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The effect of Parkinson's disease on the control of multi-segmental coordination.

An experiment was designed to test whether or not Parkinson's disease (PD) patients were able to maintain endpoint kinematic patterns in a prehension task involving movement of the torso. Nine PD patients and nine healthy controls were asked to reach for and grasp a full cup of water that was either covered or uncovered and placed beyond the reach of the outstretched arm. An OPTOTRAK (Northern Digital) 3-dimensional motion analysis system was used to capture the movement of four markers placed on the arm, hand, and torso. The results indicated the Parkinson's patients had a decreased ability to maintain the kinematics of the end effector. The PD patients were also found to be impaired in terms of their ability to synchronize the arm, hand, and torso. More specifically, although the elderly controls seemed to employ a strategy of increasing the involvement of the torso when reaching to grasp the uncovered cup, no such strategy was observed in the PD patients. Collectively, the results suggest that the multi-joint synergies observed in the elderly controls, which help preserve relatively consistent endpoint trajectories, are disrupted in Parkinson's patients.

Aged↗

A biomechanical assessment of disc pressures in the lumbosacral spine in response to external unloading forces.

BACKGROUND CONTEXT: Axial back pain affects a large percentage of the population. Often aggravated by weight-bearing activity, these patients frequently have associated degenerative or post-traumatic lumbar disc disease. Aquatherapy is frequently used to transition patients from less activity limited by pain to greater activity by reducing weight-bearing load of the lumbar spine. Development of a means to permit patients similar spinal unloading while active during normal daily living would have the potential to promote similar effects. PURPOSE: The purpose of this study is to measure internal disc pressure at L4/L5 in response to forces exerted by an external vest. The study hypothesis anticipated an unloading of the lumbar spine during upright posture, as measured by intradicsal pressure at the L4/5 disc, correlating with external forces provided to the trunk by the device. STUDY DESIGN: A controlled experimental study of spine biomechanical loading was undertaken using isolated cadaver torsos obtained from an approved tissue source. Ages ranged at death with a mean of 65+/-6 years. METHODS: The distractive force created by inflating a set of pneumatic lifters within vests for treatment of low back pain were calibrated in a materials testing machine. Effects of inflation on the disc pressures within the lumbar spine then were tested. A microscopic pressure sensor (Samba, Gothenburg, Sweden) was placed into the nucleus of the L4/L5 disc of six isolated cadaver torsos (1 female, 5 male) using a 15-gauge spinal needle under direct fluoroscopic visualization. The pressure sensor was 0.42 mm in diameter, and had a calibrated response range of 0-7500 mm Hg. A pneumatically actuated lumbar vest was fit snugly to the torso. Each torso was supported in an upright, weight-bearing position for testing. The vest was inflated while the internal disc pressure was monitored and recorded. The data were analyzed to test for correlation between the amount of external unloading force provided by the vest and the intradiscal pressure measured in vitro. RESULTS: Application of external loads between the pelvis and ribcage by the vest demonstrated a maximum mean reduction of internal disc pressure at L4/L5 of 25% when the vest was inflated to a level producing approximately 400 N of effective load. The reduction in disc pressure was significantly different compared with baseline (upright, weight-bearing disc pressure without the vest) for all distraction settings (p<.01) except for the very lowest setting which was significant only at p=.025. CONCLUSIONS: Spinal unloading with an externally applied vest with adequate surface interface is effective in reducing intradiscal pressures. Ambulatory reduction of pressure would permit beneficial reduction of loads and permit patients with weight-bearing intolerance a better quality of life.

Aged↗

Application of the single moving dipole inverse solution to the study of the Wolff-Parkinson-White syndrome in man.

