An implantable microphone for electronic hearing aids

Fully implantable hearing aids and cochlea implants of the future require an implantable microphone. A hermetically sealed implantable microphone based on the idea of a microphone implanted in the posterior wall of the auditory canal, as suggested by Ohno et al. in 1988, is presented. Through consistent technological and clinical design optimization, it was possible to achieve a membrane diameter of only 4.5 mm (as opposed to 8 mm in the Japanese system) and a significant volume reduction of nearly 50%. The microphone weights only 0.4 g. In spite of this miniaturization, the performance characteristics of the microphone equal those of the Japanese model or are superior. The sound-pressure transfer function shows a very small ripple and the bandwidth amounts to approximately 10 kHz. Because of its high tuning and high no-load resonance frequency, the microphone is mostly insensitive to post-operational changes to the loading mass on the microphone membrane initiated by the covering skin of the auditory canal. The sound-pressure transfer factor at 1000 Hz is approximately 1.5 mV/Pa. Using different manufacturing technologies, this value can be increased in the range of 6-8 dB with a corresponding reduction in bandwidth. Due to the small mass, the microphone is highly insensitive to environmental mechanical disturbances. The module is made of pure titanium and is hermetically sealed according to Mil-Std 883 D. Full metal encapsulation and additional internal electronic components protect the microphone well against environmental electromagnetic influences (EMC).     

An implantable electromagnetic sound source for speech production

Many operative and nonsurgical procedures have been designed for vocal rehabilitation following laryngectomy, but as yet a consistently successful solution with a negligible complication rate has failed to materialize. In our laboratory during the last two years, experiments have been carried out in dogs using active electromagnetic devices placed in the retropharynx as an energy source for speech production. An implantable porous coated stainless steel electromagnetic device energized from an externally controlled oscillator has been developed. Factors under investigation included biocompatibility of materials, durability, noise quality and intensity, together with the efficiency of the system. As a result of the favorable findings, it is envisaged that this system will soon be used in a carefully designed restricted clinical trial as a secondary procedure in those consenting cured laryngeal cancer patients who have failed to develop esophageal speech.     

An experimental implantable urinary sphincter

An artificial urethral sphincter was implanted in 10 dogs and observed for periods up to 18 months. No necrosis or strictures of the urethra developed. The plastic part of the device failed in 10 to 18 months.     

An implantable centrifugal blood pump for long term circulatory support

A compact centrifugal blood pump was developed as an implantable left ventricular assist system. The impeller diameter is 40 mm and the pump dimensions are 55 x 64 mm. This first prototype was fabricated from titanium alloy, resulting in a pump weight of 400 g including a brushless DC motor. Weight of the second prototype pump was reduced to 280 g. The entire blood contacting surface is coated with diamond like carbon to improve blood compatibility. Flow rates of over 7 L/min against 100 mmHg pressure at 2,500 rpm with 9 W total power consumption have been measured. A newly designed mechanical seal with a recirculating purge system ("Cool-Seal") is used as a shaft seal. In this seal system, seal temperature is kept under 40 degrees C to prevent heat denaturation of blood proteins. Purge fluid also cools the pump motor coil and journal bearing. The purge fluid is continuously purified and sterilized by an ultrafiltration filter incorporated into the paracorporeal drive console. In vitro experiments with bovine blood demonstrated an acceptably low hemolysis rate (normalized index of hemolysis = 0.005 +/- 0.002 g/100 L). In vivo experiments are currently ongoing using calves. Via left thoracotomy, left ventricular apex-descending aorta bypass was performed utilizing a PTFE (Polytetrafluoroethylene) vascular graft, with the pump placed in the left thoracic cavity. In two in vivo experiments, pump flow rate was maintained at 5-8 L/min, and pump power consumption remained stable at 9-10 W. All plasma free hemoglobin levels were measured at < 15 mg/dl. The seal system has demonstrated good seal capability with negligible purge fluid consumption (< 0.5 ml/ day). Both animals remain under observation after 162 and 91 days of continuous pump function.     

