A Video-based system for recording speech movements in three dimensions

This paper reports a study of speech articulator movement using a video-based system for tracking and recording movement in three dimensions, the MacReflex. The system is non-invasive, there is no hazardous radiation or electromagnetic field, and there are no wires that might impede movement by the subject. The facility is installed at the faculty of odontology (Departments of Clinical Neurophysiology and Clinical Oral Physiology) at the University of Umea, where it is currently being used to study strategies for motor control of precise movement in the hand, in the neck and mandible, and in various neurological disabilities.     

Bacterial translocation, endotoxaemia and apoptosis following Pringle manoeuvre in rats

BACKGROUND: Intraoperative occlusion of the hepatoduodenal ligament (Pringle manoeuvre (Pm)) is often employed for the reduction of blood loss during liver surgery. No data exist to date on the effects of Pm on mucosal barrier dysfunction, systemic bacterial translocation (BT), endotoxaemia and apoptosis. MATERIALS AND METHODS: Sixty-five male Wistar rats in three groups: I (n=25) controls, II (n=20) sham operation, III (n=20) occlusion of the hepatoduodenal ligament (Pm). Tissue samples from mesenteric lymph nodes (MLNs), liver, lungs and spleen were analysed after 30 min and at 24 h. Endotoxin was measured in portal and aortic blood and routine haematological and biochemical parameters were measured before and after Pm. RESULTS: No differences were found in the blood parameters before and after Pm, but a significant increase in contaminated MLNs and liver was noted. All cultured bacteria were enteric in origin. Portal and aortic endotoxin were significantly increased. Overall the ileal architecture remained intact in all specimens studied and no significant pathology was observed. The ABC increased after Pm significantly (P<0.01). CONCLUSION: Normothermic Pm of 30 min duration results in immediate and delayed gut barrier failure by significantly increasing BT and endotoxaemia which might be attributed to portal stasis leading to intestinal congestion as well as temporary liver ischaemia. Apoptosis increased significantly 30 min after performing the Pm.     

Effects of prolonged head-down tilt on internal jugular vein cross-sectional area

Background. Head-down tilt is often used to assist cannulationof the internal jugular vein (IJV). However, the optimal durationof tilt before cannulation is not well defined. Methods. Fifteen healthy volunteers were studied by B-mode duplexsonography to assess changes in cross-sectional area (CSA) ofthe right IJV during 10° head-down tilt. Results. Median CSA in the supine position was 102 mm²[range 16–266, mean (SD) 113 (69)]. CSA increased to 139mm² [23–388, 158 (93)] immediately after tilting (P<0.0001,repeated measures ANOVA). No significant further change wasnoted in the next 20 min. CSA returned to baseline level afterreturn to the supine position. Conclusion. The 10° head-down tilt manoeuvre in healthyvolunteers causes an immediate, significant increase in CSAin the right IJV. A longer tilt did not cause further increasein jugular CSA. Br J Anaesth 2002; 89: 769–71     

Doppler continuous-wave analysis of grafted mammary artery as a non-invasive technique for static and dynamic assessment of coronary flow in man

Summary In this paper, Doppler continuous-wave analysis of blood velocity in the internal mammary artery, anastomosed to the left coronary vascular bed in humans who have undergone myocardial revascularization, is proposed as a non-invasive technique to study coronary blood flow during physiological procedures which cause it to change. Blood velocity curves obtained in normal and anastomosed internal mammary arteries were compared during hyperventilation and the Valsalva manoeuvre. During hyperventilation, blood velocity increased in the normal mammary but not in the anastomosed artery. During the expiratory effort of the Valsalva manoeuvre, the mean blood velocity decreased in the normal mammary artery but it did not change significantly in the anastomosed artery. Variations in the mean velocity were largely prevented by simultaneous and well-balanced increases and decreases in the diastolic and systolic velocities, respectively.     

