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At least 487 records · Page 27Linked to original sources
PubMed2006

Lawnmower injuries in children: a 10-year experience.

Approximately 77,800 annual lawnmower-related injuries are treated in the USA, with 9,300 involving children. This work reviews the literature and reports our 10-year experience with lawnmower injuries. We retrospectively reviewed patients with lawnmower injuries admitted to the Women and Children's Hospital of Buffalo from 1995 to 2005 and reviewed the literature. Sixteen patients with mower-related injuries were admitted to our institution, with three due to walk-behind mowers and 13 due to riding mowers. The mean age was 7.5 years. Riding mower injuries had a higher average injury severity score (14.3 vs. 9) and a longer average length of hospital stay (15 vs. 2 days). All of the walk-behind mower injuries were extremity injuries, with two requiring amputations. Eleven of the riding mower injuries had extremity injuries alone, one had isolated torso injuries, and one had both extremity and torso injuries. Three required amputations, and the two patients with torso injuries required extensive surgical reconstructions. Pediatric lawnmower injuries, particularly due to riding mowers, are a highly preventable cause of morbidity and mortality. Increased public safety awareness and further manufacturer safety modifications should be strongly encouraged in order to limit this cause of pediatric trauma.

Accidents, Home↗
PubMed1998

Effects of repeated exercise/rest sessions at -10 degrees C on skin and rectal temperatures in men wearing chemical protective clothing.

The development of thermophysiological responses during four consecutive exercise/rest sessions in the cold was studied in men wearing chemical protective clothing and a face mask. Six men repeated four exercise/rest sessions during 8 h at -10 degrees C. Each session consisted of step exercise (240 W x m(-2)) for 60 min and rest for another 60 min. Rectal and skin temperatures were measured continuously and thermal sensations were obtained at 30-min intervals. Entering the cold from a warm environment and the onset of exercise resulted in a decrease in skin temperatures during the first session and the decrement in the temperatures of the extremities continued for 10-20 min during the following period of exercise. Torso skin temperature was at its lowest during the first rest period. After the first session of cold exposure the range and the level of variation in mean body temperature (Tb) followed a pattern which was repeated until the end of the experiment. However, the torso skin temperatures increased gradually until the fourth session, while the temperatures of the extremities, in contrast, tended to decrease up to the third session. In conclusion, the present results indicated that although Tb, reflecting the whole body heat balance, showed a typical pattern of change after the first session (2 h), the torso area was warming until the end of the cold exposure while the extremities continued to cool down up to the third session (6 h), obviously due to a prolonged redistribution of the circulation.

Adult↗
PubMed2006

Computational simulations of the human magneto- and electroenterogram.

Many functional pathologies of the small intestine are difficult to diagnose clinically without an invasive surgical intervention. Often such conditions are associated with a disruption of the normal electrical activity occurring within the musculature of the small intestine. The far field electrical signals on the torso surface arising from the electrical activity within the small intestine cannot be reliably measured. However, it has been shown that abnormal electrical activity in the small intestine can be distinguished by recording the magnetic fields of intestinal origin immediately outside the torso surface. We have developed an anatomically-based computational model to simulate slow wave propagation in the small intestine, the resulting cutaneous electrical field and the magnetic field outside the torso. Using both a one-dimensional and a three-dimensional model of the duodenum we investigate the degree of detail that is required to realistically simulate this far field activity. Our results indicate that some of the qualitative behavior in the far field activity can be replicated using a one-dimensional model, although there are clear situations where the greater level modeling detail is required.

Action Potentials↗
PubMed1993

Associated injuries in facial fractures: review of 839 patients.

