胃间质瘤患者胃电活动的初步研究

目的:分析描述胃间质瘤(GIST)患者的胃电活动特点,探讨GIST对胃电活动的影响.方法:运用多导胃电图检测27例胃GIST患者(GIST组)及30例健康志愿者(对照组)的餐前餐后胃电参数,并进行对比分析.结果:对照组餐后各导联较餐前均出现平均频率(MF)、平均幅值(MA)及正常慢波百分比(N%)增高,过缓频率百分比(B%)较餐前减低,差异有统计学意义(P < 0.05或P < 0.01), GIST组未出现相应的胃电图改变(P > 0.05);GIST组各导联餐前MF、MA高于对照组,N%餐前1、3、4导及餐后各导联均低于对照组,过速频率百分比(T%)各导联餐前餐后均高于对照组,差异有统计学意义(P < 0.01);GIST组与对照组患者胃动过速发生率分别为66.7%,3.3%,GIST组节律正常患者所占百分比低于对照组,差异有统计学意义(P < 0.01).结论:GIST患者存在餐前餐后胃电活动异常,异常胃电节律以胃动过速为主.     

咬合板治疗肌筋膜痛效果评估－随机双盲对照实验

Background Occlusal splints have been the preferred modalities in the management of myofascial temporomandibular disorders (TMDs),but now controversy exists in reporting whether they are successful for...     

Quality of pregnant women's diet in Poland – macro-elements

Introduction

The objective was to assess the quality of pregnant women''s diet in Poland concerning macro-elements and to analyze reasons for low or high quality diets.

Material and methods

Five hundred and twelve pregnant women in their 20^th to 30^th week of pregnancy took part in the research conducted by means of a 7-day observation of diet. Consumed products were analyzed by means of DIETETYK software developed by the Polish National Food and Nutrition Institute. Obtained macro values were averaged. The results were compared with the recommendations from the World Health Organization, European Union and Polish National Food and Nutrition Institute and analyzed statistically (χ² test).

Results

The pregnant women consumed an average of 1898 ±380 kcal daily. Average value of macro components supplied with the diet did not deviate from EU and NFNI nutrition recommendations: protein – 72.1 g/person daily, fats overall – 72.8 g, polyunsaturated fatty acids – 10.93 g, cholesterol – 283 mg, carbohydrates – 257 g. The study proved a significant relation between a higher quality diet of pregnant women and tertiary or secondary education (p = 0.05) as well as urban residence (p = 0.01).

Conclusions

Pregnant women''s diet in Poland is not significantly different from diet quality of pregnant women from other countries. A lower quality diet was observed among women who smoked during pregnancy and lived in rural areas.     

A randomised,open‐label,crossover study of the dopamine agonist,pramipexole, in patients with sleep bruxism

Sleep bruxism bears several similarities to restless legs syndrome, and a link to changes in central dopamine activity has been considered in both conditions. The dopamine agonist pramipexole is currently indicated for the symptomatic treatment of restless legs. The effect of pramipexole on sleep bruxism was investigated in subjects with ‘probable bruxism’ recruited at the Orofacial Pain Clinic. Thirteen patients underwent polysomnographic recordings, including bilateral masseter electromyographic activity. Following habituation to the recording equipment, a baseline registration was used to confirm bruxism [total episodes per hour, mean 11.3 (6.3)]. Following randomisation, subjects received no treatment or pramipexole titrated from 0.09 to 0.54 mg, o.d., for 3 weeks according to a crossover procedure. A polysomnographic‐electromyographic registration was performed at the end of each period. Pramipexole was associated with more frequent awakenings and a reduction in rapid eye movement sleep (both P ≤ 0.02). Sleep apnea decreased marginally after pramipexole (apnea–hypopnea index 17.1 compared with control 21.5, P ≤ 0.05). The number of bruxism episodes, phasic, tonic and mixed per hour, remained unchanged after pramipexole [total episodes per hour 12.7 (8.5) and 9.8 (5.2) during pramipexole and control conditions, respectively]. It is concluded, from this pilot study, that sleep bruxism is not affected by the dopaminergic agent, pramipexole.     

