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Model of the supine human body and its reactions to external forces.

Mechanical impedance and vibration transmissibility measurements were conducted on supine humans using sinusoidal vibrations. The frequencies tested were 1-20 Hz with a constant acceleration amplitude of 0.3 G. The tests were repeated with 4.54 kg pure mass placed on each segment. Both results were used to calculate a multi-degree-of-freedom lumped parameter model. The nonlinear reactions of the body are revealed by comparing the model parameters under "no load" and "load" conditions. When the results are compared with impedance measurements conducted under sustained acceleration, it becomes obvious that the thorax, due to its anatomical design, reacts differently from the remaining body parts.

Abdomen↗

Effects of supine versus sitting bedrest upon blood gas tensions, cardiac output, venous admixture and ventilation-perfusion ratio in man after upper abdominal surgery.

The effects of body position (sitting versus supine) on respiratory and haemodynamic patterns were evaluated in nine patients who have undergone upper abdominal surgery. Posture showed no significant influence upon arterial blood gas tensions, while in the sitting position mean central venous oxygen tension lowers and arterial-venous oxygen content difference rises. In seated patients cardiac output was notably reduced. Pulmonary gas exchange analysis, according to Riley's method, showed that the sitting position allows a higher alveolar ventilation-pulmonary capillaries perfusion ratio, as well as a lower degree of venous admixture.

Abdomen↗

The effect on supination-pronation of angular malalignment of fractures of both bones of the forearm.

UNLABELLED: Ten fresh human upper-extremity cadaver specimens were tested for the effect of residual angulation from simulated fractures of both bones of the forearm on the potential for range of rotation of the forearm and for limitations of pronation and supination specifically. Ten and 20-degree angulations for the radius and ulna, such as might be encountered in all reasonable clinical situations, were tested. Little significant loss of forearm rotation resulted from angulations of 10 degrees in any direction. With 20 degrees of angulation, there was statistically significant and functionally important loss of forearm rotation. CLINICAL RELEVANCE: A residual angulation of 10 degrees in mid-shaft fractures of the radius, ulna, or both bones of the forearm will not limit forearm rotation anatomically. Loss in the range of rotation can be expected with residual angeles of 20 degrees or more.

Forearm↗

Misleading supine chest X-ray in complete detachment of a Starr-Edwards prosthetic aortic valve.

The authors report a case of total detachment of a Starr-Edwards aortic valve prosthesis occurring eleven years after implantation. The detached valve had embolized into the descending thoracic aorta. The prosthetic valve was projected into an apparently normal position on a supine chest X-ray. The correct diagnosis was thus delayed. The authors stress the importance of obtaining lateral views or performing fluoroscopy and/or echocardiography in the emergency room in patients with acute chest symptoms after heart valve replacement.

Aortic Valve↗

Cardiovascular effects of diltiazem in healthy volunteers at rest, supine and erect, and during physical and mental stress.

The hemodynamic effects of diltiazem were investigated in six volunteers at rest, supine and erect, under psychologic stress and orthostatic conditions. Plasma concentrations were also estimated. Under all conditions diltiazem showed a vasodilating property that was more pronounced on the arterial resistance vessels than on the pulmonary vessels. The first plasma concentrations were detected 15 min after drug intake, and the highest values were seen at the end of the study in the 3rd h.

Adult↗

[The supinator syndrome. Diagnosis - therapy - results].

The compression of the r. profundus of n. radialis by m. superior is a rare nerve compression syndrome of the upper extremity. In many cases its diagnosis is very difficult. 14 patients with a emg-manifest supinator syndrome were examined after operation. The examinations were performed as to etiology, symptoms and postoperative status depending on pre-operative duration of trouble.

Adult↗

[Hemodynamic responses to supine bicycle exercise in juvenile hypertensive subjects: an echocardiographic assessment (author's transl)].

Six juvenile hypertensive patients were studied by supine bicycle ergometer exercise during continuous echocardiographic recording. Thirteen normotensive young men were also studied for the control. Left ventricular end-diastolic dimensions (Dd) during exercise was significantly increased from 28.8 +/- 0.5 mm/m2 to 29.7 +/- 0.6 mm/m2 in normotensives, but the increase in Dd was not observed in hypertensives. Effects of propranolol on changes in Dd during exercise were almost equal in two groups. Left ventricular end-systolic dimensions (Ds) were decreased during exercise in both groups. After propranolol administration, Ds in hypertensives was significantly increased from 18.8 +/- 1.0 mm/m2 to 19.4 +/- 1.1 mm/m2 at rest, and during the following exercise it reached to 19.7 +/- 1.1 mm/m2, whereas Ds in normotensives was decreased during exercise even after propranolol. Peripheral vascular resistance at rest was almost equal between the two groups, but in hypertensives the reduction during exercise was restricted. These results suggest that sympathetic activities of cardiovascular system are accentuated in juvenile hypertensive subjects.

Adult↗

Experiment with supine panoramic X-ray equipment in the diagnosis of maxillo-facial fractures.