The single moving dipole (SMD) inverse solution was performed in 28 patients with the Wolff-Parkinson-White preexcitation syndrome to see if the calculated position of the SMD during the initial delta wave could indicate the site of the underlying accessory pathway. This site was first estimated to be at one of eight locations around the atrioventricular ring, from the patient's QRS and ST segment body surface potential maps, as has been described by others. Next, SMD parameters were calculated during the delta wave so as to approximate, on a numerical torso model, the patient's body surface potential map. Visualization of the calculated position of the SMD around the atrioventricular ring was done by projecting it on a plane parallel to this ring. This plane corresponded to the most basal transverse section of a heart model present in the torso model. One limitation was the use of non-varying heart and torso models for all patients. As a result, the SMD technique lacked the precision to separate accessory pathway sites into eight atrioventricular locations. However it was capable of distinguishing between patients belonging to the larger classes of right-sided, posterior, and left-sided preexcitation, formed by combining adjacent atrioventricular accessory pathway locations. With more accurate heart and torso models, it may be possible to increase SMD resolution so as to locate accessory pathway sites deep within the heart. This would represent an advantage over the surface potential map approach which only identifies the site of earliest epicardial breakthrough associated with the accessory pathway.

Adolescent↗

Localization of cardiac ectopic activity in man by a single moving dipole. Comparison of different computation techniques.

The accuracy of different computation techniques for the non-invasive localization of cardiac ectopic activity was evaluated. Body surface potentials were recorded from 63 leads in 14 patients with implanted pacemakers. The location, orientation and magnitude of a single moving dipole (SMD) were computed from the first eight terms of a truncated multipole expansion estimated from the body surface potentials. The SMD trajectories obtained during the QRS complex were plotted along with the heart outlines and pacing leads obtained independently from chest x-rays. The origin of the SMD trajectories was compared to the position of the pacing lead to evaluate the accuracy of the SMD. The optimum computation technique used a least-squares (LS) estimation of the multipole expansion truncated at 15 multipoles, in conjunction with a torso model that included regions of lower conductivity representing the lungs. With this method, the SMD trajectories originated near the pacing lead (25 +/- 12 mm) and adequately represented the progression of the ectopic wavefront across the entire heart silhouette. With the LS techniques using 8 or 24 multipoles, the spans of the trajectories were respectively too short, or too long to cover the heart, and the average distance between the SMD at QRS onset and the pacing lead was larger. With a surface integration technique, the SMD-pacing lead distances were similar, both for a finite homogeneous torso model with a fixed geometry, as well as for torso models adapted to the torso geometry of each patient. The SMD was found adequate to represent the progression of an ectopic wavefront, and to localize its origin in man.

Aged↗

A possible mechanism for electrocardiographically silent changes in cardiac repolarization.

Despite the widespread use of electrocardiogram (ECG), changes in cardiac activity resulting from ischemia or altered recovery characteristics sometimes remain electrocardiographically "silent" or are first detectable by techniques that measure ventricular contractility, such as ultrasound or blood pressure. Especially local changes in repolarization can go undetected when ECG electrodes do not lie close to the area of the heart affected. Experiments were performed on an isolated, perfused canine heart suspended in a realistically shaped, instrumented, electrolytic torso tank with the goal of determining some mechanisms for these ambiguities. By recording simultaneously both epicardial and torso tank surface potentials, complete descriptions were obtained of the electrical response to interventions such as coronary occlusions and alterations in pacing site and frequency. One hypothesis was that some interventions produce highly variable ECG responses primarily because of differences in their location within the heart. To test this, the effect was measured of repeating the same intervention as the heart's location and orientation in the tank were varied. A numerical forward solution was also used to investigate variation of torso tank potentials with heart location. The resulting changes in tank surface potentials illustrate how, for example, precordial ST-segment shifts following occlusion change from elevation to depression to become almost undetectable as the heart rotates in the tank. The results suggest that some events are electrocardiographically silent because of the complex geometric relationship of the heart, torso, and site of the lesion, as well as the spatial sampling and analysis techniques used in detection.

Animals↗

Thiopental directly depresses lumbar dorsal horn neuronal responses to noxious mechanical stimulation in goats.

