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Ferromagnetic contamination in the lungs and other organs of the human body.

Contaminating particles which are ferromagnetic have been found in the human body. Their distribution was measured by applying an external magnetic field to the torso for a short time, and then, in a shielded room, mapping the steady magnetic field around the torso due to the magnetized particles. Maps of subjects show various distributions, including particles in the stomach from food cans and in the lungs from are welding. The fields from these two sources are strong enough to be detected with a flux-gate magnetometer, without the need for a shielded room. This simplicity of detection of larger amounts of ferromagnetic contamination suggests that this method may be used in two applications: in detecting the presence of large amounts of asbestos (ferromagnetic and harmful) in the lungs of asbestos workers, and in tests of the condition of the lung where FE(3)O(4) dust (ferromagnetic and harmless) would be used as an inhaled tracer material.

Asbestos↗

Liver abscess caused by Clostridium bifermentans following blunt abdominal trauma.

A case of hepatic abscess and subsequent septicemia caused by Clostridium bifermentans is described. The abscess manifested itself on the third day after blunt trauma to the torso. The patient had nausea, vomiting, fever, evidence of hepatic dysfunction, and subphrenic gas. This case illustrates the association of hepatic abscess and blunt trauma to the torso.

Abdominal Injuries↗

Men, muscles, and body image: comparisons of competitive bodybuilders, weight trainers, and athletically active controls.

OBJECTIVES: To investigate body image and psychosocial adjustment among competitive bodybuilders, non-competitive weight trainers, and athletically active men. METHODS: Participants were 40 men in each of the three groups who were assessed on body composition and multiple facets of body image evaluation, investment and anxiety, eating attitudes, and social self esteem. RESULTS: Relative to the other two groups, competitive bodybuilders had greater body mass due to fat-free body mass. Although groups did not differ in their situational body image discomfort, competitive bodybuilders and weight trainers had a more positive global appearance evaluation and were more psychologically invested in their physical appearance. Compared with active controls, men in both weightlifting groups were more satisfied with their upper torso and muscle tone. Competitive bodybuilders reported more mid torso satisfaction than the other two groups. Competitive bodybuilders also wished to be significantly heavier than controls did and reported higher social self esteem but greater eating disturbance. CONCLUSIONS: The findings suggest that competitive bodybuilders as a group are not more "muscle dysmorphic" than either non-competitive weight trainers or physically active men who do not train with weights.

Adult↗

Heading in football. Part 1: development of biomechanical methods to investigate head response.

OBJECTIVES: There has been growing controversy regarding long term effects of repeated low severity head impacts such as when heading a football. However, there are few scientific data substantiating these concerns in terms of the biomechanical head response to impact. The present study aimed to develop a research methodology to investigate the biomechanical response of human subjects during intentional heading and identify strategies for reducing head impact severity. METHODS: A controlled laboratory study was carried out with seven active football players, aged 20-23 and of average stature and weight. The subjects were fitted with photographic targets for kinematic analysis and instrumented to measure head linear/angular accelerations and neck muscle activity. Balls were delivered at two speeds (6 m/s and 8 m/s) as the subjects executed several specific forward heading manoeuvres in the standing position. Heading speeds up to 11 m/s were seen when the head closing speed was considered. One subject demonstrating averaged flexion-extension muscle activity phased with head acceleration data and upper torso kinematics was used to validate a biofidelic 50th percentile human model with a detailed head and neck. The model was exercised under ball incoming speeds of 6-7 m/s with parameter variations including torso/head alignment, neck muscle tensing, and follow through. The model output was subsequently compared with additional laboratory tests with football players (n = 3). Additional heading scenarios were investigated including follow through, non-active ball impact, and non-contact events. Subject and model head responses were evaluated with peak linear and rotational accelerations and maximum incremental head impact power. RESULTS: Modelling of neck muscle tensing predicted lower head accelerations and higher neck loads whereas volunteer head acceleration reductions were not consistent. Modelling of head-torso alignment predicted a modest reduction in volunteer head accelerations. Exaggerated follow through while heading reduced volunteer head accelerations modestly. CONCLUSION: Biomechanical methods were developed to measure head impact response. Changing the biomechanics of currently accepted heading techniques will have inconsistent benefits towards the reduction of head loading. Furthermore, mathematical modelling suggested an increased risk of neck loads with one alternative technique. No consistent recommendations can be made on the basis of the current study for altering heading techniques to reduce impact severity.

