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At least 127 records · Page 7Linked to original sources

Effects of visual and support surface orientation references upon postural control in vestibular deficient subjects.

Assessment of postural control in vestibular deficient subjects with and without visual and ankle joint sway information permitted: 1) a quantitative assessment of the overall vestibular information used by the individual patient for control of upright posture; 2) an estimate of the extent to which the vestibular deficient subject can appropriately "select" and alternatively use visual and ankle joint somatosensory information for compensatory postural control and 3) quantification of adaptive changes in postural responses to visual and somatosensory inputs. Results from this study support the hypothesis that abnormal vestibular function disrupts the subject's reference to gravity (earth) vertical. This loss of an absolute spatial reference normally provided by vestibular input prevents the resolution of conflicting or inaccurate visual and somatosensory spatial references which may occur during active or passive body movements.

Ear, Inner↗

Short- and long-term joint symbolic dynamics of heart rate and blood pressure in dilated cardiomyopathy.

Autonomic cardiovascular control involves complex interactions of heart rate and blood pressure. In patients with dilated cardiomyopathy (DCM), this control is impaired and parameters for its quantification might be of prognostic importance. In this paper, we introduce methods based on joint symbolic dynamics (JSD) for the enhanced analysis of heart rate and blood pressure interactions. To assess the coarse-grained dynamics beat-to-beat changes of heart rate and blood pressure are encoded in symbol strings. Subsequently, the distribution properties of short symbol sequences (words) as well as the scaling properties of the whole symbol string are assessed. The comparison of joint symbolic heart rate and blood pressure dynamics in DCM (n = 75) with those in healthy controls (n = 75) showed significant changes. Both, the distribution of words and the scaling properties indicate a loss in heart rate dynamics associated with blood pressure regulation in DCM. In conclusion, the analyses of short- and long-term JSDs provide insights into complex physiological heart rate and blood pressure interactions and furthermore reveal patho-physiological cardiovascular control in DCM.

Blood Pressure↗

[Quantitative evaluation of knee joint effusions with high resolution real-time sonography].

In three human cadaver specimens an intraarticular effusion of the knee was simulated by injecting sodium chloride in 10 ml portions. The sonographic appearance and quantification as well as the location of the fluid were evaluated. Effusions of the knee joint are a principal sign for many diseases. Their sonographic evaluation is easy and provides valuable clinical information.

Humans↗

[A holding device for standardized roentgenologic detection of ulnar, palmar and radial capsule ligament lesions of the metacarpophalangeal joint of the thumb. Hyperextensometer for the index finger metacarpophalangeal joint for determining laxity of the ligament].

A device has been designed to hold the limb for standardized radiological demonstration of lesions of the ulnar and radial collateral and palmar ligaments of the metacarpophalangeal joint of the thumb. The device also serves as a hyperextensometer of the metacarpophalangeal joint of the index finger with which to measure joint laxity. The simple mechanism allows routine application. Standardized stressed roentgenograms allow exact quantification of the extent of all lesions and consequently leads to adequate treatment.

Finger Injuries↗

Morphometric analysis of the angioarchitecture of the synovial membrane in rheumatoid arthritis and osteoarthritis.

Using three different immunohistochemical methods we measured the number of vessels, vessel area and diameter and their form factor in the synovial membrane of 102 patients suffering from different joint disease. The variables were evaluated by means of immunomorphometric analysis. We found UEA (Ulex europeus) immunostaining to be the optimal method for quantification of data characterizing the vasculature of the synovial membrane. Irrespective of causes of the given joint disease, we found increases in the number of vessels, vessel perimeter, vessel area and the product of the number of vessels and vessel area over and against the control group (patients without arthritis). Consequences are discussed regarding local bioavailability of medicaments in the synovial membrane.

Arthritis, Rheumatoid↗

The influence of neuropeptides, serotonin, and interleukin 1beta on temporomandibular joint pain and inflammation.

