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Biomedical subjects

M Nordin

Publications and source records attributed to M Nordin.

At least 19 recordsLinked to original sources

The DNA-binding protein P52 of human cytomegalovirus reacts with monoclonal antibody CCH2 and associates with the nuclear membrane at late times after infection.

Monoclonal antibody CCH2 is commonly used for the detection of human cytomegalovirus (HCMV) infected cells in tissue sections as well as in cultured cells. The specificity of CCH2 was determined by screening a recombinant lambda-gt11 cDNA gene bank from HCMV-infected fibroblasts. By sequencing a reactive clone, the antigen was identified to be the non-structural DNA binding protein p52 of HCMV (UL44 reading frame). The viral insert from the lambda clone was recloned in bacterial expression vectors. For this, a new vector, pRos-RS, was constructed. The resulting clones were tested in immunoblot analyses. They were reactive with CCH2 as well as with reconvalescent sera positive for antibodies against HCMV, by this proving the specificity of CCH2. Using this monoclonal antibody in confocal microscopy, the subcellular localization of p52 in infected cells was analyzed. In these analyses, p52 was found to be nuclear and to be associated with the nuclear membrane at late times after infection.

Amino Acid Sequence

Back pain in children and teenagers.

Controversial opinions have been published concerning the frequency of LBP among children and adolescents. Studies from orthopaedics or neurosurgical departments have reported low figures for prevalence of specific LBP due to serious disorders. Field surveys, on the contrary, have shown that cumulative life prevalence of non-specific LBP in children and teenagers can be comparable to the prevalence data for adult populations. Some specific diagnoses are more common or characteristic of children complaining of LBP. Age, gender, sports activities and family history of LBP have been found to be significantly associated with an increased prevalence in non-specific LBP among children. Low back pain among children and teenagers is common and should be recognized. This chapter provides guidelines for a clinical approach and differential diagnoses. Most back pain in these age groups is benign and should be treated as such.

Adolescent

Back schools in prevention of chronicity.

This chapter has reviewed the role of back school and educational programmes for the common and non-specific acute and subacute low back pain patient. The following seems to come out of this review. Education is an important part of patient care. However, several questions arise about the content of the education, the selection of patients, the patient compliance to instruction given, how the information is retained, and which outcome measures should be used. It is also important to realize that the back school is a modality or a tool that may be used as an adjunct, but as a sole treatment it seems to have less impact than in combination with other structured or goal-oriented programmes. When a back school is instituted in a hospital or in industry, it requires administrative and budgetary support and a multidisciplinary staff to successfully carry out the programme. The information given must be adapted to the needs of the participants and all members of the team must give the same information to the patient. A poorly structured back school where patients are dumped because the physician or other health care provider has nothing else to offer is a poor solution for the patient, a poor solution for the health care provider, and can only increase the patient's discomfort and health care costs.

Adult

Role of physical therapy in the treatment of cervical disk disease.

Table 4 summarizes how physical therapy should be implemented during the acute and chronic phase of cervical disk disease. From the outset of treatment, the patient should be encouraged to return to work or other productive activities and should be taught how to be responsible for their own recovery. If passive modalities are used, they must be an adjunct to the active modalities. As soon as the patient is able to continue with an active program without unbearable pain, the passive modalities should be discontinued gradually. If neck pain becomes chronic, the accompanying psychosocial dysfunction must be addressed through behavioral modification techniques, preferably in a multidisciplinary setting. Modification of the work place, work habits, and lifestyles must be emphasized at both the acute and chronic stages. The modalities presented in this article are commonly used by physical therapists. Unfortunately, the clinical efficacy of most of these modalities has yet to be proved. A literature search on the effectiveness of various physical therapy modalities by Sievers et al showed that only 4% of the studies published from 1979 to 1985 were controlled clinical trials. This scientific output of physical therapists needs to be corrected.

Acupuncture Therapy

Effects of spinal flexion and extension exercises on low-back pain and spinal mobility in chronic mechanical low-back pain patients.