Acceleration↗

Treatment of accidental hypothermia: a prospective clinical study.

A 15-year prospective study was carried out of 44 patients with accidental hypothermia (mean age 60 years) admitted to an intensive therapy unit. The lowest core temperature recorded in each patient ranged from 20.0 to 34.3 degrees C. The precipitating factors were poisoning (by drugs, alcohol, or coal gas) in 25 cases and various illnesses in 19. Rewarming was achieved in 42 patients by applying a radiant heat cradle over the torso, and in two patients by mediastinal irrigation with warmed fluids. Twelve patients died, but only two during the period of rewarming. Thus rewarming may be consistently and safely achieved irrespective of the cause of hypothermia, and normal body temperature may be regained as rapidly as is compatible with adequate tissue perfusion and oxygenation. Surface rewarming of the torso is perhaps the simplest technique available, but internal rewarming procedures may be desirable or essential in the presence of, for example, profound hypothermia, severe hypotension, or ventricular fibrillation. Mortality was attributable to underlying factors or disease and not to hypothermia.

Adult↗

A new approach to the analysis of multiple injuries using data from a national trauma registry.

OBJECTIVE: To present a new systematic approach for summarizing multiple injury diagnosis data into patient injury profiles. DESIGN: International Classification of Diseases, ninth revision, clinical modification injury diagnosis codes were classified using a modification of the Barell body region by nature of injury diagnosis matrix, then grouped by body region, injury nature, or a combination of both. Profiles were built which describe patients' injury combinations based on matrix units, enabling the analysis of patients, and not only the study of injuries. SETTING: The Israeli national trauma registry was used to retrieve patient demographic data, injury details, and information on treatment and outcome. Patients or subjects: All hospitalized patients injured in road traffic accidents and included in the trauma registry from January 1997 to December 2000 were included. MAIN OUTCOME MEASURES: Patient profiles consisting of body regions, injury natures, their combination, and their clinical outcomes. RESULTS: The study population comprised 17459 patients. Head and neck injuries were the most frequent in all subpopulations except for motorcyclists who sustained most injuries in the extremities. Fractures were the most common injury nature (60%). Pedestrians and drivers had the highest proportion of multiple injuries in both profiles. Forty eight percent of the patients had a single cell profile. The most frequent conditions as a sole condition were extremity fractures (14%), internal injuries to the head (11%), and injuries of other nature to the torso (6%). Mortality, length of stay, and intensive care unit treatment varied dramatically between profiles and increased for multiple injury profiles. Inpatient death was an outcome for 3.3% overall; however, in patients with an internal injury to the head and torso, inpatient death rate was nine times higher, at 31%. CONCLUSIONS: Profiles maintain information on body region and nature of injury. The use of injury profiles in describing the injured improves the understanding of casemix and can be useful for efficient staffing in multidisciplinary trauma teams and for various comparisons.

Accidents, Traffic↗

Biophysics of impact injury to the chest and abdomen.

The physical mechanism of blunt impact injuries to thoracic and abdominal viscera is often conveniently described simply in terms of "crush"--this is an over-simplification. Any impact to the torso does result in the rapid displacement of the body wall which may lacerate and contuse underlying viscera, but this simple explanation does not account for pathology at sites some distance from the contact point and does not adequately describe the dependence of the severity and location of injury upon the rate of energy transfer. Quite minor displacements of the body wall may produce serious injury if the body wall velocity is high. The motion of the body wall generates waves that propagate within the body and transfer energy to internal sites. The nature and properties of these waves are discussed in simple terms and the role of waves in the production of the characteristic injuries resulting from impact to the torso is presented.

