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A method for assessing alertness fluctuations from EEG spectra.

The object of the study was to develop a method for automatic evaluation of the vigilance level using the EEG frequency pattern. Forty-one EEG records were selected as training material, being considered representative of either a fully alert EEG, or sleep stage I. In the same epochs, 22 different variables based on EEG spectral analysis were calculated. Multiple regression analysis was applied to determine the correlation between the spectral values and the assigned levels of vigilance. The coefficients obtained were applied to the spectral values of 265 epochs belonging to another set of tracings, for estimation of the vigilance level. The correlation between the automatic and visual finding was 0.89 in the training material and 0.86 in the test material. The method can be used to evaluate the mean vigilance level and its variance, rhythmicity and trend during the examination. The preliminary results suggest that objective measurement of alertness can be of value in many applications, such as in pharmacological research, in evaluation of certain psychic symptoms and in working environment studies.

Arousal↗

Biomechanical studies of rabbit abdominal wall. Part I.--The mechanical properties of specimens from different anatomical positions.

Using biomechanical investigations of the intact abdominal wall of the rabbit, the influence of the position (location) of specimens on the mechanical characteristics (the measured variables) was analysed. The intact abdominal wall was investigated in the transverse plane as well as in the longitudinal plane. The mechanical testing was performed using a materials testing machine (Alvetron). The testing revealed that the results for the different measured parameters depended on the position from which specimens originated. The influence of the original position of specimens on the mechanical characteristics was not only due to different quantities and qualities of tissue from different positions, but also might be due to differences in fibre direction in the different specimens. The results obtained are related to biomechanical investigations of wound healing in general.

Abdominal Muscles↗

Biomechanical studies of rabbit abdominal wall. Part II.--The mechanical properties of specimens in relation to length, width, and fibre orientation.

In a biomechanical investigation of tractus iliotibialis and abdominal wall tissue from rabbits, an analysis was made of the influence that the fibre orientation in specimens as well as the length and width of specimens has on the measured parameters. The mechanical testing was performed with a materials testing machine (Alvetron). The investigation showed that the mechanical characteristics of specimens, when the width was kept constant, depended upon the fibre orientation in the specimens and the length of the specimens. The investigation further demonstrated that in intact abdominal wall no proportionality exists between, on the one side, the width of specimens (2, 4, 6 and 8 mm) and, on the other, the breaking strength, the energy absorption, and the elastic stiffness, respectively. For the 6 day old abdominal wall wounds a proportionality, however, could be demonstrated between the 4 and 8 mm broad specimens on the one side and the breaking strength, the energy absorption, and the elastic stiffness on the other. A possible explanation of the difference between the mechanical characteristics of short and long specimens can be given by the theoretical possibility that the short specimens contain relatively more fibres running all the way through the specimen from clamp to clamp than do the long specimens. The consequences on biomechanical investigations rendered by the result of the analyses are discussed.

Abdominal Muscles↗

Aortic and carotid body chemoreception in prolonged hyperoxia in the cat.

Carotid body chemosensory response to hypoxia is attenuated as a result of prolonged normobaric hyperoxia (NH) in the cat. The effect of NH is likely to be due to high cellular PO2 and O2-related free radicals. Accordingly, the effect would be less if O2 delivery to the chemoreceptor tissue could be compromised. The aortic bodies, which appear to have less of a circulatory O2 delivery, as suggested by their vigorous responses to a slight compromise of O2 flow compared with those of the carotid body, could provide a suitable testing material for the hypothesis. We tested the hypothesis by studying both aortic and carotid body chemoreceptors in the same cats (n = 6) which were exposed to nearly 100% O2 for about 60 h. These chemoreceptor organs were also studied in 6 control cats which were maintained in room air at sea-level. The cats were anesthetized and their carotid and aortic chemosensory fibers were identified by the usual procedure, and their responses to hypoxia and hypercapnia and to bolus injections (i.v.) of cyanide and nicotine were measured. In the NH cats, the carotid but not aortic chemosensory responses to hypoxia and cyanide were attenuated and to hypercapnia (both onset and steady state) augmented. The aortic chemoreceptors were stimulated by hypoxia, hypercapnia, cyanide and nicotine both in the NH and the control cats similarly. The results support the hypothesis that it is presumably a higher tissue blood flow and hence a higher concentration of O2-related free radicals which ultimately led to the specific attenuation of O2 chemoreception in the carotid body.