Patients with facial trauma may have associated injuries requiring immediate or specialised attention. This paper reports the incidence and nature of significant associated neurosurgical, ocular, spinal, torso and extremity injuries in facial fracture patients treated by the Department of Plastic and Reconstructive Surgery from June 1989 to June 1992. Of 839 patients treated during the period, 95 patients (11.3%) sustained significant concomitant injuries outside the facial skeleton. There were 45 (5.4%) patients with associated neurosurgical injuries, 33 (3.9%) with ocular injuries, 8 (0.9%) with spinal injuries, 16 (1.9%) with injuries of the torso, and 62 (7.4%) with injuries of the extremities. The spectrum of the injuries is presented. Most neurosurgical injuries are a result of focal impact and the intervention required is related mainly to local fracture management and the repair of dural tears. The risk of significant ocular injury is highest when the fracture involves the orbit. Injuries of the spine, torso (chest, abdomen, pelvis), and limbs were seen mainly in road trauma patients.

Abdominal Injuries↗
PubMed1992

Impedance response characteristics of the primate Mucaca mulatta exposed to seated whole-body gz vibration.

A mathematical model was used to quantify and describe the variability in the mechanical impedance response of the Rhesus monkey subjected to vibrations in the range 3-20 Hz at 0.5 g peak acceleration. Due to the similarities in response, a two-mass, one-degree-of-freedom (DOF) model was selected and the associated mechanical parameters determined using a nonlinear least-squares optimization program. For the six tests conducted on each of the four subjects, appreciable parameter variations were observed within a subject; however, the majority of the mean parameter values among different subjects and among the repeated tests on the population were within +/- 1 S.D. of each other. Significant differences were observed in the stiffness coefficient and the total mass among different subjects, and in the mass ratio (between inert and sprung masses) among the repeated tests. Variations in the profile shapes following resonance were described and limited by changes in the mass ratio and the damping factor. Higher mass ratios (greater than 1.0) were associated with lower damping factors (less than 0.50). The impedance response beyond resonance approached the response described by the impedance of the inert mass and the damper elements of the model combined in parallel, and supported the assumption that the lower torso was rigidly attached to the seat. Physically, the reactive force produced by the upper torso increasingly diminished following resonance, due to the load transmission/attenuation characteristics of the spinal structures at 0.5 g peak acceleration. The impedance measured at the seat becomes dominated by the transmitted damping force associated with the spine and the force generated by the rigid lower-torso mass.

Acceleration↗
PubMed1993

Body surface potential mapping of ST-segment shift in patients undergoing percutaneous transluminal coronary angioplasty. Correlations with the ECG and vectorcardiogram.

The purpose of this study was to investigate the thoracic patterns of ST-segment shift induced by the occlusion of different coronary arteries during percutaneous transluminal coronary angioplasty. Body surface potential maps were recorded with 63 leads during sinus rhythm before, during, and after balloon inflation in 20 patients. Two patients underwent dilatation of both the right and circumflex coronary arteries. A 12-lead scalar electrocardiogram and a Frank vectorcardiogram with orthogonal leads X, Y, and Z were obtained with the body surface potential maps. The body surface potential maps at 40 ms during the ST-segment showed patterns that were specific to the dilated vessel. The left anterior descending coronary artery (n = 10) was associated with the largest ST-segment shifts with a precordial maximum and negative potentials over the back; for the right coronary artery (n = 7), negative potentials covered the upper left torso with a left mid-axillary minimum and positive potentials over the rest of the torso; for the left circumflex coronary artery (n = 5), negative potentials covered the anterior torso with a precordial minimum and positive potentials over the back. These changes dissipated rapidly after balloon deflation. ST levels measured on orthogonal leads showed values greater than standard electrocardiographic leads for circumflex and right coronary arteries. In conclusion, body surface potential mapping provides a comprehensive approach for the evaluation of electrocardiographic changes and the development of optimal leads for the detection of acute occlusion of a coronary artery.

Adult↗
PubMed1990

Comparison and testing of least-squares time domain inverse solutions in electrocardiography.

