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Biomedical subjects

R M Stern

Publications and source records attributed to R M Stern.

At least 55 records · Page 3Linked to original sources

Lateralization of rectangularly modulated noise: explanations for counterintuitive reversals.

A number of years ago Hafter and Shelton [J. Acoust. Soc. Am. Suppl. 1 68, S16 (1980), Hafter and Shelton, J. Acoust. Soc. Am. 90, 1901-1907 (1991)] demonstrated that diotic bandpass noise that is multiplied by a dichotic pair of periodic rectangular gating functions could be strongly perceived toward the ear receiving the signal with the gating function that is lagging in time. These results were surprising because sounds presented with interaural time delays (ITDs) are normally perceived toward the ear receiving the signal that is leading in time. In order to better understand these counterintuitive phenomena an analytical expression for the cross-correlation function of these gated-noise stimuli is derived, and it is shown that many of the general properties of the data can be accounted for by considering only the properties of this function. The lateralization of the gated-noise stimuli is compared to predictions of three types of models of binaural signal processing: models based on the cross-correlation function of the entire signal, models based on the interaural group delay or phase delay at low frequencies, and the position-variable model, which is based on the response of the peripheral auditory system to the stimuli. It is shown that the observed lateralization results, including the unexpected reversals and various frequency effects, can be explained without further assumption by an extended implementation of the position-variable model [Stern and Colburn, J. Acoust. Soc. Am. 64, 127-140 (1978)]. The cross-correlation functions of the original stimuli can also be related to the lateralization data, but in a much less natural fashion. It is argued that models based on the interaural group delay of the original stimuli will not describe the observed results, although low-frequency phase delay is qualitatively consistent with the observed lateralization phenomena.

Attention↗

Assessing environmental carcinogens: review of an approach adopted by the expert groups of the World Health Organization Regional Office for Europe.

The World Health Organization Regional Office for Europe has adopted the viewpoint that it is necessary to attempt to evaluate potential human carcinogens in such a way so that the risk they present can be compared and used in general consideration of protecting the public from toxic substances found in various environments. In order to demonstrate this process, the evaluations for a number of criteria air pollutants as presented in the volume Air Quality Guidelines for Europe are summarized and reviewed. The basic method used is that involving the estimation of risk based on lifetime exposures to airborne carcinogens by a linear extrapolation from known data using no threshold, with the carcinogenic potency expressed as the incremental unit risk estimate. This unit risk is defined as the average expected for a hypothetical population exposed for a lifetime to a concentration of one microgram per cubic meter of the agent in the air they breathe. The advantages and disadvantages of the method are reviewed, and background information for actual environmental conditions and risks leading up to the consensus guidelines adopted are presented for those 17 of the initial 28 criteria air pollutants treated which have IARC classifications of carcinogenicity.

Air Pollutants↗

Effects of pre-exposures to a rotating optokinetic drum on adaptation to motion sickness.

The purpose of this study was to investigate the effects of two different pre-exposure procedures on adaptation to motion sickness in a rotating circular vection drum. The 45 subjects were randomly divided into three groups. The control group only had a standard 16-min exposure to the drum rotating at 60 degrees/s with no pre-exposure. The incremental exposure group had two separated 4-min pre-exposure periods at 15 degrees/s and 30 degrees/s in the rotating drum immediately prior to the standard 16-min exposure period in the drum rotating at 60 degrees/s. The abrupt-exposure group had the same pre-exposure procedure except the pre-exposure drum rotation speed was 60 degrees/s and was followed by the same standard exposure periods. Subjective motion sickness reports and a measure of gastric myoelectric activity (electrogastrogram, EGG) were obtained during the standard 16-min drum rotation period in all three groups. The results showed that subjects in the incremental exposure group reported significantly fewer motion sickness symptoms during the standard 16-min rotation period than did the subjects in the abrupt exposure group and the control group. Subjects in the incremental exposure group also had less tachyarrhythmia, abnormal gastric myoelectric activity associated with nausea, during the 16-min rotation period than did the subjects in the control and abrupt exposure group. Incremental exposure to motion stimuli may be a useful method for training resistance to visually-induced motion sickness.

