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PubMed1988

Visual masking and visual integration across saccadic eye movements.

The visual world appears unified, stable, and continuous despite rapid changes in eye position. How this is accomplished has puzzled psychologists for over a century. One possibility is that visual information from successive eye fixations is fused in memory according to environmental or spatiotopic coordinates. Evidence supporting this hypothesis was provided by Davidson, Fox, and Dick (1973). They presented a letter array in one fixation and a mask at one letter position in a subsequent fixation and found that the mask inhibited report of the letter that shared its retinal coordinates but appeared to occupy the same position as the letter that shared its spatial coordinates. This suggests the existence of a retinotopic visual persistence at which transsaccadic masking occurs and a spatiotopic visual persistence at which transsaccadic integration, or fusion, occurs. Using a similar procedure, we found retinotopic masking and retinotopic integration: The mask interfered with the letter that shared its retinal coordinates, but also appeared to cover that letter. In another experiment, instead of a mask we presented a bar marker over one letter position, and subjects reported the letter that appeared underneath the bar; subjects usually reported the letter with the same retinal coordinates as the bar, again suggesting retinotopic rather than spatiotopic integration across saccades. In Experiment 3 a bar marker was again presented over one letter position, but in addition a visual landmark was presented after the saccade so that subjects could localize the bar's spatial position; subjects still reported that the letter that shared the bar's retinal coordinates appeared to be under it, but they were also able to accurately specify the bar's spatial position. This ability could have been based on retinal information (the visual landmark) present in the second fixation only, however, rather than spatiotopic visual persistence. Because such a visual landmark was present in the Davidson et al. (1973) experiments, we conclude that their findings can be explained solely in retinotopic terms and provide no convincing evidence for spatiotopic visual persistence. But the exposure parameters that Davidson et al. (1973) and we used were biased in favor of retinotopic, rather than spatiotopic, coding: The stimuli were presented very briefly just before a saccadic eye movement, and subjects are poor at spatially localizing stimuli under these conditions. Thus, in Experiment 4 we presented the letter array about 200 ms before the saccade; then, subjects reported that the letter with the same spatial coordinates as the bar appeared under it.(ABSTRACT TRUNCATED AT 400 WORDS)

Attention↗

PubMed1984

Perceptual and conceptual masking of pictures.

We report an experiment in which target pictures, presented for 50 ms, were followed by masks. Two mask variables were implemented: mask luminance and amount of attention demanded by the mask. Luminance but not attention demand affected subsequent picture-memory performance when the mask followed the picture immediately; however, attention demand but not luminance affected performance when the mask was delayed by 300 ms following the offset of the picture. We conclude that qualitatively different processes are being carried out at 0 versus 300 ms following the offset of a 50-ms picture. We argue that these processes can profitably be viewed as perceptual processes, which operate on raw stimulus input, and conceptual processes, which operate on the output of perceptual processes.

Attention↗

PubMed1990

Temporal effects in simultaneous masking by vowel and consonant-vowel maskers.

Temporal effects in simultaneous masking were studied using synthetic vowel (V) and consonant-vowel (CV) maskers. For the steady-state V maskers (/i,a,u/), signals were presented at the beginning or in the temporal center of the masker. The masking patterns generally reflected the formant differences among the vowels, and the formant structure of each V masker was more clearly revealed when the signal was presented in the temporal center of the masker. For the CV maskers (/bi,gi/), signals were presented at the beginning of the (consonant portion of the) masker, at the beginning of the vowel portion of the masker, or in the temporal center of the masker. The second-formant difference between the maskers (observed acoustically at their onset) was generally revealed in the masking patterns when the signal was presented at the beginning of the consonant; this difference in the masking patterns was also present, to a lesser extent, when the signal was presented at the beginning of the vowel, where the two maskers were identical acoustically. The masking patterns for the two CV maskers were virtually identical when the signal was presented in the temporal center of the masker. These data extend previous tone-on-tone masking data and suggest that the auditory system requires a certain amount of time to represent most accurately the acoustic spectrum of both steady-state and dynamic complex maskers.

Adult↗

PubMed1999

The use of mini-dose suxamethonium to facilitate the insertion of a laryngeal mask airway.