It has been estimated that one fourth to one half of all patients treated in physical therapy clinics suffer from low-back pain. The purpose of this study was to compare the effects of spinal flexion (Group I) and extension (Group II) exercises on low-back pain severity and thoracolumbar spinal mobility in chronic mechanical low-back pain patients. Both groups had significantly less low-back pain after treatment (P less than .10). There was no significant difference, however, between the spinal flexion and extension exercises in reduction of low-back pain severity. The results indicated a significant difference between the groups in increasing the sagittal mobility (P less than .10). The results did not indicate any significant difference between and within groups in increasing the coronal and transverse mobility of the thoracolumbar spine. Either the spinal flexion or extension exercises could be used to reduce chronic mechanical low-back pain severity, but the flexion exercises had an advantage in increasing the sagittal mobility within a short period of time.

Adult

Environmentally induced disorders of the musculoskeletal system.

The human suffering and economic cost attributable to musculoskeletal disorders cannot be overemphasized. Biomechanical principles have been introduced to explain the microtrauma and macrotrauma as mechanisms of injury. Stress-induced remodeling is a useful paradigm in the study of environmentally induced disorders. The concept of environment should include psychosocial and organizational factors with respect to musculoskeletal complaints and chronic pain. Low back pain, osteoarthritis, osteoporosis and its associated fractures, and cumulative trauma disorders are the most critical and common musculoskeletal disorders. The risk factors for low back pain have been identified, and preventive measures for reducing the chronicity of low back pain have been discussed. Preventive approaches to control or limit the fractures associated with osteoporosis and loss of bone mass are preferred to simple management of the fracture of osteoporotic patients. It can be concluded that too little or too much stress can disturb the homeostatic or the equilibrium state of health and that much remains to be researched to quantify the optimal stress levels.

Back Pain

The relationship of torque, velocity, and power with constant resistive load during sagittal trunk movement.

Strength and fitness studies have been used to determine the predictability of back pain episodes. Tests have demonstrated that isometric strength displays little prognostic value in the development of low-back pain. Static isometric tests have achieved widespread usage due to the simplicity and safety of protocols, the readily available technology, and the low administrative costs. Dynamic lifting models have, however, predicted significantly higher spinal loads than those derived from static models. The objectives of this study were twofold: to investigate the relationship of the torque, velocity, and power to the resistive load during trunk flexion and extension, and to develop predictive models for these relationships for the subject's performance of the 10th, 50th, and 90th percentile distribution. The results of the study found that the flexion/extension torque had a positive linear correlation with the set resistance; the velocity displayed a negative linear correlation, while power had a quadratic relationship with the resistance.

Adult

Sympathetic discharges in the human supraorbital nerve and their relation to sudo- and vasomotor responses.

1. Sympathetic nerve activity occurring as bursts of multi-unit impulses was recorded with tungsten microelectrodes in the supraorbital nerve of awake healthy subjects. Within the fascicular innervation zone on the forehead, skin resistance was measured as an indicator of sweat gland activity, and skin blood flow was measured with laser-doppler flowmetry. 2. At room temperature, there was little or no background burst activity, but arousal stimuli or mental stress evoked bursts followed by a vasodilator response. Provided repeated arousal stimuli were delivered, individual bursts were followed by a decrease in skin resistance. 3. Body heating induced increasing background burst activity. After an initial period without associated electrodermal activity, there were decreases in skin resistance, which showed a positive linear correlation with the amplitude of the preceding burst. Individual bursts were followed by a vasodilator response with an average onset latency of 2.8 s and an average duration of 9.1 s, and rapid increases in blood flow coincided with a marked increase in burst activity. Arousal stimuli evoked bursts followed by both vasodilator and skin resistance responses. 4. During body cooling, there was no background burst activity, but signs of relatively weak, probably neurally mediated vasoconstriction were observed and arousal-evoked bursts were reduced or abolished, as were the associated vasodilator and skin resistance responses. 5. It is concluded that body heating induces active sympathetic vasodilatation in the skin of the human forehead, and that this is either sudomotor-mediated or caused by vasodilator fibres firing in synchrony with sudomotor fibres. A similar sympathetic mechanism probably underlies the vasodilator responses evoked by arousal stimuli and mental stress.

Adult

Low-threshold mechanoreceptive and nociceptive units with unmyelinated (C) fibres in the human supraorbital nerve.