Adaptation, Physiological↗

Motion sickness severity and physiological correlates during repeated exposures to a rotating optokinetic drum.

Fifty-two subjects were exposed to a rotating optokinetic drum. Ten of these subjects who became motion sick during the first session completed two additional sessions. Subjects' symptoms of motion sickness, perception of self-motion, electrogastrograms (EGGs), heart rate, mean successive differences of R-R intervals (RRI), and skin conductance were recorded for each session. The results from the first session indicated that the development of motion sickness was accompanied by increased EGG 4-9 cpm activity (gastric tachyarrhythmia), decreased mean successive differences of RRI, increased skin conductance levels, and increased self-motion perception. The results from the subjects who had three repeated sessions showed that 4-9 cpm EGG activity, skin conductance levels, perception of self-motion, and symptoms of motion sickness all increased significantly during the drum rotation period of the first session, but increased significantly less during the following sessions. Mean successive differences of RRI decreased significantly during the drum rotation period for the first session, but decreased significantly less during the following sessions. In conclusion, we have demonstrated that the development of motion sickness is accompanied by an increase in gastric tachyarrhythmia, and an increase in sympathetic activity and a decrease in parasympathetic activity, and that adaptation to motion sickness is accompanied by the recovery of autonomic nervous system balance.

Adaptation, Physiological↗

Gastric dysrhythmias and nausea of pregnancy.

Gastric dysrhythmias have been recorded from patients with a variety of nausea syndromes. The aim of this study was to measure gastric myoelectric activity in women with and without nausea during the first trimester of pregnancy. In 32 pregnant women gastric myoeletric activity was recorded for 30-45 min with cutaneous electrodes that yielded electrogastrograms (EGGs). Frequencies of the EGG waves were analyzed visually and by computer. Subjects rated their nausea at the time of EGG recording on a visual analog scale with 0 representing no nausea and 300 mm severe nausea. Gastric dysrhythmias were found in 26 pregnant subject: Seventeen had tachygastrias (EGG frequencies of 4-9 cpm), five had 1- to 2-cpm EGG waves, and four had flat-line patterns Mean nausea scores of the subjects with tachygastrias, 1- to 2-cpm, and flat-line patterns were 64.8 +/- 13, 93.4 +/- 23, and 77.2 +/- 36, respectively. Six pregnant subjects had normal 3-cpm EGG patterns, and their nausea scores averaged 2.8 +/- 1.1 (P less than 0.05 compared with nausea scores in subjects with tachygastrias, 1- to 2-cpm, and flat-line rhythms). Six subjects with gastric dysrhythmias during pregnancy were restudied after delivery; each of these subjects had normal 3-cpm EGG patterns and none had nausea. Thus, gastric dysrhythmias are objective pathophysiologic events associated with symptoms of nausea reported during the first trimester of pregnancy.

Adult↗

Ischemic gastroparesis: resolution after revascularization.

Patients with chronic nausea and vomiting frequently present challenging diagnostic and therapeutic problems. In such patients, gastroparesis of unknown cause, or "idiopathic" gastroparesis, may be the only objective finding. Two middle-aged women with nausea, vomiting, and weight loss of 10 and 26 kg over 6 and 18 months, respectively, were evaluated. Routine laboratory and barium study results were normal. Solid-phase gastric emptying studies showed severe gastroparesis in both patients. Upper endoscopies excluded gastric outlet obstruction. Gastric dysrhythmias (4-cpm and 1-cpm patterns) were recorded using cutaneous electrodes. An abdominal bruit was ascultated in one patient. Abdominal arteriograms in both patients showed total occlusion of all three major mesenteric vessels with collaterals supplied via hemorrhoidal arteries. Bypass grafting procedures of the celiac and superior mesenteric arteries in one patient and of the celiac artery in the other patient were performed. Six months after mesenteric artery revascularization, upper gastrointestinal symptoms had resolved and original weights were regained. Furthermore, normal 3-cpm gastric myoelectrical activity and normal gastric emptying of solids were restored in both patients. In these patients, chronic mesenteric ischemia resulted in a novel and reversible cause of gastroparesis, gastric dysrhythmias, and accompanying symptoms.