The use of mini-dose suxamethonium to facilitate the insertion of a laryngeal mask airway was investigated. Sixty patients were assigned randomly in a double-blind manner to receive 0.9% sodium chloride or suxamethonium 0.1 mg.kg-1 intravenously, following intravenous induction with propofol 2.5 mg.kg-1. The laryngeal mask was inserted after the first attempt in 87% of patients. Mini-dose suxamethonium improved the correct positioning of the laryngeal mask during the first attempt (93 vs. 67%, p < 0.02), decreased the incidence of swallowing (p < 0.001), gagging (p < 0.001) and head or limb movement (p < 0.05). Laryngeal mask insertion was graded as easy in 93% of patients who had mini-dose suxamethonium, compared with 60% in the placebo group (p < 0.01). The duration of apnoea between the two groups was not significantly different (0.54 vs. 0.61 min, p = 0. 46). The total dose of propofol needed to insert the laryngeal mask was lower in the suxamethonium group (2.57 vs. 3.25 mg.kg-1, p < 0. 01) and was associated with less hypotension (p < 0.05). Fasciculation (17%) and mild myalgia (23%) were common despite the small dose of suxamethonium used. In conclusion, mini-dose suxamethonium facilitates laryngeal mask insertion. Myalgia is common and the technique is not recommended for patients who are prone to suxamethonium myalgia.

Adolescent↗

PubMed2001

A comparison of the intubating and standard laryngeal mask airways for airway management by inexperienced personnel.

Twenty-four inexperienced participants were timed inserting the intubating laryngeal mask airway and the laryngeal mask airway in 75 anaesthetised subjects. Adequacy of ventilation was assessed on a three-point scale. The pressure at which a leak first developed around the device's cuff was also measured. There was no significant difference in insertion time or the likelihood of achieving adequate ventilation between devices. However, the intubating laryngeal mask airway was better at providing adequate ventilation without audible leak (58/75 (77%) vs. 42/75 (56%); p = 0.009). The median (range [IQR]) pressure at which an audible leak developed was higher for the intubating laryngeal mask airway, 34.5 (14-40 [29-40]) cmH2O, than for the laryngeal mask airway, 27.5 (14-40 [22-33]) cmH2O (p < 0.001). The intubating laryngeal mask airway is worthy of further consideration as a tool for emergency airway management for inexperienced personnel.

Adolescent↗

PubMed2003

A comparison of the laryngeal mask airway and PA(Xpress) for short surgical procedures.

Sixty adult patients undergoing minor peripheral surgery under general anaesthesia were randomly allocated to receive either the laryngeal mask airway (laryngeal mask airway; size 4 for females and size 5 for males) or the PAXpress (adult size), inserted by a single operator with experience of > 50 insertions of each device. The laryngeal mask airway was correctly placed on the first attempt in 27 patients (90%) compared with 20 patients (67%) when using the PAXpress (p < 0.01). No patient required more than two attempts at insertion and there were no failures with the laryngeal mask airway, compared with four (13%) who needed three attempts and two failures (7%) with the PAXpress (p < 0.001 and p < 0.01, respectively). Mean (SD) total placement time was shorter with the laryngeal mask airway [24.6 (3.1) s] than with the PAXpress[35.4 (2.5) s; p < 0.01]. The most common complication was sore throat, which occurred less frequently with the laryngeal mask airway (8 patients; 26%) than with the PAXpress (15 patients; 53.5%; p < 0.001).

Adult↗

PubMed2003

Laboratory and clinical comparisons of the Streamlined Liner of the Pharynx Airway (SLIPA) with the laryngeal mask airway.

The Streamlined Liner of the Pharynx Airway (SLIPA) is a new inexpensive disposable supraglottic airway designed to seal without the use of an inflatable cuff. It comprises a hollow blow-moulded soft plastic airway shaped to form a seal in the pharynx. Being hollow, liquid entrapment is possible and this may provide effective protection against aspiration. A model silicone rubber pharynx with an 'oesophageal' tube for injecting volumes of regurgitant liquid was designed to evaluate the SLIPA and the standard and ProSeal laryngeal mask airways during positive-pressure ventilation. A linear relationship between the volume 'regurgitated' and the volume 'aspirated' was found with the laryngeal mask airway and the ProSeal laryngeal mask airway with the drainage tube clamped. Both the ProSeal laryngeal mask airway with an open drainage tube and the SLIPA, but not the standard laryngeal mask airway, provided effective protection against 'aspiration' during positive-pressure ventilation using the model. In a clinical study, 120 patients were randomly allocated to receive controlled ventilation of the lungs via the standard laryngeal mask airway or the SLIPA. Both devices were equally easy to insert and satisfactory for airway management.

Adolescent↗

PubMed2000

Use of an illuminated flexible catheter for light-guided tracheal intubation through the intubating laryngeal mask by nurses.