Epley's canalith-repositioning manoeuvre for benign paroxysmal positional vertigo

The efficacy of the Epley's canalith-repositioning manoeuvre in the treatment of BPPV was assessed in this prospective study of 62 patients. Patients were selected based on symptoms of positional vertigo and positive Dix-Hallpike's positional test. Patients were divided into two groups; first group comprising 34 patients underwent Epley's manoeuvre alone where as the other group comprising 28 patients underwent Epley's manoeuvre along with mastoid oscillator. At the end of 1 month patients were assessed subjectively by visual analogue scale (VAS) and objectively by Dix-Hallpike's positional test. On VAS, 85.7% patients had complete resolution of symptoms of BPPV in both the groups. Objectively 88.2% did not have positional nysfagmus after 1 month in first group whereas in the second group 86% had complete response at the end of 1 month of therapy. Follow up of 6 months could be done in 38 patients, out of which 7 (18.4%) had recurrence of their symptom of vertigo and positive Dix-Hallpike's positional test, whereas one patient continued to have no relief by Epley's manoeuvre. There was no difference in subjective and objective parameters even when CRP was performed using mastoid vibrator.     

Reduction of ischemia reperfusion injury after liver resection and hepatic inflow occlusion by α-lipoic acid in humans

INTRODUCTION Excessive blood loss during surgery and the need for transfusion have been shown to hinder the post-operative course of patients[1]. In order to minimize blood loss, clamping of the portal triad (inflow occlusion), also called pringle maneuvr…     

Margin of Manoeuvre Indicators in the Workplace During the Rehabilitation Process: A Qualitative Analysis

Introduction The task of evaluating workers’ capacity to return to their pre-injury employment or other jobs continues to pose a daily challenge for clinicians. In this study, a concept frequently used in the field of ergonomics, the margin of manoeuvre (MM), was applied during the rehabilitation process. The study identified the indicators of the MM taken into account during the return to work of workers with musculoskeletal disorders. Methods This study used a multiple-case design. A case was defined as a dyad comprising a worker admitted to a work rehabilitation program and the clinician who was managing the return-to-work process. The results were then validated with investigators and expert ergonomists, through group interviews. Content analyses were performed using the conceptual framework for the work activity model adapted from Vézina and the procedures recommended by Miles and Huberman. Results A total of 11 workers, five clinicians, two experts and two investigators participated in this study. The interview analysis process resulted in a more detailed definition of the MM and the identification of 50 indicators. The indicators were classified according to six dimensions: (1) work context; (2) employer’s requirements and expectations; (3) means and tools; (4) worker’s personal parameters; (5) work activity; and (6) impacts of the work situation. Conclusions The more specific indicators identified in this study will allow for more systematic observation of the MM. Subsequent studies will seek to link each indicator described in the model with a specific method of observation.     

催眠镇痛下手法松解治疗肩周炎

目的 观察催眠镇痛下手法松解治疗冻结期肩周炎的临床疗效.方法 对60例冻结期肩周炎患者,随机分为催眠镇痛组(甲组)和经肌间沟臂丛神经阻滞组(乙组),镇痛完善后对患肩给予手法松解治疗,并时两组患者治疗前后呼吸、循环功能的影响及治疗效果进行评价.结果 甲组治疗期间呼吸、循环相对稳定,乙组患者血压(MAP)、心半(HR)、呼吸(RR)、氧饱和度(SpO2)治疗时较高,与治疗前比较有显著性差异(P＜0.05);甲组临床疗效(86.70%)优于乙组(73.30%),两者间比较有显著性差异(P＜0.05).结论 催眠镇痛下手法松解治疗冻结期肩周炎安全有效.     

Response to the Valsalva manoeuvre after spinal anaesthesia

The waveform from a Criticare 504 pulse oximeter was recorded during the performance of a standard Valsalva manoeuvre in 20 patients before and after spinal anaesthesia. The pulse oximeter waveform showed changes typical of the expected heart rate and pulse volume changes seen in each phase of the Valsalva manoeuvre. There were no significant changes in the typical pulse volume changes of the Valsalva manoeuvre after spinal anaesthesia, which achieved a sensory block ranging in upper extent from T3-T12. There was, however, a significant delay in recovery of the pulse volume in phase 4 of the Valsalva manoeuvre after spinal anaesthesia from a mean (SD) of 3.1 (0.9) s to 6.2 (3.1) s (p less than 0.05). There was also a significant reduction in reflex bradycardia seen in phase 4. However, this was found only at 5, 10 and 15 min after spinal anaesthesia and was not associated with a significant change in Valsalva ratio or maximum-to-minimum rate ratio. The study confirms that the normal response to a standard Valsalva manoeuvre is suppressed only mildly during spinal anaesthesia in normovolaemic fit patients.