The use of several mathematical methods for estimating epicardial ECG potentials from arrays of body surface potentials has been reported in the literature; most of these methods are based on least-squares reconstruction principles and operate in the time-space domain. In this paper we introduce a general Bayesian maximum a posteriori (MAP) framework for time domain inverse solutions in the presence of noise. The two most popular previously applied least-squares methods, constrained (regularized) least-squares and low-rank approximation through the singular value decomposition, are placed in this framework, each of them requiring the a priori knowledge of a 'regularization parameter', which defines the degree of smoothing to be applied to the inversion. Results of simulations using these two methods are presented; they compare the ability of each method to reconstruct epicardial potentials. We used the geometric configuration of the torso and internal organs of an individual subject as reconstructed from CT scans. The accuracy of each method at each epicardial location was tested as a function of measurement noise, the size and shape of the subarray of torso sensors, and the regularization parameter. We paid particular attention to an assessment of the potential of these methods for clinical use by testing the effect of using compact, small-size subarrays of torso potentials while maintaining a high degree of resolution on the epicardium.

Algorithms↗
PubMed1993

Outcome and prognostic factors in soft tissue sarcoma in the adult.

PURPOSE: To evaluate the outcome, patterns of failure and prognostic factors in this rare disease in adult patients treated at a single institution in the modern era. METHODS AND MATERIALS: The records of all patients (389 cases) with soft tissue sarcoma in the extremities, torso (excluding retroperitoneum), and head and neck managed between 1980 and 1988 were reviewed. A curative (radical) approach was used in 321 patients of whom 10% were recurrent lesions. The local management consisted of surgery alone in 54 cases, surgery and radiotherapy in 250 and radiotherapy alone in 17. Adjuvant chemotherapy was used as a policy for high grade lesions in the initial five years of the study (98 cases), but was omitted subsequently. RESULTS: Extremity lesions fared more favourably compared to head and neck and torso lesions (p = 0.02) with respect to survival. Extremity and torso lesions had significantly better local control (p < 0.0001) than in the head and neck where local failure was a common cause of death. A multiple Cox regression analysis revealed that resection margins, local extension of tumor, age at diagnosis, and grade correlated with local relapse and distant relapse was also associated with local extension, high grade and in addition, large lesions. Size appeared especially predictive for distant failure, the most common cause of death. Distant failure was not influenced by the use of adjuvant chemotherapy. Patients treated for recurrence in this series had significantly worse survival due to increased distant failure despite similar local control to primary cases. CONCLUSION: This series highlights the overall problem of distant failure in this disease. It also reaffirms the importance of obtaining local control both in the head and neck, where uncontrolled local disease is the major cause of death, and in general since local relapse appears to increase the risk of distant failure. It appears that the current staging systems should be reviewed in the light of the apparent effect of different prognostic factors.

Actuarial Analysis↗
PubMed1994

The effects of vertical and horizontal vibrations on the human body.

Vertical and horizontal vibrations of a 100 kg human have been investigated. A new mechanical model has been developed, and an analogous electric simulation has been carried out, which in turn has been analysed by using computer software (MICRO-CAP II). The vibration force comes from (a) hand, (b) seat and (c) combination of the two. The theoretical results obtained have been tabulated and are presented in a graphical manner. It has been found that the body segments (lower arm, head, torso, cervical spine and lumbar spine) are affected by horizontal vibrations when the input force (F(i)) comes from both hand and seat more than when (F(i)) comes from the seat alone. Similar results have been found also for the case of the lower arms and torso when the body is subjected to vertical vibrations. The head is affected by vertical vibrations when (F(i)) comes from the seat more than when (F(i)) comes from both hand and seat. An experimental set-up has been designed and measurements of vibrational signals from the human lower arm, head and torso have been carried out. Similar trends are shown for both theoretical results and experimental findings.

Adult↗
PubMed2004

MR imaging of the prostate at 3 Tesla: comparison of an external phased-array coil to imaging with an endorectal coil at 1.5 Tesla.