A biotelemetry system for monitoring heart rates in unrestrained ungulates

An EKG telemetry system has been designed for use on free-living ungulates. An FM transmitter with a battery life of 2 +/-0.5 months and a range of 2-6 km is mounted on the back of the animal by means of an adjustable harness. The EKG signal is detected by subdermal electrodes overlying the sternum and transmitted to an FM receiver equipped with a frequency down-converter. The output of the receiver is the modulated audio carrier which is recorded on magnetic tape. The EKG waveform is recovered from the tape-recorded signal using an FM demodulator connected to a strip chart recorder.     

差压式双法兰液位计在五羰基铁蒸发器上的应用

采用羰基法生产羰基铁粉的过程中,液态五羰基铁液体经过贮罐压力自压后进入蒸发器中进行蒸发,蒸发形成的五羰基铁气体进入与之相连的分解器中进行分解,从而生产出各种指标的羰基铁粉。本文主要讨论了羰基铁粉生产过程中的关键设备-五羰基铁蒸发器的控制参数,其中蒸发器液位计的控制尤为重要,在生产过程中液位计出现了不同形式的运行故障,根据故障现象进行分析并找到相应的解决方案。     

An overview of the fifth-generation implantable cardioverter defibrillator

It has been established that treatment with an implantable cardioverter is effective for life-threatening arrhythmia including ventricular tachycardia (VT) and ventricular fibrillation (VF). Although most third and fourth-generation implantable cardioverter defibrillator (ICD) models are effective for the treatment of VT and VF, they often misinterpret supraventricular tachycardia (SVT), and the incidence of inappropriate therapy delivered is as high as 20 to 40%. To solve this clinical problem, the dual-chamber ICD was developed. According to the current reports on a study of the main fifth-generation ICD models that have been clinically used, 86 to 100% sensitivity regarding discrimination was obtained. In addition, the sensitivity for delivering appropriate therapy for VT was 97 to 100%. Since the indications for ICD therapy are being expanded, additional improvement of the device and adequate patient selection are recommended.     

An implantable hearing aid for inner ear hearing loss. Short-term implantation of microphone and transducer

A microphone constructed for implantation in the posterior wall of the auditory canal and a piezoelectric transducer serving as the main components of an implantable hearing aid were temporally implanted in five patients during middle ear surgery under local anesthesia. The microphone was positioned beneath the skin of the auditory canal such that it completely covered the microphone membrane. The vibratory element of the transducer was coupled to the malleus in four patients with normal ossicular chains and directly to the stapes in one patient with missing incus. The microphone and transducer were electrically connected with an external battery-driven signal amplifier. Speech material and music were presented in the operation room at a sound level of 65 dB SPL under free-field conditions. The patients had to estimate the quality of speech, music, and their own voice as well as the effects of bone-conducting noises. All patients were able to hear with the system. An intraoperative talk without vision contact was possible without any problems, as was understanding of numerals ("Freiburger Zahlentest"). Perception of music was judged as "clear and undistorted with all broadband component." The estimation was also valid for one patient with a sensorineural hearing loss. One patient declared the music to be "a little of unnatural." Bone-conducted sound was estimated as normal in two patients, better than without an implant in one patient with sensorineural hearing loss, and "somewhat metallic" in another patient. Hearing the own voice was considered "normal" in two cases "monotonous" in one case, and "a little bit roaring" in another case. An amplification factor that can be technically realized in an implantable hearing aid was necessary for one of the patients with sensorineural hearing loss to perceive music at a pleasant volume. On the basis of this study, essential requirements for the construction of a fully implantable hearing aid are fulfilled.     