Blood Vessel Prosthesis↗

An approach to cardiac arrhythmia analysis using hidden Markov models.

This paper describes a new approach to ECG arrhythmia analysis based on "hidden Markov modeling" (HMM), a technique successfully used since the mid-1970's to model speech waveforms for automatic speech recognition. Many ventricular arrhythmias can be classified by detecting and analyzing QRS complexes and determining R-R intervals. Classification of supraventricular arrhythmias, however, often requires detection of the P wave in addition to the QRS complex. The hidden Markov modeling approach combines structural and statistical knowledge of the ECG signal in a single parametric model. Model parameters are estimated from training data using an iterative, maximum likelihood reestimation algorithm. Initial results suggest that this approach may provide improved supraventricular arrhythmia analysis through accurate representation of the entire beat including the P wave.

Arrhythmias, Cardiac↗

Neuroendocrine and gastric myoelectrical responses to illusory self-motion in humans.

We compared gastric myoelectrical activity and endogenous neuroendocrine responses in subjects with and without motion sickness elicited by illusory self-motion or vection. Rotating a drum with black and white vertical stripes around seated stationary subjects (n = 22) produced vection. Gastric myoelectrical activity was recorded with cutaneous electrodes. Thirteen subjects developed gastric dysrhythmias [4- to 9-cycles/min (cpm) signals] and motion sickness during vection, whereas nine subjects maintained normal 3-cpm gastric rhythms and remained symptom free. Base-line plasma cortisol and beta-endorphin levels were significantly greater (P less than 0.01) in the subjects who would develop gastric dysrhythmias and nausea compared with the subjects who would not develop motion sickness. Norepinephrine levels increased in the nauseated group immediately after vection ceased (354.6 +/- 41.1 pg/ml) compared with the symptom-free subjects (223.1 +/- 22.8 pg/ml, P less than 0.05). Epinephrine increased significantly (P less than 0.05) after vection only in the nauseated subjects, whereas dopamine levels were not altered by vection in either group. We conclude that 1) anticipatory increases in plasma cortisol and beta-endorphin occurred in subjects who would develop nausea and gastric tachyarrhythmias during vection; 2) endogenous epinephrine and norepinephrine were increased in subjects who had vection-induced nausea and gastric dysrhythmias; and 3) vection stimulates brain-gut interactions, resulting in gastric tachyarrhythmias and complex neuroendocrine responses in subjects with motion sickness.

Adult↗

Vasopressin and oxytocin responses to illusory self-motion and nausea in man.

Vasopressin and oxytocin are nonapeptides secreted from the neurohypophysis; increases in vasopressin are associated with nausea and vomiting in some, but not all, species. Our aim was to determine whether plasma vasopressin and oxytocin levels were altered in healthy volunteers who did or did not develop nausea during vection, an optokinetic stimulus which produces the illusion of self-motion. Vection was produced by rotating a drum with an inner surface of black and white vertical stripes around the seated stationary subject. Gastric myoelectrical activity was recorded continuously throughout the experiment with electrodes positioned on the abdominal surface. Plasma samples were obtained before vection and after drum rotation stopped when nausea and tachygastria were present. Vasopressin and oxytocin were extracted from plasma and quantified by RIA. During vection six subjects reported nausea and developed gastric dysrhythmias; six other subjects had no nausea and remained in normal 3-cpm myoelectrical rhythms. Vasopressin and oxytocin values before vection were similar in each group of subjects. One minute after vection stopped, plasma vasopressin levels were significantly greater (P less than 0.05) in subjects experiencing nausea and tachygastrias (35.4 +/- 26.7 pmol/L) than in those without symptoms (2.7 +/- 0.47 pmol/L). Oxytocin levels were unchanged by either vection or nausea. It is concluded that 1) vasopressin, not oxytocin, neurons in the magnocellular-neurohypophyseal system are activated during vection-induced nausea and gastric dysrhythmias; and 2) illusory self-motion may be used safely to study the neuroendocrine responses to brain-gut interactions and nausea in man.

