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PubMed2002

Importance of using standard rather than torso surface electrocardiographic leads for pacemapping at the right ventricular outflow tract.

Although pacemapping has been used to localize the origin of ventricular tachycardia, the effect of changes in the position of ECG electrodes during ventricular pacing remains unknown. To clarify the relationship between the position of ECG limb electrodes and QRS configuration during pacemapping at the right ventricular outflow tract (RVOT), RVOT pacing was performed on 12 patients at eight pacing sites located in the anterior, septal, lateral, and posterior portions each in the high and low RVOT. Standard and torso ECGs were recorded simultaneously during each pacing protocol, and the QRS axis and amplitude were compared between the two ECGs. Differences between sites in the horizontal plane and in the longitudinal direction were also compared. The QRS axis on the torso ECG was significantly more rightward than that on the standard ECG at all eight pacing sites (72.1+/-17.4 vs 64.0+/-21.9 degrees). The magnitude of differences in the QRS axis and amplitude between the anterior and other sites at the same height was significantly greater in the standard ECG in all locations and in 7 of 18 comparable leads, respectively. The magnitude of differences between high and low sites was significantly greater in the standard ECG in three of four locations and in 5 of 12 comparable leads, respectively. In conclusion, the torso ECG is less sensitive to changes in pacing site at the RVOT than the standard ECG. The torso ECG is, therefore, not proper for pacemapping in attempts to ablate ventricular tachycardia arising from the RVOT.

Adult↗
PubMed2007

The influence of age on isometric endurance and fatigue is muscle dependent: a study of shoulder abduction and torso extension.

The present study examined differences in isometric muscle capacity between older (55-65 years) and younger (18 - 25 years) individuals. A total of 24 younger and 24 older participants (gender balanced within each group) performed sustained shoulder abductions and torso extensions to exhaustion at 30%, 50% and 70% of individual maximal voluntary contraction (MVC). Along with endurance time, manifestations of localized fatigue were determined based on changes in surface electromyographic signals obtained from the shoulder (middle deltoid) and the torso (multifidus and longissimus thoracis) muscles. Strength recovery was monitored using post-fatigue MVCs over a 15-min period. Compared to the younger group, older individuals exhibited lower muscular strength, longer endurance time and slower development of local fatigue. Age effects on fatigue were typically moderated by effort level, while effects of gender appeared to be marginal. Non-linear relationships between target joint torque and endurance time were observed, with effects of age differing between shoulder abduction and torso extension. Overall, the effects of age on endurance and fatigue were more substantial and more consistent for the shoulder muscle than for the torso muscles and were likely related to differences in muscle fibre type composition. For strength recovery rates, no significant age or gender effects were found in either experiment. In summary, this study suggests that differences in isometric work capacity do exist between older and younger individuals, but that this effect is influenced by effort level and the muscle tested.

Adult↗
PubMedDate not supplied

Endotracheal drug delivery followed by a 90-degree torso tilt in a swine model of cardiac arrest.

OBJECTIVES: Prehospital providers are often unable to obtain intravenous (i.v.) access in cardiac arrest victims. While several drugs can be administered via the endotracheal (ET) route, serum drug levels are lower than those obtained with the i.v. route. The authors hypothesized that a 90-degree torso tilt after ET drug administration would increase drug levels. METHODS: A randomized, prospective, unblinded laboratory trial was conducted. Twenty-three mixed-breed domestic swine (20-25 kg) were sedated, anesthetized, instrumented, shocked into cardiac arrest, and randomized into three groups. Lidocaine was administered either i.v. (1.5 mg/kg), traditional ET (4.5 mg/kg), or ET followed by a 5-second 90-degree upright torso tilt (4.5 mg/kg). While standard CPR was performed, lidocaine levels were obtained at 0.5, 1, 2, 3, 4, and 5 minutes after administration. Repeated-measures ANOVA was used for data analysis (alpha = 0.05). RESULTS: Experimental ET compared with traditional ET administration produced significantly higher levels at all time points except 0.5 minutes. Comparing experimental ET with i.v. administration yielded significantly higher levels for the i.v. route at 0.5 and 1 minute and for the experimental ET route at 4 and 5 minutes. i.v. lidocaine administration resulted in significantly higher levels at 0.5, 1, and 2 minutes when compared with traditional ET administration. CONCLUSIONS: Endotracheal instillation of lidocaine followed by a 90-degree torso tilt resulted in better drug absorption, as evidenced by higher serum lidocaine levels, than did traditional recumbent ET delivery at all but the earliest time point and produced more sustained lidocaine levels than i.v. administration at 4 and 5 minutes. ET drug delivery followed by a 5-second 90-degree torso tilt and the mechanisms for this enhanced absorption warrant further investigation.

