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Sample records for hybrid assistive neuromuscular

  1. Hybrid Assistive Neuromuscular Dynamic Stimulation Therapy: A New Strategy for Improving Upper Extremity Function in Patients with Hemiparesis following Stroke

    Directory of Open Access Journals (Sweden)

    Toshiyuki Fujiwara

    2017-01-01

    Full Text Available Hybrid Assistive Neuromuscular Dynamic Stimulation (HANDS therapy is one of the neurorehabilitation therapeutic approaches that facilitates the use of the paretic upper extremity (UE in daily life by combining closed-loop electromyography- (EMG- controlled neuromuscular electrical stimulation (NMES with a wrist-hand splint. This closed-loop EMG-controlled NMES can change its stimulation intensity in direct proportion to the changes in voluntary generated EMG amplitudes recorded with surface electrodes placed on the target muscle. The stimulation was applied to the paretic finger extensors. Patients wore a wrist-hand splint and carried a portable stimulator in an arm holder for 8 hours during the daytime. The system was active for 8 hours, and patients were instructed to use their paretic hand as much as possible. HANDS therapy was conducted for 3 weeks. The patients were also instructed to practice bimanual activities in their daily lives. Paretic upper extremity motor function improved after 3 weeks of HANDS therapy. Functional improvement of upper extremity motor function and spasticity with HANDS therapy is based on the disinhibition of the affected hemisphere and modulation of reciprocal inhibition. HANDS therapy may offer a promising option for the management of the paretic UE in patients with stroke.

  2. Hybrid Assistive Neuromuscular Dynamic Stimulation Therapy: A New Strategy for Improving Upper Extremity Function in Patients with Hemiparesis following Stroke

    Science.gov (United States)

    Honaga, Kaoru; Tochikura, Michi; Abe, Kaoru

    2017-01-01

    Hybrid Assistive Neuromuscular Dynamic Stimulation (HANDS) therapy is one of the neurorehabilitation therapeutic approaches that facilitates the use of the paretic upper extremity (UE) in daily life by combining closed-loop electromyography- (EMG-) controlled neuromuscular electrical stimulation (NMES) with a wrist-hand splint. This closed-loop EMG-controlled NMES can change its stimulation intensity in direct proportion to the changes in voluntary generated EMG amplitudes recorded with surface electrodes placed on the target muscle. The stimulation was applied to the paretic finger extensors. Patients wore a wrist-hand splint and carried a portable stimulator in an arm holder for 8 hours during the daytime. The system was active for 8 hours, and patients were instructed to use their paretic hand as much as possible. HANDS therapy was conducted for 3 weeks. The patients were also instructed to practice bimanual activities in their daily lives. Paretic upper extremity motor function improved after 3 weeks of HANDS therapy. Functional improvement of upper extremity motor function and spasticity with HANDS therapy is based on the disinhibition of the affected hemisphere and modulation of reciprocal inhibition. HANDS therapy may offer a promising option for the management of the paretic UE in patients with stroke. PMID:28191352

  3. Hybrid Neuroprosthesis for the Upper Limb: Combining Brain-Controlled Neuromuscular Stimulation with a Multi-Joint Arm Exoskeleton.

    Science.gov (United States)

    Grimm, Florian; Walter, Armin; Spüler, Martin; Naros, Georgios; Rosenstiel, Wolfgang; Gharabaghi, Alireza

    2016-01-01

    Brain-machine interface-controlled (BMI) neurofeedback training aims to modulate cortical physiology and is applied during neurorehabilitation to increase the responsiveness of the brain to subsequent physiotherapy. In a parallel line of research, robotic exoskeletons are used in goal-oriented rehabilitation exercises for patients with severe motor impairment to extend their range of motion (ROM) and the intensity of training. Furthermore, neuromuscular electrical stimulation (NMES) is applied in neurologically impaired patients to restore muscle strength by closing the sensorimotor loop. In this proof-of-principle study, we explored an integrated approach for providing assistance as needed to amplify the task-related ROM and the movement-related brain modulation during rehabilitation exercises of severely impaired patients. For this purpose, we combined these three approaches (BMI, NMES, and exoskeleton) in an integrated neuroprosthesis and studied the feasibility of this device in seven severely affected chronic stroke patients who performed wrist flexion and extension exercises while receiving feedback via a virtual environment. They were assisted by a gravity-compensating, seven degree-of-freedom exoskeleton which was attached to the paretic arm. NMES was applied to the wrist extensor and flexor muscles during the exercises and was controlled by a hybrid BMI based on both sensorimotor cortical desynchronization (ERD) and electromyography (EMG) activity. The stimulation intensity was individualized for each targeted muscle and remained subthreshold, i.e., induced no overt support. The hybrid BMI controlled the stimulation significantly better than the offline analyzed ERD (p = 0.028) or EMG (p = 0.021) modality alone. Neuromuscular stimulation could be well integrated into the exoskeleton-based training and amplified both the task-related ROM (p = 0.009) and the movement-related brain modulation (p = 0.019). Combining a hybrid BMI with neuromuscular stimulation

  4. Robotics, assistive technology, and occupational therapy management to improve upper limb function in pediatric neuromuscular diseases.

    Science.gov (United States)

    Rahman, Tariq; Basante, Joseph; Alexander, Michael

    2012-08-01

    This article presents an overview of occupational therapy assessments and treatment options for individuals with neuromuscular disabilities, with a particular focus on children with neuromuscular disorders. The discussion includes descriptions of standard treatments, commercial adaptive equipment, and homemade adaptive solutions. The state of the art in therapeutic and assistive robots and orthoses for the upper and lower extremity is also provided. Copyright © 2012. Published by Elsevier Inc.

  5. Hybrid neuroprosthesis for the upper limb: combining brain-controlled neuromuscular stimulation with a multi-joint arm exoskeleton

    Directory of Open Access Journals (Sweden)

    Florian Grimm

    2016-08-01

    Full Text Available Brain-machine interface-controlled (BMI neurofeedback training aims to modulate cortical physiology and is applied during neurorehabilitation to increase the responsiveness of the brain to subsequent physiotherapy. In a parallel line of research, robotic exoskeletons are used in goal-oriented rehabilitation exercises for patients with severe motor impairment to extend their range of motion and the intensity of training. Furthermore, neuromuscular electrical stimulation (NMES is applied in neurologically impaired patients to restore muscle strength by closing the sensorimotor loop. In this proof-of-principle study, we explored an integrated approach for providing assistance as needed to amplify the task-related range of motion and the movement-related brain modulation during rehabilitation exercises of severely impaired patients. For this purpose, we combined these three approaches (BMI, NMES, and exoskeleton in an integrated neuroprosthesis and studied the feasibility of this device in seven severely affected chronic stroke patients who performed wrist flexion and extension exercises while receiving feedback via a virtual environment. They were assisted by a gravity-compensating, seven degree-of-freedom exoskeleton which was attached to the paretic arm. Neuromuscular electrical stimulation was applied to the wrist extensor and flexor muscles during the exercises and was controlled by a hybrid BMI based on both sensorimotor cortical desynchronization (ERD and electromyography (EMG activity. The stimulation intensity was individualized for each targeted muscle and remained subthreshold, i.e. induced no overt support. The hybrid BMI controlled the stimulation significantly better than the offline analyzed ERD (p=0.028 or EMG (p=0.021 modality alone. Neuromuscular stimulation could be well integrated into the exoskeleton-based training and amplified both the task-related range of motion (p=0.009 and the movement-related brain modulation (p=0

  6. The assisted 6-minute cycling test to assess endurance in children with a neuromuscular disorder

    NARCIS (Netherlands)

    Jansen, M.; Jong, M. de; Coes, H.M.; Eggermont, F.; Alfen, N. van; Groot, I.J. de

    2012-01-01

    Introduction: For late- or non-ambulant children with a neuromuscular disorder no suitable endurance tests are currently available. We developed the assisted 6-minute cycling test (A6MCT) for the legs and arms and investigated its psychometric properties in healthy boys and boys with Duchenne muscul

  7. The Influence of Robotic Assistance on Reducing Neuromuscular Effort and Fatigue during Extravehicular Activity Glove Use

    Science.gov (United States)

    Madden, Kaci E.; Deshpande, Ashish D.; Peters, Benjamin J.; Rogers, Jonathan M.; Laske, Evan A.; McBryan, Emily R.

    2017-01-01

    The three-layered, pressurized space suit glove worn by Extravehicular Activity (EVA) crew members during missions commonly causes hand and forearm fatigue. The Spacesuit RoboGlove (SSRG), a Phase VI EVA space suit glove modified with robotic grasp-assist capabilities, has been developed to augment grip strength in order to improve endurance and reduce the risk of injury in astronauts. The overall goals of this study were to i) quantify the neuromuscular modulations that occur in response to wearing a conventional Phase VI space suit glove (SSG) during a fatiguing task, and ii) determine the efficacy of Spacesuit RoboGlove (SSRG) in reversing the adverse neuromuscular modulations and restoring altered muscular activity to barehanded levels. Six subjects performed a fatigue sequence consisting of repetitive dynamic-gripping interspersed with isometric grip-holds under three conditions: barehanded, wearing pressurized SSG, and wearing pressurized SSRG. Surface electromyography (sEMG) from six forearm muscles (flexor digitorum superficialis (FDS), flexor carpi radialis (FCR), flexor carpi ulnaris (FCU), extensor digitorum (ED), extensor carpi radialis longus (ECRL), and extensor carpi ulnaris (ECU)) and subjective fatigue ratings were collected during each condition. Trends in amplitude and spectral distributions of the sEMG signals were used to derive metrics quantifying neuromuscular effort and fatigue that were compared across the glove conditions. Results showed that by augmenting finger flexion, the SSRG successfully reduced the neuromuscular effort needed to close the fingers of the space suit glove in more than half of subjects during two types of tasks. However, the SSRG required more neuromuscular effort to extend the fingers compared to a conventional SSG in many subjects. Psychologically, the SSRG aided subjects in feeling less fatigued during short periods of intense work compared to the SSG. The results of this study reveal the promise of the SSRG as a

  8. A comparison of assisted and unassisted proprioceptive neuromuscular facilitation techniques and static stretching.

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    Maddigan, Meaghan E; Peach, Ashley A; Behm, David G

    2012-05-01

    A comparison of assisted and unassisted proprioceptive neuromuscular facilitation techniques and static stretching. J Strength Cond Res 26(5): 1238-1244, 2012-Proprioceptive neuromuscular facilitation (PNF) stretching often requires a partner. Straps are available allowing an individual to perform PNF stretching alone. It is not known if a strap provides similar improvements in the range of motion (ROM) as partner-assisted PNF or static stretching. The purpose of this study was to compare assisted and unassisted (with a strap) PNF stretching and static stretching. Hip joint ROM, reaction time (RT), and movement time (MT) were measured prestretching and poststretching. Thirteen recreationally active adults participated in this study. The participants were subjected to 5 different stretch interventions in a random order on separate days. Stretch conditions included unassisted PNF stretching using (a) isometric, (b) concentric, and (c) eccentric contractions with a stretch strap, (d) partner-assisted isometric PNF, and (e) static stretching. The RT, MT, dynamic, active, passive hip flexion angle, and angular velocity with dynamic hip flexion were measured before and after the intervention. The ROM improved (p < 0.05) 2.6, 2.7, and 5.4%, respectively, with dynamic, active static, and passive static ROM, but there was no significant difference between the stretching protocols. There was a main effect for time (p < 0.05) with all stretching conditions negatively impacting dynamic angular velocity (9.2%). Although there was no significant effect on RT, MT showed a negative main effect for time (p < 0.05) slowing 3.4%. In conclusion, it was found that all 3 forms of active stretching provided similar improvements in the ROM and poststretching performance decrements in MT and angular velocity. Thus, individuals can implement PNF stretching techniques with a partner or alone with a strap to improve ROM, but athletes should not use these techniques before important

  9. The effects of electromechanical wrist robot assistive system with neuromuscular electrical stimulation for stroke rehabilitation.

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    Hu, X L; Tong, K Y; Li, R; Xue, J J; Ho, S K; Chen, P

    2012-06-01

    An electromyography (EMG)-driven electromechanical robot system integrated with neuromuscular electrical stimulation (NMES) was developed for wrist training after stroke. The performance of the system in assisting wrist flexion/extension tracking was evaluated on five chronic stroke subjects, when the system provided five different schemes with or without NMES and robot assistance. The tracking performances were measured by range of motion (ROM) of the wrist and root mean squared error (RMSE). The performance is better when both NMES and robot assisted in the tracking than those with either NMES or robot only (Pmotor functions in the hand, wrist and elbow functions after the training, as indicated by the clinical scores of Fugl-Meyer Assessment, Action Research Arm Test, Wolf Motor Function Test; and also showed reduced spasticity in the wrist and the elbow as measured by the Modified Ashworth Score of each subject. After the training, the co-contractions were reduced between the flexor carpi radialis and extensor carpi radialis, and between the biceps brachii and triceps brachii. Assistance from the robot helped improve the movement accuracy; and the NMES helped increase the muscle activation for the wrist joint and suppress the excessive muscular activities from the elbow joint. The NMES-robot assisted wrist training could improve the hand, wrist, and elbow functions.

  10. Wrist Rehabilitation Assisted by an Electromyography-Driven Neuromuscular Electrical Stimulation Robot After Stroke.

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    Hu, Xiao-Ling; Tong, Raymond Kai-yu; Ho, Newmen S K; Xue, Jing-jing; Rong, Wei; Li, Leonard S W

    2015-09-01

    Augmented physical training with assistance from robot and neuromuscular electrical stimulation (NMES) may introduce intensive motor improvement in chronic stroke. To compare the rehabilitation effectiveness achieved by NMES robot-assisted wrist training and that by robot-assisted training. This study was a single-blinded randomized controlled trial with a 3-month follow-up. Twenty-six hemiplegic subjects with chronic stroke were randomly assigned to receive 20-session wrist training with an electromyography (EMG)-driven NMES robot (NMES robot group, n = 11) and with an EMG-driven robot (robot group, n = 15), completed within 7 consecutive weeks. Clinical scores, Fugl-Meyer Assessment (FMA), Modified Ashworth Score (MAS), and Action Research Arm Test (ARAT) were used to evaluate the training effects before and after the training, as well as 3 months later. An EMG parameter, muscle co-contraction index, was also applied to investigate the session-by-session variation in muscular coordination patterns during the training. The improvement in FMA (shoulder/elbow, wrist/hand) obtained in the NMES robot group was more significant than the robot group (P application in the treatment could bring more improvements in the distal motor functions and faster rehabilitation progress. © The Author(s) 2014.

  11. Towards the use of a lower limb exoskeleton for locomotion assistance in individuals with neuromuscular locomotor deficits.

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    Murray, Spencer; Goldfarb, Michael

    2012-01-01

    The authors intend to utilize a lower limb exoskeleton for gait assistance in individuals with lower limb neuromuscular deficit. The authors suggest that two foundational elements are required to do so effectively. First, the exoskeleton system must be capable of reliable real-time gait phase detection, in order to determine the nature of gait assistance to provide. Second, in gait phases or circumstances in which the exoskeleton provides minimal assistance, the passive dynamics of the exoskeleton should not hinder the individual (i.e., should have the capability to minimally interfere with gait dynamics). As such, the exoskeleton system should be capable of actively compensating for its passive dynamics, namely the inertial, gravitational, and frictional effects it imposes on the user. This paper describes the implementation of these two foundational elements (real-time gait phase detection and active cancellation of passive dynamics) on a prototype lower limb exoskeleton, and provides experimental data demonstrating their respective efficacy.

  12. Feasibility of a Hydraulic Power Assist System for Use in Hybrid Neuroprostheses

    Directory of Open Access Journals (Sweden)

    Kevin M. Foglyano

    2015-01-01

    Full Text Available Feasibility of using pressurized hydraulic fluid as a source of on-demand assistive power for hybrid neuroprosthesis combining exoskeleton with functional neuromuscular stimulation was explored. Hydraulic systems were selected as an alternative to electric motors for their high torque/mass ratio and ability to be located proximally on the exoskeleton and distribute power distally to assist in moving the joints. The power assist system (PAS was designed and constructed using off-the-shelf components to test the feasibility of using high pressure fluid from an accumulator to provide assistive torque to an exoskeletal hip joint. The PAS was able to provide 21 Nm of assistive torque at an input pressure of 3171 kPa with a response time of 93 ms resulting in 32° of hip flexion in an able-bodied test. The torque output was independent of initial position of the joint and was linearly related to pressure. Thus, accumulator pressure can be specified to provide assistive torque as needed in exoskeletal devices for walking or stair climbing beyond those possible either volitionally or with electrical stimulation alone.

  13. Hybrid-assisted DPF regeneration in distribution trucks

    NARCIS (Netherlands)

    Foster, D.L.; Kessels, J.T.B.A.; Aneke, N.P.I.; Rojer, C.

    2009-01-01

    TNO Automotive is developing an Integrated Powertrain Control (IPC) concept for powertrain controls that focuses on integration of the engine, aftertreatment and parallel hybrid electric system. One of the first steps is the focus on hybrid assisted Diesel Particulate Filter (DPF) regeneration. For

  14. Upper limb functions regained in quadriplegia: a hybrid computerized neuromuscular stimulation system.

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    Nathan, R H; Ohry, A

    1990-05-01

    A new, computerized neuromuscular stimulation system was applied to the upper limbs of two patients with complete quadriplegia below the C4 level. The stimulation-generated movements were integrated and augmented by residual, voluntary shoulder girdle movements and mechanical splinting. Up to 12 muscles were stimulated individually with high-resolution surface electrodes; coordination and control of the stimulation was effected by microcomputer. Simple vocal commands to the computer triggered preprogrammed hand prehensions, arm motion, and other functions, giving the patient complete control over the system. In pilot clinical trials of six weeks, writing, eating, and drinking, including picking up and replacing the pen or cup, were achieved.

  15. An Adaptive Neuromuscular Controller for Assistive Lower-Limb Exoskeletons: A Preliminary Study on Subjects with Spinal Cord Injury

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    Amy R. Wu

    2017-06-01

    Full Text Available Versatility is important for a wearable exoskeleton controller to be responsive to both the user and the environment. These characteristics are especially important for subjects with spinal cord injury (SCI, where active recruitment of their own neuromuscular system could promote motor recovery. Here we demonstrate the capability of a novel, biologically-inspired neuromuscular controller (NMC which uses dynamical models of lower limb muscles to assist the gait of SCI subjects. Advantages of this controller include robustness, modularity, and adaptability. The controller requires very few inputs (i.e., joint angles, stance, and swing detection, can be decomposed into relevant control modules (e.g., only knee or hip control, and can generate walking at different speeds and terrains in simulation. We performed a preliminary evaluation of this controller on a lower-limb knee and hip robotic gait trainer with seven subjects (N = 7, four with complete paraplegia, two incomplete, one healthy to determine if the NMC could enable normal-like walking. During the experiment, SCI subjects walked with body weight support on a treadmill and could use the handrails. With controller assistance, subjects were able to walk at fast walking speeds for ambulatory SCI subjects—from 0.6 to 1.4 m/s. Measured joint angles and NMC-provided joint torques agreed reasonably well with kinematics and biological joint torques of a healthy subject in shod walking. Some differences were found between the torques, such as the lack of knee flexion near mid-stance, but joint angle trajectories did not seem greatly affected. The NMC also adjusted its torque output to provide more joint work at faster speeds and thus greater joint angles and step length. We also found that the optimal speed-step length curve observed in healthy humans emerged for most of the subjects, albeit with relatively longer step length at faster speeds. Therefore, with very few sensors and no predefined

  16. Electrical potential-assisted DNA hybridization. How to mitigate electrostatics for surface DNA hybridization.

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    Tymoczko, Jakub; Schuhmann, Wolfgang; Gebala, Magdalena

    2014-12-24

    Surface-confined DNA hybridization reactions are sensitive to the number and identity of DNA capture probes and experimental conditions such as the nature and the ionic strength of the electrolyte solution. When the surface probe density is high or the concentration of bulk ions is much lower than the concentration of ions within the DNA layer, hybridization is significantly slowed down or does not proceed at all. However, high-density DNA monolayers are attractive for designing high-sensitivity DNA sensors. Thus, circumventing sluggish DNA hybridization on such interfaces allows a high surface concentration of target DNA and improved signal/noise ratio. We present potential-assisted hybridization as a strategy in which an external voltage is applied to the ssDNA-modified interface during the hybridization process. Results show that a significant enhancement of hybridization can be achieved using this approach.

  17. The effect of timing electrical stimulation to robotic-assisted stepping on neuromuscular activity and associated kinematics

    OpenAIRE

    Sina Askari, MS; TeKang Chao; Ray D. de Leon, PhD; Deborah S. Won, PhD

    2013-01-01

    Results of previous studies raise the question of how timing neuromuscular functional electrical stimulation (FES) to limb movements during stepping might alter neuromuscular control differently than patterned stimulation alone. We have developed a prototype FES system for a rodent model of spinal cord injury (SCI) that times FES to robotic treadmill training (RTT). In this study, one group of rats (n = 6) was trained with our FES+RTT system and received stimulation of the ankle flexor (tibia...

  18. Robot-Assisted Rehabilitation of Ankle Plantar Flexors Spasticity: A Three-Month Study with Proprioceptive Neuromuscular Facilitation

    Directory of Open Access Journals (Sweden)

    Zhihao Zhou

    2016-11-01

    Full Text Available In this paper, we aim to investigate the effect of Proprioceptive Neuromuscular Facilitation (PNF based rehabilitation for ankle plantar flexors spasticity by using a Robotic Ankle-foot Rehabilitation System (RARS. A modified robot-assisted system was proposed and seven post-stroke patients with hemiplegic spastic ankles participated a three-month of robotic PNF training. Their impaired sides were used as the experimental group while their unimpaired sides as the control group. A robotic intervention for the experimental group generally started from a two minutes passive stretching to warm-up or relax the soleus and gastrocnemius muscle and also ended with the same one. Then a PNF training session included 30 trails was activated between them. The rehabilitation trainings were carried out three times a week as an addition of their regular rehabilitation exercise. Passive ankle joint range of motion, resistance torque and stiffness were measured in both ankles before and after the intervention. The changes in Achilles' tendon length, walking speed, and lower limb function were also evaluated by the same physician or physiotherapist for each participant. Biomechanical measurements before interventions showed significant difference between the experimental group and the control group due to ankle spasticity. For the control group, there was no significant difference in the three months with no robotic intervention. But for the experimental group, passive dorsiflexion range of motion increased ( p0.05 . The robotic rehabilitation also improved the muscle strength ( p0.05 and fast walking speed ( p<0.05 . These results indicated that PNF based robotic intervention could significantly alleviate lower limb spasticity and improve the motor function in chronic stroke participant. The robotic system could potentially be used as an effective tool in post-stroke rehabilitation training.

  19. Closed-Loop Neuroprosthesis for Reach-to-Grasp Assistance: Combining Adaptive Multi-channel Neuromuscular Stimulation with a Multi-joint Arm Exoskeleton.

    Science.gov (United States)

    Grimm, Florian; Gharabaghi, Alireza

    2016-01-01

    Stroke patients with severe motor deficits cannot execute task-oriented rehabilitation exercises with their affected upper extremity. Advanced rehabilitation technology may support them in performing such reach-to-grasp movements. The challenge is, however, to provide assistance as needed, while maintaining the participants' commitment during the exercises. In this feasibility study, we introduced a closed-loop neuroprosthesis for reach-to-grasp assistance which combines adaptive multi-channel neuromuscular stimulation with a multi-joint arm exoskeleton. Eighteen severely affected chronic stroke patients were assisted by a gravity-compensating, seven-degree-of-freedom exoskeleton which was attached to the paretic arm for performing reach-to-grasp exercises resembling activities of daily living in a virtual environment. During the exercises, adaptive electrical stimulation was applied to seven different muscles of the upper extremity in a performance-dependent way to enhance the task-oriented movement trajectory. The stimulation intensity was individualized for each targeted muscle and remained subthreshold, i.e., induced no overt support. Closed-loop neuromuscular stimulation could be well integrated into the exoskeleton-based training, and increased the task-related range of motion (p = 0.0004) and movement velocity (p = 0.015), while preserving accuracy. The highest relative stimulation intensity was required to facilitate the grasping function. The facilitated range of motion correlated with the upper extremity Fugl-Meyer Assessment score of the patients (p = 0.028). Combining adaptive multi-channel neuromuscular stimulation with antigravity assistance amplifies the residual motor capabilities of severely affected stroke patients during rehabilitation exercises and may thus provide a customized training environment for patient-tailored support while preserving the participants' engagement.

  20. Early Stroke Rehabilitation of the Upper Limb Assisted with an Electromyography-Driven Neuromuscular Electrical Stimulation-Robotic Arm.

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    Qian, Qiuyang; Hu, Xiaoling; Lai, Qian; Ng, Stephanie C; Zheng, Yongping; Poon, Waisang

    2017-01-01

    Effective poststroke motor rehabilitation depends on repeated limb practice with voluntary efforts. An electromyography (EMG)-driven neuromuscular electrical stimulation (NMES)-robot arm was designed for the multi-joint physical training on the elbow, the wrist, and the fingers. To investigate the training effects of the device-assisted approach on subacute stroke patients and to compare the effects with those achieved by the traditional physical treatments. This study was a pilot randomized controlled trial with a 3-month follow-up. Subacute stroke participants were randomly assigned into two groups, and then received 20-session upper limb training with the EMG-driven NMES-robotic arm (NMES-robot group, n = 14) or the time-matched traditional therapy (the control, n = 10). For the evaluation of the training effects, clinical assessments including Fugl-Meyer Assessment (FMA), Modified Ashworth Score (MAS), Action Research Arm Test (ARAT), and Function Independence Measurement (FIM) were conducted before, after the rehabilitation training, and 3 months later. Session-by-session EMG parameters in the NMES-robot group, including normalized co-contraction Indexes (CI) and EMG activation level of target muscles, were used to monitor the progress in muscular coordination patterns. Significant improvements were obtained in FMA (full score and shoulder/elbow), ARAT, and FIM [P  0.279] for both groups. Significant improvement in FMA wrist/hand was only observed in the NMES-robot group (P  0.24), and remained at an elevated level when assessed 3 months later. The EMG parameters indicated a release of muscle co-contraction in the muscle pairs of biceps brachii and flexor carpi radialis and biceps brachii and triceps brachii, as well as a reduction of muscle activation level in the wrist flexor in the NMES-robot group. The NMES-robot-assisted training was effective for early stroke upper limb rehabilitation and promoted independence in the daily living

  1. A hybrid brain interface for a humanoid robot assistant.

    Science.gov (United States)

    Finke, Andrea; Knoblauch, Andreas; Koesling, Hendrik; Ritter, Helge

    2011-01-01

    We present an advanced approach towards a semi-autonomous, robotic personal assistant for handicapped people. We developed a multi-functional hybrid brain-robot interface that provides a communication channel between humans and a state-of-the-art humanoid robot, Honda's Humanoid Research Robot. Using cortical signals, recorded, processed and translated by an EEG-based brain-machine interface (BMI), human-robot interaction functions independently of users' motor control deficits. By exploiting two distinct cortical activity patterns, P300 and event-related desynchronization (ERD), the interface provides different dimensions for robot control. An empirical study demonstrated the functionality of the BMI guided humanoid robot. All participants could successfully control the robot that accomplished a shopping task.

  2. Analysis of a Hybrid Solar-Assisted Trigeneration System

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    Elisa Marrasso

    2016-09-01

    Full Text Available A hybrid solar-assisted trigeneration system is analyzed in this paper. The system is composed of a 20 m2 solar field of evacuated tube collectors, a natural gas fired micro combined heat and power system delivering 12.5 kW of thermal power, an absorption heat pump (AHP with a nominal cooling power of 17.6 kW, two storage tanks (hot and cold and an electric auxiliary heater (AH. The plant satisfies the energy demand of an office building located in Naples (Southern Italy. The electric energy of the cogenerator is used to meet the load and auxiliaries electric demand; the interactions with the grid are considered in cases of excess or over requests. This hybrid solution is interesting for buildings located in cities or historical centers with limited usable roof surface to install a conventional solar heating and cooling (SHC system able to achieve high solar fraction (SF. The results of dynamic simulation show that a tilt angle of 30° maximizes the SF of the system on annual basis achieving about 53.5%. The influence on the performance of proposed system of the hot water storage tank (HST characteristics (volume, insulation is also studied. It is highlighted that the SF improves when better insulated and bigger HSTs are considered. A maximum SF of about 58.2% is obtained with a 2000 L storage, whereas the lower thermal losses take place with a better insulated 1000 L tank.

  3. Photon-assisted Andreev tunneling through a mesoscopic hybrid system

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    Sun, Qing-Feng; Wang, Jian; Lin, Tsung-Han

    1999-05-01

    The electron tunneling through a mesoscopic hybrid system, a normal-metal-quantum-dot-superconductor (N-QD-S) system where the intradot Coulomb interaction is neglected, in the presence of the time-varying external fields, has been investigated. By using the nonequilibrium Green-function method, the time-dependent current jL(t) and the average current are derived. The photon-assisted Andreev tunneling (PAAT) and the normal photon-assisted tunneling (PAT) are studied in detail. In the case of ħω vs the gate voltage exhibits a series of equal-interval PAAT peaks, with negative peaks on the left-hand side and positive peaks on the right-hand side of the original resonant peak in the absence of the external fields. This is very different from the N-QD-N system. While for ħω>Δ, various PAT processes cause a rather complicated dependence of the current on the gate voltage. In addition, the current-bias-voltage characteristics become more complicated: each Andreev reflection peak is split into side-band peaks and each current plateau is split into substep plateaus.

  4. The effect of timing electrical stimulation to robotic-assisted stepping on neuromuscular activity and associated kinematics

    Directory of Open Access Journals (Sweden)

    Sina Askari, MS

    2013-08-01

    Full Text Available Results of previous studies raise the question of how timing neuromuscular functional electrical stimulation (FES to limb movements during stepping might alter neuromuscular control differently than patterned stimulation alone. We have developed a prototype FES system for a rodent model of spinal cord injury (SCI that times FES to robotic treadmill training (RTT. In this study, one group of rats (n = 6 was trained with our FES+RTT system and received stimulation of the ankle flexor (tibialis anterior [TA] muscle timed according to robot-controlled hind-limb position (FES+RTT group; a second group (n = 5 received a similarly patterned stimulation, randomly timed with respect to the rats’ hind-limb movements, while they were in their cages (randomly timed stimulation [RS] group. After 4 wk of training, we tested treadmill stepping ability and compared kinematic measures of hind-limb movement and electromyography (EMG activity in the TA. The FES+RTT group stepped faster and exhibited TA EMG profiles that better matched the applied stimulation profile during training than the RS group. The shape of the EMG profile was assessed by "gamma," a measure that quantified the concentration of EMG activity during the early swing phase of the gait cycle. This gamma measure was 112% higher for the FES+RTT group than for the RS group. The FES+RTT group exhibited burst-to-step latencies that were 41% shorter and correspondingly exhibited a greater tendency to perform ankle flexion movements during stepping than the RS group, as measured by the percentage of time the hind limb was either dragging or in withdrawal. The results from this study support the hypothesis that locomotor training consisting of FES timed to hind-limb movement improves the activation of hind-limb muscle more so than RS alone. Our rodent FES+RTT system can serve as a tool to help further develop this combined therapy to target appropriate neurophysiological changes for locomotor control.

  5. The effect of timing electrical stimulation to robotic-assisted stepping on neuromuscular activity and associated kinematics.

    Science.gov (United States)

    Askari, Sina; Chao, TeKang; de Leon, Ray D; Won, Deborah S

    2013-01-01

    Results of previous studies raise the question of how timing neuromuscular functional electrical stimulation (FES) to limb movements during stepping might alter neuromuscular control differently than patterned stimulation alone. We have developed a prototype FES system for a rodent model of spinal cord injury (SCI) that times FES to robotic treadmill training (RTT). In this study, one group of rats (n = 6) was trained with our FES+RTT system and received stimulation of the ankle flexor (tibialis anterior [TA]) muscle timed according to robot-controlled hind-limb position (FES+RTT group); a second group (n = 5) received a similarly patterned stimulation, randomly timed with respect to the rats' hind-limb movements, while they were in their cages (randomly timed stimulation [RS] group). After 4 wk of training, we tested treadmill stepping ability and compared kinematic measures of hind-limb movement and electromyography (EMG) activity in the TA. The FES+RTT group stepped faster and exhibited TA EMG profiles that better matched the applied stimulation profile during training than the RS group. The shape of the EMG profile was assessed by "gamma," a measure that quantified the concentration of EMG activity during the early swing phase of the gait cycle. This gamma measure was 112% higher for the FES+RTT group than for the RS group. The FES+RTT group exhibited burst-to-step latencies that were 41% shorter and correspondingly exhibited a greater tendency to perform ankle flexion movements during stepping than the RS group, as measured by the percentage of time the hind limb was either dragging or in withdrawal. The results from this study support the hypothesis that locomotor training consisting of FES timed to hind-limb movement improves the activation of hind-limb muscle more so than RS alone. Our rodent FES+RTT system can serve as a tool to help further develop this combined therapy to target appropriate neurophysiological changes for locomotor control.

  6. Efficacy of a hybrid assistive limb in post-stroke hemiplegic patients: a preliminary report

    Science.gov (United States)

    2011-01-01

    Background Robotic devices are expected to be widely used in various applications including support for the independent mobility of the elderly with muscle weakness and people with impaired motor function as well as support for nursing care that involves heavy laborious work. We evaluated the effects of a hybrid assistive limb robot suit on the gait of stroke patients undergoing rehabilitation. Methods The study group comprised 16 stroke patients with severe hemiplegia. All patients underwent gait training. Four patients required assistance, and 12 needed supervision while walking. The stride length, walking speed and physiological cost index on wearing the hybrid assistive limb suit and a knee-ankle-foot orthosis were compared. Results The hybrid assistive limb suit increased the stride length and walking speed in 4 of 16 patients. The patients whose walking speed decreased on wearing the hybrid assistive limb suit either had not received sufficient gait training or had an established gait pattern with a knee-ankle-foot orthosis using a quad cane. The physiological cost index increased after wearing the hybrid assistive limb suit in 12 patients, but removal of the suit led to a decrease in the physiological cost index values to equivalent levels prior to the use of the suit. Conclusions Although the hybrid assistive limb suit is not useful for all hemiplegic patients, it may increase the walking speed and affect the walking ability. Further investigation would clarify its indication for the possibility of gait training. PMID:21943320

  7. Efficacy of a hybrid assistive limb in post-stroke hemiplegic patients: a preliminary report

    Directory of Open Access Journals (Sweden)

    Takeda Koji

    2011-09-01

    Full Text Available Abstract Background Robotic devices are expected to be widely used in various applications including support for the independent mobility of the elderly with muscle weakness and people with impaired motor function as well as support for nursing care that involves heavy laborious work. We evaluated the effects of a hybrid assistive limb robot suit on the gait of stroke patients undergoing rehabilitation. Methods The study group comprised 16 stroke patients with severe hemiplegia. All patients underwent gait training. Four patients required assistance, and 12 needed supervision while walking. The stride length, walking speed and physiological cost index on wearing the hybrid assistive limb suit and a knee-ankle-foot orthosis were compared. Results The hybrid assistive limb suit increased the stride length and walking speed in 4 of 16 patients. The patients whose walking speed decreased on wearing the hybrid assistive limb suit either had not received sufficient gait training or had an established gait pattern with a knee-ankle-foot orthosis using a quad cane. The physiological cost index increased after wearing the hybrid assistive limb suit in 12 patients, but removal of the suit led to a decrease in the physiological cost index values to equivalent levels prior to the use of the suit. Conclusions Although the hybrid assistive limb suit is not useful for all hemiplegic patients, it may increase the walking speed and affect the walking ability. Further investigation would clarify its indication for the possibility of gait training.

  8. Assessing neuromuscular mechanisms in human-exoskeleton interaction.

    Science.gov (United States)

    Sylla, N; Bonnet, V; Venture, G; Armande, N; Fraisse, P

    2014-01-01

    In this study, we propose to evaluate a 7 DOF exoskeleton in terms of motion control. Using criteria from the human motor control literature, inverse optimization was performed to assess an industrial screwing movement. The results of our study show that the hybrid composition of the free arm movement was accurately determined. At contrary, when wearing the exoskeleton, which produces an arbitrary determined torque compensation, the motion is different from the naturally adopted one. This study is part of the evaluation and comprehension of the complex neuromuscular mechanism resulting in wearing an exoskeleton several hours per day for industrial tasks assistance.

  9. A Hybrid Segmentation Framework for Computer-Assisted Dental Procedures

    Science.gov (United States)

    Hosntalab, Mohammad; Aghaeizadeh Zoroofi, Reza; Abbaspour Tehrani-Fard, Ali; Shirani, Gholamreza; Reza Asharif, Mohammad

    Teeth segmentation in computed tomography (CT) images is a major and challenging task for various computer assisted procedures. In this paper, we introduced a hybrid method for quantification of teeth in CT volumetric dataset inspired by our previous experiences and anatomical knowledge of teeth and jaws. In this regard, we propose a novel segmentation technique using an adaptive thresholding, morphological operations, panoramic re-sampling and variational level set algorithm. The proposed method consists of several steps as follows: first, we determine the operation region in CT slices. Second, the bony tissues are separated from other tissues by utilizing an adaptive thresholding technique based on the 3D pulses coupled neural networks (PCNN). Third, teeth tissue is classified from other bony tissues by employing panorex lines and anatomical knowledge of teeth in the jaws. In this case, the panorex lines are estimated using Otsu thresholding and mathematical morphology operators. Then, the proposed method is followed by calculating the orthogonal lines corresponding to panorex lines and panoramic re-sampling of the dataset. Separation of upper and lower jaws and initial segmentation of teeth are performed by employing the integral projections of the panoramic dataset. Based the above mentioned procedures an initial mask for each tooth is obtained. Finally, we utilize the initial mask of teeth and apply a variational level set to refine initial teeth boundaries to final contour. In the last step a surface rendering algorithm known as marching cubes (MC) is applied to volumetric visualization. The proposed algorithm was evaluated in the presence of 30 cases. Segmented images were compared with manually outlined contours. We compared the performance of segmentation method using ROC analysis of the thresholding, watershed and our previous works. The proposed method performed best. Also, our algorithm has the advantage of high speed compared to our previous works.

  10. Neuromuscular ultrasound of cranial nerves.

    Science.gov (United States)

    Tawfik, Eman A; Walker, Francis O; Cartwright, Michael S

    2015-04-01

    Ultrasound of cranial nerves is a novel subdomain of neuromuscular ultrasound (NMUS) which may provide additional value in the assessment of cranial nerves in different neuromuscular disorders. Whilst NMUS of peripheral nerves has been studied, NMUS of cranial nerves is considered in its initial stage of research, thus, there is a need to summarize the research results achieved to date. Detailed scanning protocols, which assist in mastery of the techniques, are briefly mentioned in the few reference textbooks available in the field. This review article focuses on ultrasound scanning techniques of the 4 accessible cranial nerves: optic, facial, vagus and spinal accessory nerves. The relevant literatures and potential future applications are discussed.

  11. Laser assisted hybrid additive manufacturing of thermoelectric modules

    Science.gov (United States)

    Zhang, Tao; Tewolde, Mahder; Longtin, Jon P.; Hwang, David J.

    2017-02-01

    Thermoelectric generators (TEGs) are an attractive means to produce electricity, particular from waste heat applications. However, TEGs are almost exclusively manufactured as flat, rigid modules of limited size and shape, and therefore an appropriate mounting for intimate contact of TEGs modules onto arbitrary surfaces represents a significant challenge. In this study, we introduce laser assisted additive manufacturing method to produce multi-layered thermoelectric generator device directly on flat and non-flat surfaces for waste heat recovery. The laser assisted processing spans from laser scribing of thermal sprayed thin films, curing of dispensed thermoelectric inks and selective laser sintering to functionalize thermoelectric materials.

  12. Development and application of marker-assisted reverse breeding using hybrid maize germplasm

    Institute of Scientific and Technical Information of China (English)

    GUAN Yi-Xin; WANG Bao-hua; FENG Yan; LI Ping

    2015-01-01

    Humankind has been through different periods of agricultural improvement aiming at enhancing our food supply and the performance of food crops. In recent years, whole genome sequencing and deep understanding of genetic and epigenetic mechanisms have facilitated new plant breeding approaches to meet the chalenge of growing population, dwindling re-sources, and changing climate. Here we proposed a simple and fast molecular breeding method, marker-assisted reverse breeding (MARB), which wil revert any maize hybrid into inbred lines with any level of required similarity to its original parent lines. Since al the pericarp DNA of a hybrid is from the maternal parent, whereas one half of the embryo DNA is from the maternal parent and the other half from the paternal parent, so we ifrstly extract DNA from seed embryo and pericarp of a selected elite hybrid separately and then we derived the genotypes of the two parents with high-density single nucleotide polymorphism (SNP) chips. The folowing marker-assisted selection was performed based on an Ilumina low-density SNP chip designed with 192 SNPs polymorphic between the two parental genotypes, which were uniformly distributed on 10 maize chromosomes. This method has the advantages of fast speed, ifxed heterotic mode, and quick recovery of beneifcial parental genotypes compared to traditional pedigree breeding using elite hybrids. Meanwhile, MARB has the advantage of not requiring sophisticated transformation and double haploid (DH) technologies over RNA interference (RNAi)-mediated reverse breeding. In addition, MARB can also be used with feed corn harvested from big farms, which is often similar to F2 populations, and the relevant transgenes in the population can be eliminated by marker-assisted selection. As a result, the whole global commercial maize hybrids can be utilized as germplasm for breeding with MARB technology. Starting with an F2 population derived from an elite hybrid, our experiment indicates that with three

  13. Ionic liquid-assisted formation of cellulose/calcium phosphate hybrid materials

    Science.gov (United States)

    Salama, Ahmed; Neumann, Mike; Günter, Christina

    2014-01-01

    Summary Cellulose/calcium phosphate hybrid materials were synthesized via an ionic liquid-assisted route. Scanning electron microscopy, transmission electron microscopy, energy-dispersive X-ray spectroscopy, X-ray diffraction, infrared spectroscopy, and thermogravimetric analysis/differential thermal analysis show that, depending on the reaction conditions, cellulose/hydroxyapatite, cellulose/chlorapatite, or cellulose/monetite composites form. Preliminary studies with MC3T3-E1 pre-osteoblasts show that the cells proliferate on the hybrid materials suggesting that the ionic liquid-based process yields materials that are potentially useful as scaffolds for regenerative therapies. PMID:25247137

  14. Ionic liquid-assisted formation of cellulose/calcium phosphate hybrid materials

    Directory of Open Access Journals (Sweden)

    Ahmed Salama

    2014-09-01

    Full Text Available Cellulose/calcium phosphate hybrid materials were synthesized via an ionic liquid-assisted route. Scanning electron microscopy, transmission electron microscopy, energy-dispersive X-ray spectroscopy, X-ray diffraction, infrared spectroscopy, and thermogravimetric analysis/differential thermal analysis show that, depending on the reaction conditions, cellulose/hydroxyapatite, cellulose/chlorapatite, or cellulose/monetite composites form. Preliminary studies with MC3T3-E1 pre-osteoblasts show that the cells proliferate on the hybrid materials suggesting that the ionic liquid-based process yields materials that are potentially useful as scaffolds for regenerative therapies.

  15. Hybrid PID and PSO-based control for electric power assist steering system for electric vehicle

    Science.gov (United States)

    Hanifah, R. A.; Toha, S. F.; Ahmad, S.

    2013-12-01

    Electric power assist steering (EPAS) system provides an important significance in enhancing the driving performance of a vehicle with its energy-conserving features. This paper presents a hybrid PID (Proportional-Integral-Derivative) and particle swarm optimization (PSO) based control scheme to minimize energy consumption for EPAS. This single objective optimization scheme is realized using the PSO technique in searching for best gain parameters of the PID controller. The fast tuning feature of this optimum PID controller produced high-quality solutions. Simulation results show the performance and effectiveness of the hybrid PSO-PID based controller as opposed to the conventional PID controller.

  16. Hybrid Rice Resistant to Bacterial Leaf Blight Developed By Marker Assisted Selection

    Institute of Scientific and Technical Information of China (English)

    CAO; Li-yong; ZHUANG; Jie-yun; YUAN; Shou-jiang; ZHAN; Xiao-deng; ZHENG; Kang-le; CHENG; Shi-hua

    2003-01-01

    Through recurrént backcrossing in combination with molecular marker-assisted selection (MAS), restorer lines R8006 and R1176 carrying Xa-21 , a gene having broad-spectrum resistance to rice bacterial leaf blight, were selected. By crossing the two lines to CMS line Zhong 9A, two new hybrid rice combinations, Zhongyou 6 and Zhongyou 1176 were developed. The hybrids showed high resistance to diseases, good grain quality and high yielding potential in national and provincial adaptability and yield trials.

  17. Development of hybrid solar-assisted cooling/heating system

    KAUST Repository

    Huang, B.J.

    2010-08-01

    A solar-assisted ejector cooling/heating system (SACH) was developed in this study. The SACH combines a pump-less ejector cooling system (ECS) with an inverter-type heat pump (R22) and is able to provide a stable capacity for space cooling. The ECS is driven by solar heat and is used to cool the condenser of the R22 heat pump to increase its COP and reduce the energy consumption of the compressor by regulating the rotational speed of the compressor through a control system. In a complete SACH system test run at outdoor temperature 35 °C, indoor temperature 25 °C and compressor speed 20-80 Hz, and the ECS operating at generator temperature 90 °C and condensing temperature 37 °C, the corresponding condensing temperature of the heat pump in the SACH is 24.5-42 °C, cooling capacity 1.02-2.44 kW, input power 0.20-0.98 kW, and cooling COPc 5.11-2.50. This indicates that the use of ECS in SACH can effectively reduce the condensing temperature of the heat pump by 12.6-7.3 °C and reduce the power consumption by 81.2-34.5%. The SACH can also supply heat from the heat pump. At ambient temperature from 5 °C to 35 °C, the heating COPh is in the range 2.0-3.3. © 2010 Elsevier Ltd. All rights reserved.

  18. Single axis controlled hybrid magnetic bearing for left ventricular assist device: hybrid core and closed magnetic circuit.

    Science.gov (United States)

    da Silva, Isaias; Horikawa, Oswaldo; Cardoso, Jose R; Camargo, Fernando A; Andrade, Aron J P; Bock, Eduardo G P

    2011-05-01

    In previous studies, we presented main strategies for suspending the rotor of a mixed-flow type (centrifugal and axial) ventricular assist device (VAD), originally presented by the Institute Dante Pazzanese of Cardiology (IDPC), Brazil. Magnetic suspension is achieved by the use of a magnetic bearing architecture in which the active control is executed in only one degree of freedom, in the axial direction of the rotor. Remaining degrees of freedom, excepting the rotation, are restricted only by the attraction force between pairs of permanent magnets. This study is part of a joint project in development by IDPC and Escola Politecnica of São Paulo University, Brazil. This article shows advances in that project, presenting two promising solutions for magnetic bearings. One solution uses hybrid cores as electromagnetic actuators, that is, cores that combine iron and permanent magnets. The other solution uses actuators, also of hybrid type, but with the magnetic circuit closed by an iron core. After preliminary analysis, a pump prototype has been developed for each solution and has been tested. For each prototype, a brushless DC motor has been developed as the rotor driver. Each solution was evaluated by in vitro experiments and guidelines are extracted for future improvements. Tests have shown good results and demonstrated that one solution is not isolated from the other. One complements the other for the development of a single-axis-controlled, hybrid-type magnetic bearing for a mixed-flow type VAD.

  19. Microwave-irradiation-assisted hybrid chemical approach for titanium dioxide nanoparticle synthesis: microbial and cytotoxicological evaluation.

    Science.gov (United States)

    Ranjan, Shivendu; Dasgupta, Nandita; Rajendran, Bhavapriya; Avadhani, Ganesh S; Ramalingam, Chidambaram; Kumar, Ashutosh

    2016-06-01

    Titanium dioxide nanoparticles (TNPs) are widely used in the pharmaceutical and cosmetics industries. It is used for protection against UV exposure due to its light-scattering properties and high refractive index. Though TNPs are increasingly used, the synthesis of TNPs is tedious and time consuming; therefore, in the present study, microwave-assisted hybrid chemical approach was used for TNP synthesis. In the present study, we demonstrated that TNPs can be synthesized only in 2.5 h; however, the commonly used chemical approach using muffle furnace takes 5 h. The activity of TNP depends on the synthetic protocol; therefore, the present study also determined the effect of microwave-assisted hybrid chemical approach synthetic protocol on microbial and cytotoxicity. The results showed that TNP has the best antibacterial activity in decreasing order from Escherichia coli, Bacillus subtilis, and Staphylococcus aureus. The IC50 values of TNP for HCT116 and A549 were found to be 6.43 and 6.04 ppm, respectively. Cell death was also confirmed from trypan blue exclusion assay and membrane integrity loss was observed. Therefore, the study determines that the microwave-assisted hybrid chemical approach is time-saving; hence, this technique can be upgraded from lab scale to industrial scale via pilot plant scale. Moreover, it is necessary to find the mechanism of action at the molecular level to establish the reason for greater bacterial and cytotoxicological toxicity. Graphical abstract A graphical representation of TNP synthesis.

  20. Hybrid procedure for total laryngectomy with a flexible robot-assisted surgical system.

    Science.gov (United States)

    Schuler, Patrick J; Hoffmann, Thomas K; Veit, Johannes A; Rotter, Nicole; Friedrich, Daniel T; Greve, Jens; Scheithauer, Marc O

    2017-06-01

    Total laryngectomy is a standard procedure in head-and-neck surgery for the treatment of cancer patients. Recent clinical experiences have indicated a clinical benefit for patients undergoing transoral robot-assisted total laryngectomy (TORS-TL) with commercially available systems. Here, a new hybrid procedure for total laryngectomy is presented. TORS-TL was performed in human cadavers (n = 3) using a transoral-transcervical hybrid procedure. The transoral approach was performed with a robotic flexible robot-assisted surgical system (Flex®) and compatible flexible instruments. Transoral access and visualization of anatomical landmarks were studied in detail. Total laryngectomy is feasible with a combined transoral-transcervical approach using the flexible robot-assisted surgical system. Transoral visualization of all anatomical structures is sufficient. The flexible design of the robot is advantageous for transoral surgery of the laryngeal structures. Transoral robot assisted surgery has the potential to reduce morbidity, hospital time and fistula rates in a selected group of patients. Initial clinical studies and further development of supplemental tools are in progress. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  1. Predicting Hybrid Performances for Quality Traits through Genomic-Assisted Approaches in Central European Wheat

    KAUST Repository

    Liu, Guozheng

    2016-07-06

    Bread-making quality traits are central targets for wheat breeding. The objectives of our study were to (1) examine the presence of major effect QTLs for quality traits in a Central European elite wheat population, (2) explore the optimal strategy for predicting the hybrid performance for wheat quality traits, and (3) investigate the effects of marker density and the composition and size of the training population on the accuracy of prediction of hybrid performance. In total 135 inbred lines of Central European bread wheat (Triticum aestivum L.) and 1,604 hybrids derived from them were evaluated for seven quality traits in up to six environments. The 135 parental lines were genotyped using a 90k single-nucleotide polymorphism array. Genome-wide association mapping initially suggested presence of several quantitative trait loci (QTLs), but cross-validation rather indicated the absence of major effect QTLs for all quality traits except of 1000-kernel weight. Genomic selection substantially outperformed marker-assisted selection in predicting hybrid performance. A resampling study revealed that increasing the effective population size in the estimation set of hybrids is relevant to boost the accuracy of prediction for an unrelated test population.

  2. Predicting Hybrid Performances for Quality Traits through Genomic-Assisted Approaches in Central European Wheat.

    Directory of Open Access Journals (Sweden)

    Guozheng Liu

    Full Text Available Bread-making quality traits are central targets for wheat breeding. The objectives of our study were to (1 examine the presence of major effect QTLs for quality traits in a Central European elite wheat population, (2 explore the optimal strategy for predicting the hybrid performance for wheat quality traits, and (3 investigate the effects of marker density and the composition and size of the training population on the accuracy of prediction of hybrid performance. In total 135 inbred lines of Central European bread wheat (Triticum aestivum L. and 1,604 hybrids derived from them were evaluated for seven quality traits in up to six environments. The 135 parental lines were genotyped using a 90k single-nucleotide polymorphism array. Genome-wide association mapping initially suggested presence of several quantitative trait loci (QTLs, but cross-validation rather indicated the absence of major effect QTLs for all quality traits except of 1000-kernel weight. Genomic selection substantially outperformed marker-assisted selection in predicting hybrid performance. A resampling study revealed that increasing the effective population size in the estimation set of hybrids is relevant to boost the accuracy of prediction for an unrelated test population.

  3. Doenças neuromusculares Neuromuscular disorders

    OpenAIRE

    Umbertina C. Reed

    2002-01-01

    Objetivo: apresentar os dados essenciais para o diagnóstico diferencial entre as principais doenças neuromusculares, denominação genérica sob a qual agrupam-se diferentes afecções, decorrentes do acometimento primário da unidade motora (motoneurônio medular, raiz nervosa, nervo periférico, junção mioneural e músculo). Fontes dos dados: os aspectos clínicos fundamentais para estabelecer o diagnóstico diferencial entre as diferentes doenças neuromusculares, bem como entre estas e as causas de h...

  4. EMG assisted optimization: a hybrid approach for estimating muscle forces in an indeterminate biomechanical model.

    Science.gov (United States)

    Cholewicki, J; McGill, S M

    1994-10-01

    There are two basic approaches to estimate individual muscle forces acting on a joint, given the indeterminacy of moment balance equations: optimization and electromyography (EMG) assisted. Each approach is characterized by unique advantages and liabilities. With this in mind, a new hybrid method which combines the advantages of both of these traditional approaches, termed 'EMG assisted optimization' (EMGAO), was described. In this method, minimal adjustments are applied to the individual muscle forces estimated from EMG, so that all moment equilibrium equations are satisfied in three dimensions. The result is the best possible match between physiologically observed muscle activation patterns and the predicted forces, while satisfying the moment constraints about all three joint axes. Several forms of the objective function are discussed and their effect on individual muscle adjustments is illustrated in a simple two-dimensional example.

  5. Neuromuscular disorders in pregnancy.

    Science.gov (United States)

    Guidon, Amanda C; Massey, E Wayne

    2012-08-01

    Preexisting and coincident neuromuscular disorders in pregnancy are challenging for clinicians because of the heterogeneity of disease and the limited data in the literature. Many questions arise regarding the effect of disease on the pregnancy, delivery, and newborn in addition to the effect of pregnancy on the course of disease. Each disorder has particular considerations and possible complications. An interdisciplinary team of physicians is essential. This article discusses the most recent literature on neuromuscular disorders in pregnancy including acquired root, plexus, and peripheral nerve lesions; acquired and inherited neuropathies and myopathies; disorders of the neuromuscular junction; and motor neuron diseases.

  6. Role of exact exchange in thermally-assisted-occupation density functional theory: A proposal of new hybrid schemes

    CERN Document Server

    Chai, Jeng-Da

    2016-01-01

    We propose hybrid schemes incorporating exact exchange into thermally-assisted-occupation density functional theory (TAO-DFT) [J.-D. Chai, J. Chem. Phys. 136, 154104 (2012)] for an improved description of nonlocal exchange effects. With a few simple modifications, global and range-separated hybrid functionals in Kohn-Sham density functional theory (KS-DFT) can be combined seamlessly with TAO-DFT. In comparison with global hybrid functionals in KS-DFT, the resulting global hybrid functionals in TAO-DFT yield promising performance for systems with strong static correlation effects (e.g., the H2 dissociation and electronic properties of linear acenes), while maintaining similar performance for systems without strong static correlation effects. Besides, a reasonably accurate description of noncovalent interactions can be efficiently achieved through the inclusion of dispersion corrections in hybrid TAO-DFT. Relative to TAO-DFAs (i.e., TAO-DFT with the conventional density functional approximations), global hybrid...

  7. Doenças neuromusculares Neuromuscular disorders

    Directory of Open Access Journals (Sweden)

    Umbertina C. Reed

    2002-08-01

    Full Text Available Objetivo: apresentar os dados essenciais para o diagnóstico diferencial entre as principais doenças neuromusculares, denominação genérica sob a qual agrupam-se diferentes afecções, decorrentes do acometimento primário da unidade motora (motoneurônio medular, raiz nervosa, nervo periférico, junção mioneural e músculo. Fontes dos dados: os aspectos clínicos fundamentais para estabelecer o diagnóstico diferencial entre as diferentes doenças neuromusculares, bem como entre estas e as causas de hipotonia muscular secundária ao comprometimento do sistema nervoso central ou a doenças sistêmicas não-neurológicas, são enfatizados, com base na experiência clínica vinda do atendimento a crianças com doenças neuromusculares durante os últimos 12 anos, no ambulatório de doenças neuromusculares do Hospital das Clínicas da Faculdade de Medicina, da Universidade de São Paulo. A revisão bibliográfica foi efetuada através do Medline e do periódico Neuromuscular Disorders, publicação oficial da World Muscle Society. Síntese dos dados: nas crianças, a maior parte destas afecções é geneticamente determinada, sendo as mais comuns a distrofia muscular progressiva ligada ao sexo, de Duchenne, a amiotrofia espinal infantil, a distrofia muscular congênita, a distrofia miotônica de Steinert, e as miopatias congênitas, estruturais e não estruturais. Polineuropatias hereditárias, síndrome miastênica congênita e miopatias metabólicas são menos comuns, porém mostram correlação geno-fenotípica cada vez mais precisa. Conclusões: na década passada, inúmeros avanços da genética molecular facilitaram imensamente o diagnóstico e o aconselhamento genético das doenças neuromusculares mais comuns das crianças, inclusive possibilitando diagnóstico fetal e, adicionalmente, vieram permitir melhor caracterização fenotípica e classificação mais objetiva.Objective: to discuss the most important aspects for performing a

  8. Universal quantum gates for photon-atom hybrid systems assisted by bad cavities.

    Science.gov (United States)

    Wang, Guan-Yu; Liu, Qian; Wei, Hai-Rui; Li, Tao; Ai, Qing; Deng, Fu-Guo

    2016-01-01

    We present two deterministic schemes for constructing a CNOT gate and a Toffoli gate on photon-atom and photon-atom-atom hybrid quantum systems assisted by bad cavities, respectively. They are achieved by cavity-assisted photon scattering and work in the intermediate coupling region with bad cavities, which relaxes the difficulty of their implementation in experiment. Also, bad cavities are feasible for fast quantum operations and reading out information. Compared with previous works, our schemes do not need any auxiliary qubits and measurements. Moreover, the schematic setups for these gates are simple, especially that for our Toffoli gate as only a quarter wave packet is used to interact the photon with each of the atoms every time. These atom-cavity systems can be used as the quantum nodes in long-distance quantum communication as their relatively long coherence time is suitable for multi-time operations between the photon and the system. Our calculations show that the average fidelities and efficiencies of our two universal hybrid quantum gates are high with current experimental technology.

  9. Steroidal neuromuscular blocking agents

    NARCIS (Netherlands)

    Wierda, JMKH; Mori, K; Ohmura, A; Toyooka, H; Hatano, Y; Shingu, K; Fukuda, K

    1998-01-01

    Since 1964 approximately 20 steroidal neuromuscular blocking agents have been evaluated clinically. Pancuronium, a bisquaternary compound designed on the drawingboard, was the first steroidal relaxant introduced into clinical practice worldwide in the 1970's. Although a major improvement, pancuroniu

  10. Simulation of Hybrid Photovoltaic Solar Assisted Loop Heat Pipe/Heat Pump System

    Directory of Open Access Journals (Sweden)

    Nannan Dai

    2017-02-01

    Full Text Available A hybrid photovoltaic solar assisted loop heat pipe/heat pump (PV-SALHP/HP water heater system has been developed and numerically studied. The system is the combination of loop heat pipe (LHP mode and heat pump (HP mode, and the two modes can be run separately or compositely according to the weather conditions. The performances of independent heat pump (HP mode and hybrid loop heat pipe/heat pump (LHP/HP mode were simulated and compared. Simulation results showed that on typical sunny days in spring or autumn, using LHP/HP mode could save 40.6% power consumption than HP mode. In addition, the optimal switchover from LHP mode to HP mode was analyzed in different weather conditions for energy saving and the all-year round operating performances of the system were also simulated. The simulation results showed that hybrid LHP/HP mode should be utilized to save electricity on sunny days from March to November and the system can rely on LHP mode alone without any power consumption in July and August. When solar radiation and ambient temperature are low in winter, HP mode should be used

  11. Potential Evaluation of Solar Heat Assisted Desiccant Hybrid Air Conditioning System

    Science.gov (United States)

    Tran, Thien Nha; Hamamoto, Yoshinori; Akisawa, Atsushi; Kashiwagi, Takao

    The solar thermal driven desiccant dehumidification-absorption cooling hybrid system has superior advantage in hot-humid climate regions. The reasonable air processing of desiccant hybrid air conditioning system and the utility of clean and free energy make the system environment friendly and energy efficient. The study investigates the performance of the desiccant dehumidification air conditioning systems with solar thermal assistant. The investigation is performed for three cases which are combinations of solar thermal and absorption cooling systems with different heat supply temperature levels. Two solar thermal systems are used in the study: the flat plate collector (FPC) and the vacuum tube with compound parabolic concentrator (CPC). The single-effect and high energy efficient double-, triple-effect LiBr-water absorption cooling cycles are considered for cooling systems. COP of desiccant hybrid air conditioning systems are determined. The evaluation of these systems is subsequently performed. The single effect absorption cooling cycle combined with the flat plate collector solar system is found to be the most energy efficient air conditioning system.

  12. Use of models in large-area forest surveys: comparing model-assisted, model-based and hybrid estimation

    Directory of Open Access Journals (Sweden)

    Göran Ståhl

    2016-02-01

    Full Text Available This paper focuses on the use of models for increasing the precision of estimators in large-area forest surveys. It is motivated by the increasing availability of remotely sensed data, which facilitates the development of models predicting the variables of interest in forest surveys. We present, review and compare three different estimation frameworks where models play a core role: model-assisted, model-based, and hybrid estimation. The first two are well known, whereas the third has only recently been introduced in forest surveys. Hybrid inference mixes designbased and model-based inference, since it relies on a probability sample of auxiliary data and a model predicting the target variable from the auxiliary data..We review studies on large-area forest surveys based on model-assisted, modelbased, and hybrid estimation, and discuss advantages and disadvantages of the approaches. We conclude that no general recommendations can be made about whether model-assisted, model-based, or hybrid estimation should be preferred. The choice depends on the objective of the survey and the possibilities to acquire appropriate field and remotely sensed data. We also conclude that modelling approaches can only be successfully applied for estimating target variables such as growing stock volume or biomass, which are adequately related to commonly available remotely sensed data, and thus purely field based surveys remain important for several important forest parameters. Keywords: Design-based inference, Model-assisted estimation, Model-based inference, Hybrid inference, National forest inventory, Remote sensing, Sampling

  13. Neuromuscular ultrasound findings in polyneuropathy secondary to disulfiram.

    Science.gov (United States)

    Stone, Sarah L; Cartwright, Michael S; Panea, Oana R; Vann, Ryan C; Magruder, John L; Walker, Francis O

    2014-12-01

    Disulfiram toxicity can cause multiple neurologic problems, including a reversible distal sensorimotor axonal polyneuropathy. Although electrodiagnosis and biopsy results have been described in the diagnosis and management of patients with disulfiram associated polyneuropathy, neuromuscular ultrasound findings have not been reported. The authors present a case of electrodiagnostically confirmed axonal polyneuropathy with relative sural sparing secondary to disulfiram and describe the neuromuscular ultrasound findings in this individual. Ultrasound demonstrated distal enlargement with slight side-to-side asymmetry and normal proximal cross-sectional area in the lower extremity nerves. Neuromuscular ultrasound is another diagnostic modality that may be used to assist in the diagnosis of patients with polyneuropathy secondary to disulfiram.

  14. Reproduction of continuous flow left ventricular assist device experimental data by means of a hybrid cardiovascular model with baroreflex control.

    Science.gov (United States)

    Fresiello, Libera; Zieliński, Krzysztof; Jacobs, Steven; Di Molfetta, Arianna; Pałko, Krzysztof Jakub; Bernini, Fabio; Martin, Michael; Claus, Piet; Ferrari, Gianfranco; Trivella, Maria Giovanna; Górczyńska, Krystyna; Darowski, Marek; Meyns, Bart; Kozarski, Maciej

    2014-06-01

    Long-term mechanical circulatory assistance opened new problems in ventricular assist device-patient interaction, especially in relation to autonomic controls. Modeling studies, based on adequate models, could be a feasible approach of investigation. The aim of this work is the exploitation of a hybrid (hydronumerical) cardiovascular simulator to reproduce and analyze in vivo experimental data acquired during a continuous flow left ventricular assistance. The hybrid cardiovascular simulator embeds three submodels: a computational cardiovascular submodel, a computational baroreflex submodel, and a hydronumerical interface submodel. The last one comprises two impedance transformers playing the role of physical interfaces able to provide a hydraulic connection with specific cardiovascular sites (in this article, the left atrium and the ascending/descending aorta). The impedance transformers are used to connect a continuous flow pump for partial left ventricular support (Synergy Micropump, CircuLite, Inc., Saddlebrooke, NJ, USA) to the hybrid cardiovascular simulator. Data collected from five animals in physiological, pathological, and assisted conditions were reproduced using the hybrid cardiovascular simulator. All parameters useful to characterize and tune the hybrid cardiovascular simulator to a specific hemodynamic condition were extracted from experimental data. Results show that the simulator is able to reproduce animal-specific hemodynamic status both in physiological and pathological conditions, to reproduce cardiovascular left ventricular assist device (LVAD) interaction and the progressive unloading of the left ventricle for different pump speeds, and to investigate the effects of the LVAD on baroreflex activity. Results in chronic heart failure conditions show that an increment of LVAD speed from 20 000 to 22 000 rpm provokes a decrement of left ventricular flow of 35% (from 2 to 1.3 L/min). Thanks to its flexibility and modular structure, the

  15. ANN based optimization of a solar assisted hybrid cooling system in Turkey

    Energy Technology Data Exchange (ETDEWEB)

    Ozgur, Arif; Yetik, Ozge; Arslan, Oguz [Mechanical Eng. Dept., Engineering Faculty, Dumlupinar University (Turkey)], email: maozgur@dpu.edu.tr, email: ozgeyetik@dpu.edu.tr, email: oarslan@dpu.edu.tr

    2011-07-01

    This study achieved optimization of a solar assisted hybrid cooling system with refrigerants such as R717, R141b, R134a and R123 using an artificial neural network (ANN) model based on average total solar radiation, ambient temperature, generator temperature, condenser temperature, intercooler temperature and fluid types. ANN is a new tool; it works rapidly and can thus be a solution for design and optimization of complex power cycles. A unique flexible ANN algorithm was introduced to evaluate the solar ejector cooling systems because of the nonlinearity of neural networks. The conclusion was that the best COPs value obtained with the ANN is 1.35 and COPc is 3.03 when the average total solar radiation, ambient temperature, generator temperature, condenser temperature, intercooler temperature and algorithm are respectively 674.72 W/m2, 17.9, 80, 15 and 13 degree celsius and LM with 14 neurons in single hidden layer, for R717.

  16. Hybrid quantum gates between flying photon and diamond nitrogen-vacancy centers assisted by optical microcavities

    Science.gov (United States)

    Wei, Hai-Rui; Lu Long, Gui

    2015-01-01

    Hybrid quantum gates hold great promise for quantum information processing since they preserve the advantages of different quantum systems. Here we present compact quantum circuits to deterministically implement controlled-NOT, Toffoli, and Fredkin gates between a flying photon qubit and diamond nitrogen-vacancy (NV) centers assisted by microcavities. The target qubits of these universal quantum gates are encoded on the spins of the electrons associated with the diamond NV centers and they have long coherence time for storing information, and the control qubit is encoded on the polarizations of the flying photon and can be easily manipulated. Our quantum circuits are compact, economic, and simple. Moreover, they do not require additional qubits. The complexity of our schemes for universal three-qubit gates is much reduced, compared to the synthesis with two-qubit entangling gates. These schemes have high fidelities and efficiencies, and they are feasible in experiment. PMID:26271899

  17. Electrochemical detection of protein based on hybridization chain reaction-assisted formation of copper nanoparticles.

