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PubMed1998

Accuracy of predicted ear canal speech levels using the VIOLA input/output-based fitting strategy.

OBJECTIVE: The Visual Input/Output Locator Algorithm (VIOLA) is a software-assisted method for prescribing amplification targets and selecting a hearing aid to match the targets. Although the procedure calls for selection and fitting of hearing aids in terms of their pure-tone input/output functions in a coupler, it is assumed that a hearing aid that matches the coupler prescription targets will produce specific amplified speech levels in the patient's ear canal. This investigation evaluated the validity of that assumption. DESIGN: Six hearing aids were evaluated. They were representative of linear and compression processing as well as single- and 2-channel designs. The "subject" was a KEMAR manikin with realistic assumed hearing loss and loudness perception characteristics. Each hearing aid was configured to match the subject's VIOLA prescription as closely as possible. Predicted ear canal speech levels were determined using the prescription rules and modified by the differences between coupler prescription targets and coupler performance of the actual hearing aids. With the subject wearing each hearing aid coupled to an unvented earmold, continuous speech was presented in the sound field and measured, after amplification, in the ear canal. The match between observed and predicted levels of amplified speech indicated the validity of the VIOLA assumptions under examination. RESULTS: The match between predicted and observed levels was good for soft speech input levels. As speech input levels increased, the differences between observed and predicted levels also increased, with the largest differences seen for loud speech inputs. When differences were seen between observed and predicted levels, they were always in the direction of lower than predicted ear canal levels. The differences between observed and predicted levels were attributed to the effects of limiting, effects of compression ratio in wide range compression, the individual subject's field-to-microphone transfer function, and the subject's individual real-ear-to-coupler level difference. CONCLUSIONS: Ear canal speech levels were reasonably close to predicted values, and the deviations from predicted levels were plausibly accounted for by consideration of hearing aid performance. Thus, the approach used by the VIOLA procedure holds considerable promise for extending clinical control over the complex and interactive parameters of nonlinear hearing aids. The results of this study indicate that selection and fitting of hearing aids using the current VIOLA procedure usually will result in the generation of lower than predicted ear canal speech levels, especially for loud speech inputs. However, the accuracy of the procedure could be improved substantially by modification of the software to account for the effects of limiting and those of the compression ratio in systems with compression thresholds lower than the level of unamplified loud speech.

Ear Canal↗
PubMed2006

Temporal structure in zebra finch song: implications for motor coding.

Adult zebra finch songs consist of stereotyped sequences of syllables. Although some behavioral and physiological data suggest that songs are structured hierarchically, there is also evidence that they are driven by nonhierarchical, clock-like bursting in the premotor nucleus HVC (used as a proper name). In this study, we developed a semiautomated template-matching algorithm to identify repeated sequences of syllables and a modified dynamic time-warping algorithm to make fine-grained measurements of the temporal structure of song. We find that changes in song length are expressed across the song as a whole rather than resulting from an accumulation of independent variance during singing. Song length changes systematically over the course of a day and is related to the general level of bird activity as well as the presence of a female. The data also show patterns of variability that suggest distinct mechanisms underlying syllable and gap lengths: as tempo varies, syllables stretch and compress proportionally less than gaps, whereas syllable-syllable and gap-gap correlations are significantly stronger than syllable-gap correlations. There is also increased temporal variability at motif boundaries and especially strong positive correlations between the same syllables sung in different motifs. Finally, we find evidence that syllable onsets may have a special role in aligning syllables with global song structure. Generally, the timing data support a hierarchical view in which song is composed of smaller syllable-based units and provide a rich set of constraints for interpreting the results of physiological recordings.

Animals↗
PubMed2004

Methods for testing automatic mode switching in patients implanted with DDD(R) pacemakers.

The assessment of automatic mode switching (AMS) algorithms is impossible in vivo, due to a low chance of seeing the patient at the onset of a spontaneous episode of atrial fibrillation (AF). As the induction of AF to test AMS has clinical concerns, three alternative and non-invasive techniques may be proposed for this purpose: myopotentials, chest wall stimulation, and an external supraventricular arrhythmia simulator. The first method is simple and does not require additional equipment, even though in some patients adequate signals cannot be generated with a soft effort such as handgrip or hand compression. The main advantage of the chest wall stimulation method is the possibility that it be performed in every implanting center, since it is based on the use of standard devices for cardiac stimulation. The method based on the external supraventricular arrhythmia simulator allows the most detailed of the ECG traces, but it needs a dedicated electronic device.

