A personal computer based system used in electromyography for interpretation and reporting

Programs for rule based electromyography (EMG) interpretation and reporting are described. A number of parameters are obtained during an EMG investigation. The combination of these data leads to a neurophysiological conclusion. Knowledge from the literature, research and experience is the basis for rule development. Rules have been developed for 14 of the most commonly used classifications of an EMG. The syntax is relatively easy and the user may change the rules, add rules or apply the system for other types of data. The results are displayed in a new graphical way. The system presented here is part of an integrated EMG laboratory with administrative routines, distributed databases for storage of results and routines for automatic report generation.     

Postural and symptomatic improvement after physiotherapy in patients with dizziness of suspected cervical origin

OBJECTIVE: To assess postural performance in patients with dizziness of suspected cervical origin in whom extracervical causes had been excluded, and to assess the effects of physiotherapy on postural performance and subjective complaints of neck pain and dizziness. DESIGN: Prospective, randomized, controlled trial. SETTING: Primary care centers and a tertiary referral center. PATIENTS AND SUBJECTS: Of 65 referrals, 43 patients were excluded because extracervical etiology was suspected. Of the remaining 22 patients, 17 completed the study (15 women, 2 men, x age 37 yr, range 26-49). The controls were 17 healthy subjects (15 women, 2 men, x age 36 yr, range 25-55). INTERVENTION: Physiotherapy based on analysis of symptoms and findings, and aimed to reduce cervical discomfort. Patients were randomized either to receive immediate physiotherapy (n = 9), or to wait 2 months, undergo repeat measurements, and then receive physiotherapy (n = 8). MAIN OUTCOME MEASURES: Posturography, measuring velocity and variance of vibration-induced body sway and variance of galvanically induced body sway. Subjective intensity of neck pain (Visual Analog Scale ratings, 0-100), intensity and frequency of dizziness (subjective score 0-4). RESULTS: The patients manifested significantly poorer postural performance than did healthy subjects (.05 > p > .0001). Physiotherapy significantly reduced neck pain and intensity and the frequency of dizziness (p < .01), and significantly improved postural performance (.05 > p > .0007). CONCLUSIONS: Patients with dizziness of suspected cervical origin are characterized by impaired postural performance. Physiotherapy reduces neck pain and dizziness and improves postural performance. Neck disorders should be considered when assessing patients complaining of dizziness, but alternative diagnoses are common.     

Hypoglycemic activity of glyburide (glibenclamide) metabolites in humans

OBJECTIVE: To assess the hypoglycemic effect and the insulin-releasing effect of the main glyburide (glibenclamide) metabolites 4-trans-hydroxy-glibenclamide (M1) and 3-cis-hydroxy-glibenclamide (M2) in humans. RESEARCH DESIGN AND METHODS: Eight healthy subjects participated in a placebo-controlled, randomized, single-blind crossover study with five single-dose tests, 3 months apart: 3.5 mg glibenclamide (Gb) orally, 3.5 mg Gb intravenously, 3.5 mg M1 intravenously, 3.5 mg M2 intravenously, and placebo intravenously, each in the fasting state. Standardized meals were given 0.5 and 5.5 h after each medication. Blood glucose levels were measured by a glucose oxidase method, and serum insulin concentrations were analyzed by a specific immunoassay. RESULTS: Blood glucose levels during the first 5 h were significantly lowered not only by Gb but also by M1 and M2. The mean +/- SE blood glucose reductions (versus placebo) expressed as percent of area under the curve (AUC) (0-5 h) were 18.2 +/- 3.3% for M1, 12.5 +/- 2.3% for M2, 19.9 +/- 2.1% for intravenous Gb, and 23.8 +/- 1.2% for Gb orally. Serum insulin levels were significantly increased by Gb as well as by M1 and M2. and M2. CONCLUSIONS: The two main metabolites of glyburide (glibenclamide) have a hypoglycemic effect in humans, which is due to increased insulin secretion.     

Anaerobic fermentation of xylose by pichia stipitis: The effect of forced cycling of ph

Xylose fermentation by Pichia stipitis was examined using a two-stage batch process. The cells were first grown aerobically on D-xylose (5 g/L), whereafter additional xylose (10 g/L) was added and fermented during anaerobic conditions (T=30°C). The optimum pH value for a fermentation with constant pH was found to be 4.5 (maximum specific ethanol production rate 0.21 g/(g h). Forced square wave cycling of the pH between 4 and 5, and 3.5 and 5.5 (cycle time 30 min) during the fermentation stage resulted in a fermentation rate lower than the maximum rate, but with unchanged ethanol yields.     

An Empirical Study on Views of Importance of Change Impact Analysis Issues

Change impact analysis is a change management activity that previously has been studied much from a technical perspective. For example, much work focuses on methods for determining the impact of a change. In this paper, we present results from a study on the role of impact analysis in the change management process. In the study, impact analysis issues were prioritised with respect to criticality by software professionals from an organisational perspective and a self-perspective. The software professionals belonged to three organisational levels: operative, tactical and strategic. Qualitative and statistical analyses with respect to differences between perspectives as well as levels are presented. The results show that important issues for a particular level are tightly related to how the level is defined. Similarly, issues important from an organisational perspective are more holistic than those important from a self-perspective. However, our data indicate that the self-perspective colours the organisational perspective, meaning that personal opinions and attitudes cannot easily be disregarded. In comparing the perspectives and the levels, we visualise the differences in a way that allow us to discuss two classes of issues: high-priority and medium-priority. The most important issues from this point of view concern fundamental aspects of impact analysis and its execution.     