1. In recordings from the human supraorbital nerve with tungsten microelectrodes, eleven afferent units with unmyelinated (C) axons were identified on the basis of their conduction velocities (0.6-1.4 m/s). 2. Eight units had low mechanical thresholds (less than or equal to 0.23 g) and could be activated up to their maximal firing rates of about 100 impulses/s by weak tactile stimuli, whereas three units had higher thresholds (5.5 g) and responded vigorously to noxious stimuli only. 3. During a skin indentation the low-threshold units adapted to an irregular low-frequency discharge, and release of the stimulus elicited a prominent off-response often ending with an after-discharge. Slow stroking was a particularly effective stimulus, even when done with cotton wool, whereas rapid stroking reduced the response. All types of stroking stimuli were occasionally followed by after-discharges. Repeated mechanical stimulation at short intervals resulted in a decline of the response, indicating receptor fatigue. For two units a response to skin cooling was observed. 4. The above low-threshold C units have all the main characteristics of the C mechanoreceptors known from the cat and primates but not previously proven to exist in man. The high-threshold C units are similar to the polymodal nociceptors found in other human skin areas.

Action Potentials

Histochemistry and morphology of erector spinae muscle in lumbar disc herniation.

The purpose of this study was to detect any changes in the erector spinae muscles in patients undergoing surgery for lumbar disc herniation (LDH) and to analyze which factors (sex, age, the level and site of disc protrusion, and duration of symptoms) would be related to these changes. The percentage of mean area of the type I fibers was significantly larger in males and in the older age group (P less than 0.05), due to the decreasing size of type IIa and IIb fibers. Patients with LDH have: 1) angulated and selective atrophy of type II fibers with a higher type IIb/IIa ratio; 2) with increasing age and duration of symptoms, more marked atrophy of type II fibers; and 3) other unspecific pathologic changes.

Adult

A database of isoinertial trunk strength tests against three resistance levels in sagittal, frontal, and transverse planes in normal male subjects.

Spatial joint complexes, such as the spine, require multiaxial systems to adequately assess their functional capacity. The B200 Isostation (Isotechnologies, Inc., Carrboro, North Carolina) is a triaxial system that has three hydraulic pumps under control of an IBM-XT. The transducers measure the torque, angular position, and velocity for all axes simultaneously. There is no isoinertial data base available for strength at different resistances in the sagittal, coronal, and transverse planes. A normal data base for dynamic performance against resistances equal to 30%, 50%, and 70% of the maximum isometric strength of trunk muscles in all three planes was established.

Adult

Intrafascicular multi-unit recordings from the human infra-orbital nerve.

Intrafascicular micro-electrode recordings were made from the human infra-orbital nerve close to the infra-orbital foramen. The fascicular organization was studied and multi-unit activity from low-threshold mechanoreceptive afferents was recorded during tactile stimuli, vibration and facial movements. Attempts were also made to record C-fibre activity. Innervation zones corresponding to 66 fascicles were mapped with tactile stimuli on facial hairy skin and the red zone of the lip. Most of these fields were located on the upper lip, where they overlapped, indicating a high innervation density. The fields had a median size of 3.8 cm2. Skin indentation evoked dynamic on- and off-responses and a much less pronounced static discharge. The afferent double-peaked responses to an oscillating probe applied to the peri-oral region induced similar grouping of the EMG activity during sustained lip protrusion. Contraction of facial muscles and stretching of the skin evoked on- and off-responses, whereas the static discharge was less pronounced, especially during sustained stretching. The dynamic sensitivity to minor variations in contraction and stretching was high, and during normal facial movements, as in speech, there was a barrage of impulses originating from mechanoreceptors within large facial areas. Functional implications of these sensorimotor interactions are discussed. Sympathetic C-fibre activity, frequently seen in recordings from the supra-orbital nerve, was never encountered in the infra-orbital nerve recordings, indicating a lack of such fibres. Failure to detect afferent C-fibre activity could be explained by methodological difficulties.

Adult

Mechanoreceptive units in the human infra-orbital nerve.