We evaluated the ability of inexperienced personnel in using a prototype illuminated flexible catheter to assist tracheal intubation through the intubating laryngeal mask in anaesthetised, paralysed patients. The device consists of a completely flexible thin plastic catheter, a bulb attached to its distal end and a 15-mm concentric adapter at its proximal end. The illuminated catheter is placed into a straight silicone tracheal tube in such a way that the bulb is placed at the distal end of the tracheal tube. Six nurses inexperienced in tracheal intubation followed a 2-hr training program by using the device through the intubating laryngeal mask in a mannequin and then intubated 10 patients each, with instruction from an anaesthetist. All patients (n=60) were ASA 1-2, scheduled to undergo general anaesthesia for elective surgery. After fentanyl/propofol induction the intubating laryngeal mask was inserted. When an adequate airway was established, patients received atracurium and the endotracheal tube preloaded with the device was inserted through the intubating laryngeal mask and by observing the glow in the neck was advanced into the trachea. The final outcome and the duration of the procedure were recorded. The intubating laryngeal mask was inserted successfully in all patients. The success rate of intubation was 57/60 (95%); 38 patients at first attempt and 19 after two or three attempts. The mean (+/-SD) duration of the procedure in the first five patients in the series of each nurse was 74+/-40 s while in the last five patients it was diminished to 52+/-23 s (P=0.01). We conclude that the described methodology has the potential for more widespread use of tracheal intubation through the intubating laryngeal mask even by inexperienced personnel.

Adult↗

PubMed2001

The laryngeal mask and VBM laryngeal tube compared during spontaneous ventilation. A pilot study.

BACKGROUND AND OBJECTIVE: The laryngeal tube is a variant of the oesophageal obturator airway. The manufacturer claims that it is an alternative to ventilation with a facemask, laryngeal mask or endotracheal tube. To date, published studies have only involved controlled ventilation. We wished to find out if its use in spontaneous ventilation was equivalent to using the laryngeal mask airway. METHODS: We have compared the laryngeal tube with the laryngeal mask in a randomized prospective study involving patients breathing spontaneously under general anaesthesia. Criteria and a scoring system were used for the comparison. A sequential analysis chart with P=0.01 was chosen for each of two anaesthetists. RESULTS: Only seven and 10 pairs of patients were required to indicate that the laryngeal tube was poorer at airway maintenance than the laryngeal mask. Of the 17 patients who had received the laryngeal tube, successful airway maintenance was only possible in seven. In the remaining 10 patients, the laryngeal tube was abandoned and the rescue airway was the laryngeal mask in all cases. All 17 patients randomized to the laryngeal mask were successfully managed. CONCLUSIONS: We conclude that the laryngeal tube is not a satisfactory device for management of the airway during spontaneous ventilation.

Adult↗

PubMed2002

Particulate masks and non-powdered gloves reduce latex allergen inhaled by healthcare workers.

BACKGROUND: Although allergy to latex is a well-characterized phenomenon, some hospitals continue to provide staff with powdered latex gloves as an option to low- or non-powdered gloves. OBJECTIVE: We aimed to measure the extent to which inhalation of latex particles could be reduced by the use of protective masks or by replacing powdered latex gloves with non-powdered latex gloves. METHODS: Twenty healthcare workers in a hospital setting wore nasal air samplers (NAS) and Institute of Occupational Medicine (IOM) samplers for four 20-min periods. Subjects wore powdered gloves, non-powdered gloves and no gloves during three sampling periods, and in the fourth, subjects applied an aerosol barrier face-mask or a particulate face-mask (N95) while wearing powdered gloves. All samples were stained for particles bearing Hev b 5 allergen by the Halogen assay. RESULTS: All subjects inhaled Hev b 5 bearing particles in all sampling periods. IOM samplers collected particles at 70% of the rate of NAS. The number of particles inhaled while wearing powdered gloves was 23.8-fold higher than when not wearing gloves and 9.7-fold higher than when wearing non-powdered latex gloves (P < 0.0001). Wearing an aerosol barrier mask did not significantly reduce the number of particles inhaled (P = 0.108), while use of particulate masks significantly reduced the number of particles inhaled by 17.4-fold (P = 0.003). CONCLUSIONS: Use of non-powdered gloves is the most effective method of reducing occupational aeroallergen exposure to latex arising from gloves. However, secondary protection using particulate masks is a valid alternative, and may be helpful for preventing respiratory sensitization.

Adult↗

PubMed1998

Anticephalgic photoprotective premedicated mask. A report of a successful double-blind placebo-controlled study of a new treatment for headaches with associated frontalis pain and photophobia.