Administration, Inhalation↗
PubMed2006

Synthetic torso for training in and evaluation of urologic laparoscopic skills.

BACKGROUND: The expanding use of advanced minimally invasive surgical techniques demands more advanced training methods, objective measures of resident performance, and more realistic and anatomically correct training models. MATERIALS AND METHODS: A new synthetic torso for urologic laparoscopy training was developed and assessed. The trainer, Lapman, was based on the Visible Human Model and has the exact shape of a human torso. The torso models the outer shape of the body and the abdominal and pulmonary cavities. Animal or synthetic models of the abdominal organs may be placed in the abdominal cavity. An abdominal wall provides access and seals the cavity and can be replaced after repeated punctures with laparoscopic instruments. The thoracic cavity connects to a pneumatic pump to simulate breathing. In order to render realistic mechanic properties, the torso is cast of materials with elastic properties similar to those of soft tissue and incorporates a synthetic skeleton. These similar mechanical properties and the thoracic insufflation create realistic ventilatory motion simulation. RESULTS: Twenty-five individuals--medical students, residents, and attending urologists--participated in a study comparing Lapman with a standard training box. Lapman presented several advantages over the traditional training box, specifically with regard to internal and external views and the incorporation of a realistically shaped abdominal wall. A significant and recurrent theme was the value of the synthetic wall as a tool to gain a greater appreciation of the importance of port placement. Study participants at all levels of training appreciated that Lapman gives a more realistic approximation of the operative procedure. CONCLUSIONS: The novelty of the trainer consists in its anatomic shape, realistic mechanical properties, and ventilatory simulation. This paper reports on its design, construction, and preliminary tests.

Humans↗
PubMed2006

The relation between visceral fat measurement and torso level--is one level better than another? The Atherosclerosis Risk in Communities Study, 1990-1992.

Intraabdominal fat (IAF) area is often measured indirectly in epidemiologic studies. The authors recruited 147 participants from the second examination (1990-1992) of the Atherosclerosis Risk in Communities Study to examine IAF area and determine whether there were differences in IAF area and distribution by location. Magnetic resonance imaging was used to image four 10-mm slices between the second and fourth lumbar vertebrae by an inverse recovery method, and IAF was calculated from each image. The authors constructed gender-specific mixed models with IAF area as the outcome and the location of imaging along the torso as the independent variable, using random intercepts to account for between-person variation in IAF area. The torso location of IAF measurement was a significant predictor of IAF area in both men (p = 0.02) and women (p < 0.0001) after adjustment for body mass index. A significant positive interaction between age and location was seen in men, with increasing IAF area moving down the torso with older ages. Using magnetic resonance imaging, location along the torso yields different IAF areas and distributions independently of body mass index in both genders, with measurement at the second lumbar vertebra (slightly above the umbilicus) capturing the largest amount of IAF. Studies that attempt to link IAF with cardiovascular disease risk factors should consider measurement location to accurately capture the association.

Adiposity↗
PubMed2001

The routine use of sonography in penetrating torso injury is beneficial.

BACKGROUND: Torso sonography (focused assessment with sonography for trauma [FAST]) has been added to our protocols for the evaluation of penetrating torso injury. The purpose of this study was to evaluate our recent experience and determine whether the use of FAST is beneficial. METHODS: From January 1999 to January 2000, patients with penetrating torso injury and no clinical indication for surgery were evaluated by sonography with a selective use of other investigations. FAST consisted of sonographic views of the peritoneum and/or pericardium to determine the presence or absence of fluid. RESULTS: During the study period, there were 238 victims of penetrating injury assessed by our trauma service, and sonography was performed in 72 (30%) patients as per our protocols. There were 31 stab, 37 gunshot/shotgun and, and 4 puncture wounds. Thirty-eight patients had peritoneal views, 6 patients had pericardial views, and 28 patients had both pericardial and peritoneal views obtained. Thirteen of 66 patients had free fluid in the peritoneal cavity and 12 of the 13 patients had a therapeutic laparotomy. No peritoneal fluid was seen in 53 of 66 patients, of whom 6 had abdominal injuries, 5 requiring surgery for diaphragm or bowel injuries. The sensitivity of FAST alone for abdominal injury was 67%, specificity was 98%, positive predictive value was 92%, and negative predictive value was 89%. Pericardial fluid was seen in 3 of 34 patients; one had a heart wound and two had negative pericardial windows. All 31 patients without pericardial fluid recovered without surgery. CONCLUSION: The routine use of sonography in penetrating torso injury is beneficial. The detection of pericardial or peritoneal fluid is clinically useful. However, a negative FAST examination does not exclude abdominal injury, such as a diaphragm or hollow viscus wound, and further investigation or close follow-up is required.