PURPOSE: This article describes the possible role of various peptides in producing pain and inflammation in the temporomandibular joint (TMJ). MATERIAL AND METHODS: Current research findings on the spectrophotometric quantification of TMJ synovial fluid for neuropeptide Y (NPY), serotonin (5HT), and interleukin-1beta (IL-1beta) are presented. FINDINGS: NPY was found in high levels in the synovial fluid of arthritic TMJs with resting pain, and serotonin (5-HT) was found in patients with pain perceived on mandibular movement. These pain-related mediators were also associated with restricted mandibular mobility. Interleukin-1beta (IL-1beta) was found to be strongly associated with hyperalgesia over the TMJ as well as resting pain. Anterior open bite as a clinical sign of joint destruction was found to be associated with high levels of NPY and IL-1beta in the synovial fluid. IL-1beta was also related to the radiographic signs of joint destruction. CONCLUSIONS: Interaction between the peripheral nervous system (sensory and sympathetic nerves) and the immune system is probably of importance for the modulation of pain and inflammation in the TMJ, but this subject has to be investigated further with experimental clinical studies.

Animals↗

Human patellar tendon moment arm length: measurement considerations and clinical implications for joint loading assessment.

Detailed understanding of the knee joint loading requires the calculation of muscle and joint forces in different conditions. In these applications the patellar tendon moment arm length is essential for the accurate estimation of the tibiofemoral joint loading. In this article, different methods that have been used to determine the patellar tendon moment arm length under in vivo and in vitro conditions are reviewed. The limitations and advantages associated with each of the methods are evaluated together with their applications in the different loading conditions that the musculoskeletal system is subjected to. The three main measurement methods that this review considers are the geometric method, the tendon excursion method and the direct load method. A comparison of relevant quantitative results is presented to asses the impact of the errors of each method on the quantification of the patellar tendon moment arm and the implications for joint loading assessment in clinical applications.

Compressive Strength↗

Disruptions in joint control during drawing arm movements in Parkinson's disease.

Impairments in control of multi-joint arm movements in Parkinson's Disease (PD) were investigated. The PD patients and age-matched elderly participants performed cyclical arm movements, tracking templates of a large circle and four differentially oriented ovals on a horizontal table. The wrist was immobilized and the movements were performed with shoulder and elbow rotations. The task was performed with and without vision at a cycling frequency of 1.5 Hz. Traces of the arm endpoint, joint-motion parameters represented by range of motion and relative phase, and joint-control characteristics represented by amplitude and timing of muscle torque were analyzed. The PD patients provided deformations of the template shapes that were not observed in movements of elderly controls. The deformations were consistent for each shape but differed across the shapes, making quantification of impairments in the endpoint movement difficult. In contrast, the characteristics of joint control and motion demonstrated systematic changes across all shapes in movements of PD patients, although some of these changes were observed only without vision. A specification of the PD influence was observed at the level of joint control and it was not distinguishable in joint and endpoint motion, because of the property of multi-joint movements during which control at each joint influences motion at the other joints. The results suggest that inability of PD patients to provide fine muscle torque regulation coordinated across the joints contributes to the altered endpoint trajectories during multi-joint movements. The study emphasizes the importance of the torque analysis when deficits in multi-joint movements are investigated, because specific impairments that can be detected in joint-control characteristics are difficult to trace in characteristics of joint and endpoint kinematics, because of interactions between joint motions.

Aged↗

A sensitive gait parameter for quantification of arthritis in rats.

Quantification of arthritis is helpful for investigating pain mechanisms of arthritis and for developing new drugs. We assessed and identified a feasible parameter for quantification of rat arthritis using a novel gait analyzing system. Knee-joint injection with small doses of lambda-carrageenan decreased swing time ratio (STR, swing time of the non-treated hindlimb/swing time of the lambda-carrageenan-injected hindlimb) in a dose-dependent manner. Intraperitoneal treatment with indomethacin restored the decreased STR dose-dependently. The arthritis could not be accurately quantified by swing time and swelling, common indices of arthritis. These results show that STR is a sensitive, reliable parameter for quantification of arthritis.

Animals↗

Correlation between radiation dose, synovial thickness, and efficacy of radiosynoviorthesis.