Adult↗

Functional disorders of the stomach.

Gastroenterologists frequently encounter patients who report vague epigastric discomforts or sensations of fullness, bloating, and distention in the upper abdomen. The discomfort is neither burning in character nor severe in intensity; there is no nocturnal pain. The epigastric location of discomfort and lack of radiation may help to exclude biliary tract and pancreatic diseases. Nausea may be present, but there is little or no vomiting. After these patients ingest liquids or solid foods, the symptoms of easy filling or early satiety and increasing discomfort and nausea are almost always present. The patient may only report "indigestion," but a specific chief complaint, such as pain, discomfort, nausea, or bloating may be elicited with further inquiries. Solid foods usually provoke more symptoms than do liquids. Symptoms of early satiety, nausea, bloating, and abdominal discomfort may culminate in the vomiting of undigested food. These vague upper gastrointestinal (GI) symptoms have been termed "dyspepsia." When peptic diseases of the stomach are excluded, the symptom complex has been called "nonulcer" dyspepsia, a vague syndrome with symptoms attributed to stomach dysfunction. Nonulcer dyspepsia has been reviewed recently. Such symptoms, commonly attributed to a "functional" disorder, are very common in clinical practice, with an incidence of 30% of patients. In this review, we will discuss an approach to the evaluation and treatment of patients with symptoms of nausea, early satiety, bloating, and vague epigastric discomfort--dyspeptic symptoms associated with functional stomach disorders. We will review the anatomy and motility of the stomach and suggest potential neuromuscular malfunctions of the stomach that may result in epigastric symptoms. The potential role of stress and other brain-gut interactions, which may underlie these symptoms, will also be reviewed.

Dyspepsia↗

The effects of fixation and restricted visual field on vection-induced motion sickness.

Approximately 60% of healthy human subjects experience motion sickness when exposed to a rotating optokinetic drum. The purpose of the present study was to determine the effects of certain visual factors on susceptibility to motion sickness. Vection data (illusory self-motion), horizontal eye movement recordings, subjective motion sickness report, and a measure of gastric myoelectric activity (electrogastrogram, EGG) were obtained from 45 subjects, who were randomly divided into the following three groups: a control group that observed the entire visual field with no fixation, a group that fixated on a central target, and a third group that had a visual field restricted to 15 degrees. The experimental session was divided into the following three 12-min periods: baseline, drum rotation, and recovery. The results showed that fixation greatly reduced nystagmus and slightly reduced vection. The restricted visual field slightly reduced nystagmus and greatly reduced vection. Both of these manipulations significantly reduced symptoms of motion sickness and tachyarrhythmia, the abnormal gastric myoelectric activity that usually accompanies nausea.

Electromyography↗

Sham feeding. Cephalic-vagal influences on gastric myoelectric activity.