Analysis of Variance↗

Evaluation of some formaldehyde-release compounds and other biocides in the mouse micronucleus test.

A number of biocidal chemicals were tested for clastogenic activity in the micronucleus test using C57Bl/6J mice. The materials tested were: 5-chloro-2-methyl-4-isothiazolin-3-one (I), N-methyl-isothiazolone hydrochloride (II), Glokill 77 and Parmetol A23. Two of the biocides (Glokill and Parmetol) depend on the release of formaldehyde for their activity while the other two compounds are the active chemicals in the biocide Kathon. Hexamethylphosphoramide (HMPA) was tested as the positive control for the series and N,N-dinitrosopentamethylenetetramine (DNPT) as the negative control. HMPA produced significant dose-related increases in the incidence of micronuclei whereas DNPT, I, II, Glokill and Parmetol A23 were without effect.

Animals↗

The international validation of a fixed-dose procedure as an alternative to the classical LD50 test.

In an international study involving 33 laboratories in 11 countries, the acute oral toxicity to the rat of 20 substances and preparations was evaluated using a fixed-dose procedure and the results compared with those obtained for the test materials using the classical LD50 test. The study has shown that the fixed-dose approach to acute oral toxicity testing: (1) produces consistent results that are not substantially affected by inter-laboratory variations; (2) provides adequate information for risk assessment purposes on signs of toxicity, including their nature, time to onset, duration and outcome; (3) uses fewer animals than the current internationally agreed OECD procedure (Guideline 401-revised); (4) subjects animals to less pain and distress than the classical LD50 test and causes less compound-related mortality; and (5) enables substances and preparations to be ranked according to the EEC classification system on the basis of their acute oral toxicity, such ranking being compatible with that allocated by the results of classical LD50 studies.

Administration, Oral↗

Primary stability of hamstring graft fixation with biodegradable suspension versus interference screws.

PURPOSE: During the early postoperative period, the stability of the fixation of a hamstring graft to the bone tunnel is the primary factor in limiting rehabilitation. The aim of this study was to evaluate if the initial fixation strength of a new suspension screw is comparable to that of the biodegradable interference screw fixation technique in the hamstring reconstruction of the anterior cruciate ligament (ACL). TYPE OF STUDY: Experimental laboratory study. METHODS: We evaluated the initial fixation strength of a biodegradable poly-L-lactide/tri-calcium phosphate (PLLA/TCP) screw that suspended the graft in the bone tunnel and compared it with the strength of an interference screw for fixation of hamstring grafts in ACL reconstruction using bovine knees. Single-cycle and cyclic loading tests were performed using a materials testing machine. RESULTS: The suspension screw provided a significantly higher yield load and ultimate failure load than the interference screw. There was no significant difference in the stiffness of both techniques. The typical failure mode for the suspension screw was fracture of the screw and for the interference screw it was slippage of the graft past the screw. In cyclic testing, both methods of fixation ran out to 1,000 cycles up to 250 N with a mean displacement of 2.6 mm (range, 1.8 to 3.3 mm) for the suspension screw and 4.1 mm (range, 2.3 to 6.0 mm) for the interference screw. Only the grafts fixed with the suspension screw survived a protocol with 1,000 cycles up to 400 N. CONCLUSIONS: Our biomechanical data suggest that hamstring graft fixation using a biodegradable PLLA/TCP suspension screw provides an alternative to interference screw fixation. CLINICAL RELEVANCE: Hamstring graft fixation using a suspension screw provides a reasonable alternative to interference screw fixation.