Pathophysiology of idiopathic dystonia: findings from genetic animal models

Dystonia is a common movement disorder which is thought to represent a disease of the basal ganglia. However, the pathogenesis of the idiopathic dystonias, i.e. the neuroanatomic and neurochemical basis, is still a mystery. Research in dystonia is complicated by the existence of various phenotypic and genotypic subtypes of idiopathic dystonia, probably related to heterogeneous dysfunctions.In neurological diseases in which no obvious neuronal degeneration can be found, such as in idiopathic dystonia, the identification of a primary defect is difficult, because of the large number of chemically distinct, but functionally interrelated, neurotransmitter systems in the brain.The variable response to pharmacological agents in patients with idiopathic dystonia supports the notion that the underlying biochemical dysfunctions vary in the subtypes of idiopathic dystonia. Hence, in basic research it is important to clearly define the involved type of dystonia.Animal models of dystonias were described as limited. However, over the last years, there has been considerable progress in the evaluation of animal models for different types of dystonia.Apart from animal models of symptomatic dystonia, genetic animal models with inherited dystonia which occurs in the absence of pathomorphological alterations in brain and spinal cord are described.This review will focus mainly on genetic animal models of different idiopathic dystonias and pathophysiological findings. In particular, in the case of the mutant dystonic (dt) rat, a model of generalized dystonia, and in the case of the genetically dystonic hamster (dt^sz), a model of paroxysmal dystonic choreoathetosis has been used, as these show great promise in contributing to the identification of underlying mechanisms in idiopathic dystonias, although even a proper animal model will probably never be equivalent to a human disease.Several pathophysiological findings from animal models are in line with clinical observations in dystonic patients, indicating abnormalities not only in the basal ganglia and thalamic nuclei, but also in the cerebellum and brainstem. Through clinical studies and neurochemical data several similarities were found in the genetic animal models, although the current data indicates different defects in dystonic animals which is consistent with the notion that dystonia is a heterogenous disorder.Different supraspinal dysfunctions appear to lead to manifestation of dystonic movements and postures. In addition to increasing our understanding of the pathophysiology of idiopathic dystonia, animal models may help to improve therapeutic strategies for this movement disorder.     

Potentiation of concentric plantar flexion torque following eccentric and isometric muscle actions

In a stretch-shortening cycle (SSC) the concentric muscle action is enhanced by a preceding eccentric muscle action. The hypothesis of the present study is that a preceding isometric action can also have an effect on a following concentric action, but to a lesser degree. A KINetic-COMmunicator II dynamometer was used to test muscle strength of the plantar flexion of the right foot in 20 healthy women. Maximal voluntary torque measurements were made at different angular velocities (120^o s^-1 and 240^o s^-1) and the range of motion of the ankle joint was 78–125^o. The assessment was based on concentric torque output and EMG recording from the gastrocnemius muscle under three different types of testing conditions (concentric actions with and without preceding eccentric or isometric actions, all with maximal efforts). The results showed that preceding muscle actions led to greater concentric torque output (P < 0.01) between 90 and 99^o plantar flexion. However, the increase in the concentric action was significantly (P < 0.01) larger with eccentric than with isometric preceding action, regardless of velocity. The EMG activity of the concentric action showed unchanged or lower values when preceded by a muscle action. In this model our conclusion is that the main reason for larger concentric torque values after a preceding muscle action is that time is sufficient for maximal muscle tension development; in addition, elastic energy is stored, particularly during the preceding eccentric action. Our results show that the effect of preceding muscle actions should be taken into account when measuring isokinetic muscle strength at relatively small angular movements.     

Observations on intra-abdominal pressure and patterns of abdominal intra-muscular activity in man

Cresswell , A. G., Grundström , H. & Thorstensson , A. 1992. Observations on intra-abdominal pressure and patterns of abdominal intra-muscular activity in man. Actri Physiol Scand 144 , 409418. Received 16 July 1 991 , accepted 11 October 1991. ISSN 0001–6772. Department of Physiology III, Karolinska Institute, and Department of Radiology, Danderyd Hospital, Stockholm, Sweden. The aim was to investigate possible relationships between activities of the individual muscles of the ventrolateral abdominal wall and the development of pressure within the abdominal cavity. Intra-muscular activity was recorded bilaterally from transversus abdominis, obliquus internus, obliquus externus and rectus abdominis with fine-wire electrodes guided into place using real-time ultrasound. Intra-abdominal pressure was measured intragastrically using a micro tip pressure transducer. Six males were studied during loading and movement tasks with varied levels of intra-abdominal pressure. During both maximal voluntary isometric trunk flexion and extension, transversus abdominis activity and intra-abdominal pressure remained constant, while all other abdominal muscles showed a marked reduction during extension. When maximal isometric trunk flexor or extensor torques were imposed upon a maximal Valsalva manoeuvre, transversus abdominis activity and intra-abdominal pressure remained comparable within and across conditions, whereas obliquus internus, obliquus externus and rectus abdominis activities either markedly increased (flexion) or decreased (extension). Trunk twisting movements showed reciprocal patterns of activity between the left and right sides of transversus abdominis, indicating an ability for torque development. During trunk flexion-extension, transversus abdominis showed less distinguished changes of activity possibly relating to a general stabilizing function. In varied pulsed Valsalva manoeuvres, changes in peak intra-abdominal pressure were correlated with mean amplitude electromyograms of all abdominal muscles, excluding rectus abdominis. It is concluded that the coordinative patterns shown between the muscles of the ventrolateral abdominal wall are task specific based upon demands of movement, torque and stabilization. It appears that transversus ahdominis is the abdominal muscle whose activity is most consistently related to changes in intra-abdominal pressure.     