    Science.gov (United States)

    Zhao, Jing; Hu, Suisui; Cao, Ya; Zhang, Bin; Li, Genxi

    2015-04-15

    In this paper, we report an electrochemical method for highly sensitive and specific detection of protein based on hybridization chain reaction (HCR)-assisted formation of copper nanoparticles by using small molecule such as folate-linked DNA as probe. In the presence of target protein, taking folate receptor (FR) as the model protein in this study, its binding with folate can protect the probe DNA from exonuclease I-catalyzed degradation, thus the probe DNA can be immobilized onto the electrode surface through the hybridization with capture DNA, triggering HCR on the electrode surface. Subsequently, copper nanoparticles can be formed on the electrode surface by using long duplex DNA oligomers from HCR as templates. Furthermore, copper ions released from acid-dissolution of copper nanoparticles can catalyze the oxidation of ο-phenylenediamine by dissolved oxygen, leading to significant electrochemical responses. As a result, our method can sensitively detect FR in the linear range from 0.01ng/mL to 100ng/mL with a detection limit of 3pg/mL. It can also specifically distinguish the target protein in both buffer and complex serum samples. Since many other proteins can be assayed by changing the corresponding small molecule, this method may be promising for the development of the technique for protein detections. Copyright © 2014 Elsevier B.V. All rights reserved.

  18. Hereditary neuromuscular diseases

    Energy Technology Data Exchange (ETDEWEB)

    Oezsarlak, O. E-mail: ozkan.ozsarlak@uza.be; Schepens, E.; Parizel, P.M.; Goethem, J.W. van; Vanhoenacker, F.; Schepper, A.M. de; Martin, J.J

    2001-12-01

    This article presents the actual classification of neuromuscular diseases based on present expansion of our knowledge and understanding due to genetic developments. It summarizes the genetic and clinical presentations of each disorder together with CT findings, which we studied in a large group of patients with neuromuscular diseases. The muscular dystrophies as the largest and most common group of hereditary muscle diseases will be highlighted by giving detailed information about the role of CT and MRI in the differential diagnosis. The radiological features of neuromuscular diseases are atrophy, hypertrophy, pseudohypertrophy and fatty infiltration of muscles on a selective basis. Although the patterns and distribution of involvement are characteristic in some of the diseases, the definition of the type of disease based on CT scan only is not always possible.

  19. Hybrid space heating/cooling system with Trombe wall, underground venting, and assisted heat pump

    Energy Technology Data Exchange (ETDEWEB)

    Shirley, J.W.; James, L.C.; Stevens, S.; Autry, A.N.; Nussbaum, M.; MacQueen, S.V.

    1983-06-22

    Our goal was to design and monitor a hybrid solar system/ground loop which automatically assists the standard, thermostatically controlled home heating/cooling system. The input from the homeowner was limited to normal thermostat operations. During the course of the project it was determined that to effectively gather data and control the various component interactions, a micro-computer based control system would also allow the HVAC system to be optimized by simple changes to software. This flexibility in an untested concept helped us to achieve optimum system performance. Control ranged from direct solar heating and direct ground loop cooling modes, to assistance of the heat pump by both solar space and ground loop. Sensors were strategically placed to provide data on response of the Trombe wall (surface, 4 in. deep, 8 in. deep), and the ground loop (inlet, 3/4 length, outlet). Micro-computer hardware and computer programs were developed to make cost effective decisions between the various modes of operation. Although recent advances in micro-computer hardware make similar control systems more readily achievable utilizing standard components, attention to the decision making criteria will always be required.

  20. Electrodiagnosis in neuromuscular disease.

    Science.gov (United States)

    Lipa, Bethany M; Han, Jay J

    2012-08-01

    Electromyography (EMG) is an important diagnostic tool for the assessment of individuals with various neuromuscular diseases. It should be an extension of a thorough history and physical examination. Some prototypical characteristics and findings of EMG and nerve conduction studies are discussed; however, a more thorough discussion can be found in the textbooks and resources sited in the article. With an increase in molecular genetic diagnostics, EMG continues to play an important role in the diagnosis and management of patients with neuromuscular diseases and also provides a cost-effective diagnostic workup before ordering a battery of costly genetic tests.

  1. Hybrid stent device of flow-diverting effect and stent-assisted coil embolization formed by fractal structure.

    Science.gov (United States)

    Kojima, Masahiro; Irie, Keiko; Masunaga, Kouhei; Sakai, Yasuhiko; Nakajima, Masahiro; Takeuchi, Masaru; Fukuda, Toshio; Arai, Fumihito; Negoro, Makoto

    2016-05-01

    This paper presents a novel hybrid medical stent device. This hybrid stent device formed by fractal mesh structures provides a flow-diverting effect and stent-assisted coil embolization. Flow-diverter stents decrease blood flow into an aneurysm to prevent its rupture. In general, the mesh size of a flow-diverter stent needs to be small enough to prevent blood flow into the aneurysm. Conventional flow-diverter stents are not available for stent-assisted coil embolization, which is an effective method for aneurysm occlusion, because the mesh size is too small to insert a micro-catheter for coil embolization. The proposed hybrid stent device is capable of stent-assisted coil embolization while simultaneously providing a flow-diverting effect. The fractal stent device is composed of mesh structures with fine and rough mesh areas. The rough mesh area can be used to insert a micro-catheter for stent-assisted coil embolization. Flow-diverting effects of two fractal stent designs were composed to three commercially available stent designs. Flow-diverting effects were analyzed using computational fluid dynamics (CFD) analysis and particle image velocimetry (PIV) experiment. Based on the CFD and PIV results, the fractal stent devices reduce the flow velocity inside an aneurism just as much as the commercially available flow-diverting stents while allowing stent-assisted coil embolization.

  2. Phenotypic and Marker-Assisted Genetic Enhancement of Parental Lines of Rajalaxmi, an Elite Rice Hybrid

    Science.gov (United States)

    Dash, Amit K.; Rao, Ravi N.; Rao, G. J. N.; Verma, Ram L.; Katara, Jawahar L.; Mukherjee, Arup K.; Singh, Onkar N.; Bagchi, Torit B.

    2016-01-01

    The cytoplasmic male sterile line system comprising CRMS 32A and its maintainer line CRMS 32B is a popular choice for the development of new hybrids in India as CRMS 32A, having Kalinga 1 cytoplasm (other than WA), is a viable alternative to WA cytoplasm. However, both lines are susceptible to bacterial blight (BB), a major disease on rice. As enhancement of host plant resistance is the most effective and economical strategy to control this disease, four resistance genes (Xa4, xa5, xa13, and Xa21) were transferred from a BB pyramid line of IR64, into the A and B lines using a marker-assisted backcrossing (MAB) breeding strategy. During the transfer of genes into CRMS 32B, foreground selection was applied using markers associated with the genes, and plants having resistance alleles of the donor, are selected. Selection for morphological and quality traits was practiced to select plants similar to the recurrent parent. The four gene and three gene pyramid lines exhibited high levels of resistance against the BB pathogen when challenged with eight virulent isolates. Using genome wide based SSR markers for background selection, pyramids having >95% of the recurrent parent genome were identified. With CRMS 32B gene pyramid as donor, the four resistance genes were transferred into the A line through repeated backcrosses and the A line pyramids also exhibited high level of resistance against BB. Through a combination of selection at phenotypic and molecular levels, four BB resistance genes were successfully introduced into two parental lines (CRMS 32 B and A) of Rajalaxmi, an elite popular hybrid. The pyramided B lines did exhibit high levels of resistance against BB. Selection for morphological and quality traits and background selection hastened the recovery of the recurrent parent genome in the recombinants. Through repeated backcrosses, all the four resistance genes were transferred to CRMS 32A and test crosses suggest that the maintenance ability of the improved CRMS

  3. Phenotypic and marker-assisted genetic enhancement of parental lines of Rajalaxmi, an elite rice hybrid.

    Directory of Open Access Journals (Sweden)

    Amit Kumar Dash

    2016-07-01

    Full Text Available The cytoplasmic male sterile line system comprising CRMS 32A and its maintainer line CRMS 32B is a popular choice for the development of new hybrids in India as CRMS 32A, having Kalinga 1 cytoplasm (other than WA, is a viable alternative to WA cytoplasm. However, both lines are susceptible to bacterial blight (BB, a major disease on rice. As enhancement of host plant resistance is the most effective and economical strategy to control this disease, four resistance genes (Xa4, xa5, xa13 and Xa21 were transferred from a BB pyramid line of IR64, into the A and B lines using a marker-assisted backcrossing (MAB breeding strategy. During the transfer of genes into CRMS 32B, foreground selection was applied using markers associated with the genes, and plants having resistance alleles of the donor, are selected. Selection for morphological and quality traits was practiced to select plants similar to the recurrent parent. The four gene and three gene pyramid lines exhibited high levels of resistance against the BB pathogen when challenged with eight virulent isolates. Using genome wide based SSR markers for background selection, pyramids having >95% of the recurrent parent genome were identified. With CRMS 32B gene pyramid as donor, the four resistance genes were transferred into the A line through repeated backcrosses and the A line pyramids also exhibited high level of resistance against BB. Through a combination of selection at phenotypic and molecular levels, four bacterial blight resistance genes were successfully introduced into two parental lines (CRMS 32 B and A of Rajalaxmi, an elite popular hybrid. The pyramided B lines did exhibit high levels of resistance against BB. Selection for morphological and quality traits and background selection hastened the recovery of the recurrent parent genome in the recombinants. Through repeated backcrosses, all the four resistance genes were transferred to CRMS 32A and test crosses suggest that the maintenance

  4. Throttleable GOX/ABS launch assist hybrid rocket motor for small scale air launch platform

    Science.gov (United States)

    Spurrier, Zachary S.

    Aircraft-based space-launch platforms allow operational flexibility and offer the potential for significant propellant savings for small-to-medium orbital payloads. The NASA Armstrong Flight Research Center's Towed Glider Air-Launch System (TGALS) is a small-scale flight research project investigating the feasibility for a remotely-piloted, towed, glider system to act as a versatile air launch platform for nano-scale satellites. Removing the crew from the launch vehicle means that the system does not have to be human rated, and offers a potential for considerable cost savings. Utah State University is developing a small throttled launch-assist system for the TGALS platform. This "stage zero" design allows the TGALS platform to achieve the required flight path angle for the launch point, a condition that the TGALS cannot achieve without external propulsion. Throttling is required in order to achieve and sustain the proper launch attitude without structurally overloading the airframe. The hybrid rocket system employs gaseous-oxygen and acrylonitrile butadiene styrene (ABS) as propellants. This thesis summarizes the development and testing campaign, and presents results from the clean-sheet design through ground-based static fire testing. Development of the closed-loop throttle control system is presented.

  5. The Training Effect of Early Intervention with a Hybrid Assistive Limb after Total Knee Arthroplasty

    Directory of Open Access Journals (Sweden)

    Takashi Fukaya

    2017-01-01

    Full Text Available After total knee arthroplasty (TKA, it is important for patients to show early improvements in knee joint function and walking to regain independence in performing the activities of daily life. We conducted for 4 weeks an intervention one week after TKA using a hybrid assistive limb (HAL: unilateral leg type as an exoskeleton robotic device to facilitate knee joint function and walking. The intervention improved the range of knee extension movement safely and without pain compared to preoperation. In addition, we found that training with the HAL improved walking ability, speed, and rate, as well as the time taken to perform the timed up and go (TUG test compared to preoperation. The strength of the quadriceps muscle did not improve with training; however, the patient was able to induce a knee extensor moment during the initial stance phase, as measured by kinetics and kinematics, and these actions could be performed without pain. HAL training soon after TKA improved knee joint function in a 76-year-old patient who presented with OA of the knee. The improvements in knee extension lag and knee extensor moment allowed the patient to walk without pain and regain ADL in comparison with preoperation.

  6. Clinical application of the Hybrid Assistive Limb (HAL for gait training - a systematic review.

    Directory of Open Access Journals (Sweden)

    Anneli eWall

    2015-03-01

    Full Text Available Objective: The aim of this study was to review the literature on clinical applications of the Hybrid Assistive Limb system for gait training.Methods: A systematic literature search was conducted using Web of Science, PubMed, CINAHL and clinicaltrials.gov and additional search was made using reference lists in identified reports. Abstracts were screened, relevant articles were reviewed and subject to quality assessment. Results: Out of 37 studies, 7 studies fulfilled inclusion criteria. Six studies were single group studies and 1 was an explorative randomized controlled trial. In total, these studies involved 140 participants of whom 118 completed the interventions and 107 used HAL for gait training. Five studies concerned gait training after stroke, 1 after spinal cord injury (SCI and 1 study after stroke, SCI or other diseases affecting walking ability. Minor and transient side effects occurred but no serious adverse events were reported in the studies. Beneficial effects on gait function variables and independence in walking were observed.Conclusions: The accumulated findings demonstrate that the HAL system is feasible when used for gait training of patients with lower extremity paresis in a professional setting. Beneficial effects on gait function and independence in walking were observed but data do not allow conclusions. Further controlled studies are recommended.

  7. White-light emission by phonon assisted coherent mixing of excitons in Au8-CdS hybrid nanorods

    Science.gov (United States)

    Rath, S.; Halder, O.; Pradhani, A.; Satpati, B.; Maity, A.; Chini, T. K.; Gogurla, N.; Ray, S. K.

    2016-12-01

    Gold cluster (Au8) coated CdS hybrid nanorods (HNRs), synthesized using a sonication assisted assembly route, exhibit phonon assisted coherent mixing of excitons. As observed from optical absorption, Raman scattering, x-ray diffraction and transmission electron microscopic studies, the Au8 modulates the crystal—and electronic—structure of the CdS nanorods, effecting enhancement of exciton-phonon (e-p) interactions. The e-p interaction and entropy effect mediated phase matching of the excitonic transitions, leading—via cooperative and coherent mixing of the excitons’ color—to the emission of white light, has been confirmed from room temperature and time resolved photoluminescence measurements.

  8. Enhancing prospective chemistry teachers cognitive structures in the topics of bonding and hybridization by internet-assisted chemistry applications

    OpenAIRE

    Özge Özyalçın Oskay, Sinem Dinçol

    2011-01-01

    The purpose of this study is to determine the effects of internet-assisted chemistry applications on prospective chemistry teachers’ cognitive structures in the topics of bonding and hybridization. The sample of the study consisted of 36 prospective chemistry teachers attending Hacettepe University, Faculty of Education, the Department of Chemistry Education in 2010-2011 academic year and taking Basic Chemistry I lesson. In the study, students were separated into experimental and control gr...

  9. [Characteristics of neuromuscular scoliosis].

    Science.gov (United States)

    Putzier, M; Groß, C; Zahn, R K; Pumberger, M; Strube, P

    2016-06-01

    Usually, neuromuscular scolioses become clinically symptomatic relatively early and are rapidly progressive even after the end of growth. Without sufficient treatment they lead to a severe reduction of quality of life, to a loss of the ability of walking, standing or sitting as well as to an impairment of the cardiopulmonary system resulting in an increased mortality. Therefore, an intensive interdisciplinary treatment by physio- and ergotherapists, internists, pediatricians, orthotists, and orthopedists is indispensable. In contrast to idiopathic scoliosis the treatment of patients with neuromuscular scoliosis with orthosis is controversially discussed, whereas physiotherapy is established and essential to prevent contractures and to maintain the residual sensorimotor function.Frequently, the surgical treatment of the scoliosis is indicated. It should be noted that only long-segment posterior correction and fusion of the whole deformity leads to a significant improvement of the quality of life as well as to a prevention of a progression of the scoliosis and the development of junctional problems. The surgical intervention is usually performed before the end of growth. A prolonged delay of surgical intervention does not result in an increased height but only in a deformity progression and is therefore not justifiable. In early onset neuromuscular scolioses guided-growth implants are used to guarantee the adequat development. Because of the high complication rates, further optimization of these implant systems with regard to efficiency and safety have to be addressed in future research.

  10. Investigation of Embedded Si/C System Exposed to a Hybrid Reaction of Centrifugal-Assisted Thermite Method.

    Directory of Open Access Journals (Sweden)

    Reza Mahmoodian

    Full Text Available A novel method is proposed to study the behavior and phase formation of a Si+C compacted pellet under centrifugal acceleration in a hybrid reaction. Si+C as elemental mixture in the form of a pellet is embedded in a centrifugal tube. The pellet assembly and tube are exposed to the sudden thermal energy of a thermite reaction resulted in a hybrid reaction. The hybrid reaction of thermite and Si+C produced unique phases. X-ray diffraction pattern (XRD as well as microstructural and elemental analyses are then investigated. XRD pattern showed formation of materials with possible electronic and magnetic properties. The cooling rate and the molten particle viscosity mathematical model of the process are meant to assist in understanding the physical and chemical phenomena took place during and after reaction. The results analysis revealed that up to 85% of materials converted into secondary products as ceramics-matrix composite.

  11. Enzyme-free and isothermal detection of microRNA based on click-chemical ligation-assisted hybridization coupled with hybridization chain reaction signal amplification.

    Science.gov (United States)

    Oishi, Motoi

    2015-05-01

    An enzyme-free and isothermal microRNA (miRNA) detection method has been developed based on click-chemical ligation-assisted hybridization coupled with hybridization chain reaction (HCR) on magnetic beads (MBs). The click-chemical ligation between an azide-modified probe DNA and a dibenzocyclooctyne-modified probe DNA occurred through the hybridization of target miRNA (miR-141). HCR on MBs was performed by the addition of DNA hairpin monomers (H1 and H2). After magnetic separation and denaturation/rehybridization of HCR products ([H1/H2] n ), the resulting HCR products were analyzed by the fluorescence emitted from an intercalative dye, allowing amplification of the fluorescent signal. The proposed assay had a limit of detection of 0.55 fmol, which was 230-fold more sensitive than that of the HCR on the MBs coupled with a conventional sandwich hybridization assay (without click-chemical ligation) (limit of detection 127 fmol). Additionally, the proposed assay could discriminate between miR-141 and other miR-200 family members. In contrast to quantitative reverse transcription polymerase chain reaction techniques using enzymes and thermal cycling, this is an enzyme-free assay that can be conducted under isothermal conditions and can specifically detect miR-141 in fetal bovine serum.

  12. Development of β-carotene rich maize hybrids through marker-assisted introgression of β-carotene hydroxylase allele.

    Directory of Open Access Journals (Sweden)

    Vignesh Muthusamy

    Full Text Available Development of vitamin A-rich cereals can help in alleviating the widespread problem of vitamin A deficiency. We report here significant enhancement of kernel β-carotene in elite maize genotypes through accelerated marker-assisted backcross breeding. A favourable allele (543 bp of the β-carotene hydroxylase (crtRB1 gene was introgressed in the seven elite inbred parents, which were low (1.4 µg/g in kernel β-carotene, by using a crtRB1-specific DNA marker for foreground selection. About 90% of the recurrent parent genome was recovered in the selected progenies within two backcross generations. Concentration of β-carotene among the crtRB1-introgressed inbreds varied from 8.6 to 17.5 µg/g - a maximum increase up to 12.6-fold over recurrent parent. The reconstituted hybrids developed from improved parental inbreds also showed enhanced kernel β-carotene as high as 21.7 µg/g, compared to 2.6 µg/g in the original hybrid. The reconstituted hybrids evaluated at two locations possessed similar grain yield to that of original hybrids. These β-carotene enriched high yielding hybrids can be effectively utilized in the maize biofortification programs across the globe.

  13. Against the odds: what to expect in rehabilitation of chronic spinal cord injury with a neurologically controlled Hybrid Assistive Limb exoskeleton. A subgroup analysis of 55 patients according to age and lesion level.

    Science.gov (United States)

    Grasmücke, Dennis; Zieriacks, Amrei; Jansen, Oliver; Fisahn, Christian; Sczesny-Kaiser, Matthias; Wessling, Martin; Meindl, Renate C; Schildhauer, Thomas A; Aach, Mirko

    2017-05-01

    Objective Age and lesion level are believed to represent outcome predictors in rehabilitation of patients with chronic spinal cord injury (SCI). The Hybrid Assistive Limb (HAL) exoskeleton enables patients to perform a voluntary controlled gait pattern via an electromyography-triggered neuromuscular feedback system, and has been introduced as a temporary gait training tool in patients with SCI. The aim of this prospective pre- and postintervention study was to examine functional outcomes as a function of age and lesion level in patients with chronic incomplete SCI (iSCI) or chronic complete SCI (cSCI) with zones of partial preservation (ZPP) by using the HAL as a temporary training tool. Methods Fifty-five participants with chronic iSCI or cSCI (mean time since injury 6.85 ± 5.12 years) were classified according to the American Spinal Injury Association (ASIA) Impairment Scale (AIS) and divided by age (exoskeleton. An improvement of approximately 50% in the 10MWTsss and in gait endurance (6MinWT) can be expected from such training. The influences of SCI lesion level and age on functional outcome were nonsignificant in the present study. Older age (≥ 50 years) may be associated with smaller improvements in the 10MWTsss. An iSCI in paraplegic patients with spastic motor behavior may be a nonsignificant negative predictor in gait endurance improvements. Clinical trial registration no.: DRKS00010250 ( https://drks-neu.uniklinik-freiburg.de/drks_web/setLocale_DE.do ).

  14. Enhancing prospective chemistry teachers cognitive structures in the topics of bonding and hybridization by internet-assisted chemistry applications

    Directory of Open Access Journals (Sweden)

    Özge Özyalçın Oskay, Sinem Dinçol

    2011-08-01

    Full Text Available The purpose of this study is to determine the effects of internet-assisted chemistry applications on prospective chemistry teachers’ cognitive structures in the topics of bonding and hybridization. The sample of the study consisted of 36 prospective chemistry teachers attending Hacettepe University, Faculty of Education, the Department of Chemistry Education in 2010-2011 academic year and taking Basic Chemistry I lesson. In the study, students were separated into experimental and control groups according to their pre-cognitive structures. Students were requested to answer two open ended questions. Answers by each student were gathered and evaluated by flow map method. “Bonding and hybridization” topics were taught to control group with traditional teaching method and to experimental group besides traditional method internet-assisted applications were conducted. The same open-ended questions were given to both groups and their cognitive structures were examined once more. The differences between control and experimental groups’ cognitive structures were examined. A significant difference was identified in favour of experimental group (p<0, 05. The mean score of the Experimental group was X=19.94, and the mean score of the Control group was X=13.88. In addition, subsequent to internet assisted chemistry applications differences in terms of concepts and descriptions in prospective chemistry teachers’ in experimental and control group cognitive structure have been determined. When post flow maps of prospective chemistry teachers in experimental group, on whom internet assisted chemistry applications were made, are formed, it has been determined that there are more statements about hybridization, hybridization types, molecule geometry and bond angles compared to control grou

  15. [Transition experience of patients with neuromuscular disease].

    Science.gov (United States)

    Greif, Valeria; Ugo, Florencia; de Castro Pérez, M Fernanda; Mozzoni, Julieta; Aguerre, Verónica; Saldías, Milagros; Monges, M Soledad

    2017-02-01

    Neuromuscular diseases are mostly genetic disorders, with chronic and progressive course. Affected people are at high risk of developing physical and emotional disabilities. In the last decades, the advance in technology and science has increased chronic pediatric patients survival rate, thus requiring an ongoing assistance in adult hospitals, making the transition a necessity and a challenge. This article reports the clinical practice designed between Hospital Garrahan and Hospital Ramos Mejía for the transition of 27 adolescents during 2015, setting achievements, findings and challenges resulting from this experience.

  16. [Organization of therapeutic aid to patients with hereditary neuromuscular diseases].

    Science.gov (United States)

    Kalinin, V A; Temin, P A; Arkhipov, B A; Zavadenko, N N

    1989-01-01

    The paper summarizes experience gained for many years by the All-Union Research Methodological Center for Study of Hereditary Neuromuscular Diseases. The specialists of the Center render counselling and therapeutic assistance to patients afflicted with neuromuscular diseases. The counselling and diagnostic services are characterized by the fact that it is based on the activity of a large hospital intended for the treatment of various diseases. The problems which are being solved by the out- and inpatient services of the Center are considered in detail. The advantages of the setting up of the common in- and outpatient complex on the basis of the hospital intended for the treatment of various diseases are described.

  17. Neuromuscular complications of acromegaly.

    Science.gov (United States)

    Pickett, J B; Layzer, R B; Levin, S R; Scheider, V; Campbell, M J; Sumner, A J

    1975-07-01

    Seventeen consecutive acromegalic patients were evaluated for evidence of neuromuscular dysfunction and followed for 1 year after hypophysectomy. Before treatment, four patients had both a myopathy and the carpal tunnel syndrome, five had myopathy alone, four had carpal tunnel syndrome alone, and four had neither. The myopathy was caracterized by mild, strictly promixal weakness and flabbiness of muscles; electromyography revealed typical myopathic abnormalities, but serum enzymes and muscle biopsy usually were normal. The presence of myopathy or the carpal tunnel syndrrome could not be correlated with the magnitude of growth hormone elevation or any secondary endocrine derangement, but myopathy was associated with a longer duration of acromegaly. Carpal tunnel symptoms usually improved in the first 6 weeks after hypophysectomy, while myopathy improved more slowly and sometimes was detectable 1 year later.

  18. Plasmon assisted enhanced second-harmonic generation in single hybrid Au/ZnS nanowires

    Science.gov (United States)

    Jassim, Nadia M.; Wang, Kai; Han, Xiaobo; Long, Hua; Wang, Bing; Lu, Peixiang

    2017-02-01

    We demonstrate the enhanced second-harmonic generation (SHG) in single ZnS nanowires (NWs) attached with gold nanoparticles (Au NPs). The hybrid Au/ZnS NWs with different densities of the attached Au NPs were prepared by a simple solution impregnation method. By comparing with bare ZnS NWs, ∼1.3, ∼6.6, ∼7 and ∼2 times enhancement of SH intensity was achieved in the hybrid Au/ZnS NWs with low, moderate, high and ultrahigh densities of the attached Au NPs, respectively. The enhanced SHG in the hybrid Au/ZnS NWs is attributed to the strong local-fields from the Au cluster under the near-resonant condition, which is supported by the related dark-field scattering spectra. This hybrid Au/ZnS NWs provide a simple platform for enhancing nonlinear optical responses, which have potential applications in nano-probing and nano-sensing.

  19. A new transcutaneous energy transmission system with hybrid energy coils for driving an implantable biventricular assist device.

    Science.gov (United States)

    Okamoto, Eiji; Yamamoto, Yoshiro; Akasaka, Yuhta; Motomura, Tadashi; Mitamura, Yoshinori; Nosé, Yukihiko

    2009-08-01

    We have developed a new transcutaneous energy transmission (TET) system for a totally implantable biventricular assist device (BVAD) system in the New Energy and Industrial Development Organization (NEDO) artificial heart project. The TET system mainly consists of an energy transmitter, a hybrid energy coil unit, an energy receiver, an internal battery system, and an optical telemetry system. The hybrid energy coil unit consists of an air-core energy transmission coil and an energy-receiving coil having a ferrite core. Internal units of the TET system are encapsulated in a titanium alloy casing, which has a size of 111 mm in width, 73 mm in length, and 25 mm in height. In in vitro experiments, the TET system can transmit a maximum electric energy of 60 Watts, and it has a maximum transmission efficiency of 87.3%. A maximum surface temperature of 46.1 degrees C was measured at the ferrite core of the energy-receiving coil during an energy transmission of 20 Watts in air. The long-term performance test shows that the TET system has been able to operate stably for over 4 years with a decrease of energy-transmission efficiency from 85% to 80%. In conclusion, the TET system with the hybrid energy coil can overcome the drawback of previously reported TET systems, and it promises to be the highest performance TET system in the world.

  20. Neuromuscular retraining for facial paralysis.

    Science.gov (United States)

    Diels, H J; Combs, D

    1997-10-01

    Neuromuscular retraining is an effective method for rehabilitating facial musculature in patients with facial paralysis. This nonsurgical therapy has demonstrated improved functional outcomes and is an important adjunct to surgical treatment for restoring facial movement. Treatment begins with an intensive clinical evaluation and incorporates appropriate sensory feedback techniques into a patient-specific, comprehensive, home therapy program. This article discusses appropriate patients, timelines for referral, and basic treatment practices of facial neuromuscular retraining for restoring function and expression to the highest level possible.

  1. Ultrasensitive Cracking-Assisted Strain Sensors Based on Silver Nanowires/Graphene Hybrid Particles.

    Science.gov (United States)

    Chen, Song; Wei, Yong; Wei, Siman; Lin, Yong; Liu, Lan

    2016-09-28

    Strain sensors with ultrahigh sensitivity under microstrain have numerous potential applications in heartbeat monitoring, pulsebeat detection, sound signal acquisition, and recognition. In this work, a two-part strain sensor (i.e., polyurethane part and brittle conductive hybrid particles layer on top) based on silver nanowires/graphene hybrid particles is developed via a simple coprecipitation, reduction, vacuum filtration, and casting process. Because of the nonuniform interface, weak interfacial bonding, and the hybrid particles' point-to-point conductive networks, the crack and overlap morphologies are successfully formed on the strain sensor after a prestretching; the crack-based stain sensor exhibits gauge factors as high as 20 (Δε sensor. Combined with its good response to bending, high strain resolution, and high working stability, the developed strain sensor is promising in the applications of electronic skins, motion sensors, and health monitoring sensors.

  2. An easy two-step microwave assisted synthesis of SnO2/CNT hybrids

    CSIR Research Space (South Africa)

    Motshekga, SC

    2011-11-01

    Full Text Available -ray diffraction, Raman spectroscopy, high resolution transmission electron microscopy, BET surface area analysis and DC conductivity measurement. The results showed that the microwave assisted synthesis is a very efficient method in producing CNTs that are heavily...

  3. Surface plasmon-assisted optical bistability in the quantum dot-metal nanoparticle hybrid system

    Science.gov (United States)

    Bao, Chengjun; Qi, Yihong; Niu, Yueping; Gong, Shangqing

    2016-07-01

    We theoretically investigated optical bistability (OB) of a coupled excition-plasmon hybrid system in a unidirectional ring cavity. It is found that the threshold and the region of OB can be tuned by adjusting the center-center distance between the quantum dot and metal nanoparticle (MNP), the Rabi frequency of the control field and the radius of the MNP. Due to the significantly enhanced optical nonlinearity by the surface plasmon effect, the threshold of OB can be decreased greatly when the probe field is parallel to the major axis of the hybrid system. The enhanced OB may have promising applications in optical switching and optical storage.

  4. Neuromuscular disease and hypoventilation.

    Science.gov (United States)

    Sivak, E D; Shefner, J M; Sexton, J

    1999-11-01

    Alveolar hypoventilation associated with neuromuscular disease can occur in acute and chronic forms. In the acute form, progressive weakness of respiratory muscles leads to rapid reduction in vital capacity followed by respiratory failure with hypoxemia and hypercarbia. Symptoms are those of acute respiratory failure, including dyspnea, tachypnea, and tachycardia. In the chronic form, impairment of the respiratory muscles affects mechanical properties of the lungs and chest wall, decreases the ability to clear secretions, and eventually may alter the function of the central respiratory centers. Symptoms include orthopnea, fatigue, disturbed sleep, and hypersomnolence. Treatment and outcome of the disease's chronic form are dependent on the underlying clinical cause of the alveolar hypoventilation. For chronic but stable diseases such as old polio, quadriplegia, or kyposcoliosis, mechanical support of minute ventilation can reverse symptoms. For chronic and progressive disease such as muscular dystrophy and amyotrophic lateral sclerosis, mechanical support of minute ventilation provides only symptomatic relief and is usually associated with deterioration to the point of complete ventilator dependency for survival. For the chronic progressive forms of alveolar hypoventilation, there is currently a need for quality randomized controlled clinical trials to define physiologic indicators and appropriate timing for mechanical support of minute ventilation.

  5. Neuromuscular disease classification system

    Science.gov (United States)

    Sáez, Aurora; Acha, Begoña; Montero-Sánchez, Adoración; Rivas, Eloy; Escudero, Luis M.; Serrano, Carmen

    2013-06-01

    Diagnosis of neuromuscular diseases is based on subjective visual assessment of biopsies from patients by the pathologist specialist. A system for objective analysis and classification of muscular dystrophies and neurogenic atrophies through muscle biopsy images of fluorescence microscopy is presented. The procedure starts with an accurate segmentation of the muscle fibers using mathematical morphology and a watershed transform. A feature extraction step is carried out in two parts: 24 features that pathologists take into account to diagnose the diseases and 58 structural features that the human eye cannot see, based on the assumption that the biopsy is considered as a graph, where the nodes are represented by each fiber, and two nodes are connected if two fibers are adjacent. A feature selection using sequential forward selection and sequential backward selection methods, a classification using a Fuzzy ARTMAP neural network, and a study of grading the severity are performed on these two sets of features. A database consisting of 91 images was used: 71 images for the training step and 20 as the test. A classification error of 0% was obtained. It is concluded that the addition of features undetectable by the human visual inspection improves the categorization of atrophic patterns.

  6. Reduced leakage current and improved ferroelectricity in magneto-electric composite ceramics prepared with microwave assisted radiant hybrid sintering

    Directory of Open Access Journals (Sweden)

    Sanjay Kumar Upadhyay

    2015-04-01

    Full Text Available Structural, electrical and magnetic properties of magneto-electric composite ceramics viz., 0.9 BaTi0.95Sn0.05O3 (BTSO- 0.1 Ni0.8Zn0.2Fe2O4 (NZFO prepared with microwave assisted radiant hybrid sintering (MARH are reported. Phase purity and isovalent substitution of Ti4+ by Sn4+ of the samples is confirmed from x-ray diffraction and 119Sn Mossbauer measurements respectively. Significant suppression of leakage current and improvement of ferroelectricity is observed for the composites prepared with MARH. The observed results are explained in terms of uniform dispersion of ferrite (NZFO phase in the ferroelectric (BTSO matrix as evidenced from back-scattered scanning electron micrographs.

  7. Label-free quantification of microRNAs using ligase-assisted sandwich hybridization on a DNA microarray.

    Directory of Open Access Journals (Sweden)

    Taro Ueno

    Full Text Available MicroRNAs (miRNAs can be used as biomarkers for cancer and other human diseases; therefore, high-throughput and reliable miRNA-quantification methods are required to exploit these markers for diagnostic testing. In this report, we describe the construction of a platform for miRNA-quantification using ligase-assisted sandwich hybridization (LASH without miRNA-labeling. T4 DNA ligase was used to compensate for the low affinity between miRNAs and two short complementary DNA probes, and it improved the hybridization yield ∼50,000 times. The LASH assay enabled synthesized miR-143 to be quantified at concentrations ranging from 30 fM to 30 pM. The LASH assay could also quantify endogenous miR-143 released from cultured cells as well as some miRNAs in total RNAs derived from blood. Furthermore, multi-color detection enabled us to distinguish between the highly homologous miR-141 and miR-200a. This simple label-free quantification technique is an easy-to-use approach that can be applied to disease diagnosis.

  8. Integrated design and analysis of smart actuators for hybrid assistive knee bracese-fla

    Science.gov (United States)

    Guo, H. T.; Liao, W. H.

    2009-03-01

    The objective of this paper is to develop smart actuators for knee braces as assistive devices for helping disabled people to recover their mobility. The actuator functions as motor, clutch, and brake. In the design, magnetorheological (MR) fluids are utilized to generate controllable torque. To decrease the size of the actuator, motor and MR fluids are integrated. MR fluids are filled inside the DC motor based actuator. Additional design factors of smart actuators including influence of permanent magnet on MR fluids and dynamic sealing are also considered. Finite element model of the smart actuator is built and analyzed. A prototype of the smart actuator with two different inner armatures is fabricated and their characteristics are investigated. Torques are compared between simulation and experiments. The results show that the developed smart actuator with multiple functions is promising for assistive knee braces.

  9. Doenças neuromusculares

    OpenAIRE

    Umbertina C. Reed

    2002-01-01

    Objetivo: apresentar os dados essenciais para o diagnóstico diferencial entre as principais doenças neuromusculares, denominação genérica sob a qual agrupam-se diferentes afecções, decorrentes do acometimento primário da unidade motora (motoneurônio medular, raiz nervosa, nervo periférico, junção mioneural e músculo). Fontes dos dados: os aspectos clínicos fundamentais para estabelecer o diagnóstico diferencial entre as diferentes doenças neuromusculares, bem como entre estas e as causas de h...

  10. Doenças neuromusculares

    OpenAIRE

    Umbertina C. Reed

    2002-01-01

    Objetivo: apresentar os dados essenciais para o diagnóstico diferencial entre as principais doenças neuromusculares, denominação genérica sob a qual agrupam-se diferentes afecções, decorrentes do acometimento primário da unidade motora (motoneurônio medular, raiz nervosa, nervo periférico, junção mioneural e músculo). Fontes dos dados: os aspectos clínicos fundamentais para estabelecer o diagnóstico diferencial entre as diferentes doenças neuromusculares, bem como entre estas e as causas de h...

  11. Neuromuscular control: introduction and overview.

    Science.gov (United States)

    van Leeuwen, J L

    1999-05-29

    This paper introduces some basic concepts of the interdisciplinary field of neuromuscular control, without the intention to be complete. The complexity and multifaceted nature of neuromuscular control systems is briefly addressed. Principles of stability and planning of motion trajectories are discussed. Closed-loop and open-loop control are considered, together with the inherent stability properties of muscles and the geometrical design of animal bodies. Various modelling approaches, as used by several authors in the Philosophical Transactions of the Royal Society of London, Series B, May 1999 issue, such as inverse and forward dynamics are outlined. An introductory overview is presented of the other contributions in that issue.

  12. Modeling plasma-assisted growth of graphene-carbon nanotube hybrid

    Science.gov (United States)

    Tewari, Aarti

    2016-08-01

    A theoretical model describing the growth of graphene-CNT hybrid in a plasma medium is presented. Using the model, the growth of carbon nanotube (CNT) on a catalyst particle and thereafter the growth of the graphene on the CNT is studied under the purview of plasma sheath and number density kinetics of different plasma species. It is found that the plasma parameter such as ion density; gas ratios and process parameter such as source power affect the CNT and graphene dimensions. The variation in growth rates of graphene and CNT under different plasma power, gas ratios, and ion densities is analyzed. Based on the results obtained, it can be concluded that higher hydrocarbon ion densities and gas ratios of hydrocarbon to hydrogen favor the growth of taller CNTs and graphene, respectively. In addition, the CNT tip radius reduces with hydrogen ion density and higher plasma power favors graphene with lesser thickness. The present study can help in better understanding of the graphene-CNT hybrid growth in a plasma medium.

  13. Compact quantum gates for hybrid photon-atom systems assisted by Faraday rotation

    Science.gov (United States)

    Song, Guo-Zhu; Yang, Guo-Jian; Zhang, Mei

    2017-02-01

    We present some compact circuits for a deterministic quantum computing on the hybrid photon-atom systems, including the Fredkin gate and SWAP gate. These gates are constructed by exploiting the optical Faraday rotation induced by an atom trapped in a single-sided optical microcavity. The control qubit of our gates is encoded on the polarization states of the single photon, and the target qubit is encoded on the ground states of an atom confined in an optical microcavity. Since the decoherence of the flying qubit with atmosphere for a long distance is negligible and the stationary qubits are trapped inside single-sided microcavities, our gates are robust. Moreover, ancillary single photon is not needed and only some linear-optical devices are adopted, which makes our protocols efficient and practical. Our schemes need not meet the condition that the transmission for the uncoupled cavity is balanceable with the reflectance for the coupled cavity, which is different from the quantum computation with a double-sided optical microcavity. Our calculations show that the fidelities of the two hybrid quantum gates are high with the available experimental technology.

  14. INCIDENCE OF RESIDUAL NEUROMUSCULAR BLOCKADE AT TRACHEAL EXTUBATION: COMPARISON OF ATRACURIUM WITH VECURONIUM

    Directory of Open Access Journals (Sweden)

    Shwetha S

    2015-11-01

    Full Text Available BACKGROUND: Occurrence of undetected residual neuromuscular blockade is a common event in the post anaesthesia care unit. AIM: To compare the incidence and degree of residual neuromuscular blockade with the use of intermediate acting neuromuscular blocking agents Atracurium and Vecuronium. METHODS: 360 patients satisfying the inclusion and exclusion criteria were enrolled in the study and randomly allocated into one of the two study groups of 180 each to receive either Atracurium or Vecuronium intraoperatively. The anaesthesiologist blinded from the study extubated the patient based on the standard clinical criteria and the corresponding Train of Four(TOF ratios were noted by a blinded research assistant using a TOF watch (TOF- Watch® SX Organon, Ireland Ltd., Dublin, Ireland. Residual neuromuscular blockade was defined as a TOF ratio of 0.9 thirty minutes after tracheal extubation. CONCLUSION: We conclude from our study that significant post-operative residual curarization (TOF < 0.9 exists in majority of patients at the time of tracheal extubation (54.4% incidence despite the use of intermediate acting neuromuscular blocking drugs. The incidence and degree of post-operative residual curarization is significantly greater with Vecuronium compared to Atracurium. Thus we suggest that quantitative neuromuscular monitoring is required to assure complete neuromuscular recovery.

  15. Nanomaterial-Assisted Signal Enhancement of Hybridization for DNA Biosensors: A Review

    Directory of Open Access Journals (Sweden)

    Minqiang Li

    2009-09-01

    Full Text Available Detection of DNA sequences has received broad attention due to its potential applications in a variety of fields. As sensitivity of DNA biosensors is determined by signal variation of hybridization events, the signal enhancement is of great significance for improving the sensitivity in DNA detection, which still remains a great challenge. Nanomaterials, which possess some unique chemical and physical properties caused by nanoscale effects, provide a new opportunity for developing novel nanomaterial-based signal-enhancers for DNA biosensors. In this review, recent progress concerning this field, including some newly-developed signal enhancement approaches using quantum-dots, carbon nanotubes and their composites reported by our group and other researchers are comprehensively summarized. Reports on signal enhancement of DNA biosensors by non-nanomaterials, such as enzymes and polymer reagents, are also reviewed for comparison. Furthermore, the prospects for developing DNA biosensors using nanomaterials as signal-enhancers in future are also indicated.

  16. Fast surrogate-assisted simulation-driven optimization of compact microwave hybrid couplers

    Science.gov (United States)

    Kurgan, Piotr; Koziel, Slawomir

    2016-07-01

    This work presents a robust methodology for expedited simulation-driven design optimization of compact microwave hybrid couplers. The technique relies on problem decomposition, and a bottom-up design strategy, starting from the level of basic building blocks of the coupler, and finishing with a tuning procedure that exploits a fast surrogate model of the entire structure. The latter is constructed by cascading local response surface approximations of coupler elementary elements. The cross-coupling effects within the structure are neglected in the first stage of the design process; however, they are accounted for in the tuning phase by means of space-mapping correction of the surrogate. The proposed approach is demonstrated through the design of a compact rat-race and two branch-line couplers. In all cases, the computational cost of the optimization process is very low and corresponds to just a few high-fidelity electromagnetic simulations of respective structures. Experimental validation is also provided.

  17. Vocational perspectives and neuromuscular disorders

    NARCIS (Netherlands)

    Andries, F; Wevers, CWJ; Wintzen, AR; Busch, HFM; Howeler, CJ; deJager, AEJ; Padberg, GW; deVisser, M; Wokke, JHJ

    1997-01-01

    The present study analyses the actual occupational situation, vocational handicaps and past labour career of a group of about 1000 Dutch patients suffering from a neuromuscular disorder (NMD). On the basis of the likelihood of a substantial employment history and sufficient numbers of patients, four

  18. Muscle ultrasound in neuromuscular disorders.

    NARCIS (Netherlands)

    Pillen, S.; Arts, I.M.P.; Zwarts, M.J.

    2008-01-01

    Muscle ultrasound is a useful tool in the diagnosis of neuromuscular disorders, as these disorders result in muscle atrophy and intramuscular fibrosis and fatty infiltration, which can be visualized with ultrasound. Several prospective studies have reported high sensitivities and specificities in

  19. Muscle ultrasound in neuromuscular disorders.

    NARCIS (Netherlands)

    Pillen, S.; Arts, I.M.P.; Zwarts, M.J.

    2008-01-01

    Muscle ultrasound is a useful tool in the diagnosis of neuromuscular disorders, as these disorders result in muscle atrophy and intramuscular fibrosis and fatty infiltration, which can be visualized with ultrasound. Several prospective studies have reported high sensitivities and specificities in th

  20. Muscle ultrasound in neuromuscular disorders.

    NARCIS (Netherlands)

    Pillen, S.; Arts, I.M.P.; Zwarts, M.J.

    2008-01-01

    Muscle ultrasound is a useful tool in the diagnosis of neuromuscular disorders, as these disorders result in muscle atrophy and intramuscular fibrosis and fatty infiltration, which can be visualized with ultrasound. Several prospective studies have reported high sensitivities and specificities in th

  1. Hybrid Rendering Architecture for Realtime and Photorealistic Simulation of Robot-Assisted Surgery.

    Science.gov (United States)

    Müller, Sebastijan; Bihlmaier, Andreas; Irgenfried, Stephan; Wörn, Heinz

    2016-01-01

    In this paper we present a method for combining realtime and non-realtime (photorealistic) rendering with open source software. Realtime rendering provides sufficient realism and is a good choice for most simulation and regression testing purposes in robot-assisted surgery. However, for proper end-to-end testing of the system, some computer vision algorithms require high fidelity images that capture more minute details of the real scene. One of the central practical obstacles to combining both worlds in a uniform way is creating models that are suitable for both kinds of rendering paradigms. We build a modeling pipeline using open source tools that builds on established, open standards for data exchange. The result is demonstrated through a unified model of the medical OpenHELP phantom used in the Gazebo robotics simulator, which can at the same time be rendered with more visual fidelity in the Cycles raytracer.

  2. Au Nanocluster assisted PCE improvement in PEDOT: PSS - Si Hybrid Devices

    Science.gov (United States)

    Sharma, Manisha; Pudasaini, Pushpa Raj; Ayon, Arturo A.

    2015-03-01

    Poly(3,4-ethylenedioxythiophene):poly(styrene sulfonate) (PEDOT:PSS), a P-type organic polymer is frequently employed in the fabrication of heterojunction p-n solar cell devices due to its proper HOMO-LUMO band gap as well as its tunable conductivity. In this report we describe the incorporation of gold (Au) nanoclusters in the PEDOT:PSS blend and its influence on the power-conversion-efficiency (PCE) on planar silicon (Si) hybrid heterojunction solar cell devices. Specifically, the reference samples without the aforementioned nanoclusters, were measured to exhibit a 6.10% PCE, value that increased to 7.55% upon the addition of the Au nanoclusters. The observed increase in the PCE is attributed to the enhanced electrical conductivity of the PEDOT:PSS films due to the incorporation of the nanoclusters, which is directly reflected in their improved fill factor. It is further theorized that the presence of Au nanoclusters in the insulating PSS layer in the PEDOT:PSS blend have a positive influence in the charge collection effectiveness of the devices produced. Considering that the Au nanoparticles involved in this research exercise had an average size of only 4 nm, it is considered that plasmonic effects did not play a relevant role in the observed PCE improvement.

  3. Tartaric Acid-Assisted Self-Assembly of Hybrid Block Copolymer Composites

    Science.gov (United States)

    Yao, Li; Lin, Ying; Watkins, James

    2014-03-01

    Enantiopure tartaric acid was used as an additive to increase the segregation strength of poly(ethylene oxide-block-tert-butyl acrylate) (PEO-b-PtBA) copolymers through strong, selective interactions with one of the polymer chain segments. Addition of tartaric acid to PEO-b-PtBA exhibiting cylindrical morphologies resulted in the formation of helical superstructures as observed by transmission electron microscopy. It was also found that this small acid additive can also enable phase-selective ultra-high loading of nanoparticles (NPs) into target domains of the block copolymer composites. The loading of tartaric acid can increase enthalpically favorable interactions between the nanoparticle ligands and the host domain and mitigate entropic penalties associated with NP incorporation into the target domain. A metal content of over 40 weight percent by mass of the resulting well ordered composites was achieved as measured by thermal gravimetric analysis in PEO-b-PtBA/tartaric acid/4-hydroxythiophenol functionalized Au NP hybrid system. Funding from Center for Hierarchical Manufacturing (CHM); Facility support from Materials Research Science and Engineering Center at UMass Amherst.

  4. Co-Curing of CFRP-Steel Hybrid Joints Using the Vacuum Assisted Resin Infusion Process

    Science.gov (United States)

    Streitferdt, Alexander; Rudolph, Natalie; Taha, Iman

    2017-01-01

    This study focuses on the one-step co-curing process of carbon fiber reinforced plastics (CFRP) joined with a steel plate to form a hybrid structure. In this process CFRP laminate and bond to the metal are realized simultaneously by resin infusion, such that the same resin serves for both infusion and adhesion. For comparison, the commonly applied two-step process of adhesive bonding is studied. In this case, the CFRP laminate is fabricated in a first stage through resin infusion of Non Crimp Fabric (NCF) and joined to the steel plate in a further step through adhesive bonding. For this purpose, the commercially available epoxy-based Betamate 1620 is applied. CFRP laminates were fabricated using two different resin systems, namely the epoxy (EP)-based RTM6 and a newly developed fast curing polyurethane (PU) resin. Results show comparable mechanical performance of the PU and EP based CFRP laminates. The strength of the bond of the co-cured samples was in the same order as the samples adhesively bonded with the PU resin and the structural adhesive. The assembly adhesive with higher ductility showed a weaker performance compared to the other tests. It could be shown that the surface roughness had the highest impact on the joint performance under the investigated conditions.

  5. Power Management Based Current Control Technique for Photovoltaic-Battery Assisted Wind-Hydro Hybrid System

    Science.gov (United States)

    Ram Prabhakar, J.; Ragavan, K.

    2013-07-01

    This article proposes new power management based current control strategy for integrated wind-solar-hydro system equipped with battery storage mechanism. In this control technique, an indirect estimation of load current is done, through energy balance model, DC-link voltage control and droop control. This system features simpler energy management strategy and necessitates few power electronic converters, thereby minimizing the cost of the system. The generation-demand (G-D) management diagram is formulated based on the stochastic weather conditions and demand, which would likely moderate the gap between both. The features of management strategy deploying energy balance model include (1) regulating DC-link voltage within specified tolerances, (2) isolated operation without relying on external electric power transmission network, (3) indirect current control of hydro turbine driven induction generator and (4) seamless transition between grid-connected and off-grid operation modes. Furthermore, structuring of the hybrid system with appropriate selection of control variables enables power sharing among each energy conversion systems and battery storage mechanism. By addressing these intricacies, it is viable to regulate the frequency and voltage of the remote network at load end. The performance of the proposed composite scheme is demonstrated through time-domain simulation in MATLAB/Simulink environment.

  6. Hybrid approach of ventricular assist device and autologous bone marrow stem cells implantation in end-stage ischemic heart failure enhances myocardial reperfusion

    Directory of Open Access Journals (Sweden)

    Khayat Andre

    2011-01-01

    Full Text Available Abstract We challenge the hypothesis of enhanced myocardial reperfusion after implanting a left ventricular assist device together with bone marrow mononuclear stem cells in patients with end-stage ischemic cardiomyopathy. Irreversible myocardial loss observed in ischemic cardiomyopathy leads to progressive cardiac remodelling and dysfunction through a complex neurohormonal cascade. New generation assist devices promote myocardial recovery only in patients with dilated or peripartum cardiomyopathy. In the setting of diffuse myocardial ischemia not amenable to revascularization, native myocardial recovery has not been observed after implantation of an assist device as destination therapy. The hybrid approach of implanting autologous bone marrow stem cells during assist device implantation may eventually improve native cardiac function, which may be associated with a better prognosis eventually ameliorating the need for subsequent heart transplantation. The aforementioned hypothesis has to be tested with well-designed prospective multicentre studies.

  7. [Neuromuscular disease: respiratory clinical assessment and follow-up].

    Science.gov (United States)

    Martínez Carrasco, C; Villa Asensi, J R; Luna Paredes, M C; Osona Rodríguez de Torres, F B; Peña Zarza, J A; Larramona Carrera, H; Costa Colomer, J

    2014-10-01

    Patients with neuromuscular disease are an important group at risk of frequently suffering acute or chronic respiratory failure, which is their main cause of death. They require follow-up by a pediatric respiratory medicine specialist from birth or diagnosis in order to confirm the diagnosis and treat any respiratory complications within a multidisciplinary context. The ventilatory support and the cough assistance have improved the quality of life and long-term survival for many of these patients. In this paper, the authors review the pathophysiology, respiratory function evaluation, sleep disorders, and the most frequent respiratory complications in neuromuscular diseases. The various treatments used, from a respiratory medicine point of view, will be analyzed in a next paper. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  8. Hybrid ZnO/GaN distributed Bragg reflectors grown by plasma-assisted molecular beam epitaxy

    Directory of Open Access Journals (Sweden)

    David Adolph

    2016-08-01

    Full Text Available We demonstrate crack-free ZnO/GaN distributed Bragg reflectors (DBRs grown by hybrid plasma-assisted molecular beam epitaxy using the same growth chamber for continuous growth of both ZnO and GaN without exposure to air. This is the first time these ZnO/GaN DBRs have been demonstrated. The Bragg reflectors consisted up to 20 periods as shown with cross-sectional transmission electron microscopy. The maximum achieved reflectance was 77% with a 32 nm wide stopband centered at 500 nm. Growth along both (0001 and (000 1 ̄ directions was investigated. Low-temperature growth as well as two-step low/high-temperature deposition was carried out where the latter method improved the DBR reflectance. Samples grown along the (0001 direction yielded a better surface morphology as revealed by scanning electron microscopy and atomic force microscopy. Reciprocal space maps showed that ZnO(000 1 ̄ /GaN reflectors are relaxed whereas the ZnO(0001/GaN DBRs are strained. The ability to n-type dope ZnO and GaN makes the ZnO(0001/GaN DBRs interesting for various optoelectronic cavity structures.

  9. Analysis of a Hybrid PV/Thermal Solar-Assisted Heat Pump System for Sports Center Water Heating Application

    Directory of Open Access Journals (Sweden)

    Y. Bai

    2012-01-01

    Full Text Available The application of solar energy provides an alternative way to replace the primary source of energy, especially for large-scale installations. Heat pump technology is also an effective means to reduce the consumption of fossil fuels. This paper presents a practical case study of combined hybrid PV/T solar assisted heat pump (SAHP system for sports center hot water production. The initial design procedure was first presented. The entire system was then modeled with the TRNSYS 16 computation environment and the energy performance was evaluated based on year round simulation results. The results show that the system COP can reach 4.1 under the subtropical climate of Hong Kong, and as compared to the conventional heating system, a high fractional factor of energy saving at 67% can be obtained. The energy performances of the same system under different climatic conditions, that include three other cities in France, were analyzed and compared. Economic implications were also considered in this study.

  10. Gait training with Hybrid Assistive Limb enhances the gait functions in subacute stroke patients: A pilot study.

    Science.gov (United States)

    Yoshikawa, Kenichi; Mizukami, Masafumi; Kawamoto, Hiroaki; Sano, Ayumu; Koseki, Kazunori; Sano, Kumiko; Asakawa, Yasutsugu; Kohno, Yutaka; Nakai, Kei; Gosho, Masahiko; Tsurushima, Hideo

    2017-01-01

    The robotic Hybrid Assistive Limb (HAL) provides motion according to the wearer's voluntary activity. HAL training effects on walking speed and capacity have not been clarified in subacute stroke. To determine improvement in walking ability by HAL and the most effective improvement measure for use in future large-scale trials. Sixteen first-ever hemiplegic stroke patients completed at least 20 sessions over 5 weeks. Per session, the experimental group received no more than 20 min of gait training with HAL (HT) and 40 min of conventional physiotherapy, whereas the control group received at least 60 min of conventional physiotherapy. Primary outcome was maximum walking speed (MWS). The change in MWS from baseline at week 5 was 11.6±10.6 m/min (HAL group) and 2.2±4.1 m/min (control group) (adjusted mean difference = 9.24 m/min, 95% confidence interval 0.48-18.01, P = 0.040). In HAL subjects there were significant increases in Self-selected walking speed (SWS; a secondary outcome) and in step length (a secondary outcome) at MWS and SWS compared with controls. HT improved walking speed in hemiplegic sub-acute stroke patients. In future, randomized controlled trials are needed to confirm the utility of HT.

  11. Factors Predicting the Effects of Hybrid Assistive Limb Robot Suit during the Acute Phase of Central Nervous System Injury.

    Science.gov (United States)

    Chihara, Hideo; Takagi, Yasushi; Nishino, Kazunari; Yoshida, Kazumichi; Arakawa, Yoshiki; Kikuchi, Takayuki; Takenobu, Yohei; Miyamoto, Susumu

    2016-01-01

    To improve the activities of daily living of patients with injury to the central nervous system, physical therapy starting from the acute phase of the injury is important. Recently, the efficacy of physical therapy using a hybrid assistive limb (HAL) robot suit was reported. However, individual differences exist in the effects of HAL. We investigated factors predicting the effects of HAL in 15 patients at our institution with central nervous system injury, primarily due to stroke, who underwent training using HAL during the acute phase. Patients were classified as either "with HAL suitability" or "without HAL suitability" based on scores from 10-m walking speed, gait, satisfaction, and pain. In both groups, Brunnstrom stage before HAL intervention, Fugl-Meyer assessment (FMA), stroke impairment assessment set (SIAS), and functional independence measure (FIM) were evaluated. Although motor function items did not differ significantly, FIM cognitive function items (P = 0.036), visuospatial perception items on SIAS (P = 0.0277), and pain items on SIAS (P = 0.0122) differed significantly between groups. These results indicated that training using HAL does not involve pain in patients with central nervous system injury during the acute phase, and exhibits positive effects in patients without pain and with high communication ability and visuospatial perception function. When conducting HAL intervention, incorporating functional assessment scores (FIM and SIAS), including peripheral items, may be useful to predict the suitability of HAL.

  12. Characteristic analysis of a less-rare-earth hybrid PM-assisted synchronous reluctance motor for EVs application

    Science.gov (United States)

    Wu, Wenye; Zhu, Xiaoyong; Quan, Li; Fan, Deyang; Xiang, Zixuan

    2017-05-01

    Low-energy permanent magnet (PM) such as ferrite is usually adopted in a PM-assisted reluctance (PMAREL) motor to enhance the output torque and reduce costs. However, the relatively low magnetic energy product and remanence in such PMs may lead to the risk of demagnetization. By using two types of materials of rare-earth NdFeB and non-rare-earth ferrite PM, a new less-rare-earth hybrid PMAREL motor is proposed in this paper, where the output torque and the power factor can be improved obviously, and meanwhile the risk of irreversible demagnetization in ferrite PMs can be reduced significantly due to the existence of NdFeB PMs. To verify the validity of the proposed motor, the operating principles of the motor and the positive interaction influences between the two involved types of PMs are analyzed. Moreover, by using the finite element method, the torque characteristics and anti-demagnetization capabilities are also investigated in details. Both the theoretical analysis and simulated results confirm the advantages of the proposed motor.

  13. Tailor-made rehabilitation approach using multiple types of hybrid assistive limb robots for acute stroke patients: A pilot study.

    Science.gov (United States)

    Fukuda, Hiroyuki; Morishita, Takashi; Ogata, Toshiyasu; Saita, Kazuya; Hyakutake, Koichi; Watanabe, Junko; Shiota, Etsuji; Inoue, Tooru

    2016-01-01

    This article investigated the feasibility of a tailor-made neurorehabilitation approach using multiple types of hybrid assistive limb (HAL) robots for acute stroke patients. We investigated the clinical outcomes of patients who underwent rehabilitation using the HAL robots. The Brunnstrom stage, Barthel index (BI), and functional independence measure (FIM) were evaluated at baseline and when patients were transferred to a rehabilitation facility. Scores were compared between the multiple-robot rehabilitation and single-robot rehabilitation groups. Nine hemiplegic acute stroke patients (five men and four women; mean age 59.4 ± 12.5 years; four hemorrhagic stroke and five ischemic stroke) underwent rehabilitation using multiple types of HAL robots for 19.4 ± 12.5 days, and 14 patients (six men and eight women; mean age 63.2 ± 13.9 years; nine hemorrhagic stroke and five ischemic stroke) underwent rehabilitation using a single type of HAL robot for 14.9 ± 8.9 days. The multiple-robot rehabilitation group showed significantly better outcomes in the Brunnstrom stage of the upper extremity, BI, and FIM scores. To the best of the authors' knowledge, this is the first pilot study demonstrating the feasibility of rehabilitation using multiple exoskeleton robots. The tailor-made rehabilitation approach may be useful for the treatment of acute stroke.

  14. A hybrid BMI-based exoskeleton for paresis: EMG control for assisting arm movements

    Science.gov (United States)

    Kawase, Toshihiro; Sakurada, Takeshi; Koike, Yasuharu; Kansaku, Kenji

    2017-02-01

    Objective. Brain-machine interface (BMI) technologies have succeeded in controlling robotic exoskeletons, enabling some paralyzed people to control their own arms and hands. We have developed an exoskeleton asynchronously controlled by EEG signals. In this study, to enable real-time control of the exoskeleton for paresis, we developed a hybrid system with EEG and EMG signals, and the EMG signals were used to estimate its joint angles. Approach. Eleven able-bodied subjects and two patients with upper cervical spinal cord injuries (SCIs) performed hand and arm movements, and the angles of the metacarpophalangeal (MP) joint of the index finger, wrist, and elbow were estimated from EMG signals using a formula that we derived to calculate joint angles from EMG signals, based on a musculoskeletal model. The formula was exploited to control the elbow of the exoskeleton after automatic adjustments. Four able-bodied subjects and a patient with upper cervical SCI wore an exoskeleton controlled using EMG signals and were required to perform hand and arm movements to carry and release a ball. Main results. Estimated angles of the MP joints of index fingers, wrists, and elbows were correlated well with the measured angles in 11 able-bodied subjects (correlation coefficients were 0.81  ±  0.09, 0.85  ±  0.09, and 0.76  ±  0.13, respectively) and the patients (e.g. 0.91  ±  0.01 in the elbow of a patient). Four able-bodied subjects successfully positioned their arms to adequate angles by extending their elbows and a joint of the exoskeleton, with root-mean-square errors  <6°. An upper cervical SCI patient, empowered by the exoskeleton, successfully carried a ball to a goal in all 10 trials. Significance. A BMI-based exoskeleton for paralyzed arms and hands using real-time control was realized by designing a new method to estimate joint angles based on EMG signals, and these may be useful for practical rehabilitation and the support of

  15. Solvent-Assisted Gel Printing for Micropatterning Thin Organic-Inorganic Hybrid Perovskite Films.

    Science.gov (United States)

    Jeong, Beomjin; Hwang, Ihn; Cho, Sung Hwan; Kim, Eui Hyuk; Cha, Soonyoung; Lee, Jinseong; Kang, Han Sol; Cho, Suk Man; Choi, Hyunyong; Park, Cheolmin

    2016-09-27

    While tremendous efforts have been made for developing thin perovskite films suitable for a variety of potential photoelectric applications such as solar cells, field-effect transistors, and photodetectors, only a few works focus on the micropatterning of a perovskite film which is one of the most critical issues for large area and uniform microarrays of perovskite-based devices. Here we demonstrate a simple but robust method of micropatterning a thin perovskite film with controlled crystalline structure which guarantees to preserve its intrinsic photoelectric properties. A variety of micropatterns of a perovskite film are fabricated by either microimprinting or transfer-printing a thin spin-coated precursor film in soft-gel state with a topographically prepatterned elastomeric poly(dimethylsiloxane) (PDMS) mold, followed by thermal treatment for complete conversion of the precursor film to a perovskite one. The key materials development of our solvent-assisted gel printing is to prepare a thin precursor film with a high-boiling temperature solvent, dimethyl sulfoxide. The residual solvent in the precursor gel film makes the film moldable upon microprinting with a patterned PDMS mold, leading to various perovskite micropatterns in resolution of a few micrometers over a large area. Our nondestructive micropatterning process does not harm the intrinsic photoelectric properties of a perovskite film, which allows for realizing arrays of parallel-type photodetectors containing micropatterns of a perovskite film with reliable photoconduction performance. The facile transfer of a micropatterned soft-gel precursor film on other substrates including mechanically flexible plastics can further broaden its applications to flexible photoelectric systems.

  16. [Respiratory treatments in neuromuscular disease].

    Science.gov (United States)

    Martínez Carrasco, C; Cols Roig, M; Salcedo Posadas, A; Sardon Prado, O; Asensio de la Cruz, O; Torrent Vernetta, A

    2014-10-01

    In a previous article, a review was presented of the respiratory pathophysiology of the patient with neuromuscular disease, as well as their clinical evaluation and the major complications causing pulmonary deterioration. This article presents the respiratory treatments required to preserve lung function in neuromuscular disease as long as possible, as well as in special situations (respiratory infections, spinal curvature surgery, etc.). Special emphasis is made on the use of non-invasive ventilation, which is changing the natural history of many of these diseases. The increase in survival and life expectancy of these children means that they can continue their clinical care in adult units. The transition from pediatric care must be an active, timely and progressive process. It may be slightly stressful for the patient before the adaptation to this new environment, with multidisciplinary care always being maintained. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  17. The undesirable effects of neuromuscular blocking drugs

    DEFF Research Database (Denmark)

    Claudius, C; Garvey, L H; Viby-Mogensen, J

    2009-01-01

    Neuromuscular blocking drugs are designed to bind to the nicotinic receptor at the neuromuscular junction. However, they also interact with other acetylcholine receptors in the body. Binding to these receptors causes adverse effects that vary with the specificity for the cholinergic receptor...... in question. Moreover, all neuromuscular blocking drugs may cause hypersensitivity reactions. Often the symptoms are mild and self-limiting but massive histamine release can cause systematic reactions with circulatory and respiratory symptoms and signs. At the end of anaesthesia, no residual effect...... of a neuromuscular blocking drug should be present. However, the huge variability in response to neuromuscular blocking drugs makes it impossible to predict which patient will suffer postoperative residual curarization. This article discusses the undesirable effects of the currently available neuromuscular blocking...

  18. Use of neuromuscular blockers in Brazil.

    Science.gov (United States)

    Locks, Giovani de Figueiredo; Cavalcanti, Ismar Lima; Duarte, Nadia Maria Conceição; da Cunha, Rafael Martins; de Almeida, Maria Cristina Simões

    2015-01-01

    The objective of this study was to evaluate how Brazilian anesthesiologists are using neuromuscular blockers, focusing on how they establish the diagnosis of postoperative residual curarization and the incidence of complications associated with the use of neuromuscular blockers. A questionnaire was sent to anesthesiologists inviting them to participate in the study. The online data collection remained open from March 2012 to June 2013. During the study period, 1296 responses were collected. Rocuronium, atracurium, and cisatracurium were the main neuromuscular blockers used in cases of elective surgery. Succinylcholine and rocuronium were the main neuromuscular blockers used in cases of emergency surgery. Less than 15% of anesthesiologists reported the frequent use of neuromuscular function monitors. Only 18% of those involved in the study reported that all workplaces have such a monitor. Most respondents reported using only the clinical criteria to assess whether the patient is recovered from the muscle relaxant. Most respondents also reported always using some form of neuromuscular blockade reversal. The major complications attributed to neuromuscular blockers were residual curarization and prolonged blockade. Eighteen anesthesiologists reported death attributed to neuromuscular blockers. Residual or prolonged blockade is possibly recorded as a result of the high rate of using clinical criteria to diagnose whether the patient has recovered or not from motor block and, as a corollary, the poor use of neuromuscular transmission monitors in daily practice. Copyright © 2015 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  19. Patient-specific reconstruction utilizing computer assisted 3D modelling for partial bone flap defect in hybrid cranioplasty

    Science.gov (United States)

    Hueh, Low Peh; Abdullah, Johari Yap; Abdullah, Abdul Manaf; Yahya, Suzana; Idris, Zamzuri; Mohamad, Dasmawati

    2016-12-01

    Autologous cranioplasty using a patient's original bone flap remain the commonest practice nowadays. However, partial bone flap defect is commonly encountered. Replacing the bone flap with pre-moulded synthetic bone flap is costly and not affordable to many patients. Hence most of the small to medium size defect was topped up with alloplastic material on a free hand basis intra-operatively which often resulted in inaccurate implant approximation with unsatisfactory cosmetic result. This study aims to evaluate implant accuracy and cosmetic outcome of cranioplasty candidates who underwent partial bone flap reconstruction utilising computer assisted 3D modelling. 3D images of the skull were obtained from post-craniectomy axial 1-mm spiral computed tomography (CT) scans and a virtual 3D model was generated using the Materialise Mimics software. The Materialise 3-Matic was then utilised to design a patient-specific implant. Prefabrication of the implant was performed by the 3D Objet printer, and a negative gypsum mold was created with the prefabricated cranial implant. Intraoperatively, a hybrid polymethyl methacrylate (PMMA)-autologous cranial implant was produced using the gypsum mold, and fit into the cranial defect. This study is still ongoing at the moment. To date, two men has underwent partial bone flap reconstruction utilising this technique and both revealed satisfactory implant alignment with favourable cosmesis. Mean implant size was 12cm2, and the mean duration of intraoperative reconstruction for the partial bone flap defect was 40 minutes. No significant complication was reported. As a conclusion, this new technique and approach resulted in satisfactory implant alignment and favourable cosmetic outcome. However, more study samples are needed to increase the validity of the study results.