OBJECTIVE: To correlate the therapeutic efficacy of radiosynoviorthesis (RSO) to radiation doses achieved. METHODS: In 20 patients with known rheumatoid arthritis, radiosynoviorthesis was performed in 36 joints. Arthritis disease activity was assessed by "blood pool scintigraphy" (n = 29) score after injection of 370 MBq 99mTc-MDP, before and at 1, 2, and 5 months after the RSO in 12 patients. For semiquantitative measurements, a region-of-interest technique was applied. Synovial thickness and response to the RSO were evaluated by joint ultrasonography. Pain levels were evaluated semiquantitatively. Dosimetry (n = 20) was calculated using planar quantification according to the MIRD scheme. RESULTS: The mean radiation absorbed dose of 186Re-sulfate to the whole body was 5.3+/-2.7 cGy, liver 10.0+/-8.1 cGy, spleen 20.3+/-22.9 cGy, kidneys 9.4+/-11.4 cGy, and at the injected joints of the shoulder 120.5+/-32.2 Gy, hand 130.0+/-12.6 Gy, elbow 83.6+/-38.7 Gy, and talar/subtalar joint 84.1+/-30.7 Gy. In 7 cases, where mandatory immobilization of the joint was not possible, the dose to the lymph nodes (n = 25) was 25.9+/-53.8 Gy (maximum 189 Gy) and to single lymph nodes 14.6+/-11.2 Gy (maximum 63 Gy). The reduced doses to the synovia (at 40% leakage) were: 169Er-citrate 73.10+/-25.25 Gy; 90Y-citrate 59.25+/-46.45 Gy; 186Re-sulfate 65.40+/-32.55 Gy. In cases of complete immobilization, the dose to the lymph nodes was negligible: 169Er-citrate (n = 7), whole body dose 0.4 cGy, lymph nodes 2.3 Gy, finger joints 132.3+/-34.3 Gy; 90Y-citrate (n = 6), whole body dose 15.5 cGy, liver dose 26.5 cGy, splenic dose 11.9 cGy, kidney dose 67 cGy, joint knee joint dose 130.1 Gy. Regarding therapeutic effect, mean reduction of the 99mTc-MDP blood pool activity was 41% at first month, 48% at second month, 48% at the fifth month, 48% in larger joints, and 63% in finger joints. Three and 6 months after RSO, sonography showed a mean reduction in synovial swelling: in the knee joint 1.67 and 4.38 mm, respectively; in the larger joints (shoulder, elbow, hand, talar/subtalar) 0.88/1.93 mm; and in finger joints 0.53/1.76 mm. Clinically, best results were observed in the finger joints. CONCLUSION: 1. We observed a significantly higher radiation absorbed dose to the lymph nodes and lower dose to the synovia in the absence of joint immobilization. Immobilization of the joint is essential. 2. At 2 months after treatment, a significant reduction of blood pool activity and synovial swelling was observed, with further improvement in the following months, especially in the finger joints. 3. There is a strong correlation between the reduction of blood pool activity, synovial swelling, and improvement of pain.

Arthritis, Rheumatoid↗

Substance P- and calcitonin gene-related peptide immunoreactivity in primary afferent neurons of the cat's knee joint.

The distribution of substance P and calcitonin gene-related peptide was determined in primary afferent neurons of the medial and posterior articular nerve of the cat's knee joint. Perikarya of articular afferents were visualized by retrograde labelling with the fluorescent dye Fast Blue which was applied at the transected end of the peripheral nerves. Substance P was found in about 17% of labelled medial articular afferents and in about 16% of labelled posterior articular afferents, respectively, whereas calcitonin gene-related peptide was present in about 35 and 32% of the medial and posterior articular nerve cells, respectively. Taking into account that these neuropeptides are known to be co-localized, probably not more than one-third of the joint afferents contain substance P and/or calcitonin gene-related peptide. Quantification of cell diameters revealed that substance P was found only in small- or intermediate-sized perikarya (less than 50 microns) indicating that this peptide is predominantly found in unmyelinated neurons. Calcitonin gene-related peptide was present mainly in small- and intermediate- but also in some large-sized neurons (greater than 50 microns) providing evidence that this peptide is found in unmyelinated and to a lesser extent in myelinated neurons. This is consistent with previous studies that show that substance P and calcitonin gene-related peptide are present primarily in unmyelinated and thinly myelinated primary afferents. When the portion of substance P-positive neurons of the medial articular nerve is compared to the number of articular afferents displaying a nociceptive function as determined in earlier electrophysiological studies, it can be calculated that at most 30% of the nociceptive-specific articular afferents contain this neuropeptide.(ABSTRACT TRUNCATED AT 250 WORDS)

Amidines↗

An experimental study of new diagnostic methods for the examination of osseous lesions in the temporomandibular joint.