BACKGROUND: Thiopental has hypnotic actions in the brain, but it also depresses nociceptive transmission. In this study we examined whether thiopental had direct (spinal) and/or indirect (supraspinal) effects on the responses of single lumbar dorsal horn neurons to noxious mechanical stimulation, using a method to deliver thiopental differentially to either the torso or cranial circulation in goats. METHODS: Goats (n=10) were anesthetized with isoflurane and neck dissections performed to permit cranial bypass. A lumbar laminectomy was made to permit single-unit recording of lumbar dorsal horn neuronal activity (1-2 neurons/animal). Isoflurane was maintained at 0.8+/-0.1% to both head and torso throughout the study. During cranial bypass, thiopental was separately administered to the torso (low dose, 1.5+/-0.5 mg/kg; high dose, 3.7+/-0.5 mg/kg) or cranial (low dose, 0.12+/-0.03 mg/kg; high dose, 0.2 mg/kg) circulation. RESULTS: Thiopental administered to the torso significantly depressed dorsal horn neuronal responses to noxious stimulation at the high dose: 757+/-471 to 392+/-305 impulses/min at 1 min post-injection, P<0.006 (n=14); evoked responses recovered at 5 min post-injection. At the low dose, there was a similar numerical decrease, but this did not reach significance: 876+/-780 to 407+/-499 impulses/min at 1 min post-injection, P>0.05 (n=6). No significant change was observed when thiopental was administered to the cranial circulation: low dose, 1061+/-1167 to 965+/-874 impulses/min at 1 min post-injection, P>0.05 (n=10); high dose, 864+/-331 to 917+/-525 impulses/min at 1 min post-injection, P>0.05 (n=8). CONCLUSION: Thiopental has a direct (spinal) depressant effect on dorsal neuronal responses to noxious stimulus, but no significant supraspinal effect.

Anesthetics, Intravenous↗

Seat properties affecting neck responses in rear crashes: a reason why whiplash has increased.

Whiplash has increased over the past two decades. This study compares occupant dynamics with three different seat types (two yielding and one stiff) in rear crashes. Responses up to head restraint contact are used to describe possible reasons for the increase in whiplash as seat stiffness increased in the 1980s and 1990s. Three exemplar seats were defined by seat stiffness (k) and frame rotation stiffness (j) under occupant load. The stiff seat had k=40 kN/m and j=1.8 degrees /kN representing a foreign benchmark. One yielding seat had k=20 kN/m and j=1.4 degrees /kN simulating a high-retention seat. The other had k=20 kN/m and j=3.4 degrees /kN simulating a typical yielding seat of the 1980s and 1990s. Constant vehicle acceleration for 100 ms gave delta-V of 6, 10, 16, 24, and 35 km/h. The one-dimensional model included a torso mass loading the seatback, head motion through a flexible neck, and head restraint drop and rearward displacement with seatback rotation. Neck displacement was greatest with the stiff seat due to higher loads on the torso. It peaked at 10 km/h rear delta-V and was lower in higher-severity crashes. It averaged 32% more than neck displacements with the 1980s yielding seat. The high-retention seat had 67% lower neck displacements than the stiff seat because of yielding into the seatback, earlier head restraint contact and less seatback rotation, which involved 16 mm drop in head restraint height due to seatback rotation in the 16 km/h rear delta-V. This was significantly lower than 47 mm with the foreign benchmark and 73 mm with the 1980s yielding seat. Early in the crash, neck responses are proportional to ky/mT, seat stiffness times vehicle displacement divided by torso mass, so neck responses increase with seat stiffness. The trend toward stiffer seats increased neck responses over the yielding seats of the 1980s and 1990s, which offers one explanation for the increase in whiplash over the past two decades. This is a result of not enough seat suspension compliance as stronger seat frames were introduced. As seat stiffness has increased, so have neck displacements and the Neck Injury Criterion (NIC). High-retention seats reduce neck biomechanical responses by allowing the occupant to displace into the seatback at relatively low torso loads until head restraint contact and then transferring crash energy. High-retention seats resolve the historic debate between stiff (rigid) and yielding seats by providing both a strong frame (low j) for occupant retention and yielding suspension (low k) to reduce whiplash.

Accidents, Traffic↗

Seat influences on female neck responses in rear crashes: a reason why women have higher whiplash rates.