Abdominal Injuries↗
PubMed2002

Lower torso muscle activation patterns for high-magnitude static exertions: gender differences and the effects of twisting.

STUDY DESIGN: Surface electromyographic signals were collected from 14 lower torso muscles while participants resisted high-magnitude static trunk moments applied in a variety of directions. OBJECTIVES: To obtain a description of muscle activations in response to large moment magnitudes and axial twisting, including levels of agonistic and antagonistic muscle cocontraction. To assess differences in lower torso muscle activation patterns associated with gender and trial repetition. SUMMARY OF BACKGROUND DATA: Back pain is associated with mechanical loads in the back. Biomechanical modeling of these loads is facilitated by knowledge of typical muscle activation patterns. Previous efforts in obtaining such data have often limited their scope to low-magnitude exertions or relatively simple scenarios. METHODS: Eight male and eight female participants, matched by height and mass, performed static exertions in an apparatus that immobilized their lower body while the activation levels of seven bilateral torso muscles were measured using surface electromyography. Activation patterns were analyzed to assess differences resulting from a variety of factors. RESULTS: No significant differences in activation patterns were found between genders or repetitions, but moment magnitude and direction elicited substantial differential responses. Good repeatability was found between trial repetitions, as indicated by intraclass correlation coefficients (>0.65). Significant synergistic muscle coactivation, large intersubject variability (mean coefficient of variation 82.2%), and consistent levels of antagonism ranging from 10% to 30% maximum voluntary exertions were observed. CONCLUSIONS: Individuals of different genders, but similar anthropometry, have comparable muscular reactions to complex torso loads, suggesting similar motor control strategies. Future spine models should consider that the variability in muscle recruitment patterns is larger between subjects than within subjects. High-magnitude exertions, especially those with moment loads in more than one plane, require most muscles to be active (>5%) and moderate levels of antagonism.

Adult↗
PubMedDate not supplied

Torso coupling techniques for the forward problem of electrocardiography.

The calculation of body surface potentials from a known cardiac source is traditionally formulated in terms of a two step process. The first step involves the generation of some form of equivalent cardiac source (typically dipole based) at a resolution significantly lower than that of a continuum cell. The second then places that source into a volume conductor within which the potential fields are calculated. This approach does not properly capture the feedback between the torso and the extracellular potential field. Presented here are the details of two new methods which calculate continuous potential fields throughout the torso that are the direct result of cardiac cellular electrical activity. These new methods are termed the Boundary Iteration Method and the Direct Assembly Method. While these two methods return essentially identical answers, there is a definite tradeoff between computational speed and memory overhead with the direct assembly method proving faster but requiring significantly more memory. Examples are given that demonstrate the convergence and accuracy of these methods in an idealized coupled torso system. These techniques are then applied to an anatomically based model of a slice through a human male torso.

Abdomen↗
PubMed2001

The torso ligand, unmasked?

When a transmembrane receptor protein tyrosine kinase (RTK) is expressed throughout the plasma membrane, yet only a specific handful of them must be activated, what's a ligand to do? During the development of the anterior and posterior termini of the Drosophila embryo, uniformly secreted ligand precursors are activated by proteolysis near the location of the receptors that must be activated. Stein and Stevens discuss the recent publication by Casali and Casanova that describes the mechanism of activation of the Drosophila RTK called Torso. In addition, Casali and Casanova may have identified a physiologically relevant ligand for Torso called Trunk. Proteolytic cleavage of the Trunk precursor can activate Torso-dependent signaling, but the existence of cleaved Trunk has not yet been demonstrated in vivo for Drosophila. Stein and Stevens discuss the ramifications of such a highly regulated process of ligand activation, and also prefer alternative scenarios for Torso activation.

Animals↗
PubMed1986

Automated optical measurements of human torso surface movements during breathing.

An automated light-sectioning system has been developed for continuously measuring the movements of the torso surface during breathing. The body is illuminated with planes of light of a known geometry, and the body is visualized with television cameras. The perceived angles at which the television scan detected the planes projected onto the body are encoded digitally and stored continuously on magnetic tape. Subsequently the geometry of the torso can be reconstructed at 80-ms intervals enabling the detailed pattern of movements and volume displacement over the torso surface to be determined. Displacements of 0.5 mm over the torso surface can be resolved, and respired volume can be measured to within 10% over the range of the vital capacity.