The material consist of 120 patients with facial trauma. X-ray examination was performed with an experimental panoramic tomography unit designed to examine patients with multiple injuries who could not be examined in standing position. In addition to panoramic examination, a conventional x-ray study was performed on all patients. In all, there was 39 fractures (23 mandibular, 16 middle third of facial skeleton). The equipment was suitable for diagnosis of mandibular fractures. However, for the diagnosis of mid-face fractures the supine orthopantomogram yielded only supplementary information to the conventional radiographs.

Emergencies↗

[Evaluation of the effect of therapeutic exercise and supination shoe insert on static flatfoot in children].

The 3 year study included 469 children with flat feet in preschool and school age from a section of the town of Lodz. In 2 separate age groups the influence of exercises and/or hindfoot supinating inserts on the deformity regression has been assessed. The results were being compared at every stage of the study with the deformity evaluations in control group of not treated children. The best results have been recorded in children doing exercises and wearing inserts--in 50 percent the deformity retreated. Little potential for self correction of this deformity indicates mandatory treatment of all children with flat feet.

Child↗

[Massive ascites as an initial sign, plasmacytoma of the cervical supine, and hyperammonemic consciousness disturbance in a patient with biclonal type multiple myeloma].

A 69-year-old male presented with fever, ascites and leg edema in February, 1994. He had a pathological fracture of cervical supine in October. Pathological findings at operation showed plasmacytoma. Bone marrow aspiration showed 16.2% myeloma cells. So he was diagnosed as multiple myeloma presenting biclonal gammopathy of IgA-L and IgD-K. Ascites was massive and drainage of 2 to 4 liter per week was required. Ascites was supposed to be related to multiple myeloma, because the IL-6 level in the ascites was increased (2,440 pg/ml), although repeated cytologic studies were negative. After the operation, he developed hyperammonemic drowsiness. It was also suggested that hyperammonemia was associated with multiple myeloma. In addition to radiation therapy for the cervical lesion, MP therapy, Interferon-alpha, VAD therapy and intraperitoneal cyclophosphamide infusion were administered. But no improvement of ascites or hyperammonemia were noticed. Here we described a case of multiple myeloma with very notable clinical features.

Aged↗

Subtalar stress radiography using forced dorsiflexion and supination.

We investigated a new method of stress radiography of the subtalar joints using forced maximum dorsiflexion of the ankle in a supinated position. We measured transposition of the lateral process of the talus at the posterior subtalar joint in lateral views of normal amputated ankles, normal control subjects and patients with recurrent ankle sprains. The mean displacement in the control groups (n = 36) was 29.9%, significantly different from the 43.0% in patients with recurrent ankle sprains (n = 24). In the amputated specimens with intact ligaments movement was similar to that in normal subjects. Section of the calcaneofibular and the interosseous ligaments allowed much the same movement as in patients with recurrent ankle sprains. The new method is simple and useful for detecting subtalar instability.

Adult↗

Left ventricular end-diastolic volume during supine exercise in patients with healed myocardial infarction.

Eighteen men with myocardial infarction in their history and without signs of heart failure were investigated at rest and during standard supine exercise. In nine patients aneurysma or diskinesis of the left ventricular wall were found. The left ventricular end-diastolic volume was determined from the wash-out of 133Xe injected into the left ventricle by means of precordial scintillation counting. During exercise the cardiac index rose owing to acceleration of the heart rate, whereas the stroke index remained unchanged, and the left ventricular work and stroke indices increased. The left ventricular end-diastolic pressure, elevated at rest, reached high values during exercise. The left ventricular end-diastolic and residual volumes decreased during exercise in most patients, and simultaneously the systolic ejection fraction increased. In patients with aneurysma or diskinesis the end-diastolic volume both at rest and during exercise does not differ from EDV of other patients. Six patients developed angina pectoris during exercise, but their haemodynamics did not differ significantly. It is concluded that the left ventricle in patients with advanced coronary heart disease and previous myocardial infarction shows the signs rather of diminished compliance than of heart failure during adequate exercise and still possesses some functional reserves.

Adult↗

Effect of the left lateral recumbent position compared with the supine and upright positions on placental blood flow in normal late pregnancy.

The placental blood flow was assessed by the 99mTc accumulation method in 10 normal pregnancies in the left lateral recumbent position accomplished by a 15 degree wedge and in the supine position. The postural change caused a 17% decrease in the mean placental accumulation rate, which was not statistically significant. Ten patients were moved from the left lateral recumbent position to the upright position, which caused a statistically significant 23% decrease in the mean accumulation rate. Other haemodynamic variables studied were the maternal heart rate and the systolic and diastolic blood pressures. The clinical significance of the haemodynamic changes produced by alterations in posture are briefly discussed.

Adult↗

[Lesion of the ramus profundus of the radial nerve (supinator syndrome). Dissociated radial paralysis of the proximal under arm type].

Anatomy and clinical patterns of dissociated distal paralysis of the radial nerve ("supinator syndrome" or paralysis of posterior interosseous nerve) due to trauma, tumors, rheumatic diseases and with spontaneous onset are discussed in the light of the literature and 6 personally observed cases, 5 of them with traumatic lesions. Surgical exploration and intraneural neurolysis resulted in total or partial remission in 5 instances. In our experience surgical exploration should be performed at the earliest moment after spontaneous recovery is no longer to be expected.

Bone Plates↗