表面肌电图在儿童吞咽障碍疾病中的应用

目的 探讨表面肌电图在儿童吞咽障碍疾病中的应用价值。方法 选取吞咽障碍患儿20例为观察组,招募性别及年龄相匹配的健康儿童20例为对照组。采用表面肌电图记录两组儿童静息状态及吞水状态颏下肌群和舌骨下肌群肌电积分值。比较两组儿童静息状态下及吞水5 mL后颏下肌群和舌骨下肌群肌电积分值的差异。记录观察组患儿康复治疗1个月后颏下肌群和舌骨下肌群肌电积分值的变化。采用Spearman相关分析法评估观察组患儿吞咽障碍程度与颏下肌群及舌骨下肌群肌电积分值的相关性。结果 静息状态下两组儿童颏下肌群和舌骨下肌群肌电积分差异无统计学意义（P > 0.05）,但在吞水后观察组的肌电积分值明显高于对照组（P < 0.05）。治疗后观察组吞咽障碍临床症状改善,颏下肌群和舌骨下肌群肌电积分值较前明显降低（P < 0.05）。吞咽障碍严重程度与颏下肌群和舌骨下肌群肌电积分值呈正相关（P < 0.01）。结论 表面肌电图检查可以作为儿童吞咽障碍诊断及疗效评估的方法之一。     

External validation of a data‐driven algorithm for muscular activity identification during sleep

Several automated methods for scoring periodic limb movements during sleep (PLMS) and rapid eye movement (REM) sleep without atonia (RSWA) have been proposed, but most of them were developed and validated on data recorded in the same clinic, thus they may be biased. This work aims to validate our data‐driven algorithm for muscular activity detection during sleep, originally developed based on data recorded and manually scored at the Danish Center for Sleep Medicine. The validation was carried out on a cohort of 240 participants, including de novo Parkinson's disease (PD) patients and neurologically healthy controls, whose sleep data were recorded and manually evaluated at Paracelsus‐Elena Klinik, Kassel, Germany. In the German cohort, the algorithm showed generally good agreement between manual and automated PLMS indices, and identified with 88.75% accuracy participants with PLMS index above 15 PLMS per hour of sleep, and with 84.17% accuracy patients suffering from REM sleep behaviour disorder (RBD) showing RSWA. By comparing the algorithm performances in the Danish and German cohorts, we hypothesized that inter‐clinical differences may exist in the way limb movements are manually scored and how healthy controls are defined. Finally, the algorithm performed worse in PD patients, probably as a result of increased artefacts caused by abnormal motor events related to neurodegeneration. Our algorithm can identify, with reasonable performance, participants with RBD and increased PLMS index from data recorded in different centres, and its application may reveal inter clinical differences, which can be overcome in the future by applying automated methods.     

基于肌电信号分析研究柔性电极设计参数对电极性能的影响

柔性电极因其穿戴式表面肌电采集的优势而得到研究学者的广泛关注,但很少有研究针对柔性电极的设计参数提 供明确的指导和规范。本实验首先对可能影响电极性能的参数进行了分析;然后利用柔性印刷工艺与喷墨印刷工艺制作 5种不同规格的柔性干电极,并将其与商用湿电极进行对比,设计基于尺侧腕伸肌的肌电采集实验,得到100个表面肌电 信号段;最后对信号段的时频域特性进行分析,从而确定相关参数对电极性能的影响。结果表明增加电极高度后的有源 柔性印刷电路板电极具有更好的信号采集性能。