Abdomen↗
PubMed1999

Eye movements during torso rotations in labyrinthine-defective subjects.

The aim of this study was to examine whether the chronic loss of vestibular function modifies perceptual and oculomotor responses during torso rotations in darkness. Subjects (4 patients with complete vestibular loss and 7 healthy volunteers) were seated on a rotating chair. Stimuli consisted of sinusoidal chair rotations (+/-30 degrees, 0.1 Hz and 0.011 Hz). We used 2 conditions: space stationary head (neck stimulation) and space stationary head and shoulders (torso stimulation). Horizontal eye deviations and slow component of eye movements were analysed. The results showed that eye movements and perception of head motion in space during neck stimulation were similar to those during torso stimulation both in normal and labyrinthine-defective (LD) subjects. During low-frequency chair rotations (0.011 Hz) all subjects perceived illusory head or head and shoulder rotation in space (as if the lower part of the body was stationary relative to the room) and shifted their gaze in the direction of illusory head rotation. In these conditions there was no significant difference in eye movements between normal and LD subjects. During higher frequency chair rotations (0.1 Hz), LD subjects had significantly larger eye deviations as well as increases in the gain of the slow component of eye movements relative to normals. In these conditions patients mostly perceived illusory head or head and shoulder rotation in space while normal subjects mainly perceived the head as stationary in space. The results indicate that 1) neck and torso rotations can evoke similar ocular responses in LD subjects, 2) the chronic loss of vestibular function modifies the representation of axial body segment motion relative to space.

Aged↗
PubMed1983

Head and/or torso cooling during simulated cockpit heat stress.

Liquid-conditioned garments (LCG's) may be useful in alleviating heat stress on aircrew members. This study evaluated the effects of a liquid-cooled vest and/or cap on subjects exposed to a thermal environment which simulated the stress of low-level flight in hot weather. The chamber was set at dry bulb temperature 35 degrees C, wet bulb temperature 26 degrees C, and black globe temperature 43 degrees C. Subjects were eight men, aged 23-45 yr. Each subject was studied in four 100-min exposures: uncooled control (XX); head cooling only (HX); torso cooling only (XT); and combined head and torso cooling (HT). Cooling effects were evaluated by using rectal temperature (Tre); heart rate (HR); sweat rate (SRF and SRT for forehead and total body, respectively); and subjective comfort. Uncooled runs (XX) produced final values: Tre = 37.8 degrees C, HR = 94 beats/min, SRT = 25 g/m2 X h and SRF = 45 g/m2 X h. Combined head and torso cooling maintained the subjects at nearly their initial (baseline) state. Cap effects per se were assessed by comparing HX to XX, and HT to XT. Head cooling proved 2-3 times as efficient as torso cooling, although limited by the small surface area involved. We conclude that the specific effects of head cooling in improving comfort and diminishing forehead sweating, as well as the efficient systemic cooling observed, justify further work on cockpit applications.

Adult↗
PubMed1990

Magnetic resonance imaging: calculation of rates of energy absorption by a human-torso model.

The three-dimensional impedance method was used to estimate specific absorption rate (SAR) in a human-torso model during exposure to the time-varying and static magnetic fields used in magnetic resonance imaging (MRI). Analytical data for discrete tissues as well as the entire torso are presented. Generalized equations were derived that enable calculation of whole-torso SAR over a broad range of conditions. In addition, the impedance method can generate data about internal distributions of SAR, which are needed to predict critical organs that might undergo excessive elevations of temperature. Fair to good agreement was found between impedance-method SAR and those predicted by simple phenomenological models.

Electromagnetic Fields↗
PubMed1994

The torso pathway in Drosophila: lessons on receptor tyrosine kinase signaling and pattern formation.

Pattern formation at the anterior and posterior termini of the Drosophila embryo involves intercellular communication via the Torso receptor tyrosine kinase (RTK). Recent advances in the understanding of Torso signaling has provided further support for the conservation of a signal transduction cassette downstream of RTKs. In addition, the analysis of the Torso pathway has begun to reveal general molecular mechanisms by which cells may impart patterning information to their neighbors through the use of RTKs.

Animals↗
PubMed2004

Biomechanical modelling of orthotic treatment of the scoliotic spine including a detailed representation of the brace-torso interface.