  20. Interactive Bio-feedback Therapy Using Hybrid Assistive Limbs for Motor Recovery after Stroke: Current Practice and Future Perspectives

    Science.gov (United States)

    MORISHITA, Takashi; INOUE, Tooru

    2016-01-01

    Interactive bio-feedback (iBF) was initially developed for the rehabilitation of motor function in patients with neurological disorders, and subsequently yielded the development of the hybrid assistive limb (HAL). Here, we provide a review of the theory underlying HAL treatment as well as our clinical experience and recommendations for future clinical studies using HAL in acute stroke patients. We performed a PubMed-based literature search, a retrospective data review of our acute stroke case series, and included a sample case report of our findings. Given past animal studies and functional imaging results, iBF therapy using the HAL in the acute phase of stroke seems an appropriate approach for preventing learned non-use and interhemispheric excitation imbalances. iBF therapy may furthermore promote appropriate neuronal network reorganization. Based on experiences in our stroke center, HAL rehabilitation is a safe and effective treatment modality for recovering motor impairments after acute stroke, and allows the design of tailored rehabilitation programs for individual patients. iBF therapy through the HAL system seems to be an effective and promising approach to stroke rehabilitation; however, the superiority of this treatment to conventional rehabilitation remains unclear. Further clinical studies are warranted. Additionally, the formation of a patient registry will permit a meta-analysis of HAL cases and address the problems associated with a controlled trial (e.g., the heterogeneity of an acute stroke cohort). The development of robotic engineering will improve the efficacy of HAL rehabilitation and has the potential to standardize patient rehabilitation practice. PMID:27616320

  1. BIOLOGY OF SOME NEUROMUSCULAR DISORDERS

    Directory of Open Access Journals (Sweden)

    Gerta Vrbova

    2004-12-01

    Full Text Available In order to understand and possibly interfere/ treat neuromuscular disorders it is important to analyze the biological events that may be causing the disability. We illustrate such attempts on two examples of genetically determined neuromuscular diseases: 1 Duchenne muscular dystrophy (DMD, and 2 Spinal muscular atrophy (SMA.DMD is an x-linked hereditary muscle disease that leads to progressive muscle weakness. The altered gene in DMD affects dystrophin, a muscle membrane associated proteine. Attempts were made to replace the deficient or missing gene/ protein into muscles of Duchenne children. Two main strategies were explored: 1 Myoblast and stem cell transfer and 2 Gene delivery. The possible use of methods other than the introduction of the missing gene for dystrophin into muscle fibres are based on the knowledge about the adaptive potential of muscle to different functional demands and the ability of the muscle to express a new set of genes in response to such stimuli. Stretch or overload is now known to lead to changes of gene expression in normal muscle, and the success of muscle stretch in the management of Duchenne boys is most likely to be due to such adaptive changes. Electrical stimulation of muscles is also a powerful stimulus for inducing the expression of new genes and this method too has produced beneficial effects on the progress of the disease in mice and men.SMA is a heterogeneous group of hereditary neuromuscular disorders where the loss of lower motoneurones leads to progressive weakness and muscle atrophy. The disease subdivides into 3 forms according to the severity of the symptoms and age of onset. All three forms of SMA have been mapped to chromosome 5q11.2-13.2. Clinical features of all these forms of SMA include hypotonia shortly after birth, symmetrical muscle weakness and atrophy, finger tremor, areflexia or hyporeflexia and later contractures. In patients with SMA 1 and 2 the development of all parts of the motor

  2. Neuromuscular Control and Coordination during Cycling

    Science.gov (United States)

    Li, Li

    2004-01-01

    The neuromuscular control aspect of cycling has been investigated through the effects of modifying posture and cadence. These studies show that changing posture has a more profound influence on neuromuscular coordination than does changing slope. Most of the changes with standing posture occur late in the downstroke: increased ankle and knee joint…

  3. One-pot microwave-assisted combustion synthesis of graphene oxide-TiO{sub 2} hybrids for photodegradation of methyl orange

    Energy Technology Data Exchange (ETDEWEB)

    Pu, Xipeng [School of Materials Science and Engineering, Liaocheng University, Liaocheng, Shandong 252000 (China); Zhang, Dafeng, E-mail: dafengzh@hotmail.com [School of Materials Science and Engineering, Liaocheng University, Liaocheng, Shandong 252000 (China); Gao, Yanyan; Shao, Xin [School of Materials Science and Engineering, Liaocheng University, Liaocheng, Shandong 252000 (China); Ding, Guqiao [State Key Laboratory of Functional Materials for Informatics, Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, Shanghai 200050 (China); Li, Songsong; Zhao, Shuping [School of Materials Science and Engineering, Liaocheng University, Liaocheng, Shandong 252000 (China)

    2013-02-25

    Highlights: Black-Right-Pointing-Pointer GO-TiO{sub 2} hybrids were synthesized by a microwave-assistant combustion method. Black-Right-Pointing-Pointer Reduction of GO, and nitrogen doping of TiO{sub 2} and graphene were one-pot achieved. Black-Right-Pointing-Pointer GO-TiO{sub 2} hybrids show improved photocatalystic properties and photostability. - Abstract: Graphene oxide (GO)-TiO{sub 2} hybrids (GTHs) were synthesized by a one-pot microwave-assistant combustion method. The structures, morphologies, and photocatalytic properties of samples were characterized by X-ray diffraction, Fourier transform infrared spectroscopy, Raman spectra, transmission electron microscopy, X-ray photoelectron spectroscopy, and photoluminescence. The effects of microwave irradiation time and GO content on the photocatalystic performances of as-synthesized GTHs for methyl orange were investigated. The experimental results show that reduction of GO, synthesis of TiO{sub 2}, and nitrogen doping of TiO{sub 2} and graphene can be achieved simultaneously during the combustion process. GTHs showed improved photocatalystic properties than neat TiO{sub 2}, due to the effective transfer of photo-generated electron from TiO{sub 2} to GO and improved absorbance performance of GTHs. Moreover, the photostability of GTHs was characterized.

  4. Mitochondrial dysfunction in neuromuscular disorders.

    Science.gov (United States)

    Katsetos, Christos D; Koutzaki, Sirma; Melvin, Joseph J

    2013-09-01

    This review deciphers aspects of mitochondrial (mt) dysfunction among nosologically, pathologically, and genetically diverse diseases of the skeletal muscle, lower motor neuron, and peripheral nerve, which fall outside the traditional realm of mt cytopathies. Special emphasis is given to well-characterized mt abnormalities in collagen VI myopathies (Ullrich congenital muscular dystrophy and Bethlem myopathy), megaconial congenital muscular dystrophy, limb-girdle muscular dystrophy type 2 (calpainopathy), centronuclear myopathies, core myopathies, inflammatory myopathies, spinal muscular atrophy, Charcot-Marie-Tooth neuropathy type 2, and drug-induced peripheral neuropathies. Among inflammatory myopathies, mt abnormalities are more prominent in inclusion body myositis and a subset of polymyositis with mt pathology, both of which are refractory to corticosteroid treatment. Awareness is raised about instances of phenotypic mimicry between cases harboring primary mtDNA depletion, in the context of mtDNA depletion syndrome, and established neuromuscular disorders such as spinal muscular atrophy. A substantial body of experimental work, derived from animal models, attests to a major role of mitochondria (mt) in the early process of muscle degeneration. Common mechanisms of mt-related cell injury include dysregulation of the mt permeability transition pore opening and defective autophagy. The therapeutic use of mt permeability transition pore modifiers holds promise in various neuromuscular disorders, including muscular dystrophies.

  5. Pharmacokinetic studies of neuromuscular blocking agents: good clinical research practice (GCRP).

    Science.gov (United States)

    Viby-Mogensen, J; Ostergaard, D; Donati, F; Fisher, D; Hunter, J; Kampmann, J P; Kopman, A; Proost, J H; Rasmussen, S N; Skovgaard, L T; Varin, F; Wright, P M

    2000-11-01

    In September 1997, an international consensus conference on standardization of studies of neuromuscular blocking agents was held in Copenhagen, Denmark. Based on the conference, a set of guidelines for good clinical research practice (GCRP) in pharmacokinetic studies of neuromuscular blocking agents is presented. Guidelines include: design of the study; relevant patient groups to investigate; test drug administration, sampling and analysis; pharmacokinetic analysis; pharmacokinetic/pharmacodynamic modeling; population pharmacokinetics; statistics; and presentation of pharmacokinetic data. The guidelines are intended to aid those working in this research area; it is hoped that they will assist researchers, editors of scientific papers, and pharmaceutical companies in improving the quality of pharmacokinetic studies.

  6. Imaging on the surfaces of an uneven thickness medium based on hybrid phase retrieval with the assistance of off-axis digital holography

    Science.gov (United States)

    Wang, Fengpeng; Wang, Dayong; Panezai, Spozmai; Rong, Lu; Wang, Yunxin; Zhao, Jie

    2017-10-01

    A hybrid phase retrieval method with the assistance of off-axis digital holography is proposed for imaging objects on the surfaces of a transparent medium with uneven thickness. The approximate phase distribution is obtained by a constrained optimization approach from the off-axis hologram, and it is used in an iterative procedure for retrieving the complex field of the object from the Gabor hologram. Furthermore, principal component analysis is introduced for compensating for phase aberrations caused by the medium. Numerical simulations and optical experiments were carried out to validate the proposed method. The quality of the reconstructed image is improved remarkably compared to only off-axis digital holography.

  7. The effects of roxatidine on neuromuscular transmission.

    Science.gov (United States)

    Bossa, R; Chiericozzi, M; Galatulas, I; Salvatore, G; Teli, M; Baggio, G; Castelli, M

    1995-01-01

    We have investigated the effects of the H2 receptor antagonist roxatidine on the neuromuscular transmission by using the sciatic nerve-gastrocnemius muscle preparation of the rat in vivo. Roxatidine, administered by i.v. injection, potentiates the neuromuscular blockade induced by d-tubocurarine, pancuronium and aminoglycoside antibiotic, kanamycin. Moreover, the drug alone is capable of producing a blockade on the preparation stimulated at high frequency. The neuromuscular blockade induced by roxatidine is partially reversed by 4-aminopyridine but not by dimaprit.

  8. Acute neuromuscular weakness associated with dengue infection

    OpenAIRE

    Harmanjit Singh Hira; Amandeep Kaur; Anuj Shukla

    2012-01-01

    Background: Dengue infections may present with neurological complications. Whether these are due to neuromuscular disease or electrolyte imbalance is unclear. Materials and Methods: Eighty-eight patients of dengue fever required hospitalization during epidemic in year 2010. Twelve of them presented with acute neuromuscular weakness. We enrolled them for study. Diagnosis of dengue infection based on clinical profile of patients, positive serum IgM ELISA, NS1 antigen, and sero-typing. Complete ...

  9. Sugammadex: A revolutionary drug in neuromuscular pharmacology

    Science.gov (United States)

    Nag, Kusha; Singh, Dewan Roshan; Shetti, Akshaya N.; Kumar, Hemanth; Sivashanmugam, T.; Parthasarathy, S.

    2013-01-01

    Sugammadex (ORG 25969) is a unique neuromuscular reversal drug; a novel cyclodextrin, the first in a new class of selective relaxant binding agents, which reverse neuromuscular blockade (NMB) with the aminosteroid non-depolarizing muscle relaxants rocuronium and vecuronium. Sugammadex can reverse moderate or deep NMB. The clinical use of sugammadex promises to eliminate many of the shortcomings in current anesthetic practice with regard to antagonism of rocuronium and other aminosteroid muscle relaxants. PMID:25885973

  10. Radical hybrid video-assisted thoracic segmentectomy: long-term results of minimally invasive anatomical sublobar resection for treating lung cancer.

    Science.gov (United States)

    Okada, Morihito; Tsutani, Yasuhiro; Ikeda, Takuhiro; Misumi, Keizo; Matsumoto, Kotaro; Yoshimura, Masahiro; Miyata, Yoshihiro

    2012-01-01

    We analysed the results of radical segmentectomy achieved through a hybrid video-assisted thoracic surgery (VATS) approach that used both direct vision and television monitor visualization at a median follow-up of over 5 years. Between April 2004 and October 2010, 102 consecutive patients able to tolerate lobectomy to treat clinical T1N0M0 non-small cell lung cancer (NSCLC) underwent hybrid VATS segmentectomy in which we used electrocautery without a stapler to divide the intersegmental plane detected by selective jet ventilation in addition to the path of the intersegmental veins. Curative resection was achieved in all patients. The median surgical duration and blood loss during the surgery were 129 min (range, 60-275 min) and 50 ml (range, 10-350 ml), respectively. The complication rate was 9.8% (10/102) with the most frequent being prolonged air leak, and there was no case of in-hospital death or 30-day mortality post procedure. Five and seven patients developed locoregional and distant recurrences, respectively. The overall and disease-free 5-year survival rates were 89.8% and 84.7%, respectively. Radical hybrid VATS segmentectomy including atypical resection of (sub)segments is a useful option for clinical stage-I NSCLC. The exact identification of anatomical intersegmental plane followed by dissection using electrocautery is critical from oncological and functional perspectives.

  11. Eccentric Exercise to Enhance Neuromuscular Control.

    Science.gov (United States)

    Lepley, Lindsey K; Lepley, Adam S; Onate, James A; Grooms, Dustin R

    Neuromuscular alterations are a major causal factor of primary and secondary injuries. Though injury prevention programs have experienced some success, rates of injuries have not declined, and after injury, individuals often return to activity with functionality below clinical recommendations. Considering alternative therapies to the conventional concentric exercise approach, such as one that can target neuromuscular injury risk and postinjury alterations, may provide for more effective injury prevention and rehabilitation protocols. Peer-reviewed sources available on the Web of Science and MEDLINE databases from 2000 through 2016 were gathered using searches associated with the keywords eccentric exercise, injury prevention, and neuromuscular control. Eccentric exercise will reduce injury risk by targeting specific neural and morphologic alterations that precipitate neuromuscular dysfunction. Clinical review. Level 4. Neuromuscular control is influenced by alterations in muscle morphology and neural activity. Eccentric exercise beneficially modifies several underlying factors of muscle morphology (fiber typing, cross-sectional area, working range, and pennation angle), and emerging evidence indicates that eccentric exercise is also beneficial to peripheral and central neural activity (alpha motorneuron recruitment/firing, sarcolemma activity, corticospinal excitability, and brain activation). There is mounting evidence that eccentric exercise is not only a therapeutic intervention influencing muscle morphology but also targets unique alterations in neuromuscular control, influencing injury risk.

  12. Neuromuscular blockade in the elderly patient

    Directory of Open Access Journals (Sweden)

    Lee LA

    2016-06-01

    Full Text Available Luis A Lee, Vassilis Athanassoglou, Jaideep J Pandit Nuffield Department of Anaesthetics, Oxford University Hospitals NHS Foundation Trust, Oxford, UK Abstract: Neuromuscular blockade is a desirable or even essential component of general anesthesia for major surgical operations. As the population continues to age, and more operations are conducted in the elderly, due consideration must be given to neuromuscular blockade in these patients to avoid possible complications. This review considers the pharmacokinetics and pharmacodynamics of neuromuscular blockade that may be altered in the elderly. Compartment distribution, metabolism, and excretion of drugs may vary due to age-related changes in physiology, altering the duration of action with a need for reduced dosage (eg, aminosteroids. Other drugs (atracurium, cisatracurium have more reliable duration of action and should perhaps be considered for use in the elderly. The range of interpatient variability that neuromuscular blocking drugs may exhibit is then considered and drugs with a narrower range, such as cisatracurium, may produce more predictable, and inherently safer, outcomes. Ultimately, appropriate neuromuscular monitoring should be used to guide the administration of muscle relaxants so that the risk of residual neuromuscular blockade postoperatively can be minimized. The reliability of various monitoring is considered. This paper concludes with a review of the various reversal agents, namely, anticholinesterase drugs and sugammadex, and the alterations in dosing of these that should be considered for the elderly patient. Keywords: anesthesia, elderly, drugs, pharmacokinetics, pharmacodynamics 

  13. Sugammadex: A Review of Neuromuscular Blockade Reversal.

    Science.gov (United States)

    Keating, Gillian M

    2016-07-01

    Sugammadex (Bridion(®)) is a modified γ-cyclodextrin that reverses the effect of the steroidal nondepolarizing neuromuscular blocking agents rocuronium and vecuronium. Intravenous sugammadex resulted in rapid, predictable recovery from moderate and deep neuromuscular blockade in patients undergoing surgery who received rocuronium or vecuronium. Recovery from moderate neuromuscular blockade was significantly faster with sugammadex 2 mg/kg than with neostigmine, and recovery from deep neuromuscular blockade was significantly faster with sugammadex 4 mg/kg than with neostigmine or spontaneous recovery. In addition, recovery from neuromuscular blockade was significantly faster when sugammadex 16 mg/kg was administered 3 min after rocuronium than when patients spontaneously recovered from succinylcholine. Sugammadex also demonstrated efficacy in various special patient populations, including patients with pulmonary disease, cardiac disease, hepatic dysfunction or myasthenia gravis and morbidly obese patients. Intravenous sugammadex was generally well tolerated. In conclusion, sugammadex is an important option for the rapid reversal of rocuronium- or vecuronium-induced neuromuscular blockade.

  14. Improvement of Resistance to Bacterial Blight by Marker-Assisted Selection in a Wide Compatibility Restorer Line of Hybrid Rice

    Institute of Scientific and Technical Information of China (English)

    CHEN Xiu-hua; LUO Yan-chang; LIU Qiao-quan; WANG Shou-hai; WU Hsin-kan; LI Cheng-quan; WANG Zong-yang; WU Shuang; GU Ming-hong; WANG De-zheng; DU Shi-yun

    2004-01-01

    4183 is a promising wide compatibility restorer line with good grain quality. Its hybrid rice Shuangyou 4183 (Shuangjiu A/4183) was registered in Anhui Province in 2003. However, the line and its hybrid rice are susceptible to bacterial blight caused by Xanthomonas oryzae pv. oryzae (Xoo). R4183 carrying Xa21 was developed to improve bacterial blight resistance of 4183 through introducing the broad-spectrum resistance gene Xa21 by marker-aided selection. R4183 had similar level of bacterial blight resistance to IRBB21, the resistant donor, while maintained the wide compatibility, restoring ability and other good economic traits of the recurrent parent 4183. Critical issues on improvement of bacterial blight resistance of hybrid rice and breeding strategies were also discussed.

  15. Sonication assisted preparation of graphene oxide/graphitic-C₃N₄ nanosheet hybrid with reinforced photocurrent for photocatalyst applications.

    Science.gov (United States)

    Dai, Kai; Lu, Luhua; Liu, Qi; Zhu, Guangping; Wei, Xiaoqin; Bai, Jin; Xuan, Lingling; Wang, Heng

    2014-05-01

    Graphitic C3N4 (g-C3N4), as an advanced metal free photocatalyst, is known to be poorly exfoliated and dispersed in water from its powder form which has a layered structure, the intrinsic plane structure is not destroyed, and this has largely limited its application. In this work, we report our progress on successful sonication exfoliation of g-C3N4 nanosheets in graphene oxide (GO) aqueous solution. By making use of the substrate character of GO, g-C3N4 nanosheets of unvaried intrinsic structure were exfoliated and anchored on the GO surface, resulting in a GO/g-C3N4 hybrid. Moreover, the photocurrent of the hybrid was largely reinforced at the optimal weight fraction of GO. As a result, the corresponding photocatalytic performance of the hybrid with optimized photocurrent character was largely improved.

  16. Interdiffusion Reaction-Assisted Hybridization of Two-Dimensional Metal-Organic Frameworks and Ti3C2Tx Nanosheets for Electrocatalytic Oxygen Evolution.

    Science.gov (United States)

    Zhao, Li; Dong, Biliang; Li, Shaozhou; Zhou, Lijun; Lai, Linfei; Wang, Zhiwei; Zhao, Shulin; Han, Min; Gao, Kai; Lu, Min; Xie, Xiaoji; Chen, Bo; Liu, Zhengdong; Wang, Xiangjing; Zhang, Hao; Li, Hai; Liu, Juqing; Zhang, Hua; Huang, Xiao; Huang, Wei

    2017-06-27

    Two-dimensional (2D) metal-organic framework (MOF) nanosheets have been recently regarded as the model electrocatalysts due to their porous structure, fast mass and ion transfer through the thickness, and large portion of exposed active metal centers. Combining them with electrically conductive 2D nanosheets is anticipated to achieve further improved performance in electrocatalysis. In this work, we in situ hybridized 2D cobalt 1,4-benzenedicarboxylate (CoBDC) with Ti3C2Tx (the MXene phase) nanosheets via an interdiffusion reaction-assisted process. The resulting hybrid material was applied in the oxygen evolution reaction and achieved a current density of 10 mA cm(-2) at a potential of 1.64 V vs reversible hydrogen electrode and a Tafel slope of 48.2 mV dec(-1) in 0.1 M KOH. These results outperform those obtained by the standard IrO2-based catalyst and are comparable with or even better than those achieved by the previously reported state-of-the-art transition-metal-based catalysts. While the CoBDC layer provided the highly porous structure and large active surface area, the electrically conductive and hydrophilic Ti3C2Tx nanosheets enabled the rapid charge and ion transfer across the well-defined Ti3C2Tx-CoBDC interface and facilitated the access of aqueous electrolyte to the catalytically active CoBDC surfaces. The hybrid nanosheets were further fabricated into an air cathode for a rechargeable zinc-air battery, which was successfully used to power a light-emitting diode. We believe that the in situ hybridization of MXenes and 2D MOFs with interface control will provide more opportunities for their use in energy-based applications.

  17. Neuromuscular Adaptations to Reduced Use

    Science.gov (United States)

    Ploutz-Snyder, Lori

    2009-01-01

    This viewgraph presentation reviews the studies done to reduce neuromuscular strength loss during unilateral lower limb suspension (ULLS). Since there are animals that undergo fairly long periods of muscular disuse without any or minimal muscular atrophy, there is an answer to that might be applicable to human in situations that require no muscular use to diminish the effects of muscular atrophy. Three sets of ULLS studies were reviewed indicated that muscle strength decreased more than the muscle mass. The study reviewed exercise countermeasures to combat the atrophy, including: ischemia maintained during Compound muscle action potential (CMAP), ischemia and low load exercise, Japanese kaatsu, and the potential for rehabilitation or situations where heavy loading is undesirable. Two forms of countermeasures to unloading have been successful, (1) high-load resistance training has maintained muscle mass and strength, and low load resistance training with blood flow restriction (LL(sub BFR)). The LL(sub BFR) has been shown to increase muscle mass and strength. There has been significant interest in Tourniquet training. An increase in Growth Hormone(GH) has been noted for LL(sub BFR) exercise. An experimental study with 16 subjects 8 of whom performed ULLS, and 8 of whom performed ULLS and LL(sub BFR) exercise three times per week during the ULLS. Charts show the results of the two groups, showing that performing LL(sub BFR) exercise during 30 days of ULLS can maintain muscle size and strength and even improve muscular endurance.

  18. Feedback control of arm movements using Neuro-Muscular Electrical Stimulation (NMES) combined with a lockable, passive exoskeleton for gravity compensation

    OpenAIRE

    Christian eKlauer; Thomas eSchauer; Werner eReichenfelser; Jakob eKarner; Sven eZwicker; Marta eGandolla; Emilia eAmbrosini; Simona eFerrante; Marco eHack; Andreas eJedlitschka; Alexander eDuschau-Wicke; Margit eGfoehler; Alessandra ePedrocchi

    2014-01-01

    Within the European project MUNDUS, an assistive framework was developed for the support of arm and hand functions during daily life activities in severely impaired people. Potential users of this system are patients with high-level spinal cord injury and neurodegenerative neuromuscular diseases, such as amyotrophic lateral sclerosis, Friedreich ataxia, and multiple sclerosis. This contribution aims at designing a feedback control system for Neuro-Muscular Electrical Stimulation (NMES) to ena...

  19. [Use of neuromuscular blockers in Brazil].

    Science.gov (United States)

    Locks, Giovani de Figueiredo; Cavalcanti, Ismar Lima; Duarte, Nadia Maria Conceição; Cunha, Rafael Martins da; Almeida, Maria Cristina Simões de

    2015-01-01

    The objective of this study was to evaluate how Brazilian anesthesiologists are using neuromuscular blockers (NMB), focusing on how they establish the diagnosis of postoperative residual curarization and the incidence of complications associated with the use of NMB. A questionnaire was sent to anesthesiologists inviting them to participate in the study. The online data collection remained open from March 2012 to June 2013. During the study period, 1296 responses were collected. Rocuronium, atracurium, and cisatracurium were the main neuromuscular blockers used in cases of elective surgery. Succinylcholine and rocuronium were the main NMB used in cases of emergency surgery. Less than 15% of anesthesiologists reported the frequent use of neuromuscular function monitors. Only 18% of those involved in the study reported that all workplaces have such a monitor. Most respondents reported using only the clinical criteria to assess whether the patient is recovered from the muscle relaxant. Most respondents also reported always using some form of neuromuscular blockade reversal. The major complications attributed to NMB were residual curarization and prolonged blockade. Eighteen anesthesiologists reported death attributed to NMB. Residual or prolonged blockade is possibly recorded as a result of the high rate of using clinical criteria to diagnose whether the patient has recovered or not from motor block and, as a corollary, the poor use of neuromuscular transmission monitors in daily practice. Copyright © 2015 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  20. Ultrasonically assisted hydrothermal synthesis of activated carbon-HKUST-1-MOF hybrid for efficient simultaneous ultrasound-assisted removal of ternary organic dyes and antibacterial investigation: Taguchi optimization.

    Science.gov (United States)

    Azad, F Nasiri; Ghaedi, M; Dashtian, K; Hajati, S; Pezeshkpour, V

    2016-07-01

    Activated carbon (AC) composite with HKUST-1 metal organic framework (AC-HKUST-1 MOF) was prepared by ultrasonically assisted hydrothermal method and characterized by FTIR, SEM and XRD analysis and laterally was applied for the simultaneous ultrasound-assisted removal of crystal violet (CV), disulfine blue (DSB) and quinoline yellow (QY) dyes in their ternary solution. In addition, this material, was screened in vitro for their antibacterial actively against Methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa (PAO1) bacteria. In dyes removal process, the effects of important variables such as initial concentration of dyes, adsorbent mass, pH and sonication time on adsorption process optimized by Taguchi approach. Optimum values of 4, 0.02 g, 4 min, 10 mg L(-1) were obtained for pH, AC-HKUST-1 MOF mass, sonication time and the concentration of each dye, respectively. At the optimized condition, the removal percentages of CV, DSB and QY were found to be 99.76%, 91.10%, and 90.75%, respectively, with desirability of 0.989. Kinetics of adsorption processes follow pseudo-second-order model. The Langmuir model as best method with high applicability for representation of experimental data, while maximum mono layer adsorption capacity for CV, DSB and QY on AC-HKUST-1 estimated to be 133.33, 129.87 and 65.37 mg g(-1) which significantly were higher than HKUST-1 as sole material with Qm to equate 59.45, 57.14 and 38.80 mg g(-1), respectively.

  1. Employment profiles in neuromuscular diseases.

    Science.gov (United States)

    Fowler, W M; Abresch, R T; Koch, T R; Brewer, M L; Bowden, R K; Wanlass, R L

    1997-01-01

    Consumer and rehabilitation provider factors that might limit employment opportunities for 154 individuals with six slowly progressive neuromuscular diseases (NMD) were investigated. The NMDs were spinal muscular atrophy (SMA), hereditary motor sensory neuropathy (HMSN), Becker's muscular dystrophy (BMD), facioscapulohumeral muscular dystrophy (FSHD), myotonic muscular dystrophy (MMD), and limb-girdle syndrome (LGS). Forty percent were employed in the competitive labor market at the time of the study, 50% had been employed in the past, and 10% had never been employed. The major consumer barrier to employment was education. Other important factors were type of occupation, intellectual capacity, psychosocial adjustment, and the belief by most individuals that their physical disability was the only or major barrier to obtaining a job. Psychological characteristics were associated with level of unemployment. However, physical impairment and disability were not associated with level of unemployment. There also were differences among the types of NMDs. Compared with the SMA, HMSN, BMD, and FSHD groups, the MMD and LGS groups had significantly higher levels of unemployment, lower educational levels, and fewer employed professional, management, and technical workers. Nonphysical impairment factors such as a low percentage of college graduates, impaired intellectual function in some individuals, and poor psychological adjustment were correlated with higher unemployment levels in the MMD group. Unemployment in the LGS group was correlated with a failure to complete high school. Major provider barriers to employment were the low level of referrals to Department of Rehabilitation by physicians and the low percentage of acceptance into the State Department of Rehabilitation. The low rate of acceptance was primarily attributable to the low number of referrals compounded by a lack of counselor experience with individuals with NMD. Both consumer and provider barriers may

  2. Protein defects in neuromuscular diseases

    Directory of Open Access Journals (Sweden)

    Vainzof M.

    2003-01-01

    Full Text Available Muscular dystrophies are a heterogeneous group of genetically determined progressive disorders of the muscle with a primary or predominant involvement of the pelvic or shoulder girdle musculature. The clinical course is highly variable, ranging from severe congenital forms with rapid progression to milder forms with later onset and a slower course. In recent years, several proteins from the sarcolemmal muscle membrane (dystrophin, sarcoglycans, dysferlin, caveolin-3, from the extracellular matrix (alpha2-laminin, collagen VI, from the sarcomere (telethonin, myotilin, titin, nebulin, from the muscle cytosol (calpain 3, TRIM32, from the nucleus (emerin, lamin A/C, survival motor neuron protein, and from the glycosylation pathway (fukutin, fukutin-related protein have been identified. Mutations in their respective genes are responsible for different forms of neuromuscular diseases. Protein analysis using Western blotting or immunohistochemistry with specific antibodies is of the utmost importance for the differential diagnosis and elucidation of the physiopathology of each genetic disorder involved. Recent molecular studies have shown clinical inter- and intra-familial variability in several genetic disorders highlighting the importance of other factors in determining phenotypic expression and the role of possible modifying genes and protein interactions. Developmental studies can help elucidate the mechanism of normal muscle formation and thus muscle regeneration. In the last fifteen years, our research has focused on muscle protein expression, localization and possible interactions in patients affected by different forms of muscular dystrophies. The main objective of this review is to summarize the most recent findings in the field and our own contribution.

  3. Microwave assisted synthesis and characterisation of a zinc oxide/tobacco mosaic virus hybrid material. An active hybrid semiconductor in a field-effect transistor device.

    Science.gov (United States)

    Sanctis, Shawn; Hoffmann, Rudolf C; Eiben, Sabine; Schneider, Jörg J

    2015-01-01

    Tobacco mosaic virus (TMV) has been employed as a robust functional template for the fabrication of a TMV/zinc oxide field effect transistor (FET). A microwave based approach, under mild conditions was employed to synthesize stable zinc oxide (ZnO) nanoparticles, employing a molecular precursor. Insightful studies of the decomposition of the precursor were done using NMR spectroscopy and material characterization of the hybrid material derived from the decomposition was achieved using dynamic light scattering (DLS), transmission electron microscopy (TEM), grazing incidence X-ray diffractometry (GI-XRD) and atomic force microscopy (AFM). TEM and DLS data confirm the formation of crystalline ZnO nanoparticles tethered on top of the virus template. GI-XRD investigations exhibit an orientated nature of the deposited ZnO film along the c-axis. FET devices fabricated using the zinc oxide mineralized virus template material demonstrates an operational transistor performance which was achieved without any high-temperature post-processing steps. Moreover, a further improvement in FET performance was observed by adjusting an optimal layer thickness of the deposited ZnO on top of the TMV. Such a bio-inorganic nanocomposite semiconductor material accessible using a mild and straightforward microwave processing technique could open up new future avenues within the field of bio-electronics.

  4. Microwave assisted synthesis and characterisation of a zinc oxide/tobacco mosaic virus hybrid material. An active hybrid semiconductor in a field-effect transistor device

    Directory of Open Access Journals (Sweden)

    Shawn Sanctis

    2015-03-01

    Full Text Available Tobacco mosaic virus (TMV has been employed as a robust functional template for the fabrication of a TMV/zinc oxide field effect transistor (FET. A microwave based approach, under mild conditions was employed to synthesize stable zinc oxide (ZnO nanoparticles, employing a molecular precursor. Insightful studies of the decomposition of the precursor were done using NMR spectroscopy and material characterization of the hybrid material derived from the decomposition was achieved using dynamic light scattering (DLS, transmission electron microscopy (TEM, grazing incidence X-ray diffractometry (GI-XRD and atomic force microscopy (AFM. TEM and DLS data confirm the formation of crystalline ZnO nanoparticles tethered on top of the virus template. GI-XRD investigations exhibit an orientated nature of the deposited ZnO film along the c-axis. FET devices fabricated using the zinc oxide mineralized virus template material demonstrates an operational transistor performance which was achieved without any high-temperature post-processing steps. Moreover, a further improvement in FET performance was observed by adjusting an optimal layer thickness of the deposited ZnO on top of the TMV. Such a bio-inorganic nanocomposite semiconductor material accessible using a mild and straightforward microwave processing technique could open up new future avenues within the field of bio-electronics.

  5. Knee-Extension Training with a Single-Joint Hybrid Assistive Limb during the Early Postoperative Period after Total Knee Arthroplasty in a Patient with Osteoarthritis

    Science.gov (United States)

    Sugaya, Hisashi; Kubota, Shigeki; Onishi, Mio; Kanamori, Akihiro; Sankai, Yoshiyuki; Yamazaki, Masashi

    2016-01-01

    The knee range of motion is an important outcome of total knee arthroplasty (TKA). According to previous studies, the knee range of motion temporarily decreases for approximately 1 month after TKA due to postoperative pain and quadriceps dysfunction following surgical invasion into the knee extensor mechanism. We describe our experience with a knee-extension training program based on a single-joint hybrid assistive limb (HAL-SJ, Cyberdyne Inc., Tsukuba, Japan) during the acute recovery phase after TKA. HAL-SJ is a wearable robot suit that facilitates the voluntary control of knee joint motion. A 76-year-old man underwent HAL-SJ-based knee-extension training, which enabled him to perform knee function training during the acute phase after TKA without causing increased pain. Thus, he regained the ability to fully extend his knee postoperatively. HAL-SJ-based knee-extension training can be used as a novel post-TKA rehabilitation modality.

  6. The Realization of Low Loop Voltage Start-up of HT-7 Tokamak Discharge with the Assistance of Lower Hybrid Wave

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Low voltage start-up was realized in HT-7 discharges under the assistance of lower hybrid (LH) waves. The use of a strong LH wave, which can change its N// spectrum in a large range of several milliseconds, made the loop voltage for start-up reduce from around 20 V to less than 5 V. It means that the electric field for HT-7 start-up decreases from 2.5~3 V/m to 0.6 V/m.Some physical phenomena such as the consumption of magnetic flux in start-up phase and the radiation from the initial plasma were observed in this kind of low voltage start-up discharges.

  7. Enhanced Etching, Surface Damage Recovery, and Submicron Patterning of Hybrid Perovskites using a Chemically Gas-Assisted Focused-Ion Beam for Subwavelength Grating Photonic Applications

    KAUST Repository

    Alias, Mohd Sharizal

    2015-12-22

    The high optical gain and absorption of organic–inorganic hybrid perovskites have attracted attention for photonic device applications. However, owing to the sensitivity of organic moieties to solvents and temperature, device processing is challenging, particularly for patterning. Here, we report the direct patterning of perovskites using chemically gas-assisted focused-ion beam (GAFIB) etching with XeF2 and I2 precursors. We demonstrate etching enhancement in addition to controllability and marginal surface damage compared to focused-ion beam (FIB) etching without precursors. Utilizing the GAFIB etching, we fabricated a uniform and periodic submicron perovskite subwavelength grating (SWG) absorber with broadband absorption and nanoscale precision. Our results demonstrate the use of FIB as a submicron patterning tool and a means of providing surface treatment (after FIB patterning to minimize optical loss) for perovskite photonic nanostructures. The SWG absorber can be patterned on perovskite solar cells to enhance the device efficiency through increasing light trapping and absorption.

  8. Enhanced Etching, Surface Damage Recovery, and Submicron Patterning of Hybrid Perovskites using a Chemically Gas-Assisted Focused-Ion Beam for Subwavelength Grating Photonic Applications.

    Science.gov (United States)

    Alias, Mohd S; Yang, Yang; Ng, Tien K; Dursun, Ibrahim; Shi, Dong; Saidaminov, Makhsud I; Priante, Davide; Bakr, Osman M; Ooi, Boon S

    2016-01-01

    The high optical gain and absorption of organic-inorganic hybrid perovskites have attracted attention for photonic device applications. However, owing to the sensitivity of organic moieties to solvents and temperature, device processing is challenging, particularly for patterning. Here, we report the direct patterning of perovskites using chemically gas-assisted focused-ion beam (GAFIB) etching with XeF2 and I2 precursors. We demonstrate etching enhancement in addition to controllability and marginal surface damage compared to focused-ion beam (FIB) etching without precursors. Utilizing the GAFIB etching, we fabricated a uniform and periodic submicron perovskite subwavelength grating (SWG) absorber with broadband absorption and nanoscale precision. Our results demonstrate the use of FIB as a submicron patterning tool and a means of providing surface treatment (after FIB patterning to minimize optical loss) for perovskite photonic nanostructures. The SWG absorber can be patterned on perovskite solar cells to enhance the device efficiency through increasing light trapping and absorption.

  9. Identification of nitrite-reducing bacteria using sequential mRNA fluorescence in situ hybridization and fluorescence-assisted cell sorting.

    Science.gov (United States)

    Mota, Cesar R; So, Mark Jason; de los Reyes, Francis L

    2012-07-01

    Sequential mRNA fluorescence in situ hybridization (mRNA FISH) and fluorescence-assisted cell sorting (SmRFF) was used for the identification of nitrite-reducing bacteria in mixed microbial communities. An oligonucleotide probe labeled with horseradish peroxidase (HRP) was used to target mRNA of nirS, the gene that encodes nitrite reductase, the enzyme responsible for the dissimilatory reduction of nitrite to nitric oxide. Clones for nirS expression were constructed and used to provide proof of concept for the SmRFF method. In addition, cells from pure cultures of Pseudomonas stutzeri and denitrifying activated sludge were hybridized with the HRP probe, and tyramide signal amplification was performed, conferring a strongly fluorescent signal to cells containing nirS mRNA. Flow cytometry-assisted cell sorting was used to detect and physically separate two subgroups from a mixed microbial community: non-fluorescent cells and an enrichment of fluorescent, nitrite-reducing cells. Denaturing gradient gel electrophoresis (DGGE) and subsequent sequencing of 16S ribosomal RNA (rRNA) genes were used to compare the fragments amplified from the two sorted subgroups. Sequences from bands isolated from DGGE profiles suggested that the dominant, active nitrite reducers were closely related to Acidovorax BSB421. Furthermore, following mRNA FISH detection of nitrite-reducing bacteria, 16S rRNA FISH was used to detect ammonia-oxidizing and nitrite-oxidizing bacteria on the same activated sludge sample. We believe that the molecular approach described can be useful as a tool to help address the longstanding challenge of linking function to identity in natural and engineered habitats.

  10. Lung tattooing combined with immediate video-assisted thoracoscopic resection (IVATR) as a single procedure in a hybrid room: our institutional experience in a pediatric population.

    Science.gov (United States)

    Narayanam, Surendra; Gerstle, Ted; Amaral, Joao; John, Philip; Parra, Dimitri; Temple, Michael; Connolly, Bairbre

    2013-09-01

    Analysis of small pulmonary nodules in children poses an important diagnostic and therapeutic challenge for clinicians. To review our experience of lung tattooing with immediate video-assisted thoracoscopic resection (IVATR) performed as a single procedure in a hybrid room for technical difficulties, complications and diagnostic yield of the procedure. Retrospective analysis of 31 children (16 boys, 15 girls) who underwent lung tattooing of various lesions from January 2001 to July 2011. Data were collected from the Interventional Radiology database, Electronic Patient Chart (EPC) and PACS. A total of 34 lesions were treated in 31 children. Tattooing was performed on lung lesions with median size 3 mm and median depth 2 mm from pleura. Technical success was 91.1% and diagnostic yield was 100%. In seven children, it was combined with other interventional radiologic procedures. The median procedure time for lung tattooing and IVATR was 197 min. Lung tattooing with IVATR as a single procedure in a hybrid room is safe and effective in children with several inherent advantages, including avoiding the need to move the child from the interventional radiology suite to the operating room.

  11. Effects of C/N ratio on the performance of a hybrid sponge-assisted aerobic moving bed-anaerobic granular membrane bioreactor for municipal wastewater treatment.

    Science.gov (United States)

    Chen, C; Guo, W S; Ngo, H H; Chang, S W; Nguyen, D D; Zhang, J; Liang, S; Guo, J B; Zhang, X B

    2017-09-09

    This study aimed to evaluate the impact of C/N ratio on the performance of a hybrid sponge-assisted aerobic moving bed-anaerobic granular membrane bioreactor (SAAMB-AnGMBR) in municipal wastewater treatment. The results showed that organic removal efficiencies were above 94% at all C/N conditions. Nutrient removal was over 91% at C/N ratio of 100/5 but was negatively affected when decreasing C/N ratio to 100/10. At lower C/N ratio (100/10), more noticeable membrane fouling was caused by aggravated cake formation and pore clogging, and accumulation of extracellular polymeric substances (EPS) in the mixed liquor and sludge cake as a result of deteriorated granular quality. Foulant analysis suggested significant difference existed in the foulant organic compositions under different C/N ratios, and humic substances were dominant when the fastest fouling rate was observed. The performance of the hybrid system was found to recover when gradually increasing C/N ratio from 100/10 to 100/5. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Label-free in-situ real-time DNA hybridization kinetics detection employing microfiber-assisted Mach-Zehnder interferometer.

    Science.gov (United States)

    Song, Binbin; Zhang, Hao; Liu, Bo; Lin, Wei; Wu, Jixuan

    2016-07-15

    A label-free DNA biosensor based on microfiber-assisted Mach-Zehnder interferometer (MAMZI) for in-situ real-time DNA hybridization kinetics detection has been proposed and experimentally demonstrated. A microfiber of hundreds of microns in length is fabricated by tapering a segment of standard single-mode fiber (SMF) to construct the U-shaped microcavity between the lead-in and lead-out SMFs. Thanks to the mode field mismatching between the SMF and microfiber, the incident guided mode light would separate into two beams that respectively propagate in the air microcavity and the microfiber. Consequently, interference between different light modes would occur at the joint between the microfiber and the lead-out SMF. Experimental results indicate that owing to the participation of opening cavity modes in the modal interference process, the interferometric spectrum of our proposed microcavity sensor is highly sensitive to the variation of environmental refractive index (RI), especially for the RI range around 1.34 which is useful for most biological applications. The microfiber functionalization is achieved by stepwise modifying the microfiber with monolayer Poly-l-lysine (PLL) and single-stranded DNA (ssDNA) probes to produce the sensitive surface that could uniquely attach specific target ssDNAs. The fiber surface functionalization as well as DNA hybridization processes have been experimentally investigated for different target ssDNA solutions in real time. The interferometric transmission spectrum shows large wavelength shift for different biological phases, and a detection limit conservatively down to 0.0001pmol/μL has been acquired by employing the U-shaped microcavity of 176.88μm in length. Our proposed DNA biosensor possesses several advantages such as compact size, ease of fabrication, and strong response for DNA hybridization, which make it a promising candidate for potential applications in such rapidly expanding areas as medical diagnosis, cancer

  13. Scoliosis and the impact in neuromuscular disease.

    Science.gov (United States)

    Mayer, Oscar Henry

    2015-01-01

    Scoliosis can alter respiratory mechanics by changing the orientation of the muscles and joints of the respiratory system and in severe forms can put a patient at risk of severe respiratory morbidity or respiratory failure. However, perhaps the most important factor in determining the pulmonary morbidity in scoliosis is the balance between the "load" or altered respiratory mechanics and the "pump" or the respiratory muscle strength. Therefore, scoliosis in patients with neuromuscular disease will both lead to increased "load" and a weakened "pump", an exceptionally unfortunate combination. While progressive neuromuscular disease by its nature does not respond favorably to attempts to improve respiratory muscle strength, the natural approach of early proactive management of the "load" and in the case of scoliosis a variety of different strategies have been tried with variable short term and long term results. Figuring this out requires both an understanding of the underlying pathophysiology of a particular neuromuscular condition and the available options for and timing of surgical intervention.

  14. Neuromuscular action of crotalid venom: preliminar data

    OpenAIRE

    Maria Dorvalina Silva; Luiz Antônio L. Resende; Anete Kimuni Ueda; Benedito Barraviera; Mendes, R P; Montenegro, Mário Rubens G. [UNESP

    1996-01-01

    Estudamos 6 pacientes, 2 cães e um coelho com intoxicação crotálica. Avaliamos a condução nervosa periférica sensitiva e motora, a transmissão neuromuscular e eletromiografias. As biópsias de músculo foram processadas por histoquímica. Os 6 pacientes apresentaram mononeuropatia sensitiva no nervo periférico adjacente ao local da inoculação do veneno e encontramos evidências histoquímicas de miopatia mitocondrial. Os defeitos da transmissão neuromuscular foram mínimos. A maioria dos autores ad...

  15. Research highlights of partial neuromuscular disorders

    Directory of Open Access Journals (Sweden)

    Cheng ZHANG

    2014-05-01

    Full Text Available In order to understand the latest progression on neuromuscular disorders for clinicians, this review screened and systemized the papers on neuromuscular disorders which were collected by PubMed from January 2013 to February 2014. This review also introduced the clinical diagnosis and treatment hightlights on glycogen storage disease type Ⅱ (GSD Ⅱ, Duchenne muscular dystrophy (DMD, amyotrophic lateral sclerosis (ALS and spinal muscular atrophy (SMA. The important references will be useful for clinicians. doi: 10.3969/j.issn.1672-6731.2014.05.004

  16. Atividade neuromuscular no swing do golfe

    OpenAIRE

    Marta, Sérgio Miguel Álvaro

    2014-01-01

    Doutoramento em Motricidade Humana na especialidade de Comportamento Motor O objetivo desta tese foi estudar da atividade neuromuscular da técnica de swing da modalidade de golfe. Para concretizar o objetivo foram realizados cinco estudos: um estudo em que se efetuou uma revisão de literatura sobre a atividade neuromuscular do swing de golfe e quatro estudos laboratoriais que analisaram o swing de golfe nos músculos do membro superior, tronco e do membro inferior. A revisão de ...

  17. 21 CFR 882.5860 - Implanted neuromuscular stimulator.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Implanted neuromuscular stimulator. 882.5860... (CONTINUED) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Therapeutic Devices § 882.5860 Implanted neuromuscular stimulator. (a) Identification. An implanted neuromuscular stimulator is a device that...

  18. ULTRA-HIGH BW OPTICAL COMMUNICATION USING OXYGEN PLASMA ASSISTED InP BASED HYBRID Si LASER

    Directory of Open Access Journals (Sweden)

    PRATTAY BIN ABDUL WAHAB

    2010-12-01

    Full Text Available This paper demonstrates the development of a hybrid integration platform to build major electrically driven photonic active devices: silicon evanescent DFB lasers, silicon evanescent amplifiers, silicon evanescent waveguide photo-detectors or pre-amplified photo-detectors on a single silicon platform consisting of III-V gain layers with passive waveguide for board to board and for chip to chip optical communication for tera scale computing. The structural description proposed here may push forward the manufacturing of photonic ICs tomake high speed communicational imaginings to reality and to start a new era.

  19. Combined therapy using botulinum toxin A and single-joint hybrid assistive limb for upper-limb disability due to spastic hemiplegia.

    Science.gov (United States)

    Saita, Kazuya; Morishita, Takashi; Hyakutake, Koichi; Fukuda, Hiroyuki; Shiota, Etsuji; Sankai, Yoshiyuki; Inoue, Tooru

    2017-02-15

    We investigated the combination of robot-assisted rehabilitation (RT) using a single-joint hybrid assistive limb (HAL-SJ) and botulinum toxin A (BTX-A) as therapy for paretic arm with spasticity in post-stroke patients. Participants were seven patients (4 females, 3 males; mean (±SD) age: 60.6±8.4years) who had spastic hemiplegia following chronic stroke. On the day following BTX-A injection, we started RT, which was performed for 20 sessions of 60min each over a two-week period. Clinical outcome measures, including Fugl-Meyer Assessment (FMA), Motor Activity Log (MAL), and Disability Assessment Scale (DAS), and cortical activity were evaluated at baseline, and two weeks, and four months following BTX-A injection. Cortical activity associated with elbow joint movement of the affected arm was assessed via functional near infrared spectroscopy (fNIRS). FMA, MAL, and DAS scores significantly improved at two weeks and four months (phemiplegia due to stroke, and functional imaging study showed neuroplasticity induced by the treatment. Copyright © 2016 Elsevier B.V. All rights reserved.

  20. Synthesis of hybrid hollow sub-microspheres assisted by pre-added colloidal SiO2.

    Science.gov (United States)

    Huang, Ting; Wang, Chao; Zhang, Xinping; Wang, Chen; Li, Ailing; Qiu, Dong

    2015-03-01

    A novel method was developed to synthesize organic-inorganic hybrid hollow sub-microspheres (HHSs) through the addition of colloidal SiO2. The hydrolysis rate of 3-(methacryloyloxy)propyltrimethoxysilane (MPS) was accelerated by SiO2 particles; meanwhile, the condensation rate of the hydrolytic species was decelerated. Thus, the hydrolytic monomers and oligomers of MPS were preserved as emulsifiers. These emulsifiers can then emulsify the isopentyl acetate (PEA) to form a steady O/W emulsion. The HHSs were produced by subsequent free radical polymerization and removal of the oil core. The hydrolytic MPS acted as emulsifiers and polymerizable monomers at the emulsification and polymerization stage, respectively. Thus, extra emulsifiers, co-emulsifiers, and organic monomers were omitted, which simplified the synthesis process. The good dispersion of HHSs in water and oil, as well as the EDX results, indicated the organic-inorganic hybrid structure of HHSs. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  1. CLINICAL PHARMACOKINETICS OF NEUROMUSCULAR BLOCKING-DRUGS

    NARCIS (Netherlands)

    AGOSTON, S; VANDENBROM, RHG; WIERDA, JMKH

    1992-01-01

    Neuromuscular blocking agents provide muscle relaxation for a great variety of surgical procedures with light planes of general anaesthesia. Besides having a significant impact in the development of anaesthesia and surgery, these agents continue to play an important role as pharmacological tools in

  2. Neuromuscular transmission: new concepts and agents.

    NARCIS (Netherlands)

    Boer, H.D. de

    2009-01-01

    Sugammadex is the first selective relaxant binding agent which was originally designed to reverse the steroidal NMB drug rocuronium. The results of recent studies demonstrate that sugammadex is effective for reversal of rocuronium and vecuronium-induced neuromuscular block without apparent

  3. Prevalence of complications in neuromuscular scoliosis surgery

    DEFF Research Database (Denmark)

    Sharma, Shallu; Wu, Chunsen; Andersen, Thomas;

    2013-01-01

    PURPOSE: Our objectives were primarily to review the published literature on complications in neuromuscular scoliosis (NMS) surgery and secondarily, by means of a meta-analysis, to determine the overall pooled rates (PR) of various complications associated with NMS surgery. METHODS: PubMed and Em...

  4. Neuromuscular Effects of Acute Organophosphate Poisoning

    Directory of Open Access Journals (Sweden)

    Taylan Pekoz

    2014-08-01

    Conclusion: There is no evoked potential studies performed in organophosphate poisoning althoung electroneurography repetitive and P300 studies exist in literature. More further studies are needed to evaluate the cardiac and neuromuscular effects of organophosphate poisoning. [Cukurova Med J 2014; 39(4.000: 795-800

  5. Experienced and physiological fatigue in neuromuscular disorders.

    NARCIS (Netherlands)

    Schillings, M.L.; Kalkman, J.S.; Janssen, H.M.; Engelen, B.G.M. van; Bleijenberg, G.; Zwarts, M.J.

    2007-01-01

    OBJECTIVE: Fatigue has been described as a typical symptom of neurological diseases. It might be caused both by changes at the peripheral and at the central level. This study measured the level of experienced fatigue and physiological correlates of fatigue in three genetically defined neuromuscular

  6. Electrodiagnosis of disorders of neuromuscular transmission.

    Science.gov (United States)

    Howard, James F

    2013-02-01

    This article reviews the use of electrodiagnostic testing in disorders of neuromuscular transmission and discusses the differences between various presynaptic and postsynaptic disorders. Attention is paid to quality control issues that influence the sensitivity of repetitive nerve stimulation and single fiber electromyography. Electrodiagnostic testing, when used as an extension of the clinician's history and physical examination, will provide appropriate direction in establishing the diagnosis.

  7. Testing of a Hybrid FES-Robot Assisted Hand Motor Training Program in Sub-Acute Stroke Survivors

    Directory of Open Access Journals (Sweden)

    GRIGORAS, A. V.

    2016-11-01

    Full Text Available While hands-on therapy is the most commonly used technique for upper limb rehabilitation after stroke, it requires a therapist and residual activity and is best suited for active-assisted exercises. Robotic therapy on the other hand, can provide intention driven training in a motivating environment. We compared a robotic and standard therapy group, allowing intention driven finger flexion/extention respectively active-assisted exercises and a standard therapy only group. A total of 25 patients, 2 to 6 months post–stroke, with moderate motor deficit (Fugl-Meyer Assessment or FMA between 15 and 50, were randomly assigned in one of the groups. Patients practiced 30 minutes of hands-on therapy each day for 2 weeks with a supplementary 30 minutes of robotic therapy each day for patients in the experimental group. Subjects were evaluated using the FMA, Box and Blocks test (BBT and Stroke Impact Scale (SIS before and after the treatment. Patients in the experimental group showed higher average gain in all tests than those in the control group but only the SIS average gain was on the limit of statistical significance. This study shows the potential efficacy of robotic therapy for hand rehabilitation in subacute stroke patients.

  8. O uso de bloqueadores neuromusculares no Brasil El uso de bloqueadores neuromusculares en Brasil Neuromuscular blockers in Brazil

    Directory of Open Access Journals (Sweden)

    Maria Cristina Simões de Almeida

    2004-12-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Dados estatísticos referentes ao uso de bloqueadores neuromusculares no Brasil são desconhecidos. Este trabalho se propõe a análise estatística desse tópico. MÉTODO: Foram compiladas 831 respostas de um questionário preenchido em parte por anestesiologistas presentes ao 48º Congresso Brasileiro de Anestesiologia em Recife, 2001 e em parte via Internet, por anestesiologistas cujos endereços eletrônicos constam na página da Sociedade Brasileira de Anestesiologia (www.sba.com.br. Foram analisados os seguintes dados: tempo de contato com a especialidade, região onde atuam os anestesiologistas, uso de bloqueadores neuromusculares (BNM em ordem de preferência, indicações do uso de succinilcolina, uso do monitor da transmissão neuromuscular, critérios para se considerar o paciente descurarizado, uso de neostigmina, forma de administração dos BNM e descrição de complicações observadas. RESULTADOS: A maioria dos anestesiologistas em questão exerce a profissão há mais de 11 anos e o maior número de respostas foi proveniente da região sudeste do Brasil. O BNM mais empregado é o atracúrio, seguido de pancurônio e succinilcolina. A succinilcolina é mais empregada na indução rápida e em crianças (80% e 25% respectivamente. Monitores da transmissão neuromuscular, 53% dos anestesiologistas nunca usam, e como critério de recuperação, 92% consideram o paciente descurarizado mediante sinais clínicos. Em 45% das vezes os profissionais empregam a neostigmina de forma rotineira, e 94% administra os BNM sob forma de bolus. Cerca de 30% registra ter havido complicação decorrente do uso de BNM. As complicações mais apontadas foram o bloqueio prolongado, o broncoespasmo grave e a curarização residual. CONCLUSÕES: O atracúrio é o bloqueador neuromuscular mais empregado no Brasil, há percentual alto de uso da succinilcolina em situações não emergenciais, o uso de monitores da transmiss

  9. Supercritical CO2 assisted process for the production of high-purity and sterile nano-hydroxyapatite/chitosan hybrid scaffolds.

    Science.gov (United States)

    Ruphuy, G; Souto-Lopes, M; Paiva, D; Costa, P; Rodrigues, A E; Monteiro, F J; Salgado, C L; Fernandes, M H; Lopes, J C; Dias, M M; Barreiro, M F

    2017-05-04

    Hybrid scaffolds composed of hydroxyapatite (HAp), in particular in its nanometric form (n-HAp), and chitosan (CS) are promising materials for non-load-bearing bone graft applications. The main constraints of their production concern the successful implementation of the final purification/neutralization and sterilization steps. Often, the used purification strategies can compromise scaffold structural features, and conventional sterilization techniques can result in material's thermal degradation and/or contamination with toxic residues. In this context, this work presents a process to produce n-HAp/CS scaffolds mimicking bone composition and structure, where an innovative single step based on supercritical CO2 extraction was used for both purification and sterilization. A removal of 80% of the residual acetic acid was obtained (T = 75°C, p = 8.0 MPa, 2 extraction cycles of 2 h) giving rise to scaffolds exhibiting adequate interconnected porous structure, fast swelling and storage modulus compatible with non-load-bearing applications. Moreover, the obtained scaffolds showed cytocompatibility and osteoconductivity without further need of disinfection/sterilization procedures. Among the main advantages, the proposed process comprises only three steps (n-HAp/CS dispersion preparation; freeze-drying; and supercritical CO2 extraction), and the supercritical CO2 extraction show clear advantages over currently used procedures based on neutralization steps. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2017. © 2017 Wiley Periodicals, Inc.

  10. Neuromuscular blockade in children Bloqueadores neuromusculares em crianças

    Directory of Open Access Journals (Sweden)

    João Fernando Lourenço de Almeida

    2000-06-01

    Full Text Available Neuromuscular blocking agents (NMBAs have been widely used to control patients who need to be immobilized for some kind of medical intervention, such as an invasive procedure or synchronism with mechanical ventilation. The purpose of this monograph is to review the pharmacology of the NMBAs, to compare the main differences between the neuromuscular junction in neonates, infants, toddlers and adults, and moreover to discuss their indications in critically ill pediatric patients. Continuous improvement of knowledge about NMBAs pharmacology, adverse effects, and the many other remaining unanswered questions about neuromuscular junction and neuromuscular blockade in children is essential for the correct use of these drugs. Therefore, the indication of these agents in pediatrics is determined with extreme judiciousness. Computorized (Medline 1990-2000 and active search of articles were the mechanisms used in this review.Os bloqueadores neuromusculares têm sido amplamente utilizados para controlar pacientes que necessitem imobilidade para algum tipo de intervenção médica, desde a realização de procedimentos invasivos até a obtenção de sincronismo com a ventilação mecânica. O objetivo básico desta monografia é revisar a farmacologia dos principais bloqueadores neuromusculares, analisar as diferenças existentes na junção neuromuscular de neonatos, lactentes, pré-escolares e adultos, além de discutir suas indicações em pacientes criticamente enfermos internados em unidade de terapia intensiva pediátrica. Revisão computadorizada da literatura (Medline 1990-2000 associado a busca ativa de artigos compuseram o mecanismo de busca dos dados desta revisão.

  11. The use of "stabilization exercises" to affect neuromuscular control in the lumbopelvic region: a narrative review.

    Science.gov (United States)

    Bruno, Paul

    2014-06-01

    It is well-established that the coordination of muscular activity in the lumbopelvic region is vital to the generation of mechanical spinal stability. Several models illustrating mechanisms by which dysfunctional neuromuscular control strategies may serve as a cause and/or effect of low back pain have been described in the literature. The term "core stability" is variously used by clinicians and researchers, and this variety has led to several rehabilitative approaches suggested to affect the neuromuscular control strategies of the lumbopelvic region (e.g. "stabilization exercise", "motor control exercise"). This narrative review will highlight: 1) the ongoing debate in the clinical and research communities regarding the terms "core stability" and "stabilization exercise", 2) the importance of sub-grouping in identifying those patients most likely to benefit from such therapeutic interventions, and 3) two protocols that can assist clinicians in this process.

  12. Donepezil: A cause of inadequate muscle relaxation and delayed neuromuscular recovery

    Directory of Open Access Journals (Sweden)

    Alka Bhardwaj

    2011-01-01

    Full Text Available A 74-year-old female with diabetes mellitus type II and Alzheimer′s disease, taking donepezil for 4 months was operated for right modified radical mastectomy under general anesthesia. During the procedure a higher dose of non-depolarizing muscle relaxant was required than those recommended for her age yet the muscle relaxation was inadequate intra-operatively. Residual neuromuscular blockade persisted postoperatively, due to the cumulative effect of large doses of non-depolarizing muscle relaxant, needing post-operative ventilatory assistance. After ruling out other causes of resistance to non-depolarizing muscle relaxants, we concluded that acetylcholinesterase inhibitor donepezil was primarily responsible for inadequate muscle relaxation and delayed post-operative neuromuscular recovery.

  13. One-step microwave-assisted colloidal synthesis of hybrid silver oxide/silver nanoparticles: characterization and catalytic study

    Science.gov (United States)

    Prakoso, S. P.; Taufik, A.; Saleh, R.

    2017-04-01

    This study reports the characterization and catalytic activities of silver-oxide/silver nanoparticles (Ag2O/Ag NPs) synthesized by microwave-assisted colloidal method in the presence of anionic sodium dodecyl sulfate (SDS) surfactant. To promote different contents of silver in silver oxide, the volume ratio (VR) of ethylene glycol (EG) was varied (VR: 10% to 14%) in relation to the total volume of distilled water solvent. The plasmonic resonance of Ag2O/Ag NPs could be detected around a wavelength of 350 nm, and it is suggested that Ag2O/Ag NPs were successfully formed in the colloid solution following exposure to microwaves. Additionally, the growth rate for each crystal phase within Ag2O and Ag was influenced by an increase of EG as revealed by x-ray diffraction patterns. The morphology, average diameter, and uniformity of Ag2O/Ag NPs were studied simultaneously by transmission electron microscopy. Infrared absorption measurement of Ag2O/Ag NPs confirmed the existence of SDS surfactant as a protective agent. Based on the characterization data, Ag2O/Ag NPs synthesized using this technique exhibited good properties, with high-yield production of NPs. The photocatalytic experiments demonstrate the key role of the crystal phase of Ag2O/Ag NPs in photocatalytic efficiency.

  14. Multimodal hybrid imaging agents for sentinel node mapping as a means to (re)connect nuclear medicine to advances made in robot-assisted surgery

    Energy Technology Data Exchange (ETDEWEB)

    KleinJan, Gijs H. [Leiden University Medical Hospital, Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden (Netherlands); The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Department of Nuclear Medicine, Amsterdam (Netherlands); Berg, Nynke S. van den [Leiden University Medical Hospital, Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden (Netherlands); The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Department of Urology, Amsterdam (Netherlands); Jong, Jeroen de [The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Department of Pathology, Amsterdam (Netherlands); Wit, Esther M.; Poel, Henk G. van der [The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Department of Urology, Amsterdam (Netherlands); Thygessen, Helene [The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Department of Biostatistics, Amsterdam (Netherlands); Vegt, Erik [The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Department of Nuclear Medicine, Amsterdam (Netherlands); Leeuwen, Fijs W.B. van [Leiden University Medical Hospital, Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden (Netherlands); The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Department of Urology, Amsterdam (Netherlands); The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Department of Head and Neck Surgery and Oncology, Amsterdam (Netherlands)

    2016-07-15

    Radical prostatectomy and complementary extended pelvic lymph node dissection (ePLND) of sentinel lymph nodes (SNs) and non-sentinel lymph nodes (LNs) at risk of containing metastases are increasingly being performed using high-tech robot-assisted approaches. Although this technological evolution has clear advantages, the physical nature of robotic systems limits the integrated use of routine radioguided surgery technologies. Hence, engineering effort in robotics are focused on the integration of fluorescence guidance technologies. Using the hybrid SN tracer indocyanine green-{sup 99m}Tc-nanocolloid (radioactive and fluorescent), for the first time in combination with a robot-integrated laparoscope, we investigated whether the robot-assisted approach affects the accuracy of fluorescence detection of SNs identified preoperatively using nuclear medicine. The study included 55 patients (Briganti nomogram-based risk >5 % on LN metastases) scheduled for robot-assisted radical prostatectomy, SN biopsy and ePLND. Following indocyanine green-{sup 99m}Tc-nanocolloid injection, preoperative nuclear imaging (lymphoscintigraphy and SPECT/CT) was used to locate the SN(s). The fluorescence laparoscope was used intraoperatively to identify the SN(s) with standard fluorescence settings (in 50 patients) and with customized settings (in 5 patients). The number and location of the SNs, the radioactive, fluorescence (both in vivo and ex vivo) and tumour status of the resected SNs/LNs, and postoperative complications were recorded and analysed. Combined, preoperative lymphoscintigraphy and SPECT/CT imaging identified 212 SNs (median 4 per patient). Intraoperative fluorescence imaging using standard fluorescence settings visualized 80.4 % (148/184 SNs; 50 patients; ex vivo 97.8 %). This increased to 85.7 % (12/14 SNs; 5 patients; ex vivo 100 %) with customized fluorescence settings. SPECT/CT images provided guidance towards the residual SNs. Ex vivo all removed SNs were radioactive. SNs

  15. Quick Screening of Pareto-Optimal Operating Conditions for Expanding Solvent–Steam Assisted Gravity Drainage Using Hybrid Multi-Objective Optimization Approach

    Directory of Open Access Journals (Sweden)

    Baehyun Min

    2017-07-01

    Full Text Available Solvent–steam mixture is a key factor in controlling the economic efficiency of the solvent-aided thermal injection process for producing bitumen in a highly viscous oil sands reservoir. This paper depicts a strategy to quickly provide trade-off operating conditions of the Expanding Solvent–Steam Assisted Gravity Drainage (ES-SAGD process based on Pareto-optimality. Response surface models are employed to evaluate multiple ES-SAGD scenarios at low computational costs. The surrogate models play a role of objective-estimators in the multi-objective optimization that provides qualified ES-SAGD scenarios regarding bitumen recovery, steam–energy efficiency, and solvent-energy efficiency. The developed hybrid approach detects positive or negative correlations among the performance indicators of the ES-SAGD process. The derived Pareto-optimal operating conditions give flexibility in field development planning and thereby help decision makers determine the operating parameters of the ES-SAGD process based on their preferences.