Since the earliest crash investigations, whiplash has been found to occur more often in women than men. This study addresses seat properties that may explain a reason for the higher rates in women, and changes in whiplash in general over the past two decades. Three exemplar seats were defined on the basis of seat stiffness (k) and frame rotation stiffness (j) for rearward occupant load. Stiff seats have k=40 kN/m and j=1.8 degrees /kN representing a foreign benchmark loaded by a male. One yielding seat had k=20 kN/m and j=1.4 degrees /kN simulating a high-retention seat (1997 Grand Prix) and another k=20 kN/m and j=3.4 degrees /kN simulating a 1980s to 1990s yielding seat (1990 Buick Park Avenue). Constant vehicle acceleration for 100 msec gave delta-V of 6, 10, 16, and 24 km/h. The one-dimensional model included a torso mass loading the seatback with flexible neck and head mass. Based on biomechanical data and scaling, neck stiffness was 5 kN/m and 3 kN/m for the male and female, respectively. Based on validation tests, seat stiffness was 25% less with the female. Occupant dynamics were simulated in a step-forward solution based on the differential displacement between the head, torso, and seat up to head restraint contact. Neck responses were 30% higher in the female than male through most of the rear impact and are proportional to (kF/mTF)/(kM/mTM), which is the ratio of seat stiffness divided by torso mass for the female and male. Neck displacements were higher with the stiff seat than the 1990 C car seat for both the female and male. They peaked at 10 km/h and dropped off for higher severity crashes due to the shorter time to head contact. Neck displacements were greater in the female than male for the lowest severity crashes with the stiff and 1990 C car seats, when displacement was scaled for equal tolerance. The female in 1997 W car seat had the lowest neck displacements. Stiff seats increased neck displacements over the yielding seats of the 1980s in rear crashes. The trend is similar in men and women, but early neck displacements are greater in women because of a higher ratio of seat stiffness to torso mass. This implies that seat stiffness is not sufficiently low in proportion to the female mass in comparison to males. The j and k seat properties influence neck biomechanics and occupant dynamics, but k is important in determining early response differences between males and females.

Accidents, Traffic↗

Influence of seat properties on occupant dynamics in severe rear crashes.

Seat performance in retaining an occupant, transferring energy, and controlling neck responses is often questioned after severe rear crashes when fatal or disabling injury occur. It is argued that a stiffer seat would have improved occupant kinematics. However, there are many factors in occupant interactions with the seat. This study evaluates four different seat types in 26 and 32 mph (42 and 51 km/h), rear crash delta Vs. Two seats were yielding with k = 20 kN/m occupant load per displacement. One represented a 1970s yielding seat with j = 3.4 degrees /kN frame rotation per occupant load, and 3 kN maximum load (660 Nm moment), and the other a high retention seat phased into production since 1997 with j = 1.4 degrees /kN, and 10 kN maximum load (2200 Nm). Two seats were stiff with k = 40 kN/m. One represented a 1990s foreign benchmark with j = 1.8 degrees /kN and a 7.7 kN maximum load (1700 Nm), and the other an all belts to seat (ABTS) with j = 1.0 degrees /kN and 20 kN maximum load (4400 Nm). The crash was a constant acceleration of 11.8 g, or 14.5 g for 100 ms. Occupant interactions with the seat were modeled using a torso mass, flexible neck and head mass. By analysis of the equations of motion, the initial change in seatback angle (Deltatheta) is proportional to jk(y - x), the product jk and the differential motion between the vehicle (seat cushion) and occupant. The transition from 1970s-80s yielding seats to stronger seats of the 1990s involved an increase in k stiffness; however, the jk property did not change as frame structures became stronger. The yielding seats of the 1970s had jk = 68 degrees /m, while the stiff foreign benchmark seat had jk = 72 degrees /m. The foreign benchmark rotated about the same as the 1970s seat up to 50 ms in the severe rear crashes. While it was substantially stronger, it produced higher loads on the occupant, and the higher loads increased seatback rotations and neck responses. The ABTS seat had the lowest rotations but also caused high neck responses because of the greater loads on the torso. Neck displacement (d) is initially proportional to (k/m(T)) integral integral y, seat stiffness times the second integral of vehicle displacement divided by torso mass. As seat stiffness increases, head-torso acceleration, velocity, and neck displacement increase. This study shows that the jk seat property determines the initial seatback rotation in rear crashes. If a stronger seat has a higher stiffness, it rotates at higher loads on the occupant, reducing the overall benefit of the stronger frame, while increasing neck responses related to whiplash or neck extension prior to subsequent impacts. The aim of seat designs should be to reduce jk, provide pocketing of the pelvis, and give head-neck support for the best protection in severe rear crashes. For low-speed crashes, a low k is important to reduce early neck responses related to whiplash.