An implantable piezoelectric hearing aid transducer for inner ear deafness. II: Clinical implant]

A miniature, hermetically sealed implant was development and manufactured in several clinical and technical iteration steps based on the prototype of an implantable piezo-electric hearing-aid transducer described in Part 1 of the work presented here. The transducer is made of pure titanium (medical grade 2, ASTM F67) and designed to be implanted into the mastoid cavity. Transfer of mechanical oscillations to an ossicle in the middle ear is effected by a fixed directly coupling rod of pure titanium or via suitable coupling elements. The transducer is highly tuned with a resonance frequency in the range of 7-10 kHz, depending on the dynamic mass load. Below this resonance and down to low frequencies, the frequency response of elongation is smooth with a very small ripple of less than +/- 1 dB. Unlike the prototype, an increase in vibration amplitude of around 10 dB was achieved for a comparable power consumption. Vibration amplitude at low and middle frequencies is about 60 nm with a transducer voltage of 1 V, corresponding to an equivalent sound-pressure level of around 100 dB SPL at up to 1 kHz. At higher frequencies of up to 10 kHz, the output level increases to beyond 130 dB SPL. Nonlinear distortions at maximum volume (1 V) are extremely small (THD < 0.1%) throughout the whole transfer range. Due to an extremely short attack time (50 microseconds) and short release time (approximately 2 ms), the dynamic properties of the transducer allow good transmission of audio signals with fast changes in the time domain, i.e., plosives in speech signals. Electric power consumption at full volume and broadband signals is in the region of 1 microW. Unlike electromagnetic transducers described in the literature, the low power consumption of this piezoelectric transducer allows the realization of fully implantable hearing aids for rehabilitation of moderate to severe sensorineural hearing loss.     

The lifetime lessons of six psychologists: An introduction.

This article introduces the special section of Psychotherapy—"Lasting Lessons from a Lifetime of Conducting and Researching Psychotherapy." This special section was designed for prominent psychologists of disparate persuasions to articulate the most important lessons they have learned from their years of psychotherapy practice and research. They have been explicitly asked not to explicate the origins or the fundamentals of their theoretical orientations. Rather, they will each share a limited number of enduring lessons, which they have culled from their lifetimes and which they would emphasize to other psychotherapists. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Thin film rechargeable lithium batteries for implantable devices

Thin films of LiCoO2 have been synthesized in which the strongest x-ray reflection is either weak or missing, indicating a high degree of preferred orientation. Thin film solid state batteries with these textured cathode films can deliver practical capacities at high current densities. For example, for one of the cells, 70% of the maximum capacity between 4.2 and 3 V (approximately 0.2 mAh/cm2) was delivered at a current of 2 mA/cm2. When cycled at rates of 0.1 mA/cm2, the capacity loss was < or = 0.001%/cycle. The reliability and performance of Li-LiCoO2 thin film batteries make them attractive for application in implantable devices such as neural stimulators, pacemakers, and defibrillators.     

A single-channel implantable microstimulator for functional neuromuscular stimulation

This paper describes a single-channel implantable microstimulator for functional neuromuscular stimulation. This device measures 2 x 2 x 10 mm3 and can be inserted into paralyzed muscle groups by expulsion from a hypodermic needle. Power and data to the device are supplied from outside by RF telemetry using an amplitude-modulated 2-MHz RF carrier generated using a high-efficiency class-E transmitter. The transmitted signal carries a 5-b address which selects one of the 32 possible microstimulators. The selected device then delivers up to 2 microC of charge store in a tantalum chip capacitor for up to 200 microseconds (10 mA) into loads of < 800 omega through a high-current thin-film iridium-oxide (IrOx) electrode (approximately 0.3 mm2 in area). A bi-CMOS receiver circuitry is used to: generate two regulated voltage supplies (4.5 and 9 V), recover a 2-MHz clock from the carrier, demodulate the address code, and activate the output current delivery circuitry upon the reception of an external command. The overall power dissipation of the receiver circuitry is 45-55 mW. The implant is hermetically packaged using a custom-made glass capsule.     