  16. Neuromuscular blockade during laparoscopic ventral herniotomy

    DEFF Research Database (Denmark)

    Medici, Roar; Madsen, Matias V; Asadzadeh, Sami;

    2015-01-01

    INTRODUCTION: Laparoscopic herniotomy is the preferred technique for some ventral hernias. Several factors may influence the surgical conditions, one being the depth of neuromuscular blockade (NMB) applied. We hypothesised that deep neuromuscular blockade defined as a post-tetanic count below eight...... would provide a better surgical workspace. METHODS: This was an investigator-initiated, assessor- and patient-blinded randomised cross-over study. A total of 34 patients with planned laparoscopic umbilical, incisional and linea alba herniotomy were studied. Patients would be randomised to receive deep......'s rating of surgical conditions during suturing, duration of surgery and duration of the suturing of the hernia. CONCLUSION: This randomised cross-over study investigated a potential effect on the surgical workspace in laparoscopic ventral herniotomy using deep NMB compared with no NMB. The study may...

  17. Neuromuscular monitoring: old issues, new controversies.

    Science.gov (United States)

    Kopman, Aaron F

    2009-03-01

    "Expert" editorial opinion suggests that objective or quantitative neuromuscular monitors should be used whenever nondepolarizing blocking agents are administered. It is clear that this advice has by and large fallen on deaf ears. A sizeable number of clinicians here (North America) and abroad (Europe) fail to use even conventional peripheral nerve stimulators routinely. This chapter will explore potential reasons for and consequences of this disconnect between academia and "the real world." Along the way, we will examine such questions as how do we define and measure adequate recovery from nondepolarizing block. What are the limitations of clinical tests of recovery such as the "head-lift test?" What is the incidence of undetected postoperative residual curarization (PORC)? Does neuromuscular monitoring reduce the frequency of PORC? How will the availability of sugammadex alter the above discussion?

  18. Neuromuscular electrical stimulation for skeletal muscle function.

    Science.gov (United States)

    Doucet, Barbara M; Lam, Amy; Griffin, Lisa

    2012-06-01

    Lack of neural innervation due to neurological damage renders muscle unable to produce force. Use of electrical stimulation is a medium in which investigators have tried to find a way to restore movement and the ability to perform activities of daily living. Different methods of applying electrical current to modify neuromuscular activity are electrical stimulation (ES), neuromuscular electrical stimulation (NMES), transcutaneous electrical nerve stimulation (TENS), and functional electrical stimulation (FES). This review covers the aspects of electrical stimulation used for rehabilitation and functional purposes. Discussed are the various parameters of electrical stimulation, including frequency, pulse width/duration, duty cycle, intensity/amplitude, ramp time, pulse pattern, program duration, program frequency, and muscle group activated, and how they affect fatigue in the stimulated muscle.

  19. Autoregulation of Neuromuscular Transmission by Nerve Terminals.

    Science.gov (United States)

    1985-09-01

    strengthen muscular FC because of the so- called "margin of safety." However, select prejunctional cholinoceptor antagonism may have the potential...receptor. Br. J. Anaesth. 54: 115- 130, 1982. 17. Peper , K., Bradley, R.J. and Dreyer, F. The acetylcholine 28 receptor at the neuromuscular junction...and Peper , K., Prejunctional effects of anticholinesterase drugs at the endplate mediated by presynaptic acetylcholine receptors or by postsynaptic

  20. Neuromuscular adaptation to actual and simulated weightlessness

    Science.gov (United States)

    Edgerton, V. R.; Roy, R. R.

    1994-01-01

    The chronic "unloading" of the neuromuscular system during spaceflight has detrimental functional and morphological effects. Changes in the metabolic and mechanical properties of the musculature can be attributed largely to the loss of muscle protein and the alteration in the relative proportion of the proteins in skeletal muscle, particularly in the muscles that have an antigravity function under normal loading conditions. These adaptations could result in decrements in the performance of routine or specialized motor tasks, both of which may be critical for survival in an altered gravitational field, i.e., during spaceflight and during return to 1 G. For example, the loss in extensor muscle mass requires a higher percentage of recruitment of the motor pools for any specific motor task. Thus, a faster rate of fatigue will occur in the activated muscles. These consequences emphasize the importance of developing techniques for minimizing muscle loss during spaceflight, at least in preparation for the return to 1 G after spaceflight. New insights into the complexity and the interactive elements that contribute to the neuromuscular adaptations to space have been gained from studies of the role of exercise and/or growth factors as countermeasures of atrophy. The present chapter illustrates the inevitable interactive effects of neural and muscular systems in adapting to space. It also describes the considerable progress that has been made toward the goal of minimizing the functional impact of the stimuli that induce the neuromuscular adaptations to space.

  1. Influence of intense neuromuscular blockade on surgical conditions during laparotomy

    DEFF Research Database (Denmark)

    Madsen, Matias Vested; Donatsky, Anders Meller; Jensen, Bente Rona

    2015-01-01

    neuromuscular block on surgical conditions with a subjective rating scale, force needed to close the fascia, incidences of abdominal contractions while suctioning the lungs, width of the wound diastase and operating time as outcome parameters. RESULTS: In all six pigs no abdominal contractions occurred while...... neuromuscular block suctioning the lungs elicited brief periods of abdominal EMG activity. No difference was found in the force needed to close the fascia when comparing no neuromuscular block with intense neuromuscular block. Furthermore, no significant differences were found in the width of the diastase...... not influence the force needed to close the fascia....

  2. Microwave-assisted rapid synthesis of Fe{sub 2}O{sub 3}/ACF hybrid for high efficient As(V) removal

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Huiyun; Lv, Kangle; Du, Ying; Ye, Hengpeng; Du, Dongyun, E-mail: dydu666@mail.scuec.edu.cn

    2016-07-25

    In this paper, an efficient adsorbent, iron-modified activated carbon fiber (Fe{sub 2}O{sub 3}/ACF), was rapidly fabricated by microwave-assisted heating treatment strategy, which is used to remove As(V) from simulated wastewater. The adsorbent was characterized by scanning electron microscopy (SEM), TEM, N{sub 2} sorption, X-ray diffraction (XRD), and X-ray photoelectron spectroscopy (XPS). The characterization results showed that rod-like Fe{sub 2}O{sub 3} particles in sizes of about 20 nm × 50 nm were homogeneously anchored on the surface of ACF. The goal of high As(V) removal efficiency was achieved with maximum adsorption capacity of 20.33 mg g{sup −1}. The effects of temperature on thermodynamics and kinetics of As(V) adsorption were systematically studied. It was found that the adsorption of As(V) on the surface of Fe{sub 2}O{sub 3}/ACF is an endothermic process with a standard enthalpy change (ΔH{sup 0}) of 24.79 kJ mol{sup −1}. Batch experimental result showed that almost all of the As(V) with initial concentration of 3.0 mg L{sup −1} can be removed in the presence of Fe{sub 2}O{sub 3}/ACF, where the residual As(V) in filtrate was less than 0.01 mg L{sup −1}, below the tolerance level of drinking water suggested by World Health Organization (WHO). The presence of salt such as NaCl, Na{sub 2}SO{sub 4}, and MgSO{sub 4} showed little effects on the adsorption of As(V), indicating the promising application of Fe{sub 2}O{sub 3}/ACF in industrial wastewater. - Highlights: • Fe{sub 2}O{sub 3}/ACF hybrid was rapidly fabricated using a microwave-assisted heating strategy. • Fe{sub 2}O{sub 3} nanorods in sizes of 20 × 50 nm were homogeneously anchored on the surface of ACF. • The maximum adsorption capacity of 20.33 mg g{sup −1} As (V) on Fe{sub 2}O{sub 3}/ACF was achieved. • The adsorption of As (V) is an endothermic process (ΔH{sup 0} = 24.79 kJ mol{sup −1}). • The presence of salt shows little effect on the adsorption of As (V).

  3. Selective sequential separation of ABS/HIPS and PVC from automobile and electronic waste shredder residue by hybrid nano-Fe/Ca/CaO assisted ozonisation process.

    Science.gov (United States)

    Mallampati, Srinivasa Reddy; Lee, Byoung Ho; Mitoma, Yoshiharu; Simion, Cristian

    2017-02-01

    The separation of plastics containing brominated flame retardants (BFR) like (acrylonitrile-butadiene-styrene (ABS), high-impact polystyrene (HIPS), and polyvinyl chloride (PVC)) from automobile and electronic waste shredder residue (ASR/ESR) are a major concern for thermal recycling. In laboratory scale tests using a hybrid nano-Fe/Ca/CaO assisted ozonation treatment has been found to selectively hydrophilize the surface of ABS/HIPS and PVC plastics, enhancing ABS wettability and thereby promoting its separation from ASR/ESR by means of froth flotation. The water contact angles, of ABS/HIPS and PVC decreased, about 18.7°, 18.3°, and 17.9° in ASR and about 21.2°, 20.7°, and 20.0° in ESR respectively. SEM-EDS, FT-IR, and XPS analyses demonstrated a marked decrease in [Cl] and a significant increase in the number of hydrophilic groups, such as CO, CO, and (CO)O, on the PVC or ABS surface. Under froth flotation conditions at 50rpm, about 99.1% of combined fraction of ABS/HIPS in ASR samples and 99.6% of ABS/HIPS in ESR samples were separated as settled fraction. After separation, the purity of the recovered combined ABS/HIPS fraction was 96.5% and 97.6% in ASR and ESR samples respectively. Furthermore, at 150rpm a 100% PVC separation in the settled fraction, with 98% and 99% purity in ASR and ESR plastics, respectively. Total recovery of non-ABS/HIPS and PVC plastics reached nearly 100% in the floating fraction. Further, this process improved the quality of recycled ASR/ESR plastics by removing surface contaminants or impurities.

  4. Possible applications of Neuromuscular Taping in pain reduction in Multiple Sclerosis subject: a preliminary report

    Directory of Open Access Journals (Sweden)

    Carmine Berlingieri

    2016-12-01

    Full Text Available Pain is a common disabling symptom in patients with Multiple Sclerosis (MS. It has been indicated that pain prevalence in MS patients is between 29–86 %. It is evident that most MS patients requiring treatment will be also searching pain related treatments to assist in day to day activities. Neuropathic pain is a difficult symptom and is generally inadequately relieved even though different rehabilitative approaches may be used. Neuromuscular Taping inducing micro-movements by stimulating receptors in the skin has been described in literature as a possible intervention in neurological and orthopedic rehabilitation improving mobility and in pain reduction. The aim of this preliminary report was to analyze the effect and to evaluate the possible applications of Neuromuscular Taping (NMT in patients with MS in order to reduce pain in comparison to the Transcutaneous Electrical Nerve Stimulation (TENS and to physical rehabilitation treatment alone. We observed that NMT together with standard physical rehabilitation was able to reduce neuropathic pain to greater lengths, with statistically significant differences between pre and post treatment, compared to the other treatments evaluated. This study showed increased efficacy in pain reduction when NMT was applied to standard physical treatment in long standing pain conditions. Neuromuscular Taping may constitute a low cost treatment strategy for neuropathic pain conditions in MS.

  5. Genotyping for Glycophorin GYP(B-A-B) Hybrid Genes Using a Single Nucleotide Polymorphism-Based Algorithm by Matrix-Assisted Laser Desorption/Ionisation, Time-of-Flight Mass Spectrometry.

    Science.gov (United States)

    Wei, Ling; Lopez, Genghis H; Ji, Yanli; Condon, Jennifer A; Irwin, Darryl L; Luo, Guangping; Hyland, Catherine A; Flower, Robert L

    2016-10-01

    The genetic basis for five GP(B-A-B) MNS system hybrid glycophorin blood group antigens results from rearrangement between the homologous GYPA and GYPB genes. Each hybrid glycophorin displays a characteristic profile of antigens. Currently, no commercial serological reagents are currently available to serologically type for these antigens. The aim of this study was to develop a single nucleotide polymorphism (SNP) mapping genotyping technique to allow characterisation of various GYP(B-A-B) hybrid alleles. Matrix-assisted laser desorption/ionisation time-of-flight (MALDI-TOF) mass spectrometry (MS) assays were designed to genotype five GYP(B-A-B) hybrid alleles. Eight nucleotide positions were targeted and incorporated into the SNP mapping protocol. The allelic frequencies were calculated using peak areas. Sanger sequencing was performed to resolve a GYP*Hop 3' breakpoint. Observed allelic peak area ratios either coincided with the expected ratio or were skewed (above or below) from the expected ratio with switching occurring at and after the expected break point to generate characteristic mass spectral plots for each hybrid. Sequencing showed that the GYP*Hop crossover in the intron 3 region, for this example, was identical to that for GYP*Bun reference sequence. An analytical algorithm using MALDI-TOF MS genotyping platform defined GYPA inserts for five GYP(B-A-B) hybrids. The SNP mapping technique described here demonstrates proof of concept that this technology is viable for genotyping hybrid glycophorins, GYP(A-B-A), GYP(A-B) and GYP(B-A), and addresses the gap in current typing technologies.

  6. Classification of neuromuscular blocking agents in a new neuromuscular preparation of the chick in vitro

    NARCIS (Netherlands)

    Riezen, H. van

    1968-01-01

    A neuromuscular preparation of the chick is described: 1. 1. The sciatic nerve-tibilis anterior muscle preparation of the 2–10 days old chick fulfils all criteria of an assay preparation and differentiates between curare-like and decamethonium-like agents. 2. 2. The preparation responds to

  7. Neuromuscular Manifestations of West Nile Virus Infection

    Directory of Open Access Journals (Sweden)

    A. Arturo eLeis

    2012-03-01

    Full Text Available The most common neuromuscular manifestation of West Nile virus (WNV infection is a poliomyelitis syndrome with asymmetric paralysis variably involving one (monoparesis to four limbs (quadriparesis, with or without brainstem involvement and respiratory failure. This syndrome of acute flaccid paralysis may occur without overt fever or meningoencephalitis. Although involvement of anterior horn cells in the spinal cord and motor neurons in the brainstem are the major sites of pathology responsible for neuromuscular signs, inflammation also may involve skeletal or cardiac muscle (myositis, myocarditis, motor axons (polyradiculitis, peripheral nerve (Guillain-Barré syndrome, brachial plexopathy. In addition, involvement of spinal sympathetic neurons and ganglia provides a plausible explanation for autonomic instability seen in some patients. Many patients also experience prolonged subjective generalized weakness and disabling fatigue. Despite recent evidence that WNV may persist long term in the central nervous system or periphery in animals, the evidence in humans is controversial. WNV persistence would be of great concern in immunosuppressed patients or in those with prolonged or recurrent symptoms. Support for the contention that WNV can lead to autoimmune disease arises from reports of patients presenting with various neuromuscular diseases that presumably involve autoimmune mechanisms (GBS, other demyelinating neu¬ropathies, myasthenia gravis, brachial plexopathies, stiff-person syndrome, and delayed or recurrent symptoms. Although there is no specific treatment or vaccine currently approved in humans, and the standard remains supportive care, drugs that can alter the cascade of immunobiochemical events leading to neuronal death may be potentially useful (high-dose corticosteroids, interferon preparations, and intravenous immune globulin containing WNV-specific antibodies. Human experience with these agents seems promising based on anecdotal

  8. Acute neuromuscular weakness associated with dengue infection

    Directory of Open Access Journals (Sweden)

    Harmanjit Singh Hira

    2012-01-01

    Full Text Available Background: Dengue infections may present with neurological complications. Whether these are due to neuromuscular disease or electrolyte imbalance is unclear. Materials and Methods: Eighty-eight patients of dengue fever required hospitalization during epidemic in year 2010. Twelve of them presented with acute neuromuscular weakness. We enrolled them for study. Diagnosis of dengue infection based on clinical profile of patients, positive serum IgM ELISA, NS1 antigen, and sero-typing. Complete hemogram, kidney and liver functions, serum electrolytes, and creatine phosphokinase (CPK were tested. In addition, two patients underwent nerve conduction velocity (NCV test and electromyography. Results: Twelve patients were included in the present study. Their age was between 18 and 34 years. Fever, myalgia, and motor weakness of limbs were most common presenting symptoms. Motor weakness developed on 2 nd to 4 th day of illness in 11 of 12 patients. In one patient, it developed on 10 th day of illness. Ten of 12 showed hypokalemia. One was of Guillain-Barré syndrome and other suffered from myositis; they underwent NCV and electromyography. Serum CPK and SGOT raised in 8 out of 12 patients. CPK of patient of myositis was 5098 IU. All of 12 patients had thrombocytopenia. WBC was in normal range. Dengue virus was isolated in three patients, and it was of serotype 1. CSF was normal in all. Within 24 hours, those with hypokalemia recovered by potassium correction. Conclusions: It was concluded that the dengue virus infection led to acute neuromuscular weakness because of hypokalemia, myositis, and Guillain-Barré syndrome. It was suggested to look for presence of hypokalemia in such patients.

  9. Desarrollo neuromuscular en la atrofia muscular espinal

    OpenAIRE

    Martínez Hernàndez, Rebeca

    2012-01-01

    INTRODUCCIÓN: La atrofia muscular espinal (AME) es una enfermedad neuromuscular infantil caracterizada por la muerte de las neuronas motoras del asta anterior de la médula espinal. Como consecuencia de ello hay una degeneración y atrofia muscular, por lo que los pacientes mueren a menudo de insuficiencias respiratorias graves. La AME se clasifica en tres tipos principales según el grado de gravedad, la edad de aparición y las pautas motoras. Se trata de una enfermedad con patrón de herencia a...

  10. Motoneuron and sensory neuron plasticity to varying neuromuscular activity levels

    Science.gov (United States)

    Ishihara, Akihiko; Roy, Roland R.; Ohira, Yoshinobu; Edgerton, V. Reggie

    2002-01-01

    The size and phenotypic properties of the neural and muscular elements of the neuromuscular unit are matched under normal conditions. When subjected to chronic decreases or increases in neuromuscular activity, however, the adaptations in these properties are much more limited in the neural compared with the muscular elements.

  11. Functional neuromuscular stimulation: outcomes in young people with tetraplegia.

    Science.gov (United States)

    Mulcahey, M J; Smith, B T; Betz, R R; Triolo, R J; Peckham, P H

    1994-01-01

    Percutaneous intramuscular functional neuromuscular stimulation (FNS) systems were fitted to the forearms of five adolescents with tetraplegia in an effort to provide active grasp and release. Two assessments designed at Case Western Reserve University to evaluate functional outcomes of FNS in adults were employed. The common object test (COT) was used to assess hand function during five activities of daily living (ADLs): eating, drinking, writing, brushing teeth and applying toothpaste. A usage survey provided information on the frequency of FNS use in environments outside of the laboratory. In addition, interviews were employed using open-ended questions to gain a deeper understanding of the perceptions of FNS in the adolescents' own environments. Based on the COT results, each adolescent was able to perform ADLs with and without FNS. However, FNS allowed unilateral function so that the extremity without FNS was freed to assist in balance or participate in bilateral tasks. Also, FNS reduced the need for multiple devices, providing users with the potential to perform activities in a variety of environments without transporting adaptive equipment. Those who reported using FNS most often obtained hard-bound school books, held pens during classroom and homework assignments, engaged in leisure activities and performed hygiene tasks. FNS was also used as a means to communicate and socialize through hand gestures. Well-known factors that influence the independence of people with tetraplegia also appeared to affect FNS use.

  12. Pulmonary rehabilitation to decrease perioperative risks of spinal fusion for patients with neuromuscular scoliosis and low vital capacity.

    Science.gov (United States)

    Lee, Jang W; Won, Yu H; Kim, Dong H; Choi, Won A; Bach, John R; Kim, Dong J; Kang, Seoung W

    2016-02-01

    In patients with neuromuscular disease and a forced vital capacity (FVC) of transcutaneous carbon dioxide was monitored and noninvasive intermittent positive pressure ventilation was applied as needed to maintain normal carbon dioxide concentration. Air stacking, manually assisted coughing and mechanical insufflation-exsufflation were used to maintain normal oxygen saturation. A total of 24 patients of neuromuscular disease (mean age: 15.2 years; average FVC: 19.2%) were included Noninvasive intermittent positive pressure ventilator (NIPPV) was applied in 22 of the 24 patients. The endotracheal tubes of all except two patients were removed within 3 days after the operation, and they were transferred to the general ward within 3 days of extubation. Eight patients had complications, such as pneumonia, wound infection, heart failure, and debility, which were controlled easily with medical management, there were neither life-threatening complications nor a need for an invasiverespiratory intervention. Through pulmonary rehabilitation, scoliosis correction surgery could be performed safely even in patients with a neuromuscular disease and a low FVC. The findings of this study can be used as a basis for practical guidelines for successful and safe mechanical correction of neuromuscular scoliosis.

  13. NEUROMUSCULAR AND CARDIOVASCULAR EFFECTS OF NEOSTIGMINE AND METHYL-ATROPINE ADMINISTERED AT DIFFERENT DEGREES OF ROCURONIUM-INDUCED NEUROMUSCULAR BLOCK

    NARCIS (Netherlands)

    VANDENBROEK, L; PROOST, JH; WIERDA, JMKH; NJOO, MD; HENNIS, PJ

    1994-01-01

    The neuromuscular and cardiovascular effects of neostigmine, 40 mug kg-1, and methyl-atropine, 7 mug kg-1, administered at different degrees of rocuronium-induced (600 mug kg-1) neuromuscular block were evaluated. In one group of patients spontaneous recovery was awaited (Group A; n = 20). Neostigmi

  14. Neuromuscular imaging in inherited muscle diseases

    Energy Technology Data Exchange (ETDEWEB)

    Wattjes, Mike P. [VU University Medical Center, Department of Radiology, De Boelelaan 1117, HV, Amsterdam (Netherlands); Kley, Rudolf A. [Klinken Bergmannsheil, Ruhr-University, Department of Neurology, Neuromuscular Centre Ruhrgebiet, Bochum (Germany); Fischer, Dirk [University Hospital of Basel, Department of Neurology, Basel (Switzerland); University Children' s Hospital Basel, Department of Neuropaediatrics, Basel (Switzerland)

    2010-10-15

    Driven by increasing numbers of newly identified genetic defects and new insights into the field of inherited muscle diseases, neuromuscular imaging in general and magnetic resonance imaging (MRI) in particular are increasingly being used to characterise the severity and pattern of muscle involvement. Although muscle biopsy is still the gold standard for the establishment of the definitive diagnosis, muscular imaging is an important diagnostic tool for the detection and quantification of dystrophic changes during the clinical workup of patients with hereditary muscle diseases. MRI is frequently used to describe muscle involvement patterns, which aids in narrowing of the differential diagnosis and distinguishing between dystrophic and non-dystrophic diseases. Recent work has demonstrated the usefulness of muscle imaging for the detection of specific congenital myopathies, mainly for the identification of the underlying genetic defect in core and centronuclear myopathies. Muscle imaging demonstrates characteristic patterns, which can be helpful for the differentiation of individual limb girdle muscular dystrophies. The aim of this review is to give a comprehensive overview of current methods and applications as well as future perspectives in the field of neuromuscular imaging in inherited muscle diseases. We also provide diagnostic algorithms that might guide us through the differential diagnosis in hereditary myopathies. (orig.)

  15. Cardiorespiratory and neuromuscular responses to motocross riding.

    Science.gov (United States)

    Konttinen, Tomi; Kyröläinen, Heikki; Häkkinen, Keijo

    2008-01-01

    The aim of the present study was to examine physiological and neuromuscular responses during motocross riding at individual maximal speed together with the riding-induced changes in maximal isometric force production. Seven A-level (group A) and 5 hobby-class (group H) motocross-riders performed a 30-minute riding test on a motocross track and maximal muscle strength and oxygen uptake (VO2max) tests in a laboratory. During the riding the mean (+/-SD) VO2 reduced in group A from 86 +/- 10% to 69 +/- 6% of the maximum (P correlated with riding speed (r = 0.70, P sport that causes great physical stress and demands on both skill and physical capacity of the rider. Physical stress occurs as the result of handling of the bike when receiving continuous impacts in the situation requiring both aerobic and anaerobic metabolism. Our data suggest that both maximal capacity and strain during the ride should be measured to analyze the true physiological and neuromuscular demands of motocross ride. For the practice, this study strongly suggests to train not only aerobic and anaerobic capacity but also to use strength and power training for successful motocross riding.

  16. Electrophysiological study in neuromuscular junction disorders

    Directory of Open Access Journals (Sweden)

    Ajith Cherian

    2013-01-01

    Full Text Available This review is on ultrastructure and subcellular physiology at normal and abnormal neuromuscular junctions. The clinical and electrophysiological findings in myasthenia gravis, Lambert-Eaton myasthenic syndrome (LEMS, congenital myasthenic syndromes, and botulinum intoxication are discussed. Single fiber electromyography (SFEMG helps to explain the basis of testing neuromuscular junction function by repetitive nerve stimulation (RNS. SFEMG requires skill and patience and its availability is limited to a few centers. For RNS supramaximal stimulation is essential and so is display of the whole waveform of each muscle response at maximum amplitude. The amplitudes of the negative phase of the first and fourth responses are measured from baseline to negative peak, and the percent change of the fourth response compared with the first represents the decrement or increment. A decrement greater than 10% is accepted as abnormal and smooth progression of response amplitude train and reproducibility form the crux. In suspected LEMS the effect of fast rates of stimulation should be determined after RNS response to slow rates of stimulation. Caution is required to avoid misinterpretation of potentiation and pseudofacilitation.

  17. Neuromuscular disruption with ultrashort electrical pulses

    Science.gov (United States)

    Pakhomov, Andrei; Kolb, Juergen F.; Joshi, Ravindra P.; Schoenbach, Karl H.; Dayton, Thomas; Comeaux, James; Ashmore, John; Beason, Charles

    2006-05-01

    Experimental studies on single cells have shown that application of pulsed voltages, with submicrosecond pulse duration and an electric field on the order of 10 kV/cm, causes sudden alterations in the intracellular free calcium concentration, followed by immobilization of the cell. In order to examine electrical stimulation and incapacitation with such ultrashort pulses, experiments on anesthetized rats have been performed. The effect of single, 450 nanosecond monopolar pulses have been compared with that of single pulses with multi-microsecond duration (TASER pulses). Two conditions were explored: 1. the ability to elicit a muscle twitch, and, 2. the ability to suppress voluntary movement by using nanosecond pulses. The second condition is relevant for neuromuscular incapacitation. The preliminary results indicate that for stimulation microsecond pulses are advantageous over nanosecond pulses, whereas for incapacitation, the opposite seems to apply. The stimulation effects seem to scale with electrical charge, whereas the disruption effects don't follow a simple scaling law. The increase in intensity (time of incapacitation) for a given pulse duration, is increasing with electrical energy, but is more efficient for nanosecond than for microsecond pulses. This indicates different cellular mechanisms for incapacitation, most likely subcellular processes, which have been shown to become increasingly important when the pulse duration is shortened into the nanosecond range. If further studies can confirm these initial results, consequences of reduced pulse duration are a reduction in weight and volume of the pulse delivery system, and likely, because of the lower required energy for neuromuscular incapacitation, reduced safety risks.

  18. Neuromuscular dressing effects: a literature review

    Directory of Open Access Journals (Sweden)

    Calero PA

    2012-05-01

    Full Text Available The kinesio taping is a technique that was created in 1979 by Doctor Kenzo Kase I’m looking through it that could generate a new therapeutic option to control pain, improve athletic performance and reduce the impact of musculoskeletal disorders. From the Sydney 2000 Olympic Games, this technique as a therapeutic alternative PTO and is composed of health professionals in the field of sport and physical rehabilitation.Objetive: This article aims to identify theoretical approaches on the bandage neuromuscular. Material and methods: held today, for which conducted a literature search of databases such as como Proquest, Ovid, Cochraine, PEDro, Journal of Orthopedic and Sports Physical, Sciencedirect, Pubmed y Literatura Latinoamericana y del Caribe en Ciencias de la Salud (Lilacs.The paper proposes a scheme of contextualization of the current landscape of the use and effects of kinesio taping in the management of different pathologies of the musculo-skeletal system in sports. Conclusion: it is concluded that currently many health professionals, and take the neuromuscular bandage a good therapeutic option in the management of diseases affecting the human body is investigated and every day more about the subject, which makes these new therapeutic methods to acquire a scientific value and transcends knowledge.

  19. Neuromuscular Dysfunction in Experimental Sepsis and Glutamine

    Science.gov (United States)

    Çankayalı, İlkin; Boyacılar, Özden; Demirağ, Kubilay; Uyar, Mehmet; Moral, Ali Reşat

    2016-01-01

    Background: Electrophysiological studies show that critical illness polyneuromyopathy appears in the early stage of sepsis before the manifestation of clinical findings. The metabolic response observed during sepsis causes glutamine to become a relative essential amino acid. Aims: We aimed to assess the changes in neuromuscular transmission in the early stage of sepsis after glutamine supplementation. Study Design: Animal experimentation. Methods: Twenty male Sprague-Dawley rats were randomized into two groups. Rats in both groups were given normal feeding for one week. In the study group, 1 g/kg/day glutamine was added to normal feeding by feeding tube for one week. Cecal ligation and perforation (CLP) surgery was performed at the end of one week. Before and 24 hours after CLP, compound muscle action potentials were recorded from the gastrocnemius muscle. Results: Latency measurements before and 24 hours after CLP were 0.68±0.05 ms and 0.80±0.09 ms in the control group and 0.69±0.07 ms and 0.73±0.07 ms in the study group (p<0.05). Conclusion: Since enteral glutamine prevented compound muscle action potentials (CMAP) latency prolongation in the early phase of sepsis, it was concluded that enteral glutamine replacement might be promising in the prevention of neuromuscular dysfunction in sepsis; however, further studies are required. PMID:27308070

  20. Neuromuscular blockade in cardiac surgery: An update for clinicians

    Directory of Open Access Journals (Sweden)

    Hemmerling Thomas

    2008-01-01

    Full Text Available There have been great advancements in cardiac surgery over the last two decades; the widespread use of off-pump aortocoronary bypass surgery, minimally invasive cardiac surgery, and robotic surgery have also changed the face of cardiac anaesthesia. The concept of "Fast-track anaesthesia" demands the use of nondepolarising neuromuscular blocking drugs with short duration of action, combining the ability to provide (if necessary sufficiently profound neuromuscular blockade during surgery and immediate re-establishment of normal neuromuscular transmission at the end of surgery. Postoperative residual muscle paralysis is one of the major hurdles for immediate or early extubation after cardiac surgery. Nondepolarising neuromuscular blocking drugs for cardiac surgery should therefore be easy to titrate, of rapid onset and short duration of action with a pathway of elimination independent from hepatic or renal dysfunction, and should equally not affect haemodynamic stability. The difference between repetitive bolus application and continuous infusion is outlined in this review, with the pharmacodynamic and pharmacokinetic characteristics of vecuronium, pancuronium, rocuronium, and cisatracurium. Kinemyography and acceleromyography are the most important currently used neuromuscular monitoring methods. Whereas monitoring at the adductor pollicis muscle is appropriate at the end of surgery, monitoring of the corrugator supercilii muscle better reflects neuromuscular blockade at more central, profound muscles, such as the diaphragm, larynx, or thoraco-abdominal muscles. In conclusion, cisatracurium or rocuronium is recommended for neuromuscular blockade in modern cardiac surgery.

  1. Effects of sugammadex on incidence of postoperative residual neuromuscular blockade

    DEFF Research Database (Denmark)

    Brueckmann, B; Sasaki, N; Grobara, P;

    2015-01-01

    by randomized allocation to sugammadex (2 or 4 mg kg(-1)) or usual care (neostigmine/glycopyrrolate, dosing per usual care practice) for reversal of neuromuscular blockade. Timing of reversal agent administration was based on the providers' clinical judgement. Primary endpoint was the presence of residual......BACKGROUND: This study aimed to investigate whether reversal of rocuronium-induced neuromuscular blockade with sugammadex reduced the incidence of residual blockade and facilitated operating room discharge readiness. METHODS: Adult patients undergoing abdominal surgery received rocuronium, followed...... neuromuscular blockade at PACU admission, defined as a train-of-four (TOF) ratio

  2. Neuromuscular Exercise Post Partial Medial Meniscectomy

    DEFF Research Database (Denmark)

    Hall, Michelle; Hinman, Rana S; Wrigley, Tim V

    2015-01-01

    outcomes included additional measures of knee joint load distribution, patient-reported outcomes, maximal knee and hip muscle strength, and physical function measures. RESULTS: 60 out of 62 randomized participants (97%) completed the trial. There were no significant between-group differences in the change......PURPOSE: To evaluate the effects of a 12-week, home-based, physiotherapist-guided neuromuscular exercise program on the knee adduction moment (an indicator of mediolateral knee load distribution) in people with a medial arthroscopic partial meniscectomy within the past 3-12 months. METHODS...... or a control group with no exercise. The exercise program included eight individual sessions with one of seven physiotherapists in private clinics, together with home exercises. Primary outcomes were the peak external knee adduction moment during normal pace walking and during a one-leg sit-to-stand. Secondary...

  3. Visual and tactile assessment of neuromuscular fade.

    Science.gov (United States)

    Brull, S J; Silverman, D G

    1993-08-01

    The accuracy of visual and tactile assessment of the neuromuscular fade in response to train-of-four (TOF) and double-burst stimulation (DBS) were compared to assess their relative utility in the clinical setting. For each of 74 data sets with a mechanographic TOF ratio less than 0.70, an observer (blinded to the presence or degree of fade) performed visual and tactile assessments of fade in response to TOF, DBS3,3, and DBS3,2 stimuli at low current (20 and 30 mA) and high current (50 and 60 mA). For the range of mechanographic TOF ratios between 0.41 and 0.70, visual assessment failed to identify TOF, DBS3,3, and DBS3,2 fade in 46%, 18%, and 14% of cases at high current and in 23%, 5%, and 0% of cases at low current, respectively. Tactile assessments failed to identify fade in 55%, 23%, and 14% of cases at high current and in 23%, 14%, and 14% of cases at low current. Overall, the ability to detect fade was comparable for visual and tactile assessments regardless of the method of neurostimulation (P = NS with paired t-test). However, the degree of overestimation of the fade ratio (i.e., quantitative assessment) tended to be less when using tactile means; the difference achieved significance for TOF at low current and DBS3,3 at both low and high currents. We conclude that the differences between the visual and tactile means of assessment are relatively small compared to the differences among the TOF and DBS patterns of neurostimulation. Both subjective techniques are often inadequate in settings in which assurance of full recovery of neuromuscular function is critical.

  4. Neuromuscular impairment following backpack load carriage.

    Science.gov (United States)

    Blacker, Sam D; Fallowfield, Joanne L; Bilzon, James L J; Willems, Mark E T

    2013-01-01

    Load Carriage using backpacks is an occupational task and can be a recreational pursuit. The aim of this study was to investigate the mechanisms responsible for changes in neuromuscular function of the m. quadriceps femoris following load carriage. The physiological responses of 10 male participants to voluntary and electrically stimulated isometric contractions were measured before and immediately after two hours of treadmill walking at 6.5 km•h(-1) during level walking with no load [LW], and level walking with load carriage (25 kg backpack) [LC]. Maximal voluntary contraction force decreased by 15 ± 11 % following LC (p=0.006), with no change following LW (p=0.292). Voluntary activation decreased after LW and LC (p=0.033) with no difference between conditions (p=0.405). Doublet contraction time decreased after both LW and LC (p=0.002), with no difference between conditions (p=0.232). There were no other changes in electrically invoked doublet parameters in either condition. The 20:50 Hz ratio did not change following LW (p=0.864) but decreased from 0.88 ± 0.04 to 0.84 ± 0.04 after LC (p=0.011) indicating reduced Ca2+ release from the sarcoplasmic reticulum during excitation contraction coupling. In conclusion, two hours of load carriage carrying a 25 kg back pack caused neuromuscular impairment through a decrease in voluntary activation (i.e. central drive) and fatigue or damage to the peripheral muscle, including impairment of the excitation contraction coupling process. This may reduce physical performance and increase the risk of musculoskeletal injury.

  5. Noninvasive respiratory management and diaphragm and electrophrenic pacing in neuromuscular disease and spinal cord injury.

    Science.gov (United States)

    Bach, John R

    2013-02-01

    The purpose of this monograph is to describe noninvasive management of respiratory muscle weakness/paralysis for patients with neuromuscular disease (NMD) and spinal cord injury (SCI). Noninvasive ventilation (NIV) assists and supports inspiratory muscles, whereas mechanically assisted coughing (MAC) simulates an effective cough. Long-term outcomes will be reviewed as well as the use of NIV, MAC, and electrophrenic pacing (EPP) and diaphragm pacing (DP) to facilitate extubation and decannulation. Although EPP and DP can facilitate decannulation and maintain alveolar ventilation for high-level SCI patients when they cannot use NIV because of lack of access to oral interfaces, there is no evidence that they have any place in the management of NMD. Copyright © 2012 Wiley Periodicals, Inc.

  6. Spatial factors and muscle spindle input influence the generation of neuromuscular responses to stimulation of the human foot

    Science.gov (United States)

    Layne, Charles S.; Forth, Katharine E.; Abercromby, Andrew F. J.

    2005-05-01

    Removal of the mechanical pressure gradient on the soles leads to physiological adaptations that ultimately result in neuromotor degradation during spaceflight. We propose that mechanical stimulation of the soles serves to partially restore the afference associated with bipedal loading and assists in attenuating the negative neuromotor consequences of spaceflight. A dynamic foot stimulus device was used to stimulate the soles in a variety of conditions with different stimulation locations, stimulation patterns and muscle spindle input. Surface electromyography revealed the lateral side of the sole elicited the greatest neuromuscular response in ankle musculature, followed by the medial side, then the heel. These responses were modified by preceding stimulation. Neuromuscular responses were also influenced by the level of muscle spindle input. These results provide important information that can be used to guide the development of a "passive" countermeasure that relies on sole stimulation and can supplement existing exercise protocols during spaceflight.

  7. The use of “stabilization exercises” to affect neuromuscular control in the lumbopelvic region: a narrative review

    Science.gov (United States)

    Bruno, Paul

    2014-01-01

    It is well-established that the coordination of muscular activity in the lumbopelvic region is vital to the generation of mechanical spinal stability. Several models illustrating mechanisms by which dysfunctional neuromuscular control strategies may serve as a cause and/or effect of low back pain have been described in the literature. The term “core stability” is variously used by clinicians and researchers, and this variety has led to several rehabilitative approaches suggested to affect the neuromuscular control strategies of the lumbopelvic region (e.g. “stabilization exercise”, “motor control exercise”). This narrative review will highlight: 1) the ongoing debate in the clinical and research communities regarding the terms “core stability” and “stabilization exercise”, 2) the importance of sub-grouping in identifying those patients most likely to benefit from such therapeutic interventions, and 3) two protocols that can assist clinicians in this process. PMID:24932016

  8. Reduced neuromuscular performance in amenorrheic elite endurance athletes

    DEFF Research Database (Denmark)

    Tornberg, Åsa B; Melin, Anna; Manderson Koivula, Fiona

    2017-01-01

    INTRODUCTION: Secondary functional hypothalamic amenorrhea (SFHA) is common among female athletes, especially in weight-sensitive sports. The aim of this study was to investigate the link between SFHA and neuromuscular performance in elite endurance athletes. METHODS: Sixteen eumenorrheic (EUM...

  9. The potential of disease management for neuromuscular hereditary disorders.

    Science.gov (United States)

    Chouinard, Maud-Christine; Gagnon, Cynthia; Laberge, Luc; Tremblay, Carmen; Côté, Charlotte; Leclerc, Nadine; Mathieu, Jean

    2009-01-01

    Neuromuscular hereditary disorders require long-term multidisciplinary rehabilitation management. Although the need for coordinated healthcare management has long been recognized, most neuromuscular disorders are still lacking clinical guidelines about their long-term management and structured evaluation plan with associated services. One of the most prevalent adult-onset neuromuscular disorders, myotonic dystrophy type 1, generally presents several comorbidities and a variable clinical picture, making management a constant challenge. This article presents a healthcare follow-up plan and proposes a nursing case management within a disease management program as an innovative and promising approach. This disease management program and model consists of eight components including population identification processes, evidence-based practice guidelines, collaborative practice, patient self-management education, and process outcomes evaluation (Disease Management Association of America, 2004). It is believed to have the potential to significantly improve healthcare management for neuromuscular hereditary disorders and will prove useful to nurses delivering and organizing services for this population.

  10. The role of proprioception and neuromuscular stability in carpal instabilities.

    Science.gov (United States)

    Hagert, E; Lluch, A; Rein, S

    2016-01-01

    Carpal stability has traditionally been defined as dependent on the articular congruity of joint surfaces, the static stability maintained by intact ligaments, and the dynamic stability caused by muscle contractions resulting in a compression of joint surfaces. In the past decade, a fourth factor in carpal stability has been proposed, involving the neuromuscular and proprioceptive control of joints. The proprioception of the wrist originates from afferent signals elicited by sensory end organs (mechanoreceptors) in ligaments and joint capsules that elicit spinal reflexes for immediate joint stability, as well as higher order neuromuscular influx to the cerebellum and sensorimotor cortices for planning and executing joint control. The aim of this review is to provide an understanding of the role of proprioception and neuromuscular control in carpal instabilities by delineating the sensory innervation and the neuromuscular control of the carpus, as well as descriptions of clinical applications of proprioception in carpal instabilities.

  11. Neuromuscular training for sports injury prevention: a systematic review

    National Research Council Canada - National Science Library

    Hübscher, Markus; Zech, Astrid; Pfeifer, Klaus; Hänsel, Frank; Vogt, Lutz; Banzer, Winfried

    2010-01-01

    The aim of this systematic review was to assess the effectiveness of proprioceptive/neuromuscular training in preventing sports injuries by using the best available evidence from methodologically well...

  12. Genetics of Pediatric-Onset Motor Neuron and Neuromuscular Diseases

    Science.gov (United States)

    2015-08-24

    Spinal Muscular Atrophy; Charcot-Marie-Tooth Disease; Muscular Dystrophy; Spinal Muscular Atrophy With Respiratory Distress 1; Amyotrophic Lateral Sclerosis; Motor Neuron Disease; Neuromuscular Disease; Peroneal Muscular Atrophy; Fragile X Syndrome

  13. Exploring employment in consultation reports of patients with neuromuscular diseases

    NARCIS (Netherlands)

    Heerkens, Yvonne; Kuyk-Minis, Marie Antoinette van; Cup, Edith; Engels, Josephine; Engelen, Baziel van; Oostendorp, Rob

    2012-01-01

    To explore consultation reports for patient and employment characteristics and recommendations on employment regarding patients with neuromuscular diseases (NMDs). Eighty percent of the included consultation reports contained information on employment. Less than half the patients with NMD were emplo

  14. Effect of nimodipine and flunarizine on neuromuscular function in mice

    Directory of Open Access Journals (Sweden)

    Swapnil B. Kaikade

    2016-08-01

    Conclusions: Nimodipine has significant dose dependent depressant action on neuromuscular function while flunarizine has no effect on the above mentioned parameter. [Int J Basic Clin Pharmacol 2016; 5(4.000: 1524-1527

  15. The function of neuromuscular compartments in human shoulder muscles

    National Research Council Canada - National Science Library

    Wickham, J B; Brown, J M M

    2012-01-01

    The aim of this study was to use a surface electromyographic (sEMG) technique with a ballistic isotonic shoulder joint adduction movement to determine the function of the neuromuscular compartments (NMCs...

  16. Exploring employment in consultation reports of patients with neuromuscular diseases

    NARCIS (Netherlands)

    Minis, M.A.H; Cup, E.H.C.; Heerkens, Y.F.; Engels, J.A.; Engelen, B.G. van; Oostendorp, R.A.B.

    2012-01-01

    Minis MA, Cup EH, Heerkens YF, Engels JA, van Engelen BG, Oostendorp RA. Exploring employment in consultation reports of patients with neuromuscular diseases. OBJECTIVES: To explore consultation reports for patient and employment characteristics and recommendations on employment regarding patients

  17. The sagital balance in idiopatic and neuromuscular scoliosis

    OpenAIRE

    Borges,Paulo Alvim; Ocampos, Guilherme Pereira; Mancuso Filho,José Antonio; Letaif,Olavo Biraghi; Marcon, Raphael Martus; Cristante, Alexandre Fogaça

    2014-01-01

    OBJECTIVES: To describe and compare the distribution of spinopelvic parameters (SPP) in a Brazilian population with idiopathic scoliosis (IS) and neuromuscular scoliosis (NMS), and evaluate the association between pelvic incidence (PI) and lumbar lordosis (LL). METHOD: Medical records investigation was performed. Sagital balance angles were measured in patients with neuromuscular and idiopathic scoliosis. RESULTS: IS sample means (in degrees): PI 55.55; Sacral Slope (SS) 45.35; Pelvic Tilt (P...

  18. Synthesis of ZnO nanorods-Au nanoparticles hybrids via in-situ plasma sputtering-assisted method for simultaneous electrochemical sensing of ascorbic acid and uric acid

    Energy Technology Data Exchange (ETDEWEB)

    Hou, Chao [College of Life Information Science & Instrument Engineering, Hangzhou Dianzi University, Hangzhou 310018 (China); Liu, Hongying, E-mail: liuhongying@hdu.edu.cn [College of Life Information Science & Instrument Engineering, Hangzhou Dianzi University, Hangzhou 310018 (China); State Key Laboratory of Analytical Chemistry for Life Science, School of Chemistry & Chemical Engineering, Nanjing University, Nanjing 210093 (China); Zhang, Dan; Yang, Chi [Department of Pharmacy, Nantong University, Nantong 226001 (China); Zhang, Mingzhen [College of Life Information Science & Instrument Engineering, Hangzhou Dianzi University, Hangzhou 310018 (China)

    2016-05-05

    In this study, ZnO nanorods-Au nanoparticles (ZnO NRs-Au NPs) hybrids were prepared using an in-situ plasma sputtering-assisted method without any template. Characterization results from scanning electron microscopy, high-resolution transmission electron microscopy, and energy dispersive X-ray spectroscopy showed that Au NPs are highly dispersed and tightly anchored on the surface of ZnO NRs. The size and surface coverage of Au NPs were well controlled by plasma sputtering time. Moreover, the hybrids exhibited excellent electrocatalytic properties towards oxidation of ascorbic acid (AA) and uric acid (UA) due to large surface area of Au NPs and ZnO NRs, and thus can be used as electrochemical sensors. Differential pulse voltammetry results showed that AA and UA could be detected simultaneously by ZnO NRs-Au NPs hybrids modified glassy carbon electrode. The linear ranges for AA and UA are 0.1 to 4 mM and 0.01 to 0.4 mM, respectively. The results suggest promising future applications in clinical diagnosis. - Highlights: • ZnO nanorods-Au nanoparticles were synthesized by in-situ plasma sputtering method. • Influence of sputtering time on the formation of Au nanoparticles was studied. • It exhibited a strong electrocatalytic activity toward the oxidation of ascorbic acid and uric acid. • A portable and cheap approach for simultaneous detection of ascorbic acid and uric acid was developed.

  19. Facile synthesis of aluminium doped zinc oxide-polyaniline hybrids for photoluminescence and enhanced visible-light assisted photo-degradation of organic contaminants

    Science.gov (United States)

    Mitra, Mousumi; Ghosh, Amrita; Mondal, Anup; Kargupta, Kajari; Ganguly, Saibal; Banerjee, Dipali

    2017-04-01

    The emergence of organic-inorganic photoactive materials has led to marked progress in the field of heterogeneous visible-light photocatalysis. Visible-light active aluminium doped zinc oxide-polyaniline (PAZ) hybrid was prepared employing in-situ oxidative polymerization of polyaniline (PANI) in the presence of aluminium doped zinc oxide (AlZnO) nanorods, synthesized via sol-gel route. The compositions, structural and optical properties of the synthesized hybrids were characterized. Among various samples, the 22 wt% aluminium doped zinc oxide-polyaniline (PAZ 3) hybrid show the best photocatalytic action for the degradation of methyl orange (MO) and rose bengal (RB) dyes under visible-light illumination, even after repeated use. The performance of the photocatalytic process was determined by the first order rate constant, 1.77 × 10-2 min-1 and 2.61 × 10-2 min-1 for MO and RB dyes, respectively. Scavenger test was used to determine the role of active species and accordingly a mechanism was proposed. Electrochemical impedance spectroscopy and linear scan voltammetry under dark and visible-light irradiation also established the visible-light activity of the PAZ hybrid due to decrease in the electron transfer resistance that resulted in an enhancement in photocurrent. The significant enhancement of photo degradation may be attributed to the efficiency of charge separation, induced by synergistic effect between an organic conductor PANI and an inorganic semiconductor AlZnO. Owing to its superior photo electrochemical performance and photocatalytic degradation, aluminium doped zinc oxide-polyaniline (PAZ) hybrid offers stable and efficient organic-inorganic hybrid hetero-structures in near future.

  20. Applications for a hybrid operating room in thoracic surgery: from multidisciplinary procedures to ­­image-guided video-assisted thoracoscopic surgery

    Science.gov (United States)

    Terra, Ricardo Mingarini; Andrade, Juliano Ribeiro; Mariani, Alessandro Wasum; Garcia, Rodrigo Gobbo; Succi, Jose Ernesto; Soares, Andrey; Zimmer, Paulo Marcelo

    2016-01-01

    ABSTRACT The concept of a hybrid operating room represents the union of a high-complexity surgical apparatus with state-of-the-art radiological tools (ultrasound, CT, fluoroscopy, or magnetic resonance imaging), in order to perform highly effective, minimally invasive procedures. Although the use of a hybrid operating room is well established in specialties such as neurosurgery and cardiovascular surgery, it has rarely been explored in thoracic surgery. Our objective was to discuss the possible applications of this technology in thoracic surgery, through the reporting of three cases. PMID:27812640

  1. Rapid detection of t(15;17)(q24;q21) in acute promyelocytic leukaemia by microwave-assisted fluorescence in situ hybridization.

    Science.gov (United States)

    Soriani, Silvia; Mura, Cinzia; Panico, Anna Rita; Scarpa, Anna Maria; Recchimuzzo, Patrizia; Dadati, Raffaella; Farioli, Renata; De Canal, Gabriella; Mura, Maria Angela; Cesana, Clara

    2017-03-01

    Acute promyelocytic leukaemia (APL) is a hematologic malignancy characterized by the rearrangement of the PML and RARα genes, mostly due to a reciprocal chromosomal translocation t(15;17)(q24;q21). A quick APL diagnosis is essential for starting a prompt suitable therapy. We describe a new rapid diagnostic laboratory approach to detect the PML-RARα rearrangement, which gives clear genetic results within 30 min of hybridization. It combines quick cell harvesting, fluorescence in situ hybridization performed with commercial DNA probe and microwave beams supplied by a domestic microwave oven. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  2. Neuromuscular disorders in chronic alcohol intoxication

    Directory of Open Access Journals (Sweden)

    A. Yu. Emelyanova

    2015-01-01

    Full Text Available The paper reviews the present-day Russian and foreign literature on neuromuscular disorders in chronic alcohol intoxication. The most common manifestations of alcohol disease include alcoholic polyneuropathy (PNP and alcohol-induced skeletal muscle injury. The clinical polymorphism of alcoholic PNP is discussed. The paper considers a chronic sensory automatic form due to the direct toxic effects of ethanol and its metabolites during long-term alcohol intoxication, as well as acute/subacute sensorimotor neuropathy, the basis for the pathogenesis of which is B group vitamins, predominantly thiamine, deficiency that develops in the presence of drinking bouts concurrent with malnutrition and/or alcohol-related gastrointestinal tract diseases. In addition to nonuse of alcohol and a properly balanced diet, antioxidant therapy with alphalipoic acid and neurotropic B group vitamins is considered to be pathogenetic therapy for neuropathy. The most common and least studied clinicalform of alcohol-induced musculoskeletal injury is chronic alcoholic myopathy (AM, the diagnostic standard for which is morphometricand immunohistochemical examination of a muscle biopsy specimen. The morphological base for this form of myopathy is predominantly type 2 muscle fiber atrophy caused by impaired protein synthesis and a decreased regenerative potential of muscle fiber. The efficacy of antioxidants and leucine-containing amino acid mixtures in the treatment of chronic AM is discussed.

  3. Diagnostic Certified Assay: Neuromuscular and Cardiac Assessments

    Directory of Open Access Journals (Sweden)

    Rea Valaperta

    2013-01-01

    Full Text Available The expansion of the specific trinucleotide sequence, [CTG], is the molecular pathological mechanism responsible for the clinical manifestations of DM1. Many studies have described different molecular genetic techniques to detect DM1, but as yet there is no data on the analytical performances of techniques used so far in this disease. We therefore developed and validated a molecular method, “Myotonic Dystrophy SB kit,” to better characterize our DM1 population. 113 patients were examined: 20 DM1-positive, 11 DM1/DM2-negative, and13 DM1-negative/DM2-positive, who had a previous molecular diagnosis, while 69 were new cases. This assay correctly identified 113/113 patients, and all were confirmed by different homemade assays. Comparative analysis revealed that the sensitivity and the specificity of the new kit were very high (>99%. Same results were obtained using several extraction procedures and different concentrations of DNA. The distribution of pathologic alleles showed a prevalence of the “classical” form, while of the 96 nonexpanded alleles 19 different allelic types were observed. Cardiac and neuromuscular parameters were used to clinically characterize our patients and support the new genetic analysis. Our findings suggest that this assay appears to be a very robust and reliable molecular test, showing high reproducibility and giving an unambiguous interpretation of results.

  4. Sleep polygraphic parameters in neuromuscular diseases

    Directory of Open Access Journals (Sweden)

    Márcia Pradella

    1994-12-01

    Full Text Available In a polysomnography study of 32 neuromuscular patients - 22 with a form of muscular dystrophy, 3 with a form of congenital myopathy, 4 with a form of spinal muscular atrophy, 1 with a recurrent form of polymyositis and 1 with osteogenesis imperfecta syndrome - of which 21 were nonambulatory, we observed sleep related respiratory disturbances represented by: drops in oxygen saturation (SaO2, cardiac arrythmia, sleep disruption, apneas, tachypnea, tachycardia and snoring. Nine out of the cohort of 32 patients presented with significant desaturations periods. These patients presented with an associated restrictive syndrome and thoracic deformities, some with tachypnea and/or SaO2 below 90% during wakefulness. In this group, snoring was observed in those patients with a form of muscular dystrophy while tachypnea was observed in patients who presented the highest desaturations levels. Sleep quantification revealed an increase of stage 1 sleep coupled with a decrease or even total absence of REM sleep. This is, we believe, a likely consequence of episodic desaturations that may accompany sleep hypoventilation which is potentialised during REM sleep stage.

  5. Neuromuscular dentistry: Occlusal diseases and posture.

    Science.gov (United States)

    Khan, Mohd Toseef; Verma, Sanjeev Kumar; Maheshwari, Sandhya; Zahid, Syed Naved; Chaudhary, Prabhat K

    2013-01-01

    Neuromuscular dentistry has been a controversial topic in the field of dentistry and still remains debatable. The issue of good occlusion and sound health has been repeatedly discussed. Sometimes we get complains of sensitive teeth and sometimes of tired facial muscles on getting up in the morning. Owing to the intimate relation of masticatory apparatus with the cranium and cervico-scapular muscular system, the disorders in any system, draw attention from concerned clinicians involved in management, to develop an integrated treatment protocol for the suffering patients. There may be patients reporting to the dental clinics after an occlusal restoration or extraction, having pain in or around the temporomandibular joint, headache or neck pain. Although their esthetic demands must not be undermined during the course of treatment plan, whenever dental treatment of any sort is planned, occlusion/bite should be given prime importance. Very few dentist are able to diagnose the occlusal disease and of those who diagnose many people resort to aggressive treatment modalities. This paper aims to report the signs of occlusal disease, and discuss their association with TMDs and posture.

  6. Electrophysiology of autonomic neuromuscular transmission involving ATP.

    Science.gov (United States)

    Sneddon, P

    2000-07-01

    Electrophysiological investigations of autonomic neuromuscular transmission have provided great insights into the role of ATP as a neurotransmitter. Burnstock and Holman made the first recordings of excitatory junction potentials (e.j.p.s) produced by sympathetic nerves innervating the smooth muscle of the guinea-pig vas deferens. This led to the identification of ATP as the mediator of e.j.p.s in this tissue, where ATP acts as a cotransmitter with noradrenaline. The e.j.p.s are mediated solely by ATP acting on P2X(1) receptors leading to action potentials and a rapid phasic contraction, whilst noradrenaline mediates a slower, tonic contraction which is not dependent on membrane depolarisation. Subsequent electrophysiological studies of the autonomic innervation of smooth muscles of the urogenital, gastrointestinal and cardiovascular systems have revealed a similar pattern of response, where ATP mediates a fast electrical and mechanical response, whilst another transmitter such as noradrenaline, acetylcholine, nitric oxide or a peptide mediates a slower response. The modulation of junction potentials by a variety of pre-junctional receptors and the mechanism of inactivation of ATP as a neurotransmitter will also be described.

  7. Neuromuscular Fatigue During 200 M Breaststroke

    Directory of Open Access Journals (Sweden)

    Ana Conceição

    2014-03-01

    Full Text Available The aims of this study were: i to analyze activation patterns of four upper limb muscles (duration of the active and non-active phase in each lap of 200m breaststroke, ii quantify neuromuscular fatigue, with kinematics and physiologic assessment. Surface electromyogram was collected for the biceps brachii, deltoid anterior, pectoralis major and triceps brachii of nine male swimmers performing a maximal 200m breaststroke trial. Swimming speed, SL, SR, SI decreased from the 1st to the 3rd lap. SR increased on the 4th lap (35.91 ± 2.99 stroke·min-1. Peak blood lactate was 13.02 ± 1.72 mmol·l-1 three minutes after the maximal trial. The EMG average rectified value (ARV increased at the end of the race for all selected muscles, but the deltoid anterior and pectoralis major in the 1st lap and for biceps brachii, deltoid anterior and triceps brachii in the 4th lap. The mean frequency of the power spectral density (MNF decreased at the 4th lap for all muscles. These findings suggest the occurrence of fatigue at the beginning of the 2nd lap in the 200m breaststroke trial, characterized by changes in kinematic parameters and selective changes in upper limb muscle action. There was a trend towards a non-linear fatigue state.

  8. Assessment of Motor Units in Neuromuscular Disease.

    Science.gov (United States)

    Henderson, Robert D; McCombe, Pamela A

    2017-01-01

    The motor unit comprises the anterior horn cell, its axon, and the muscle fibers that it innervates. Although the true number of motor units is unknown, the number of motor units appears to vary greatly between different muscles and between different individuals. Assessment of the number and function of motor units is needed in diseases of the anterior horn cell and other motor nerve disorders. Amyotrophic lateral sclerosis is the most important disease of anterior horn cells. The need for an effective biomarker for assessing disease progression and for use in clinical trials in amyotrophic lateral sclerosis has stimulated the study of methods to measure the number of motor units. Since 1970 a number of different methods, including the incremental, F-wave, multipoint, and statistical methods, have been developed but none has achieved widespread applicability. Two methods (MUNIX and the multipoint incremental method) are in current use across multiple centres and are discussed in detail in this review, together with other recently published methods. Imaging with magnetic resonance and ultrasound is increasingly being applied to this area. Motor unit number estimates have also been applied to other neuromuscular diseases such as spinal muscular atrophy, compression neuropathies, and prior poliomyelitis. The need for an objective measure for the assessment of motor units remains tantalizingly close but unfulfilled in 2016.

  9. Neuromuscular monitoring and postoperative residual curarisation: a meta-analysis.

    Science.gov (United States)

    Naguib, M; Kopman, A F; Ensor, J E

    2007-03-01

    We conducted a meta-analysis to examine the effect of intraoperative monitoring of neuromuscular function on the incidence of postoperative residual curarisation (PORC). PORC has been considered present when a patient has a train-of-four (TOF) ratio of < 0.7 or < 0.9. We analysed data from 24 trials (3375 patients) that were published between 1979 and 2005. We excluded data on mivacurium from this meta-analysis because only three studies had examined the incidence of PORC associated with its use. Long- and intermediate-acting neuromuscular blocking drugs had been given to 662 and 2713 patients, respectively. Neuromuscular function was monitored in 823 patients (24.4%). A simple peripheral nerve stimulator was used in 543 patients, and an objective monitor was used in 280. The incidence of PORC was found to be significantly lower after the use of intermediate neuromuscular blocking drugs. We could not demonstrate that the use of an intraoperative neuromuscular function monitor decreased the incidence of PORC.

  10. Current Status of Neuromuscular Reversal and Monitoring: Challenges and Opportunities.

    Science.gov (United States)

    Brull, Sorin J; Kopman, Aaron F

    2017-01-01

    Postoperative residual neuromuscular block has been recognized as a potential problem for decades, and it remains so today. Traditional pharmacologic antagonists (anticholinesterases) are ineffective in reversing profound and deep levels of neuromuscular block; at the opposite end of the recovery curve close to full recovery, anticholinesterases may induce paradoxical muscle weakness. The new selective relaxant-binding agent sugammadex can reverse any depth of block from aminosteroid (but not benzylisoquinolinium) relaxants; however, the effective dose to be administered should be chosen based on objective monitoring of the depth of neuromuscular block.To guide appropriate perioperative management, neuromuscular function assessment with a peripheral nerve stimulator is mandatory. Although in many settings, subjective (visual and tactile) evaluation of muscle responses is used, such evaluation has had limited success in preventing the occurrence of residual paralysis. Clinical evaluations of return of muscle strength (head lift and grip strength) or respiratory parameters (tidal volume and vital capacity) are equally insensitive at detecting neuromuscular weakness. Objective measurement (a train-of-four ratio greater than 0.90) is the only method to determine appropriate timing of tracheal extubation and ensure normal muscle function and patient safety.

  11. Fibromatosis: a potential sequela of neuromuscular choristoma.

    Science.gov (United States)

    Hébert-Blouin, Marie-Noëlle; Scheithauer, Bernd W; Amrami, Kimberly K; Durham, Susan R; Spinner, Robert J

    2012-02-01

    Neuromuscular choristoma (NMC) is a rare peripheral nerve lesion in which mature skeletal muscle fibers lie within the nerve and its fascicles. Given limited follow-up, its natural history is poorly understood. The occurrence of aggressive fibromatosis in one of the authors' patients and its occurrence in reported cases suggests an etiological relationship between the 2 lesions. This study attempts to explain the association and its frequency. All cases of NMCs seen in consultation or treated at the Mayo Clinic were identified. Demographic and clinical data were reviewed in cases with coexistent aggressive fibromatosis. Pathology and neuroimaging studies were reexamined. In addition, an extensive literature review was performed to explore the association of NMC with aggressive fibromatosis, with special attention given to pathological and imaging characteristics and the development of aggressive fibromatosis. The authors identified 10 patients with a diagnosis of NMC who were treated at the Mayo Clinic between 1992 and 2010. Four of 5 with adequate follow-up had developed a definite or suspected aggressive fibromatosis. A review of the initial pathological specimens in these cases revealed no evidence of fibromatosis, but all of the lesions exhibited accompanying hypocellular collagenous tissue. On MR images, all cases showed areas of low signal intensity, which significantly differed from muscle, nerve, and NMC components. On available serial MR imaging studies, aggressive fibromatosis seemed to originate in such lower-intensity regions. In the 18 previously reported cases of NMC, 5 patients developed recurrent masses diagnosed as either definite (2 cases) or possible (3 cases) fibromatosis. Review of the published imaging studies in these cases suggests the presence of lower intensity areas similar to those observed in the 10 patients treated at the Mayo Clinic. This study confirms that the development of aggressive fibromatosis in patients with NMC has been

  12. NREL technical assistance to Argentina

    Energy Technology Data Exchange (ETDEWEB)

    Lilienthal, P. [National Renewable Energy Lab., Golden, CO (United States)

    1997-12-01

    This paper describes assistance to Argentina from the National Renewable Energy Laboratory which has touched on four programs: tariff analysis for rural concessions programs; wind/diesel hybrid retrofits in Patagonia; small hybrid systems designs for rural schools; an assessment of wind resources. The paper expands briefly on the first two points.

  13. Genome-wide association analysis of bacterial cold water disease resistance in rainbow trout reveals the potential of a hybrid approach between genomic selection and marker assisted selection

    Science.gov (United States)

    Genomic selection (GS) simultaneously incorporates dense SNP marker genotypes with phenotypic data from related animals to predict animal-specific genomic breeding value (GEBV), which circumvents the need to measure the disease phenotype in potential breeders. Marker assisted selection (MAS) involv...

  14. Reversal of profound rocuronium neuromuscular blockade by sugammadex in anesthetized rhesus monkeys.

    NARCIS (Netherlands)

    Boer, H.D. de; Egmond, J. van; Pol, F. van de; Bom, A.; Booij, L.H.D.J.

    2006-01-01

    BACKGROUND: Reversal of neuromuscular blockade can be accomplished by chemical encapsulation of rocuronium by sugammadex, a synthetic gamma-cyclodextrin derivative. The current study determined the feasibility of reversal of rocuronium-induced profound neuromuscular blockade with sugammadex in the

  15. Quelles aides les formations hybrides en langues proposent-elles à l'apprenant pour favoriser son autonomie ? What kind of assistance do blended language learning courses provide to learners in order to foster their autonomy?

    Directory of Open Access Journals (Sweden)

    Elke Nissen

    2007-11-01

    Full Text Available L'apprenant qui suit une formation hybride en langues travaille partiellement à distance, ce qui lui demande une certaine autonomie. La question alors est de savoir si ces formations soutiennent l'apprenant dans le développement de son autonomie et si oui, comment. Les réponses des concepteurs de huit formations hybrides à un questionnaire auto-administré montrent que les nécessaires développement et soutien de l'autonomie sont toujours respectés ; ainsi, ces huit formations proposent des aides pour favoriser l'autonomie dans les domaines technique, méthodologique, social et, bien sûr, langagier. Développer ces autonomies semble donc être devenu un standard dans le cadre des formations observées. En revanche, les autonomies de type psycho-affectif, informationnel, cognitif et métacognitif ne sont pas prises en considération dans toutes les formations.When taking a blended learning course, a learner works partially at a distance, which requires some autonomy. The aim of this study is to find out whether blended learning courses sustain the development of learner autonomy and if they do so, how they do it. The statements that 8 course designers made in a questionnaire show that their courses always help the learners to become or to be autonomous. All 8 courses provide assistance (advice, information and activities in order to foster technical, methodological, social and, of course, language autonomy. Consequently, sustaining these four types of autonomy seems to have become a standard in blended learning courses. But, on the contrary, assistance for other types of autonomy is not systematically provided: only several of these courses help the learners to develop psycho affective, informational, cognitive and metacognive autonomy.

  16. Real-world experience with neuromuscular blockade reversal.

    Science.gov (United States)

    Groudine, Scott B; Minkowitz, Harold S; Valentine, Danny L

    2017-11-01

    Neuromuscular blocking agents are used in many surgical procedures and have enabled new surgical advances. The expanded landscape of neuromuscular blockade (NMB) reversal drugs allows for fast and complete NMB reversal and the reduction of postoperative complications from residual block. In the United States, neostigmine/glycopyrrolate and sugammadex are the primary agents for pharmacologic antagonism of neuromuscular blocking agents. Whereas neostigmine and an anticholinergic have been available for decades, sugammadex has only recently become available. We present real-world cases in a variety of surgical procedures and clinical settings in which the use of NMB reversal agents played a significant role in the patients’ clinical outcome. Online access: http://courses.elseviercme.com/nmb/711.

  17. Fibromatosis arising in association with neuromuscular hamartoma of the mandible.

    Science.gov (United States)

    Taher, Leena Yaseen; Saleem, Muhammad; Velagapudi, Suresh; Dababo, Anas

    2013-09-01

    Aggressive fibromatosis is a benign but locally-aggressive tumor, which most often affects the muscles of the shoulder, the pelvic girdle, and the thigh. It usually affects adolescents and young adults. Desmoplastic fibroma, considered the bone counterpart of soft tissue fibromatosis, is a rare tumor that usually affects the metaphyseal or diaphyseal portions of long bones or, less commonly, the jaw. Neuromuscular hamartoma, a rare developmental lesion composed of mature elements of both striated muscle and nerve, is usually diagnosed in infants and children and affects large nerve trunks. Rarely, it can affect the head and neck region. Occasional cases showing an association between aggressive fibromatosis and neuromuscular hamartoma have been reported in the literature. Here we present a unique case of an adult patient with desmoplastic fibroma of the mandible in association with neuromuscular hamartoma.