RATIONALE AND OBJECTIVES: To qualitatively compare the image quality of torso phased-array 3-Tesla (3T) imaging of the prostate with that of endorectal 1.5-Tesla imaging. MATERIALS AND METHODS: Twenty cases of torso phased-array prostate imaging performed at 3-Tesla with FSE T2 weighted images were evaluated by two readers independently for visualization of the posterior border (PB), seminal vesicles (SV), neurovascular bundles (NVB), and image quality rating (IQR). Studies were performed at large fields of view(FOV) (25 cm) (14 cases) (3TL) and smaller FOV (14 cm) (19 cases) (3TS). A comparison was made to 20 consecutive cases of 1.5-T endorectal evaluation performed during the same time period.Results. 3TL produced a significantly better image quality compared with the small FOV for PB (P = .0001), SV (P =.0001), and IQR (P = .0001). There was a marginally significant difference within the NVB category (P = .0535). 3TL produced an image of similar quality to image quality at 1.5 T for PB (P = .3893), SV (P = .8680), NB (P = .2684), and IQR (P = .8599). CONCLUSION: Prostate image quality at 3T with a torso phased-array coil can be comparable with that of endorectal 1.5-T imaging. These findings suggest that additional options are now available for magnetic resonance imaging of the prostate gland.

Adenocarcinoma↗
PubMed2006

Randomized controlled clinical trial of point-of-care, limited ultrasonography for trauma in the emergency department: the first sonography outcomes assessment program trial.

STUDY OBJECTIVE: Annually, 38 million people are evaluated for trauma, the leading cause of death in persons younger than 45 years. The primary objective is to assess whether using a protocol inclusive of point-of-care, limited ultrasonography (PLUS), compared to usual care (control), among patients presenting to the emergency department (ED) with suspected torso trauma decreased time to operative care. METHODS: The study was a randomized controlled clinical trial conducted during a 6-month period at 2 Level I trauma centers. The intervention was PLUS conducted by verified clinician sonographers. The primary outcome measure was time from ED arrival to transfer to operative care; secondary outcomes included computed tomography (CT) use, length of stay, complications, and charges. Regression models controlled for confounders and analyzed physician-to-physician variability. All analyses were conducted on an intention-to-treat basis. Results are presented as mean, first-quartile, median, and third-quartile, with multiplicative change and 95% confidence intervals (CIs), or percentage with odds ratio and 95% CIs. RESULTS: Four hundred forty-four patients with suspected torso trauma were eligible; 136 patients lacked consent, and attending physicians refused enrollment of 46 patients. Two hundred sixty-two patients were enrolled: 135 PLUS patients and 127 controls. There were no important differences between groups. Time to operative care was 64% (48, 76) less for PLUS compared to control patients. PLUS patients underwent fewer CTs (odds ratio 0.16) (0.07, 0.32), spent 27% (1, 46) fewer days in hospital, and had fewer complications (odds ratio 0.16) (0.07, 0.32), and charges were 35% (19, 48) less compared to control. CONCLUSION: A PLUS-inclusive protocol significantly decreased time to operative care in patients with suspected torso trauma, with improved resource use and lower charges.

Adult↗
PubMed2004

Cot mattresses as reservoirs of potentially harmful bacteria and the sudden infant death syndrome.

Cot mattress materials were investigated as potential reservoirs of bacteria in relation to the sudden infant death syndrome (SIDS). The sleeping position of the infant significantly influenced bacterial population density of cot mattress polyurethane foams (p<0.0000001) and their covers (p<0.004). Staphylococcus aureus was isolated at significantly higher frequency (p<0.03) from the infant's head region of cot mattress materials. Significantly higher bacterial population densities (p<0.001) were associated with polyurethane foams from non-integral mattresses (exposed polyurethane foam), when compared to those from mattresses completely covered by polyvinyl chloride (integral type mattress). The frequency of isolation of S. aureus from polyurethane foams from non-integral mattresses was also significantly higher (p=0.03) than from foams from the integral type. The following factors were significantly associated with increased frequency of isolation of S. aureus: from the polyurethane foam, previous use of non-integral mattresses by another child (p=0.03 for all sample sites, p=0.01 for torso region); from the covers, sleeping in the prone position (p=0.003 head region, p=0.001 torso region). Prone sleeping was also significantly associated with increased bacterial population levels (p=0.01) and increased frequency of isolation of Escherichia coli (p=0.02) from the torso region of cot mattress covers. These findings could explain some recently identified risk factors for SIDS associated with type and previous use of cot mattresses. Clostridium perfringens was isolated at very low frequency and Streptococcus pyogenes was not isolated from any cot mattress materials tested.