Digital subtraction radiography, tomosynthesis, bone uptake of radionuclide, and arthroscopy were evaluated for detection and quantification of bony lesions induced unilaterally in the condyles of six dogs. A stereotaxic head-holder facilitated acquisition of reproducible radiographs suitable for subtraction and for circular tomosynthesis. Bone uptake of technetium-99m methylene diphosphonate was measured with a hand-held collimated miniature detector. Arthroscopy was performed with an arthroscope of 2.4 mm diameter. Bone defect mass determined by subtraction radiography correlated highly (r = 0.92, p less than 0.001) with the calcium content of removed bone measured by atomic spectroscopy. Both subtraction radiography and tomosynthesis indicated reshaping of the condyle into a more anterior position over a 10-week follow-up period. Radionuclide uptake was significantly elevated (p less than 0.04) from 2 to 10 weeks after surgery and correlated (r = 0.73, p less than 0.05) with regained bone mass measured by subtraction radiography. Arthroscopy revealed progressive degeneration of cartilage with denudation in the fossa. Both radiographic techniques demonstrated the lesions and bone remodeling, but only subtraction provided quantitative results. Radionuclide uptake predicted quantitatively future bone mass changes, and arthroscopy revealed cartilage and soft tissue status not otherwise observable.

Animals↗

Quantification of inflammation in the wrist with gadolinium-enhanced MR imaging and PET with 2-[F-18]-fluoro-2-deoxy-D-glucose.

PURPOSE: To quantify the activity of joint inflammation with magnetic resonance (MR) imaging and positron emission tomography (PET). MATERIALS AND METHODS: Gadolinium-enhanced MR imaging and 2-[fluorine-18]fluoro-2-deoxy-D-glucose (FDG) PET of the wrist were performed prospectively in 12 patients receiving antiinflammatory therapy. Patients were studied three times: off medications for 2 weeks, after 2 weeks of treatment with prednisone or nonsteroid antiinflammatory drugs, and after 12 weeks of treatment with methotrexate. Volume of enhancing pannus (VEP) was determined from fat-suppressed MR images (12 patients). FDG uptake was calculated from PET images (11 patients). RESULTS: VEP and FDG uptake were closely correlated (r > .86, P < .0001), as were changes in VEP and standardized uptake volume (r > .91, P < .0002). VEP and FDG uptake were strongly associated with clinical findings in wrists (P < .002) but not with treatment outcomes (P > .05). CONCLUSION: Contrast material-enhanced MR imaging and PET allow quantification of volumetric and metabolic changes in joint inflammation and comparison of efficacies of antiinflammatory drugs.

Acetaminophen↗

Validity of digital subtraction of transcranial plain films in quantification of positional changes of the mandibular condyle.

Condylar positioning problems have been associated with temporomandibular joint signs and symptoms. The position of the mandibular condyle is difficult to predict and quantify with existing routinely used radiographic techniques. An investigation was implemented to test the validity and reliability of digital subtraction to enhance transcranial plain films and to quantify positional changes of the condyle in a laboratory model. The model consisted of a mounted dried human skull and a mandibular condyle attached to a micromanipulator. Controlled changes in condylar position were made, and the condyle and fossa were imaged. The data were analyzed with descriptive statistics, analyses of variance to evaluate the sources of variability, and linear contrasts to evaluate the differences between observed and expected values. The results indicated that digital subtraction detected posterior positional change within 10% of the expected value. However, inferior positional changes were poorly detected and lateral positional changes could not be evaluated by this technique. We conclude that digitally subtracted transcranial radiographs may be useful for detection of posterior condylar movements, assuming that appropriate head-holding devices are used to fix x-ray source and head geometry.

Analysis of Variance↗

Stimulation of articular cartilage repair in established arthritis by local administration of transforming growth factor-beta into murine knee joints.