  18. Exercise Therapy in Spinobulbar Muscular Atrophy and Other Neuromuscular Disorders

    DEFF Research Database (Denmark)

    Dahlqvist, Julia Rebecka; Vissing, John

    2016-01-01

    There is no curative treatment for most neuromuscular disorders. Exercise, as a treatment for these diseases, has therefore received growing attention. When executed properly, exercise can maintain and improve health and reduce the risk of cardiovascular disease, obesity, and diabetes. In persons...... in patients with neuromuscular diseases associated with weakness and wasting. We review studies that have investigated different types of exercise in both myopathies and motor neuron diseases, with particular emphasis on training of persons affected by spinobulbar muscular atrophy (SBMA). Finally, we provide...... with muscle wasting due to neuromuscular conditions, however, a common belief has been that physical activity could accelerate degeneration of the diseased muscle and a careful approach to training has therefore been suggested. In this review, we describe the current knowledge about physical training...

  19. Perceived pain and temporomandibular disorders in neuromuscular diseases.

    Science.gov (United States)

    Fischer, Michael J; Riedlinger, Kathrin; Schoser, Benedikt; Bernateck, Michael

    2009-10-01

    Little is known about pain associated with temporomandibular disorders (TMD) in neuromuscular diseases. Inpatients (N = 134) with neuromuscular disorder diagnoses were given questionnaires to estimate pain localization and intensity. Research Diagnostic Criteria for Temporomandibular Disorders and the Temporomandibular Index (TMI) were utilized to assess TMD. Pain was reported by 116 patients (86%). Legs (52%) and arms (33%) were the most common locations for pain localization, but the highest Pearson correlations (TMI vs. perceived pain) appeared for pain located in the trunk and arms (0.861, P < 0.01). No correlation between TMI and diagnosis group existed except for "acquired myopathy" and "miscellaneous neuromuscular diseases." These results suggest that the degree of TMD does not correlate with pain according to disease, although common mechanisms might be responsible for pain development in specific body regions connected with TMD. Most important, higher levels of TMD are associated with higher levels of perceived pain.

  20. Neuromuscular exercise as treatment of degenerative knee disease

    DEFF Research Database (Denmark)

    Ageberg, Eva; Roos, Ewa M.

    2015-01-01

    Exercise is recommended as first-line treatment of degenerative knee disease. Our hypothesis is that neuromuscular exercise is feasible and at least as effective as tradionally used strength or aerobic training, but aims to more closely target the sensorimotor deficiencies and functional instabil......Exercise is recommended as first-line treatment of degenerative knee disease. Our hypothesis is that neuromuscular exercise is feasible and at least as effective as tradionally used strength or aerobic training, but aims to more closely target the sensorimotor deficiencies and functional...... instability associated with the degenerative knee disease than traditionally used training methods.SUMMARY FOR TABLE OF CONTENTS PAGECurrent data suggests that the effect from neuromuscular exercise on pain and function is comparable to the effects seen from other forms of exercise....

  1. Analysis of Operating Characteristics of Hybrid Ground Source Heat Pump Assisted with Chiller%冷机辅助复合式地源热泵运行特性探析

    Institute of Scientific and Technical Information of China (English)

    周世玉; 崔文智

    2015-01-01

    Hybrid ground source heat pump system assisted with chiller is proposed in this paper, and also two kinds of operation scheme. System operation of 30 years is simulated using TRNSYS software. Compared with conventional ground source heat pump system, operating characteristics and the feasibility of the hybrid ground source heat pump system are analyzed from the ground temperature increase, system performance, energy consumption and also the technical and economic aspects.%提出了冷水机组和热泵机组分设的复合式地源热泵系统,并提出了两种运行方案。采用 TRNSYS软件模拟其30年的系统运行,并分别从地温增幅、系统性能、能耗及技术经济角度和常规地源热泵系统进行比较,分析了该复合式地源热泵系统的运行特性及其可行性。

  2. Train-of-four fade during onset of neuromuscular block with nondepolarising neuromuscular blocking agents.

    Science.gov (United States)

    Gibson, F M; Mirakhur, R K

    1989-04-01

    Fade in the train-of-four (TOF) responses during onset of neuromuscular block was studied following administration of atracurium (225 or 450 micrograms/kg), vecuronium (40 or 80 micrograms/kg), pancuronium (60 or 120 micrograms/kg) and tubocurarine (450 micrograms/kg). TOF ratios were measured at approximate heights of T1 (first response in the TOF) of 75, 50 and 25%. Fade in TOF increased as the height of T1 decreased, with maximum fade being observed at T1 of 25%. The greatest difference between relaxants was observed at T1 of 25%, vecuronium showing the least fade and pancuronium, atracurium and tubocurarine showing increasing fade, in that order. The difference between atracurium and tubocurarine or between vecuronium and pancuronium was not significant, but the degree of TOF fade was significantly greater with atracurium and tubocurarine in comparison to vecuronium or pancuronium.

  3. Urgencias en patología neuromuscular Emergencies in neuromuscular pathology

    Directory of Open Access Journals (Sweden)

    T. Ayuso

    2008-01-01

    Full Text Available La debilidad muscular aguda (DMA es el síntoma predominante de las urgencias neuromusculares, especialmente si afecta a la musculatura respiratoria u orofaríngea. La DMA es un síndrome plurietiológico y con distintos niveles lesionales en la unidad motora. Dentro del amplio grupo de enfermedades neuromusculares, las que con mayor frecuencia provocan DMA e insuficiencia respiratoria son el síndrome de Guillain-Barré (SGB y la miastenia gravis (MG. El SGB constituye la causa más frecuente de parálisis flácida aguda; puede ocasionar fallo respiratorio en un tercio de los casos precisando ventilación mecánica. El diagnóstico preciso de este síndrome permitirá iniciar tratamiento inmunomodulador, que ha demostrado que modifica el curso de la enfermedad. Además, la valoración clínica de los pacientes y el conocimiento de sencillos tests neurofisiológicos y de función respiratoria guiarán la decisión de ventilación mecánica evitando la intubación de urgencia. La urgencia más frecuente que ocasiona la MG es la crisis miasténica, definida por el deterioro en la función bulbar con insuficiencia respiratoria aguda y riesgo de parada respiratoria. Ocurre en un 15-20% de pacientes miasténicos y puede desencadenarse por múltiples factores. Además del diagnóstico preciso de la crisis es importante la supresión de los factores desencadenantes y medidas de soporte ventilatorio. Entre las medidas farmacológicas son la plasmaféresis y las inmunoglobulinas intravenosas los instrumentos más útiles en la actualidad; estos tratamientos no sustituyen la vigilancia intensiva y el reconocimiento de los signos inminentes de fallo respiratorio que implican soporte ventilatorio invasivo o no invasivo.Acute muscle weakness (AMW is the predominant symptom of neuromuscular emergencies, especially if it affects the respiratory or oropharyngeal musculature . AMW is a multi-etiological syndrome, with different lesion levels in the motor unit

  4. New techniques in the tissue diagnosis of gastrointestinal neuromuscular diseases

    Institute of Scientific and Technical Information of China (English)

    Charles H Knowles; Joanne E Martin

    2009-01-01

    Gastrointestinal neuromuscular diseases are a clinically heterogeneous group of disorders of children and adults in which symptoms are presumed or proven to arise as a result of neuromuscular (including interstitial cell of Cajal) dysfunction. Common to most of these diseases are symptoms of impaired motor activity which manifest as slowed or obstructed transit with or without evidence of transient or persistent radiological visceral dilatation. A variety of histopathological techniques and allied investigations are being increasingly applied to tissue biopsies from such patients. This review outlines some of the more recent advances in this field, particularly in the most contentious area of small bowel disease manifesting as intestinal pseudo-obstruction.

  5. Neuromuscular hip biomechanics and pathology in the athlete.

    Science.gov (United States)

    Torry, Michael R; Schenker, Mara L; Martin, Hal D; Hogoboom, Doug; Philippon, Marc J

    2006-04-01

    Although hip arthroscopic techniques have been developed and evolved over the last 5 to 10 years to help active athletes, the mechanisms of athletic hip injuries across various sports are not well understood. The purpose of this article is to review the literature related to the osseous and ligamentous support as well as the neuromuscular control strategies associated with hip joint mechanics. The neuromuscular contributions to hip stability and mobility with respect to gait will be provided because this data represents the largest body of knowledge regarding hip function. Further, this article will present and describe probable mechanisms of injury in sporting activities most often associated with hip injury in the young athlete.

  6. Prevention and management of limb contractures in neuromuscular diseases.

    Science.gov (United States)

    Skalsky, Andrew J; McDonald, Craig M

    2012-08-01

    Limb contractures are a common impairment in neuromuscular diseases. They contribute to increased disability from decreased motor performance, mobility limitations, reduced functional range of motion, loss of function for activities of daily living, and increased pain. The pathogenesis of contractures is multifactorial. Myopathic conditions are associated with more severe limb contractures compared with neuropathic disorders. Although the evidence supporting the efficacy of multiple interventions to improve range of motion in neuromuscular diseases in a sustained manner is lacking, there are generally accepted principles with regard to splinting, bracing, stretching, and surgery that help minimize the impact or disability from contractures.

  7. Efectos del vendaje neuromuscular sobre la flexibilidad del raquis lumbar

    OpenAIRE

    A.M. Labrador-Cerrato; P. Ortega Sánchez-Diezma; G. Lanzas Melendo; Gutiérrez-Ortega, C.

    2015-01-01

    Introducción: El vendaje neuromuscular es una técnica que produce una estimulación muy selectiva sobre la piel a través de la aplicación de unas vendas elásticas especiales con el fin de lograr cambios propioceptivos, aumento o inhibición del tono muscular y mitigación de algias, entre otros. Objetivos: Comprobar si la aplicación del vendaje neuromuscular permite aumentar la flexión del raquis lumbar comparándola con otras técnicas de vendaje placebo (esparadrapo rígido convencional; Omniplas...

  8. Neuromuscular activity and knee kinematics in adolescents with patellofemoral pain

    DEFF Research Database (Denmark)

    Rathleff, Michael Skovdal; Samani, Afshin; Olesen, Jens L.

    2013-01-01

    This study aimed to investigate the neuromuscular control of the knee during stair descent among female adolescents with patellofemoral pain (PFP) and to report its association with self-reported clinical status assessed by the Knee Injury and Osteoarthritis Outcome Score (KOOS).......This study aimed to investigate the neuromuscular control of the knee during stair descent among female adolescents with patellofemoral pain (PFP) and to report its association with self-reported clinical status assessed by the Knee Injury and Osteoarthritis Outcome Score (KOOS)....

  9. Anormalidades neuromuscular no desuso, senilidade e caquexia

    Directory of Open Access Journals (Sweden)

    João Aris Kouyoumdjian

    1993-09-01

    Full Text Available É feita revisão de literatura sobre as principais alterações do sistema neuromuscular no desuso, senilidade e caquexia no ser humano e em modelos animais. A diminuição do diâmetro das fibras musculares após período de inatividade/imobilidade (desuso deve-se à perda de miofibrilas periféricas não ocorrendo formação de core-targetóides ou diminuição da atividade da miofosforilase, próprias da desnervação; mantêm-se a liberação espontânea de acetilcolina e fatores tróficos na junção mio-neural; em geral são afetadas preferencialmente fibras II, que podem assumir forma angular. Existe um processo contínuo intrínseco de envelhecimento de nervos e músculos, com desnervação e reinervação lenta e progressiva; o número de unidades motoras se reduz após 60 anos, sem ocorrência de atividade elétrica desnervatória; a quantidade de acetilcolina liberada nos neurônios terminais e a capacidade máxima de utilização de oxigênio estão diminuídas; a redução da capacidade oxidativa mitocondrial pode explicar o aumento de fibras I, mantendo-se o equilíbrio energético. Após poucas semanas de caquexia as fibras musculares podem ter o diâmetro reduzido em 30%, essa redução ocorre em ordem decrescente nos músculos dos membros inferiores, superiores e tronco; existe atrofia II preferencial com fibras angulares ocasionais, redução de RNA/síntese proteica, mantendo-se DNA normal.

  10. Applications for a hybrid operating room in thoracic surgery: from multidisciplinary procedures to --image-guided video-assisted thoracoscopic surgery.

    Science.gov (United States)

    Terra, Ricardo Mingarini; Andrade, Juliano Ribeiro; Mariani, Alessandro Wasum; Garcia, Rodrigo Gobbo; Succi, Jose Ernesto; Soares, Andrey; Zimmer, Paulo Marcelo

    2016-01-01

    The concept of a hybrid operating room represents the union of a high-complexity surgical apparatus with state-of-the-art radiological tools (ultrasound, CT, fluoroscopy, or magnetic resonance imaging), in order to perform highly effective, minimally invasive procedures. Although the use of a hybrid operating room is well established in specialties such as neurosurgery and cardiovascular surgery, it has rarely been explored in thoracic surgery. Our objective was to discuss the possible applications of this technology in thoracic surgery, through the reporting of three cases. RESUMO O conceito de sala híbrida traduz a união de um aparato cirúrgico de alta complexidade com recursos radiológicos de última geração (ultrassom, TC, radioscopia e/ou ressonância magnética), visando a realização de procedimentos minimamente invasivos e altamente eficazes. Apesar de bem estabelecido em outras especialidades, como neurocirurgia e cirurgia cardiovascular, o uso da sala hibrida ainda é pouco explorado na cirurgia torácica. Nosso objetivo foi discutir as aplicações e as possibilidades abertas por essa tecnologia na cirurgia torácica através do relato de três casos.

  11. Volume of the effect compartment in simulations of neuromuscular block

    NARCIS (Netherlands)

    Nigrovic, Vladimir; Proost, Johannes H.; Amann, Anton; Bhatt, Shashi B.

    2005-01-01

    Background: The study examines the role of the volume of the effect compartment in simulations of neuromuscular block (NMB) produced by nondepolarizing muscle relaxants. Methods: The molar amount of the postsynaptic receptors at the motor end plates in muscle was assumed constant; the apparent recep

  12. Drug Development and Challenges for Neuromuscular Clinical Trials.

    Science.gov (United States)

    El Mouelhi, Mohamed

    2016-03-01

    Drug development process faces many challenges, including those encountered in clinical trials for neuromuscular diseases. Drug development is a lengthy and highly costly process. Out of 10 compounds entering first study in man (phase 1), only one compound reaches the market after an average of 14 years with a cost of $2.7 billion. Nevertheless, according to the Centers for Medicare and Medicaid services, prescription drugs constituted only 9 % of each health care dollar spent in USA in 2013. Examples of challenges encountered in neuromuscular clinical trials include lack of validated patient-reported outcome tools, blinding issues, and the use of placebo in addition to lack of health authority guidance for orphan diseases. Patient enrollment challenge is the leading cause of missed clinical trial deadlines observed in about 80 % of clinical trials, resulting in delayed availability of potentially life-saving therapies. Another specific challenge introduced by recent technology is the use of social media and risk of bias. Sharing personal experiences while in the study could easily introduce bias among patients that would interfere with accurate interpretation of collected data. To minimize this risk, recent neuromuscular studies incorporate as an inclusion criterion the patient's agreement not to share any of study experiences through social media with other patients during the study conduct. Consideration of these challenges will allow timely response to the high unmet medical needs for many neuromuscular diseases.

  13. Antagonism of non-depolarising neuromuscular block: current practice.

    Science.gov (United States)

    Kopman, A F; Eikermann, M

    2009-03-01

    There is now mounting evidence that even small degrees of postoperative residual neuromuscular block increases the incidence of adverse respiratory events in the Post Anaesthesia Care Unit and may increase longer-term morbidity as well. In the absence of quantitative neuromuscular monitoring, residual block is easily missed. A very strong case can be made for the routine administration of a non-depolarising antagonist unless it can be objectively demonstrated that complete recovery has occurred spontaneously. However, the use of acetylcholinesterase inhibitors is associated with the potential for cardiovascular and respiratory side-effects, so there are cogent reasons for using low doses when the level of neuromuscular block is not intense. As little as 0.015-0.025 mg.kg(-1) of neostigmine is required at a train-of-four count of four with minimal fade, whereas 0.04-0.05 mg.kg(-1) is needed at a train-of-four count of two or three. If only a single twitch or none at all can be evoked, neostigmine should not be expected to promptly reverse neuromuscular block, and antagonism is best delayed till a train-of-four-count of two is achieved.

  14. Neuromuscular Electrical Stimulation for Motor Restoration in Hemiplegia.

    Science.gov (United States)

    Knutson, Jayme S; Fu, Michael J; Sheffler, Lynne R; Chae, John

    2015-11-01

    This article reviews the most common therapeutic and neuroprosthetic applications of neuromuscular electrical stimulation (NMES) for upper and lower extremity stroke rehabilitation. Fundamental NMES principles and purposes in stroke rehabilitation are explained. NMES modalities used for upper and lower limb rehabilitation are described, and efficacy studies are summarized. The evidence for peripheral and central mechanisms of action is also summarized.

  15. Validation of the ICF core set for neuromuscular diseases

    NARCIS (Netherlands)

    Bos, Isaac; Stallinga, H. A.; Middel, B.; Kuks, J. B. M.; Wynia, K.

    Background. Understanding of the consequences of a neuromuscular disease (NMD) can improve when a valid sample of disease-specific categories based on the International Classification of Functioning, Disabilities, and Health (ICF) is available. Objective. To examine the content validity of the

  16. Neuromuscular function during stair descent in meniscectomized patients and controls

    DEFF Research Database (Denmark)

    Thorlund, Jonas Bloch; Roos, Ewa M; Aagaard, Per

    2011-01-01

    The aim of this study was to identify differences in knee range of motion (ROM), movement speed, ground reaction forces (GRF) profile, neuromuscular activity, and muscle coactivation during the transition between stair descent and level walking in meniscectomized patients at high risk of knee...

  17. Neuromuscular and metabolic characteristics of elite basketball referees.

    Science.gov (United States)

    Bonganha, V; Cavaglieri, C R; Daniel, J F; Mercadante, L A; Montagner, P C; Borin, J P

    2013-06-01

    The dynamics of Basketball refereeing has changed and more recently the championships started to use the participation of three referees, but there is still a lack of information about the physical characteristics and performance of the referees. The aim of this study was to characterize the neuromuscular and metabolic performances and body composition of Brazilian elite basketball referees, with a level of national and international refereeing. Thirty-seven referees participated in the study (international level N.=17 and national level N.=20). We evaluated anthropometric and body composition variables, among them: height, body mass, body mass index (BMI) and body fat (%); metabolic parameters: lactate at rest and post-exercise; and neuromuscular performance: speed, explosive lower limbs strength, flexibility and aerobic capacity. The main results showed a statistically significant difference in age, in which the international referees were older than the national level (41.94±6.71; 37.30±7.23; P=0.036). There were not significant differences between the levels for neuromuscular and metabolic parameters and body composition. Comparing the results with athletes, the referees showed lower neuromuscular and metabolic parameters and the body composition showed higher body fat than basketball players. These data may represent physiological parameters to be considered in the prescription of physical training during the preparation and competition period.

  18. Neuromuscular training for rehabilitation of sports injuries: a systematic review.

    Science.gov (United States)

    Zech, Astrid; Hübscher, Markus; Vogt, Lutz; Banzer, Winfried; Hänsel, Frank; Pfeifer, Klaus

    2009-10-01

    Although proprioceptive and neuromuscular exercises are considered to be part and parcel of rehabilitation programs after sport injuries, there is an uncertainty regarding the effectiveness of corresponding training interventions. The objective of this review was to evaluate the effectiveness of proprioceptive and neuromuscular training (PT/NT) for the treatment of ankle, knee, and shoulder joint injuries. Two independent reviewers performed a literature search in various databases and reference lists of articles. Data of included trials were then extracted, and methodological quality was assessed by using predetermined forms. Fifteen trials met the inclusion criteria. PT/NT was effective at increasing functionality as well as at decreasing the incidence of recurrent injuries and "giving way" episodes after ankle sprains and in conservative treatment of anterior cruciate ligament injuries. However, conflicting results or no efficacy of training were reported for static postural control, joint position sense, neuromuscular control, joint laxity, and lower extremity strength. No study that examined PT/NT after shoulder injuries was found. From this review, it can be concluded that proprioceptive and neuromuscular interventions after ankle and knee joint injuries can be effective for the prevention of recurrent injuries and the improvement of joint functionality.

  19. Intraorbital neuromuscular choristoma adjacent to the optic nerve

    Directory of Open Access Journals (Sweden)

    Arie Perry, M.D.

    2017-03-01

    Full Text Available Neuromuscular choristoma is a rare tumor that incorporates mature skeletal muscle within fascicles of peripheral nerve. The etiology is poorly understood, yet most present in large nerves of children, with a tight link to post-operative fibromatosis recently appreciated. Herein, we report an exceptional intra-orbital example in a 53-year-old man with optic nerve compression.

  20. Tortuosity and anomalous diffusion in the neuromuscular junction

    Science.gov (United States)

    Lacks, Daniel J.

    2008-04-01

    The signal transfer from nerve to muscle occurs by diffusion across the neuromuscular junction. The continuum level analysis of diffusion processes is based on the diffusion equation, which in one dimension is ∂c/∂t=D(∂2c/∂x2) , where c is the molecular concentration and D is the diffusivity. However, in confined systems such as the neuromuscular junction, the diffusion equation may not be valid, and even if valid the value of D may be altered by the confinement. In this paper, Monte Carlo simulations are used to probe diffusion at the molecular level in a realistic model of a neuromuscular junction. The results show that diffusion is anomalous (i.e., not described by the diffusion equation) for time scales less than ˜0.01s , which is the time scale relevant for signaling processes in the synapse. At longer time scales, the diffusion is normal (i.e., described by the diffusion equation), but with a value of D that is reduced by a factor of ˜5 times compared to the value for diffusion in open space. As the width of the synaptic cleft decreases, these effects become even more pronounced. The physical basis of these results is described in terms of the structure of the neuromuscular junction.

  1. Optimising abdominal space with deep neuromuscular blockade in gynaecologic laparoscopy

    DEFF Research Database (Denmark)

    Madsen, Matias Vested; Gätke, M R; Springborg, H H

    2015-01-01

    neuromuscular blockade (NMB) would enlarge surgical space, measured as the distance from the sacral promontory to the trocar in patients undergoing gynaecologic laparoscopy. METHODS: Fourteen patients were randomised in an assessor-blinded crossover design. The distance from the sacral promontory to the trocar...

  2. Neuromuscular Bandage: Neurophysiological Effects and the Role of Fascias

    Directory of Open Access Journals (Sweden)

    Ximena María Villota Chicaíza

    2014-05-01

    Full Text Available During the last years, neuromuscular bandage, a therapeutic application created in 1979 by doctor Kenzo Kase has been introduced in the management of many disorders of the musculo-skeletal system and even more so in the treatment of neurological disorders; This therapeutic tool which consists of a self adhesive elastic bandage allows recovery of the injured party without diminishing its bodily function. According to the existing literature on the physiological effects of this therapeutic application in the body, you could say that there is consensus. However in this article the author wants to highlight the significant although little highlighted role played by the fas¬cias on the therapeutic effects of neuromuscular bandage, analyzing from a reflective perspective the analgesic, neuromechanical and circulatory effects, as fundamental effects of neuromuscular bandage and fascias in the same function, trying to bring a global understanding on the way they relate to all connective tissues, aspects that are of great importance for the proper evaluation of alterations and prescription of neuromuscular bandage

  3. Muscle ultrasound quantifies segmental neuromuscular outcome in pediatric myelomeningocele

    NARCIS (Netherlands)

    Verbeek, Renate J; Hoving, Eelco; Maurits, Natalia M; Brouwer, Oebele F; van der Hoeven, Johannes H; Sival, Deborah A

    2014-01-01

    In pediatric spina bifida aperta (SBA), non-invasive assessment of neuromuscular integrity by muscle ultrasound density (MUD) could provide important information about the clinical condition. We therefore aimed to determine the association between pediatric SBA MUD and segmental neurologic function.

  4. Facial rehabilitation: a neuromuscular reeducation, patient-centered approach.

    Science.gov (United States)

    Vanswearingen, Jessie

    2008-05-01

    Individuals with facial paralysis and distorted facial expressions and movements secondary to a facial neuromotor disorder experience substantial physical, psychological, and social disability. Previously, facial rehabilitation has not been widely available or considered to be of much benefit. An emerging rehabilitation science of neuromuscular reeducation and evidence for the efficacy of facial neuromuscular reeducation, a process of facilitating the return of intended facial movement patterns and eliminating unwanted patterns of facial movement and expression, may provide patients with disorders of facial paralysis or facial movement control opportunity for the recovery of facial movement and function. We provide a brief overview of the scientific rationale for facial neuromuscular reeducation in the structure and function of the facial neuromotor system, the neuropsychology of facial expression, and relations among expressions, movement, and emotion. The primary purpose is to describe principles of neuromuscular reeducation, assessment and outcome measures, approach to treatment, the process, including surface-electromyographic biofeedback as an adjunct to reeducation, and the goal of enhancing the recovery of facial expression and function in a patient-centered approach to facial rehabilitation.

  5. Is deep neuromuscular blockade beneficial in laparoscopic surgery?

    DEFF Research Database (Denmark)

    Madsen, M V; Staehr-Rye, A K; Claudius, C;

    2016-01-01

    BACKGROUND: Deep neuromuscular blockade during laparoscopic surgery may provide some clinical benefit. We present the 'Pro-' argument in this paired position paper. METHODS: We reviewed recent evidence from a basic database of references which we agreed on with the 'Con-' side, and present this i...

  6. Neuromuscular and mitochondrial disorders: what is relevant to the anaesthesiologist?

    NARCIS (Netherlands)

    Driessen, J.J.

    2008-01-01

    PURPOSE OF REVIEW: The review provides an up-to-date information to the anaesthesiologist about the more frequent and important neuromuscular disorders for which new basic insights or clinical implications have been reported. RECENT FINDINGS: The findings include the mechanisms of the hyperkalemia a

  7. Roles of neuro-exocytotic proteins at the neuromuscular junction

    NARCIS (Netherlands)

    Sons-Michel, Michèle S.

    2011-01-01

    The aim of the studies described in the thesis was to elucidate the roles of several neuro-exocytotic proteins at the motor nerve terminal in neuromuscular synaptic transmission, making use of genetic knockout (KO) mice, each missing one (or more) neuro-exocytotic proteins. In addition, it was

  8. Neuromuscular stimulation after stroke: from technology to clinical deployment

    NARCIS (Netherlands)

    IJzerman, Maarten Joost; Renzenbrink, Gerbert J.; Geurts, Alexander C.H.

    2009-01-01

    Since the early 1960s, electrical or neuromuscular electrical stimulation (NMES) has been used to support the rehabilitation of stroke patients. One of the earliest applications of NMES included the use of external muscle stimulation to correct drop-foot after stroke. During the last few decades

  9. Neuromuscular stimulation after stroke: from technology to clinical deployment.

    NARCIS (Netherlands)

    IJzerman, M.J.; Renzenbrink, G.J.; Geurts, A.C.H.

    2009-01-01

    Since the early 1960s, electrical or neuromuscular electrical stimulation (NMES) has been used to support the rehabilitation of stroke patients. One of the earliest applications of NMES included the use of external muscle stimulation to correct drop-foot after stroke. During the last few decades

  10. Thermal decomposition assisted synthesis and upconversion property of Fe3O4@YPO4:Tm/Yb hybrid nano-composite phosphor

    Science.gov (United States)

    Tiwari, S. P.; Kumar, K.; Rai, V. K.

    2015-06-01

    Hybrid nano-composite phosphor has been successfully synthesized through thermal decomposition method. The dual phase of samples assigned by XRD analysis shows the formation of nano-composite with crystallite size 20 nm and 12 nm for YPO4: Tm/Yb and Fe3O4@YPO4:Tm/Yb respectively. The FESEM images show the spherical shape and non agglomerated formation of nanoparticles. Three bands in upconversion emission mode were found in intense blue at 472 nm, red at 662 nm and NIR at 798 nm regions corresponding to1G4 → 3H6, 1G4 → 3F4 and 3H4 → 3H6 transition states respectively. The lifetime for1G4 → 3H6 level is found 1150 microsecond and 1400 microsecond for YPO4: Tm/Yb and Fe3O4@YPO4:Tm/Yb samples respectively.

  11. Development of a Hybrid Piezo Natural Rubber Piezoelectricity and Piezoresistivity Sensor with Magnetic Clusters Made by Electric and Magnetic Field Assistance and Filling with Magnetic Compound Fluid

    Directory of Open Access Journals (Sweden)

    Kunio Shimada

    2017-02-01

    Full Text Available Piezoelements used in robotics require large elasticity and extensibility to be installed in an artificial robot skin. However, the piezoelements used until recently are vulnerable to large forces because of the thin solid materials employed. To resolve this issue, we utilized a natural rubber and applied our proposed new method of aiding with magnetic and electric fields as well as filling with magnetic compound fluid (MCF and doping. We have verified the piezoproperties of the resulting MCF rubber. The effect of the created magnetic clusters is featured in a new two types of multilayered structures of the piezoelement. By measuring the piezoelectricity response to pressure, the synergetic effects of the magnetic clusters, the doping and the electric polymerization on the piezoelectric effect were clarified. In addition, by examining the relation between the piezoelectricity and the piezoresistivity created in the MCF piezo element, we propose a hybrid piezoelement.

  12. Development of a Hybrid Piezo Natural Rubber Piezoelectricity and Piezoresistivity Sensor with Magnetic Clusters Made by Electric and Magnetic Field Assistance and Filling with Magnetic Compound Fluid.

    Science.gov (United States)

    Shimada, Kunio; Saga, Norihiko

    2017-02-10

    Piezoelements used in robotics require large elasticity and extensibility to be installed in an artificial robot skin. However, the piezoelements used until recently are vulnerable to large forces because of the thin solid materials employed. To resolve this issue, we utilized a natural rubber and applied our proposed new method of aiding with magnetic and electric fields as well as filling with magnetic compound fluid (MCF) and doping. We have verified the piezoproperties of the resulting MCF rubber. The effect of the created magnetic clusters is featured in a new two types of multilayered structures of the piezoelement. By measuring the piezoelectricity response to pressure, the synergetic effects of the magnetic clusters, the doping and the electric polymerization on the piezoelectric effect were clarified. In addition, by examining the relation between the piezoelectricity and the piezoresistivity created in the MCF piezo element, we propose a hybrid piezoelement.

  13. Development of a Hybrid Piezo Natural Rubber Piezoelectricity and Piezoresistivity Sensor with Magnetic Clusters Made by Electric and Magnetic Field Assistance and Filling with Magnetic Compound Fluid

    Science.gov (United States)

    Shimada, Kunio; Saga, Norihiko

    2017-01-01

    Piezoelements used in robotics require large elasticity and extensibility to be installed in an artificial robot skin. However, the piezoelements used until recently are vulnerable to large forces because of the thin solid materials employed. To resolve this issue, we utilized a natural rubber and applied our proposed new method of aiding with magnetic and electric fields as well as filling with magnetic compound fluid (MCF) and doping. We have verified the piezoproperties of the resulting MCF rubber. The effect of the created magnetic clusters is featured in a new two types of multilayered structures of the piezoelement. By measuring the piezoelectricity response to pressure, the synergetic effects of the magnetic clusters, the doping and the electric polymerization on the piezoelectric effect were clarified. In addition, by examining the relation between the piezoelectricity and the piezoresistivity created in the MCF piezo element, we propose a hybrid piezoelement. PMID:28208625

  14. Neuromuscular Activity of Micrurus laticollaris (Squamata: Elapidae Venom in Vitro

    Directory of Open Access Journals (Sweden)

    Alejandro Carbajal-Saucedo

    2014-01-01

    Full Text Available In this work, we have examined the neuromuscular activity of Micrurus laticollaris (Mexican coral snake venom (MLV in vertebrate isolated nerve-muscle preparations. In chick biventer cervicis preparations, the MLV induced an irreversible concentration- and time-dependent (1–30 µg/mL neuromuscular blockade, with 50% blockade occurring between 8 and 30 min. Muscle contractures evoked by exogenous acetylcholine were completely abolished by MLV, whereas those of KCl were also significantly altered (86% ± 11%, 53% ± 11%, 89% ± 5% and 89% ± 7% for one, three, 10 and 30 µg of venom/mL, respectively; n = 4; p < 0.05. In mouse phrenic nerve-diaphragm preparations, MLV (1–10 µg/mL promoted a slight increase in the amplitude of twitch-tension (3 µg/mL, followed by neuromuscular blockade (n = 4; the highest concentration caused complete inhibition of the twitches (time for 50% blockade = 26 ± 3 min, without exhibiting a previous neuromuscular facilitation. The venom (3 µg/mL induced a biphasic modulation in the frequency of miniature end-plate potentials (MEPPs/min, causing a significant increase after 15 min, followed by a decrease after 60 min (from 17 ± 1.4 (basal to 28 ± 2.5 (t15 and 12 ± 2 (t60. The membrane resting potential of mouse diaphragm preparations pre-exposed or not to d-tubocurarine (5 µg/mL was also significantly less negative with MLV (10 µg/mL. Together, these results indicate that M. laticollaris venom induces neuromuscular blockade by a combination of pre- and post-synaptic activities.

  15. Neuromuscular activity of Micrurus laticollaris (Squamata: Elapidae) venom in vitro.

    Science.gov (United States)

    Carbajal-Saucedo, Alejandro; Floriano, Rafael Stuani; Dal Belo, Cháriston André; Olvera-Rodríguez, Alejandro; Alagón, Alejandro; Rodrigues-Simioni, Léa

    2014-01-17

    In this work, we have examined the neuromuscular activity of Micrurus laticollaris (Mexican coral snake) venom (MLV) in vertebrate isolated nerve-muscle preparations. In chick biventer cervicis preparations, the MLV induced an irreversible concentration- and time-dependent (1-30 µg/mL) neuromuscular blockade, with 50% blockade occurring between 8 and 30 min. Muscle contractures evoked by exogenous acetylcholine were completely abolished by MLV, whereas those of KCl were also significantly altered (86% ± 11%, 53% ± 11%, 89% ± 5% and 89% ± 7% for one, three, 10 and 30 µg of venom/mL, respectively; n = 4; p < 0.05). In mouse phrenic nerve-diaphragm preparations, MLV (1-10 µg/mL) promoted a slight increase in the amplitude of twitch-tension (3 µg/mL), followed by neuromuscular blockade (n = 4); the highest concentration caused complete inhibition of the twitches (time for 50% blockade = 26 ± 3 min), without exhibiting a previous neuromuscular facilitation. The venom (3 µg/mL) induced a biphasic modulation in the frequency of miniature end-plate potentials (MEPPs)/min, causing a significant increase after 15 min, followed by a decrease after 60 min (from 17 ± 1.4 (basal) to 28 ± 2.5 (t15) and 12 ± 2 (t60)). The membrane resting potential of mouse diaphragm preparations pre-exposed or not to d-tubocurarine (5 µg/mL) was also significantly less negative with MLV (10 µg/mL). Together, these results indicate that M. laticollaris venom induces neuromuscular blockade by a combination of pre- and post-synaptic activities.

  16. Hybrid Baryons

    CERN Document Server

    Page, P R

    2003-01-01

    We review the status of hybrid baryons. The only known way to study hybrids rigorously is via excited adiabatic potentials. Hybrids can be modelled by both the bag and flux-tube models. The low-lying hybrid baryon is N 1/2^+ with a mass of 1.5-1.8 GeV. Hybrid baryons can be produced in the glue-rich processes of diffractive gamma N and pi N production, Psi decays and p pbar annihilation.

  17. Facile One-Step Microwave-Assisted Route towards Ni Nanospheres/Reduced Graphene Oxide Hybrids for Non-Enzymatic Glucose Sensing

    Directory of Open Access Journals (Sweden)

    Mojiao Zhou

    2012-04-01

    Full Text Available In this work, a facile one-step microwave-assisted method for deposition of monodisperse Ni nanospheres on reduced graphene oxide (rGO sheets to form Ni-rGO nanohybrids is discussed. In the presence of hydrazine monohydrate, Ni nanospheres are grown onto rGO sheets using nickel precursor and GO as starting materials in ethylene glycol (EG solution under a low level of microwave irradiation (300 W for 20 min, during which GO is also reduced to rGO. The as-prepared nanohybrids exhibit well-dispersed Ni nanosphere (about 80 nm in diameter loadings and effective reduction of graphene oxide. The resulting Ni-rGO nanohybrids-modified glassy carbon electrode (GCE shows significantly improved electrochemical performance in nonenzymatic amperometric glucose detection. In addition, interference from the oxidation of common interfering species under physiological conditions, such as ascorbic acid (AA and uric acid (UA, is effectively avoided.

  18. Microwave assisted synthesis of a noble metal-graphene hybrid photocatalyst for high efficient decomposition of organic dyes under visible light

    Energy Technology Data Exchange (ETDEWEB)

    Ullah, Kefayat; Ye, Shu; Zhu, Lei; Meng, Ze-Da; Sarkar, Sourav; Oh, Won-Chun, E-mail: wc_oh@hanseo.ac.kr

    2014-02-15

    Highlights: • Pt/graphene nanocomposites were synthesized via facile, fast, and scalable microwave irradiation method. • MB and Rh.B were used as sample dye solutions. • The Pt/graphene nanocomposites displayed distinctly enhanced photocatalytic activities. • UV–vis spectroscopic analysis was carried out to measure decomposition effect. -- Abstract: We report fast and facile synthesis of Pt/graphene nanocomposite via microwave assisted techniques. The “as-prepared” composites were characterized by X-ray diffraction (XRD), scanning electron microscopy (SEM) with an energy dispersive X-ray (EDX) analysis, transmission electron microscopy (TEM), UV–vis absorbance spectra analysis, diffuse reflectance spectra (DRS) analysis and Raman spectroscopic analysis. The visible light photo catalytic activities of Pt/graphene nanocomposite were tested by rhodamine B (Rh.B) and methylene blue (MB) as a standard model dyes. These analysis provide a promising development toward graphene based high efficient photocatalyst under visible light as an energy source.

  19. Surface Modification of nTiO2/Ag Hybrid Nanoparticles Using Microwave-Assisted Polymerization in the Presence of Bis(2-hydroxyethyl Terephthalate

    Directory of Open Access Journals (Sweden)

    P. A. De León-Martínez

    2017-01-01

    Full Text Available Titanium dioxide doped silver (nTiO2/Ag nanoparticles were surface-modified by microwave-assisted polymerization of 2-bis-(hydroxyethyl terephthalate (BHET. The modified and unmodified nanoparticles were analyzed by FTIR, XRD, TGA, and TEM. A thin layer of grafted PET on the surface of the nanoparticles was observed and quantified by TGA giving a value of 40 wt-%. XRD and electron diffraction analyses showed traces of AgO2 after the modification. The bactericide activity of modified and unmodified nanoparticles was evaluated; the presence of the thin layer of grafted-PET on the nTiO2/Ag did not change significantly the bactericide activity, showing an excellent performance similar to unmodified nanoparticles.

  20. Corticosteroids and neuromuscular blockers in development of critical illness neuromuscular abnormalities: A historical review.

    Science.gov (United States)

    Wilcox, Susan R

    2017-02-01

    Weakness is common in critically ill patients, associated with prolonged mechanical ventilation and increased mortality. Corticosteroids and neuromuscular blockade (NMB) administration have been implicated as etiologies of acquired weakness in the intensive care unit. Medical literature since the 1970s is replete with case reports and small case series of patients with weakness after receiving high-dose corticosteroids, prolonged NMB, or both. Several risk factors for weakness appear in the early literature, including large doses of steroids, the dose and duration of NMB, hyperglycemia, and the duration of mechanical ventilation. With improved quality of data, however, the association between weakness and steroids or NMB wanes. This may reflect changes in clinical practice, such as a reduction in steroid dosing, use of cisatracurium besylate instead of aminosteroid NMBs, improved glycemic control, or trends in minimizing mechanical ventilatory support. Thus, based on the most recent and high-quality literature, neither corticosteroids in commonly used doses nor NMB is associated with increased duration of mechanical ventilation, the greatest morbidity of weakness. Minimizing ventilator support as soon as the patient's condition allows may be associated with a reduction in weakness-related morbidity.

  1. Hybrid-Mode-Assisted Long-Distance Excitation of Short-Range Surface Plasmons in a Nanotip-Enhanced Step-Index Fiber.

    Science.gov (United States)

    Tuniz, Alessandro; Chemnitz, Mario; Dellith, Jan; Weidlich, Stefan; Schmidt, Markus A

    2017-02-08

    We propose and experimentally demonstrate a monolithic nanowire-enhanced fiber-based nanoprobe for the broadband delivery of light (550-730 nm) to a deep subwavelength scale using short-range surface plasmons. The geometry is formed by a step index fiber with an integrated gold nanowire in its core and a protruding gold nanotip with sub-10 nm apex radius. We present a novel coupling scheme to excite short-range surface plasmons, whereby the radially polarized hybrid mode propagating inside the nanowire section excites the plasmonic mode close to the fiber endface, which is in turn superfocused down to nanoscale dimensions at the tip apex. We show that in this all-integrated fiber-plasmonic coupling scheme the wire length can be orders of magnitude longer than the attenuation length of short-range plasmon polaritons, yielding a broadband plasmon excitation and reducing demands in fabrication. We observe that the scattered light in the far-field from the nanotip is axially polarized and preferentially excited by a radially polarized input, unambiguously revealing that it originates from a short-range plasmon propagating on the nanotip, in agreement with simulations. This novel excitation scheme will have important applications in near-field microscopy and nanophotonics and potentially offers significantly improved resolution compared to current delivery near-field probes.

  2. MgO-hybridized TiO2 interfacial layers assisting efficiency enhancement of solid-state dye-sensitized solar cells

    Science.gov (United States)

    Sakai, Nobuya; Ikegami, Masashi; Miyasaka, Tsutomu

    2014-02-01

    Interfacial modification of a thin TiO2 compact layer (T-CL) by hybridization with MgO enhanced the quantum conversion efficiency of solid-state dye-sensitized solar cells (ssDSSCs) comprising a multilayer structure of transparent electrode/T-CL/dye-sensitized mesoporous TiO2/hole conductor/metal counter electrode. The Mg(CH3COO)2 treatment was employed to introduce a MgO-TiO2 CL (T/M-CL), which enhanced the physical connection and conduction between the CL and mesoporous semiconductor layer as a consecutive interface, owing to the dehydration reaction of Mg(CH3COO)2. The photocurrent density of ssDSSC was increased 33% by the T/M-CL compared with the T-CL, using an equivalent amount of adsorbed dye. The ssDSSC with the T/M-CL yielded the highest efficiency of 4.02% under irradiation at 100 mW cm-2. The electrical impedance spectroscopy showed that the charge-transfer resistance (Rct) of the photoelectrode with T/M-CL was reduced by 300 Ω from the reference non-treated T-CL electrode. Characterized by the intrinsically low Rct of the compact layer, the T/M-CL is capable of improving the photovoltaic performance of solid-state sensitized mesoscopic solar cells.

  3. Oxygen Evolution Assisted Fabrication of Highly Loaded Carbon Nanotube/MnO2 Hybrid Films for High-Performance Flexible Pseudosupercapacitors.

    Science.gov (United States)

    Chen, Hongyuan; Zeng, Sha; Chen, Minghai; Zhang, Yongyi; Zheng, Lianxi; Li, Qingwen

    2016-04-01

    To date, it has been a great challenge to design high-performance flexible energy storage devices for sufficient loading of redox species in the electrode assemblies, with well-maintained mechanical robustness and enhanced electron/ionic transport during charge/discharge cycles. An electrochemical activation strategy is demonstrated for the facile regeneration of carbon nanotube (CNT) film prepared via floating catalyst chemical vapor deposition strategy into a flexible, robust, and highly conductive hydrogel-like film, which is promising as electrode matrix for efficient loading of redox species and the fabrication of high-performance flexible pseudosupercapacitors. The strong and conductive CNT films can be effectively expanded and activated by electrochemical anodic oxygen evolution reaction, presenting greatly enhanced internal space and surface wettability with well-maintained strength, flexibility, and conductivity. The as-formed hydrogel-like film is quite favorable for electrochemical deposition of manganese dioxide (MnO2 ) with loading mass up to 93 wt% and electrode capacitance kept around 300 F g(-1) (areal capacitance of 1.2 F cm(-2) ). This hybrid film was further used to assemble a flexible symmetric pseudosupercapacitor without using any other current collectors and conductive additives. The assembled flexible supercapacitors exhibited good rate performance, with the areal capacitance of more than 300 mF cm(-2) , much superior to other reported MnO2 based flexible thin-film supercapacitors. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  4. Efectos del vendaje neuromuscular sobre la flexibilidad del raquis lumbar

    Directory of Open Access Journals (Sweden)

    A.M. Labrador-Cerrato

    2015-03-01

    Full Text Available Introducción: El vendaje neuromuscular es una técnica que produce una estimulación muy selectiva sobre la piel a través de la aplicación de unas vendas elásticas especiales con el fin de lograr cambios propioceptivos, aumento o inhibición del tono muscular y mitigación de algias, entre otros. Objetivos: Comprobar si la aplicación del vendaje neuromuscular permite aumentar la flexión del raquis lumbar comparándola con otras técnicas de vendaje placebo (esparadrapo rígido convencional; Omniplaste®-E; observar la concordancia entre la prueba sit-and-reach y el test de Schober en la valoración de la ganancia de flexión lumbar. Material y métodos: Estudio piloto experimental a triple ciego. Se distribuyeron aleatoriamente 45 sujetos sanos de 20-55 años en tres grupos: 1 esparadrapo convencional; 2 Omniplaste®-E; 3 vendaje neuromuscular. En todos los participantes se evaluó la flexión del raquis lumbar mediante la prueba sit-and-reach y el test de Schober antes y después de la intervención siguiendo el mismo protocolo. Resultados: Considerado un intervalo de confianza del 95% y grado de significación estadística p<0,05 en todos los casos, se obtuvo un incremento estadísticamente significativo de la flexión lumbar en todos los grupos según la prueba sit-and-reach, que fue mayor en el grupo del vendaje neuromuscular (1,5 cm de mediana; p=0,011. Según el test de Schober, solamente el vendaje neuromuscular se mostró eficiente (p<0,001, incrementándose el valor basal en un 6,25% (1 cm de mediana. Conclusiones: La aplicación del vendaje neuromuscular sobre la columna lumbar mejora la flexión lumbar respecto a técnicas placebo a partir de los resultados obtenidos mediante el test de Schober, así como una mayor flexión global del tronco que estas técnicas según la prueba sit-and-reach. El test de Schober parece ser más fiable y preciso que la prueba sit-and-reach para estudios de este tipo.

  5. Histochemical and immunohistological approach to comparative neuromuscular diseases.

    Directory of Open Access Journals (Sweden)

    Serenella Papparella

    2009-12-01

    Full Text Available The broad category of neuromuscular diseases covers conditions that involve the weakness or wasting of the body muscles. These problems may occur in the spinal cord, the peripheral nerves or the muscle fibers. Some may be hereditary, while others are acquired. Commonly recognized conditions fall into the categories of myopathies, which are diseases of the muscle like muscular dystrophy, disorders of the junction where the nerve impulses are transmitted to the muscle like myasthenia gravis, and neuropathies, which are diseases of the peripheral nervous system. The diagnosis of most neuromuscular diseases rest on careful clinical evaluation of the patient, electromyography, the muscle biopsy, and in some instances, molecular genetic studies. Muscle biopsy, associated to histochemical and immunohistological techniques, plays a key role in diagnosis of many neuromuscular disorders. A number of morphological abnormalities of muscle can be recognized on histological stains such as haematoxylin and eosin and Engel trichrome. Histochemical techniques are essential for the study of muscle biopsies for four main reasons. First, they demonstrate the non-uniform nature of the muscle highlighting the different biochemical properties of specific fibre type and their selective involvement in certain disease processes. Second, they may show an absences of a particular enzyme. Third, an excess of a particular substrate can be demonstrated. Fourth, they may show structural changes in the muscle which would not be apparent with routine histological stains, such as the enzyme-deficient cores in central core disease "mouth-eaten" fibers, and abnormalities in the distribution of mitochondria. In some neuromuscular disorders there could be only non-specific myopathological features. However, a number of proteins, including sarcolemmal, sarcomeric, and nuclear proteins as well as enzymes with defects responsible for neuromuscular disorders, have been identified during

  6. The role of patient advocacy organisations in neuromuscular disease R&D - The case of the Dutch neuromuscular disease association VSN

    NARCIS (Netherlands)

    Boon, W.P.C.; Broekgaarden, R.

    2010-01-01

    This article investigates to what extent patient advocacy organisations play a role in influencing R&D and policymaking for rare neuromuscular diseases. The Dutch neuromuscular disease organisation VSN is studied in depth. A brief history of the VSN is sketched along with the international embedding

  7. Development of network-based multichannel neuromuscular electrical stimulation system for stroke rehabilitation.

    Science.gov (United States)

    Qu, Hongen; Xie, Yongji; Liu, Xiaoxuan; He, Xin; Hao, Manzhao; Bao, Yong; Xie, Qing; Lan, Ning

    2016-01-01

    Neuromuscular electrical stimulation (NMES) is a promising assistive technology for stroke rehabilitation. Here we present the design and development of a multimuscle stimulation system as an emerging therapy for people with paretic stroke. A network-based multichannel NMES system was integrated based on dual bus architecture of communication and an H-bridge current regulator with a power booster. The structure of the system was a body area network embedded with multiple stimulators and a communication protocol of controlled area network to transmit muscle stimulation parameter information to individual stimulators. A graphical user interface was designed to allow clinicians to specify temporal patterns and muscle stimulation parameters. We completed and tested a prototype of the hardware and communication software modules of the multichannel NMES system. The prototype system was first verified in nondisabled subjects for safety, and then tested in subjects with stroke for feasibility with assisting multijoint movements. Results showed that synergistic stimulation of multiple muscles in subjects with stroke improved performance of multijoint movements with more natural velocity profiles at elbow and shoulder and reduced acromion excursion due to compensatory trunk rotation. The network-based NMES system may provide an innovative solution that allows more physiological activation of multiple muscles in multijoint task training for patients with stroke.

  8. Anormalidades neuromuscular no desuso, senilidade e caquexia Neuromuscular abnormalities in disuse, cachexia and ageing

    Directory of Open Access Journals (Sweden)

    João Aris Kouyoumdjian

    1993-09-01

    Full Text Available É feita revisão de literatura sobre as principais alterações do sistema neuromuscular no desuso, senilidade e caquexia no ser humano e em modelos animais. A diminuição do diâmetro das fibras musculares após período de inatividade/imobilidade (desuso deve-se à perda de miofibrilas periféricas não ocorrendo formação de core-targetóides ou diminuição da atividade da miofosforilase, próprias da desnervação; mantêm-se a liberação espontânea de acetilcolina e fatores tróficos na junção mio-neural; em geral são afetadas preferencialmente fibras II, que podem assumir forma angular. Existe um processo contínuo intrínseco de envelhecimento de nervos e músculos, com desnervação e reinervação lenta e progressiva; o número de unidades motoras se reduz após 60 anos, sem ocorrência de atividade elétrica desnervatória; a quantidade de acetilcolina liberada nos neurônios terminais e a capacidade máxima de utilização de oxigênio estão diminuídas; a redução da capacidade oxidativa mitocondrial pode explicar o aumento de fibras I, mantendo-se o equilíbrio energético. Após poucas semanas de caquexia as fibras musculares podem ter o diâmetro reduzido em 30%, essa redução ocorre em ordem decrescente nos músculos dos membros inferiores, superiores e tronco; existe atrofia II preferencial com fibras angulares ocasionais, redução de RNA/síntese proteica, mantendo-se DNA normal.Cachexia, ageing and disuse and their effects on the human and animals neuromuscular system are reviewed. Disuse induces reduction of muscle fibers (mainly II diameter with peripheral myofibrils lost; there is no core-targetoid or even reduction on myophosphorilase activity, both typical of denervation; the acetylcholine spontaneous release and trophic factors on myoneural junction are maintained; muscle fibers could change to angular shape. Ageing affects nerve and muscle by a continuous and progressive process of denervation and reinner

  9. Early appearance and possible roles of non-neuromuscular cholinesterases.

    Directory of Open Access Journals (Sweden)

    Carla eFalugi

    2012-04-01

    Full Text Available The biological function of the cholinesterase (ChE enzymes is well known and has been studied since the beginning of the XXth century; in particular, acetylcholinesterase (AChE, E.C. 3.1.1.7 is an enzyme playing a key role in the modulation of neuromuscular impulse transmission. However, in the past decades, there has been increasing interest concerning its role in regulating non-neuromuscular cell-to-cell interactions mediated by intracellular ion concentration changes, like the ones occurring during gamete interaction and embryonic development. An understanding of the mechanisms of the cholinergic regulation of these events can help us foresee the possible impact on environmental and human health, including gamete efficiency and possible teratogenic effects on different models, and help elucidate the extent to which exposure to ChE inhibitors may affect human health.

  10. An overview of neurological and neuromuscular signs in mitochondrial diseases.

    Science.gov (United States)

    Chaussenot, A; Paquis-Flucklinger, V

    2014-05-01

    Mitochondrial disorders have a broad clinical spectrum and are genetically heterogeneous, involving two genomes. These disorders may be develop at any age, with isolated or multiple system involvement, and any pattern of inheritance. Neurological involvement is the most frequent, and concerns muscular, peripheral and central nervous system. Among these diverse signs, some are suggestive of mitochondrial disease, such as progressive external ophthalmoplegia, exercise intolerance, psychomotor regression, stroke-like episodes, refractory epilepsy and Epilepsia Partialis Continua. Others are less specific and mitochondrial hypothesis may be evocated because of either association of different neuromuscular signs or a multisystemic involvement. This review describes the wealth of this neurological and neuromuscular symptomatology through different syndromes reported in the literature, according to preponderant signs and to modes of inheritance, as key elements to guide genetics testing.

  11. Supervised neuromuscular exercise prior to hip and knee replacement

    DEFF Research Database (Denmark)

    Fernandes, Linda; Roos, Ewa M; Overgaard, Søren

    2017-01-01

    BACKGROUND: There are indications of beneficial short-term effect of pre-operative exercise in reducing pain and improving activity of daily living after total hip replacement (THR) and total knee replacement (TKR) surgery. Though, information from studies conducting longer follow-ups and economic...... evaluations of exercise prior to THR and TKR is needed. The aim of the study was to analyse 12-month clinical effect and cost-utility of supervised neuromuscular exercise prior to THR and TKR surgery. METHODS: The study was conducted alongside a randomised controlled trial including 165 patients scheduled...... for standard THR or TKR at a hospital located in a rural area of Denmark. The patients were randomised to replacement surgery with or without an 8-week preoperative supervised neuromuscular exercise program (Clinical Trials registration no.: NCT01003756). Clinical effect was measured with Hip disability...

  12. Computed tomography of skeletal muscles in neuromuscular disease

    Energy Technology Data Exchange (ETDEWEB)

    Rodiek, S.O.; Kuether, G.

    1985-06-01

    CT-documentation of skeletal muscular lesions caused by neuromuscular diseases implies an essential contribution to conventional techniques in the macroscopic field. Size, distribution and degree of lesions as well as compensatory mechanisms are proved thereby. We report about the different effects on muscle appearance referring to 106 patients of our own experience in amyotrophic lateral sclerosis, spinal muscular atrophy, poliomyelitis, polyradiculitis, polyneuropathy as well as peripheral traumatic nerve lesions.

  13. Aggravated neuromuscular symptoms of mercury exposure from dental amalgam fillings.

    Science.gov (United States)

    Akbal, Ayla; Yılmaz, Hınç; Tutkun, Engin; Köş, Durdu Mehmet

    2014-01-01

    Dental amalgam fillings are widely used all over the world. However, their mercury content can lead to various side effects and clinical problems. Acute or chronic mercury exposure can cause several side effects on the central nerve system, renal and hepatic functions, immune system, fetal development and it can play a role on exacerbation of neuromuscular diseases. In this case, we will present a patient with vacuolar myopathy whose symptoms were started and aggravated with her dental amalgam fillings.

  14. Report on Adaptive Force, a specific neuromuscular function

    Directory of Open Access Journals (Sweden)

    Marko Hoff

    2015-08-01

    Full Text Available In real life motions, as well as in sports, the adaptation of the neuromuscular systems to externally applied forces plays an important role. The term Adaptive Force (AF shall characterize the ability of the nerve-muscle-system to adapt to impacting external forces during isometric and eccentric muscle action. The focus in this paper is on the concept of this neuromuscular action, which is not yet described in this way. A measuring system was constructed and evaluated for this specific neuromuscular function, but only the main information of the evaluation of the measuring system and the preliminary reference values are mentioned here, while an article with detailed description will be published separately. This paper concentrates on the three following points: 1 What is the peculiarity of this neuromuscular function, introduced as AF? 2 Is the measuring system able to capture its specific characteristics and which phases of measurement occur? 3 It seems reasonable to discuss if AF can be distinguished and classified among the known force concepts. The article describes the measuring system and how it is able to capture special features of real life motions like submaximal intensities and the subjects’ option to react adequately on external varying forces. Furthermore, within one measurement the system records three different force qualities: the isometric submaximal Adaptive Force (AFiso, the maximal isometric Adaptive Force (AFisomax and the maximal eccentric Adaptive Force (AFeccmax. Each of these phases provide different and unique information on the nerve-muscle-system that are discussed in detail. Important, in terms of the Adaptive Force, seems to be the combination of conditional and coordinative abilities.

  15. Fatty replacement of lower paraspinal muscles: normal and neuromuscular disorders

    Energy Technology Data Exchange (ETDEWEB)

    Hader, H.; Gadoth, N.; Heifetz, H.

    1983-11-01

    The physiologic replacement of the lower paraspinal muscles by fat was evaluated in 157 patients undergoing computed tomography for reasons unrelated to abnormalities of the locomotor system. Five patients with neuromuscular disorders were similarly evaluated. The changes were graded according to severity at three spinal levels: lower thoracic-upper lumbar, midlumbar, and lumbosacral. The results were analyzed in relation to age and gender. It was found that fatty replacement of paraspinal muscles is a normal age-progressive phenomenon most prominent in females. It progresses down the spine, being most advanced in the lumbosacral region. The severest changes in the five patients with neuromuscular disorders (three with poliomyelitis and two with progressive muscular dystrophy) consisted of complete muscle group replacement by fat. In postpoliomyelitis atrophy, the distribution was typically asymmetric and sometimes lacked clinical correlation. In muscular dystrophy, fatty replacement was symmetric, showing relative sparing of the psoas and multifidus muscles. In patients with neuromuscular diseases, computed tomography of muscles may be helpful in planning a better rehabilitation regimen.

  16. Neuromuscular adaptations to isoload versus isokinetic eccentric resistance training.

    Science.gov (United States)

    Guilhem, Gaël; Cornu, Christophe; Maffiuletti, Nicola A; Guével, Arnaud

    2013-02-01

    The purpose of this study was to compare neuromuscular adaptations induced by work-matched isoload (IL) versus isokinetic (IK) eccentric resistance training. A total of 31 healthy subjects completed a 9-wk IL (n = 11) or IK (n = 10) training program for the knee extensors or did not train (control group; n = 10). The IL and IK programs consisted of 20 training sessions, which entailed three to five sets of eight repetitions in the respective modalities. The amount of work and the mean angular velocity were strictly matched between IL and IK conditions. Neuromuscular tests were performed before and after training and consisted of the assessment of quadriceps muscle strength, muscle architecture (vastus lateralis), EMG activity, and antagonist coactivation. IL, but not IK, eccentric resistance training enhanced eccentric strength at short muscle length (+20%), high-velocity eccentric strength (+15%), muscle thickness (+10%), and fascicle angle measured at rest (+11%; P eccentric movements (i.e., at short muscle lengths), which results in greater torque and angular velocities compared with IK actions, is the main determinant of strength and neuromuscular adaptations to eccentric training. These findings have important consequences for the optimization of IL and IK eccentric exercise for resistance training and rehabilitation purposes.

  17. Altered neuromuscular control mechanisms of the trapezius muscle in fibromyalgia

    Directory of Open Access Journals (Sweden)

    Karlsson Stefan J

    2010-03-01

    Full Text Available Abstract Background fibromyalgia is a relatively common condition with widespread pain and pressure allodynia, but unknown aetiology. For decades, the association between motor control strategies and chronic pain has been a topic for debate. One long held functional neuromuscular control mechanism is differential activation between regions within a single muscle. The aim of this study was to investigate differences in neuromuscular control, i.e. differential activation, between myalgic trapezius in fibromyalgia patients and healthy controls. Methods 27 fibromyalgia patients and 30 healthy controls performed 3 minutes bilateral shoulder elevations with different loads (0-4 Kg with a high-density surface electromyographical (EMG grid placed above the upper trapezius. Differential activation was quantified by the power spectral median frequency of the difference in EMG amplitude between the cranial and caudal parts of the upper trapezius. The average duration of the differential activation was described by the inverse of the median frequency of the differential activations. Results the median frequency of the differential activations was significantly lower, and the average duration of the differential activations significantly longer in fibromyalgia compared with controls at the two lowest load levels (0-1 Kg (p Conclusion these findings illustrate a different neuromuscular control between fibromyalgia patients and healthy controls during a low load functional task, either sustaining or resulting from the chronic painful condition. The findings may have clinical relevance for rehabilitation strategies for fibromyalgia.

  18. Neuromuscular responses to simulated brazilian jiu-jitsu fights.

    Science.gov (United States)

    da Silva, Bruno Victor Corrêa; Ide, Bernardo Neme; de Moura Simim, Mário Antônio; Marocolo, Moacir; da Mota, Gustavo Ribeiro

    2014-12-01

    The aim of this study was to investigate the neuromuscular performance responses following successive Brazilian Jiu-Jitsu (BJJ) fights. Twenty-three BJJ athletes (age: 26.3 ± 6.3 years; body mass: 79.4 ± 9.7 kg; body height: 1.80 ± 0.1 m) undertook 3 simulated BJJ fights (10 min duration each separated by 15 min of rest). Neuromuscular performance was measured by the bench press throw (BPT) and vertical counter movement jump (VCMJ) tests, assessed before the 1st fight (Pre) and after the last one (Post). Blood lactate (LA) was measured at Pre, 1 min Post, and 15 min Post fights. Paired t-tests were employed in order to compare the BPT and VCMJ results. One-way ANOVA with Bonferroni post hoc tests were utilized to compare LA responses. The results revealed a significant (p BJJ fights demanded considerable anaerobic contribution of ATP supply, reinforcing the high-intensity intermittent nature of the sport. Nevertheless, no negative impact on acute neuromuscular performance (power) was observed.

  19. Magnetic resonance imaging (MRI) in the diagnosis of neuromuscular diseases

    Energy Technology Data Exchange (ETDEWEB)

    Schalke, B.C.G.; Rohkamm, R. (Neurologische Universitaetsklinik, Wuerzburg (Germany, F.R.)); Kaiser, W.

    1990-12-01

    In the last few years imaging procedures became also important in the diagnosis of neuromuscular diseases. We examined more than 150 patients with different neuromuscular diseases with MRI. Conventional diagnostic procedures like EMG, muscle biopsy can not be replaced by imaging procedures. MRI gives the chance to get additional diagnostic informations. It is possible to determine exact distribution and intensity of pathological changes in the muscle. Inflammatory muscle diseases can be differrentiated by T1/T2 values from atrophic/dystrophic diseases. The resolving power is very high and allows the exact detection of affected areas even in a single muscle. This can help to reduce false negative muscle biopsies. This is very useful in children and young adults. MRI can be used for the early detection of genetic myopathies and neuropathies. MRI allows to examine all muscles, including the heart, bone artefacts are absent. Heart muscle involvement in neuromuscular diseases can directly be shown by this method without any risk for the patient. In addition P-spectroscopy can be done for better understanding of pathogenesis, especially if the exact distribution of pathological changes is known. (author).

  20. Defective membrane remodeling in neuromuscular diseases: insights from animal models.

    Directory of Open Access Journals (Sweden)

    Belinda S Cowling

    Full Text Available Proteins involved in membrane remodeling play an essential role in a plethora of cell functions including endocytosis and intracellular transport. Defects in several of them lead to human diseases. Myotubularins, amphiphysins, and dynamins are all proteins implicated in membrane trafficking and/or remodeling. Mutations in myotubularin, amphiphysin 2 (BIN1, and dynamin 2 lead to different forms of centronuclear myopathy, while mutations in myotubularin-related proteins cause Charcot-Marie-Tooth neuropathies. In addition to centronuclear myopathy, dynamin 2 is also mutated in a dominant form of Charcot-Marie-Tooth neuropathy. While several proteins from these different families are implicated in similar diseases, mutations in close homologues or in the same protein in the case of dynamin 2 lead to diseases affecting different tissues. This suggests (1 a common molecular pathway underlying these different neuromuscular diseases, and (2 tissue-specific regulation of these proteins. This review discusses the pathophysiology of the related neuromuscular diseases on the basis of animal models developed for proteins of the myotubularin, amphiphysin, and dynamin families. A better understanding of the common mechanisms between these neuromuscular disorders will lead to more specific health care and therapeutic approaches.

  1. Dental Assistants

    Science.gov (United States)

    ... Z INDEX | OOH SITE MAP | EN ESPAÑOL Healthcare > Dental Assistants PRINTER-FRIENDLY EN ESPAÑOL Summary What They ... of workers and occupations. What They Do -> What Dental Assistants Do About this section Assistants prepare and ...

  2. Surgical Assisting

    Science.gov (United States)

    ... Insert and remove Foley urinary bladder catheter Place pneumatic tourniquet Confirm procedure with surgeon Drape patient within ... Technology and Surgical Assisting (NBSTSA) offers the CertifiedSurgical First Assistant (CSFA) credential, and the National Surgical Assistant ...

  3. Hybrid flow analyzer for automatic hollow-fiber-assisted ionic liquid-based liquid-phase microextraction with in-line membrane regeneration.

    Science.gov (United States)

    Nitiyanontakit, Sira; Varanusupakul, Pakorn; Miró, Manuel

    2013-04-01

    The proof-of-concept of a new methodology for in-line hollow-fiber (HF)-assisted three-phase liquid-phase microextraction (LPME) allowing for handling of the feed and acceptor aqueous solutions and of minute volumes of the organic extracting phase in a programmable flow mode is reported in this paper. The flow analyzer fosters in-line anchoring of ionic-liquid-laden extracting solution (10 % (v/v) methyltrioctyl ammonium chloride in kerosene) in the pores of a single-strand microporous polypropylene HF, and regeneration of the liquid-phase membrane itself for each individual analysis cycle in a fully automated mode. Using hexavalent chromium as a model analyte and 1,5-diphenylcarbazide as a chromogenic probe in the acceptor solution, the flow-based HF-LPME hyphenated system was harnessed to the clean-up of troublesome samples (viz., domestic wastewater and soil leachates) with concomitant enrichment of target species. Distinct extraction modes and chemistries were assessed for enhanced Cr(VI) permeability. A single sample plug was subjected to a twofold backward-forward flow extraction so as to decrease the thickness of the boundary layer at the HF shell side for improved extraction efficiency. Under the optimized physicochemical variables, a limit of detection of 4.6 μg L(-1) Cr(VI), a dynamic linear range of up to 500 μg L(-1) and intermediate precision better than 10 % were obtained for a sample volume of 2.8 mL buffered at pH 4 and a volume of organic extractant of 120 μL, with an enrichment factor of ca. 11 for a sample residence time in the donor compartment of merely 4.5 min. Analyte recoveries in domestic wastewaters were ≥83 % using external calibration with relative standard deviations better than 14 %, thereby demonstrating the expedient clean-up of samples with elevated content of dissolved organic carbon. The automatic HF-LPME method was validated in terms of bias against the SRM 2701 (NIST soil) preceded by the EPA alkaline digestion method 3060A

  4. Muscle fiber hypotrophy with intact neuromuscular junctions. A study of a patient with congenital neuromuscular disease and ophthalmoplegia.

