Pneumoperitoneum or Chilaiditi's sign.

Chilaiditi's sign describes the incidental radiographic finding of the bowel positioned between the right diaphragm and the liver. This is often misdiagnosed as pneumoperitoneum or free air under the diaphragm, which may lead to unnecessary investigations or surgical procedures. Here, we report two incidental chest radiograph findings of air under the diaphragm in patients who were being screened for pulmonary tuberculosis. This case series highlights the importance of awareness of the diagnosis of Chilaiditi's sign to avoid unnecessary hospital referrals.

Measurements of middle-ear function in the Mongolian gerbil, a specialized mammalian ear.

The middle ear of the Mongolian gerbil is thought to be specialized so that it can hear the 3,000-Hz and lower sounds produced by approaching predators. Evidence in the literature suggests several specializations: (1) an effect of the large middle-ear air spaces in the gerbil is to increase the sensitivity of this ear to sounds of 3, 000 Hz and lower in frequency; (2) the combined action of the middle-ear cavity and the significant pars flaccida of the tympanic membrane in the gerbil ear reduces the sensitivity to sounds of frequencies below 500 Hz. This paper describes anatomical and functional measurements of stapes motion and suggests that the stiffness of the gerbil ossicular system also acts to reduce sensitivity to low-frequency sounds. The primary conclusion is that the frequency dependence of the gerbil middle ear is the result of the interaction of multiple factors, thereby complicating the relationship between single structural specializations and overall function.

Effects of pars flaccida on sound conduction in ears of Mongolian gerbil: acoustic and anatomical measurements.

This paper presents evidence on how the pars flaccida of the tympanic membrane affects the acoustic input to the middle and inner ear. Measurements of middle-ear acoustic input admittance and sound-pressure levels in both the ear canal and the middle-ear cavity were made in ears of eight gerbils before and after manipulations of the middle ear and tympanic membrane. The results are interpreted in terms of a model proposed by Kohllöffel [Hear, Res. 13(1984) 83-88]. The input-admittance measurements show that the pars flaccida of gerbil acts as a resonator with a resonance frequency of approx. 500 Hz. The admittance of this resonator appears in parallel with the input admittance of the pars tensa and its ossicular and cochlear load. At frequencies below the resonance, the pars flaccida admittance is compliance-like and its magnitude is comparable to that of the pars tensa and its load; consequently, the presence of pars flaccida increases the overall middle-ear input admittance and decreases the pressure difference across the tympanic membrane. At higher frequencies, the admittance of pars flaccida is mass-like and small in magnitude, and it has negligible influence on the overall middle-ear input admittance and the pressure difference across the tympanic membrane. These results suggest that the presence of pars flaccida reduces low-frequency acoustic input to the middle- and inner-ear and consequently decreases hearing sensitivity in this frequency range. Our measurements suggest that with a constant sound pressure stimulus, stiffening the gerbil pars flaccida would increase the motion of the pars tensa by 3-10 dB at frequencies below the normal flaccida resonance.