Abdominal Injuries↗

Antibody CDR H3 modeling rules: extension for the case of absence of Arg H94 and Asp H101.

The third complementary determining region of the immunoglobulin heavy chain (CDR H3) is one of the more difficult structures to model due to genetic reasons. However, the conformation of proximal to beta-framework ("torso") part of the CDR H3 is very predictable. Current "CDR's canonical classes" theory is based on identifying the key positions, H94 and H101. We can determine the CDR H3 "torso" structure if arginine or lysine is present in the H94 position and/or aspartic acid in the H101 position. We target the case characterized by the absence of key residues in both the H94 and H101 positions. There has not been discussion on this case in the literature. 51 CDR H3 structures of this nature are analyzed and we established new sequence-structure rules. These rules contribute to more accurate modeling of the antibody's structure.

Amino Acid Sequence↗

Patient radiation dose at CT urography and conventional urography.

PURPOSE: To measure and compare patient radiation dose from computed tomographic (CT) urography and conventional urography and to compare these doses with dose estimates determined from phantom measurements. MATERIALS AND METHODS: Patient skin doses were determined by placing a thermoluminescent dosimeter (TLD) strip (six TLD chips) on the abdomen of eight patients examined with CT urography and 11 patients examined with conventional urography. CT urography group consisted of two women and six men (mean age, 55.5 years), and conventional urography group consisted of six women and five men (mean age, 58.9 years). CT urography protocol included three volumetric acquisitions of the abdomen and pelvis. Conventional urography protocol consisted of acquisition of several images involving full nephrotomography and oblique projections. Mean and SD of measured patient doses were compared with corresponding calculated doses and with dose measured on a Lucite pelvic-torso phantom. Correlation coefficient (R(2)) was calculated to compare measured and calculated skin doses for conventional urography examination, and two-tailed P value significance test was used to evaluate variation in effective dose with patient size. Radiation risk was calculated from effective dose estimates. RESULTS: Mean patient skin doses for CT urography measured with TLD strips and calculated from phantom data (CT dose index) were 56.3 mGy +/- 11.5 and 54.6 mGy +/- 4.1, respectively. Mean patient skin doses for conventional urography measured with TLD strips and calculated as entrance skin dose were 151 mGy +/- 90 and 145 mGy +/- 76, respectively. Correlation coefficient between measured and calculated skin doses for conventional urography examinations was 0.95. Mean effective dose estimates for CT urography and conventional urography were 14.8 mSv +/- 90.0 and 9.7 mSv +/- 3.0, respectively. Mean effective doses estimated for the pelvic-torso phantom were 15.9 mSv (CT urography) and 7.8 mSv (conventional urography). CONCLUSION: Standard protocol for CT urography led to higher mean effective dose, approximately 1.5 times the radiation risk for conventional urography. Patient dose estimates should be taken into consideration when imaging protocols are established for CT urography.

Adult↗

Pancreas divisum: evaluation with MR cholangiopancreatography.

PURPOSE: To determine the usefulness of magnetic resonance (MR) cholangiopancreatography in the diagnosis of pancreas divisum. MATERIALS AND METHODS: In 310 patients, MR imaging was performed with heavily T2-weighted, two-dimensional, fast-spin-echo sequences. A body coil was used for 139 patients, and a torso multicoil and high-resolution imaging parameters were used for 171 patients. In 108 patients, correlation with endoscopic retrograde cholangiopancreatography (ERCP) was available. RESULTS: Two hundred sixty-eight examinations (86%) were diagnostic. Pancreas divisum was observed with MR imaging in 25 of 268 cases (9%)(interobserver agreement, 98% [kappa = .88]). Among the 171 examinations performed with a torso multicoil, 10% were nondiagnostic and the rate of detection of pancreas divisum was 12%. Pancreas divisum was depicted in six of the 108 patients who underwent ERCP, and there were no false-negative or false-positive MR imaging results in these patients. CONCLUSION: MR cholangiopancreatography is an accurate tool in the diagnosis of pancreas divisum and could replace ERCP.