Absorbable Implants↗

Biomechanical strength of deep-frozen versus lyophilized large cortical allografts.

OBJECTIVE: To compare biomechanical strength of deep-frozen versus lyophilized large cortical allografts. DESIGN: In vivo transplantation studies performed in tibia of adult cats using 4 cm deep-frozen and lyophilized, gamma-irradiated allografts to bridge large cortical defect model. BACKGROUND: Bridging large cortical bone defect is a challenging problem. Options include autografts, allografts, bioceramics and prostheses. Allografts provide a suitable option. METHODS: Forty mature cats were used. A large defect (4 cm) was created in mid-diaphysis of right tibia. In 16 cats, cortical defect was reconstructed using deep-frozen allografts (-80 degrees C) with intra-medullary rodding. In another 16 cats, lyophilized, gamma-irradiated allografts were used. Observation periods include 8, 12, 16 and 24 weeks. The specimens were procured together with unoperated legs as controls. Mechanical testing was performed using a materials testing machine with torsion test device of up to 500 Nm at speed of 0.18 rpm. Parameters studied included maximum torque, torsional stiffness and energy of absorption. RESULTS: Deep-frozen allografts did not reach 100% strength, achieving only 64% at 6 months. In marked contrast, lyophilized allografts were significantly weaker with only 12% maximum torque strength at 6 months. Lyophilized allografts were significantly weaker than deep-frozen allografts in all observation periods (p < 0.05). CONCLUSION: Deep-frozen allografts did not reach 100% normal strength and were significantly weaker than non-vascularised autografts. Lyophilized allografts were significantly weaker than deep-frozen allografts. RELEVANCE: For the reconstruction of massive cortical bone defects, only deep-frozen cortical allografts should be used. Lyophilized allografts are not suitable.

Animals↗

Effects of exogenous crosslinking on in vitro tensile and compressive moduli of lumbar intervertebral discs.

BACKGROUND: Collagen crosslinks may play a vital role in preventing ongoing disc degeneration. Age-accumulating crosslinks have been thought to increase brittleness and reduce fatigue resistance. However recent studies have demonstrated increases in fatigue resistance, joint stability and nutritional flow properties resulting from crosslink augmentation. In this study, multi-directional moduli of bovine lumbar intervertebral discs were measured in vitro, including circumferential tension, radial compression, axial tension, and axial compression in control and crosslinked specimens. METHODS: Four types of annulus fibrosus specimens were dissected from control and crosslinked discs. Cross-sectional areas were measured using a non-contact laser measurement system and then four separate mechanical tests were conducted using a materials testing machine with custom-made loading fixtures. FINDINGS: The circumferential specimens demonstrated the highest moduli in both low stiffness and linear elastic regions. After a crosslink treatment, the modulus increased more in circumferential tension compared to axial tension and more in axial compression compared to radial compression. Other tensile properties had higher increases in circumferential tension compared to axial tension after crosslinking. INTERPRETATION: Assuming form follows function, circumferential tension is the predominant type of stress experienced by non-degenerated annulus fibrosus. The anisotropic mechanical properties of the annulus fibrosus is non-uniformly affected by crosslink augmentation. Dominant effects were in the directions with greater inherent stiffnesses. These results suggest some beneficial effects of crosslink augmentation on the mechanical properties of the annulus fibrosus: increase in ultimate strength, yield strength, toughness, and modulus in the principal stress directions.

Animals↗

A biomechanical comparison of three sternotomy closure techniques.