Atrial Fibrillation↗
PubMed1995

Suprascapular nerve entrapment by ganglion cysts: a report of six cases with arthroscopic findings and review of the literature.

Suprascapular nerve entrapment by a ganglion cyst can produce pain and shoulder dysfunction. We report six cases with the associated arthroscopic intraarticular findings of a posterior capsulolabral injury (only the second such description) and review the literature. Based on the current literature and our experience, we document our treatment algorithm for suprascapular nerve entrapment secondary to a ganglion cyst. We believe it is necessary to evaluate and treat the intraarticular pathology as well as the ganglion cyst/nerve entrapment to successfully manage these patients.

Adult↗
PubMed2001

A data compression method for image time series.

Image time series for functional studies frequently vary relatively little from one time point to the next. We describe here a method of lossless file compression that calculates the change in signal intensity as a char (one byte), as opposed to a short or long integer (usually two or four bytes), thus resulting in a compressed file size just over half the size of the original (a 2:1 compression ratio). The calculations and format are exceedingly simple; the compression time is comparable to the time required for a file copy, and is thus transparent to most users. The approach works equally well on any integer-based scanning modality, such as PET, CT, or DSA. Our purpose in this communication is to advocate it as a potential standard, to promote free interchange of scan data.

Algorithms↗
PubMed1994

Mediastinal tumors--airway obstruction and management.

Large mediastinal massess can cause compression of surrounding mediastinal structures. Patients may have symptoms of airway obstruction or cardiovascular compromise. The additive effects of anesthetics, paralysis, and positioning during biopsy can lead to acute airway obstruction and death. In some cases, tissue diagnosis can be achieved and treatment initiated without general anesthesia. When general anesthesia is necessary, specific measures should be taken to avoid disaster or immediately alleviate obstruction should it occur. Some patients at greatest risk will require pretreatment of the mass before tissue diagnosis. This article reviews these issues and provides a useful algorithm for managing patients with mediastinal masses.

Adolescent↗
PubMedDate not supplied

Rationale for zoledronic acid therapy in men with hormone-sensitive prostate cancer with or without bone metastasis.

Men with prostate cancer are at risk for bone loss and skeletal complications throughout the course of their disease. Bone loss is prevalent in many men with prostate cancer at initial diagnosis, and initiating androgen deprivation therapy results in accelerated bone resorption, leading to bone loss and an increased risk of fracture. These men are also at high risk for disease progression and bone metastases that can result in significant skeletal morbidity, including pathologic fracture, spinal cord compression, and debilitating bone pain requiring additional therapy. Excessive osteoclast activity plays a central role in the pathophysiology of bone disease at each stage of prostate cancer disease progression. Zoledronic acid, a highly potent inhibitor of osteoclast-mediated bone resorption, has increased bone mineral density in men receiving androgen deprivation therapy and is the only bisphosphonate that has shown statistically significant reductions in skeletal morbidity in patients with bone metastases from prostate cancer. Furthermore, preclinical evidence suggests that zoledronic acid has antitumor activity in prostate cancer models. Recently, a treatment algorithm was developed by the 3rd International Consultation on Prostate Cancer recommending the use of zoledronic acid for the prevention of skeletal complications in patients with bone metastases from prostate cancer, regardless of their hormone status, and for the prevention of treatment-induced bone loss in patients without evidence of bone metastases. According to this algorithm, zoledronic acid should be considered for the prevention of skeletal morbidity in patients with prostate cancer throughout their treatment continuum.

Algorithms↗
PubMed2005

Cervical pedicle screws: conventional versus computer-assisted placement of cannulated screws.