Case-Control Studies↗

Hodgkin disease: prediction of outcome with 67Ga scintigraphy after one cycle of chemotherapy.

PURPOSE: To investigate gallium 67 scintigraphy performed early during treatment as a means to predict outcome and thus to optimize treatment of Hodgkin disease (HD) in the future. MATERIALS AND METHODS: Ninety-eight patients with HD were examined. Thirty-one patients underwent 67Ga scintigraphy after one chemotherapy cycle and 83 patients after a mean 3.5 cycles (range, 2-5 cycles). Sixteen patients underwent 67Ga scintigraphy both after one cycle and at midtreatment. Patients underwent whole-body scintigraphy and single photon emission computed tomography of the torso. Torso computed tomography (CT) was performed after a mean 3.5 cycles (range, 2-6 cycles). Failure-free survival was compared between patients with positive and patients with negative test findings (Kaplan-Meier method), and the significance of the difference was calculated. The association of failure-free survival with various prognostic clinical factors before treatment was compared (log-rank test univariate analysis). RESULTS: Failure-free survival differed significantly (P < .002) between patients with positive and patients with negative 67Ga scintigrams after one chemotherapy cycle but not at midtreatment. Failure-free survival was not significantly different between patients with positive and patients with negative CT scans at midtreatment. Twenty-two (92%) of 24 patients with negative 67Ga scintigrams after one cycle and 64 (82%) of 78 patients with negative scintigrams at midtreatment remained in complete response. In four (57%) of seven patients with positive 67Ga scintigrams after one cycle, treatment failed. CONCLUSION: 67Ga scintigraphy after one cycle of chemotherapy is a good early predictor of outcome of HD.

Adult↗

Noninvasive three-dimensional electrocardiographic imaging of ventricular activation sequence.

Imaging the myocardial activation sequence is critical for improved diagnosis and treatment of life-threatening cardiac arrhythmias. It is desirable to reveal the underlying cardiac electrical activity throughout the three-dimensional (3-D) myocardium (rather than just the endocardial or epicardial surface) from noninvasive body surface potential measurements. A new 3-D electrocardiographic imaging technique (3-DEIT) based on the boundary element method (BEM) and multiobjective nonlinear optimization has been applied to reconstruct the cardiac activation sequences from body surface potential maps. Ultrafast computerized tomography scanning was performed for subsequent construction of the torso and heart models. Experimental studies were then conducted, during left and right ventricular pacing, in which noninvasive assessment of ventricular activation sequence by means of 3-DEIT was performed simultaneously with 3-D intracardiac mapping (up to 200 intramural sites) using specially designed plunge-needle electrodes in closed-chest rabbits. Estimated activation sequences from 3-DEIT were in good agreement with those constructed from simultaneously recorded intracardiac electrograms in the same animals. Averaged over 100 paced beats (from a total of 10 pacing sites), total activation times were comparable (53.3 +/- 8.1 vs. 49.8 +/- 5.2 ms), the localization error of site of initiation of activation was 5.73 +/- 1.77 mm, and the relative error between the estimated and measured activation sequences was 0.32 +/- 0.06. The present experimental results demonstrate that the 3-D paced ventricular activation sequence can be reconstructed by using noninvasive multisite body surface electrocardiographic measurements and imaging of heart-torso geometry. This new 3-D electrocardiographic imaging modality has the potential to guide catheter-based ablative interventions for the treatment of life-threatening cardiac arrhythmias.

Algorithms↗

Heat intolerance as a function of percent of body surface involved with miliaria rubra.