Acceleration↗

Estimation of tissue resistivities from multiple-electrode impedance measurements.

In order to measure in vivo resistivity of tissues in the thorax, the possibility of combining anatomical data extracted from high-resolution images with multiple-electrode impedance measurements, a priori knowledge of the range of tissue resistivities, and a priori data on the instrumentation noise is assessed in this study. A statistically constrained minimum-mean-square error estimator (MIMSEE) that minimizes the effects of linearization errors and instrumentation noise is developed and compared to the conventional least-squares error estimator (LSEE). The MIMSEE requires a priori signal and noise information. The statistical constraint signal information was obtained from a priori knowledge of the physiologically allowed range of regional resistivities. The noise constraint information was obtained from a priori knowledge of the linearization error and the instrumentation noise. The torso potentials were simulated by employing a three-dimensional canine torso model. The model consists of four different conductivity regions: heart, right lung, left lung, and body. It is demonstrated that the statistically constrained MIMSEE performs significantly better than the LSEE in determining resistivities. The results based on the torso model indicate that regional resistivities can be estimated to within 40% accuracy of their true values by utilizing a statistically constrained MIMSEE, even if the instrumentation noise is comparable to the measured torso potentials. The errors obtained using the LSEE with the same linearized transfer function and level of instrumentation noise were about five times larger than those obtained using the MIMSEE. For larger measurement errors the MIMSEE performs even better when compared to the LSEE.

Animals↗

The effect of volume currents due to myocardial anisotropy on body surface potentials.

Changes in anterior and posterior body surface potential maps (BSPMs) due to myocardial anisotropy were examined using a highly heterogeneous finite element model of an adult male subject constructed from segmented magnetic resonance images. A total of 23 different tissue types were identified in the whole torso. The myocardial fibre orientations in the human heart wall were mapped from the fibre orientations of a canine heart which are available in the literature using deformable mapping techniques. The current and potential distributions in the whole torso were computed using dipolar sources in the septum, apical area, left ventricular wall or right ventricular wall. For each dipole x, y, z orientations were studied. An adaptive finite element solver was used to compute currents and potential distributions in the whole torso with an element size of 0.78 x 0.78 x 3 mm in the myocardium and larger elements in other parts of the torso. For each dipole position two cases were studied. In one case the myocardium was isotropic and in the other it was anisotropic. It was found that BSPMs showed a very notable difference between the isotropic and the anisotropic myocardium for all dipole positions with the largest difference for the apical dipoles. The correlation coefficients for the BSPMs between the isotropic and anisotropic cases ranged from 0.83 for an apical dipole to 0.99 for an RV wall dipole. These results suggest that myocardial fibre anisotropy plays an important role in determining the body surface potentials.

Adult↗

Isoflurane depresses motoneuron excitability by a direct spinal action: an F-wave study.

UNLABELLED: Isoflurane decreases motoneuron excitability as measured by the F wave. It is unknown how much of this effect is direct and how much occurs as the result of an indirect, supraspinal effect. Seven goats were anesthetized with isoflurane, and the carotid arteries and jugular veins were isolated to permit cranial bypass. Isoflurane was delivered to the head via a bypass-oxygenator unit and to the torso via the lungs. Evoked gastrocnemius muscle potentials were measured after supramaximal electrical stimulation of the ischiatic nerve. F- and M-wave amplitudes and F-wave latencies were determined from 20 evoked responses obtained at each of the following head/torso isoflurane concentrations: 0.8%/0.3%, 1.3%/0.3%, 3%/0.3%, 0.3/0.8%, and 1.3%/0.8%. When the torso isoflurane was 0.3%, increasing the cranial isoflurane concentration from 0.8% to 1.3% did not significantly affect the F/M amplitude ratio (from 0.188 +/- 0.166 to 0.194 +/- 0.124; P > 0.05), but the ratio decreased approximately 50% when the cranial isoflurane was 3% (to 0.088 +/- 0.078; P < 0.05). F-wave latency was not affected by changing the cranial isoflurane concentration. The F/M amplitude ratio decreased 80%-85% when isoflurane 0.8% was administered to the torso and was not measurable in five animals; at this torso concentration, changing the cranial concentration from 0.3% to 1.3% had no effect on the F/M ratio (from 0.042 +/- 0.065 to 0.030 +/- 0.041; P > 0.05). In goats, motoneuron excitability is very sensitive to the direct action of isoflurane, and supraspinal effects occur between cranial isoflurane concentrations of 1.3% and 3%. IMPLICATIONS: We studied the effect of isoflurane action in the brain on motoneuron excitability, using the F wave. We found that the F wave is very sensitive to the direct action of isoflurane and that cranial isoflurane has indirect effects between concentrations of 1.3% and 3%.