Bedding and Linens↗
PubMed2004

Compensatory stepping in response to waist pulls in balance-impaired and unimpaired women.

An effective stepping response is often critical in avoiding a fall. Our objective was to study the effects of age and balance impairment on anterior and posterior compensatory stepping strategies in response to waist pull perturbations of 1-5% body weight (BW). Based on maximal unipedal stance time (UST), we tested 15 balance-impaired old (BI, UST < 10s, mean age = 76 years), 12 healthy old (O, UST>30s, mean age = 71 years), and 13 healthy young women (Y, UST >30s, mean age=23 years). Randomized anterior and posterior pulls of 1-5% body weight (BW) were applied to the waist while kinematic and kinetic recovery responses were recorded. Results show that O and BI required 0.5 more steps than Y to recover balance for posterior pulls of 4-5% BW (P < 0.01). For anterior pulls of 4-5% BW, only BI had a greater probability of step initiation (P<or=0.05 or <0.02) and mean number of steps required to recover balance (P < 0.03). The Y used 93% greater torso extension and 24% greater torso flexion in responding to anterior and posterior pulls, respectively. In the posterior, but not anterior direction, O employed smaller (P < 0.007), but more laterally-directed (P < 0.03) steps than the Y. The BI were less able to attenuate their momentum during the step landing in both directions. We conclude that the additional steps required by the BI in both directions occurred because their initial step failed to properly arrest their momentum. Controlling torso inclination before step liftoff and linear momentum after step landing are critical components of successful compensatory stepping.

Accidental Falls↗
PubMed2005

A mechanism for balancing the human body on the hips.

A mechanism for the postural balance of the human torso over the hip joints is reported that does not appear to have been fully recognised. The centre of gravity of the torso is usually considered poised above the hips. This is in a state of unstable equilibrium. Here, we propose that body weight acting through the sacrum is counter-balanced by tension in the ilio-femoral ligament; the hips acting as the fulcrum. This places the torso in stable equilibrium and means that balance may be maintained with minimal muscular forces. The joint reaction force due to this mechanism in a two-legged stance is then of the order of the body-weight on each hip. An implication is that capsular ligaments are important and consideration should be given to retaining or restoring them as much as possible in hip arthroplasty.

Biomechanical Phenomena↗
PubMed2003

Cardiac electrical activity--from heart to body surface and back again.

We report here on our latest developments in the forward and inverse problems of electrocardiology. In the forward problem, a coupled cellular model of cardiac excitation-contraction is embedded within an anatomically realistic model of the cardiac ventricles, which is itself embedded within a torso model. This continuum modelling framework allows the effects of cellular-level activity on the surface electrocardiogram (ECG) to be carefully examined. Furthermore, the contributions of contraction and local ischemia on body surface recordings can also be elucidated. Such information can provide theoretical limits to the sensitivity and ultimately the detection capability of body surface ECG recordings. Despite being very useful, such detailed forward modelling is not directly applicable when seeking to use densely sampled ECG information to assess a patient in a clinical environment (the inverse problem). In such a situation patient specific models must be constructed and, due to the nature of the inverse problem, the level of detail that can be reliably reproduced is limited. Extensive simulation studies have shown that the accuracy with which the heart is localised within the torso is the primary limiting factor. To further identify the practical performance capabilities of the current inverse algorithms, high quality experimental data is urgently needed. We have been working towards such an objective with a number of groups, including our local hospital in Auckland. At that hospital, in patients undergoing catheter ablation surgery, up to 256 simultaneous body surface signals were recorded by using various catheter pacing protocols. The geometric information required to customize the heart and torso model was obtained using a combination of ultrasound and laser scanning technologies. Our initial results indicate that such geometric imaging modalities are sufficient to produce promising inversely-constructed activation profiles.