    Science.gov (United States)

    Bender, A N; Bender, M B

    1977-03-01

    An infant born with severe but nonprogressive somatic and cranial muscle weakness including bilateral external ophthalmoplegia was studied with a motor-point muscle biopsy. There was a strinking generalized decrease in the size of muscle fibers (hypotrophy), most marked in the type I fibers. Many of the small fibers were immature, resembling myotubes. Neuromuscular junctions on severely hypotrophic fibers were normal with esterase staining and by ultrastructural criteria. Although these are unusual clinical and biopsy characteristics, this infant's condition bears a resemblance to two other congenital nonprogressive neuromuscular diseases:myotubular myopathy and congenital fiber type disproportion. In these conditions and in our patient, there is no primary degenerative process affecting nerve or muscle but, rather, an apparent lack of maturation of fetal muscle fibers, indicating a defective normal trophic interaction between nerve and muscle.

  5. Fatigue in neuromuscular disorders: focus on Guillain–Barré syndrome and Pompe disease

    OpenAIRE

    2009-01-01

    textabstractFatigue accounts for an important part of the burden experienced by patients with neuromuscular disorders. Substantial high prevalence rates of fatigue are reported in a wide range of neuromuscular disorders, such as Guillain-Barré syndrome and Pompe disease. Fatigue can be subdivided into experienced fatigue and physiological fatigue. Physiological fatigue in turn can be of central or peripheral origin. Peripheral fatigue is an important contributor to fatigue in neuromuscular di...

  6. PICU EXTUBATION FAILURE: THE ROLE OF NEUROMUSCULAR DISORDERS

    Directory of Open Access Journals (Sweden)

    N. Billan MD,

    2007-02-01

    Full Text Available ObjectiveNeuromuscular disorders (diseases of the motor unit, can cause respiratory problems such as impaired cough reflex, chest deformity, recurrent pneumonia and acute respiratory failure; these are the worst most common complications of these diseases and the leading cause of death in such patients (1, 2. Their management hence, very often, entails admission to the Pediatric Intensive Care Unit (PICU (3,4 and during this phase, endotracheal intubation is almost always necessary, to maintain the patency of airways and to apply Positive Pressure Ventilation (PPV. However, endotracheal intubation is always temporary, and its success or failure depends on the timely decision of its termination to restore the normal respiration or to avoid the risk of recurring respiratory failure (5, 6. We designed this study to evaluate the role of neuromuscular disorders in causing extubation failure as compared to that of other risk factors.Materials & MethodsIn an analytical cross-sectional study, the risk factors of reintubation and duration of mechanical ventilation in two groups of 30 patients each, was compared, the first successful extubation and the second with extubation failure.ResultsNeuromuscular disorders (including Spinal Muscular Atrophy, Guillain- Barre' Syndrome, Congenital Myopathies and Muscular Dystrophies were the main underlying diseases in extubation-failure group (P= 0.0002. Hypercapnia (PaCO2>50mmHg was shown to be the most common cause of both the first intubation (P=0.001 and reintubation (P=0.004 in the group of patients who failed extubation. The mean duration of intubation and mechanical ventilation was longer in patients with neuromuscular disorders who had extubation failure (P= 0.01.ConclusionThis study showed that, as underlying problems, neuromuscular disorders are the most common causes of prolonged intubation which defeat weaning from the ventilator and result in reintubation by inducing hypercapnia. Therefore the weaning

  7. Neuromuscular control of trunk stability: clinical implications for sports injury prevention.

    Science.gov (United States)

    Zazulak, Bohdanna; Cholewicki, Jacek; Reeves, N Peter

    2008-09-01

    Recent prospective evidence supports the hypothesis that impaired trunk control is a contributing factor to sports injuries of the spine as well as to segments of the kinetic chain. The current concepts regarding neuromuscular control of trunk stability are best described from a systems engineering perspective. In the analysis of current neuromuscular training protocols for sports injury prevention, these principles are applied to identify components that optimize neuromuscular control of trunk stability. Current perspectives of neuromuscular learning can be applied clinically to aid in the formulation of injury prevention strategies.

  8. Use of neuromuscular monitoring to detect prolonged effect of succinylcholine or mivacurium

    DEFF Research Database (Denmark)

    Cassel, J; Staehr-Rye, A K; Nielsen, C V

    2014-01-01

    effect of the neuromuscular blocking agent was not discovered until after extubation. In the third patient, the lack of response to nerve stimulation was interpreted as a technical failure and the prolonged effect of succinylcholine was discovered when general anaesthesia was terminated. Both patients...... allowed a prolonged neuromuscular blockade to be discovered prior to tracheal extubation of the patient. The patient was extubated after successful reversal of the neuromuscular blockade. On the contrary, neuromuscular monitoring was not used during anaesthesia in the second patient; hence, the prolonged...

  9. A case series of re-establishment of neuromuscular block with rocuronium after sugammadex reversal.

    Science.gov (United States)

    Iwasaki, Hajime; Sasakawa, Tomoki; Takahoko, Kenichi; Takagi, Shunichi; Nakatsuka, Hideki; Suzuki, Takahiro; Iwasaki, Hiroshi

    2016-06-01

    We report the use of rocuronium to re-establish neuromuscular block after reversal with sugammadex. The aim of this study was to investigate the relationship between the dose of rocuronium needed to re-establish neuromuscular block and the time interval between sugammadex administration and re-administration of rocuronium. Patients who required re-establishment of neuromuscular block within 12 h after the reversal of rocuronium-induced neuromuscular block with sugammadex were included. After inducing general anesthesia and placing the neuromuscular monitor, the protocol to re-establish neuromuscular block was as follows. An initial rocuronium dose of 0.6 mg/kg was followed by additional 0.3 mg/kg doses every 2 min until train-of-four responses were abolished. A total of 11 patients were enrolled in this study. Intervals between sugammadex and second rocuronium were 12-465 min. Total dose of rocuronium needed to re-establish neuromuscular block was 0.6-1.2 mg/kg. 0.6 mg/kg rocuronium re-established neuromuscular block in all patients who received initial sugammadex more than 3 h previously. However, when the interval between sugammadex and second rocuronium was less than 2 h, more than 0.6 mg/kg rocuronium was necessary to re-establish neuromuscular block.

  10. Proprioceptive neuromuscular facilitation and strength training to gain muscle strength in elderly women

    National Research Council Canada - National Science Library

    Cesário, Denise Ferreira; Mendes, Geovânia Barbosa da Silva; Uchôa, Érica Patrícia Borba Lira; Veiga, Paulo Henrique Altran

    2014-01-01

    ...: To perform comparative analyze of results of proprioceptive neuromuscular facilitation (PNF) techniques and strength training to gain muscle strength of biceps and quadriceps and grip in the elderly...

  11. Hybrid vehicles

    Energy Technology Data Exchange (ETDEWEB)

    West, J.G.W. [Electrical Machines (United Kingdom)

    1997-07-01

    The reasons for adopting hybrid vehicles result mainly from the lack of adequate range from electric vehicles at an acceptable cost. Hybrids can offer significant improvements in emissions and fuel economy. Series and parallel hybrids are compared. A combination of series and parallel operation would be the ideal. This can be obtained using a planetary gearbox as a power split device allowing a small generator to transfer power to the propulsion motor giving the effect of a CVT. It allows the engine to run at semi-constant speed giving better fuel economy and reduced emissions. Hybrid car developments are described that show the wide range of possible hybrid systems. (author)

  12. Classification of EMG signals using PSO optimized SVM for diagnosis of neuromuscular disorders.

    Science.gov (United States)

    Subasi, Abdulhamit

    2013-06-01

    Support vector machine (SVM) is an extensively used machine learning method with many biomedical signal classification applications. In this study, a novel PSO-SVM model has been proposed that hybridized the particle swarm optimization (PSO) and SVM to improve the EMG signal classification accuracy. This optimization mechanism involves kernel parameter setting in the SVM training procedure, which significantly influences the classification accuracy. The experiments were conducted on the basis of EMG signal to classify into normal, neurogenic or myopathic. In the proposed method the EMG signals were decomposed into the frequency sub-bands using discrete wavelet transform (DWT) and a set of statistical features were extracted from these sub-bands to represent the distribution of wavelet coefficients. The obtained results obviously validate the superiority of the SVM method compared to conventional machine learning methods, and suggest that further significant enhancements in terms of classification accuracy can be achieved by the proposed PSO-SVM classification system. The PSO-SVM yielded an overall accuracy of 97.41% on 1200 EMG signals selected from 27 subject records against 96.75%, 95.17% and 94.08% for the SVM, the k-NN and the RBF classifiers, respectively. PSO-SVM is developed as an efficient tool so that various SVMs can be used conveniently as the core of PSO-SVM for diagnosis of neuromuscular disorders.

  13. Evaluating the Pedagogical Potential of Hybrid Models

    Science.gov (United States)

    Levin, Tzur; Levin, Ilya

    2013-01-01

    The paper examines how the use of hybrid models--that consist of the interacting continuous and discrete processes--may assist in teaching system thinking. We report an experiment in which undergraduate students were asked to choose between a hybrid and a continuous solution for a number of control problems. A correlation has been found between…

  14. Parallel Hybrid Vehicle Optimal Storage System

    Science.gov (United States)

    Bloomfield, Aaron P.

    2009-01-01

    A paper reports the results of a Hybrid Diesel Vehicle Project focused on a parallel hybrid configuration suitable for diesel-powered, medium-sized, commercial vehicles commonly used for parcel delivery and shuttle buses, as the missions of these types of vehicles require frequent stops. During these stops, electric hybridization can effectively recover the vehicle's kinetic energy during the deceleration, store it onboard, and then use that energy to assist in the subsequent acceleration.

  15. Neuromuscular electrical stimulation and biofeedback therapy may improve endometrial growth for patients with thin endometrium during frozen-thawed embryo transfer: A preliminary report

    Directory of Open Access Journals (Sweden)

    Chen Shaoqing

    2011-08-01

    Full Text Available Abstract Background To investigate the effect of pelvic floor Neuromuscular Electrical Stimulation (NMES Therapy in improving endometrial thickness in women with thin endometrium. Methods 41 patients undergoing assisted reproduction with a thin endometrium (less than or equal to7 mm were recruited and advised to go for a pelvic floor NMES in frozen-thawed embryo transfer cycle. PHENIX Neuromuscular Electrical Stimulation Therapy System was used according to the manufacturer's recommended protocol for 20 to 30 minutes of intermittent vaginal electrical stimulation on the treatment days. Results A total of 20 and 21 were included in the NMES and non-NMES groups respectively. 12 out of 20 (60% patients developed endometrial thickness equal to or more than 8 mm after the NMES therapy, which was the primary outcome. The mean thickness of endometrium before and after was respectively 5.60 mm (0.82 mm and 7.93 mm (1.42 mm in the therapy group versus 5.50 mm (1.00 and 6.78 mm (0.47 in the control group; the difference was statistically significant (P = 0.002. There was higher pregnancy rate in the NMES group (42% versus 35% but the difference was not statistically significant. Conclusion Neuromuscular Electrical stimulation therapy may be effective for the patients with a thin endometrium. Further studies are needed to investigate its effectiveness.

  16. Hybrid of g-C3N4 Assisted Metal-Organic Frameworks and Their Derived High-Efficiency Oxygen Reduction Electrocatalyst in the Whole pH Range.

    Science.gov (United States)

    Gu, Wenling; Hu, Liuyong; Li, Jing; Wang, Erkang

    2016-12-28

    A highly active electrocatalyst in the whole pH range for oxygen reduction reaction (ORR) is produced by employing the g-C3N4 assisted metal-organic frameworks (MOF) of C3N4@NH2-MIL-101 as the precursor. By pyrolyzing the hybrid at 700 °C, the C3N4@NH2-MIL-101 could be easily transformed into an abundant iron and nitrogen codoped porous carbon skeleton. The selective use of g-C3N4 as a support template plays a critical role in facilitating the formation of the architecture with high surface area and rich N content. The obtained catalyst of C3N4@NH2-MIL-101-700 manifested remarkable oxygen reduction activity over the pH 0-14. Noteworthy, the catalyst displayed outstanding ORR activity with more positive half-wave potential than that of the commercial Pt/C catalyst in both alkaline and neutral conditions. Additionally, the optimal C3N4@NH2-MIL-101-700 also exhibited prominent ORR activity which is almost equal to that of commercial Pt/C in acidic electrolyte with high selectivity and very low H2O2 yield. Most importantly, the better methanol tolerance and much higher stability than the commercial Pt/C of C3N4@NH2-MIL-101-700 no matter under alkaline, neutral, or acid conditions further demonstrate the catalyst to be a promising candidate for practical electrocatalytic applications.

  17. Impact of locomotion training with a neurologic controlled hybrid assistive limb (HAL) exoskeleton on neuropathic pain and health related quality of life (HRQoL) in chronic SCI: a case study (.).

    Science.gov (United States)

    Cruciger, Oliver; Schildhauer, Thomas A; Meindl, Renate C; Tegenthoff, Martin; Schwenkreis, Peter; Citak, Mustafa; Aach, Mirko

    2016-08-01

    Chronic neuropathic pain (CNP) is a common condition associated with spinal cord injury (SCI) and has been reported to be severe, disabling and often treatment-resistant and therefore remains a clinical challenge for the attending physicians. The treatment usually includes pharmacological and/or nonpharmacological approaches. Body weight supported treadmill training (BWSTT) and locomotion training with driven gait orthosis (DGO) have evolved over the last decades and are now considered to be an established part in the rehabilitation of SCI patients. Conventional locomotion training goes along with improvements of the patients' walking abilities in particular speed and gait pattern. The neurologic controlled hybrid assistive limb (HAL®, Cyberdyne Inc., Ibraki, Japan) exoskeleton, however, is a new tailored approach to support motor functions synchronously to the patient's voluntary drive. This report presents two cases of severe chronic and therapy resistant neuropathic pain due to chronic SCI and demonstrates the beneficial effects of neurologic controlled exoskeletal intervention on pain severity and health-related quality of life (HRQoL). Both of these patients were engaged in a 12 weeks period of daily HAL®-supported locomotion training. In addition to improvements in motor functions and walking abilities, both show significant reduction in pain severity and improvements in all HRQoL domains. Although various causal factors likely contribute to abatement of CNP, the reported results occurred due to a new approach in the rehabilitation of chronic spinal cord injury patients. These findings suggest not only the feasibility of this new approach but in conclusion, demonstrate the effectiveness of neurologic controlled locomotion training in the long-term management of refractory neuropathic pain. Implications for Rehabilitation CNP remains a challenge in the rehabilitation of chronic SCI patients. Locomotion training with the HAL exoskeleton seems to improve CNP

  18. Rapid discrimination of Haemophilus influenzae, H. parainfluenzae, and H. haemolyticus by fluorescence in situ hybridization (FISH and two matrix-assisted laser-desorption-ionization time-of-flight mass spectrometry (MALDI-TOF-MS platforms.

    Directory of Open Access Journals (Sweden)

    Hagen Frickmann

    Full Text Available BACKGROUND: Due to considerable differences in pathogenicity, Haemophilus influenzae, H. parainfluenzae and H. haemolyticus have to be reliably discriminated in routine diagnostics. Retrospective analyses suggest frequent misidentifications of commensal H. haemolyticus as H. influenzae. In a multi-center approach, we assessed the suitability of fluorescence in situ hybridization (FISH and matrix-assisted laser-desorption-ionization time-of-flight mass-spectrometry (MALDI-TOF-MS for the identification of H. influenzae, H. parainfluenzae and H. haemolyticus to species level. METHODOLOGY: A strain collection of 84 Haemophilus spp. comprising 50 H. influenzae, 25 H. parainfluenzae, 7 H. haemolyticus, and 2 H. parahaemolyticus including 77 clinical isolates was analyzed by FISH with newly designed DNA probes, and two different MALDI-TOF-MS systems (Bruker, Shimadzu with and without prior formic acid extraction. PRINCIPAL FINDINGS: Among the 84 Haemophilus strains analyzed, FISH led to 71 correct results (85%, 13 uninterpretable results (15%, and no misidentifications. Shimadzu MALDI-TOF-MS resulted in 59 correct identifications (70%, 19 uninterpretable results (23%, and 6 misidentifications (7%, using colony material applied directly. Bruker MALDI-TOF-MS with prior formic acid extraction led to 74 correct results (88%, 4 uninterpretable results (5% and 6 misidentifications (7%. The Bruker MALDI-TOF-MS misidentifications could be resolved by the addition of a suitable H. haemolyticus reference spectrum to the system's database. In conclusion, no analyzed diagnostic procedure was free of errors. Diagnostic results have to be interpreted carefully and alternative tests should be applied in case of ambiguous test results on isolates from seriously ill patients.

  19. Determination of osteocalcin in meat and bone meal of bovine and porcine origin using matrix-assisted laser desorption ionization/time-of-flight mass spectrometry and high-resolution hybrid mass spectrometry.

    Science.gov (United States)

    Balizs, Gabor; Weise, Christoph; Rozycki, Christel; Opialla, Tobias; Sawada, Stefanie; Zagon, Jutta; Lampen, Alfonso

    2011-05-05

    A method has been developed for determining the origin of meat and bone meal (MBM) by detecting species-specific osteocalcin (OC) using matrix-assisted laser desorption ionization/time-of-flight (MALDI/TOF) and high-resolution hybrid mass spectrometry (HR-Q/TOF MS). The analysis is based on the detection of typical species-specific OC and its tryptic peptide fragments which differ in mass due to differences in the amino-acid sequences between species. After dissolving the MBM samples in EDTA buffer, purification after ultrafiltration was performed using two methods: solid-phase extraction using Zip-Tip C(18) or size exclusion coupled with reverse-phase chromatography. Fractions containing partially purified intact OC were analyzed using LC-Q/TOF and MALDI/TOF mass spectrometry. Species-specific OC was detected at the typical protonated and doubly protonated molecular ions. Furthermore, typical porcine- and bovine-derived tryptic fragments from MBM were detected after enzymatic digestion. In order to determine the underlying amino-acid sequences and to confirm the assignment to OC-derived peptides, MS/MS analysis was carried out. In conclusion, we were able to detect OC in bovine and porcine MBM with high sensitivity and the MS-based method described here by which total OC mass and marker peptides of digested OC are recorded can be used as an alternative approach to detect genus-specific differences in MBM and can be applied as a confirmatory method to mainly immunological osteocalcin screening methods.

  20. Determination of osteocalcin in meat and bone meal of bovine and porcine origin using matrix-assisted laser desorption ionization/time-of-flight mass spectrometry and high-resolution hybrid mass spectrometry

    Energy Technology Data Exchange (ETDEWEB)

    Balizs, Gabor, E-mail: gabor.balizs@bfr.bund.de [Federal Institute for Risk Assessment, Thielallee 88-92, D-14195 Berlin (Germany); Weise, Christoph [Freie Universitaet Berlin, Institute for Chemistry and Biochemistry, Thielallee 63, D-14195 Berlin (Germany); Rozycki, Christel; Opialla, Tobias; Sawada, Stefanie; Zagon, Jutta; Lampen, Alfonso [Federal Institute for Risk Assessment, Thielallee 88-92, D-14195 Berlin (Germany)

    2011-05-05

    A method has been developed for determining the origin of meat and bone meal (MBM) by detecting species-specific osteocalcin (OC) using matrix-assisted laser desorption ionization/time-of-flight (MALDI/TOF) and high-resolution hybrid mass spectrometry (HR-Q/TOF MS). The analysis is based on the detection of typical species-specific OC and its tryptic peptide fragments which differ in mass due to differences in the amino-acid sequences between species. After dissolving the MBM samples in EDTA buffer, purification after ultrafiltration was performed using two methods: solid-phase extraction using Zip-Tip C{sub 18} or size exclusion coupled with reverse-phase chromatography. Fractions containing partially purified intact OC were analyzed using LC-Q/TOF and MALDI/TOF mass spectrometry. Species-specific OC was detected at the typical protonated and doubly protonated molecular ions. Furthermore, typical porcine- and bovine-derived tryptic fragments from MBM were detected after enzymatic digestion. In order to determine the underlying amino-acid sequences and to confirm the assignment to OC-derived peptides, MS/MS analysis was carried out. In conclusion, we were able to detect OC in bovine and porcine MBM with high sensitivity and the MS-based method described here by which total OC mass and marker peptides of digested OC are recorded can be used as an alternative approach to detect genus-specific differences in MBM and can be applied as a confirmatory method to mainly immunological osteocalcin screening methods.

  1. Comparison of peptide nucleic acid fluorescence in situ hybridization assays with culture-based matrix-assisted laser desorption/ionization-time of flight mass spectrometry for the identification of bacteria and yeasts from blood cultures and cerebrospinal fluid cultures.

    Science.gov (United States)

    Calderaro, A; Martinelli, M; Motta, F; Larini, S; Arcangeletti, M C; Medici, M C; Chezzi, C; De Conto, F

    2014-08-01

    Peptide nucleic acid fluorescence in situ hybridization (PNA FISH) is a molecular diagnostic tool for the rapid detection of pathogens directly from liquid media. The aim of this study was to prospectively evaluate PNA FISH assays in comparison with culture-based matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS) identification, as a reference method, for both blood and cerebrospinal fluid (CSF) cultures, during a 1-year investigation. On the basis of the Gram stain microscopy results, four different PNA FISH commercially available assays were used ('Staphylococcus aureus/CNS', 'Enterococcus faecalis/OE', 'GNR Traffic Light' and 'Yeasts Traffic Light' PNA FISH assays, AdvanDx). The four PNA FISH assays were applied to 956 positive blood cultures (921 for bacteria and 35 for yeasts) and 11 CSF cultures. Among the 921 blood samples positive for bacteria, PNA FISH gave concordant results with MALDI-TOF MS in 908/921 (98.64%) samples, showing an agreement of 99.4% in the case of monomicrobial infections. As regards yeasts, the PNA FISH assay showed a 100% agreement with the result obtained by MALDI-TOF MS. When PNA FISH assays were tested on the 11 CSF cultures, the results agreed with the reference method in all cases (100%). PNA FISH assays provided species identification at least one work-day before the MALDI-TOF MS culture-based identification. PNA FISH assays showed an excellent efficacy in the prompt identification of main pathogens, yielding a significant reduction in reporting time and leading to more appropriate patient management and therapy in cases of sepsis and severe infections.

  2. Comparison of mechanomyography and acceleromyography for the assessment of rocuronium induced neuromuscular block in myotonic dystrophy type 1.

    NARCIS (Netherlands)

    Vanlinthout, L.E.H.; Booij, L.H.D.J.; Egmond, J. van; Robertson, E.N.

    2010-01-01

    We measured acceleromyography and mechanomyography simultaneously with monitoring of rocuronium-induced neuromuscular block in four patients with myotonic dystrophy type 1. Furthermore, we compared neuromuscular block measures from these patients with those from normal controls from previous studies

  3. Early reversal of profound rocuronium-induced neuromuscular blockade by sugammadex in a randomized multicenter study - Efficacy, safety, and pharmacokinetics

    NARCIS (Netherlands)

    Sparr, Harald J.; Vermeyen, Karel M.; Beaufort, Anton M.; Rietbergen, Henk; Proost, Johannes H.; Saldien, Vera; Velik-Salchner, Corinna; Wierda, J. Mark K. H.

    2007-01-01

    Background: Sugammadex reverses the neuromuscular blocking effects of rocuronium by chemical encapsulation. The efficacy, safety, and pharmacokinetics of sugammadex for reversal of profound rocuronium-induced neuromuscular blockade were evaluated. Methods: Ninety-eight male adult patients were rando

  4. Early reversal of profound rocuronium-induced neuromuscular blockade by sugammadex in a randomized multicenter study - Efficacy, safety, and pharmacokinetics

    NARCIS (Netherlands)

    Sparr, Harald J.; Vermeyen, Karel M.; Beaufort, Anton M.; Rietbergen, Henk; Proost, Johannes H.; Saldien, Vera; Velik-Salchner, Corinna; Wierda, J. Mark K. H.

    Background: Sugammadex reverses the neuromuscular blocking effects of rocuronium by chemical encapsulation. The efficacy, safety, and pharmacokinetics of sugammadex for reversal of profound rocuronium-induced neuromuscular blockade were evaluated. Methods: Ninety-eight male adult patients were

  5. Neuromuscular Changes and Damage after Isoload versus Isokinetic Eccentric Exercise.

    Science.gov (United States)

    Doguet, Valentin; Nosaka, Kazunori; Plautard, Mathieu; Gross, Raphaël; Guilhem, GaËL; Guével, Arnaud; Jubeau, Marc

    2016-12-01

    This study compared the effects of isoload (IL) and isokinetic (IK) knee extensor eccentric exercises on changes in muscle damage and neuromuscular parameters to test the hypothesis that the changes would be different after IL and IK exercises. Twenty-two young men were paired based on their strength and placed in the IL (N = 11) or the IK (N = 11) group. The IL group performed 15 sets of 10 eccentric contractions with a 150% of predetermined one-repetition maximum load. The IK group performed 15 sets of several maximal eccentric contractions matched set by set for the total amount of work and mean angular velocity with the IL group. Muscle damage markers (voluntary isometric peak torque, muscle soreness, and creatine kinase activity) and neuromuscular variables (e.g., voluntary activation, H-reflex, M-wave, and evoked torque) were measured before, immediately after, and 24, 48, 72, and 96 h postexercise. Voluntary isometric peak torque decreased to the same extent (P = 0.94) in both groups immediately after (IL = -40.6% ± 13.8% vs IK = -42.4% ± 10.2%) to 96 h after the exercise (IL = -21.8% ± 28.5% vs IK = -26.7% ± 23.5%). Neither peak muscle soreness (IL = 48.1 ± 28.2 mm vs IK = 54.7 ± 28.9 mm, P = 0.57) nor creatine kinase activity (IL = 12,811 ± 22,654 U·L vs IK = 15,304 ± 24,739 U·L, P = 0.59) significantly differed between groups. H-reflex (IL = -23% vs IK = -35%) and M-wave (IL = -10% vs IK = -17%) significantly decreased immediately postexercise similarly between groups. The changes in muscle damage and neuromuscular function after the exercise are similar between IL and IK, suggesting that resistance modality has little effects on acute muscle responses.

  6. Quality of life after surgery for neuromuscular scoliosis

    Directory of Open Access Journals (Sweden)

    Peter Obid

    2013-02-01

    Full Text Available Surgery in patients with neuromuscular scoliosis is associated with a higher rate of complications. It is still controversially discussed whether the patients truly benefit from deformity correction. The purpose of this study is to investigate if the quality of life has been improved and if the patients and their caregivers are satisfied with the results of surgery. This is a retrospective clinical outcome study of 46 patients with neuromuscular scoliosis which were treated with primary stable posterior pedicle screw instrumentation and correction. To achieve fusion only autologous bone was used. Follow up was minimum 2 years and maximum 5 years with an average of 36 months. The patients and/or their caregivers received a questionnaire based on the PEDI (pediatric disability inventory and the GMFS (gross motor function score. The patients (and their caregivers were also asked if the quality of life has improved after surgery. Only 32 of 46 patients answered the questionnaire. The answers showed a high approval-rate regarding the patients satisfaction with the surgery and the improvement of quality of life. The questionnaire could be answered from 1 (I do not agree to 4 (I completely agree. The average agreement to the following statements was: i the quality of life has improved: 3.35; ii I am satisfied with surgery: 3.95; iii the operation has fulfilled my expectations: 3.76. The average age at surgery was 12.7 years. The mean pre-operative cobb-angle of the main curve was 83.1° with a correction post-operatively to a mean of 36.9° and 42.6° at final follow-up. That is an average correction of 56.9%. Although spinal fusion in neuromuscular scoliosis is associated with a higher rate of complications our results show that the patients and their caregivers are satisfied with the operation and the quality of life has improved after surgery.

  7. Case report: Neuromuscular block induced by rocuronium following sugammadex administration.

    Science.gov (United States)

    Askin, Tugba; Unver, Suheyla; Oguz, Deniz; Kutay, Kubra

    2017-02-01

    We present a case in which rocuronium was applied for muscle relaxation following the administration of sugammadex. An emergency surgery under general anesthesia was planned for a 43-year-old male patient due to an L1 vertebral corpus and right tibia-fibula shaft fracture. Anesthesia was induced with fentanyl, propofol and lidocaine. After applying only 30mg of the total induction dose of rocuronium, it was learned that the neurological examination should be controlled again from the surgeon because of the controversial of the neurological deficit. As a result, patient awakened from anesthesia. We administered 2mg/kg sugammadex and spontaneous breathing of patient returned immediately. The patient became conscious and orientated immediately afterwards. The neurological examination of the lower extremities was performed. The patient was anesthetized once again and 0.6mg/kg rocuronium was given in order to gain neoromuscular block approximately 10min after sugammadex administration. 2min later, the patient was smoothly intubated. Neuromuscular monitorization was not used because of emergency. We administered 2mg/kg sugammadex at the end of the procedure and the patient was extubated. The most suitable time for the re-establishment of rocuronium following sugammadex is currently unclear. This case showed that neuromuscular block can be effectively re-induced by rocuronium following the reversal of rocuronium-induced neuromuscular block with sugammadex. In this case, we consider that the ability to effectively reuse normal induction doses of rocuronium is an important clinical observation. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Clinical use of creatine in neuromuscular and neurometabolic disorders.

    Science.gov (United States)

    Tarnopolsky, Mark A

    2007-01-01

    Many of the neuromuscular (e.g., muscular dystrophy) and neurometabolic (e.g., mitochondrial cytopathies) disorders share similar final common pathways of cellular dysfunction that may be favorably influenced by creatine monohydrate (CrM) supplementation. Studies using the mdx model of Duchenne muscular dystrophy have found evidence of enhanced mitochondrial function, reduced intra-cellular calcium and improved performance with CrM supplementation. Clinical trials in patients with Duchenne and Becker's muscular dystrophy have shown improved function, fat-free mass, and some evidence of improved bone health with CrM supplementation. In contrast, the improvements in function in myotonic dystrophy and inherited neuropathies (e.g., Charcot-Marie-Tooth) have not been significant. Some studies in patients with mitochondrial cytopathies have shown improved muscle endurance and body composition, yet other studies did not find significant improvements in patients with mitochondrial cytopathy. Lower-dose CrM supplementation in patients with McArdle's disease (myophosphorylase deficiency) improved exercise capacity, yet higher doses actually showed some indication of worsened function. Based upon known cellular pathologies, there are potential benefits from CrM supplementation in patients with steroid myopathy, inflammatory myopathy, myoadenylate deaminase deficiency, and fatty acid oxidation defects. Larger randomized control trials (RCT) using homogeneous patient groups and objective and clinically relevant outcome variables are needed to determine whether creatine supplementation will be of therapeutic benefit to patients with neuromuscular or neurometabolic disorders. Given the relatively low prevalence of some of the neuromuscular and neurometabolic disorders, it will be necessary to use surrogate markers of potential clinical efficacy including markers of oxidative stress, cellular energy charge, and gene expression patterns.

  9. Neuromuscular Responses to Simulated Brazilian Jiu-Jitsu Fights

    Directory of Open Access Journals (Sweden)

    Corrêa da Silva Bruno Victor

    2014-12-01

    Full Text Available The aim of this study was to investigate the neuromuscular performance responses following successive Brazilian Jiu-Jitsu (BJJ fights. Twenty-three BJJ athletes (age: 26.3 ± 6.3 years; body mass: 79.4 ± 9.7 kg; body height: 1.80 ± 0.1 m undertook 3 simulated BJJ fights (10 min duration each separated by 15 min of rest. Neuromuscular performance was measured by the bench press throw (BPT and vertical counter movement jump (VCMJ tests, assessed before the 1st fight (Pre and after the last one (Post. Blood lactate (LA was measured at Pre, 1 min Post, and 15 min Post fights. Paired t-tests were employed in order to compare the BPT and VCMJ results. One-way ANOVA with Bonferroni post hoc tests were utilized to compare LA responses. The results revealed a significant (p < 0.05 increase in VCMJ performance (40.8 ± 5.5 cm Pre vs. 42.0 ± 5.8 cm Post, but no significant changes in the BPT (814 ± 167 W Pre vs. 835 ± 213 W Post were observed. LA concentration increased significantly (p < 0.05 at Post, both in the 1st min and the 15th min of recovery. We concluded that successive simulated BJJ fights demanded considerable anaerobic contribution of ATP supply, reinforcing the high-intensity intermittent nature of the sport. Nevertheless, no negative impact on acute neuromuscular performance (power was observed.

  10. Cardiac involvement in children with neuro-muscular disorders

    Directory of Open Access Journals (Sweden)

    E. N. Arkhipova

    2015-01-01

    Full Text Available Many inherited neuromuscular disorders include cardiac involvement as a typical clinical feature. Among the most common of them is the group of muscular dystrophies. Dilated cardiomyopathy, ventricular arrhythmias, atrial fibrillations, atrioventricular and intraventricular conduction abnormalities, and sudden cardiac death are well known pathological findings in Duchenne muscular dystrophies, myotonic dystrophy type I and 2, Emery-Dreifuss muscular dystrophies and different types of limb-girdle muscular dystrophies and other disorders. Detection of cardiac pathology in patients with different muscular dystrophies is possible with ECG, echocardiography and cardiovascular magnetic resonance imaging, which are recommended for screening and early cardioprotective treatment.

  11. Preventing Ischial Pressure Ulcers: I. Review of Neuromuscular Electrical Stimulation

    Directory of Open Access Journals (Sweden)

    Hilton M. Kaplan

    2011-01-01

    Full Text Available Objective: Pressure ulcers (PUs are common and debilitating wounds that arise when immobilized patients cannot shift their weight. Treatment is expensive and recurrence rates are high. Pathophysiological mechanisms include reduced bulk and perfusion of chronically atrophic muscles as well as prolonged occlusion of blood flow to soft tissues from lack of voluntary postural shifting of body weight. This has suggested that PUs might be prevented by reanimating the paralyzed muscles using neuromuscular electrical stimulation (NMES. A review of the published literature over the past 2 decades is detailed.

  12. Calcium channels, neuromuscular synaptic transmission and neurological diseases.

    Science.gov (United States)

    Urbano, Francisco J; Pagani, Mario R; Uchitel, Osvaldo D

    2008-09-15

    Voltage-dependent calcium channels are essential in neuronal signaling and synaptic transmission, and their functional alterations underlie numerous human disorders whether monogenic (e.g., ataxia, migraine, etc.) or autoimmune. We review recent work on Ca(V)2.1 or P/Q channelopathies, mostly using neuromuscular junction preparations, and focus specially on the functional hierarchy among the calcium channels recruited to mediate neurotransmitter release when Ca(V)2.1 channels are mutated or depleted. In either case, synaptic transmission is greatly compromised; evidently, none of the reported functional replacements with other calcium channels compensates fully.

  13. MRI in neuromuscular disorders; MRT bei neuromuskulaeren Erkrankungen

    Energy Technology Data Exchange (ETDEWEB)

    Fischmann, Arne [Klinik St. Anna, Luzern (Switzerland). Inst. fuer Radiologie und Nuklearmedizin; Fischer, Dirk [Kantonsspital Bruderholz (Switzerland)

    2014-03-15

    Neuromuscular disorders are caused by damage of the skeletal muscles or supplying nerves, in many cases due to a genetic defect, resulting in progressive disability, loss of ambulation and often a reduced life expectancy. Previously only supportive care and steroids were available as treatments, but several novel therapies are under development or in clinical trial phase. Muscle imaging can detect specific patterns of involvement and facilitate diagnosis and guide genetic testing. Quantitative MRT can be used to monitor disease progression either to monitor treatment or as a surrogate parameter for clinical trails. Novel imaging sequences can provide insights into disease pathology and muscle metabolism. (orig.)

  14. El vendaje neuromuscular en podología

    OpenAIRE

    Vázquez Amela, F. Xavier (Francesc Xavier); Verdaguer Sanmartí, Josefina; Lluch Fruns, Joan; Genís Barniol, Silvia

    2008-01-01

    Desde hace unos cinco años la introducción en España de los vendajes neuromusculares ha ido cobrando mayor relevancia, llegando el momento más álgido las imágenes de las olimpiadas de Beijing, donde se pudo observar el uso de este tipo de vendajes en muchas de las disciplinas deportivas. En este artículo pretendemos hacer una introducción general a este tipo de vendajes y la aplicación en patologías podales de gran incidencia en nuestras consultas.

  15. Tissue engineering for neuromuscular disorders of the gastrointestinal tract

    Institute of Scientific and Technical Information of China (English)

    Kenneth L Koch; Khalil N Bitar; John E Fortunato

    2012-01-01

    The digestive tract is designed for the optimal processing of food that nourishes all organ systems.The esophagus,stomach,small bowel,and colon are sophisticated neuromuscular tubes with specialized sphincters that transport ingested food-stuffs from one region to another.Peristaltic contractions move ingested solids and liquids from the esophagus into the stomach; the stomach mixes the ingested nutrients into chyme and empties chyme from the stomach into the duodenum.The to-and-fro movement of the small bowel maximizes absorption of fat,protein,and carbohydrates.Peristaltic contractions are necessary for colon function and defecation.

  16. Active zone stability: insights from fly neuromuscular junction

    Directory of Open Access Journals (Sweden)

    Xiaolin Tian

    2015-01-01

    Full Text Available The presynaptic active zone is a dynamic structure that orchestrates regulated release of neurotransmitters. Developmental and aging processes, and changes in neuronal network activity can all modulate the number, size and composition of active zone and thereby synaptic efficacy. However, very little is known about the mechanism that controls the structural stability of active zone. By studying a model synapse, the Drosophila neuromuscular junction, our recent work shed light on how two scaffolding proteins at the active zone regulate active zone stability by promoting a localized dephosphorylation event at the nerve terminal. Here we discuss the major insights from our findings and their implications for future research.

  17. Correction of organophosphate-induced neuromuscular blockade by diphenhydramine.

    Science.gov (United States)

    Clemmons, R M; Meyer, D J; Sundlof, S F; Rappaport, J J; Fossler, M E; Hubbell, J; Dorsey-Lee, M R

    1984-10-01

    Dogs exposed to topical organophosphate (fenthion) developed decreased plasma and muscle cholinesterase activities. After 2 doses were applied (1 week between doses), plasma concentrations declined 80% and muscle cholinesterase activity was reduced by 56%. Decremental responses to repetitive nerve stimulation developed after fenthion administration. Diphenhydramine, but not placebo, corrected the electrical abnormalities caused by organophosphate application, but without altering plasma or muscle cholinesterase activity. Control dogs housed in the same kennel demonstrated a slight decrease (18%) of plasma cholinesterase, which indicates that there may be potential cross contamination. Diphenydramine may be effective in treating organophosphate-induced neuromuscular weakness which is refractory to other forms of therapy.

  18. Nonlinear analysis of electromyogram following gait training with myoelectrically triggered neuromuscular electrical stimulation in stroke survivors

    Science.gov (United States)

    Dutta, Anirban; Khattar, Bhawna; Banerjee, Alakananda

    2012-12-01

    Neuromuscular electrical stimulation (NMES) facilitates ambulatory function after paralysis by activating the muscles of the lower extremities. The NMES-assisted stepping can either be triggered by a heel-switch (switch-trigger), or by an electromyogram (EMG)-based gait event detector (EMG-trigger). The command sources—switch-trigger or EMG-trigger—were presented to each group of six chronic (>6 months post-stroke) hemiplegic stroke survivors. The switch-trigger group underwent transcutaneous NMES-assisted gait training for 1 h, five times a week for 2 weeks, where the stimulation of the tibialis anterior muscle of the paretic limb was triggered with a heel-switch detecting heel-rise of the same limb. The EMG-trigger group underwent transcutaneous NMES-assisted gait training of the same duration and frequency where the stimulation was triggered with surface EMG from medial gastrocnemius (MG) of the paretic limb in conjunction with a heel-switch detecting heel-rise of the same limb. During the baseline and post-intervention surface EMG assessment, a total of 10 s of surface EMG was recorded from bilateral MG muscle while the subjects tried to stand steady on their toes. A nonlinear tool—recurrence quantification analysis (RQA)—was used to analyze the surface EMG. The objective of this study was to find the effect of NMES-assisted gait training with switch-trigger or EMG-trigger on two RQA parameters—the percentage of recurrence (%Rec) and determinism (%Det), which were extracted from surface EMG during fatiguing contractions of the paretic muscle. The experimental results showed that during fatiguing contractions, (1) %Rec and %Det have a higher initial value for paretic muscle than the non-paretic muscle, (2) the rate of change in %Rec and %Det was negative for the paretic muscle but positive for the non-paretic muscle, (3) the rate of change in %Rec and %Det significantly increased from baseline for the paretic muscle after EMG-triggered NMES-assisted

  19. Time course and dimensions of postural control changes following neuromuscular training in youth field hockey athletes

    NARCIS (Netherlands)

    Zech, Astrid; Klahn, Philipp; Hoeft, Jon; Eulenburg, Christine Zu; Steib, Simon

    2014-01-01

    Purpose Injury prevention effects of neuromuscular training have been partly attributed to postural control adaptations. Uncertainty exists regarding the magnitude of these adaptations and on how they can be adequately monitored. The objective was to determine the time course of neuromuscular traini

  20. Pharmacokinetic studies of neuromuscular blocking agents : Good Clinical Research Practice (GCRP)

    NARCIS (Netherlands)

    Viby-Mogensen, J; Ostergaard, D; Donati, F; Fisher, D; Hunter, J; Kampmann, JP; Kopman, A; Proost, JH; Rasmussen, SN; Skovgaard, LT; Varin, F; Wright, PMC

    2000-01-01

    In September 1997, an international consensus conference on standardization of studies of neuromuscular blocking agents was held in Copenhagen, Denmark. Based on the conference, a set of guidelines fur good clinical research practice (GCRT) in pharmacokinetic studies of neuromuscular blocking agents

  1. Fatigue in neuromuscular disorders: Focus on Guillain-Barré syndrome and Pompe disease

    NARCIS (Netherlands)

    J.M. de Vries (Juna); M.L.C. Hagemans (Marloes); J.B.J. Bussmann (Hans); A.T. van der Ploeg (Ans); P.A. van Doorn (Pieter)

    2010-01-01

    textabstractFatigue accounts for an important part of the burden experienced by patients with neuromuscular disorders. Substantial high prevalence rates of fatigue are reported in a wide range of neuromuscular disorders, such as Guillain-Barré syndrome and Pompe disease. Fatigue can be subdivided

  2. Motor function measure: validation of a short form for young children with neuromuscular diseases.

    Science.gov (United States)

    de Lattre, Capucine; Payan, Christine; Vuillerot, Carole; Rippert, Pascal; de Castro, Denis; Bérard, Carole; Poirot, Isabelle

    2013-11-01

    To validate a useful version of the Motor Function Measure (MFM) in children with neuromuscular diseases aged .90), and discriminant validity was good. The MFM-20 can be used as an outcome measure for assessment of motor function in young children with neuromuscular disease. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  3. The prejunctional inhibitory effect of suramin on neuromuscular transmission in vitro

    NARCIS (Netherlands)

    Henning, RH; Rowan, EG; Braga, MFM; Nelemans, A; Harvey, AL

    1996-01-01

    The P-2 purinoceptor antagonist suramin reverses skeletal muscle paralysis evoked by non-depolarizing neuromuscular blocking agents in vitro and in vivo. To further study the action of suramin on neuromuscular transmission, (miniature) endplate potentials ((m.)e.p.ps), motor nerve terminal currents

  4. Neuromuscular blockade for optimising surgical conditions during abdominal and gynaecological surgery

    DEFF Research Database (Denmark)

    Madsen, M V; Staehr-Rye, A K; Gätke, M R

    2015-01-01

    BACKGROUND: The level of neuromuscular blockade (NMB) that provides optimal surgical conditions during abdominal surgery has not been well established. The aim of this systematic review was to evaluate current evidence on the use of neuromuscular blocking agents in order to optimise surgical cond...

  5. Time course and dimensions of postural control changes following neuromuscular training in youth field hockey athletes

    NARCIS (Netherlands)

    Zech, Astrid; Klahn, Philipp; Hoeft, Jon; Eulenburg, Christine Zu; Steib, Simon

    2014-01-01

    Purpose Injury prevention effects of neuromuscular training have been partly attributed to postural control adaptations. Uncertainty exists regarding the magnitude of these adaptations and on how they can be adequately monitored. The objective was to determine the time course of neuromuscular traini

  6. Critical illness polyneuropathy and myopathy; a neuromuscular disorder encountered in the intensive care unit

    NARCIS (Netherlands)

    M-A.C.J. de Letter

    2001-01-01

    textabstractPatients with neuromuscular disorders encountered on the ICU can be divided into two main categories. One category has been admitted to the intensive care unit (ICU) due to an underlying neuromuscular disorder, mainly the Guillam Barre Syndrome ( GBS) and myasthenia gravis. The other cat

  7. Sugammadex, a new reversal agent for neuromuscular block induced by rocuronium in the anaesthetized Rhesus monkey.

    NARCIS (Netherlands)

    Boer, H.D. de; Egmond, J. van; Pol, F. van de; Bom, A.; Booij, L.H.D.J.

    2006-01-01

    BACKGROUND: Binding of the steroidal molecule of rocuronium by a cyclodextrin is a new concept for reversal of neuromuscular block. The present study evaluated the ability of Sugammadex Org 25969, a synthetic gamma-cyclodextrin derivative, to reverse constant neuromuscular block of about 90% induced

  8. Reversal of rocuronium-induced profound neuromuscular block by sugammadex in Duchenne muscular dystrophy.

    NARCIS (Netherlands)

    Boer, H.D. de; Egmond, J. van; Booij, L.H.D.J.; Driessen, J.J.

    2009-01-01

    A case is reported in which a child with Duchenne muscular dystrophy received a dose of sugammadex to reverse a rocuronium-induced profound neuromuscular block. Sugammadex is the first selective relaxant binding agent and reverses rocuronium- and vecuronium-induced neuromuscular block. A fast and

  9. A new approach to anesthesia management in myasthenia gravis: reversal of neuromuscular blockade by sugammadex.

    NARCIS (Netherlands)

    Boer, H.D. de; Egmond, J. van; Driessen, J.J.; Booij, L.H.D.J.

    2010-01-01

    A neuromuscular blocking drug (NMBD) induced neuromuscular blockade (NMB) in patients with myasthenia gravis usually dissipates either spontaneously or by administration of neostigmine. We administered sugammadex to a patient with myasthenia gravis to reverse a rocuronium-induced profound NMB. NMBDs

  10. An 8-Week Neuromuscular Exercise Program for Patients With Mild to Moderate Knee Osteoarthritis

    DEFF Research Database (Denmark)

    Clausen, Brian; Holsgaard-Larsen, Anders; Roos, Ewa M

    2017-01-01

    OBJECTIVE:   To describe the feasibility of a neuromuscular exercise (NEMEX) program in patients with mild to moderate knee osteoarthritis (KOA). BACKGROUND:   Neuromuscular exercise has been increasingly used in patients with osteoarthritis to achieve sensorimotor control and improved daily func...

  11. Plantar flexor neuromuscular adjustments following match-play football in hot and cool conditions

    DEFF Research Database (Denmark)

    Girard, O; Nybo, Lars; Mohr, Magni;

    2015-01-01

    We assessed neuromuscular fatigue and recovery of the plantar flexors after playing football with or without severe heat stress. Neuromuscular characteristics of the plantar flexors were assessed in 17 male players at baseline and ∼30 min, 24, and 48 h after two 90-min football matches in tempera...

  12. Consecuencias clínicas de las alteraciones neuromusculares en el paciente crítico Clinical consequences of neuromuscular impairments in critically ill patients

    Directory of Open Access Journals (Sweden)

    A. Mesejo

    2006-05-01

    weakness and quadriplegia which most typical manifestation is the need for assisted ventilation and/or weaning difficulty/impossibility. Triggering factors considered are multiorgan failure and sepsis in polyneuropathy, and steroids and neuromuscular blockers in myopathy, with malnutrition, particularly hypoalbuminemia, and hyperglycemia being co-adjuvant in both conditions.Considering that neuropathic and myopathic conditions may frequently coexist, the term polyneuromyopathy of the critically ill patient has been coined. Both Guillain-Barré syndrome and polyneuropathy of the critically ill patient involve peripheral nerves, so that the differential diagnosis has to be made between both.The presenting picture is different, since the former is an acute pathology that motivates ICU admission, whereas the latter is a polyneuropathy acquired during hospitalization. In the former, involvement of the autonomous nervous system and CSF albumin-cytology dissociation are common, which do not occur in polyneuropathy. Electrophysiological studies show demyelinating signs with decreased conduction velocity and normal amplitude of motor potentials in Guillain-Barré syndrome versus normal conduction velocity and reduced amplitude of motor potentials in axonal polyneuropathy. Myasthenic crisis affects the neuromuscular junction and its diagnosis tends to be easier since in most of the cases a previous diagnosis of myasthenia gravis exists.Muscle weakness increases during repeated activity (muscle fatigue and improves on resting. Diagnostic confirmation is done by means of edrophonium test and by repeated nerve stimulation, which leads to a rapid decrease by 10-15% of the amplitude of evoked responses. Myopathy of the critically ill patient involves the muscle and provokes a generalized weakness with quadriplegia, very similar to that from polyneuropathy, which prevents or delays weaning from mechanical ventilation, and which may lead to CPK and myoglobin increase in more advanced

  13. Neuromuscular interfacing: establishing an EMG-driven model for the human elbow joint.

    Science.gov (United States)

    Pau, James W L; Xie, Shane S Q; Pullan, Andrew J

    2012-09-01

    Assistive devices aim to mitigate the effects of physical disability by aiding users to move their limbs or by rehabilitating through therapy. These devices are commonly embodied by robotic or exoskeletal systems that are still in development and use the electromyographic (EMG) signal to determine user intent. Not much focus has been placed on developing a neuromuscular interface (NI) that solely relies on the EMG signal, and does not require modifications to the end user's state to enhance the signal (such as adding weights). This paper presents the development of a flexible, physiological model for the elbow joint that is leading toward the implementation of an NI, which predicts joint motion from EMG signals for both able-bodied and less-abled users. The approach uses musculotendon models to determine muscle contraction forces, a proposed musculoskeletal model to determine total joint torque, and a kinematic model to determine joint rotational kinematics. After a sensitivity analysis and tuning using genetic algorithms, subject trials yielded an average root-mean-square error of 6.53° and 22.4° for a single cycle and random cycles of movement of the elbow joint, respectively. This helps us to validate the elbow model and paves the way toward the development of an NI.

  14. A Novel Neuromuscular Electrical Stimulation Treatment for Recovery of Ankle Dorsiflexion in Chronic Hemiplegia

    Science.gov (United States)

    Knutson, Jayme S.; Chae, John

    2011-01-01

    Objective To evaluate the feasibility of improving active ankle dorsiflexion with contralaterally controlled neuromuscular electrical stimulation (CCNMES). Design CCNMES dorsiflexes the paretic ankle with a stimulation intensity that is directly proportional to the degree of voluntary dorsiflexion of the unimpaired contralateral ankle, which is detected by an instrumented sock. Three subjects with chronic (>6-mo poststroke) dorsiflexor paresis participated in a 6-wk CCNMES treatment, which consisted of self-administering CCNMES-assisted ankle dorsiflexion exercises at home daily and practicing an ankle motor control task in the research laboratory twice a week. Results For subjects 1 and 2, respectively, maximum voluntary ankle dorsiflexion increased by 13 and 17 degrees, ankle movement tracking error decreased by ~57% and 57%, and lower limb Fugl-Meyer score (maximum score is 34) increased by 4 and 5 points. Subject 3 had no appreciable improvement in these measures. Both subjects 1 and 2 maintained their performance in ankle movement tracking through the 3-mo follow-up; subject 2 also maintained the gains in maximum ankle dorsiflexion and Fugl-Meyer score. Conclusions These results suggest that CCNMES may have a positive effect on ankle motor impairment in some stroke survivors. Further investigation of the effect of CCNMES on gait is warranted. PMID:20531158

  15. EEG controlled neuromuscular electrical stimulation of the upper limb for stroke patients

    Science.gov (United States)

    Tan, Hock Guan; Shee, Cheng Yap; Kong, Keng He; Guan, Cuntai; Ang, Wei Tech

    2011-03-01

    This paper describes the Brain Computer Interface (BCI) system and the experiments to allow post-acute (neuromuscular electrical stimulation (NMES)-assisted extension of the wrist/fingers, which are essential pre-requisites for useful hand function. EEG was recorded while subjects performed motor imagery of their paretic limb, and then analyzed to determine the optimal frequency range within the mu-rhythm, with the greatest attenuation. Aided by visual feedback, subjects then trained to regulate their mu-rhythm EEG to operate the BCI to trigger NMES of the wrist/finger. 6 post-acute stroke patients successfully completed the training, with 4 able to learn to control and use the BCI to initiate NMES. This result is consistent with the reported BCI literacy rate of healthy subjects. Thereafter, without the loss of generality, the controller of the NMES is developed and is based on a model of the upper limb muscle (biceps/triceps) groups to determine the intensity of NMES required to flex or extend the forearm by a specific angle. The muscle model is based on a phenomenological approach, with parameters that are easily measured and conveniently implemented.

  16. Using rolling to develop neuromuscular control and coordination of the core and extremities of athletes.

    Science.gov (United States)

    Hoogenboom, Barbara J; Voight, Michael L; Cook, Gray; Gill, Lance

    2009-05-01

    Rolling is a movement pattern seldom used by physical therapists for assessment and intervention with adult clientele with normal neurologic function. Rolling, as an adult motor skill, combines the use of the upper extremities, core, and lower extremities in a coordinated manner to move from one posture to another. Rolling is accomplished from prone to supine and supine to prone, although the method by which it is performed varies among adults. Assessment of rolling for both the ability to complete the task and bilateral symmetry may be beneficial for use with athletes who perform rotationally-biased sports such as golf, throwing, tennis, and twisting sports such as dance, gymnastics, and figure skating. Additionally, when used as intervention techniques, the rolling patterns have the ability to affect dysfunction of the upper quarter, core, and lower quarter. By applying proprioceptive neuromuscular facilitation (PNF) principles, the therapist may assist patients and clients who are unable to complete a rolling pattern. Examples given in the article include distraction/elongation, compression, and manual contacts to facilitate proper rolling. The combined experience of the four authors is used to describe techniques for testing, assessment, and treatment of dysfunction, using case examples that incorporate rolling. The authors assert that therapeutic use of the developmental pattern of rolling with techniques derived from PNF is a hallmark in rehabilitation of patients with neurologic dysfunction, but can be creatively and effectively utilized in musculoskeletal rehabilitation.

  17. Neuromuscular rate of force development deficit in Parkinson disease.

    Science.gov (United States)

    Hammond, Kelley G; Pfeiffer, Ronald F; LeDoux, Mark S; Schilling, Brian K

    2017-06-01

    Bradykinesia and reduced neuromuscular force exist in Parkinson disease. The interpolated twitch technique has been used to evaluate central versus peripheral manifestations of neuromuscular strength in healthy, aging, and athletic populations, as well as moderate to advanced Parkinson disease, but this method has not been used in mild Parkinson disease. This study aimed to evaluate quadriceps femoris rate of force development and quantify potential central and peripheral activation deficits in individuals with Parkinson disease. Nine persons with mild Parkinson Disease (Hoehn & Yahr≤2, Unified Parkinson Disease Rating Scale total score=mean 19.1 (SD 5.0)) and eight age-matched controls were recruited in a cross-sectional investigation. Quadriceps femoris voluntary and stimulated maximal force and rate of force development were evaluated using the interpolated twitch technique. Thirteen participants satisfactorily completed the protocol. Individuals with early Parkinson disease (n=7) had significantly slower voluntary rate of force development (p=0.008; d=1.97) and rate of force development ratio (p=0.004; d=2.18) than controls (n=6). No significant differences were found between groups for all other variables. Persons with mild-to-moderate Parkinson disease display disparities in rate of force development, even without deficits in maximal force. The inability to produce force at a rate comparable to controls is likely a downstream effect of central dysfunction of the motor pathway in Parkinson disease. Copyright © 2017. Published by Elsevier Ltd.

  18. Stathmin is required for stability of the Drosophila neuromuscular junction.

    Science.gov (United States)

    Graf, Ethan R; Heerssen, Heather M; Wright, Christina M; Davis, Graeme W; DiAntonio, Aaron

    2011-10-19

    Synaptic connections can be stably maintained for prolonged periods, yet can be rapidly disassembled during the developmental refinement of neural circuitry and following cytological insults that lead to neurodegeneration. To date, the molecular mechanisms that determine whether a synapse will persist versus being remodeled or eliminated remain poorly understood. Mutations in Drosophila stathmin were isolated in two independent genetic screens that sought mutations leading to impaired synapse stability at the Drosophila neuromuscular junction (NMJ). Here we demonstrate that Stathmin, a protein that associates with microtubules and can function as a point of signaling integration, is necessary to maintain the stability of the Drosophila NMJ. We show that Stathmin protein is widely distributed within motoneurons and that loss of Stathmin causes impaired NMJ growth and stability. In addition, we show that stathmin mutants display evidence of defective axonal transport, a common feature associated with neuronal degeneration and altered synapse stability. The disassembly of the NMJ in stathmin includes a predictable sequence of cytological events, suggesting that a common program of synapse disassembly is induced following the loss of Stathmin protein. These data define a required function for Stathmin during synapse maintenance in a model system in which there is only a single stathmin gene, enabling future genetic investigation of Stathmin function with potential relevance to the cause and progression of neuromuscular degenerative disease.

  19. Antisense Oligonucleotide-Based Therapy for Neuromuscular Disease.

    Science.gov (United States)

    Sardone, Valentina; Zhou, Haiyan; Muntoni, Francesco; Ferlini, Alessandra; Falzarano, Maria Sofia

    2017-04-05

    Neuromuscular disorders such as Duchenne Muscular Dystrophy and Spinal Muscular Atrophy are neurodegenerative genetic diseases characterized primarily by muscle weakness and wasting. Until recently there were no effective therapies for these conditions, but antisense oligonucleotides, a new class of synthetic single stranded molecules of nucleic acids, have demonstrated promising experimental results and are at different stages of regulatory approval. The antisense oligonucleotides can modulate the protein expression via targeting hnRNAs or mRNAs and inducing interference with splicing, mRNA degradation, or arrest of translation, finally, resulting in rescue or reduction of the target protein expression. Different classes of antisense oligonucleotides are being tested in several clinical trials, and limitations of their clinical efficacy and toxicity have been reported for some of these compounds, while more encouraging results have supported the development of others. New generation antisense oligonucleotides are also being tested in preclinical models together with specific delivery systems that could allow some of the limitations of current antisense oligonucleotides to be overcome, to improve the cell penetration, to achieve more robust target engagement, and hopefully also be associated with acceptable toxicity. This review article describes the chemical properties and molecular mechanisms of action of the antisense oligonucleotides and the therapeutic implications these compounds have in neuromuscular diseases. Current strategies and carrier systems available for the oligonucleotides delivery will be also described to provide an overview on the past, present and future of these appealing molecules.

  20. Sarcocystis fayeri in skeletal muscle of horses with neuromuscular disease.

    Science.gov (United States)

    Aleman, Monica; Shapiro, Karen; Sisó, Silvia; Williams, Diane C; Rejmanek, Daniel; Aguilar, Beatriz; Conrad, Patricia A

    2016-01-01

    Recent reports of Sarcocystis fayeri-induced toxicity in people consuming horse meat warrant investigation on the prevalence and molecular characterization of Sarcocystis spp. infection in horses. Sarcocysts in skeletal muscle of horses have been commonly regarded as an incidental finding. In this study, we investigated the prevalence of sarcocysts in skeletal muscle of horses with neuromuscular disease. Our findings indicated that S. fayeri infection was common in young mature horses with neuromuscular disease and could be associated with myopathic and neurogenic processes. The number of infected muscles and number of sarcocysts per muscle were significantly higher in diseased than in control horses. S. fayeri was predominantly found in low oxidative highly glycolytic myofibers. This pathogen had a high glycolytic metabolism. Common clinical signs of disease included muscle atrophy, weakness with or without apparent muscle pain, gait deficits, and dysphagia in horses with involvement of the tongue and esophagus. Horses with myositis were lethargic, apparently painful, stiff, and reluctant to move. Similar to humans, sarcocystosis and cardiomyopathy can occur in horses. This study did not establish causality but supported a possible association (8.9% of cases) with disease. The assumption of Sarcocysts spp. being an incidental finding in every case might be inaccurate.

  1. Assistive Technology

    Science.gov (United States)

    ... Page Resize Text Printer Friendly Online Chat Assistive Technology Assistive technology (AT) is any service or tool that helps ... be difficult or impossible. For older adults, such technology may be a walker to improve mobility or ...

  2. A Hybrid Neuromechanical Ambulatory Assist System

    Science.gov (United States)

    2014-06-01

    male at the high end, based on data from the National Health and Nutrition Examination Survey (NHANES). The measurements pertinent to the exoskeleton...more cosmetic appearance. Figure15. Thigh upright Figure 16. Thigh abduction for donning and doffing while sitting. Figure 17. CAD

  3. A Hybrid Neuromechanical Ambulatory Assist System

    Science.gov (United States)

    2016-08-01

    testing and production of the technical components of the untethered HNP2 prototype and new wireless communication and control system. Any human test...reduce resistance to flow and to create a cleaner appearance. Potential manifold solutions and their advantages and disadvantages were presented in our...Quinn RD, Triolo RJ. Improving stand-to-sit maneuver for individuals with spinal cord injury. Journal of NeuroEngineering and Rehabilitation. 13:27

  4. A Hybrid Neuromechanical Ambulatory Assist System

    Science.gov (United States)

    2015-06-01

    Huq MS, Tokhi OM, Genetic algorithms based approach for designing spring brake orthosis – Part I: Spring parameters. Applied Bionics and Biomechanics ...states and stimulation pattern state. The embedded control board has a microprocessor control unit which runs the finite state controller, and...communicate wirelessly with a finite state controller running onboard HNP2. A gait event detector using FSRs as inputs to the finite state controller

  5. Invasive home mechanical ventilation, mainly focused on neuromuscular disorders

    Directory of Open Access Journals (Sweden)

    Börger, Sandra

    2010-01-01

    Full Text Available Introduction and background: Invasive home mechanical ventilation is used for patients with chronic respiratory insufficiency. This elaborate and technology-dependent ventilation is carried out via an artificial airway (tracheal cannula to the trachea. Exact numbers about the incidence of home mechanical ventilation are not available. Patients with neuromuscular diseases represent a large portion of it. Research questions: Specific research questions are formulated and answered concerning the dimensions of medicine/nursing, economics, social, ethical and legal aspects. Beyond the technical aspect of the invasive home, mechanical ventilation, medical questions also deal with the patient’s symptoms and clinical signs as well as the frequency of complications. Economic questions pertain to the composition of costs and the differences to other ways of homecare concerning costs and quality of care. Questions regarding social aspects consider the health-related quality of life of patients and caregivers. Additionally, the ethical aspects connected to the decision of home mechanical ventilation are viewed. Finally, legal aspects of financing invasive home mechanical ventilation are discussed. Methods: Based on a systematic literature search in 2008 in a total of 31 relevant databases current literature is viewed and selected by means of fixed criteria. Randomized controlled studies, systematic reviews and HTA reports (health technology assessment, clinical studies with patient numbers above ten, health-economic evaluations, primary studies with particular cost analyses and quality-of-life studies related to the research questions are included in the analysis. Results and discussion: Invasive mechanical ventilation may improve symptoms of hypoventilation, as the analysis of the literature shows. An increase in life expectancy is likely, but for ethical reasons it is not confirmed by premium-quality studies. Complications (e. g. pneumonia are rare

  6. Assistive Technologies

    Science.gov (United States)

    Auat Cheein, Fernando A., Ed.

    2012-01-01

    This book offers the reader new achievements within the Assistive Technology field made by worldwide experts, covering aspects such as assistive technology focused on teaching and education, mobility, communication and social interactivity, among others. Each chapter included in this book covers one particular aspect of Assistive Technology that…

  7. Housing Assistance

    Directory of Open Access Journals (Sweden)

    Emma Baker

    2013-07-01

    Full Text Available In Australia, an increasing number of households face problems of access to suitable housing in the private market. In response, the Federal and State Governments share responsibility for providing housing assistance to these, mainly low-income, households. A broad range of policy instruments are used to provide and maintain housing assistance across all housing tenures, for example, assisting entry into homeownership, providing affordability assistance in the private rental market, and the provision of socially owned and managed housing options. Underlying each of these interventions is the premise that secure, affordable, and appropriate housing provides not only shelter but also a number of nonshelter benefits to individuals and their households. Although the nonshelter outcomes of housing are well acknowledged in Australia, the understanding of the nonshelter outcomes of housing assistance is less clear. This paper explores nonshelter outcomes of three of the major forms of housing assistance provided by Australian governments—low-income mortgage assistance, social housing, and private rent assistance. It is based upon analysis of a survey of 1,353 low-income recipients of housing assistance, and specifically measures the formulation of health and well-being, financial stress, and housing satisfaction outcomes across these three assistance types. We find clear evidence that health, finance, and housing satisfaction outcomes are associated with quite different factors for individuals in these three major housing assistance types.

  8. Ventricular assist device

    Science.gov (United States)

    VAD; RVAD; LVAD; BVAD; Right ventricular assist device; Left ventricular assist device; Biventricular assist device; Heart pump; Left ventricular assist system; LVAS; Implantable ventricular assist device

  9. Neuromuscular Adaptations to Unilateral vs. Bilateral Strength Training in Women.

    Science.gov (United States)

    Botton, Cíntia E; Radaelli, Regis; Wilhelm, Eurico N; Rech, Anderson; Brown, Lee E; Pinto, Ronei S

    2016-07-01

    Botton, CE, Radaelli, R, Wilhelm, EN, Rech, A, Brown, LE, and Pinto, RS. Neuromuscular adaptations to unilateral vs. bilateral strength training in women. J Strength Cond Res 30(7): 1924-1932, 2016-Considering the bilateral deficit, the sum of forces produced by each limb in a unilateral condition is generally greater than that produced by them in a bilateral condition. Therefore, it can be speculated that performing unilateral strength exercises may allow greater training workloads and subsequently greater neuromuscular adaptations when compared with bilateral training. Hence, the purpose of this study was to compare neuromuscular adaptations with unilateral vs. bilateral training in the knee extensor muscles. Forty-three recreationally active young women were allocated to a control, unilateral (UG) or bilateral (BG) training group, which performed 2 times strength training sessions a week for 12 weeks. Knee extension one repetition maximum (1RM), maximal isometric strength, muscle electrical activity, and muscle thickness were obtained before and after the study period. Muscle strength was measured in unilateral (right + left) and bilateral tests. Both UG and BG increased similarly their unilateral 1RM (33.3 ± 14.3% vs. 24.6 ± 11.9%, respectively), bilateral 1RM (20.3 ± 6.8% vs. 28.5 ± 12.3%, respectively), and isometric strength (14.7 ± 11.3% vs. 13.1 ± 12.5%, respectively). The UG demonstrated greater unilateral isometric strength increase than the BG (21.4 ± 10.5% vs. 10.3 ± 11.1%, respectively) and only the UG increased muscle electrical activity. Muscle thickness increased similarly for both training groups. Neither group exhibited pretesting 1RM bilateral deficit values, but at post-testing, UG showed a significant bilateral deficit (-6.5 ± 7.8%) whereas BG showed a significant bilateral facilitation (5.9 ± 9.0%). Thus, performing unilateral or bilateral exercises was not a decisive factor for improving morphological adaptations and bilateral

  10. Hybrid Metaheuristics

    CERN Document Server

    2013-01-01

    The main goal of this book is to provide a state of the art of hybrid metaheuristics. The book provides a complete background that enables readers to design and implement hybrid metaheuristics to solve complex optimization problems (continuous/discrete, mono-objective/multi-objective, optimization under uncertainty) in a diverse range of application domains. Readers learn to solve large scale problems quickly and efficiently combining metaheuristics with complementary metaheuristics, mathematical programming, constraint programming and machine learning. Numerous real-world examples of problems and solutions demonstrate how hybrid metaheuristics are applied in such fields as networks, logistics and transportation, bio-medical, engineering design, scheduling.