Eighty-four low-threshold mechanoreceptive afferents innervating facial hairy skin or the red zone of the lip were recorded with micro-electrodes from the human infra-orbital nerve. Based on their responses to skin indentations, the units were classified as slowly or fast-adapting, with small or large receptive fields. The responses to hair movement, skin stretching and contraction of facial muscles were also studied. Both hairy skin and the red zone were innervated by slowly and by fast-adapting units. The innervation density was found to be highest at the corner of the mouth and on the upper lip. Slowly adapting units with small fields in hairy skin were most common and included units responding to sustained hair displacement. These units are suggested to have two types of end-organs, either pilo-Ruffini endings or Merkel cell-neurite complexes. The slowly adapting units with large fields were spontaneously active stretch receptors and may have corresponded to Ruffini corpuscles, although the possibility of other, intramuscular, receptors could not be ruled out. Only one afferent possibly innervated a Pacinian corpuscle. Most mechanoreceptors were also activated by skin stretching or contraction of facial muscles. Many of the slowly adapting units with small fields responded to the onset and release of stretch, whereas their discharge in response to sustained stretching adapted more or less completely. Spontaneously active units had the most sustained stretch response. It is concluded that several types of cutaneous mechanoreceptors can operate as sensitive proprioceptors of importance for facial kinaesthesia and motor control.

Adult

Reproducibility of trunk isoinertial performances in the sagittal, coronal, and transverse planes.

A new triaxial dynamometer to quantify the performance of trunk muscles has been developed, and a study was conducted to determine the best control parameters to use with this triaxial isodynamic mode of testing. Nine male subjects were tested at three resistance levels in the sagittal, coronal, and transverse planes. The purpose was to establish the reproducibility of the performance parameters in each plane at all resistance levels, and to identify those parameters which gave the most reliable information for objective assessment of the low back functional state. Measured torque had the highest reproducibility rate, and the most reliable assessments were obtained at the highest resistance level.

Adult

Three-dimensional spinal motion measurements. Part 2: A noninvasive assessment of lumbar brace immobilization of the spine.

The purpose of this study was to evaluate the limitation of motion as well as comfort provided by four different types of lumbar braces. The four braces were the Raney jacket, the Camp lace-up corset, a molded-polypropylene thoracolumbar-sacral orthosis (TLSO), and a common elastic corset. The data revealed that all braces significantly restrict free lumbar and thoracic motion in the sagittal and frontal planes. All braces restricted lumbar motion more in the frontal than in the sagittal plane. The rigid TLSO and Raney jackets were most restrictive when compared with the Camp corset and the elastic corset. Axial rotation in the lumbar spine is normally minimal and further limitation by a brace would be negligible. All braces restricted thoracic motion despite the fact that lumbar braces were used. The elastic corset was rated the most comfortable and the Raney jacket the least comfortable. This verifies that there is an inverse relationship between a brace's ability to restrict motion and comfort.

Adolescent

1988 Volvo award in biomechanics. The triaxial coupling of torque generation of trunk muscles during isometric exertions and the effect of fatiguing isoinertial movements on the motor output and movement patterns.

Previous studies have shown that reduction of precise motor control accompanies local muscular fatigue. The effects of isodynamic fatiguing of flexion and extension trunk movements on the movement patterns and the motor output of the trunk were investigated. Twenty male subjects with no history of low-back pain for the past 6 months volunteered for the study. A triaxial dynamometer was used that simultaneously provided measurement of torque, angular position and velocity of each axis. Resistances were set independently for each axis by an interfaced computer. The subjects performed trunk flexion and extension movement against a sagittal plane resistance equal to 70% of their maximum isometric extension strength in the upright position. The minimum resistances in the coronal and transverse planes were set up at 7 Newton meters. The subjects were asked to perform trunk movement as quickly and as accurately as possible while exerting the maximum efforts until exhaustion. Analysis of variance, the MANOVA procedure with a repeated measure design, was performed among the selected parameters of the first, middle and last three repetition cycles. The selected parameters are the trunk motor output and movement patterns; the total angular excursion, range of motion, maximum and average torque and angular velocity of the trunk. All the selected parameters were significantly reduced in the sagittal plane. Subjects displayed significantly less motor control and greater range of motion in the coronal and transverse planes in performing the primary task of flexion and extension. The reduction in the functional capacity of the primary muscles performing the required task is compensated by secondary muscle groups and the spinal structure is loaded in a more injury prone pattern, as identified by finite element models. In addition it is suggested that the fatigued muscles would be less able to compensate any perturbation in the load or position of the trunk. The repetitive loading results in a weakening of the viscoelastic passive elements of the spineless structure. The loss of ability to protect these weakened passive elements makes the spine susceptible to industrial and recreational injuries.

Adult