An Arabidopsis mutant hypersensitive to red and far-red light signals

A new mutant called psi2 (for phytochrome signaling) was isolated by screening for elevated activity of a chlorophyll a/b binding protein-luciferase (CAB2-LUC) transgene in Arabidopsis. This mutant exhibited hypersensitive induction of CAB1, CAB2, and the small subunit of ribulose-1,5-bisphosphate carboxylase (RBCS) promoters in the very low fluence range of red light and a hypersensitive response in hypocotyl growth in continuous red light of higher fluences. In addition, at high- but not low-light fluence rates, the mutant showed light-dependent superinduction of the pathogen-related protein gene PR-1a and developed spontaneous necrotic lesions in the absence of any pathogen. Expression of genes responding to various hormone and environmental stress pathways in the mutant was not significantly different from that of the wild type. Analysis of double mutants demonstrated that the effects of the psi2 mutation are dependent on both phytochromes phyA and phyB. The mutation is recessive and maps to the bottom of chromosome 5. Together, our results suggest that PSI2 specifically and negatively regulates both phyA and phyB phototransduction pathways. The induction of cell death by deregulated signaling pathways observed in psi2 is reminiscent of retinal degenerative diseases in animals and humans.     

基于六西格玛管理法在降低焦比方面的分析

以六西格玛管理理念为基础,利用Minitab软件对2500m3高炉生产焦比进行过程能力分析,确定焦比过程能力不足,有很大的降低空间,并通过失效矩阵分析、相关分析和回归分析确定影响焦比的主要因素有煤比、富氧率和入炉矿石品位,并利用试验设计（DOE）确定当煤比为180kg/t、富氧率为2.9%、入炉品位为57.5%时,焦比达到最低值,以此为现场生产提供参考和指导。     

An Israeli family with six cisAB members: serologic and enzymatic studies

Multicentric melanomas in the same eye are rare, with few cases substantiated by histology and serial sectioning. We report a patient with two documented choroidal malignant melanomas in one eye. The initial tumor spontaneously decreased in size for over 2 years before a second tumor appeared in a noncontiguous location in the same eye. After enucleation, serial sections showed that the two lesions were independent choroidal melanomas. We review the literature regarding multiple, independent intraocular choroidal malignant melanomas.     

Two structural adaptations for regulating transmitter release at lobster neuromuscular synapses

The distal accessory flexor muscle (DAFM) in the lobster (Homarus americanus) walking leg consists of 5 muscle fiber bundles. All five bundles, one proximal, one distal, and 3 medial, are innervated by one excitatory and one inhibitory motor neuron. Both neurons release more transmitter on the distal bundle than on the proximal bundle. The aim of our studies was to investigate the structural basis of this differentiation. Thin sections cut at 50 microns intervals showed a similar number of excitatory synapses on the two bundles. Freeze-fracture views of excitatory synapses showed that synapse size, active zone number per synapse, and intramembrane particle density in the postsynaptic membrane are similar proximally and distally. Active zones at synapses on the distal bundle are larger and contain about 50% more large intramembrane particles, which are thought to include the voltage-gated Ca2+ channels that couple the action potential to transmitter release, than their counterparts on the most proximal bundle. This difference in channel number appears to produce a disproportionate increase in the probability of transmitter release sufficient to account for most of the proximal-distal disparity in the amplitude of the excitatory postsynaptic potential. In contrast, staining the inhibitor for antibodies to the inhibitory neurotransmitter, GABA, showed that it forms more varicosities on the distal bundle than on the proximal bundle. Because most of the synapses are located in the varicosities, differences in synapse number likely regulate the proximal-distal disparity in the amount of inhibitory transmitter released. Therefore, the regional differentiation in the amount of transmitter released in the DAFM appears to be based on two distinct mechanisms. In the inhibitor, transmitter release appears to be regulated differentially by differences in synapse number. In the excitor, transmitter release appears to be regulated differentially from a similar number of synapses by differences in active zone structure.