Comparison of disability behavior after different sites and types of injury in a workers' compensation population

In this study, an extensive data set from a regional workers' compensation system was analyzed to determine whether particular sites or types of injury were associated with prolonged disability. This data shows a similar pattern of vocational disability for almost all sites and types of injury. A workers' compensation carrier collects data for financial purposes related to insurance, and such data therefore has several serious potential deficiencies when used for clinical research. However, published data on disablement after nonoccupational trauma shows similar patterns of vocational and nonvocational disability, and also shows dependence on severity of injury. In both settings, head injury is associated with greater occupational disability. Because treatment, policy, and medicolegal decisions are based on the impression of "typical disability" for particular sites and types of injury, there is a need for better documentation of post-traumatic disablement in compensation settings and in noncompensation settings. This should include better classification of the cause, type, and severity of the injury, and of the functional outcome in terms of both the resumption of occupational and nonoccupational roles, and of persistence in these roles.     

Development of a scoring system to assess disability in an Italian elderly population. Evaluation of a disability questionnaire

Patients with idiopathic and symptomatic restless legs syndrome (RLS) suffer from "dyskinesia while awake" or "daytime myoclonus" when at rest preceded by sensory symptoms. In order to characterise the RLS either as reflex movement or as voluntary movement we measured movement-related cortical potentials in 5 idiopathic and 8 uraemic RLS patients. Movements from both legs were polygraphically recorded concomitantly with cortical activity 2000 msec before to 500 msec after onset of EMG activity. These data were compared with a voluntary simulation of each patient's movement pattern and with 5 age-matched controls performing dorsiflexion of the right, left and both feet. Cortical activity preceding daytime myoclonus was absent in RLS patients whereas self-initiated leg movements in patients elicited onset times (1180-1380 msec) and amplitudes of Bereitschaftspotential (readiness potential) not significantly different from readiness potentials in control subjects (P > 0.05). Lack of movement-related potentials in myoclonus and/or dyskinesias during daytime in RLS patients is compatible with an involuntary mechanism of induction and points towards a subcortical or spinal origin of RLS.     

The renal factor in the post-traumatic "fluid overload" syndrome

Hypervolemia with hypertension often occurs 36-72 hours following massive blood and fluid replacement for hypovolemic shock. This syndrome of "fluid overload" has been attributed to the rapid intravascular flux of previously sequestered fluid in patients with impaired diuresis. This hypothesis was tested in 35 injured patients who received a mean of 9.3 L of blood and 17.4 L of salt during resucitation. The renal parameters measured soon after resuscitation included: 1) renal clearance of inulin (GFR), para-amino hippurate (ERPF), milliosmoles, sodium, and free water; 2) inulin space, renal vascular resistance (RVR), O2 consumption, renin, renal blood flow (RBF), and response to furosemide. Eighteen patients developed hypertension, hypervolemia, and respiratory insufficiency. When compared to the 17 normovolemic, non-hypertensive patients, the 18 hypervolemic patients had significantly increased RVR, with a significant decrease in RBF despite an increase in plasma volume and cardiac output. Furosemide produced less diuresis and natriuresis in the hypertensive patients. The balance between hypovolemia and "fluid overload" seemed percarious in the hypertensive patients. Peripheral renin and catecholamine levels were normal in both groups. Patients with post-traumatic "fluid overload" appear to have a combination of hypervolemia, respiratory insufficiency, hypertension, increased cardiac output, decreased extracellular fluid space, and decreased renal perfusion. These findings suggest that decreased interstitial fluid space compliance rather than "fluid overload" is the underlying factor leading to respiratory insufficiency. The therapeutic aspects of these findings are discussed.     

Axonal excitability and motor propagation velocity of peripheral nerves in patients with acute vascular lesions of the brain

From measurements of maximum and minimum motor nerve propagation velocity and neuronal excitability we conclude that there is a functional loss of motor units and distal nerve "dying back" in persons affected with unilateral acute cerebral vascular lesions. The study also suggests that transynaptic degeneration affects the lower motor neurone function on both sides.     