Anesthesia, Inhalation↗

Mechanisms and patterns of injuries related to large animals.

BACKGROUND: Injuries from encounters with large animals represent a significant health risk for rural communities. We evaluated our regional trauma centers' experience with large-animal injuries to determine whether certain mechanisms and patterns of injury predicted either major head/craniofacial or torso (chest/abdomen/pelvis) trauma. METHODS: The hospital courses of 145 patients with injuries related to large animals were reviewed retrospectively to determine patterns of injury, specific injury mechanisms, species-specific injuries, and predictors of multiple body region trauma. RESULTS: Seventy-nine patients (55%) were injured by horses, 47 patients (32%) by bulls, 16 patients (11%) by cows, and 3 patients (2%) by wild animal attacks. The predominant species-specific mechanisms of injury were falls (horses), tramplings (bulls), and kicks (cows). Brain/craniofacial injuries were most common from horse-related encounters (32%), whereas bull and cow encounters usually resulted in torso injuries (45% and 56%, respectively). Multiple body region injuries occurred in 32% of patients. Fractures of the upper extremities were more often associated with torso and head/craniofacial injuries (48%) than lower extremity injuries (17%) (p = 0.02). CONCLUSION: Large animal injuries frequently involve multiple body regions with species-specific mechanisms. Upper extremity injuries are associated with a significantly higher percentage of torso and head/craniofacial injuries, which may have implications for field triage.

Adult↗

Endotracheal tube obstruction during stereotactic craniotomy.

The authors present a case of endotracheal tube (ETT) obstruction during stereotactic computer-assisted volumetric resection of an enlarging left thalamic mass in a prone patient. The head was fixed in a stereotactic COMPASS head frame and the patient positioned on transverse hip and shoulder rolls. The prone position was achieved with attention given to ensure an adequate distance between the sternum and mentum. At the time of dural incision, the patient's peak airway pressure and end-tidal CO2 tension increased markedly whereas the O2 saturation remained stable at 99%. It immediately became clear that the patient's torso had moved cephalad resulting in ETT obstruction, despite the continued integrity of head fixation. We emphasize the need for proper and safe patient positioning, the placement of a bite block between the molar teeth, and particularly in obese patients, the need to tape the patient's torso securely to the operating room table. In addition, it may be necessary to place the operating room table in reverse Trendelenberg position to prevent cephalad movement of the torso. This case represents an unusual mechanism of ETT obstruction, as normally the latter is caused by flexion of the head rather than by cephalad movement of the torso.

Adult↗

A new method for regularization parameter determination in the inverse problem of electrocardiography.

Computing the potentials on the heart's epicardial surface from the body surface potentials constitutes one form of the inverse problem of electrocardiography. An often-used approach to overcoming the ill-posed nature of the inverse problem and stabilizing the solution is via zero-order Tikhonov regularization, where the squared norms of both the surface potential residual and the solution are minimized, with a relative weight determined by a so-called regularization parameter. This paper looks at the composite residual and smoothing operator (CRESO) and L-curve methods currently used to determine a suitable value for this regularization parameter, t, and proposes a third method that works just as well and is much simpler to compute. This new zero-crossing method selects t such that the squared norm of the surface potential residual is equal to t times the squared norm of the solution. Its performance was compared with those of the other two methods, using three stimulation protocols of increasing complexity. The first of these protocols involved a concentric spheres model for the heart and torso and three current dipoles placed inside the inner sphere as the source distribution. The second replaced the spheres with realistic epicardial and torso geometries, while keeping the three-dipole source configuration. The final simulation kept the realistic epicardial and torso geometries, but used epicardial potential distributions corresponding to both normal and ectopic activation of the heart as the source model. Inverse solutions were computed in the presence of both geometry noise, involving assumed erroneous shifts in the heart position, and of Gaussian measurement noise added to the torso surface potentials. It was verified that in an idealistic situation, in which correlated geometry noise dominated the uncorrelated Gaussian measurement noise, only the CRESO approach arrived at a value for t. Both L-curve and zero-crossing approaches did not work. Once measurement noise dominated geometry noise, all three approaches resulted in comparable t values. It was also shown, however, that often under low measurement noise conditions none of the three resulted in an optimum solution.