A severe consequence of rheumatoid arthritis is depletion of proteoglycans (PGs) from articular cartilage leading to functional impairment of this tissue. We investigated whether local administration of anabolic factors (transforming growth factors-beta1 and -beta2 [TGF-beta1 and -beta2, respectively] and bone morphogenetic protein-2 (BMP-2) into joints could stimulate cartilage repair during arthritis. A unilateral arthritis was induced in mice by intra-articular injection of zymosan. Starting on Day 4 after the induction of arthritis, three injections of TGF-beta1 (200 ng) were given (Days 4, 6, and 8). On Day 11, articular cartilage PG synthesis was measured by 35S-sulfate incorporation, and histologic knee joint sections were prepared, which were used to analyze cartilage PG content by quantification of safranin O staining. Additionally, histologic sections were used to analyze inflammation and chondrophyte-formation. Local administration of TGF-beta1 did not modify inflammation but clearly stimulated PG synthesis and restored PG content of depleted cartilage. TGF-beta2 appeared to be as potent as TGF-beta1 in the stimulation of cartilage repair, and both TGF-beta isoforms also stimulated the formation of chondrophytes in this rodent model. In contrast to TGF-beta, three intra-articular injections with 200 ng BMP-2 did not stimulate the repair process. In summary, this study demonstrates for the first time that local administration of TGF-beta into arthritic joints stimulates the replenishment of PGs in depleted cartilage.

Administration, Topical↗

Adaptive filtering, modelling and classification of knee joint vibroarthrographic signals for non-invasive diagnosis of articular cartilage pathology.

Interpretation of vibrations or sound signals emitted from the patellofemoral joint during movement of the knee, also known as vibroarthrography (VAG), could lead to a safe, objective, and non-invasive clinical tool for early detection, localisation, and quantification of articular cartilage disorders. In this study with a reasonably large database of VAG signals of 90 human knee joints (51 normal and 39 abnormal), a new technique for adaptive segmentation based on the recursive least squares lattice (RLSL) algorithm was developed to segment the non-stationary VAG signals into locally-stationary components; the stationary components were then modelled autoregressively, using the Burg-Lattice method. Logistic classification of the primary VAG signals into normal and abnormal signals (with no restriction on the type of cartilage pathology) using only the AR coefficients as discriminant features provided an accuracy of 68.9% with the leave-one-out method. When the abnormal signals were restricted to chondromalacia patella only, the classification accuracy rate increased to 84.5%. The effects of muscle contraction interference (MCI) on VAG signals were analysed using signals from 53 subjects (32 normal and 21 abnormal), and it was found that adaptive filtering of the MCI from the primary VAG signals did not improve the classification accuracy rate. The results indicate that VAG is a potential diagnostic tool for screening for chondromalacia patella.

Adult↗

Joint modelling of bivariate longitudinal data with informative dropout and left-censoring, with application to the evolution of CD4+ cell count and HIV RNA viral load in response to treatment of HIV infection.

Several methodological issues occur in the context of the longitudinal study of HIV markers evolution. Three of them are of particular importance: (i) correlation between CD4+ T lymphocytes (CD4+) and plasma HIV RNA; (ii) left-censoring of HIV RNA due to a lower quantification limit; (iii) and potential informative dropout. We propose a likelihood inference for a parametric joint model including a bivariate linear mixed model for the two markers and a lognormal survival model for the time to drop out. We apply the model to data from patients starting antiretroviral treatment in the CASCADE collaboration where all of the three issues needed to be addressed.

Anti-HIV Agents↗

Cell proliferation assessment in oncology.

A review of the current knowledge on cell cycle control and the techniques used to assess proliferation of normal and neoplastic cells was the focus of a workshop in Regensburg, Germany, held under the joint auspices of the Graduiertenkolleg: Therapieforschung Onkologie and the Committee on AgNOR Quantification. An overview of the recently discovered group of cyclins and their specific kinases, and of other proliferation-associated antigens, such as Ki67, PCNA and topoiseromase II alpha, was given. The topics continued with a reappraisal of modern imaging and flow-cytometric techniques. An update of the relation of AgNORs to cellular proliferation and differentiation was the link to presentations on clinical data, problems and strategies for standardization, as well as guidelines to establish the prognostic value of marker molecules. These lectures were supported by posters. Bringing together researchers from life sciences, technically oriented workers, pathologists, and clinicians resulted in a lively and constructive discussion, which is briefly summarized in the Concluding remarks.

Cell Cycle↗