BACKGROUND: A biomechanical study of three sternotomy closure techniques (figure-of-eight stainless-steel wires, Pectofix Dynamic Sternal Fixation [DSF] stainless-steel plates, and figure-of-eight stainless-steel cables) was conducted to compare strength and stiffness variables in three clinically relevant loading modes (anterior-posterior shear, longitudinal shear, and lateral distraction). METHODS: All tests were conducted on polyurethane foam sternal models that simulate the properties of cancellous bone. Each model was divided longitudinally and reconstructed using one of the sternotomy closure repair techniques. Tests were performed using a materials testing system that applies a continuously increasing amount of force in one direction to the model until it catastrophically breaks. A total of six trials of each fixation type in each of three test groups were prepared and tested, for a total of 54 tests. Strength and stiffness variables as well as a post-yield analysis of failure were evaluated. RESULTS: Sternums repaired using the DSF plate system are a more rigid construct than sternums repaired using the stainless-steel wires or cables in the distraction and transverse shear modes and they are not significantly different from sternums repaired with wires or cables in the longitudinal shear mode. The DSF plate system offers a 25% improvement in resistance to failure (yield) compared to wires when a transverse shear force is applied to the model. The cable system had a higher resistance to failure than the wires in all modes although the differences were not statistically significant. Additionally, the DSF plate system provides substantial reduction of the implant's cutting into the sternal model under loading as evidenced by the post-yield displacement when compared with either cables or wires for the distraction and longitudinal shear modes. For the transverse shear mode, the cables or wires would completely fail at the load for which cutting begins for the DSF. CONCLUSIONS: Both the DSF plate system and the stainless-steel cable system offer important advantages over figure-of-eight wire for sternal closure.

Biomechanical Phenomena↗

Variations in Valsalva leak point pressure with increasing vesical volume.

PURPOSE: Although leak point pressure testing is a valuable tool in the diagnosis of female stress urinary incontinence, little standardization in methodology exists. We examined the effect of vesical volume on leak point pressure to assess the need for determining an optimal volume for leak point pressure testing. MATERIALS AND METHODS: Video urodynamic testing was performed in 52 consecutive women with a mean age of 52 years who presented with stress urinary incontinence. By fluoroscopic criteria stress urinary incontinence was type I in 12 patients, type II in 20 and type III in 20. Leak point pressure determined at 50 cc volume increments was correlated with fluoroscopic criteria. RESULTS: Women with type I stress urinary incontinence had high leak point pressure, which remained high at increasing vesical volumes, and those with type III had low leak point pressure, which remained low at increasing volumes. In patients with type II incontinence initially high leak point pressure decreased significantly at increasing vesical volumes. The most appropriate classification of patients occurred at a volume of 250 to 300 cc. CONCLUSIONS: Leak point pressure is affected by vesical volume. At a volume of 250 to 300 cc leak point pressure correlates best with fluoroscopic findings, and it may be used to guide therapy in women presenting with stress urinary incontinence.

Adult↗

Concentrations and decay rates of ozone in indoor air in dependence on building and surface materials.

The decay of ozone in indoor air was measured in a closed chamber after contact with different building materials and residential surfaces. The tested materials were: vinyl wall paper, woodchip paper, plywood, latex paint, fitted carpet, and plaster. In the summer of 1996, the entry of ozone from ambient air into indoor air during ventilation and the ozone decay in indoor air, after windows had been closed again, were studied. Measurements were done in a residential house on the outskirts of Berlin. The following results were gained: the chamber measurements showed a decay of ozone after contact with most of the materials put inside the chamber. Higher decay rates have been obtained for wall papers, plywood, fitted carpet and plaster. As described in the literature, ozone is able to react with olefines inside the materials and is able to form formaldehyde and other components. This formation of formaldehyde could also be confirmed in our investigations. Thus, in most cases, the formaldehyde concentrations were lower than the German guideline value of 0.1 ppm. The formation of formaldehyde could be prevented when a special wall paper that was coated with activated carbon was used. In the house, a complete ozone diffusion into indoor air took place during ventilation within 30 min. After closing the windows, the ozone concentrations decreased to the basic level before ventilation within 60-90 min.