STUDY DESIGN: Prospective clinical study with postoperative radiologic control of pedicle screw placement in the cervical spine. OBJECTIVES: To evaluate whether cervical pedicle screws can be placed safely in a conventional technique when using cannulated screws and separate stab incisions. Also, to evaluate if accuracy and safety of pedicle screw placement can be improved using a computer-assisted surgery (CAS) system (VectorVision; BrainLAB AG, Heimstetten, Germany). SUMMARY OF BACKGROUND DATA: Pedicle screws are rarely used in the cervical spine compared to the use in lumbar and thoracic spine. The main reason is probably the potential risk of iatrogenic damage to the spinal cord, nerve roots, or vertebral artery caused by screw misplacement as well as the more demanding technique of pedicle screw placement in the cervical spine. METHODS: A total of 52 consecutive patients with posterior cervical or cervicothoracic instrumentations using pedicle screws were evaluated prospectively. For the first 20 patients, 93 pedicle screws were implanted using the conventional technique with the image intensifier in the lateral view, and for the next 32 patients (167 screws), a CAS system was additionally used. For registration of the vertebra, surface-matching algorithms were used. For evaluation of screw placement, postoperative computerized tomography with multiplanar reconstructions in the screw axis was performed for each screw. RESULTS: No implant-related complications were observed. No neurologic or vascular complications were found related to pedicle screws. The rate of pedicle perforations was 8.6% (8 screws) in the conventional group and 3.0% (5 screws) in the CAS group, and in all cases, less than 2-mm displacement. None of the screws with pedicle perforation had to be revised as a result of nonsufficient biomechanical stability or compression of neural/vascular structures. CONCLUSIONS: Transpedicular screws in the cervical spine and cervicothoracic junction can be applied safely and with high accuracy in a conventional technique. Cannulated screws and the use of separate stab incisions from C3-C6 with a trocar system allow for reduced screw misplacement rates. The CAS system leads to significantly reduced screw misplacement rates. Therefore, because of the potential risk of injury to the vertebral artery and neural elements, the use of a CAS system seems to be beneficial, especially for pedicle instrumentation C3-C6.

Adult↗
PubMedDate not supplied

[Diagnosis of textilomas].

Despite all the precautions during surgery, it may be assert that obliviousness of a compress or of a mesh remains still possible. In order to define this accident a non-medical term, textiloma, is used, only in hospital environment. Radiology and medical imaging represent the main tool for the diagnosis of textilomas. Plain film of the abdomen and/or ecography may be sufficient for revealing the textiloma. Just in a few cases a computed tomography may be required. In order to demonstrate all these, using two cases, we'll emphasize the main radio-semiological aspect of textilomas, and thus intending to establish an examination algorithm.

Diagnosis, Differential↗
PubMed2004

Molecular dynamics simulations of HPr under hydrostatic pressure.

The histidine-containing protein (HPr) plays an important role in the phosphotransferase system (PTS). The deformations induced on the protein structure at high hydrostatic pressure values (4, 50, 100, 150, and 200 MPa) were previously (H. Kalbitzer, A. Görler, H. Li, P. Dubovskii, A. Hengstenberg, C. Kowolik, H. Yamada, and K. Akasaka, Protein Science 2000, Vol. 9, pp. 693-703) analyzed by NMR experiments: the nonlinear variations of the amide chemical shifts at high pressure values were supposed to arise from induced shifts in the protein conformational equilibrium. Molecular dynamics (MD) simulations are here performed, to analyze the protein internal mobility at 0.1 MPa, and to relate the nonlinear variations of chemical shifts observed at high pressure, to variations in conformational equilibrium. The global features of the protein structure are only slightly modified along the pressure. Nevertheless, the values of the Voronoi residues volumes show that the residues of alpha-helices are more compressed that those belonging to the beta-sheet. The alpha-helices are also displaying the largest internal mobility and deformation in the simulations. The nonlinearity of the 1H chemical shifts, computed from the MD simulation snapshots, is in qualitative agreement with the nonlinearity of the experimentally observed chemical shifts.

Algorithms↗
PubMed2006

Variable-length lapped transforms with a combination of multiple synthesis filter banks for image coding.

A class of lapped transforms for image coding, which are characterized by variable-length synthesis filters, is introduced. In this class, the synthesis filter bank (FB) is first defined with an arbitrary combination of finite impulse response synthesis filters of perfect reconstruction FBs. An analysis FB is then obtained using direct matrix inversion or iterative implementation of Neumann series expansion. Moreover, to improve compression, we introduce a unitary transform that follows the analysis FB. This class enables a greater freedom of design than previously presented variable-length lapped transforms. We illustrate several design examples and present experimental results for image coding, which indicate that the proposed transforms are promising and comparable with conventional subband transforms including wavelets.

Algorithms↗
PubMed2004

Estimation of displacement vectors and strain tensors in elastography using angular insonifications.

