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Biomedical subjects

M Milner

Publications and source records attributed to M Milner.

At least 37 records · Page 2Linked to original sources

Value of echocardiographic measurement of left ventricular mass in predicting cardiovascular morbid events in hypertensive men.

To assess whether echocardiographic and electrocardiographic detection of left ventricular hypertrophy could predict cardiovascular morbid events in patients with uncomplicated essential hypertension, we followed 140 men for a mean of 4.8 years. Initial echocardiographic measurements of left ventricular mass were normal (less than 125 g/m2 body surface area) in 111 patients and revealed hypertrophy in 29 patients. Morbid events occurred in more patients with hypertrophy on echocardiography (7 of 29, 4.6/100 patient-years) than with normal ventricular mass (7 of 111, 1.4/100 patient-years; p less than 0.01). Electrocardiography showed hypertrophy in too few patients to be of predictive value. Multiple logistic regression analysis showed that left ventricular mass index had the highest independent relative risk for future events and that systolic and diastolic pressures and age had slightly lower relative risks. In men with mild uncomplicated hypertension, left ventricular hypertrophy detected by echocardiography identifies patients at high risk for cardiovascular morbid events and is a significant risk factor for future morbid events independent of age, blood pressure, or resting ventricular function.

Adolescent

Oral motor functioning, frequency of swallowing and drooling in normal children and in children with cerebral palsy.

Attempts to eliminate drooling in children with cerebral palsy have ranged from speech therapy to radical surgery. Drooling primarily results from an overflow of saliva from the mouth due to dysfunctional voluntary oral motor activity, improper swallowing, or oral sphincter deficits and rarely from hypersalivation. A study was undertaken to determine typical orofacial electromyographic patterns and swallowing frequencies of normal children and children with cerebral palsy with oral involvement who do, and who do not drool, as well as to determine the correlation between swallowing frequency and drooling rate. Results suggest that drooling in the pediatric cerebral palsy population is caused by both inefficient and infrequent swallowing.

Adolescent

Myoelectric training methods for the preschool child with congenital below-elbow amputation. A comparison of two training programmes.

The Ontario Crippled Children's Centre has completed a two-year research project designed to develop effective strategies for training the preschool child to use a myoelectric prosthesis. Two programmes were developed: one home-based with the parent as primary trainer, and the other Centre-based with a therapist as trainer. Seventeen children were successfully trained and fitted with myoelectric prostheses. Both training programmes appear to be equally effective, proving that informed parents can assume responsibility for the training of their children. Economic implications are self-evident. The functional assessment of the children's skill with the myoelectric prosthesis is very encouraging so far. However, long-term studies are indicated for adequate assessment of the cost-effectiveness of early myoelectric fitting. As a result of this study, effective training methods can now be used in routine clinical service; a manual is available to provide guidelines.

Age Factors

Prosthesis with electric elbow and hand for a three-year-old multiply handicapped child.

The usefulness of wisely prescribed powered components in the rehabilitation of upper extremity amputees has long been recognized (Schmidl, 1973). Their value is especially evident in the prosthetic rehabilitation of high level adult and child amputees (Heger et al, 1985). In recent years, manufacturers of prosthetic hardware have provided practitioners with a wide selection of either myo-electrically or switch controlled electromechanical components and systems. As a rule, however, most commercially available components are designed to serve the adult amputee and do not lend themselves for use in the prosthetic rehabilitation of children. One current exception is the availability of child-size electric hands. The availability of the world's first child-size electric hand in 1970 at the Ontario Crippled Children's Centre later known as the Variety Village 105 hand, gave tremendous impetus to the fitting of younger children with externally powered components and myoelectric control systems. However, this trend served to benefit the young below-elbow patient only (Sorbye et al, 1972). The successful fitting of higher amputation levels in this age group stopped at the elbow level. Existing artificial elbows such as the Variety Village and Hosmer elbow with their necessary powerpacks are simply too bulky and too heavy for pre-school age children. The need for a lightweight compact electric elbow, suitable for 3-8 year old children, still has not been addressed. This single case report illustrates an innovative and successful conversion of a 6-3/4 Otto Bock hand into a small electric elbow. The idea was first proposed by Schmidl (1973).

Arm

Leucocyte membrane sodium transport in normotensive populations: dissociation of abnormalities of sodium efflux from raised blood-pressure.

Sodium efflux rates were measured in leucocytes from eighteen normotensive subjects who had one or more first-degree relatives with essential hypertension and from twenty-four matched controls with no such family history. The total efflux rate constant was significantly lower in those with a family history of hypertension, owing to reduced ouabain-sensitive sodium pump activity. The presence of a membrane electrolyte handling abnormality characteristic of essential hypertension in normotensive individuals genetically predisposed to hypertension points to an underlying genetic factor. At the same time, the fact that blood-pressure was normal in these subjects indicates that the abnormality does not participate directly in blood-pressure elevation. Rather, the abnormality, like other red-cell changes in electrolyte handling, seems to be a marker for a genetically determined alteration in membrane structure, and thus only indirectly related to hypertension.

Adult

Angle--angle diagrams in the assessment of locomotion.

This paper includes original research relating to kinematic information presented in the form of knee-angle/hip-angle diagrams. Cyclic loops which had been utilized in the past mainly for their visual representation have been quantified using a shape recognition technique. Quantitative analyses of angle-angle diagrams associated with 5 normal subjects were carried out. The quantification and physical interpretations of the parameters extracted from the angle-angle diagrams provided a valuable adjunct to visual assessment of the gaits.

Biomechanical Phenomena

Angle-angle diagrams in above-knee amputee and cerebral palsy gait.

This paper presents the results of further research relating to quantitative analyses of angle-angle diagrams associated with an above-knee (A/K) amputee and a cerebral palsied (C.P.) subject. The quantification and physical interpretations of the parameters extracted from the angle-angle diagrams not only provided a valuable adjunct to visual assessment of the gaits but also elicited significant information regarding overall coordination and control during each gait.

Adult