This study was performed to determine the efficacy of an anticephalgic photoprotective premedicated mask in the treatment of migraine and/or tension-type headaches. There were 54 patients. They were given masks and numbered bottles of topical medication containing either salicin or placebo. The patients were instructed to apply the medication to their frontalis region in the event they should suffer a headache, apply a photoprotective mask, and lie down. Furthermore, they were instructed to take their usual oral or parenteral medications, if required, for relief of the headache. They subsequently filled out forms rating the degree of relief which they attributed to the topical medications and the masks using a 0 to 10 scale. They were also simply asked if this form of treatment helped or not. Seven of the 20 patients receiving placebo stated the medication and mask helped. The placebo group rated the treatment an average of 4.31 on a 0 to 10 scale. Twenty-eight of 34 patients receiving salicin stated it was effective. The salicin group rated it 7.42 on a 0 to 10 scale (P < 0.001). The majority of the salicin patients stated the duration of their headaches was significantly reduced, as was their need for analgesic and/or narcotic medications. This study demonstrates a significant difference between placebo and salicin in association with the photoprotective mask in treating migraines and/or tension-type headaches with associated frontalis pain and photophobia.

Administration, Topical↗

PubMed2001

Surgical face masks in the operating theatre: re-examining the evidence.

In most modern hospitals, no one is allowed to enter the operating theatre without wearing a surgical face mask. The practice of wearing masks is believed to minimize the transmission of oro- and nasopharyngeal bacteria from operating theatre staff to patients' wounds, thereby decreasing the likelihood of postoperative surgical site infections. In this era of cost-restraints, shrinking hospital budgets, and evidence-based medicine, many health care professionals have begun to re-examine traditional infection control practices. Over the past decade, studies challenging the accepted dogma of surgical face mask usage have been published. Masks that function as protective barriers are another emerging issue. Due to a greater awareness of HIV and other blood-borne viruses, masks are taking on a greater role in protecting health care workers from potentially infectious blood and body fluids. The purpose of this review is to evaluate the latest evidence for and against routine use of surgical face masks in the operating theatre.

Cross Infection↗

PubMed2003

Pharyngeal mucosal pressures with the laryngeal tube airway versus ProSeal laryngeal mask airway.

We tested the hypothesis that mucosal pressures are higher for the laryngeal tube airway trade mark than the ProSeal laryngeal mask airway. Fifteen fresh cadavers were studied. Microchip pressure sensors were attached to the laryngeal tube airway and ProSeal laryngeal mask airway at four similar anatomical locations (base of tongue, lateral pharynx, posterior pharynx and posterior hypopharynx) and three dissimilar locations (laryngeal tube airway trade mark, anterior and lateral hypopharynx; ProSeal laryngeal mask airway, pyriform fossa). The cuff volume (laryngeal tube airway, < or = 140 ml; ProSeal laryngeal mask airway, < or = 30 ml) was adjusted until the oropharyngeal leak pressure was 15 cm H2O and the mucosal pressures recorded. This was repeated at an oropharyngeal leak pressure of 20, 25 and 30 cm H2O. Mucosal pressures in the lateral pharynx were always similar. Mucosal pressures at the base of tongue and posterior pharynx were similar for the laryngeal tube airway and ProSeal laryngeal mask airway at 15 and 20 cm H2O, but were higher for the laryngeal tube airway at 25 cm H2O at 30 cm H2O. Mucosal pressures in the posterior hypopharynx were always higher for the laryngeal tube airway (all: p < 0.03). Mean mucosal pressures for the laryngeal tube airway ranged from 8-31, 2-13 and 15-41 cm H2O for the base of tongue, lateral pharynx and posterior pharynx (proximal cuff) respectively and 3-7, 3-7 and 7-18 cm H2O for the anterior, lateral and posterior hypopharynx (distal cuff) respectively. Mean mucosal pressures for the ProSeal laryngeal mask airway ranged from 6-23, 3-10, 8-25, 6-17 and 2-8 cm H2O for the base of tongue, lateral pharynx, posterior pharynx, pyriform fossa and posterior hypopharynx respectively. We conclude that mucosal pressures are higher for the laryngeal tube airway, particularly when oropharyngeal leak pressure greater than 25 cm H2O. This suggests that mucosal ischemic injury will be more common with the LTA than the PLMA.

Aged↗

PubMed1995

[Unexpectedly difficult intubation: fiberoptic endotracheal intubation with the laryngeal mask].