Artifacts↗

The effect of geometric and topologic differences in boundary element models on magnetocardiographic localization accuracy.

This study was performed to evaluate the changes in magnetocardiographic (MCG) source localization results when the geometry and the topology of the volume conductor model were altered. Boundary element volume conductor models of three patients were first constructed. These so-called reference torso models were then manipulated to mimic various sources of error in the measurement and analysis procedures. Next, equivalent current dipole localizations were calculated from simulated and measured multichannel MCG data. The localizations obtained with the reference models were regarded as the "gold standard." The effect of each modification was investigated by calculating three-dimensional distances from the gold standard localizations to the locations obtained with the modified model. The results show that the effect of the lungs and the intra-ventricular blood masses is significant for deep source locations and, therefore, the torso model should preferably contain internal inhomogeneities. However, superficial sources could be localized within a few millimeters even with nonindividual, so called standard torso models. In addition, the torso model should extend long enough in the pelvic region, and the positions of the lungs and the ventricles inside the model should be known in order to obtain accurate localizations.

Biomedical Engineering↗

Support force measures of midsized men in seated positions.

Two areas not well researched in the field of seating mechanics are the distribution of normal and shear forces, and how those forces change with seat position. The availability of these data would be beneficial for the design and development of office, automotive and medical seats. To increase our knowledge in the area of seating mechanics, this study sought to measure the normal and shear loads applied to segmental supports in 12 seated positions, utilizing three inclination angles and four levels of seat back articulation that were associated with automotive driving positions. Force data from six regions, including the thorax, sacral region, buttocks, thighs, feet, and hand support were gathered using multi-axis load cells. The sample contained 23 midsized subjects with an average weight of 76.7 kg and a standard deviation of 4.2 kg, and an average height of 1745 mm with a standard deviation of 19 mm. Results were examined in terms of seat back inclination and in terms of torso articulation for relationships between seat positions and support forces. Using a repeated measures analysis, significant differences (p<0.05) were identified for normal forces relative to all inclination angles except for forces occurring at the hand support. Other significant differences were observed between normal forces behind the buttocks, pelvis, and feet for torso articulations. Significant differences in the shear forces occurred under the buttocks and posterior pelvis during changes in seat back inclination. Significant differences in shear forces were also identified for torso articulations. These data suggest that as seat back inclination or torso articulation change, significant shifts in force distribution occur.

Adult↗

Computational reconstruction of body surfact isopotential maps in myocardial infarction: comparison between nontransmural and transmural infarction.

The relationship between the lack of electromotive force in myocardial infarction and body surface potential distribution was investigated on maps reconstructed from a simulated heart model and transfer impedance vectors of human torso model. The heart model, a cluster of 3-mm cubic blocks, was stored in the memory of a computer. Transfer impedance vectors between 81 lead points on the human torso model and 392 positions covering ventricular areas in the torso were measure. Body surface potential values were calculated mathematically by summing up scalar products between the electromotive force of the heart model and the measured transfer impedance vectors. Thus, reconstructed maps changed in their patterns with the alternation in lacation and/or extent of infarcted region in the heart model. In particular, the appearance of the abnormal potential minimum, which projects the infarcted region in the heart model onto the torso surface, was characteristic in both transmural and subendocardial infarction. In addition, delayed activation in the intact layer of the epicardium overlying the infarcted region produced a potential maximum on the same place as the abnormal potential minimum appeared previously.

Action Potentials↗