Air Pollution, Indoor↗

Knot security in simple sliding knots and its relationship to rotator cuff repair: how secure must the knot be?

We sought to determine which simple sliding knot configurations would have adequate strength for rotator cuff repair. Four knot configurations were tied with both No. 1 polydioxanone suture and No. 2 Ethibond suture (Ethicon, Somerville, NJ) using 3 different tying techniques: hand-tie, standard knot pusher, and cannulated double-diameter knot pusher. The knots were then tested to failure on a materials testing system. The weakest standard knot configuration was S=S=S=S. The other 3 knot configurations (S//S//S//S, SxSxSxS, and S//xS//xS//xS) generally failed in the 35 to 50 N range. Ultimate strength in this range can be shown to be adequate to withstand, without suture failure, a maximal contraction of a repaired rotator cuff tear within the rotator crescent, assuming certain conditions are met (suture anchors placed 1 cm apart, 2 sutures per anchor). More complex knots are not necessary for adequate knot security. However, the same configuration with only 1 suture per anchor will not be strong enough because the suture will fail under maximum physiological load. This study shows that we can predict the adequacy of a given knot configuration under maximum physiological loading conditions.

Arthroscopy↗

Strain of the anterior band of the inferior glenohumeral ligament during capsule failure.

Efficacious surgical treatment of glenohumeral instability requires a combination of anterior band origin repair and capsuloligamentous plication. The purpose of this article was to determine anterior band of the inferior glenohumeral ligament stretching at the time of glenohumeral failure. Thirteen fresh-frozen cadaver glenohumeral joints were thawed and dissected of soft tissue except for the capsuloligamentous structures. Testing was performed with a material testing system device, simulating the anterior instability apprehension position of the shoulder with 90 degrees of shoulder abduction and the humerus externally rotated until the bicipital groove was aligned with the supraglenoid tubercle. The length of each anterior band of the inferior glenohumeral ligament was obtained, and a variable reluctance transducer was applied to the anterior band midsubstance. Tensile testing at a strain rate of 100%/sec ensued until complete capsular failure occurred. Mid-substance strain of the anterior band of the inferior glenohumeral ligament at the time of capsular failure averaged 7.23% +/- 2.25% (mean +/- SD) with a range of 3.68% to 10.68%. Load to failure was 712.9 +/- 238.2 N (range 363.6 to 1136.9 N). All of the glenohumeral capsules failed at the glenoid origin, simulating a Bankart lesion, except for one that failed at the humeral insertion. When the intact capsuloligamentous tissue of the glenohumeral joint is tensile-tested in the apprehension position, there is only slight anterior band strain and failure occurring, predominantly at the glenoid insertion site. This has implications for the success of surgical procedures designed for acute repair of Bankart lesions.

Aged↗

Effects of using same- versus alternate-form memory tests during short-interval repeated assessments in multiple sclerosis.

Repeated neuropsychological testing gives rise to practice effects in that patients become familiar with test material as well as test-taking procedures. Using alternate forms prevents the learning of specific test stimuli, potentially mitigating practice effects. However, changing forms could diminish test-retest reliability coefficients. Our objective was to examine test-retest effects in multiple sclerosis (MS) patients randomly assigned to same- (SF) or alternate-form (AF) conditions. Thirty-four MS patients underwent neuropsychological evaluation. The battery included the California Verbal Learning Test II (CVLT-II) and the Brief Visuospatial Memory Test-Revised (BVMT-R), memory tests recommended by a recently convened consensus panel. Patients were randomly assigned to SF or AF groups and then tested at baseline and follow-up examination 1 week later. Analysis of variance tests (ANOVAs) revealed significant group x time interactions, with SF patients showing greater gain than AF patients. SF practice effects were often large, compromising test validity. Reliability coefficients were either equivalent or higher in the AF group, a finding attributed to ceiling effects and reduced variance in the SF group at retest. The generalizability of the findings may be limited to short test-retest intervals and the MS population. Nevertheless, I conclude that the use of CVLT-II and BVMT-R alternate forms likely helps preserve test validity without compromising test-retest reliability.

