 and May 2002 were recruited. To examine their features related to tinnitus, the following scales were administered; Tinnitus-related basic questionnaire including dysfunctional beliefs, Tinnitus Handicap Inventory, State-Trait Anxiety Inventory, Anxious Thought and Tendencies, Self-Consciousness Scale, and modified 'catastrophic thought' from Coping Strategies Questionnaire. The results showed that the duration of experiencing tinnitus was 4.7 +/-7.1 yr, those who complained of hearing one sound were the most common (45.5%), and hearing sounds similarly described to whistling were the most common (22.5%). Also, there were significant correlations among tinnitus features, cognitive characteristics, and distresses from tinnitus. As a result of testing the model, Normed fit index, Incremental fit index, Tucker-Lewis index, and Comparative fit index were over .90, indicating that it is a good model, and Root mean square error of approximation showed a reasonable fit. Also, the direct effects of the trait or severity of tinnitus on distress did not appear to be significant, thus it appeared to be affecting indirectly through the cognitive characteristics. This result shows that cognitive interventions can be important for the psychological adaptations of tinnitus patients.