A 67-year old patient, scheduled for elective transvesical resection of the prostate gland, presented intubation problems. Fibreoptic assessment of the larynx revealed secretions as well as a swollen laryngeal mucosa; endotracheal intubation guided by the fibreoptic bronchoscope was not possible. After multiple attempts to intubate the trachea a laryngeal mask airway was inserted. Endotracheal intubation was completed by guidance of the fibreoptic bronchoscope via the laryngeal mask airway. After surgery the patient was transferred to an ICU and ventilated for one day. Fibreoptically controlled extubation was uneventful. Management of the unexpectedly difficult intubation is a challenge for every anaesthetist. The laryngeal mask airway, a relatively new device for airway protection, has proved to be beneficial in planned as well as in unexpectedly difficult endotracheal intubation. However, although the laryngeal mask airway may solve ventilation problems initially, prelaryngeal alterations present a contraindication for perioperative ventilation via the laryngeal mask airway. The fibreoptic intubation through the laryngeal mask airway is an important technique to consider in the "cannot intubate" situation.

Aged↗

PubMed1979

Decrease in metacontrast masking following adaptation to flicker.

Selective adaptation was used to explore the characterisitcs of a metacontrast masking stimulus which contribute to its effectiveness in masking the test stimulus. Subjects adapted for 10 s to a configuration like the masking stimulus that was either continuously on or flickering. Following this they viewed a metacontrast presentation and estimated the brightness of the test stimulus. Prior adaptation to a continuously present stimulus did not appreciably affect metacontrast masking; however, masking was greatly reduced following adaptation to flickering stimuli. These results are consistent with recent models of metacontrast masking based on transient and sustained visual channels.

Adaptation, Ocular↗

PubMed1982

Visual masking: a unified approach.

The suppression effect observed in masking is assumed to be due to neural inhibition between two stimuli that interact spatially or within a narrow span of time in the fashion demonstrated in simultaneous brightness-contrast experiments. Three principles are brought together in a comprehensive mathematical model of visual masking. The three principles are: lateral inhibition, the integrated visual response function (VRF), and stimulus decay after its offset over a limited period of time (up to about 100 ms). Block's law is extended to apply to the integration of the VRF, including decay. The three principles combined are sufficient to explain well-known masking phenomena such as metacontrast, and forward and backward masking. The mathematical model presented demonstrates clearly the common underlying basis of all masking. The validity of the lesser documented decay after stimulus offset, a necessary assumption to explain masking effects with stimuli that are delayed relative to each other, is demonstrated with experimental evidence.

Humans↗

PubMed1988

Uniform-field flicker masking in control and specifically-disabled readers.

Possible transient-system deficiencies in subjects with specific reading disabilities (SRDs) were investigated in groups of 13-year-old SRDs and control normal readers. In experiment 1, in which a 6 Hz uniform-field flicker (UFF) mask and a stationary test stimulus were used, it was found that the overall effect of UFF masking was to reduce differences in contrast sensitivity between SRDs and normal readers. In experiments 2a and 2b, with UFF masks of 6 and 20 Hz and a 6 Hz moving (experiment 2a) or flickering (experiment 2b) test stimulus, contrast sensitivity in both groups was decreased in the presence of the 6 Hz UFF mask. Only the control group, however, showed a further decrease in sensitivity with the 20 Hz UFF mask. This indicates that the groups differ in terms of a mechanism sensitive to high temporal frequencies. A 20 Hz counterphase flickering test stimulus was used in experiment 3 in the presence of 6 Hz UFF, and it was found that SRDs are less sensitive than controls to 20 Hz flicker across all spatial frequencies used. The 6 Hz mask, however, did not differentially affect the two groups. These findings provide further evidence for a transient-system deficit in the visual systems of SRDs, but also suggest a more complex situation by showing that the two groups differ in a high-temporal-frequency mechanism.

Child↗

PubMed1992

Lateral masking as a determinant of global dominance.

The term compound letter refers to a large (global) letter made up of small (local) letters. Reaction time to identify local letters is longer when local and global letters are different than when they are the same (the global dominance effect). The possible contribution of lateral masking to this effect was investigated. Lateral masking denotes reduced probability of identifying a stimulus when it is closely surrounded by other stimuli (as is the case for the local items in a compound stimulus). Three experiments were conducted in which the dependent measure was percentage of correct responses, rather than reaction time. In experiment 1 compound letters were used; accuracy of performance yielded evidence of global dominance such as obtained with reaction time measures. In experiments 2 and 3 the strength of lateral masking in geometrical forms was varied by varying the density of their component items. In agreement with earlier suggestions based on indirect evidence, the results directly implicated lateral masking as an important determinant of global dominance. However, lateral masking could not account fully for the experimental outcome. Factors beyond lateral masking, such as global precedence in the processing sequence or inhibitory interactions among low and high spatial-frequency components of the compound images are required in order to provide a comprehensive account of global dominance effects.

Cognition↗