In current practice, only one out of three components of the tissue displacement vector and one of nine components of the strain tensor are accurately estimated and imaged in ultrasound elastography. Since, only the axial component of both the displacement and strain are imaged, other important elastic parameters, such as shear strains and the Poisson's ratio, also are not imaged. Moreover, reconstruction of the Young's modulus would be significantly improved if all components of the strain tensor were available. In this paper, we describe a new method for estimating all the components of the tissue displacement vector following a quasi-static compression. The method uses displacements estimated from radiofrequency echo-signals along multiple ultrasound beam insonification directions. At each spatial location in the compressed medium, orthogonal tissue displacements in both the axial and lateral direction with respect to the direction of the applied compression are estimated by curve fitting angular displacement vector data calculated for all insonification directions. Following displacement estimation in orthogonal directions, components of the corresponding normal and shear strain tensors are estimated. Simulation and experimental results demonstrate the utility of this technique for the computation of the normal and shear strain tensors.

Algorithms↗
PubMed1997

Quantitative coronary arteriography: current status and future.

Quantitative coronary arteriography (QCA) has been accepted as a means for the objective assessment of vessel sizing. Gradient field transform (GFT) is now available as a third generation QCA approach for the quantification of complex morphology. In the meantime the DICOM-3 (DICOM: Digital Imaging and Communications in Medicine) standard has been accepted for the exchange of digital data acquired in a catheterization laboratory. Issues to be resolved in digital imaging include the basic question of whether the commonly used matrix size of 512 x 512 pixels and 8 bits of density resolution is really sufficient to appreciate the same fine details as are visible on cinefilm. Other major issues of differences between the conventional cinefilm and the modern digital approach are edge enhancement and image compression. We believe that digital imaging and the DICOM-3 standard are here to stay; although the transition period may take longer and be hampered in practice by more hurdles than were originally anticipated, in a few years' time, 35-mm film will be an exception.

Algorithms↗
PubMed2005

Compressive nanomechanics of opposing aggrecan macromolecules.

In this study, we have measured the nanoscale compressive interactions between opposing aggrecan macromolecules in near-physiological conditions, in order to elucidate the molecular origins of tissue-level cartilage biomechanical behavior. Aggrecan molecules from fetal bovine epiphyseal cartilage were chemically end-grafted to planar substrates, standard nanosized atomic force microscopy (AFM) probe tips (R(tip) approximately 50 nm), and larger colloidal probe tips (R(tip) approximately 2.5 microm). To assess normal nanomechanical interaction forces between opposing aggrecan layers, substrates with microcontact printed aggrecan were imaged using contact mode AFM, and aggrecan layer height (and hence deformation) was measured as a function of solution ionic strength (IS) and applied normal load. Then, using high-resolution force spectroscopy, nanoscale compressive forces between opposing aggrecan on the tip and substrate were measured versus tip-substrate separation distance in 0.001-1M NaCl. Nanosized tips enabled measurement of the molecular stiffness of 2-4 aggrecan while colloidal tips probed the nanomechanical properties of larger assemblies (approximately 10(4) molecules). The compressive stiffness of aggrecan was much higher when using a densely packed colloidal tip than the stiffness measured for using the nanosized tip with a few aggrecan, demonstrating the importance of lateral interactions to the normal nanomechanical properties. The measured stress at 0.1M NaCl (near-physiological ionic strength) increased sharply at aggrecan densities under the tip of approximately 40 mg/ml (physiological densities are approximately 20-80 mg/ml), corresponding to an average inter-GAG spacing of 4-5 Debye lengths (4-5 nm); this characteristic spacing is consistent with the onset of significant electrostatic interactions between GAG chains of opposing aggrecan molecules. Comparison of nanomechanical data to the predictions of Poisson-Boltzmann-based models further elucidated the regimes over which electrostatic and nonelectrostatic interactions affect aggrecan stiffness in compression. The most important aspects of this study include: the incorporation of experiments at two different length scales, the use of microcontact printing to enable quantification of aggrecan deformation and the corresponding nanoscale compressive stress vs. strain curve, the use of tips of differing functionality to provide insights into the molecular mechanisms of deformation, and the comparison of experimental data to the predictions of three increasingly refined Poisson-Boltzmann (P-B)-based theoretical models for the electrostatic double layer component of the interaction.

Aggrecans↗
PubMed2003

[Ultrasound diagnostic techniques in dermatologic angiology and phlebology].