The effects of sham feeding on gastric motility of human subjects have not previously been studied. The amplitude of 3-cpm electrogastrogram (EGG) waves increases after the ingestion of food. We hypothesized that sham feeding would stimulate a similar, but briefer gastric myoelectric response. Healthy human subjects chewed and expectorated a hot dog on a roll and later ate a second hot dog. EGGs were continuously recorded before, during, and after sham feeding and eating. The results of experiment I (N = 27) showed that the hand-scored amplitude of the 3-cpm waves increased significantly (P less than 0.01) during sham feeding. Two minutes after sham feeding, the mean amplitude of 3-cpm EGG waves returned to baseline level. The increase in EGG amplitude during eating was also significant (P less than 0.01), and remained increased for approximately 30 min after ingestion. The procedure used in experiment II (N = 20) was similar to experiment I, but EGGs were computer analyzed and power, ie, spectral intensities, at 3 cpm were obtained. The increase in power at 3 cpm during sham feeding and during eating was significant (P less than 0.05 and P less than 0.02, respectively). Similar to experiment I, the duration of increase in power at 3 cpm was brief during sham feeding compared to the postprandial increase. Four vagotomized subjects failed to show an increase in power at 3 cpm in response to sham feeding. We conclude: (1) The cephalic-vagal stimulation of sham feeding increases briefly the amplitude and power of 3-cpm gastric myoelectric activity in healthy subjects but not vagotomized patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Lateralization of bands of noise: effects of bandwidth and differences of interaural time and phase.

The effects of stimulus bandwidth on lateralization of narrow bands of noise were investigated with an acoustic pointing task. Stimuli were narrow bands of noise (centered on 500 Hz with bandwidths ranging from 50-400 Hz) that contained interaural time delays and/or interaural phase shifts. The overall extent of lateralization and sidedness was found to vary greatly as a function of stimulus bandwidth, as insightfully discussed earlier by Jeffress [L. A. Jeffress, Foundations of Modern Auditory Theory, edited by J. V. Tobias (Academic, New York, 1972)]. The data are qualitatively consistent with a weighted-image model [Stern et al., J. Acoust. Soc. Am. 84, 156-165 (1988)] that specifies and utilizes the shapes and locations of patterns of hypothesized neural activity. These patterns are topographically organized along a two-dimensional surface, and they describe the cross-correlation function of the stimuli as a joint function of frequency and the delay parameter of the cross-correlation operation. In this fashion, lateralization depends upon individual modes of such patterns that are weighed with respect to their straightness (consistency of interaural delay over frequency) and centrality (the extent to which interaural delays are small in magnitude).

Acoustic Stimulation↗

Motion sickness and gastric myoelectric activity as a function of speed of rotation of a circular vection drum.

Motion sickness symptoms and electrogastrograms (EGGs) were obtained from 60 healthy subjects while they viewed an optokinetic drum rotated at one of four speeds: 15, 30, 60 or 90 degrees.s-1. All subjects experienced vection, illusory self-motion. Motion sickness symptoms increased as drum speed increased up to 60 degrees.s-1; i.e., symptoms decreased at 90 degrees.s-1. Power, spectral intensity, of the EGG at the tachygastria frequencies (4-9 cpm) was calculated at each drum rotation speed since previous studies have shown a close correspondence between development of tachygastrias and motion sickness symptoms. Power at 4-9 cpm increased as a function of drum speed up to 60 degrees.s-1 and then decreased at 90 degrees.s-1. Power at 4-9 cpm and 60 degrees.s-1 was significantly greater than at 15 degrees.s-1. The correlation between the motion sickness symptoms and the power at 4-9 cpm was significant. Thus, drum rotation speed influenced the spectral power of the EGG at 4-9 cpm, tachygastria, and the intensity of motion sickness symptoms.

Adult↗

Adaptation to vection-induced symptoms of motion sickness.