As part of the development of new modelling tools for the simulation and design of brace treatment of scoliosis, a finite element model of a brace and its interface with the torso was proposed. The model was adapted to represent one scoliotic adolescent girl treated with a Boston brace. The 3D geometry was acquired using multiview radiographs. The model included the osseo-ligamentous structures, thoracic and abdominal soft tissues, brace foam and shell, and brace-torso interface. The simulations consisted of brace opening to include the patient's trunk followed by brace closing. To validate the model, the resulting geometry was compared with the real in-brace geometry, and the resulting contact reaction forces at the brace-torso interface were compared with the equivalent forces calculated from pressure measurements made on the in-brace patient. Differences between coronal equivalent and reaction forces were less than 7N. However, sagittal reaction forces (47N) were computed on the abdomen, whereas negligible equivalent forces were measured. The simulated geometry presented partially reduced coronal Cobb angles (1-4 degrees), over-corrected sagittal Cobb angles and maximum deformation plane (5 degrees), completely corrected coronal shift, and sagittal shift and rib humps that were not corrected. This study demonstrated the feasibility of a new approach that represents the load transfer from the brace to the spine more realistically than does the direct application of forces.

Adolescent↗
PubMedDate not supplied

Geometric modeling of the human torso using cubic hermite elements.

We discuss the advantages and problems associated with fitting geometric data of the human torso obtained from magnetic resonance imaging, with high-order (bicubic Hermite) surface elements. These elements preserve derivative (C1) continuity across element boundaries and permit smooth anatomically accurate surfaces to be obtained with relatively few elements. These elements are fitted to the data with a new nonlinear fitting procedure that minimizes the error in the fit while maintaining C1 continuity with nonlinear constraints. Nonlinear Sobelov smoothing is also incorporated into this fitting scheme. The structures fitted along with their corresponding root mean-squared error, number of elements used, and number of degrees of freedom (df) per variable are: epicardium (0.91 mm, 40 elements, 142 df), left lung (1.66 mm, 80 elements, 309 df), right lung (1.69 mm, 80 elements. 309 df), skeletal muscle surface (1.67 mm, 264 elements, 1,010 df), fat layer (1.79 mm, 264 elements, 1.010 df), and the skin layer (1.43 mm, 264 elements, 1,010 df). The fitted surfaces are assembled into a combined finite element/boundary element model of the torso in which the exterior surfaces of the heart and lungs are modeled with two-dimensional boundary elements and the layers of the skeletal muscle, fat, and skin are modeled with finite elements. The skeletal muscle and fat layers are modeled with bicubic Hermite linear elements and are obtained by joining the adjacent surface elements for each layer. Applications for the torso model include the forward and inverse problems of electrocardiography, defibrillation studies, radiation dosage studies, and heat transfer studies.

Abdomen↗
PubMed2006

[Helical computed tomography in penetrating injury to the torso. Diagnostic value in emergent use].

BACKGROUND: Nontherapeutic laparotomy and thoracotomy rates in penetrating torso trauma remain high. The aim of this study was to define the value of helical computed tomography (CT) in this emergency situation. MATERIAL AND METHODS: Retrospectively, we studied 11 hemodynamically stable patients with penetrating injury to the torso admitted to our trauma center over a 3-year period who underwent intravenous contrasted helical CT immediately after admission. A positive CT scan was defined as showing any evidence of intrathoracal or intra-abdominal injury necessitating immediate operation. Patients with positive CT underwent laparotomy and/or thoracotomy. Patients with negative CT were observed. RESULTS: Eleven consecutive patients were studied: nine male, two female; mean age 39 years (range 19-62). Nine stab wounds and two shotgun wounds were seen. Seven patients had positive helical CT findings, and four patients were negative. All patients with positive CT findings were operated on; those with negative scans recovered uneventfully. This imaging method accurately predicted whether thoracotomy or laparotomy was needed in 10/11 cases. CONCLUSION: In penetrating torso trauma, helical CT can clarify the need for thoracotomy or laparotomy vs nonoperative treatment.

Abdominal Injuries↗
PubMedDate not supplied

Deep planed torso-abdominoplasty combined with buttocks pexy.

This new procedure was created for aesthetic purposes with the intention of creating a longer and more slender waist and at the same time treating neighboring areas. This procedure also is used to raise or change the position of a previous abdominoplasty scar. In addition it is also beneficial for treating gestation sequelae of the torso-abdominal wall, ptosis of the abdomen, vertical and horizontal enlargements of the musculoaponeurotic system, lipodystrophy, stretch marks, rhytidosis of the inguinal region, and ptosis of the external quadrant of the gluteous and the external trochanter area in one surgical procedure. It is not always necessary to apply the entire procedure to each case. The deep planed torso-abdominoplasty offers a broader selection of techniques for creating aesthetic contouring of the torso-abdominal wall, flanks, inguinal region, and outer thighs. It also creates pexy of the external quadrant of the gluteous region.

Abdominal Muscles↗