  11. Review of Continuous Infusion Neuromuscular Blocking Agents in the Adult Intensive Care Unit.

    Science.gov (United States)

    Smetana, Keaton S; Roe, Neil A; Doepker, Bruce A; Jones, G Morgan

    The use of continuous infusion neuromuscular blocking agents remains controversial. The clinical benefit of these medications may be overshadowed by concerns of propagating intensive care unit-acquired weakness, which may prolong mechanical ventilation and impair the inability to assess neurologic function or pain. Despite these risks, the use of neuromuscular blocking agents in the intensive care unit is indicated in numerous clinical situations. Understanding pharmacologic nuances and clinical roles of these agents will aid in facilitating safe use in a variety of acute disease processes. This article provides clinicians with information regarding pharmacologic differences, indication for use, adverse effects, recommended doses, ancillary care, and monitoring among agents used for continuous neuromuscular blockade.

  12. Neuromuscular medicine competency in physical medicine and rehabilitation residents: a method of development and assessment.

    Science.gov (United States)

    Lin, Lei; Cuccurullo, Sara J; Innerfield, Caitlin E; Strax, Thomas E; Petagna, Anne

    2013-03-01

    This project endeavored to create an educational module including methodology to instruct physical medicine and rehabilitation residents in the evaluation and appropriate treatment of patients with neuromuscular disorders. It further sought to verify acquired competencies in neuromuscular rehabilitation through objective evaluation methodology. An American Association of Neuromuscular and Electrodiagnostic Medicine board-certified physician with 10 yrs of clinical experience in neuromuscular and general rehabilitation trained 19 residents using a standardized competency-based module. The residents were trained through clinical training, lectures, and review of self-assessment examination concepts from the American Academy of Physical Medicine & Rehabilitation syllabus provided in the Archives of Physical Medicine and Rehabilitation. After delivery of the educational module, knowledge acquisition and skill proficiency were measured in (1) completion of neuromuscular history and physical examination satisfactorily, (2) diagnosis and ability to design a patient care management plan via chart stimulated recall examinations, (3) physician-patient interaction via patient surveys, (4) physician-staff interaction via 360-degree global ratings, and (5) ability to write a comprehensive patient care report and to document a patient care management plan in accordance with Medicare guidelines via written patient reports. Assessment tools developed for this program address the basic competencies outlined by the Accreditation Council for Graduate Medical Education. To test the success of the standardized educational module, data were collected on an ongoing basis. The objective measures compared resident self-assessment examination scores in neuromuscular rehabilitation before and after the institution of the comprehensive neuromuscular competency module in the residency program. Nineteen (100%) of 19 residents successfully demonstrated proficiency in every segment of the

  13. The use of neuromuscular blocking agents in the ICU: where are we now?

    Science.gov (United States)

    Greenberg, Steven B; Vender, Jeffery

    2013-05-01

    Intensivists use neuromuscular blocking agents for a variety of clinical conditions, including for emergency intubation, acute respiratory distress syndrome, status asthmaticus, elevated intracranial pressure, elevated intra-abdominal pressure, and therapeutic hypothermia after ventricular fibrillation-associated cardiac arrest. The continued creation and use of evidence-based guidelines and protocols could ensure that neuromuscular blocking agents are used and monitored appropriately. A collaborative multidisciplinary approach coupled with constant review of the pharmacology, dosing, drug interactions, and monitoring techniques may reduce the adverse events associated with the use of neuromuscular blocking agents.

  14. Abdominal compartment syndrome successfully treated with neuromuscular blockade

    Directory of Open Access Journals (Sweden)

    Kris T Chiles

    2011-01-01

    Full Text Available A 48 year old male admitted to the intensive care unit after a cardiac arrest complicated by a stroke intra-operatively during automatic implantable cardioverter defibrillator placement. He post-operatively developed a rigid abdomen, elevated peak and plateau pressures, hypoxia and renal insufficiency. He was diagnosed with abdominal compartment syndrome with an intra-abdominal compartment pressure of 40mmHg. The patient was administered 10 mg of intravenous cisatracuriumbesylate in preparation for bedside surgical abdominal decompression. Cisatracurium eliminated the patients need for surgical intervention by reducing his abdominal compartment pressures to normal and improving his hypoxia and renal function. This case illustrates that neuromuscular blockade should be attempted in patients with abdominal compartment syndrome prior to surgical intervention.

  15. Isozyme patterns and protein profiles in neuromuscular disorders.

    Science.gov (United States)

    Edwards, Y H; Tipler, T D; Morgan-Hughes, J A; Neerunjun, J S; Hopkinson, D A

    1982-06-01

    The isozyme patterns of six different enzymes and the polypeptide profiles of soluble proteins have been examined in muscle biopsy specimens from 74 patients with a wide variety of neuromuscular disorders. About half of the samples showed unusual features in at least one, and often several, of the enzymes and proteins tested. The extent of the biochemical abnormalities was roughly proportional to the severity of the disorders. In all cases the unusual isozymes and polypeptide profiles seemed to reflect a reversion to the fetal pattern of gene expression. However, this change appeared to occur in extant muscle and was not dependent on the appearance of new muscle fibres. Among the enzymes, phosphoglycerate mutase followed by creatine kinase appeared to be the most sensitive index of muscle disorder. The extent of the change in the muscle creatine kinase isozyme pattern was not correlated with the levels of serum creatine kinase activity.

  16. Regional neuromuscular regulation within human rectus femoris muscle during gait.

    Science.gov (United States)

    Watanabe, Kohei; Kouzaki, Motoki; Moritani, Toshio

    2014-11-01

    The spatial distribution pattern of neuromuscular activation within the human rectus femoris (RF) muscle was investigated during gait by multi-channel surface electromyography (surface EMG). Eleven healthy men walked on a treadmill with three gait speeds (4, 5, and 6 km/h) and gradients (0°, 12.5°, and 25°). The spatial distribution of surface EMG was tested by central locus activation (CLA), which is calculated from 2-D multi-channel surface EMG with 46 surface electrodes. For all conditions, CLA was around the middle regions during the swing-to-stance transition and moved in a proximal direction during the stance phase and stance-to-swing transition (pphase significantly moved to proximal site with increasing gait speed (pphases, with increasing grade, CLA significantly moved distally (pgait cycle and is non-uniformly regulated longitudinally.

  17. Resúmenes de los trabajos sobre las Enfermedades Neuromusculares

    Directory of Open Access Journals (Sweden)

    Congreso Nacional de Neurología

    2010-03-01

    Full Text Available Las enfermedades neuromusculares constituyen un conjunto de afectaciones que afectan las neuronas motoras periférica, las vías motoras eferentes o los efectores (músculos esqueléticos. Sus manifestaciones clínicas son muy variadas y dependen de la causa y de los niveles de afectación. En este acápite se pueden encontrar los resúmenes de trabajos relacionados con el síndrome de Guillain Barre, polineuropatía diabética, Atrofia Muscular Espinal, Distrofia miotónica y otros todos presentados en el salón que abordó estas enfermedades.

  18. Fuzzy Control Method with Application for Functional Neuromuscular Stimulation System

    Institute of Scientific and Technical Information of China (English)

    吴怀宇; 周兆英; 熊沈蜀

    2001-01-01

    A fuzzy control technique is applied to a functional neuromuscular stimulation (FNS) physicalmultiarticular muscle control system. The FNS multiarticular muscle control system based on the fuzzy controllerwas developed with the fuzzy control rule base. Simulation experiments were then conducted for the joint angletrajectories of both the elbow flexion and the wrist flexion using the proposed fuzzy control algorithm and aconventional PID control algorithm with the FNS physical multiarticular muscle control system. The simulationresults demonstrated that the proposed fuzzy control method is more suitable for the physiologicalcharacteristics than conventional PID control. In particular, both the trajectory-following and the stability of theFNS multiarticular muscle control system were greatly improved. Furthermore, the stimulating pulse trainsgenerated by the fuzzy controller were stable and smooth.``

  19. Alterations in neuromuscular function in girls with generalized joint hypermobility

    DEFF Research Database (Denmark)

    Jensen, Bente Rona; Melcher, Jesper Sandfeld; Melcher, Pia Grethe Sandfeld

    2016-01-01

    BACKGROUND: Generalized Joint Hypermobility (GJH) is associated with increased risk of musculoskeletal joint pain. We investigated neuromuscular performance and muscle activation strategy. METHODS: Girls with GJH and non-GJH (NGJH) performed isometric knee flexions (90°,110°,130°), and extensions...... (90°) at 20 % Maximum Voluntary Contraction, and explosive isometric knee flexions while sitting. EMG was recorded from knee flexor and extensor muscles. RESULTS: Early rate of torque development was 53 % faster for GJH. Reduced hamstring muscle activation in girls with GJH was found while knee...... extensor and calf muscle activation did not differ between groups. Flexion-extension and medial-lateral co-activation ratio during flexions were higher for girls with GJH than NGJH girls. CONCLUSIONS: Girls with GJH had higher capacity to rapidly generate force than NGJH girls which may reflect motor...

  20. Neuromuscular electrical stimulation for muscle wasting in heart failure patients.

    Science.gov (United States)

    Saitoh, Masakazu; Dos Santos, Marcelo Rodrigues; Anker, Markus; Anker, Stefan D; von Haehling, Stephan; Springer, Jochen

    2016-12-15

    Neuromuscular electrical stimulation (NMES) seems to be safe and beneficial in improvement in functional capacity, muscle strength, and quality of life when compared with conventional aerobic exercise, while the change in muscle fiber composition and muscle size was conflicting in patients with heart failure (HF). Moreover, NMES studies seem to have beneficial effects on pro-inflammatory cytokine, oxidative enzyme activity, and protein anabolic and catabolic metabolism that are the key molecular mechanism of muscle wasting in patients with HF. We review specific issues related to the effects of NMES on muscle wasting in patients with HF, whether NMES seems to be an alternative exercise modality preventing or improving in muscle wasting for HF patients who are unable or unwilling to engage in conventional exercise training; however no established strategies currently exist to focus on the patients with HF accompanied by muscle wasting. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  1. Neuromuscular fatigue during dynamic maximal strength and hypertrophic resistance loadings.

    Science.gov (United States)

    Walker, Simon; Davis, Lisa; Avela, Janne; Häkkinen, Keijo

    2012-06-01

    The purpose of this study was to compare the acute neuromuscular fatigue during dynamic maximal strength and hypertrophic loadings, known to cause different adaptations underlying strength gain during training. Thirteen healthy, untrained males performed two leg press loadings, one week apart, consisting of 15 sets of 1 repetition maximum (MAX) and 5 sets of 10 repetition maximums (HYP). Concentric load and muscle activity, electromyography (EMG) amplitude and median frequency, was assessed throughout each set. Additionally, maximal bilateral isometric force and muscle activity was assessed pre-, mid-, and up to 30 min post-loading. Concentric load during MAX was decreased after set 10 (Pmuscle activity during HYP loading. Copyright © 2011 Elsevier Ltd. All rights reserved.

  2. Active zone stability:insights from fly neuromuscular junction

    Institute of Scientific and Technical Information of China (English)

    Xiaolin Tian; Chunlai Wu

    2015-01-01

    The presynaptic active zone is a dynamic structure that orchestrates regulated release of neurotrans-mitters. Developmental and aging processes, and changes in neuronal network activity can all modulate the number, size and composition of active zone and thereby synaptic efifcacy. However, very little is known about the mechanism that controls the structural stability of active zone. By study-ing a model synapse, theDrosophila neuromuscular junction, our recent work shed light on how two scaffolding proteins at the active zone regulate active zone stability by promoting a localized dephos-phorylation event at the nerve terminal. Here we discuss the major insights from our ifndings and their implications for future research.

  3. Alterations in neuromuscular function in girls with generalized joint hypermobility

    DEFF Research Database (Denmark)

    Jensen, Bente Rona; Melcher, Jesper Sandfeld; Melcher, Pia Grethe Sandfeld;

    2016-01-01

    BACKGROUND: Generalized Joint Hypermobility (GJH) is associated with increased risk of musculoskeletal joint pain. We investigated neuromuscular performance and muscle activation strategy. METHODS: Girls with GJH and non-GJH (NGJH) performed isometric knee flexions (90°,110°,130°), and extensions...... (90°) at 20 % Maximum Voluntary Contraction, and explosive isometric knee flexions while sitting. EMG was recorded from knee flexor and extensor muscles. RESULTS: Early rate of torque development was 53 % faster for GJH. Reduced hamstring muscle activation in girls with GJH was found while knee...... adaptation to compensate for hypermobility. Higher medial muscle activation indicated higher levels of medial knee joint compression in girls with GJH. Increased flexion-extension co-activation ratios in GJH were explained by decreased agonist drive to the hamstrings....

  4. Hybrid intermediaries

    OpenAIRE

    Cetorelli, Nicola

    2014-01-01

    I introduce the concept of hybrid intermediaries: financial conglomerates that control a multiplicity of entity types active in the "assembly line" process of modern financial intermediation, a system that has become known as shadow banking. The complex bank holding companies of today are the best example of hybrid intermediaries, but I argue that financial firms from the "nonbank" space can just as easily evolve into conglomerates with similar organizational structure, thus acquiring the cap...

  5. Hybrid composites

    CSIR Research Space (South Africa)

    Jacob John, Maya

    2009-04-01

    Full Text Available effect was observed for the elongation at break of the hybrid composites. The impact strength of the hybrid composites increased with the addition of glass fibres. The tensile and impact properties of thermoplastic natural rubber reinforced short... panels made from conventional structural materials. Figure 3 illustrates the performance of cellular biocomposite panels against conventional systems used for building and residential construction, namely a pre- cast pre-stressed hollow core concrete...

  6. The origins of neuromuscular fatigue post-stroke.

    Science.gov (United States)

    Knorr, S; Ivanova, T D; Doherty, T J; Campbell, J A; Garland, S J

    2011-10-01

    Fatigue post-stroke is a disabling and persistent symptom affecting many stroke survivors. Despite its high prevalence, the pathophysiology underlying this phenomenon remains obscure. The aim of the present study was to investigate the origins of neuromuscular fatigue post-stroke. Ten chronic stroke survivors and 10 controls sustained an isometric contraction at 30% of maximal voluntary contraction (MVC) with the ankle dorsiflexors. Motor evoked potential (MEP), cortical silent period (SP), voluntary activation, M wave and contractile properties were evaluated before, during and after fatigue among the paretic, non-paretic and control limbs. The pattern of response to fatigue in the non-paretic and control limbs was comparable; therefore, results are presented between the paretic and non-paretic limbs. Before fatigue, reduced MVC peak torque and MEP amplitude were observed on the paretic side in comparison with the non-paretic side. During fatigue, the cortical SP duration increased significantly in both limbs, whereas the MEP amplitude significantly increased only in the non-paretic limb. After fatigue, MVC peak torque decreased significantly in both limbs. Significant reductions in M wave and twitch peak torque were observed in both limbs, pointing to the development of peripheral fatigue. However, central fatigue, evident by a significant reduction in voluntary activation, was greater in the paretic than in the non-paretic limb. After stroke, an inability to increase central excitability in response to an increased cortical inhibition associated with the fatiguing contraction may contribute to central fatigue observed in the paretic limb, which may also be linked to increased self-reported fatigue during activities of daily living. These findings advance our understanding of the neuromuscular basis of fatigue post-stroke.

  7. EFFECT OF NEUROMUSCULAR TRAINING ON BALANCE AMONG UNIVERSITY ATHLETES

    Directory of Open Access Journals (Sweden)

    Mohansundar Sankaravel

    2016-06-01

    Full Text Available Background: Proprioceptive deficiency followed by lateral ankle sprain leads to poor balance is not uncommon. It has been linked with increased injury risk among young athletes. Introducing neuromuscular training programs for this have been believed as one of the means of injury prevention. Hence, this study was aimed to determine the effects of six weeks progressive neuromuscular training (PNM Training on static balance gains among the young athletes with a previous history of ankle sprains. Methods: This study was an experimental study design, with pre and post test method to determine the effects of PNM Training on static balance gains. All data were collected at university’s sports rehabilitation lab before and after six weeks of intervention period. There were 20 male and female volunteer young athletes (20.9 ± 0.85 years of age with a previous history of ankle sprain involving various sports were recruited from the University community. All the subjects were participated in a six week PNM Training that included stability, strength and power training. Outcome measures were collected by calculating the errors on balance error scoring system made by the athletes on static balance before and after the six weeks of intervention period. Static balance was tested in firm and foam surfaces and recorded accordingly. Results: The researchers found a significant decrease (2.40 ± 0.82 in total errors among the samples at the post test compared with their pre test (P >0.05. Conclusions: The study demonstrates that a PNM Training can improve the static balance on both the firm and foam surfaces among the young athletes with a previous history of ankle sprains.

  8. Neuromuscular anatomy and evolution of the cetacean forelimb.

    Science.gov (United States)

    Cooper, Lisa Noelle; Dawson, Susan D; Reidenberg, Joy S; Berta, Annalisa

    2007-09-01

    The forelimb of cetaceans (whales, dolphins, and porpoises) has been radically modified during the limb-to-flipper transition. Extant cetaceans have a soft tissue flipper encasing the manus and acting as a hydrofoil to generate lift. The neuromuscular anatomy that controls flipper movement, however, is poorly understood. This study documents flipper neuromuscular anatomy and tests the hypothesis that antebrachial muscle robustness is related to body size. Data were gathered during dissections of 22 flippers, representing 15 species (7 odontocetes, 15 mysticetes). Results were compared with published descriptions of both artiodactyls and secondarily aquatic vertebrates. Results indicate muscle robustness is best predicted by taxonomic distribution and is not a function of body size. All cetaceans have atrophied triceps muscles, an immobile cubital joint, and lack most connective tissue structures and manus muscles. Forelimbs retain only three muscle groups: triceps (only the scapular head is functional as the humeral heads are vestigal), and antebrachial extensors and flexors. Well-developed flexor and extensor muscles were found in mysticetes and basal odontocetes (i.e., physeterids, kogiids, and ziphiids), whereas later diverging odontocetes (i.e., monodontids, phocoenids, and delphinids) lack or reduce these muscles. Balaenopterid mysticetes (e.g., fin and minke whales) may actively change flipper curvature, while basal odontocetes (e.g., sperm and beaked whales) probably stiffen the flipper through isometric contraction. Later diverging odontocetes lack musculature supporting digital movements and are unable to manipulate flipper curvature. Cetacean forelimbs are unique in that they have lost agility and several soft tissue structures, but retain sensory innervations.

  9. Combined application of neuromuscular electrical stimulation and voluntary muscular contractions.

    Science.gov (United States)

    Paillard, Thierry

    2008-01-01

    Electromyostimulation (EMS) and voluntary muscle contraction (VC) constitute different modes of muscle activation and induce different acute physiological effects on the neuromuscular system. Long-term application of each mode of muscle activation can produce different muscle adaptations. It seems theoretically possible to completely or partially cumulate the muscle adaptations induced by each mode of muscle activation applied separately. This work consisted of examining the literature concerning the muscle adaptations induced by long-term application of the combined technique (CT) [i.e. EMS is combined with VC - non-simultaneously] compared with VC and/or EMS alone in healthy subjects and/or athletes and in post-operative knee-injured subjects. In general, CT induced greater muscular adaptations than VC whether in sports training or rehabilitation. This efficiency would be due to the fact that CT can facilitate cumulative effects of training completely or partially induced by VC and EMS practiced alone. CT also provides a greater improvement of the performance of complex dynamic movements than VC. However, EMS cannot improve coordination between different agonistic and antagonistic muscles and thus does not facilitate learning the specific coordination of complex movements. Hence, EMS should be combined with specific sport training to generate neuromuscular adaptations, but also allow the adjustment of motor control during a voluntary movement. Likewise, in a therapeutic context, CT was particularly efficient to accelerate recovery of muscle contractility during a rehabilitation programme. Strength loss and atrophy inherent in a traumatism and/or a surgical operation would be more efficiently compensated with CT than with VC. Furthermore, CT also restored more functional abilities than VC. Finally, in a rehabilitation context, EMS is complementary to voluntary exercise because in the early phase of rehabilitation it elicits a strength increase, which is necessary

  10. Electrical stimulation for testing neuromuscular function: from sport to pathology.

    Science.gov (United States)

    Millet, Guillaume Y; Martin, Vincent; Martin, Alain; Vergès, Samuel

    2011-10-01

    The use of electrical stimulation (ES) can contribute to our knowledge of how our neuromuscular system can adapt to physical stress or unloading. Although it has been recently challenged, the standard technique used to explore central modifications is the twitch interpolated method which consists in superimposing single twitches or high-frequency doublets on a maximal voluntary contraction (MVC) and to compare the superimposed response to the potentiated response obtained from the relaxed muscle. Alternative methods consist in (1) superimposing a train of stimuli (central activation ratio), (2) comparing the MVC response to the force evoked by a high-frequency tetanus or (3) examining the change in maximal EMG response during voluntary contractions, if this variable is normalized to the maximal M wave, i.e. EMG response to a single stimulus. ES is less used to examine supraspinal factors but it is useful for investigating changes at the spinal level, either by using H reflexes, F waves or cervicomedullary motor-evoked potentials. Peripheral changes can be examined with ES, usually by stimulating the muscle in the relaxed state. Neuromuscular propagation of action potentials on the sarcolemma (M wave, high-frequency fatigue), excitation-contraction coupling (e.g. low-frequency fatigue) and intrinsic force (high-frequency stimulation at supramaximal intensity) can all be used to non-invasively explore muscular function with ES. As for all indirect methods, there are limitations and these are discussed in this review. Finally, (1) ES as a method to measure respiratory muscle function and (2) the comparison between electrical and magnetic stimulation will also be considered.

  11. Acute Effects of Static and Proprioceptive Neuromuscular Facilitation Stretching on Muscle Strength and Power Output

    OpenAIRE

    Marek, Sarah M; Cramer, Joel T; Fincher, A. Louise; Massey, Laurie L; Dangelmaier, Suzanne M; Purkayastha, Sushmita; Fitz, Kristi A; Culbertson, Julie Y

    2005-01-01

    Context: Stretching is commonly used as a technique for injury prevention in the clinical setting. Our findings may improve the understanding of the neuromuscular responses to stretching and help clinicians make decisions for rehabilitation progression and return to play.

  12. Neuromuscular electrical stimulation for preventing skeletal-muscle weakness and wasting in critically ill patients

    DEFF Research Database (Denmark)

    Maffiuletti, Nicola A.; Roig, Marc; Karatzanos, Eleftherios

    2013-01-01

    Background: Neuromuscular electrical stimulation (NMES) therapy may be useful in early musculoskeletal rehabilitation during acute critical illness. The objective of this systematic review was to evaluate the effectiveness of NMES for preventing skeletal-muscle weakness and wasting in critically...

  13. Exercise therapy and other types of physical therapy for patients with neuromuscular diseases: a systematic review.

    NARCIS (Netherlands)

    Cup, E.H.C.; Pieterse, A.J.; Broek-Pastoor, J.M. Ten; Munneke, M.; Engelen, B.G.M. van; Hendricks, H.T.; Wilt, G.J. van der; Oostendorp, R.A.B.

    2007-01-01

    OBJECTIVE: To summarize and critically appraise the available evidence on exercise therapy and other types of physical therapies for patients with neuromuscular diseases (NMD). DATA SOURCES: Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews, Medline, CINAHL,

  14. Impaired voluntary neuromuscular activation limits muscle power in mobility-limited older adults

    Science.gov (United States)

    Background. Age-related alterations of neuromuscular activation may contribute to deficits in muscle power and mobility function. This study assesses whether impaired activation of the agonist quadriceps and antagonist hamstrings, including amplitude- and velocity-dependent characteristics of activa...

  15. Muscle size, neuromuscular activation, and rapid force characteristics in elderly men and women

    DEFF Research Database (Denmark)

    Suetta, C; Aagaard, P; Magnusson, S P

    2007-01-01

    quadriceps muscle cross-sectional area (LCSA), contractile rate of force development (RFD, Delta force/Delta time), impulse (integral force dt), muscle activation deficit (interpolated twitch technique), maximal neuromuscular activity [electromyogram (EMG)], and antagonist muscle coactivation in elderly men...

  16. Speech pathology interventions in patients with neuromuscular diseases: a systematic review

    NARCIS (Netherlands)

    Knuijt, S.; Cup, E.H.C.; Pieterse, A.J.; Swart, B.J.M. de; Wilt, G.J. van der; Engelen, B.G.M. van; Oostendorp, R.A.B.; Hendricks, H.T.

    2011-01-01

    PURPOSE: A systematic review was conducted to summarize and evaluate the literature on the effectiveness of speech pathology interventions in adults with neuromuscular diseases. METHOD: Databases searched included the Cochrane Database of Systematic Reviews, the Cochrane Central Register of

  17. Can hyperbaric oxygen be used to prevent deep infections in neuro-muscular scoliosis surgery?

    OpenAIRE

    Inanmaz, Mustafa Erkan; Kose, Kamil Cagri; Isik, Cengiz; Atmaca, Halil; Basar, Hakan

    2014-01-01

    Background The prevalence of postoperative wound infection in patients with neuromuscular scoliosis surgery is significantly higher than that in patients with other spinal surgery. Hyperbaric oxygen has been used as a supplement to treat postsurgical infections. Our aim was to determine beneficiary effects of hyperbaric oxygen treatment in terms of prevention of postoperative deep infection in this specific group of patients in a retrospective study. Methods Forty two neuromuscular scoliosis ...

  18. Proprioceptive Neuromuscular Facilitation (PNF): Its Mechanisms and Effects on Range of Motion and Muscular Function

    OpenAIRE

    Hindle, Kayla B.; Whitcomb, Tyler J.; Briggs, Wyatt O.; Hong, Junggi

    2012-01-01

    Proprioceptive neuromuscular facilitation (PNF) is common practice for increasing range of motion, though little research has been done to evaluate theories behind it. The purpose of this study was to review possible mechanisms, proposed theories, and physiological changes that occur due to proprioceptive neuromuscular facilitation techniques. Four theoretical mechanisms were identified: autogenic inhibition, reciprocal inhibition, stress relaxation, and the gate control theory. The studies s...

  19. Treatment of neuromuscular scoliosis with posterior-only pedicle screw fixation

    OpenAIRE

    Fernandez Harry M; Song Hae-Ryong; Suh Seung-Woo; Modi Hitesh N; Yang Jae-Hyuk

    2008-01-01

    Abstract Background To determine whether posterior-only approach using pedicle screws in neuromuscular scoliosis population adequately addresses the correction of scoliosis and maintains the correction over time. Methods Between 2003 and 2006, 26 consecutive patients (7 cerebral palsy, 10 Duchenne muscular dystrophy, 5 spinal muscular atrophy and 4 others) with neuromuscular scoliosis underwent posterior pedicle screw fixation for the deformity. Preoperative, immediate postoperative and final...

  20. Evaluation of neuromuscular activity in patients with obstructive sleep apnea using chin surface electromyography of polysomnography

    Institute of Scientific and Technical Information of China (English)

    YIN Guo-ping; YE Jing-ying; HAN De-min; WANG Xiao-yi; ZHANG Yu-huan; LI Yan-ru

    2013-01-01

    Background It is believed that defects in upper airway neuromuscular control play a role in sleep apnea pathogenesis.Currently,there is no simple and non-invasive method for evaluating neuromuscular activity for the purpose of screening in patients with obstructive sleep apnea.This study was designed to assess the validity of chin surface electromyography of routine polysomnography in evaluating the neuromuscular activity of obstructive sleep apnea subjects and probe the neuromuscular contribution in the pathogenesis of the condition.Methods The chin surface electromyography of routine polysomnography during normal breathing and obstructive apnea were quantified in 36 male patients with obstructive sleep apnea.The change of chin surface electromyography from normal breathing to obstructive apnea was expressed as the percent compensated electromyography value,where the percent compensated electromyography value =(normal breath surface electromyography-apnea surface electromyography)/normal breath surface electromyography,and the percent compensated electromyography values among subjects were compared.The relationship between sleep apnea related parameters and the percent compensated electromyography value was examined.Results The percent compensated electromyography value of the subjects varied from 1% to 90% and had a significant positive correlation with apnea hypopnea index (R2=0.382,P <0.001).Conclusions Recording and analyzing chin surface electromyography by routine polysomnography is a valid way of screening the neuromuscular activity in patients with obstructive sleep apnea.The neuromuscular contribution is different among subjects with obstructive sleep apnea.

  1. Sugammadex given for rocuronium-induced neuromuscular blockade in infants: a retrospectıve study.

    Science.gov (United States)

    Ozmete, Ozlem; Bali, Cagla; Cok, Oya Yalcin; Turk, Hatice Evren Eker; Ozyilkan, Nesrın Bozdogan; Civi, Soner; Aribogan, Anıs

    2016-12-01

    To evaluate the efficacy and safety of sugammadex in reversing profound neuromuscular block induced by rocuronium in infant patients. Retrospective observational study. University teaching hospital. Twenty-six infants (2-12 months of age; 3-11 kg) with an American Society of Anesthesiologists classification I, II, or III who were scheduled to undergo neurosurgical procedures were included in the study. Anesthesia was induced with 5 mg/kg thiopental, 1 μg/kg fentanyl and 0.6 mg/kg rocuronium. Sevoflurane was administered to all patients after intubation. The neuromuscular block was monitored with acceleromyography using train-of-four (TOF) stimuli. Patients received additional doses of rocuronium to maintain a deep block during surgery. If profound neuromuscular block (TOF, 0) persisted at the end of the surgery, 3mg/kg sugammadex was administered. The demographic data, surgeries, and anesthetic agents were recorded. The time from sugammadex administration to recovery of neuromuscular function (TOF ratio, >0.9) and complications during and after extubation were also recorded. Twenty-six infants who had a deep neuromuscular block (TOF, 0) at the end of surgery received 3 mg/kg sugammadex. The mean recovery time of the T4/T1 ratio of 0.9 was 112 seconds. No clinical evidence of recurarization or residual curarization was observed. The efficacy and safety of sugammadex were confirmed in infant surgical patients for reversal of deep neuromuscular block induced by rocuronium. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Analgesia, sedação e relaxamento neuromuscular no doente ventilado em cuidados intensivos cardíacos: parte III: relaxantes neuromusculares

    OpenAIRE

    Vilela, H; D. Ferreira

    2006-01-01

    Neste artigo são revistos aspectos clínicos relevantes relacionados com a sedação, analgesia e relaxamento neuromuscular em cuidados intensivos cardíacos, incluindo métodos de monitorização e opções terapêuticas disponíveis. São ainda abordadas as implicações fisiopatológicas da dor, agitação, ansiedade e delírio no doente ventilado. Apesar de terem sido publicadas recentemente normas de orientação para sedação, analgesia e relaxamento neuromuscular em Cuidados I...

  3. Exploring the Psychosocial Impact of Wheelchair and Contextual Factors on Quality of Life of People with Neuromuscular Disorders.

    Science.gov (United States)

    Pousada García, Thais; Groba González, Betania; Nieto Rivero, Laura; Pereira Loureiro, Javier; Díez Villoria, Emiliano; Pazos Sierra, Alejandro

    2015-01-01

    Neuromuscular disorders (NMDs) are a group of heterogeneous diseases that show differences in incidence, hereditary, etiology, prognosis, or functional impairments. Wheelchair use (manual or powered) is influenced by several factors, including personal and contextual factors, and comprehensive evaluation of their impact is required in order to optimize prescription and provision of wheelchairs. The authors therefore assessed the influence of wheelchair use on the quality of life (QoL) of 60 participants with NMD using the Psychosocial Impact of Assistive Devices Scale (PIADS). The Functional Independence Measure (FIM) and a specially developed questionnaire were used to obtain information about contextual factors and participants' activity profile of activities of the participants. The results showed that using a wheelchair has psychosocial benefits, with the main determinants of benefit being type of wheelchair (powered), non-ambulation ability, and independence in mobility. Ensuring a good match between user and assistive technology (AT; e.g., wheelchair), as well as the effectiveness of the particular device, will increase the likelihood that the user will adopt it and use it effectively in daily life. Clinical prescription of AT would be improved by making appropriate use of outcome measures.

  4. Static balance and function in children with cerebral palsy submitted to neuromuscular block and neuromuscular electrical stimulation: Study protocol for prospective, randomized, controlled trial

    Directory of Open Access Journals (Sweden)

    Kazon Soráia

    2012-05-01

    Full Text Available Abstract Background The use of botulinum toxin A (BT-A for the treatment of lower limb spasticity is common in children with cerebral palsy (CP. Following the administration of BT-A, physical therapy plays a fundamental role in potentiating the functionality of the child. The balance deficit found in children with CP is mainly caused by muscle imbalance (spastic agonist and weak antagonist. Neuromuscular electrical stimulation (NMES is a promising therapeutic modality for muscle strengthening in this population. The aim of the present study is to describe a protocol for a study aimed at analyzing the effects of NMES on dorsiflexors combined with physical therapy on static and functional balance in children with CP submitted to BT- A. Methods/Design Protocol for a prospective, randomized, controlled trial with a blinded evaluator. Eligible participants will be children with cerebral palsy (Levels I, II and III of the Gross Motor Function Classification System between five and 12 years of age, with independent gait with or without a gait-assistance device. All participants will receive BT-A in the lower limbs (triceps surae. The children will then be randomly allocated for either treatment with motor physical therapy combined with NMES on the tibialis anterior or motor physical therapy alone. The participants will be evaluated on three occasions: 1 one week prior to the administration of BT-A; 2 one week after the administration of BT-A; and 3 four months after the administration of BT-A (end of intervention. Spasticity will be assessed by the Modified Ashworth Scale and Modified Tardieu Scale. Static balance will be assessed using the Medicapteurs Fusyo pressure platform and functional balance will be assessed using the Berg Balance Scale. Discussion The aim of this protocol study is to describe the methodology of a randomized, controlled, clinical trial comparing the effect of motor physical therapy combined with NMES on the tibialis anterior

  5. Neuromechanical adaptations during a robotic powered exoskeleton assisted walking session.

    Science.gov (United States)

    Ramanujam, Arvind; Cirnigliaro, Christopher M; Garbarini, Erica; Asselin, Pierre; Pilkar, Rakesh; Forrest, Gail F

    2017-04-20

    To evaluate gait parameters and neuromuscular profiles of exoskeleton-assisted walking under Max Assist condition during a single-session for; (i) able bodied (AB) individuals walking assisted with (EXO) and without (non-EXO) a powered exoskeleton, (ii) non-ambulatory SCI individuals walking assisted with a powered exoskeleton. Single-session. Motion analysis laboratory. Four AB individuals and four individuals with SCI. Powered lower extremity exoskeleton. Temporal-spatial parameters, kinematics, walking velocity and electromyography data. AB individuals in exoskeleton showed greater stance time and a significant reduction in walking velocity (P exoskeleton movements, they walked with an increased velocity and lowered stance time to resemble that of slow walking. For SCI individuals, mean percent stance time was higher and walking velocity was lower compared to all AB walking conditions (P exoskeleton and moreover with voluntary control there is a greater temporal-spatial response of the lower limbs. Also, there are neuromuscular phasic adaptions for both AB and SCI groups while walking in the exoskeleton that are inconsistent to non-EXO gait muscle activation.

  6. Robotic-locomotor training as a tool to reduce neuromuscular abnormality in spinal cord injury: the application of system identification and advanced longitudinal modeling.

    Science.gov (United States)

    Mirbagheri, Mehdi M; Kindig, Matthew; Niu, Xun; Varoqui, Deborah; Conaway, Petra

    2013-06-01

    In this study, the effect of the LOKOMAT, a robotic-assisted locomotor training system, on the reduction of neuromuscular abnormalities associated with spasticity was examined, for the first time in the spinal cord injury (SCI) population. Twenty-three individuals with chronic incomplete SCI received 1-hour training sessions in the LOKOMAT three times per week, with up to 45 minutes of training per session; matched control group received no intervention. The neuromuscular properties of the spastic ankle were then evaluated prior to training and after 1, 2, and 4 weeks of training. A parallel-cascade system identification technique was used to determine the reflex and intrinsic stiffness of the ankle joint as a function of ankle position at each time point. The slope of the stiffness vs. joint angle curve, i.e. the modulation of stiffness with joint position, was then calculated and tracked over the four-week period. Growth Mixture Modeling (GMM), an advanced statistical method, was then used to classify subjects into subgroups based on similar trends in recovery pattern of slope over time, and Random Coefficient Regression (RCR) was used to model the recovery patterns within each subgroup. All groups showed significant reductions in both reflex and intrinsic slope over time, but subjects in classes with higher baseline values of the slope showed larger improvements over the four weeks of training. These findings suggest that LOKOMAT training may also be useful for reducing the abnormal modulation of neuromuscular properties that arises as secondary effects after SCI. This can advise clinicians as to which patients can benefit the most from LOKOMAT training prior to beginning the training. Further, this study shows that system identification and GMM/RCR can serve as powerful tools to quantify and track spasticity over time in the SCI population.

  7. "THE EFFECTS OF ANODAL IONTOPHORESIS OF EPINEPHRINE ON NEUROMUSCULAR RESPONSES IN HEALTHY MEN AND PATIENTS WITH MYASTHENIA GRAVIS "

    OpenAIRE

    Talebian, S.; Abolfazli, R.; G. R. Olyaei S. Hajizadeh

    2005-01-01

    Iontophoresis of epinephrine for assessment of neuromuscular junction response is a new technique that can improve diagnose of neuromuscular dysfunction. The purpose of this study was to investigate the effects of iontophoresis of epinephrine on neuromuscular junction response. Iontophoresis of epinephrine solution (1mg/ml), sodium chloride, calcium gluconate, epinephrine with sodium chloride and distilled water was applied in five groups of healthy men and 7 patients with myasthenia gravis (...

  8. Assisted Living

    Science.gov (United States)

    ... if needs change. Assisted living costs less than nursing home care. It is still fairly expensive. Older people or their families usually pay for it. Health and long-term care insurance policies may cover ...

  9. Tetanic fade following administration of nondepolarizing neuromuscular blocking drugs.

    Science.gov (United States)

    Gibson, F M; Mirakhur, R K

    1989-06-01

    Fade in response to tetanic stimulation was studied following administration of atracurium 120 or 225 micrograms/kg, vecuronium 23 or 40 micrograms/kg, pancuronium 30 or 60 micrograms/kg, or d-tubocurarine 185 or 450 micrograms/kg. Ten patients received each dose and tetanic fade was measured at maximum block in the patients, who received the lower doses of the relaxants or at 10% recovery in those who received the higher doses. Fade during tetanic stimulation was generally similar in all the groups with the exception of the higher dose of pancuronium which showed a significantly greater fade in comparison with the higher doses of atracurium and d-tubocurarine. If fade in response to tetanic stimulation represents a prejunctional effect, the results from the present study suggest that neuromuscular blocking drugs cannot be differentiated with respect to their relative prejunctional effects by measurement of tetanic fade during established block after administration of clinically useful doses as used in the present study.

  10. Neuromuscular fatigue after maximal exercise in patients with cystic fibrosis.

    Science.gov (United States)

    Vallier, J M; Gruet, M; Mely, L; Pensini, M; Brisswalter, J

    2011-04-01

    The aim of this study was to determine whether patients with cystic fibrosis (CF), despite their ventilatory limitation, would develop neuromuscular fatigue of quadriceps muscles following a maximal cycling exercise. Eleven adults with CF (age=26.8±6.9years; forced expiratory volume in 1s=54.1±12.8% predicted) and 11 age-matched healthy subjects performed a maximal incremental cycle test with respiratory gas exchange measurements. Maximal voluntary contraction (MVC) and electromyographic (EMG) activity of the vastus medialis muscle were recorded before and after exercise. Neural and contractile properties of the quadriceps were also investigated using femoral nerve electrical stimulation. Patients had lower exercise capacity, peak oxygen uptake and MVC than controls. MVC fell significantly postexercise in both groups (CF: -20±10%, controls: -19±6%; ppattern (-38.4±14.4%, -42.1±14.7% and -15±20.4%) but the statistical significance was not reached for the maximal rate of twitch torque relaxation. In conclusion, CF patients demonstrated lower limb fatigue following symptom-limited cycle exercise, which was comparable to that exhibited by healthy controls. This fatigue may be due to contractile impairments and not to transmission failure. Further studies should be conducted in a larger sample to confirm these preliminary results.

  11. Neuromuscular disorders: genes, genetic counseling and therapeutic trials

    Directory of Open Access Journals (Sweden)

    Mayana Zatz

    Full Text Available Abstract Neuromuscular disorders (NMD are a heterogeneous group of genetic conditions, with autosomal dominant, recessive, or X-linked inheritance. They are characterized by progressive muscle degeneration and weakness. Here, we are presenting our major contributions to the field during the past 30 years. We have mapped and identified several novel genes responsible for NMD. Genotype-phenotype correlations studies enhanced our comprehension on the effect of gene mutations on related proteins and their impact on clinical findings. The search for modifier factors allowed the identification of a novel "protective"; variant which may have important implication on therapeutic developments. Molecular diagnosis was introduced in the 1980s and new technologies have been incorporated since then. Next generation sequencing greatly improved our capacity to identify disease-causing mutations with important benefits for research and prevention through genetic counseling of patients' families. Stem cells researches, from and for patients, have been used as tools to study human genetic diseases mechanisms and for therapies development. The clinical effect of preclinical trials in mice and canine models for muscular dystrophies are under investigation. Finally, the integration of our researches and genetic services with our post-graduation program resulted in a significant output of new geneticists, spreading out this expertise to our large country.

  12. Neuromuscular factors related to success in Olympic wrestling

    Directory of Open Access Journals (Sweden)

    Alfonso Martínez-Moreno

    2011-03-01

    Full Text Available AbstractThis study was undertaken to determine the relationship between maximum dynamic and isometric strength and success in male and female Olympic wrestling. Thirty-five female and thirty-seven male wrestlers were assigned into 4 groups according to their gender and competitive level: men elite (♂ ET, n = 18 and amateur (AT ♂, n = 19 and female elite (♀ ET n = 13 and amateur (AT ♀, n = 22. All subjects underwent assessments of body composition, countermovement jump, maximum dynamic strength test in full squat and bench press exercises and maximum isometric strength test of grip and hip extension. All the neuromuscular markers studied showed significantly higher values in the two elite groups compared to their respective amateur groups results, except the jump height between ♀ET y ♀AT, where no significant differences were detected. The present results suggest that the higher maximum isometric and dynamic strength values, explained in part by the differences in lean mass, will give elite wrestlers a clear advantage during the most frequently used techniques in Olympic wrestling. Key  Words: bench press; squat; maximum dynamic strength; maximum isometric strength; combat.

  13. Verifax: Biometric instruments measuring neuromuscular disorders/performance impairments

    Science.gov (United States)

    Morgenthaler, George W.; Shrairman, Ruth; Landau, Alexander

    1998-01-01

    VeriFax, founded in 1990 by Dr. Ruth Shrairman and Mr. Alex Landau, began operations with the aim of developing a biometric tool for the verification of signatures from a distance. In the course of developing this VeriFax Autograph technology, two other related applications for the technologies under development at VeriFax became apparent. The first application was in the use of biometric measurements as clinical monitoring tools for physicians investigating neuromuscular diseases (embodied in VeriFax's Neuroskill technology). The second application was to evaluate persons with critical skills (e.g., airline pilots, bus drivers) for physical and mental performance impairments caused by stress, physiological disorders, alcohol, drug abuse, etc. (represented by VeriFax's Impairoscope prototype instrument). This last application raised the possibility of using a space-qualified Impairoscope variant to evaluate astronaut performance with respect to the impacts of stress, fatigue, excessive workload, build-up of toxic chemicals within the space habitat, etc. The three applications of VeriFax's patented technology are accomplished by application-specific modifications of the customized VeriFax software. Strong commercial market potentials exist for all three VeriFax technology applications, and market progress will be presented in more detail below.

  14. [Critical study of radiculomedullary and neuromuscular complications of ankylosing spondylitis].

    Science.gov (United States)

    Serratrice, G; Acquaviva, P; Pouget, J; Guerra, L

    1987-03-01

    Medullo-radicular and neuro-muscular involvements of ankylosing spondylarthritis, often reported in an analytic fashion in the literature, deserve to be the subject of a critical study. Various neurological manifestations secondary to exceptional atlo-occipital and sometimes axis-atlas subluxations and medullary lesions as well as syndromes of the cauda equina. The medullary lesions have an epidural origin (3 cases in the literature, 2 cases from the authors) or are secondary to a spondylodiscitis (4 cases in the literature) or secondary to both (1 case reported by the authors). As for syndromes of the cauda equina the authors report 3 cases to be added to the 55 published previously. It concerns always old spondylarthritis. The lesions combine posterior diverticula and lesions of the lamina. The treatment is usually ineffective. A special case is represented by forms with trophic disorders. More debatable are the radicular lesions, which, except for intercostal pain, should be linked to local pain. Electromyographic abnormalities are of no significance. Alterations of the paravertebral muscles viewed on the scanner X have, for now, an uncertain significance. Finally, various associations, without significance such as multiple sclerosis, diffuse muscular lesions and the classic spondylotic pseudo-tabes, should be rejected.

  15. Neuromuscular function during knee extension exercise after cold water immersion.

    Science.gov (United States)

    Wakabayashi, Hitoshi; Wijayanto, Titis; Tochihara, Yutaka

    2017-06-23

    Human adaptability to cold environment has been focused on in the physiological anthropology and related research area. Concerning the human acclimatization process in the natural climate, it is necessary to conduct a research assessing comprehensive effect of cold environment and physical activities in cold. This study investigated the effect of cold water immersion on the exercise performance and neuromuscular function during maximal and submaximal isometric knee extension. Nine healthy males participated in this study. They performed maximal and submaximal (20, 40, and 60% maximal load) isometric knee extension pre- and post-immersion in 23, 26, and 34 °C water. The muscle activity of the rectus femoris (RF) and vastus lateralis (VL) was measured using surface electromyography (EMG). The percentages of the maximum voluntary contraction (%MVC) and mean power frequency (MPF) of EMG data were analyzed. The post-immersion maximal force was significantly lower in 23 °C than in 26 and 34 °C conditions (P water temperature conditions at 40 and 60% maximal intensities (P muscle fibers conduction velocity. To compensate for the impairment of each muscle fibers function, more muscle fibers might be recruited to maintain the working load. This might result in the greater amplitude of EMG after the cold immersion.

  16. Neuromuscular Fatigue after Submaximal Intermittent Contractions in Motorcycle Riders.

    Science.gov (United States)

    Torrado, P; Cabib, C; Morales, M; Valls-Sole, J; Marina, M

    2015-11-01

    Highly repetitive submaximal intermittent contractions of the forearm muscles during periods of 30-50 min partially explain why motorcycle races are so demanding for the neuromuscular system. This study investigated the contribution of central and peripheral mechanisms of fatigue on the exerted and contralateral extensor digitorum communis following an intermittent fatigue protocol (IFP) designed for motorcycle riders. 12 riders performed an IFP, which simulates the braking and throttle handle gesture. We examined the time course of recovery of maximal voluntary contraction (MVC), M-wave, motor evoked potential (MEP) to transcranial magnetic stimuli in relaxed and facilitated condition, and the cortical silent period (CSP) at time windows of 1, 3, 5, 10 and 20 min after the IFP. Whereas MVC, M-wave and MEP decreased, CSP lengthened significantly in the fatigued limb after completion of the IFP. Nevertheless, no differences were observed in the contralateral limb. All neurophysiological parameters reverted to baseline values in less than 20 min, while MVC remained lower in the exercised limb. No cross-over effects were observed in the contralateral non-exercised limb. Our results suggest that local factors are those mainly responsible for the incomplete MVC recovery after an intermittent muscle contraction protocol.

  17. Drosophila RSK negatively regulates bouton number at the neuromuscular junction.

    Science.gov (United States)

    Fischer, Matthias; Raabe, Thomas; Heisenberg, Martin; Sendtner, Michael

    2009-03-01

    Ribosomal S6 kinases (RSKs) are growth factor-regulated serine-threonine kinases participating in the RAS-ERK signaling pathway. RSKs have been implicated in memory formation in mammals and flies. To characterize the function of RSK at the synapse level, we investigated the effect of mutations in the rsk gene on the neuromuscular junction (NMJ) in Drosophila larvae. Immunostaining revealed transgenic expressed RSK in presynaptic regions. In mutants with a full deletion or an N-terminal partial deletion of rsk, an increased bouton number was found. Restoring the wild-type rsk function in the null mutant with a genomic rescue construct reverted the synaptic phenotype, and overexpression of the rsk-cDNA in motoneurons reduced bouton numbers. Based on previous observations that RSK interacts with the Drosophila ERK homologue Rolled, genetic epistasis experiments were performed with loss- and gain-of-function mutations in Rolled. These experiments provided evidence that RSK mediates its negative effect on bouton formation at the Drosophila NMJ by inhibition of ERK signaling.

  18. Neuromuscular characteristics and fatigue during 10 km running.

    Science.gov (United States)

    Paavolainen, L; Nummela, A; Rusko, H; Häkkinen, K

    1999-11-01

    This study investigated neuromuscular characteristics and fatigue during 10 km running (10 K) performance in well-trained endurance athletes with different distance running capability. Nine high (HC) and ten low (LC) caliber endurance athletes performed the 10 K on a 200 m indoor track, constant velocity lap (CVL, 4.5 m x s(-1)) 5 times during the course of the 10 K and maximal 20 m speed test before (20 m(b)) and after (20 m(a)) the 10 K. Running velocity (V), ground contact times (CT), ground reaction forces (F) and electromyographic activity (EMG) of the leg muscles (vastus lateralis; VL, biceps femoris; BF, gastrocnemius; GA) were measured during 20 m(b), 20 m(a), and CVLs. The 10 K times differed (pactivity of GA in relation to the IEMG of the total contact phase during the CVLs was higher (prun did not differentiate endurance athletes with different V10K. However, a capability to produce force rapidly throughout the 10 K accompanied with optimal preactivation and contact phase activation seem to be important for 10 km running performance in well trained endurance athletes.

  19. Interleaved neuromuscular electrical stimulation after spinal cord injury.

    Science.gov (United States)

    Bergquist, Austin J; Wiest, Matheus J; Okuma, Yoshino; Collins, David F

    2017-02-28

    Neuromuscular electrical stimulation (NMES) over a muscle belly (mNMES) recruits superficial motor units (MUs) preferentially, whereas NMES over a nerve trunk (nNMES) recruits MUs evenly throughout the muscle. We performed tests to determine whether "interleaving" pulses between the mNMES and nNMES sites (iNMES) reduces the fatigability of contractions for people experiencing paralysis because of chronic spinal cord injury. Plantar flexion torque and soleus electromyography (M-waves) were recorded from 8 participants. A fatigue protocol (75 contractions; 2 s on/2 s off for 5 min) was delivered by iNMES. The results were compared with previously published data collected with mNMES and nNMES in the same 8 participants. Torque declined ∼40% more during mNMES than during nNMES or iNMES. M-waves declined during mNMES but not during nNMES or iNMES. To reduce fatigability of electrically evoked contractions of paralyzed plantar flexors, iNMES is equivalent to nNMES, and both are superior to mNMES. Muscle Nerve, 2017. © 2017 Wiley Periodicals, Inc.

  20. Applications of shape memory alloys for neurology and neuromuscular rehabilitation.

    Science.gov (United States)

    Pittaccio, Simone; Garavaglia, Lorenzo; Ceriotti, Carlo; Passaretti, Francesca

    2015-05-27

    Shape memory alloys (SMAs) are a very promising class of metallic materials that display interesting nonlinear properties, such as pseudoelasticity (PE), shape memory effect (SME) and damping capacity, due to high mechanical hysteresis and internal friction. Our group has applied SMA in the field of neuromuscular rehabilitation, designing some new devices based on the mentioned SMA properties: in particular, a new type of orthosis for spastic limb repositioning, which allows residual voluntary movement of the impaired limb and has no predetermined final target position, but follows and supports muscular elongation in a dynamic and compliant way. Considering patients in the sub-acute phase after a neurological lesion, and possibly bedridden, the paper presents a mobiliser for the ankle joint, which is designed exploiting the SME to provide passive exercise to the paretic lower limb. Two different SMA-based applications in the field of neuroscience are then presented, a guide and a limb mobiliser specially designed to be compatible with diagnostic instrumentations that impose rigid constraints in terms of electromagnetic compatibility and noise distortion. Finally, the paper discusses possible uses of these materials in the treatment of movement disorders, such as dystonia or hyperkinesia, where their dynamic characteristics can be advantageous.

  1. The neuromuscular features of acromegaly: a clinical and pathological study.

    Science.gov (United States)

    Khaleeli, A A; Levy, R D; Edwards, R H; McPhail, G; Mills, K R; Round, J M; Betteridge, D J

    1984-09-01

    A study of the neuromuscular features of acromegaly was performed in six patients. Clinical assessment was supplemented by quadriceps force measurements, plasma creatine kinase (CK) activities, electromyography (EMG) and nerve conduction studies. Muscle mass was measured by urinary creatinine/height indices (CHI) and cross sectional area (CSA) of thighs and calves on computed tomography. Quadriceps force/unit cross sectional area was derived. Needle biopsies of vastus lateralis were studied by histochemical and ultrastructural methods. Mean fibre area (MFA) and fibre type proportions were measured. Most of the subjects studied had muscle pain and proximal muscle weakness confirmed by quadriceps force measurements. This occurred in the absence of muscle wasting, as shown by cross sectional area measurements and normal or raised creatinine/height indices. "Myopathic" features were demonstrated by needle biopsy in half the patients and occasionally by electromyography and raised plasma creatine kinase activity. Abnormalities on needle biopsy included variation in fibre size, type 2 fibre atrophy and large type 1 MFA relative to type 2 MFA. Electronmicroscopy showed the non-specific findings of increased glycogen accumulation, excess lipofuscin pigment and myofilament loss.

  2. Pseudoephedrine and circadian rhythm interaction on neuromuscular performance.

    Science.gov (United States)

    Pallarés, J G; López-Samanes, Á; Fernández-Elías, V E; Aguado-Jiménez, R; Ortega, J F; Gómez, C; Ventura, R; Segura, J; Mora-Rodríguez, R

    2015-12-01

    This study analyzed the effects of pseudoephedrine (PSE) provided at different time of day on neuromuscular performance, side effects, and violation of the current doping cut-off threshold [World Anti-Doping Agency (WADA)]. Nine resistance-trained males carried out bench press and full squat exercises against four incremental loads (25%, 50%, 75%, and 90% one repetition maximum [1RM]), in a randomized, double-blind, cross-over design. Participants ingested either 180 mg of PSE (supra-therapeutic dose) or placebo in the morning (7:00 h; AM(PLAC) and AM(PSE)) and in the afternoon (17:00 h; PM(PLAC) and PM(PSE)). PSE enhanced muscle contraction velocity against 25% and 50% 1RM loads, only when it was ingested in the mornings, and only in the full squat exercise (4.4-8.7%; P < 0.05). PSE ingestion raised urine and plasma PSE concentrations (P < 0.05) regardless of time of day; however, cathine only increased in the urine samples. PSE ingestion resulted in positive tests occurring in 11% of samples, and it rose some adverse side effects such us tachycardia and heart palpitations. Ingestion of a single dose of 180 mg of PSE results in enhanced lower body muscle contraction velocity against low and moderate loads only in the mornings. These mild performance improvements are accompanied by undesirable side effects and an 11% risk of surpassing the doping threshold.

  3. Applications of Shape Memory Alloys for Neurology and Neuromuscular Rehabilitation

    Directory of Open Access Journals (Sweden)

    Simone Pittaccio

    2015-05-01

    Full Text Available Shape memory alloys (SMAs are a very promising class of metallic materials that display interesting nonlinear properties, such as pseudoelasticity (PE, shape memory effect (SME and damping capacity, due to high mechanical hysteresis and internal friction. Our group has applied SMA in the field of neuromuscular rehabilitation, designing some new devices based on the mentioned SMA properties: in particular, a new type of orthosis for spastic limb repositioning, which allows residual voluntary movement of the impaired limb and has no predetermined final target position, but follows and supports muscular elongation in a dynamic and compliant way. Considering patients in the sub-acute phase after a neurological lesion, and possibly bedridden, the paper presents a mobiliser for the ankle joint, which is designed exploiting the SME to provide passive exercise to the paretic lower limb. Two different SMA-based applications in the field of neuroscience are then presented, a guide and a limb mobiliser specially designed to be compatible with diagnostic instrumentations that impose rigid constraints in terms of electromagnetic compatibility and noise distortion. Finally, the paper discusses possible uses of these materials in the treatment of movement disorders, such as dystonia or hyperkinesia, where their dynamic characteristics can be advantageous.

  4. Neuromuscular adjustments of the quadriceps muscle after repeated cycling sprints.

    Directory of Open Access Journals (Sweden)

    Olivier Girard

    Full Text Available PURPOSE: This study investigated the supraspinal processes of fatigue of the quadriceps muscle in response to repeated cycling sprints. METHODS: Twelve active individuals performed 10 × 6-s "all-out" sprints on a cycle ergometer (recovery = 30 s, followed 6 min later by 5 × 6-s sprints (recovery = 30 s. Transcranial magnetic and electrical femoral nerve stimulations during brief (5-s and sustained (30-s isometric contractions of the knee extensors were performed before and 3 min post-exercise. RESULTS: Maximal strength of the knee extensors decreased during brief and sustained contractions (~11% and 9%, respectively; P0.05. While cortical voluntary activation declined (P 40% reduced (P<0.001 following exercise. CONCLUSION: The capacity of the motor cortex to optimally drive the knee extensors following a repeated-sprint test was shown in sustained, but not brief, maximal isometric contractions. Additionally, peripheral factors were largely involved in the exercise-induced impairment in neuromuscular function, while corticospinal excitability was well-preserved.

  5. Some aspects of the neuromuscular system of Ascaris.

    Science.gov (United States)

    del Castillo, J; Rivera, A; Solórzano, S; Serrato, J

    1989-12-01

    1. The structure and physiological properties of the somatic neuromuscular system of the nematode Ascaris lumbricoides var. suum are discussed taking into account early work from this laboratory, the results of other workers, and experiments in progress. 2. Anatomically, the central feature of the somatic musculature is the presence of a specialized muscular, but not contractile, structure: the syncytium or sarcopile, formed by the terminal processes of the muscle cell arms that contact the nerve cord. In this region, they are electrically coupled to one another and form chemical synapses with the nerve fibres. 3. The syncytium serves, primarily, as a nerve-muscle manifold, or device which allows the neural control of the muscle fields with great economy in the amount of nervous tissue, numbers of chemical junctions and quantities of synaptic transmitters. 4. The structure of the syncytium is being studied with the scanning electron microscope. The results reveal the convergence of the arms on discrete sites as they approach the cords, as well as a longitudinal arrangement of the terminal processes as they course over the cords, at least in the posterior region of the animal. 5. The characteristics of the electrical coupling between the muscle cells are being investigated. A pattern has been observed that is dependent on the position of the cell pairs with respect to the longitudinal axis of the animal. 6. A study of signal propagation in the arms has revealed that the morphology of the muscle cells contributes to the extent and preferential direction of propagation.

  6. Noninvasive Respiratory Management of Patients With Neuromuscular Disease.

    Science.gov (United States)

    Bach, John R

    2017-08-01

    This review article describes definitive noninvasive respiratory management of respiratory muscle dysfunction to eliminate need to resort to tracheotomy. In 2010 clinicians from 22 centers in 18 countries reported 1,623 spinal muscular atrophy type 1 (SMA1), Duchenne muscular dystrophy (DMD), and amyotrophic lateral sclerosis users of noninvasive ventilatory support (NVS) of whom 760 required it continuously (CNVS). The CNVS sustained their lives by over 3,000 patient-years without resort to indwelling tracheostomy tubes. These centers have now extubated at least 74 consecutive ventilator unweanable patients with DMD, over 95% of CNVS-dependent patients with SMA1, and hundreds of others with advanced neuromuscular disorders (NMDs) without resort to tracheotomy. Two centers reported a 99% success rate at extubating 258 ventilator unweanable patients without resort to tracheotomy. Patients with myopathic or lower motor neuron disorders can be managed noninvasively by up to CNVS, indefinitely, despite having little or no measurable vital capacity, with the use of physical medicine respiratory muscle aids. Ventilator-dependent patients can be decannulated of their tracheostomy tubes.

  7. Safe neuromuscular electrical stimulator designed for the elderly.

    Science.gov (United States)

    Krenn, Matthias; Haller, Michael; Bijak, Manfred; Unger, Ewald; Hofer, Christian; Kern, Helmut; Mayr, Winfried

    2011-03-01

    A stimulator for neuromuscular electrical stimulation (NMES) was designed, especially suiting the requirements of elderly people with reduced cognitive abilities and diminished fine motor skills. The aging of skeletal muscle is characterized by a progressive decline in muscle mass, force, and condition. Muscle training with NMES reduces the degradation process. The discussed system is intended for evoked muscle training of the anterior and posterior thigh. The core of the stimulator is based on a microcontroller with two modular output stages. The system has two charge-balanced biphasic voltage-controlled stimulation channels. Additionally, the evoked myoelectric signal (M-wave) and the myokinematic signal (surface acceleration) are measured. A central controller unit allows using the stimulator as a stand-alone device. To set up the training sequences and to evaluate the compliance data, a personal computer is connected to the stimulator via a universal serial bus. To help elderly people handle the stimulator by themselves, the user interface is kept very simple. For safety reasons, the electrode impedance is monitored during stimulation. A comprehensive compliance management with included measurements of muscle activity and stimulation intensity enables a scientific use of the stimulator in clinical trials.

  8. Motor unit recruitment when neuromuscular electrical stimulation is applied over a nerve trunk compared with a muscle belly: triceps surae

    National Research Council Canada - National Science Library

    A. J. Bergquist; J. M. Clair; D. F. Collins

    2011-01-01

    Neuromuscular electrical stimulation (NMES) can be delivered over a nerve trunk or muscle belly and can generate contractions by activating motor (peripheral pathway) and sensory (central pathway) axons...

  9. Pilates and Proprioceptive Neuromuscular Facilitation Methods Induce Similar Strength Gains but Different Neuromuscular Adaptations in Elderly Women.

    Science.gov (United States)

    Teixeira de Carvalho, Fabiana; de Andrade Mesquita, Laiana Sepúlveda; Pereira, Rafael; Neto, Osmar Pinto; Amaro Zangaro, Renato

    2017-09-26

    Background/Study Context: The aging process is associated with a decline in muscle mass, strength, and conditioning. Two training methods that may be useful to improve muscle function are Pilates and proprioceptive neuromuscular facilitation (PNF). Thus, the present study aimed to compare the influence of training programs using Pilates and PNF methods with elderly women. Sixty healthy elderly women were randomly divided into three groups: Pilates group, PNF group, and control group. Pilates and PNF groups underwent 1-month training programs with Pilates and PNF methods, respectively. The control group received no intervention during the 1 month. The maximal isometric force levels from knee extension and flexion, as well as the electromyography (EMG) signals from quadriceps and biceps femoris, were recorded before and after the 1-month intervention period. A two-way analysis of variance revealed that the Pilates and PNF methods induced similar strength gains from knee flexors and extensors, but Pilates exhibited greater low-gamma drive (i.e., oscillations in 30-60 Hz) in the EMG power spectrum after the training period. These results support use of both Pilates and PNF methods to enhance lower limb muscle strength in older groups, which is very important for gait, postural stability, and performance of daily life activities.

  10. Functional Connectivity under Optogenetic Control Allows Modeling of Human Neuromuscular Disease.

    Science.gov (United States)

    Steinbeck, Julius A; Jaiswal, Manoj K; Calder, Elizabeth L; Kishinevsky, Sarah; Weishaupt, Andreas; Toyka, Klaus V; Goldstein, Peter A; Studer, Lorenz

    2016-01-07

    Capturing the full potential of human pluripotent stem cell (PSC)-derived neurons in disease modeling and regenerative medicine requires analysis in complex functional systems. Here we establish optogenetic control in human PSC-derived spinal motorneurons and show that co-culture of these cells with human myoblast-derived skeletal muscle builds a functional all-human neuromuscular junction that can be triggered to twitch upon light stimulation. To model neuromuscular disease we incubated these co-cultures with IgG from myasthenia gravis patients and active complement. Myasthenia gravis is an autoimmune disorder that selectively targets neuromuscular junctions. We saw a reversible reduction in the amplitude of muscle contractions, representing a surrogate marker for the characteristic loss of muscle strength seen in this disease. The ability to recapitulate key aspects of disease pathology and its symptomatic treatment suggests that this neuromuscular junction assay has significant potential for modeling of neuromuscular disease and regeneration. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Appropriate dosing of sugammadex to reverse deep rocuronium-induced neuromuscular blockade in morbidly obese patients.

    Science.gov (United States)

    Loupec, T; Frasca, D; Rousseau, N; Faure, J-P; Mimoz, O; Debaene, B

    2016-03-01

    In morbidly obese patients, the speed of reversal of neuromuscular blockade with sugammadex based on ideal body weight is still matter of debate. In this single-center, randomised, double-blinded study, neuromuscular blockade was monitored in 50 patients using acceleromyography at the adductor pollicis. At the end of surgery with deep rocuronium-induced neuromuscular blockade, patients randomly received sugammadex 4 mg.kg(-1) (high dose group), 2 mg.kg(-1) (middle dose group), or 1 mg.kg(-1) (low dose group) of ideal body weight. After administration of the first dose of sugammadex, the mean (SD) recovery time (censored at 600 s) from deep neuromuscular blockade was significantly shorter (p sugammadex administration, were 93%, 77% and 22% for these high, middle and low-dose groups respectively (p sugammadex allows suitable reversal of deep rocuronium-induced neuromuscular blockade. Monitoring remains essential to detect residual curarisation or recurarisation. © 2015 The Association of Anaesthetists of Great Britain and Ireland.

  12. Effects of sugammadex on incidence of postoperative residual neuromuscular blockade: a randomized, controlled study.

    Science.gov (United States)

    Brueckmann, B; Sasaki, N; Grobara, P; Li, M K; Woo, T; de Bie, J; Maktabi, M; Lee, J; Kwo, J; Pino, R; Sabouri, A S; McGovern, F; Staehr-Rye, A K; Eikermann, M

    2015-11-01

    This study aimed to investigate whether reversal of rocuronium-induced neuromuscular blockade with sugammadex reduced the incidence of residual blockade and facilitated operating room discharge readiness. Adult patients undergoing abdominal surgery received rocuronium, followed by randomized allocation to sugammadex (2 or 4 mg kg(-1)) or usual care (neostigmine/glycopyrrolate, dosing per usual care practice) for reversal of neuromuscular blockade. Timing of reversal agent administration was based on the providers' clinical judgement. Primary endpoint was the presence of residual neuromuscular blockade at PACU admission, defined as a train-of-four (TOF) ratio sugammadex patients and 33 out of 76 (43.4%) usual care patients had TOF-Watch SX-assessed residual neuromuscular blockade at PACU admission (odds ratio 0.0, 95% CI [0-0.06], Psugammadex vs usual care (14.7 vs. 18.6 min respectively; P=0.02). After abdominal surgery, sugammadex reversal eliminated residual neuromuscular blockade in the PACU, and shortened the time from start of study medication administration to the time the patient was ready for discharge from the operating room. Clinicaltrials.gov:NCT01479764. © The Author 2015. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  13. A Dutch guideline for the treatment of scoliosis in neuromuscular disorders

    Directory of Open Access Journals (Sweden)

    Titarsolej PJ

    2008-09-01

    Full Text Available Abstract Background Children with neuromuscular disorders with a progressive muscle weakness such as Duchenne Muscular Dystrophy and Spinal Muscular Atrophy frequently develop a progressive scoliosis. A severe scoliosis compromises respiratory function and makes sitting more difficult. Spinal surgery is considered the primary treatment option for correcting severe scoliosis in neuromuscular disorders. Surgery in this population requires a multidisciplinary approach, careful planning, dedicated surgical procedures, and specialized after care. Methods The guideline is based on scientific evidence and expert opinions. A multidisciplinary working group representing experts from all relevant specialties performed the research. A literature search was conducted to collect scientific evidence in answer to specific questions posed by the working group. Literature was classified according to the level of evidence. Results For most aspects of the treatment scientific evidence is scarce and only low level cohort studies were found. Nevertheless, a high degree of consensus was reached about the management of patients with scoliosis in neuromuscular disorders. This was translated into a set of recommendations, which are now officially accepted as a general guideline in the Netherlands. Conclusion In order to optimize the treatment for scoliosis in neuromuscular disorders a Dutch guideline has been composed. This evidence-based, multidisciplinary guideline addresses conservative treatment, the preoperative, perioperative, and postoperative care of scoliosis in neuromuscular disorders.