Lanthanzirkonat: ein innovatives Wärmedämmschichtmaterial. Lanthanum zirconate: an innovative Thermal Barrier Material

This paper presents the work of the research project AiF‐13114 N/1. Within the scope of this project coating systems from Lanthanum Zirconate and Y ttria s tabilised Z irconia (YSZ) were developed by use of E lectron B eam P hysical V apour D eposition (EB‐PVD). In addition, the potentials of Lanthanum Zirconate and YSZ as thermal barrier coatings within gas turbines were examined. Basis of the coating development was the use of powdery Lanthanum and YSZ, that were vaporised in a PVD‐machine from a double‐grooved cupreous crucible. Process parameters are evaluated to gain long lasting, columnar Lanthanum Zirconate EB‐PVD coatings with high stability, low heat conductivity a higher sintering inertness, that offer the opportunity to increase the temperature within the first stage of a gas turbine system [1, 2, 3, 4, 5, 6]. Therefor YSZ ‐ commonly used as conventional thermal barrier coating ‐ was used as a reference system during the tests. As base material Inconel Alloy 600 (a nickel‐based superalloy) was applied. The microstructure and the topography of the developed coating systems were characterized with the help of scanning electron microscopy. Nanoindentation proved to be a measurement method in order to define the stiffness distribution along the columns. The thermal cycle durability was determined via thermal cycle test.     

Quantal transmitter release at somatic motor-nerve terminals: stochastic analysis of the subunit hypothesis

Here we analyze the problem of determining whether experimentally measured spontaneous miniature end-plate currents (MEPCs) indicate that quanta are composed of subunits. The properties of MEPCs at end plates with or without secondary clefts at the neuromuscular junction are investigated, using both stochastic and deterministic models of the action of a quantum of transmitter. It is shown that as the amount of transmitter in a quantum is increased above about 4000 acetylcholine (ACh) molecules there is a linear increase in the size of the MEPC. It is possible to then use amplitude-frequency histograms of such MEPCs to detect a subunit structure, as there is little potentiation effect above 4000 ACh molecules. Autocorrelation and power spectral analyses of such histograms establish that their subunit structure can be detected if the coefficient of variation of the subunit size is less than about 0.12 or, if electrical noise is added, about 0.1. Positive gradients relate the rise time and half-decay times of MEPCs to their amplitude, even in the absence of potentiating effects; these gradients are shallower at motor nerve terminals that possess secondary clefts. The effect of asynchronous release of subunits is also investigated. The criteria determined by this analysis for identifying a subunit composition in the quantum are applied to an amplitude-frequency histogram of MEPCs recorded from a small group of active zones at a visualized amphibian motor-nerve terminal. This did not provide evidence for a subunit structure.     

Positive chronotropic actions of parathyroid hormone and parathyroid hormone-related peptide are associated with increases in the current, I(f), and the slope of the pacemaker potential

BACKGROUND: The classic calciotropic hormone parathyroid hormone (PTH) and its paracrine factor parathyroid hormone-related protein (PTHrP) both increase heart rate. METHODS AND RESULTS: We used standard electrophysiological techniques to study the effects of PTH and PTHrP on isolated rabbit sinus node, isolated canine Purkinje fibers, and disaggregated rabbit sinus node myocytes. Sinus node maximum diastolic potential, activation voltage, and amplitude were unchanged by PTH or PTHrP (P>.05). However, the slope of phase 4 and the automatic rate were increased at PTH and PTHrP > or = 10 nmol/L (P<.05). Comparable results were seen in canine Purkinje fibers. We then used the perforated-patch technique to study the I(f) pacemaker current in sinus node. PTH 12.5 nmol/L and PTHrP 12.5 to 18 nmol/L increased I(f) at -65 mV by 68+/-41% (n=5) and 69+/-50% (n=5), respectively. Actions of both agents were reversible. The increase in I(f) appeared to result from a change in maximal conductance and not a shift in the voltage dependence of activation. CONCLUSIONS: These observations provide, for the first time, direct electrophysiological support for the chronotropic actions of PTH and PTHrP. They suggest that classic hormones and paracrine factors can have multiple functions and that in the case of PTH and PTHrP, a newly recognized action is to alter automaticity directly.     

Thermo-mechanical optimization of porous building materials based on micromechanical concepts: Application to load-carrying insulation materials

In this paper, a multiscale model for the prediction and, finally, optimization of mechanical (elastic) and thermal (heat conductivity) properties of porous building materials is presented. These technical composites are characterized by the increase of porous space in the respective material system, resulting in a reduction of Young’s modulus, on the one hand, and in an increase of the thermal insulation capacity, on the other hand, yielding either a load-carrying insulation material or a structural material with enhanced resistance to heat transfer. Determination of engineering properties within the proposed multiscale approach departs from the underlying material composition, on the one hand, and the intrinsic properties of the constituents, i.e., the material phases, on the other hand, employing homogenization techniques based on continuum micromechanics.     

Diamine oxidase supplementation improves symptoms in patients with histamine intolerance

Food Science and Biotechnology - Histamine intolerance (HIT) is thought to be caused by a disproportionate amount of histamine in the body. The enzyme diamine oxidase (DAO) is considered for the...