Algorithms↗
PubMed1999

Endurance times for low back stabilization exercises: clinical targets for testing and training from a normal database.

OBJECTIVE: To establish isometric endurance holding times, as well as ratios between torso extensors, flexors, and lateral flexors (stabilizers), for clinical assessment and rehabilitation targets. DESIGN: Simple measurement of endurance times in four tests performed in random order by a healthy cohort. To measure reliability, a subsample also performed the tests again 8 weeks later. SETTING: University laboratory. PARTICIPANTS: Seventy-five young healthy subjects (31 men, 44 women). RESULTS: Women had longer endurance times than men for torso extension, but not for torso flexion or for the "side bridge" exercise, which challenges the lateral flexors (stabilizers). Men could sustain the "side bridge" for 65% of their extensor time and 99% of their flexion time, whereas women could sustain the "side bridge" for only 39% of their extensor time and 79% of their flexion time. The tests proved reliable, with reliability coefficients of >.97 for the repeated tests on 5 consecutive days and again 8 weeks later. CONCLUSION: Healthy young men and women possess different endurance profiles for the spine stabilizing musculature. Given the growing support for quantification of endurance, these data of endurance times and their ratios between extensor, flexor, and lateral flexor groups in healthy normal subjects are useful for patient evaluation and for providing clinical training targets.

Adult↗
PubMed1998

The forced expiratory volume-time curve estimation using the electrocardiogram.

The feasibility of estimating the forced expiratory volume-time curve from the amplitude modulation of the electrocardiogram was studied using a numerical torso model and ECG signal processing. A two dimensional numerical model of the torso was solved for the maximum expiration and inspiration to study the changes in the surface potential as a result of changes in the lung volume. The numerical model showed that significant changes in the surface potential amplitude occur between maximum inspiration and maximum expiration and that this amplitude change in the left-right axis of the torso might be three times as large as in the front-back axis. In the experimental setup, ECG waveforms from the surface of the chest and the mouth air flow were simultaneously recorded from four male subjects during several forced vital capacity (FVC) maneuvers. The amplitude of the QRS complex was measured for different expired lung volumes and an estimation of the forced expiratory volume-time curve was obtained. The FVC and the FEV1 (forced expiratory volume after 1 s) spirometry indices were calculated for the two volume-time curves obtained from the electrocardiogram and from the spirometry measurements. The results differ between 0.1 and 0.8 1. These preliminary results are encouraging and might indicate that a relationship between the volume-time curve during FVC test and the electrocardiogram signals does exist. Further validation in a larger number of subjects and patients is needed before the technique can be applicable for clinical use.

Adult↗
PubMed1978

Effects of the volume conductor on the apparent orientation of a known cardiac dipole.

The surface electrocardiogram (EKG) is dependent on two major factors: the cardiac generator and the volume conductor. This investigation assessed the effects of the volume conductor in man on the apparent orientation of a simulated cardiac dipole. The apparent orientation of the dipole was calculated from measured surface potentials from about 60 locations on the body of five patients with implanted cardiac pacemakers. The real orientation of the dipole (an implanted pacemaker) was determined radiographically. The effects of both inhomogeneity and boundary characteristics of the volume conductor on the apparent orientation of the dipole were assessed using a new inverse algorithm. The difference between the orientation of the real and the calculated dipoles averaged 30 degrees (range 15 degrees--40 degrees) when the torso was assumed to be an infinite-homogeneous volume conductor. When the configuration of the torso was accounted for, however, the difference between the orientation of the real and calculated dipoles was reduced to 9 degrees (range 5 degrees--13 degrees). Thus, by taking into account the geometry of the torso and neglecting the inhomogeneities in the volume conductor, it is possible to calculate the orientation of a dipole in the cardiac region with an accuracy of about 9 degrees. It is reasonable to assume that the orientation of real activation wave fronts from localized areas of the heart could be calculated with a similar degree of accuracy.

Aged↗