Twenty-four heat-acclimatized male volunteers were wrapped as previously described (Am. J. Physiol. 239 (Regulatory Integrative Comp. Physiol. 8): R226-R232, 1980) but to produce miliaria rubra (heat rash) in specific regions of the body. Three experimental rash groups were involved: 1) the torso (17% total skin surface rashed, n = 6), 2) torso and arms (38%, n = 8), or 3) legs (41%, n = 6), while four subjects served as controls. All subjects were reexposed to walking in the heat on the 7th day after unwrapping, and again 14, 21, and 28 days after unwrapping. When compared to responses for the last heat acclimatization day, tolerance time and sweat rate were lower and mean body temperature and delta heat storage significantly higher for experimental rash subjects contrasted to the controls for up to 21 days; however, no significant differences between the three rashed groups were found. The critical amount of surface area for heat intolerance from heat rash appears to be related to the specific region of the body and associated sweating responses; smaller rashed areas of the trunk, because they have greater potential for abundant sweating, may produce similar responses to heat stress as larger rashed areas of the limbs. Heat intolerance due to rash was not resolved until after 21 days.

Acclimatization↗

Regional distribution of blood flow during mild dynamic leg exercise in the baboon.

Five chair-restrained baboons were trained with operant techniques and a food reward to perform dynamic leg exercise. Cardiac output and blood flows to most tissues were determined by radioactive microsphere distribution. After 2 min of exercise mean arterial blood pressure had increased by 11 +/- 3% (SE), heart rate by 34 +/- 7%, cardiac output by 50 +/- 12%, and O2 consumption by 157 +/- 17%. The blood flow to exercising leg muscle increased by 585 +/- 338% and to the myocardium by 35 +/- 19%. Blood flow to torso and limb skin fell by 38 +/- 4 and 38 +/- 6%, respectively, and similar reductions occurred in adipose tissue blood flow. Nonworking skeletal muscle blood flow decreased by 30 +/- 10%. Renal blood flow was lowered by 16 +/-2%. The lower visceral organs had more variable responses, but when grouped together total splanchnic blood flow fell by 21 +/- 9%. Blood flow to the brain was unchanged with exercise, whereas spinal cord perfusion increased 23 +/- 3%. Thus during short dynamic exercise baboons redistributed blood flow away from skin, fat, nonworking muscles, and visceral organs to supply the needs of exercising muscles. Our data suggest the baboon is a useful animal model for investigating vascular responses of tissues, such as torso skin, adipose, individual visceral organs, and the spinal cord, that cannot be examined in humans.

Adipose Tissue↗

Skin blood flow in sheep: comparison of xenon-133 washout and radioactive microsphere techniques.

Blood flow was measured in leg and torso skin of conscious or anesthetized sheep by using 15-micron radioactive microspheres (Qm) and the 133Xe washout method (QXe). There was a good relationship between Qm in the cutaneous compartment and QXe calculated from the fast component of the biexponential washout curves (QXe = 0.40.Qm + 6.2, r = 0.90, P less than 0.001) with QXe values substantially below those determined with microspheres. Only at low blood flow levels was there a tendency for QXe to overestimate capillary blood flow as assessed with microspheres, but at higher blood flow levels the 133Xe washout method resulted in values substantially below those determined with microspheres. The slope of the slow component of the washout curves was inversely related to the tissue-blood partition coefficient in the subcutaneous tissue (r = 0.52, P less than 0.001), indicating an influence of the amount of subcutaneous fat on the washout rate. QXe calculated from the slow component of the washout curves was not significantly correlated with Qm in the subcutaneous compartment (r = 0.19, P greater than 0.10). In leg skin with dilated arteriovenous anastomoses, QXe was generally higher than in torso skin and leg skin with constricted arteriovenous anastomoses, indicating that shunt blood flow increases the washout of 133Xe.

Animals↗

Effect of lung volume on the respiratory action of the canine pectoral muscles.