The visual-vestibular-proprioceptive sensory mismatch of vection provokes motion sickness in approximately 60% of healthy subjects. Approximately 60% of astronauts experience motion sickness in microgravity where vestibular/otolith function is altered. The purpose of this study was to determine the extent to which symptoms of motion sickness and tachygastria, an abnormal 4-9 cpm rhythm of the stomach, decrease or adapt during three repeated exposures to a rotating circular vection drum. Subjects sat in the drum for 45 min: 15 min baseline, 15 min drum rotation at 60 degrees.s-1, and 15 min recovery. Gastric myoelectric activity was continuously recorded with the electrogastrogram (EGG). Symptom reports were obtained during rotation. In Experiment I, 10 subjects were exposed to the drum 3 times with intersession intervals of 4-24 d. They failed to show adaptation based on subjective reports and all showed tachygastria. In Experiment II, 14 new subjects were exposed to the drum 3 times with intersession intervals of 48 h. The group experienced a reduction in symptoms and tachygastria with repeated exposure to the drum. Thus, symptomatic and physiological improvement occurred after training in subjects susceptible to vection-induced motion sickness. Preflight adaptation to visual-vestibular sensory mismatch may reduce motion sickness experienced in the environment of microgravity.

Adaptation, Physiological↗

Gastric emptying and gastric myoelectrical activity in patients with diabetic gastroparesis: effect of long-term domperidone treatment.

We measured gastric emptying and gastric myoelectrical activity with solid-phase gastric-emptying tests and cutaneously recorded electrogastrograms (EGGs), respectively, in six insulin-dependent diabetic patients with nausea and vomiting who did not respond to standard treatments. Baseline solid phase gastric emptying was markedly delayed (78 +/- 8% retained at 120 min) and EGG recordings revealed gastric dysrhythmias; tachygastria (4-9 cpm signals) in one patient, 1- to 2-cpm waves in two patients, and flatline patterns in three patients. No patient had a normal 3-cpm EGG pattern. After 6 months of domperidone treatment, mean upper gastrointestinal symptoms scores decreased from 17.8 to 3.7 (p less than 0.01), and normal 3-cpm EGG frequencies were recorded from each of the six patients. The mean percentage of meal retained at 120 min decreased but did not improve significantly. Thus, establishment of normal 3-cpm gastric myoelectric activity and resolution of dysrhythmias, not normalization of emptying rates, was associated with improvement in upper gastrointestinal symptoms in these diabetic patients.

Adult↗

Indicators of matrix dependent variation in effective dose for chromium and nickel aerosol exposures.

Inhaled particulates containing Cr and Ni are partially cleared or dissolved thus contributing to short-term internal exposures and partial retention in airways and airspaces. The retained fraction may continuously contribute to internal exposure after external exposure has ceased, through intra- and extracellular chemical processes which continuously liberate various metallic species; i.e. via an active deposit. Recent experiments with Ni and Cr compounds, and freshly produced welding fumes, which contain Ni and Cr, demonstrate a strong dependence of the distribution of these metals on oxidation state, solubility, bioavailability and toxicity as measured by in-vitro bioassay, depending on the collection, storage and analytical technique. It is suggested that exposure limits must consider the wide variation in short- and long-term delivered dose of toxic metals to target tissue with matrix, and that current protocols may be inadequate to protect workers in different industries involving exposures to widely different types of aerosols having only the same chemical element in common.

Aerosols↗

In vitro toxicity of welding fumes and their constituents.

Welding fumes from a wide variety of processes and applications were assayed for toxicity with BHK21 cell line and SHE primary cells in culture. The most toxic fumes are those from the manual metal arc welding of stainless steel (MMA/SS) (LD50 = 7-14 microgram/ml), although all other welding fumes tested are toxic, with potencies lower by a factor of 10-200. The activity of MMA/SS is presumably due to the presence of high concentrations of Cr(VI) in the soluble fraction: For all other fumes the lowered activity (LD50 = 80-800 microgram/ml) is limited mostly to the insoluble fraction, and in part can be related to the presence of MnO2 and Fe3O4 which are toxic at such levels in these cell culture assays. Slight discrepancies between survival tests for the two cell lines, and between survival and lactate dehydrogenate release for BHK, indicate a differential response to certain constituents of these complex materials. These results suggest the need for a battery of different types of assays for use in an eventual ranking of exposures for the purpose of relative risk assessment.

Air Pollutants, Occupational↗