Adult↗

Analytic study of the Tadoma method: discrimination ability of untrained observers.

This study reports the ability of two observers with normal-hearing and sight to discriminate pairs of speech elements through the Tadoma method of speechreading. The observers were blindfolded and exposed to masking noise to eliminate visual and auditory cues. They placed their right hand over the speaker's face and neck so that the thumb rested lightly on the lips and the fingers fanned out over the cheek and neck. The discrimination tests were conducted using an ABX procedure. Average discrimination scores for the five types of test materials used in the ABX tests were 87% on W-22 words, 83% on Modified Rhyme Test words, 70% on vowels, 77% on CV and VC nonsense syllables, and 71% on consonant clusters. In all of the ABX tests, the inexperienced observers performed at least as well as the experienced Tadoma user studied by Norton, et al (1977). This finding indicates that the basic tactile sensitivity of inexperienced observers is comparable to that of an experienced deaf-blind Tadoma user.

Cues↗

Correlation of bone tunnel diameter with quadrupled hamstring graft fixation strength using a biodegradable interference screw.

PURPOSE: The purpose of this study was to determine whether the ultimate load at failure of a quadrupled hamstring tendon graft (QHT) fixed with a biodegradable interference screw is improved with a more precise match of the bone tunnel diameter to the diameter of the QHT. TYPE OF STUDY: Biomechanical testing. METHODS: In group A, 8 cadaver knees with a mean age of 69.4 years (range, 60 to 76) were used. QHT graft diameters were measured using sleeves in standard 1.0-mm increments, with matching bone tunnels drilled in 1.0-mm increments. In group B, 9 cadaver knees, with a mean age of 66.5 (53 to 81) were used. Grafts were measured using sleeves in 0.5-mm increments and matching bone tunnels in 0.5-mm increments were drilled. In both groups, the QHT grafts were fixed with a biodegradable interference screw (BioScrew, Linvatec, Largo, FL) in both the tibia and the femur. Tendon interference fixation was tested to failure using a material testing device that tensioned the grafts directly in line with the bone tunnels. Bone mineral density was measured using dual photon absorptimetry for the metaphyseal area of the tibias and femora in the area of interference screw fixation. RESULTS: Femoral maximum load at failure significantly improved from 341 N in the 1.0-mm group to 530 N (P <.05) in the 0.5-mm group; the tibial maximum load at failure improved from 221 N to 308 N (P =.35). CONCLUSIONS: Fixation strength results of this study suggest that commercially available instrumentation could be improved with sleeves and reamers available in 0.5-mm increments.

Absorbable Implants↗

[Stability of human bone cortex following various preservation and sterilization methods].

In a biomechanical study we evaluated the stability of human femurs. In order to document the inter- and intraindividual differences in bending stability, and the changes in breaking strength after different storing and sterilizing procedures, we tested 200 bony blocks, which were harvested from the femurs of 5 multiorgan donors. The bending tests were performed with a material testing machine (ZWICK) under standardized conditions. The bone blocks we randomized into five different treatment groups (-25 degrees C deep freezing, steam sterilization, lyophilization, lyophilization + gamma irradiation, lyophilization + gamma-irradiation in argon). The statistical analysis was performed by a multivariant analysis. Our results revealed significant differences concerning breaking strength among different femurs of the 5 multiorgan donors, and a significant difference concerning stability in different areas of the same femur. Further on we found a significant difference with regard to the treatment modalities of the five groups. Compared to the control group (-25 degrees C deep freezing), we documented a decrease of 8.7% after steam sterilization, an increase of 18.9% after lyophilization, a decrease of 1.7% after lyophilization + gamma-irradiation, and an increase of 3.4% after lyophilization + gamma-irradiation in argon.

Adult↗