Lung volume influences the mechanical action of the primary inspiratory and expiratory muscles by affecting their precontraction length, alignment with the rib cage, and mechanical coupling to agonistic and antagonistic muscles. We have previously shown that the canine pectoral muscles exert an expiratory action on the rib cage when the forelimbs are at the torso's side and an inspiratory action when the forelimbs are held elevated. To determine the effect of lung volume on intrathoracic pressure changes produced by the canine pectoral muscles, we performed isolated bilateral supramaximal electrical stimulation of the deep pectoral and superficial pectoralis (descending and transverse heads) muscles in 15 adult supine anesthetized dogs during hyperventilation-induced apnea. Lung volume was altered by application of a negative or positive pressure (+/- 30 cmH2O) to the airway. In all animals, selective electrical stimulation of the descending, transverse, and deep pectoral muscles with the forelimbs held elevated produced negative intrathoracic pressure changes (i.e., an inspiratory action). Moreover, with the forelimbs elevated, increasing lung volume decreased both pectoral muscle fiber precontraction length and the negative intrathoracic pressure changes generated by contraction of each of these muscles. Conversely, with the forelimbs along the torso, increasing lung volume lengthened pectoral muscle precontraction length and augmented the positive intrathoracic pressure changes produced by muscle contraction (i.e., an expiratory action). These results indicate that lung volume significantly affects the length of the canine pectoral muscles and their mechanical actions on the rib cage.

Animals↗

Relationship between body heat content and finger temperature during cold exposure.

The purpose of the present experiment was to examine the relationship between rate of body heat storage (S), change in body heat content (DeltaH(b)), extremity temperatures, and finger dexterity. S, DeltaH(b), finger skin temperature (T(fing)), toe skin temperature, finger dexterity, and rectal temperature were measured during active torso heating while the subjects sat in a chair and were exposed to -25 degrees C air. S and DeltaH(b) were measured using partitional calorimetry, rather than thermometry, which was used in the majority of previous studies. Eight men were exposed to four conditions in which the clothing covering the body or the level of torso heating was modified. After 3 h, T(fing) was 34.9 +/- 0.4, 31.2 +/- 1.2, 18.3 +/- 3.1, and 12.1 +/- 0.5 degrees C for the four conditions, whereas finger dexterity decreased by 0, 0, 26, and 39%, respectively. In contrast to some past studies, extremity comfort can be maintained, despite S that is slightly negative. This study also found a direct linear relationship between DeltaH(b) and T(fing) and toe skin temperature at a negative DeltaH(b). In addition, DeltaH(b) was a better indicator of the relative changes in extremity temperatures and finger dexterity over time than S.

Adult↗

Reaching during virtual rotation: context specific compensations for expected coriolis forces.

Subjects who are in an enclosed chamber rotating at constant velocity feel physically stationary but make errors when pointing to targets. Reaching paths and endpoints are deviated in the direction of the transient inertial Coriolis forces generated by their arm movements. By contrast, reaching movements made during natural, voluntary torso rotation seem to be accurate, and subjects are unaware of the Coriolis forces generated by their movements. This pattern suggests that the motor plan for reaching movements uses a representation of body motion to prepare compensations for impending self-generated accelerative loads on the arm. If so, stationary subjects who are experiencing illusory self-rotation should make reaching errors when pointing to a target. These errors should be in the direction opposite the Coriolis accelerations their arm movements would generate if they were actually rotating. To determine whether such compensations exist, we had subjects in four experiments make visually open-loop reaches to targets while they were experiencing compelling illusory self-rotation and displacement induced by rotation of a complex, natural visual scene. The paths and endpoints of their initial reaching movements were significantly displaced leftward during counterclockwise illusory rotary displacement and rightward during clockwise illusory self-displacement. Subjects reached in a curvilinear path to the wrong place. These reaching errors were opposite in direction to the Coriolis forces that would have been generated by their arm movements during actual torso rotation. The magnitude of path curvature and endpoint errors increased as the speed of illusory self-rotation increased. In successive reaches, movement paths became straighter and endpoints more accurate despite the absence of visual error feedback or tactile feedback about target location. When subjects were again presented a stationary scene, their initial reaches were indistinguishable from pre-exposure baseline, indicating a total absence of aftereffects. These experiments demonstrate that the nervous system automatically compensates in a context-specific fashion for the Coriolis forces associated with reaching movements.

Adaptation, Physiological↗