New Insights in the Control of Fat Homeostasis: The Role of Neurotensin

Neurotensin (NT) is a small peptide with pleiotropic functions, exerting its primary actions by controlling food intake and energy balance. The first evidence of an involvement of NT in metabolism came from studies on the central nervous system and brain circuits, where NT acts as a neurotransmitter, producing different effects in relation to the specific region involved. Moreover, newer interesting chapters on peripheral NT and metabolism have emerged since the first studies on the NT-mediated regulation of gut lipid absorption and fat homeostasis. Intriguingly, NT enhances fat absorption from the gut lumen in the presence of food with a high fat content, and this action may explain the strong association between high circulating levels of pro-NT, the NT stable precursor, and the increased incidence of metabolic disorders, cardiovascular diseases, and cancer observed in large population studies. This review aims to provide a synthetic overview of the main regulatory effects of NT on several biological pathways, particularly those involving energy balance, and will focus on new evidence on the role of NT in controlling fat homeostasis, thus influencing the risk of unfavorable cardio–metabolic outcomes and overall mortality in humans.     

Histomorphological, histomorphometrical and biomechanical analysis of ceramic bone substitutes in a weight-bearing animal model

It was the purpose of this investigation to prove the biomechanical properties, the osteoconductive capacity and the degradation rate of tricalcium phosphate ( TCP), a neutralized glass ceramics (GB9N) and a composite material (GB9N+copolymers). In a weight-bearing animal model six substitutes each were implanted in the medial tibial head of the right lower leg of adult Merino-sheep in a standardized surgical technique. After nine months the implants were harvested and prepared for histomorphological and histomorphometrical investigations (undecalcified Masson Goldner staining). For additional biomechanical testing of the specimens, non-operated bone blocks from the contralateral tibia as well as native implants served as controls. No significant differences for the maximum fracture load as well as for the yield strength were detected between harvested specimens and bone blocks from the contralateral tibia. However there were marked differences to ceramics that were not implanted. All substitutes showed osteoconduction, leading to a continuous ingrowth of new formed bone. However in the composite material soft tissue could be identified within the scaffold and there were signs of ongoing bone remodeling, nine months after implantation. The bone per tissue volume of -TCP in conjunction to new bone (=percentage of trabecular bone volume plus percentage of residual substitute) was higher than for GB9N and the composite material. Nine months after implantation the percentage of residual -TCP was 48%, it was 32% for GB9N and 28% for the composite.The intention of further studies should be to accelerate the degradation rates of substitutes and to improve biomechanical properties of implants by either modifying the chemical composition or combining materials with agents as, e.g. growth factors.     

FEM Study of Fatigue Response of 3‐Sheet Spot Welded Joints

The commercial software used for predicting fatigue strength for load‐carrying spot welds in sheet structures, like car bodies, is mainly developed for two‐sheet joints. The purpose of this work was to study the fatigue properties of three‐sheet spot welded joints with a dimensioning method used in the automotive industry and to compare such computational results to those obtained from a more accurate method and to experimental data. Eleven three‐sheet, single spot welded specimens were studied using a structural stress approach, followed by shell element simulations, similar to those used in commercial software. These results were compared to calculations based on fine meshed solid element models. Fracture mechanics was used to evaluate the loading conditions at the spot welds. Comparison between the results from the different methods and experimental results for three shear loaded specimens, consisting of triple sheets, found in literature showed good correlation. The shell element method in shear loaded cases gives stress intensities within +35% to ‐5% of the solid element method results. In peel loaded cases the results differ up to ‐60%, an under‐estimation that leads to an increase of estimated fatigue life up to 65 times.     

Establishment of a knee-joint coordinate system from helical axes analysis--a kinematic approach without anatomical referencing

This study establishes a functional knee-joint coordinate system (FCS) derived from active motion. The scale invariant properties of helical axes were used in order to avoid inter-observer errors associated with the traditional anatomical referencing techniques. The algorithm was tested with six cadaveric specimens in a knee-joint motion and loading apparatus. To determine the FCS sensitivity to variable loading, rotational moments were applied to the tibia while extending and flexing the knee. Each derived FCS was compared with the clinically derived anatomical coordinate system (ACS). The FCS was reproducible when the loading condition was the same. Changing the rotational moments from internal to external affected the orientations and the positions of the FCS. The largest displacement of 20.8 mm in average occurred in the medio/lateral direction. The FCS corresponded with the ACS for all specimens and loading conditions. The origin was always located within the femur along the transepicondylar line. The orientations differed less than 16.6 degrees in average, thus allowing the use of clinical terminology. These findings suggest that the FCS might improve the ability to clinically assess kinematic alterations provided that the reference motion is reproducible.