The diagnostic uses of high-resolution ultrasonography (7.5-20 MHZ) have dramatically advanced in the past 20 years. We present representative examples of ultrasound diagnosis, based on our experience with over 15,000 examinations. For example, peripheral arterial disease was identified in 30% of older patients with venous diseases, while peripheral emboli and vasculitis can lead to widespread skin disease. Ultrasonographic diagnosis is required for appropriate interdisciplinary treatment. In addition, regular evaluation of the supra-aortic vessels and coronary arteries as well as arteries and veins of the limbs is needed in some forms of vasculitis. The causes of peripheral venous disease can be subdivided into four groups based on sonographic findings: Primary or secondary epi- and/or subfascial venous insufficiency, thrombotic venous occlusion, venous compression syndrome and arteriovenous-lymphatic malformations. The diagnosis and therapeutic approach to lymphedema and soft tissue diseases, with or without lymphadenopathy, requires careful sonographic evaluation. Ultrasonography is an essential part of dermatologic oncology, both for planning primary therapy and for follow-up. A sound command of ultrasonography is today an essential aspect of dermatologic diagnosis and therapy.

Algorithms↗
PubMed1995

Dynamic behavior of a biphasic cartilage model under cyclic compressive loading.

It is well known that dynamic mechanical loads can stimulate the biosynthetic activity of articular cartilage. Studying the mechanical environment of chondrocytes under dynamic loading conditions can help to explain this mechano-biological phenomenon in articular cartilage. In this study, the linear biphasic theory was used to examine the dynamic mechanical behavior of articular cartilage under a cyclic compressive force. We first studied the dynamic confined compression of a cartilage disk as a simplified one-dimensional model and then investigated the role of the relatively impermeable subchondral bone structure on the dynamic behavior of the cartilage extracellular matrix (ECM). Under an assumption of articular cartilage as a biphasic composite structure of a porous elastic solid matrix and interstitial fluid, the porous ECM of the articular cartilage was repeatedly compressed and expanded during the loading-unloading phases of the cyclic compressive force. One interesting finding of this study was the oscillating positive (supra-ambient)-negative (sub-ambient) hydrostatic pressure within the cartilage ECM under cyclic compressive loading. The pattern of the dynamic behavior of the cartilage ECM strongly depended on the loading frequency and the primary diffusion characteristic time, tau d. This finding is consistent with those of previous studies (Guilak et al., 1990 Adv Biomech. ASME, 225-228; Mow et al., 1990, Biomechanics of Diarthrodial Joints, pp. 215-260.

Algorithms↗
PubMed1996

Noise reduction in elastograms using temporal stretching with multicompression averaging.

Elastography uses estimates of the time delay (obtained by cross-correlation) to compute strain estimates in tissue due to quasistatic compression. Because the time delay estimates do not generally occur at the sampling intervals, the location of the cross-correlation peak does not give an accurate estimate of the time delay. Sampling errors in the time-delay estimate are reduced using signal interpolation techniques to obtain subsample time-delay estimates. Distortions of the echo signals due to tissue compression introduce correlation artifacts in the elastogram. These artifacts are reduced by a combination of small compressions and temporal stretching of the postcompression signal. Random noise effects in the resulting elastograms are reduced by averaging several elastograms, obtained from successive small compressions (assuming that the errors are uncorrelated). Multicompression averaging with temporal stretching is shown to increase the signal-to-noise ratio in the elastogram by an order of magnitude, without sacrificing sensitivity, resolution or dynamic range. The strain filter concept is extended in this article to theoretically characterize the performance of multicompression averaging with temporal stretching.

Algorithms↗
PubMed2006

Two-dimensional multi-level strain estimation for discontinuous tissue.

A large number of the strain estimation methods presented in the literature are based on the assumption of tissue continuity that establishes a continuous displacement field. However, in certain locations in the body such as the arteries in vivo scanning may produce displacement fields that are discontinuous between the two walls of the artery. Many of the displacement or strain estimators fail when the displacement fields are discontinuous. In this paper, we present a new 2D multi-level motion or displacement tracking method for accurate estimation of the strain in these situations. The final high-resolution displacement estimate is obtained using two processing steps. The first step involves an estimation of a coarse displacement estimate utilizing B-mode or envelope signals. To reduce computational time, the coarse displacement estimates are obtained starting from down-sampled B-mode pre- and post-compression image pairs using a pyramidal processing approach. The coarse displacement estimate obtained from the B-mode data is used to guide the final 2D cross-correlation computations on radio-frequency (RF) data. Results from finite element simulations and in vivo experimental data demonstrate the feasibility of this approach for imaging tissue with discontinuous displacement fields.

Algorithms↗