  14. Neuromuscular scoliosis and pelvic fixation in 2015: Where do we stand?

    Science.gov (United States)

    Anari, Jason B; Spiegel, David A; Baldwin, Keith D

    2015-09-18

    Neuromuscular scoliosis is a challenging problem to treat in a heterogeneous patient population. When the decision is made for surgery the surgeon must select a technique employed to correct the curve and achieve the goals of surgery, namely a straight spine over a level pelvis. Pre-operatively the surgeon must ask if pelvic fixation is worth the extra complications and infection risk it introduces to an already compromised host. Since the advent of posterior spinal fusion the technology used for instrumentation has changed drastically. However, many of the common problems seen with the unit rod decades ago we are still dealing with today with pedicle screw technology. Screw cut out, pseudoarthrosis, non-union, prominent hardware, wound complications, and infection are all possible complications when extending a spinal fusion construct to the pelvis in a neuromuscular scoliosis patient. Additionally, placing pelvic fixation in a neuromuscular patient results in extra blood loss, greater surgical time, more extensive dissection with creation of a deep dead space, and an incision that extends close to the rectum in patients who are commonly incontinent. Balancing the risk of placing pelvic fixation when the benefit, some may argue, is limited in non-ambulating patients is difficult when the literature is so mottled. Despite frequent advancements in technology issues with neuromuscular scoliosis remain the same and in the next 10 years we must do what we can to make safe neuromuscular spine surgery a reality.

  15. Effects of neuromuscular electrostimulation in patients with heart failure admitted to ward

    Directory of Open Access Journals (Sweden)

    de Araújo Carlos José Soares

    2012-11-01

    Full Text Available Abstract Background Neuromuscular electrostimulation has become a promising issue in cardiovascular rehabilitation. However there are few articles published in the literature regarding neuromuscular electrostimulation in patients with heart failure during hospital stay. Methods This is a randomized controlled pilot trial that aimed to investigate the effect of neuromuscular electrostimulation in the walked distance by the six-minute walking test in 30 patients admitted to ward for heart failure treatment in a tertiary cardiology hospital. Patients in the intervention group performed a conventional rehabilitation and neuromuscular electrostimulation. Patients underwent 60 minutes of electrostimulation (wave frequency was 20 Hz, pulse duration of 20 us two times a day for consecutive days until hospital discharge. Results The walked distance in the six-minute walking test improved 75% in the electrostimulation group (from 379.7 ± 43.5 to 372.9 ± 46.9 meters to controls and from 372.9 ± 62.4 to 500 ± 68 meters to electrostimulation, p Conclusion The neuromuscular electrostimulation group showed greater improvement in the walked distance in the six-minute walking test in patients admitted to ward for compensation of heart failure.

  16. RANDOMIZED CLINICAL TRIAL TO COMPARE THE INCIDENCE OF RESIDUAL NEUROMUSCULAR BLOCK FOLLOWING PANCURONIUM AND ATRACURIUM USING TRAIN OF FOUR RATIO

    Directory of Open Access Journals (Sweden)

    Nagesha

    2014-04-01

    Full Text Available BACKGROUND: Several clinical studies have reported that significant number of patients receiving non depolarizing muscle relaxants during general anesthesia show postoperative residual neuromuscular block when assessed by neuromuscular monitor in the recovery room. The degree of residual neuromuscular block produced by non-depolarizing muscle relaxants can be evaluated by clinical tests as well as by neuromuscular monitoring y neuromuscular monitor in the recovery room. A randomized double blind clinical trial to determine and compare the incidence of postoperative residual neuromuscular block in patients receiving pancuronium and atracurium applying Train of Four ratio using Train of Four- Guard neuromuscular monitor. AIMS AND OBJECTIVES: To compare the incidence of postoperative residual neuromuscular block following pancuronium and atracurium using Train of Four Ratio in the recovery room. MATERIALS AND METHODS: Comparative randomized study done using 100 patients of age between 15-60 years belonging to either sex, ASA grade 1 and 2 with GROUP ‘P’ – Pancuronium was employed as the muscle relaxant, GROUP ‘A’ – Atracurium was employed as the muscle relaxant. Statistical analysis done using student “t” test. RESULTS: The mean duration required to attain Train of Four Ratio of 0.80 in patients with initial Train of four ratio <0.80 in group ‘P’ was 9.65±5.4413 min and in group ‘A’ was 2.8± 1.4832 min. CONCLUSION: 1. Our study concludes that the incidence of residual neuromuscular block in patients receiving pancuronium and atracurium were 40% and 10% respectively. Thus residual neuromuscular block can be a significant problem in recovery room, during the postoperative period. 2. The use of intermediate acting non depolarizing muscle relaxant like atracurium lowers the incidence of residual neuromuscular block but does not eliminate it.

  17. Hybrid microelectronic technology

    Science.gov (United States)

    Moran, P.

    Various areas of hybrid microelectronic technology are discussed. The topics addressed include: basic thick film processing, thick film pastes and substrates, add-on components and attachment methods, thin film processing, and design of thick film hybrid circuits. Also considered are: packaging hybrid circuits, automating the production of hybrid circuits, application of hybrid techniques, customer's view of hybrid technology, and quality control and assurance in hybrid circuit production.

  18. Hearing Assistive Technology

    Science.gov (United States)

    ... for the Public / Hearing and Balance Hearing Assistive Technology Hearing Assistive Technology: FM Systems | Infrared Systems | Induction ... Assistive Technology Systems Solutions What are hearing assistive technology systems (HATS)? Hearing assistive technology systems (HATS) are ...

  19. A murine model of muscle training by neuromuscular electrical stimulation.

    Science.gov (United States)

    Ambrosio, Fabrisia; Fitzgerald, G Kelley; Ferrari, Ricardo; Distefano, Giovanna; Carvell, George

    2012-05-09

    Neuromuscular electrical stimulation (NMES) is a common clinical modality that is widely used to restore (1), maintain (2) or enhance (3-5) muscle functional capacity. Transcutaneous surface stimulation of skeletal muscle involves a current flow between a cathode and an anode, thereby inducing excitement of the motor unit and the surrounding muscle fibers. NMES is an attractive modality to evaluate skeletal muscle adaptive responses for several reasons. First, it provides a reproducible experimental model in which physiological adaptations, such as myofiber hypertophy and muscle strengthening (6), angiogenesis (7-9), growth factor secretion (9-11), and muscle precursor cell activation (12) are well documented. Such physiological responses may be carefully titrated using different parameters of stimulation (for Cochrane review, see (13)). In addition, NMES recruits motor units non-selectively, and in a spatially fixed and temporally synchronous manner (14), offering the advantage of exerting a treatment effect on all fibers, regardless of fiber type. Although there are specified contraindications to NMES in clinical populations, including peripheral venous disorders or malignancy, for example, NMES is safe and feasible, even for those who are ill and/or bedridden and for populations in which rigorous exercise may be challenging. Here, we demonstrate the protocol for adapting commercially available electrodes and performing a NMES protocol using a murine model. This animal model has the advantage of utilizing a clinically available device and providing instant feedback regarding positioning of the electrode to elicit the desired muscle contractile effect. For the purpose of this manuscript, we will describe the protocol for muscle stimulation of the anterior compartment muscles of a mouse hindlimb.

  20. Effects of hindlimb unloading on neuromuscular development of neonatal rats

    Science.gov (United States)

    Huckstorf, B. L.; Slocum, G. R.; Bain, J. L.; Reiser, P. M.; Sedlak, F. R.; Wong-Riley, M. T.; Riley, D. A.

    2000-01-01

    We hypothesized that hindlimb suspension unloading of 8-day-old neonatal rats would disrupt the normal development of muscle fiber types and the motor innervation of the antigravity (weightbearing) soleus muscles but not extensor digitorum longus (EDL) muscles. Five rats were suspended 4.5 h and returned 1.5 h to the dam for nursing on a 24 h cycle for 9 days. To control for isolation from the dam, the remaining five littermates were removed on the same schedule but not suspended. Another litter of 10 rats housed in the same room provided a vivarium control. Fibers were typed by myofibrillar ATPase histochemistry and immunostaining for embryonic, slow, fast IIA and fast IIB isomyosins. The percentage of multiple innervation and the complexity of singly-innervated motor terminal endings were assessed in silver/cholinesterase stained sections. Unique to the soleus, unloading accelerated production of fast IIA myosin, delayed expression of slow myosin and retarded increases in standardized muscle weight and fiber size. Loss of multiple innervation was not delayed. However, fewer than normal motor nerve endings achieved complexity. Suspended rats continued unloaded hindlimb movements. These findings suggest that motor neurons resolve multiple innervation through nerve impulse activity, whereas the postsynaptic element (muscle fiber) controls endplate size, which regulates motor terminal arborization. Unexpectedly, in the EDL of unloaded rats, transition from embryonic to fast myosin expression was retarded. Suspension-related foot drop, which stretches and chronically loads EDL, may have prevented fast fiber differentiation. These results demonstrate that neuromuscular development of both weightbearing and non-weightbearing muscles in rats is dependent upon and modulated by hindlimb loading.

  1. Neuromuscular consequences of an extreme mountain ultra-marathon.

    Directory of Open Access Journals (Sweden)

    Guillaume Y Millet

    Full Text Available We investigated the physiological consequences of one of the most extreme exercises realized by humans in race conditions: a 166-km mountain ultra-marathon (MUM with 9500 m of positive and negative elevation change. For this purpose, (i the fatigue induced by the MUM and (ii the recovery processes over two weeks were assessed. Evaluation of neuromuscular function (NMF and blood markers of muscle damage and inflammation were performed before and immediately following (n = 22, and 2, 5, 9 and 16 days after the MUM (n = 11 in experienced ultra-marathon runners. Large maximal voluntary contraction decreases occurred after MUM (-35% [95% CI: -28 to -42%] and -39% [95% CI: -32 to -46%] for KE and PF, respectively, with alteration of maximal voluntary activation, mainly for KE (-19% [95% CI: -7 to -32%]. Significant modifications in markers of muscle damage and inflammation were observed after the MUM as suggested by the large changes in creatine kinase (from 144 ± 94 to 13,633 ± 12,626 UI L(-1, myoglobin (from 32 ± 22 to 1,432 ± 1,209 µg L(-1, and C-Reactive Protein (from <2.0 to 37.7 ± 26.5 mg L(-1. Moderate to large reductions in maximal compound muscle action potential amplitude, high-frequency doublet force, and low frequency fatigue (index of excitation-contraction coupling alteration were also observed for both muscle groups. Sixteen days after MUM, NMF had returned to initial values, with most of the recovery process occurring within 9 days of the race. These findings suggest that the large alterations in NMF after an ultra-marathon race are multi-factorial, including failure of excitation-contraction coupling, which has never been described after prolonged running. It is also concluded that as early as two weeks after such an extreme running exercise, maximal force capacities have returned to baseline.

  2. Neuromuscular fatigue following isometric contractions with similar torque time integral.

    Science.gov (United States)

    Rozand, V; Cattagni, T; Theurel, J; Martin, A; Lepers, R

    2015-01-01

    Torque time integral (TTI) is the combination of intensity and duration of a contraction. The aim of this study was to compare neuromuscular alterations following different isometric sub-maximal contractions of the knee extensor muscles but with similar TTI. Sixteen participants performed 3 sustained contractions at different intensities (25%, 50%, and 75% of Maximal Voluntary Contraction (MVC) torque) with different durations (68.5±33.4 s, 35.1±16.8 s and 24.8±12.9 s, respectively) but similar TTI value. MVC torque, maximal voluntary activation level (VAL), M-wave characteristics and potentiated doublet amplitude were assessed before and immediately after the sustained contractions. EMG activity of the vastus lateralis (VL) and -rectus femoris (RF) muscles was recorded during the sustained contractions. MVC torque reduction was similar in the 3 conditions after the exercise (-23.4±2.7%). VAL decreased significantly in a similar extent (-3.1±1.3%) after the 3 sustained contractions. Potentiated doublet amplitude was similarly reduced in the 3 conditions (-19.7±1.5%), but VL and RF M-wave amplitudes remained unchanged. EMG activity of VL and RF muscles increased in the same extent during the 3 contractions (VL: 54.5±40.4%; RF: 53.1±48.7%). These results suggest that central and peripheral alterations accounting for muscle fatigue are similar following isometric contractions with similar TTI. TTI should be considered in the exploration of muscle fatigue during sustained isometric contractions.

  3. Interface-assisted molecular spintronics

    Energy Technology Data Exchange (ETDEWEB)

    Raman, Karthik V. [Solid State and Structural Chemistry Unit, Indian Institute of Science, Bangalore 560012 (India)

    2014-09-15

    Molecular spintronics, a field that utilizes the spin state of organic molecules to develop magneto-electronic devices, has shown an enormous scientific activity for more than a decade. But, in the last couple of years, new insights in understanding the fundamental phenomena of molecular interaction on magnetic surfaces, forming a hybrid interface, are presenting a new pathway for developing the subfield of interface-assisted molecular spintronics. The recent exploration of such hybrid interfaces involving carbon based aromatic molecules shows a significant excitement and promise over the previously studied single molecular magnets. In the above new scenario, hybridization of the molecular orbitals with the spin-polarized bands of the surface creates new interface states with unique electronic and magnetic character. This study opens up a molecular-genome initiative in designing new handles to functionalize the spin dependent electronic properties of the hybrid interface to construct spin-functional tailor-made devices. Through this article, we review this subject by presenting a fundamental understanding of the interface spin-chemistry and spin-physics by taking support of advanced computational and spectroscopy tools to investigate molecular spin responses with demonstration of new interface phenomena. Spin-polarized scanning tunneling spectroscopy is favorably considered to be an important tool to investigate these hybrid interfaces with intra-molecular spatial resolution. Finally, by addressing some of the recent findings, we propose novel device schemes towards building interface tailored molecular spintronic devices for applications in sensor, memory, and quantum computing.

  4. Reversal of rocuronium-induced neuromuscular block by the selective relaxant binding agent sugammadex: a dose-finding and safety study

    DEFF Research Database (Denmark)

    Sorgenfrei, Iben F; Norrild, Kathrine; Larsen, Per Bo;

    2006-01-01

    Sugammadex (Org 25969) forms a complex with steroidal neuromuscular blocking agents, thereby reversing neuromuscular block. This study investigated the dose-response relation, safety, and pharmacokinetics of sugammadex to reverse rocuronium-induced block....

  5. Reversal of rocuronium-induced (1.2 mg/kg) profound neuromuscular block by sugammadex - A multicenter, dosefinding and safety study

    NARCIS (Netherlands)

    de Boer, Hans D.; Driessen, Jacques J.; Marcus, Marco A. E.; Kerkkamp, Hans; Heeringa, Marten; Klimek, Markus

    Background: Reversal of rocuronium-induced neuromuscular blockade can be accomplished by chemical encapsulation of rocuronium by sugammadex, a modified gamma-cyclodextrin derivative. This study investigated the efficacy and safety of sugammadex in reversing rocuronium-induced profound neuromuscular

  6. Reversal of rocuronium-induced (1.2 mg/kg) profound neuromuscular block by sugammadex: a multicenter, dose-finding and safety study.

    NARCIS (Netherlands)

    Boer, H.D. de; Driessen, J.J.; Marcus, M.A.; Kerkkamp, H.E.M.; Heeringa, M.; Klimek, M.

    2007-01-01

    BACKGROUND: Reversal of rocuronium-induced neuromuscular blockade can be accomplished by chemical encapsulation of rocuronium by sugammadex, a modified gamma-cyclodextrin derivative. This study investigated the efficacy and safety of sugammadex in reversing rocuronium-induced profound neuromuscular

  7. Neuromuscular scoliosis as a sequelae of Guillain-Barré syndrome.

    Science.gov (United States)

    Edwards, Max R; Panteliadis, Pavlos; Lucas, Jonathan D

    2010-01-01

    The neuromuscular sequaelae of Guillain-Barré syndrome are well documented in the literature. Persistent distal muscular weakness and loss of peripheral limb reflexes are common in those affected. We report a case of a 14-year-old boy who developed the Miller-Fisher variant of Guillain-Barré syndrome at the age of 8 years. Six years after the acute episode, he had persistent lower limb areflexia and mild weakness. He had also developed a neuromuscular scoliosis. The scoliosis was successfully treated with posterior instrumentation and fusion surgery. Neuromuscular scoliosis is rare following Guillain-Barré syndrome, with no previous reports associated with the Miller-Fisher variant that we are aware of. When evaluating patients post Guillain-Barré syndrome, structural spinal examination is essential to identify rare deformity that may need surgical correction.

  8. Naturally occurring plant polyphenols as potential therapies for inherited neuromuscular diseases.

    Science.gov (United States)

    Fuller, Heidi R; Humphrey, Emma L; Morris, Glenn E

    2013-11-01

    There are several lines of laboratory-based evidence emerging to suggest that purified polyphenol compounds such as resveratrol, found naturally in red grapes, epigallocatechin galate from green tea and curcumin from turmeric, might be useful for the treatment of various inherited neuromuscular diseases, including spinal muscular atrophy, Duchenne muscular dystrophy and Charcot-Marie-Tooth disease. Here, we critically examine the scientific evidence related to the known molecular effects that these polyphenols have on different models of inherited neuromuscular disease, with particular attention to problems with the validity of in vitro evidence. We also present proteomic evidence that polyphenols have in vitro effects on cells related to metal ion chelation in cell-culture media. Although their precise mechanisms of action remain somewhat elusive, polyphenols could be an attractive approach to therapy for inherited neuromuscular disease, especially since they may be safer to use on young children, compared with some of the other drug candidates.

  9. Local identifiability and sensitivity analysis of neuromuscular blockade and depth of hypnosis models.

    Science.gov (United States)

    Silva, M M; Lemos, J M; Coito, A; Costa, B A; Wigren, T; Mendonça, T

    2014-01-01

    This paper addresses the local identifiability and sensitivity properties of two classes of Wiener models for the neuromuscular blockade and depth of hypnosis, when drug dose profiles like the ones commonly administered in the clinical practice are used as model inputs. The local parameter identifiability was assessed based on the singular value decomposition of the normalized sensitivity matrix. For the given input signal excitation, the results show an over-parameterization of the standard pharmacokinetic/pharmacodynamic models. The same identifiability assessment was performed on recently proposed minimally parameterized parsimonious models for both the neuromuscular blockade and the depth of hypnosis. The results show that the majority of the model parameters are identifiable from the available input-output data. This indicates that any identification strategy based on the minimally parameterized parsimonious Wiener models for the neuromuscular blockade and for the depth of hypnosis is likely to be more successful than if standard models are used.

  10. Effect of exercise therapy on neuromuscular activity and knee strength in female adolescents with patellofemoral pain

    DEFF Research Database (Denmark)

    Rathleff, Michael S.; Samani, Afshin; Olesen, Jens L.

    2016-01-01

    BACKGROUND: Female adolescents with patellofemoral pain are characterized by altered neuromuscular knee control and reduced maximal quadriceps torque. The purpose of this study is to investigate whether exercise therapy and patient education are associated with larger improvements in neuromuscular...... knee control and maximal quadriceps torque compared with patient education alone. METHODS: This is an ancillary analysis of a cluster randomized controlled trial investigating the effect of patient education and exercise therapy on self-reported recovery in 121 adolescents with patellofemoral pain...... flexion/extension kinematics and maximal quadriceps torque. FINDINGS: There was an 8-15% greater decrease in the complexity of surface electromyography suggesting an improvement in neuromuscular knee control among those randomized to exercise therapy (0.08

  11. Assessment of bone density in patients with scoliosis neuromuscular secondary to cerebral palsy

    Directory of Open Access Journals (Sweden)

    Charbel Jacob Júnior

    2014-09-01

    Full Text Available OBJECTIVE: To evaluate bone mineral density in patients with neuromuscular scoliosis secondary to spastic quadriplegic cerebral palsy. METHODS: A prospective descriptive study in which, in addition to bone densitometry, the anthropometric data of the patients were assessed. As inclusion criterion we adopted patients with spastic quadriplegic cerebral palsy, wheelchair users, aged between 10 and 20 years and with neuromuscular scoliosis. RESULTS: We evaluated 31 patients, 20 female, whose average age was 14.2 years. The mean bone density was -3.2 standard deviation (Z-score, with mean biceps circumference of 19.4 cm, calf circumference 18.6 cm and BMI of 13.6 kg/m². CONCLUSION: There is a high incidence of osteoporosis in patients with neuromuscular scoliosis secondary to spastic quadriplegic cerebral palsy.

  12. Interpretation of electroneuromyographic studies in diseases of neuromuscular junction and myopathies

    Directory of Open Access Journals (Sweden)

    Mansukhani Khushnuma

    2008-01-01

    Full Text Available Electroneuromyography (ENMG also called electrodiagnosis or at times simply (and erroneously electromyography (EMG, has been used for the diagnosis of neuromuscular and muscle diseases. It consists of tests done serially and assessed collectively, to arrive at a diagnosis of neuromuscular weakness. The test should be treated as an extension of the clinical examination and not a replacement. When done adequately ENMG is the only test which gives information about the function of the peripheral nervous system and hence co-relates well with the clinical signs. This article reviews the role of ENMG in the evaluation of neuromuscular and muscle disease. We hope this will meet the requirements of both practicing neurologists and dedicated electromyographers.

  13. Update on the approach of respiratory therapy in patients with neuromuscular diseases

    Directory of Open Access Journals (Sweden)

    Priscilla Barreto Paula

    2010-03-01

    Full Text Available Objective: To assess the role of physiotherapy in approaching neuromuscular disease (NMD, with emphasis on preventive and therapeutic aspects of respiratory therapy. Methods: A nonsystematic literature review covering the past twenty years, using the databases MEDLINE and LILACS through the following descriptors: neuromuscular diseases, physical therapy, vital capacity and respiratory failure. Results: The studies reviewed show the need to establish a routine periodic evaluation of respiratory function in order to introduce physical therapy measures relevant to each stage of the disease. The monitoring should include pulmonary function tests and specific techniques of chest physiotherapy, in order to avoid complications such as respiratory failure. Conclusion: The introduction of regular monitoring and preventive physiotherapy measures have helped to increase survival and improve quality of life of patients with neuromuscular diseases.

  14. Neuromuscular factors related to success in Olympic wrestling FACTORES NEUROMUSCULARES RELACIONADOS CON EL RENDIMIENTO EN LUCHA OLÍMPICA

    Directory of Open Access Journals (Sweden)

    Francisco Borrego

    2011-03-01

    Full Text Available AbstractThis study was undertaken to determine the relationship between maximum dynamic and isometric strength and success in male and female Olympic wrestling. Thirty-five female and thirty-seven male wrestlers were assigned into 4 groups according to their gender and competitive level: men elite (♂ ET, n = 18 and amateur (AT ♂, n = 19 and female elite (♀ ET n = 13 and amateur (AT ♀, n = 22. All subjects underwent assessments of body composition, countermovement jump, maximum dynamic strength test in full squat and bench press exercises and maximum isometric strength test of grip and hip extension. All the neuromuscular markers studied showed significantly higher values in the two elite groups compared to their respective amateur groups results, except the jump height between ♀ET y ♀AT, where no significant differences were detected. The present results suggest that the higher maximum isometric and dynamic strength values, explained in part by the differences in lean mass, will give elite wrestlers a clear advantage during the most frequently used techniques in Olympic wrestling. Key  Words: bench press; squat; maximum dynamic strength; maximum isometric strength; combat.ResumenEste estudio se llevó a cabo para determinar la relación entre la fuerza dinámica e isométrica máxima con el éxito en Lucha Olímpica masculina y femenina. Treinta cinco mujeres y treinta y siete varones luchadores fueron divididos en 4 grupos de acuerdo a su género y nivel competitivo: hombres élite (♂ET, n = 18 y amateur (♂AT, n = 19 y mujeres élite (♀ET, n = 13 y amateur (♀AT, n = 22. Todos los sujetos fueron sometidos a valoraciones de la composición corporal, salto con contramovimiento, test de fuerza dinámica máxima en los ejercicios de sentadilla completa y press banca así como test de fuerza isométrica máxima de agarre y de extensión de cadera. Todas las variables neuromusculares estudiadas presentaron valores

  15. Partial neuromuscular blockade in humans enhances muscle blood flow during exercise independently of muscle oxygen uptake and acetylcholine receptor blockade

    DEFF Research Database (Denmark)

    Hellsten, Ylva; Krustrup, Peter; Iaia, F Marcello

    2009-01-01

    conductance during exercise, events that are not associated with either acetylcholine or an increased oxygen demand. The results do not support an essential role for acetylcholine, released form the neuromuscular junction, in exercise hyperaemia or for the enhanced blood flow during neuromuscular blockade...

  16. The effects of neuromuscular training on knee joint motor control during sidecutting in female elite soccer and handball players

    DEFF Research Database (Denmark)

    Zebis, Mette K; Bencke, Jesper; Andersen, Lars

    2008-01-01

    and knee, and ground reaction forces were recorded during a sidecutting maneuver. Neuromuscular activity in the prelanding phase was obtained 10 and 50 ms before foot strike on a force plate and at 10 and 50 ms after foot strike on a force plate. RESULTS: Neuromuscular training markedly increased before...

  17. Reversal of rocuronium-induced neuromuscular block by the selective relaxant binding agent sugammadex: a dose-finding and safety study

    DEFF Research Database (Denmark)

    Sorgenfrei, Iben F; Norrild, Kathrine; Larsen, Per Bo

    2006-01-01

    Sugammadex (Org 25969) forms a complex with steroidal neuromuscular blocking agents, thereby reversing neuromuscular block. This study investigated the dose-response relation, safety, and pharmacokinetics of sugammadex to reverse rocuronium-induced block.......Sugammadex (Org 25969) forms a complex with steroidal neuromuscular blocking agents, thereby reversing neuromuscular block. This study investigated the dose-response relation, safety, and pharmacokinetics of sugammadex to reverse rocuronium-induced block....

  18. Teaching Assistants.

    Science.gov (United States)

    Feinman, Jay M.

    1991-01-01

    A discussion of teaching assistants (TAs) in the law school looks at the TA's cognitive and affective roles and effective ways to use TAs to reinforce usual forms of learning in the large class; introduce a broadened range of materials, skills, and learning methods; and transform the large class experience. (MSE)

  19. Assistive Devices

    Science.gov (United States)

    ... a number of assistive devices. These are tools, products or types of equipment that help you perform tasks and activities. They may help you move around, see, communicate, eat, or get dressed. Some are high-tech tools, such as computers. Others are much simpler, ...

  20. The role of neuromuscular changes in aging and knee osteoarthritis on dynamic postural control.

    Science.gov (United States)

    Takacs, Judit; Carpenter, Mark G; Garland, S Jayne; Hunt, Michael A

    2013-04-01

    Knee osteoarthritis (OA) is a chronic joint condition, with 30% of those over the age of 75 exhibiting severe radiographic disease. Nearly 50% of those with knee OA have experienced a fall in the past year. Falls are a considerable public health concern, with a high risk of serious injury and a significant socioeconomic impact. The ability to defend against a fall relies on adequate dynamic postural control, and alterations in dynamic postural control are seen with normal aging. Neuromuscular changes associated with aging may be responsible for some of these alterations in dynamic postural control. Even greater neuromuscular deficits, which may impact dynamic postural control and the ability to defend against a fall, are seen in people with knee OA. There is little evidence to date on how knee OA affects the ability to respond to and defend against falls and the neuromuscular changes that contribute to balance deficits. As a result, this review will: summarize the key characteristics of postural responses to an external perturbation, highlight the changes in dynamic postural control seen with normal aging, review the neuromuscular changes associated with aging that have known and possible effects on dynamic postural control, and summarize the neuromuscular changes and balance problems in knee OA. Future research to better understand the role of neuromuscular changes in knee OA and their effect on dynamic postural control will be suggested. Such an understanding is critical to the successful creation and implementation of fall prevention and treatment programs, in order to reduce the excessive risk of falling in knee OA.

  1. Effect of a 6-week dynamic neuromuscular training programme on ankle joint function: A Case report

    LENUS (Irish Health Repository)

    O'Driscoll, Jeremiah

    2011-06-09

    Abstract Background Ankle joint sprain and the subsequent development of chronic ankle instability (CAI) are commonly encountered by clinicians involved in the treatment and rehabilitation of musculoskeletal injuries. It has recently been advocated that ankle joint post-sprain rehabilitation protocols should incorporate dynamic neuromuscular training to enhance ankle joint sensorimotor capabilities. To date no studies have reported on the effects of dynamic neuromuscular training on ankle joint positioning during landing from a jump, which has been reported as one of the primary injury mechanisms for ankle joint sprain. This case report details the effects of a 6-week dynamic neuromuscular training programme on ankle joint function in an athlete with CAI. Methods The athlete took part in a progressive 6-week dynamic neuromuscular training programme which incorporated postural stability, strengthening, plyometric, and speed\\/agility drills. The outcome measures chosen to assess for interventional efficacy were: 1 Cumberland Ankle Instability Tool (CAIT) scores, 2 Star Excursion Balance Test (SEBT) reach distances, 3 ankle joint plantar flexion during drop landing and drop vertical jumping, and 4 ground reaction forces (GRFs) during walking. Results CAIT and SEBT scores improved following participation in the programme. The angle of ankle joint plantar flexion decreased at the point of initial contact during the drop landing and drop vertical jumping tasks, indicating that the ankle joint was in a less vulnerable position upon landing following participation in the programme. Furthermore, GRFs were reduced whilst walking post-intervention. Conclusions The 6-week dynamic neuromuscular training programme improved parameters of ankle joint sensorimotor control in an athlete with CAI. Further research is now required in a larger cohort of subjects to determine the effects of neuromuscular training on ankle joint injury risk factors.

  2. Effect of a 6-week dynamic neuromuscular training programme on ankle joint function: A Case report

    Directory of Open Access Journals (Sweden)

    O'Driscoll Jeremiah

    2011-06-01

    Full Text Available Abstract Background Ankle joint sprain and the subsequent development of chronic ankle instability (CAI are commonly encountered by clinicians involved in the treatment and rehabilitation of musculoskeletal injuries. It has recently been advocated that ankle joint post-sprain rehabilitation protocols should incorporate dynamic neuromuscular training to enhance ankle joint sensorimotor capabilities. To date no studies have reported on the effects of dynamic neuromuscular training on ankle joint positioning during landing from a jump, which has been reported as one of the primary injury mechanisms for ankle joint sprain. This case report details the effects of a 6-week dynamic neuromuscular training programme on ankle joint function in an athlete with CAI. Methods The athlete took part in a progressive 6-week dynamic neuromuscular training programme which incorporated postural stability, strengthening, plyometric, and speed/agility drills. The outcome measures chosen to assess for interventional efficacy were: 1 Cumberland Ankle Instability Tool (CAIT scores, 2 Star Excursion Balance Test (SEBT reach distances, 3 ankle joint plantar flexion during drop landing and drop vertical jumping, and 4 ground reaction forces (GRFs during walking. Results CAIT and SEBT scores improved following participation in the programme. The angle of ankle joint plantar flexion decreased at the point of initial contact during the drop landing and drop vertical jumping tasks, indicating that the ankle joint was in a less vulnerable position upon landing following participation in the programme. Furthermore, GRFs were reduced whilst walking post-intervention. Conclusions The 6-week dynamic neuromuscular training programme improved parameters of ankle joint sensorimotor control in an athlete with CAI. Further research is now required in a larger cohort of subjects to determine the effects of neuromuscular training on ankle joint injury risk factors.

  3. Hybrid Gear

    Science.gov (United States)

    Handschuh, Robert F. (Inventor); Roberts, Gary D. (Inventor)

    2016-01-01

    A hybrid gear consisting of metallic outer rim with gear teeth and metallic hub in combination with a composite lay up between the shaft interface (hub) and gear tooth rim is described. The composite lay-up lightens the gear member while having similar torque carrying capability and it attenuates the impact loading driven noise/vibration that is typical in gear systems. The gear has the same operational capability with respect to shaft speed, torque, and temperature as an all-metallic gear as used in aerospace gear design.

  4. Hybrid Qualifications

    DEFF Research Database (Denmark)

    has turned out as a major focus of European education and training policies and certainly is a crucial principle underlying the European Qualifications Framework (EQF). In this context, «hybrid qualifications» (HQ) may be seen as an interesting approach to tackle these challenges as they serve «two...... masters», i.e. by producing skills for the labour market and enabling individuals to progress more or less directly to higher education. The specific focus of this book is placed on conditions, structures and processes which help to combine VET with qualifications leading into higher education...

  5. Ação neuro-muscular do veneno crotálico: dados preliminares

    OpenAIRE

    Silva,Maria Dorvalina; Luiz Antônio L. Resende; Ueda,Anete Kimuni; Barraviera, Benedito [UNESP; Mendes, R P; Montenegro, Mário Rubens G. [UNESP

    1996-01-01

    Estudamos 6 pacientes, 2 cães e um coelho com intoxicação crotálica. Avaliamos a condução nervosa periférica sensitiva e motora, a transmissão neuromuscular e eletromiografias. As biópsias de músculo foram processadas por histoquímica. Os 6 pacientes apresentaram mononeuropatia sensitiva no nervo periférico adjacente ao local da inoculação do veneno e encontramos evidências histoquímicas de miopatia mitocondrial. Os defeitos da transmissão neuromuscular foram mínimos. A maioria dos autores ad...

  6. Postoperative effects of neuromuscular exercise prior to hip or knee arthroplasty

    DEFF Research Database (Denmark)

    Villadsen, Allan; Overgaard, Søren; Holsgaard-Larsen, Anders

    2014-01-01

    OBJECTIVE: To investigate the postoperative efficacy of a supervised programme of neuromuscular exercise prior to hip or knee arthroplasty. METHODS: In this assessor-blinded randomised controlled trial, we included 165 patients scheduled for hip or knee arthroplasty due to severe osteoarthritis (OA......). An 8-week preoperative neuromuscular supervised exercise programme was delivered twice a week for 1 h as adjunct treatment to the standard arthroplasty procedure and compared with the standard arthroplasty procedure alone. The primary outcome was self-reported physical function measured...

  7. Efectividad del vendaje neuromuscular en pacientes con retropié pronado

    OpenAIRE

    Bersano, Federico

    2012-01-01

    Por medio de una evaluación funcional del retropié, recolectaremos datos sobre su estado desde el punto de vista de la semiología clínica, de la osteocinemática, la artrocinemática y la miocinematica. A partir de aquí se procederá a realizar la aplicación de un Vendaje Neuromuscular para analizar el beneficio de la técnica de corrección articular. Objetivos: Determinar los efectos de la aplicación del vendaje neuromuscular en pacientes con retropié pronado. Sujetos de estudio: Pacientes...

  8. Propiocepción y control neuromuscular en el fútblo infantil

    OpenAIRE

    Zarza, Cristían

    2014-01-01

    En el fútbol profesional la escasa utilización de la pierna no hábil hace que muchas situaciones de juego no se resuelvan eficazmente, además de predisponer a la aparición de lesiones. El presente estudio se concentró en determinar la influencia del entrenamiento propioceptivo y del control neuromuscular en las cualidades físicas y técnicas del miembro no hábil. Objetivo: Indagar el nivel propioceptivo y de control neuromuscular del miembro inferior no hábil en chicos que re...

  9. Acceleromyography and mechanomyography for establishing potency of neuromuscular blocking agents: a randomized-controlled trial

    DEFF Research Database (Denmark)

    Claudius, C; Viby-Mogensen, J; Skovgaard, Lene Theil

    2009-01-01

    and opioid. Neuromuscular blockade was induced with rocuronium 100, 150, 200 or 250 microg/kg. Neuromuscular monitoring was performed with AMG (TOF-Watch SX) with pre-load (Hand Adapter) at one arm and MMG (modified TOF-Watch SX) on the other, using 0.1 Hz single twitch stimulation. Dose......) for this purpose. The aim of this study was to compare AMG and MMG for establishing dose-response relationship and potency, using rocuronium as an example. METHODS: We included 40 adult patients in this randomized-controlled single-dose response study. Anaesthesia was induced and maintained with propofol...

  10. Sugammadex to reverse neuromuscular blockade and provide optimal conditions for motor-evoked potential monitoring

    Directory of Open Access Journals (Sweden)

    Mehdi Trifa

    2017-01-01

    Full Text Available Sugammadex is a novel pharmacologic agent, which reverses neuromuscular blockade (NMB via a mechanism that differs completely from acetylcholinesterase inhibitors. By encapsulating rocuronium, sugammadex can provide recovery of neuromuscular function even when there is a profound degree of NMB. We report anecdotal experience with the use of sugammadex to reverse NMB to facilitate intraoperative neurophysiological monitoring (motor evoked potentials in an adolescent with scoliosis during posterior spinal fusion. Its potential application in this unique clinical scenario is discussed, and potential dosing schemes are reviewed.

  11. Efectividad del vendaje neuromuscular en pacientes con retropié pronado

    OpenAIRE

    Bersano, Federico

    2012-01-01

    Por medio de una evaluación funcional del retropié, recolectaremos datos sobre su estado desde el punto de vista de la semiología clínica, de la osteocinemática, la artrocinemática y la miocinematica. A partir de aquí se procederá a realizar la aplicación de un Vendaje Neuromuscular para analizar el beneficio de la técnica de corrección articular. Objetivos: Determinar los efectos de la aplicación del vendaje neuromuscular en pacientes con retropié pronado. Sujetos de estudio: Pacientes...

  12. Valoració i entrenament del control neuromuscular per a la millora del rendiment esportiu

    OpenAIRE

    Fort Vanmeerhaeghe, Azahara

    2010-01-01

    El control neuromuscular ha estat descrit com un important factor per a l'èxit en el rendiment esportiu. De la mateixa manera, també s'ha identificat com a clau en la prevenció i readaptació de les lesions esportives. El principal objectiu d'aquesta tesi doctoral és avaluar l'eficàcia de diferents tipus d'entrenament neuromuscular en esportistes.S'ha utilitzat una mostra de 81 esportistes sans entre els diferents estudis que s'hi presenten. Les diferents avaluacions realitzades han registrat ...

  13. Clinical applications of immunoglobulin in neuromuscular diseases: focus on inflammatory myopathies

    Directory of Open Access Journals (Sweden)

    Paulo Victor Sgobbi de Souza

    2014-12-01

    Full Text Available During recent years, an increasing number of neuromuscular diseases have been recognized either to be caused primarily by autoimmune mechanisms, or to have important autoimmune components. The involved pathophysiological mechanisms and clinical manifestations have been better recognized and many of these disorders are potentially treatable by immunosuppression or by immunomodulation with intravenous immunoglobulin (IVIg. IVIg has been tried in a variety of immune-mediated neurological diseases, being target of widespread use in central and peripheral nervous systems diseases. Objective To give an overview of the main topics regarding the mechanism of action and different therapeutic uses of IVIg in neurological practice, mainly in neuromuscular diseases.

  14. Propiocepción y control neuromuscular en el fútblo infantil

    OpenAIRE

    Zarza, Cristían

    2014-01-01

    En el fútbol profesional la escasa utilización de la pierna no hábil hace que muchas situaciones de juego no se resuelvan eficazmente, además de predisponer a la aparición de lesiones. El presente estudio se concentró en determinar la influencia del entrenamiento propioceptivo y del control neuromuscular en las cualidades físicas y técnicas del miembro no hábil. Objetivo: Indagar el nivel propioceptivo y de control neuromuscular del miembro inferior no hábil en chicos que re...

  15. Neuromuscular electrical stimulation for mobility support of elderly

    Directory of Open Access Journals (Sweden)

    Winfried Mayr

    2015-10-01

    Full Text Available The stimulator for neuromuscular electrical stimulation for mobility support of elderly is not very complicated, but for application within "MOBIL" we have some additional demands to fulfill. First we have specific safety issues for this user group. A powerful compliance management system is crucial not only to guide daily application, but for creating hard data for the scientific outcome. We also need to assure easy handling of the stimulator, because the subjects are generally not able to cope with too difficult and complex motor skills. So, we developed five generations of stimulators and optimizing solutions after field tests. We are already planning the sixth generation with wireless control of the stimulation units by the central main handheld control unit. In a prototype, we have implemented a newly available high capacity memory, a breakthrough in “compliance data storage” as they offer the necessary high storage capacity and fast data handling for an affordable prize. The circuit also contains a 3D accelerometer sensor which acts as a further important safety features: if the control unit drops, this event is detected automatically by the sensor and activates an emergency switch-off that disables the stimulation to avoid associated risks. Further, we have implemented a hardware emergence shutdown and other safety measures. Finally, in the last example muscle torque measurements are referenced with compliance data. In the study normalized maximum voluntary contraction (MVC and maximum stimulation induced contraction (MSC were assessed in regular check-ups along the training period. With additional consideration of adjusted stimulation intensity for training out of the compliance data records we are able to estimate the induced contraction strength, which turned out to amount in average 11% of MVC. This value may seem on a first sight rather low, and ought to be considered in relation to the results at the end of the training period

  16. Genetic and evolutionary analysis of the Drosophila larval neuromuscular junction

    Science.gov (United States)

    Campbell, Megan

    Although evolution of brains and behaviors is of fundamental biological importance, we lack comprehensive understanding of the general principles governing these processes or the specific mechanisms and molecules through which the evolutionary changes are effected. Because synapses are the basic structural and functional units of nervous systems, one way to address these problems is to dissect the genetic and molecular pathways responsible for morphological evolution of a defined synapse. I have undertaken such an analysis by examining morphology of the larval neuromuscular junction (NMJ) in wild caught D. melanogaster as well as in over 20 other species of Drosophila. Whereas variation in NMJ morphology within a species is limited, I discovered a surprisingly extensive variation among different species. Compared with evolution of other morphological traits, NMJ morphology appears to be evolving very rapidly. Moreover, my data indicate that natural selection rather than genetic drift is primarily responsible for evolution of NMJ morphology. To dissect underlying molecular mechanisms that may govern NMJ growth and evolutionary divergence, I focused on a naturally occurring variant in D. melanogaster that causes NMJ overgrowth. I discovered that the variant mapped to Mob2, a gene encoding a kinase adapter protein originally described in yeast as a member of the Mitotic Exit Network (MEN). I have subsequently examined mutations in the Drosophila orthologs of all the core components of the yeast MEN and found that all of them function as part of a common pathway that acts presynaptically to negatively regulate NMJ growth. As in the regulation of yeast cytokinesis, these components of the MEN appear to act ultimately by regulating actin dynamics during the process of bouton growth and division. These studies have thus led to the discovery of an entirely new role for the MEN---regulation of synaptic growth---that is separate from its function in cell division. This work

  17. Neuromuscular abnormality and autonomic dysfunction in patients with cerebrotendinous xanthomatosis

    Directory of Open Access Journals (Sweden)

    Huang Chi-Ren

    2011-05-01

    Full Text Available Abstract Background Cerebrotendinous xanthomatosis (CTX is a rare lipid-storage disease. Neuromuscular abnormality and autonomic system (ANS dysfuction in CTX are rarely examined in large-scale studies in the literature. We studied the peripheral nervous system, myopathology, and autonomic system of four CTX patients and performed a literature review of the reported CTX patients with peripheral neuropathy. Methods Four biochemically and genetically confirmed CTX patients, belonging to two families, were included for study and all received nerve conduction study (NCS, muscle biopsy for histopathologic and ultrastructural study, skin biopsy for intraepidermal nerve fiber (INEF density measurement, autonomic testings including sympathetic skin response, R-R interval variation and head-up tilt test using an automated tilt table to record the changes of blood pressure and heart rate in different postures. The Q-Sweat test was also applied for the detection of sweat amount and onset time of response. The clinical characteristics, study methods and results of 13 studies of peripheral neuropathy in CTX patients in the literature were also recorded for analysis. Results The results of NCS study showed axonal sensory-motor polyneuropathy in three CTX cases and mixed axonal and demyelinating sensor-motor polyneuropathy in one. The myopathological and histopathologic studies revealed mild denervation characteristics, but the ultrastructural study revealed changes of mitochondria and the membranous system, and increased amounts of glycogen, lipofuscin and lipid deposition. The ANS study revealed different degrees of abnormalities in the applied tests and the INEF density measurement showed small fiber neuropathy in three of the four CTX patients. The literature review of peripheral neuropathy in CTX revealed different types of peripheral neuropathy, of which axonal peripheral neuropathy was the most common. Conclusions Peripheral neuropathy, especially the

  18. Critical components of neuromuscular training to reduce ACL injury risk in female athletes: meta-regression analysis

    Science.gov (United States)

    Sugimoto, Dai; Myer, Gregory D; Barber Foss, Kim D; Pepin, Michael J; Micheli, Lyle J; Hewett, Timothy E

    2017-01-01

    Objective The aim of this study was to determine key components in neuromuscular training that optimise ACL injury reduction in female athletes using meta-regression analyses. Design Systematic review and meta-regression. Data sources The literature search was performed in PubMed and EBSCO. Eligibility criteria Inclusion criteria for the current analysis were: (1) documented the number of ACL injuries, (2) employed a neuromuscular training intervention that aimed to reduce ACL injuries, (3) had a comparison group, (4) used a prospective control study design and (5) recruited female athletes as participants. Two independent reviewers extracted studies which met the inclusion criteria. Methodological quality of included study and strength of recommendation were evaluated. Number of ACL injuries and participants in control and intervention groups, age of participants, dosage of neuromuscular training, exercise variations within neuromuscular training and status of verbal feedback were extracted. Results The meta-regression analyses identified age of participants, dosage of neuromuscular training, exercise variations within neuromuscular training and utilisation of verbal feedback as significant predictors of ACL injury reduction (p=0.01 in fixed-effects model, p=0.03 in random-effects model). Inclusion of 1 of the 4 components in neuromuscular training could reduce ACL injury risk by 17.2–17.7% in female athletes. No significant heterogeneity and publication bias effects were detected. Strength of recommendation was rated as A (recommendation based on consistent and good-quality patient-oriented study evidence). Conclusions Age of participants, dosage of neuromuscular training, exercise variations within neuromuscular training and utilisation of verbal feedback are predictors that influence the optimisation of prophylactic effects of neuromuscular training and the resultant ACL injury reduction in female athletes. PMID:27251898

  19. Ação neuro-muscular do veneno crotálico: dados preliminares Neuromuscular action of crotalid venom: preliminar data

    Directory of Open Access Journals (Sweden)

    Maria Dorvalina Silva

    1996-03-01

    Full Text Available Estudamos 6 pacientes, 2 cães e um coelho com intoxicação crotálica. Avaliamos a condução nervosa periférica sensitiva e motora, a transmissão neuromuscular e eletromiografias. As biópsias de músculo foram processadas por histoquímica. Os 6 pacientes apresentaram mononeuropatia sensitiva no nervo periférico adjacente ao local da inoculação do veneno e encontramos evidências histoquímicas de miopatia mitocondrial. Os defeitos da transmissão neuromuscular foram mínimos. A maioria dos autores admite que veneno crotálico determina síndrome miastênica. Nossos achados indicam que ptose palpebral, facies miastênico e fraqueza muscular observados após acidente crotálico, correspondem provavelmente a miopatia mitocondrial, muitas vezes transitória e reversível.We studied 6 patients and 2 dogs that have been bitten by South American rattlesnake Crotalus durissus terrificus and one rabbit inoculated with crotalid venom. We analized sensory and motor peripheral nerve conduction, repetitive stimulation for studying neuromuscular transmission and electromyographies. Muscle biopsies were processed by histochemistry. All patients had peripheral mononeuropathy of the closest sensitive nerve to the area of snakebite. The neuromuscular transmission alterations were minimal. Muscle histochemistry of 4 patients, 2 dogs and 1 rabbit showed findings of mitochondrial myopathy. The majority of authors admit that crotalid venom causes myastenic syndrome. Our findings suggest that palpebral ptosis, myastenic facies and muscular weakness observed after crotalid poisoning are, probably, due to transient and reversible mitochondrial myopathy. As far as we know, this is the first report on the ability of the venom of this rattlesnake to cause local sensitive mononeuropathy and the first muscle histochemistry showing mitochondrial myopathy in humans poisoned by crotalid venom.

  20. [Translation and validation of the Individualised Neuromuscular Quality of Life scale for the Spanish population: quality of life assessment for persons with neuromuscular diseases].

    Science.gov (United States)

    Fagoaga, J; Girabent-Farres, M; Bagur-Calafat, C

    2017-03-01

    Introduccion. La escala Individualized Neuromuscular Quality of Life (INQoL) es un cuestionario que valora la calidad de vida relacionada con la salud de personas adultas con enfermedades neuromusculares. Objetivo. Validar y analizar la fiabilidad de la version española de la INQoL, como instrumento de medicion de la calidad de vida relacionada con la salud en individuos con enfermedades neuromusculares. Pacientes y metodos. Se realiza una traduccion-retrotraduccion de la INQoL en la poblacion española y, posteriormente, para el analisis de fiabilidad se llevan a cabo dos mediciones, test-retest, a 50 pacientes de 19 a 67 años. De este modo se evalua la concordancia intraobservador y se evalua la consistencia interna de la escala. Resultados. El estudio de la fiabilidad del indice de concordancia intraobservador tiene un valor de excelente en siete de las diez subdimensiones y en la puntuacion total de la calidad de vida; de buena, en dos; y de moderada, en una. El analisis del alfa de Cronbach para las subdimensiones de la INQoL tiene un valor de excelente (> 0,818) en siete de ellas, asi como en la puntuacion total de la calidad de vida relacionada con la salud (0,928), un valor de buena consistencia interna en tres de las subdimensiones y de moderada en una. Conclusiones. La version española de la INQoL es un instrumento valido y fiable como herramienta de medicion de la calidad de vida en individuos adultos con enfermedades neuromusculares.

  1. Phenobarbital influence on neuromuscular block produced by rocuronium in rats Influência do fenobarbital no bloqueio neuromuscular produzido pelo rocurônio em ratos

    OpenAIRE

    Angélica de Fátima de Assunção Braga; Caroline Coutinho de Barcelos; Franklin Sarmento da Silva Braga; Samanta Cristina Antoniassi Fernandes; Yoko Oshima Franco; Mario Mantovani; Léa Rodrigues Simioni

    2008-01-01

    PURPOSE: To evaluate in vitro and in vivo neuromuscular blockade produced by rocuronium in rats treated with Phenobarbital and to determine cytochrome P450 and cytochrome b5 concentrations in hepatic microsomes. METHODS: Thirty rats were included in the study and distributed into 6 groups of 5 animals each. Rats were treated for seven days with phenobarbital (20 mg/kg) and the following parameters were evaluated: 1) the amplitude of muscle response in the preparation of rats exposed to phenob...

  2. Neuromuscular adaptations to training, injury and passive interventions: implications for running economy.

    Science.gov (United States)

    Bonacci, Jason; Chapman, Andrew; Blanch, Peter; Vicenzino, Bill

    2009-01-01

    Performance in endurance sports such as running, cycling and triathlon has long been investigated from a physiological perspective. A strong relationship between running economy and distance running performance is well established in the literature. From this established base, improvements in running economy have traditionally been achieved through endurance training. More recently, research has demonstrated short-term resistance and plyometric training has resulted in enhanced running economy. This improvement in running economy has been hypothesized to be a result of enhanced neuromuscular characteristics such as improved muscle power development and more efficient use of stored elastic energy during running. Changes in indirect measures of neuromuscular control (i.e. stance phase contact times, maximal forward jumps) have been used to support this hypothesis. These results suggest that neuromuscular adaptations in response to training (i.e. neuromuscular learning effects) are an important contributor to enhancements in running economy. However, there is no direct evidence to suggest that these adaptations translate into more efficient muscle recruitment patterns during running. Optimization of training and run performance may be facilitated through direct investigation of muscle recruitment patterns before and after training interventions. There is emerging evidence that demonstrates neuromuscular adaptations during running and cycling vary with training status. Highly trained runners and cyclists display more refined patterns of muscle recruitment than their novice counterparts. In contrast, interference with motor learning and neuromuscular adaptation may occur as a result of ongoing multidiscipline training (e.g. triathlon). In the sport of triathlon, impairments in running economy are frequently observed after cycling. This impairment is related mainly to physiological stress, but an alteration in lower limb muscle coordination during running after cycling

  3. Intuitionistic hybrid logic

    DEFF Research Database (Denmark)

    Braüner, Torben

    2011-01-01

    Intuitionistic hybrid logic is hybrid modal logic over an intuitionistic logic basis instead of a classical logical basis. In this short paper we introduce intuitionistic hybrid logic and we give a survey of work in the area.......Intuitionistic hybrid logic is hybrid modal logic over an intuitionistic logic basis instead of a classical logical basis. In this short paper we introduce intuitionistic hybrid logic and we give a survey of work in the area....

  4. Continuity Controlled Hybrid Automata

    OpenAIRE

    Bergstra, J. A.; Middelburg, C.A.

    2004-01-01

    We investigate the connections between the process algebra for hybrid systems of Bergstra and Middelburg and the formalism of hybrid automata of Henzinger et al. We give interpretations of hybrid automata in the process algebra for hybrid systems and compare them with the standard interpretation of hybrid automata as timed transition systems. We also relate the synchronized product operator on hybrid automata to the parallel composition operator of the process algebra. It turns out that the f...

  5. COMPARISION OF POTENCY OF DIFFERENT TYPES NEURO-MUSCULAR JUNCTION (NMJ BLOCKERS ON ISOLATED RECTUS ABDOMINIS MUSCLE OF RANA TIGRINA

    Directory of Open Access Journals (Sweden)

    Sanghishetty Vijay Prasad

    2012-08-01

    Full Text Available The most important use of neuromuscular blockers is as adjuvant to general anaesthesia whereadequate muscle relaxation can be achieved at lighter plane. They also reduce reflex muscle contraction in the regionundergoing surgery and assist maintenance of controlled ventilation during anaesthesia. They are particularly helpfulin abdominal and thoracic surgery, intubations and endoscopies, orthopedic manipulation, etc. Thus, the risk ofrespiratory and cardiovascular depression is minimized, and post anesthetic recovery is shortened. The potency ratioof two commonly used neuromuscular agents depolarizing succinylcholine and non depolarizing pancuronium.Double pith a frog and fasten it to a frog board with ventral side up. The sternum was cut through just above thexiphisternum at its base and a pair of muscle attached to it were dissected out and transferred to a dish containingfrog Ringer solution at room temperature. All the drug containing solutions were freshly prepared before theexperiments Succinyl choline, Pancuronium (1,10,100μg/ml and 1mg/dl respectively Acetyl choline (10,100μg/mland 1mg/dl. Acetylcholine solution in various strength were prepared starting from 0.1% to 0.0001%.NMJblockerPancuroniumwas added to the biophase in addition to selected dose (128μgor 256μgand the contraction ofmuscle till the 70-80% of inhibition is produced and the difference from sub maximal contractions. The medianED50was interpolated from the figure taking 50%of inhibition from Height of contractionin mm. The ‘t’ test wasperformed to compare the ED50value were interpolated from the regression line to find out the ED50of the drug. Themedian doses (ED50 of both of them were calculated graphically and compared. The mean ED50 value ofsuccinylcholine was found to be 1.59 ± 0.08μg (95% confidential limit was from 1.53 to 1.66μg. The ED50ofpancuronium was found to be 0.52 ± 0.10μg with 95% confidence limit being from 0.44 to 0.60μg. The ED50valueof the

  6. Integrated approach for hybrid rocket technology development

    Science.gov (United States)

    Barato, Francesco; Bellomo, Nicolas; Pavarin, Daniele

    2016-11-01

    Hybrid rocket motors tend generally to be simple from a mechanical point of view but difficult to optimize because of their complex and still not well understood cross-coupled physics. This paper addresses the previous issue presenting the integrated approach established at University of Padua to develop hybrid rocket based systems. The methodology tightly combines together system analysis and design, numerical modeling from elementary to sophisticated CFD, and experimental testing done with incremental philosophy. As an example of the approach, the paper presents the experience done in the successful development of a hybrid rocket booster designed for rocket assisted take off operations. It is thought that following the proposed approach and selecting carefully the most promising applications it is possible to finally exploit the major advantages of hybrid rocket motors as safety, simplicity, low cost and reliability.

  7. Hybridized tetraquarks

    Directory of Open Access Journals (Sweden)

    A. Esposito

    2016-07-01

    Full Text Available We propose a new interpretation of the neutral and charged X,Z exotic hadron resonances. Hybridized-tetraquarks are neither purely compact tetraquark states nor bound or loosely bound molecules but rather a manifestation of the interplay between the two. While meson molecules need a negative or zero binding energy, its counterpart for h-tetraquarks is required to be positive. The formation mechanism of this new class of hadrons is inspired by that of Feshbach metastable states in atomic physics. The recent claim of an exotic resonance in the Bs0π± channel by the D0 Collaboration and the negative result presented subsequently by the LHCb Collaboration are understood in this scheme, together with a considerable portion of available data on X,Z particles. Considerations on a state with the same quantum numbers as the X(5568 are also made.

  8. Hybridized Tetraquarks

    CERN Document Server

    Esposito, A.; Polosa, A.D.

    2016-01-01

    We propose a new interpretation of the neutral and charged X, Z exotic hadron resonances. Hybridized-tetraquarks are neither purely compact tetraquark states nor bound or loosely bound molecules. The latter would require a negative or zero binding energy whose counterpart in h-tetraquarks is a positive quantity. The formation mechanism of this new class of hadrons is inspired by that of Feshbach metastable states in atomic physics. The recent claim of an exotic resonance in the Bs pi+- channel by the D0 collaboration and the negative result presented subsequently by the LHCb collaboration are understood in this scheme, together with a considerable portion of available data on X, Z particles. Considerations on a state with the same quantum numbers as the X(5568) are also made.

  9. Neuromuscular Adaptations to Eccentric Strength Training in Children and Adolescents with Cerebral Palsy

    Science.gov (United States)

    Reid, Siobhan; Hamer, Peter; Alderson, Jacqueline; Lloyd, David

    2010-01-01

    Aim: To determine the neuromuscular outcomes of an eccentric strength-training programme for children and adolescents with cerebral palsy (CP). Method: In this randomised, parallel-group trial with waiting control, 14 participants with CP (six males, eight females; mean age 11y, SD 2y range 9-15y), diagnosed with upper-limb spasticity were…

  10. Choice of Intravenous Agents and Intubation Neuromuscular Blockers by Anesthesia Providers

    Science.gov (United States)

    1996-09-01

    nondepolarizing muscle blockers (Omoigui, 1995). 8 Neuromuscular Blockers Atracurium is a nondepolarizing skeletal muscle relaxant and its...vecuronium. Feldman (1994) and Wicks (1994) report that rocuronium has the most rapid onset of any other nondepolarizing muscle relaxant with...prolonged muscle relaxant block at usual intubation doses. Mirakhur (1994) and Robertson, Hull, Verbeek, 8L Bonjii (1994) report minimal changes in

  11. Surgical Space Conditions During Low-Pressure Laparoscopic Cholecystectomy with Deep Versus Moderate Neuromuscular Blockade

    DEFF Research Database (Denmark)

    Staehr-Rye, Anne K; Rasmussen, Lars S.; Rosenberg, Jacob;

    2014-01-01

    described, but deep neuromuscular blockade may be beneficial. We investigated if deep muscle relaxation would be associated with a higher proportion of procedures with "optimal" surgical space conditions compared with moderate relaxation during low-pressure (8 mm Hg) laparoscopic cholecystectomy. METHODS...... with surgical space conditions that were marginally better than with moderate muscle relaxation during low-pressure laparoscopic cholecystectomy....

  12. Sugammadex as a reversal agent for neuromuscular block: an evidence-based review

    Directory of Open Access Journals (Sweden)

    Schaller SJ

    2013-09-01

    Full Text Available Stefan Josef Schaller,1,2 Heidrun Fink11Klinik für Anaesthesiologie, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; 2Department of Anesthesia, Massachusetts General Hospital, Boston, MA, USAAbstract: Sugammadex is the first clinical representative of a new class of drugs called selective relaxant binding agents. It has revolutionized the way anesthesiologists think about drug reversal. Sugammadex selectively binds rocuronium or vecuronium, thereby reversing their neuromuscular blocking action. Due to its 1:1 binding of rocuronium or vecuronium, it is able to reverse any depth of neuromuscular block. So far, it has been approved for use in adult patients and for pediatric patients over 2 years. Since its approval in Europe, Japan, and Australia, further insight on its use in special patient populations and specific diseases have become available. Due to its pharmacodynamic profile, sugammadex, in combination with rocuronium, may have the potential to displace succinylcholine as the "gold standard" muscle relaxant for rapid sequence induction. The use of rocuronium or vecuronium, with the potential of reverse of their action with sugammadex, seems to be safe in patients with impaired neuromuscular transmission, ie, neuromuscular diseases, including myasthenia gravis. Data from long-term use of sugammadex is not yet available. Evidence suggesting an economic advantage of using sugammadex and justifying its relatively high cost for an anesthesia-related drug, is missing. Keywords: reversal agent, cyclodextrin, PORC, SRBAs

  13. INTUBATING CONDITIONS AND ONSET OF NEUROMUSCULAR BLOCK OF ROCURONIUM (ORG-9426) - A COMPARISON WITH SUXAMETHONIUM

    NARCIS (Netherlands)

    HUIZINGA, ACT; VANDENBROM, RHG; WIERDA, JMKH; HOMMES, FDM; HENNIS, PJ

    1992-01-01

    The intubating conditions and neuromuscular blocking profile following 600-mu-g.kg-1 rocuronium (Org 9426) have been investigated in patients under various experimental conditions. They were compared with conditions following 1.5 mg.kg-1 suxamethonium, preceded by a precurarising dose (10 mg) of gal

  14. Neuromuscular Adaptations to Eccentric Strength Training in Children and Adolescents with Cerebral Palsy

    Science.gov (United States)

    Reid, Siobhan; Hamer, Peter; Alderson, Jacqueline; Lloyd, David

    2010-01-01

    Aim: To determine the neuromuscular outcomes of an eccentric strength-training programme for children and adolescents with cerebral palsy (CP). Method: In this randomised, parallel-group trial with waiting control, 14 participants with CP (six males, eight females; mean age 11y, SD 2y range 9-15y), diagnosed with upper-limb spasticity were…

  15. A survey of the current use of neuromuscular blocking drugs among the Middle Eastern anesthesiologists

    Directory of Open Access Journals (Sweden)

    Abdelazeem Eldawlatly

    2013-01-01

    Full Text Available Background: This survey aimed to assess the extent of practice of the Middle Eastern anesthesiologists in the use of neuromuscular blocking agents (NMB in 2012. Methods: We distributed an electronic survey among 577 members of the Triple-M Middle Eastern Yahoo anesthesia group, enquiring about their practice in the use of neuromuscular blocking agents. Questions concerned the routine "first choice" use of NMB, choice for tracheal intubation, the use of neuromuscular monitoring (NMT, type of NMB used in difficult airway, frequency of using suxamethonium, cisatracurium, rocuronium and sugammadex, observed side effects of rocuronium, residual curarization, and the reversal of residual curarization of rocuronium. Results: A total of 71 responses from 22 Middle Eastern institutions were collected. Most of the Middle Eastern anesthesiologists were using cisatracurium and rocuronium frequently for tracheal intubation (39% and 35%, respectively. From the respondents, 2/3 were using suxamethonium for tracheal intubation in difficult airway, 1/3 were using rocuronium routinely and 17% have observed hypersensitivity reactions to rocuronium, 54% reported residual curarization from rocuronium, 78% were routinely using neostigmine to reverse the rocuronium, 21% used sugammadex occasionally, and 35% were using NMT routinely during the use of NMB. Conclusions: We believe that more could be done to increase the awareness of the Middle Eastern anesthesiologists about the high incidence of PROC (>20% and the need for routine monitoring of neuromuscular function. This could be accomplished with by developing formal training programs and providing official guidelines.

  16. Proprioceptive Neuromuscular Facilitation Flexibility Techniques: Acute Effects on Arterial Blood Pressure.

    Science.gov (United States)

    Cornelius, William L.; Craft-Hamm, Kelley

    1988-01-01

    The effects of stretching techniques on arterial blood pressure (ABP) were studied in three groups of 20 men each. Each group performed one of three proprioceptive neuromuscular facilitation (PNF) techniques. Results are presented. The study indicates that the benefits of stretching may outweigh the risk of elevated ABP. (JL)

  17. How Persons with a Neuromuscular Disease Perceive Employment Participation : A Qualitative Study

    NARCIS (Netherlands)

    Minis, Marie-Antoinette; Satink, Ton; Kinébanian, Astrid; Engels, Josephine; Heerkens, Yvonne; Engelen, Baziel van

    2014-01-01

    Introduction A qualitative study was carried out to understand how people with a slow progressive adult type neuromuscular disease (NMD) perceive employment participation. Methods 16 paid employed persons with NMD were interviewed in open, in-depth interviews. Data were analyzed using the constant c

  18. Synaptic defects in the spinal and neuromuscular circuitry in a mouse model of spinal muscular atrophy.

    Directory of Open Access Journals (Sweden)

    Karen K Y Ling

    Full Text Available Spinal muscular atrophy (SMA is a major genetic cause of death in childhood characterized by marked muscle weakness. To investigate mechanisms underlying motor impairment in SMA, we examined the spinal and neuromuscular circuitry governing hindlimb ambulatory behavior in SMA model mice (SMNΔ7. In the neuromuscular circuitry, we found that nearly all neuromuscular junctions (NMJs in hindlimb muscles of SMNΔ7 mice remained fully innervated at the disease end stage and were capable of eliciting muscle contraction, despite a modest reduction in quantal content. In the spinal circuitry, we observed a ∼28% loss of synapses onto spinal motoneurons in the lateral column of lumbar segments 3-5, and a significant reduction in proprioceptive sensory neurons, which may contribute to the 50% reduction in vesicular glutamate transporter 1(VGLUT1-positive synapses onto SMNΔ7 motoneurons. In addition, there was an increase in the association of activated microglia with SMNΔ7 motoneurons. Together, our results present a novel concept that synaptic defects occur at multiple levels of the spinal and neuromuscular circuitry in SMNΔ7 mice, and that proprioceptive spinal synapses could be a potential target for SMA therapy.

  19. Whole-body vibration does not influence knee joint neuromuscular function or proprioception.

    Science.gov (United States)

    Hannah, R; Minshull, C; Folland, J P

    2013-02-01

    This study examined the acute effects of whole-body vibration (WBV) on knee joint position sense and indices of neuromuscular function, specifically strength, electromechanical delay and the rate of force development. Electromyography and electrically evoked contractions were used to investigate neural and contractile responses to WBV. Fourteen healthy males completed two treatment conditions on separate occasions: (1) 5 × 1 min of unilateral isometric squat exercise on a synchronous vibrating platform [30 Hz, 4 mm peak-to-peak amplitude] (WBV) and (2) a control condition (CON) of the same exercise without WBV. Knee joint position sense (joint angle replication task) and quadriceps neuromuscular function were assessed pre-, immediately-post and 1 h post-exercise. During maximum voluntary knee extensions, the peak force (PF(V)), electromechanical delay (EMD(V)), rate of force development (RFD(V)) and EMG of the quadriceps were measured. Twitch contractions of the knee extensors were electrically evoked to assess EMD(E) and RFD(E). The results showed no influence of WBV on knee joint position, EMD(V), PF(V) and RFD(V) during the initial 50, 100 or 150 ms of contraction. Similarly, electrically evoked neuromuscular function and neural activation remained unchanged following the vibration exercise. A single session of unilateral WBV did not influence any indices of thigh muscle neuromuscular performance or knee joint proprioception.

  20. Family Stress with Chronic Childhood Illness: Cystic Fibrosis, Neuromuscular Disease, and Renal Disease.

    Science.gov (United States)

    Holroyd, Jean; Guthrie, Donald

    1986-01-01

    Parents of children with neuromuscular disease, cystic fibrosis, and renal disease were compared with parents of control subjects matched by age to the clinical cases. The three clinical groups exhibited different patterns of stressful response, consistent with the nature of their illnesses and the requirements for care imposed on the families.…